Expression of Interest Form

Please complete this form to submit an Expression of Interest for appointment to the Equity and Inclusion Committee for the 2025-2027 term of office. Applications that reflect the diversity of the ACEM membership are encouraged. Where applicable, appointments will be made with consideration given to the objective of ensuring this diversity is reflected in the membership of the entity.

Applications close at 9:00am AEST on Monday 29 September 2025.

1. Applicant Details

Please provide your details below.

2. Available Positions

The following positions are available on the Equity and Inclusion Committee for the 2025-2027 term: 9 'ordinary' FACEM members; 1 ACEM member in the category of Certificant, Diplomate, Advanced Diplomate or Associate; 3 FACEM Training Program trainee members; and 3 Community Members.

Members must have knowledge and interest in matters that are the remit of the Equity and InclusionCommittee, and backgrounds that ensure a range of perspectives are able to be provided. At least 1 ordinary FACEM member must be resident in Aotearoa New Zealand and at least 1 must be or have previously been a Director or Deputy Director of Emergency Medicine.

3. Supporting Statement

Please provide a brief statement addressing the requirements of the role and relevant experience (not exceeding 500 words).

4. Curriculum Vitae

The Curriculum Vitae provided will be made available to members of the ACEM Board and/or their delegate and the Trainee Committee (as applicable) for consideration of appointment. Please ensure any personal details are omitted, as required.

5. ACEM Core Values

The ACEM Core Values of respect, integrity, collaboration, and equity define the organisation’s guiding principles, and underpin the way ACEM works in order to meet its vision and mission of ensuring the highest standards are maintained in the training of emergency physicians, and in the provision of emergency care to the communities of Australia and Aotearoa New Zealand.

All appointees to ACEM roles and entities are required to have completed the ACEM Core Values module by the close of the applicable application process. Individuals seeking to clarify whether they have completed the ACEM Core Values module should contact the ACEM Membership Team via email (membership@acem.org.au) at the earliest opportunity.

** If no, please note that the module must be completed by the close of the Expressions of Interest period in order for your application to be considered. 

6. Conflicts of Interest

ACEM requires all entity members to disclose any conflicts of interest (perceived or actual) in line with the Conflict of Interest Policy (COR139). Please indicate any conflicts of interest to be considered in the context of your application and potential appointment to the Equity and Inclusion Committee. If there are none, please leave this field blank.

7. Declaration

By completing the following declaration, you acknowledge that the information that you have provided in your application is true and accurate to the best of your knowledge. Additionally, you acknowledge that your Curriculum Vitae and Supporting Statement will be made available to members of the ACEM Board and/or their delegate and the Trainee Committee (as applicable) for consideration of appointment.