Application form

Application form for graduates interested in taking part in the 6-month practical training corresponding to the clinical part of post-graduate internship.

Student data(wymagane)

Surname Name

MUL student number(wymagane)

Obtained professional title:(wymagane)

doctor

dentist

Year of obtaining the title above(wymagane)

e-mail address (with @umed domain)(wymagane)

e-mail address (private)(wymagane)

I declare that I fullfill all the criteria necessary to undergo the internship:

I have graduated from the Medical University of Lodz in a language other than Polish and have not as yet completed the post-graduate internship

I will begin the internship no later than within two years from receiving the professional title of a doctor or a dentist

I will provide all necessary documents required in the recruitment process

I will purchase and present valid civil liability (OC) and personal accident insurance (NNW), extended with additional benefits for professional exposure related to potential contact with biological agents, covering the entire internship period

I will perform mandatory tests and provide a medical certificate issued by a doctor authorized to conduct preventive examinations

I will comply with the provisions of the contract, including paying a one-time fee for practical training in the amount and on the terms and conditions specified in the contract

General information on personal data protection at the Medical University of Łódź

Based on Art. 13 item 1 and item 2 of the regulations implemented by the European Parliament and the European Union Council 2016/679 of 27th April, 2016 on the protection of individuals with regard of personal data protection and on the free movement of such data, and repealing Directive 95/46/WE (general data protection regulation), the Medical University of Łódź hereby informs of the following:

The administrator of your personal data is the Medical University of Łódź, located in Aleja T. Kościuszki 4, postal code: 90-419 Łódź, phone number: 422725803, tax identification number (NIP): 725 18 43 739, national business registry number (REGON): 473 073 308.
Any contact with the Data Protection Officer is possible via the following e-mail address: iod@umed.lodz.pl.
Your personal data will be processed in order to:
1. execution of the contract for practical training - based on Art. 6 item 1 letter b. of the general data protection regulation,
2. realization of the practical training session organized by the Medical University of Łódź as a part of post-graduate education – based on Art. 6 item 1 letters c. and e. of the general data protection regulation,
3. perform reporting and archiving purposes – based on Art. 6 item 1 letter c. of the general data protection regulation,
4. provide current information related to the recruitment procedure, the course of practical training and the educational process (e.g. via SMS or e-mail) - pursuant to Art. 6 item 1 letters a and f of the general data protection regulation,
5. establish, pursue and secure any potential claims and defend against such claims - pursuant to Art. 6 item 1 letter f of the General Data Protection Regulation,
6. provide information on the activities of the University, including information on the recruitment for the newly opened post-graduate studies and other organized courses - based on Art. 6 item 1 letter a. of the general data protection regulation;
Your personal data may be revealed only to the persons that are authorized to process personal data on the basis of legal regulations
Your personal data will be stored for the period of time necessary to achieve the purposes of processing, resulting from the applicable legal regulations and the internal regulations of the administrator;
You have the right to access your data in order to verify it, remove it, limit access to processing it, you also have the right to object to processing it or to transfer it;
You have the right to lodge a complaint to the supervising body should you reach the conclusion that the Medical University of Łódź is processing your data in a manner that is not compliant with the general regulations concerning personal data protection
There is no automated decision making or profiling during data processing for the purposes of post-graduate training sessions organized by the Medical University of Łódź;
Providing your personal data is voluntary, however, it shall not be possible to apply for courses organized by the Medical University of Łódź as part of post-graduate education without it.

I hereby declare that I have read and understood the above-mentioned GDPR legal disclaimer.

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Application form

Application form

General information on personal data protection at the Medical University of Łódź

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