Full Registration – The Medical Board of Trinidad and Tobago

Date Completed Internship

Date Obtained Upload Scanned Qualification (JPG/JPEG/PNG/PDF only)

1. Have you ever been suspended, restricted, or revoked of your licensure, registration, permit or any other authority to practice medicine in another jurisdiction?

YES NO

2. Have you ever been denied an application for licensure, registration, permit or any other authority to practice medicine in another jurisdiction?

YES NO

3. Have you ever been found guilty of professional misconduct, conduct unbecoming, incompetence or an incapacity or lack of fitness to practice medicine in another jurisdiction?

YES NO

4. Do you have a health condition that may impact on the safe performance of your duties as a medical practitioner?

YES NO

5. Are you currently or have you been under investigation or other proceeding in relation to your conduct, competence, or capacity or fitness to practice medicine in another jurisdiction?

YES NO

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