{"id":2057,"date":"2026-09-15T14:31:14","date_gmt":"2026-09-15T06:31:14","guid":{"rendered":"https:\/\/www.pbo.net.ph\/landing_page\/?page_id=2057"},"modified":"2026-09-17T16:10:29","modified_gmt":"2026-09-17T08:10:29","slug":"norap-application-2026","status":"publish","type":"page","link":"https:\/\/www.pbo.net.ph\/landing_page\/norap-application-2026\/","title":{"rendered":"NORAP Application 2026"},"content":{"rendered":"<script type=\"text\/javascript\">var gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,initializeOnLoaded:function(o){gform.domLoaded&&gform.scriptsLoaded?o():!gform.domLoaded&&gform.scriptsLoaded?window.addEventListener(\"DOMContentLoaded\",o):document.addEventListener(\"gform_main_scripts_loaded\",o)},hooks:{action:{},filter:{}},addAction:function(o,r,n,t){gform.addHook(\"action\",o,r,n,t)},addFilter:function(o,r,n,t){gform.addHook(\"filter\",o,r,n,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,n){gform.removeHook(\"filter\",o,r,n)},addHook:function(o,r,n,t,i){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var e=gform.hooks[o][r];null==i&&(i=r+\"_\"+e.length),gform.hooks[o][r].push({tag:i,callable:n,priority:t=null==t?10:t})},doHook:function(o,r,n){if(n=Array.prototype.slice.call(n,1),null!=gform.hooks[o][r]){var t,i=gform.hooks[o][r];i.sort(function(o,r){return o.priority-r.priority});for(var e=0;e<i.length;e++)\"function\"!=typeof(t=i[e].callable)&&(t=window[t]),\"action\"==o?t.apply(null,n):n[0]=t.apply(null,n)}if(\"filter\"==o)return n[0]},removeHook:function(o,r,n,t){if(null!=gform.hooks[o][r])for(var i=gform.hooks[o][r],e=i.length-1;0<=e;e--)null!=t&&t!=i[e].tag||null!=n&&n!=i[e].priority||i.splice(e,1)}});<\/script>\n                <div class='gf_browser_gecko gform_wrapper gravity-theme' id='gform_wrapper_50' style='display:none'><div id='gf_50' class='gform_anchor' tabindex='-1'><\/div><form method='post' enctype='multipart\/form-data'  id='gform_50'  action='\/landing_page\/wp-json\/wp\/v2\/pages\/2057#gf_50' novalidate>\n        <div id='gf_progressbar_wrapper_50' class='gf_progressbar_wrapper'>\n        \t<p class=\"gf_progressbar_title\">Step <span class='gf_step_current_page'>1<\/span> of <span class='gf_step_page_count'>5<\/span>\n        \t<\/p>\n            <div class='gf_progressbar gf_progressbar_blue' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_blue percentbar_20' style='width:20%;'><span>20%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform_body gform-body'><div id='gform_page_50_1' class='gform_page' >\n                                    <div class='gform_page_fields'><div id='gform_fields_50' class='gform_fields top_label form_sublabel_below description_below'><fieldset id=\"field_50_33\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >The PBO is committed to protecting your privacy and ensuring that your personal information is handled in compliance with applicable data protection laws. \u00a0The information you provide will be used solely for the purposes related to your application, examination process, and communications with you regarding the ITE. Your data will not be shared with any third parties without your consent, except as required by law or for the necessary conduct of the examination. By clicking &quot;I agree&quot; below, you acknowledge that you have read, understood, and consent to the collection and use of your data as outlined above.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_33.1' id='input_50_33_1' type='checkbox' value='1'   aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gfield_consent_label\" for='input_50_33_1' >I agree to the privacy policy.<\/label><input type='hidden' name='input_33.2' value='I agree to the privacy policy.' class='gform_hidden' \/><input type='hidden' name='input_33.3' value='11' class='gform_hidden' \/><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_50_18' class='gform_next_button button' value='Next'  onclick='jQuery(\"#gform_target_page_number_50\").val(\"2\");  jQuery(\"#gform_50\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_50\").val(\"2\");  jQuery(\"#gform_50\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_50_2' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_50_2' class='gform_fields top_label form_sublabel_below description_below'><div id=\"field_50_2\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_50_2' >Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_2' id='input_50_2' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><fieldset id=\"field_50_1\" class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container no_prefix has_first_name has_middle_name has_last_name no_suffix gf_name_has_3 ginput_container_name' id='input_50_1'>\n                            \n                            <span id='input_50_1_3_container' class='name_first' >\n                                                    <input type='text' name='input_1.3' id='input_50_1_3' value='' aria-label='First name'   aria-required='true'     \/>\n                                                    <label for='input_50_1_3' >First<\/label>\n                                                <\/span>\n                            <span id='input_50_1_4_container' class='name_middle' >\n                                                    <input type='text' name='input_1.4' id='input_50_1_4' value='' aria-label='Middle name'   aria-required='false'     \/>\n                                                    <label for='input_50_1_4' >Middle<\/label>\n                                                <\/span>\n                            <span id='input_50_1_6_container' class='name_last' >\n                                                    <input type='text' name='input_1.6' id='input_50_1_6' value='' aria-label='Last name'   aria-required='true'     \/>\n                                                    <label for='input_50_1_6' >Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_50_3\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_50_3' >Mobile Number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_3' id='input_50_3' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_50_6\" class=\"gfield gfield--width-full field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label gfield_label_before_complex'  >Mailing Address<\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_city has_state has_zip ginput_container_address' id='input_50_6' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1' id='input_50_6_1_container' >\n                                        <input type='text' name='input_6.1' id='input_50_6_1' value=''    aria-required='false'    \/>\n                                        <label for='input_50_6_1' id='input_50_6_1_label' >Street Address<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city' id='input_50_6_3_container' >\n                                    <input type='text' name='input_6.3' id='input_50_6_3' value=''    aria-required='false'    \/>\n                                    <label for='input_50_6_3' id='input_50_6_3_label' >City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state' id='input_50_6_4_container' >\n                                        <input type='text' name='input_6.4' id='input_50_6_4' value=''      aria-required='false'    \/>\n                                        <label for='input_50_6_4' id='input_50_6_4_label' >Province \/ Region<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip' id='input_50_6_5_container' >\n                                    <input type='text' name='input_6.5' id='input_50_6_5' value=''    aria-required='false'    \/>\n                                    <label for='input_50_6_5' id='input_50_6_5_label' >ZIP \/ Postal Code<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_6.6' id='input_50_6_6' value='' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_50_7\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_50_7' >Medical Education (School Graduated from)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_7' id='input_50_7' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_50_8\" class=\"gfield gfield--width-third gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_50_8' >Year of Graduation<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_8' id='input_50_8' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_50_9\" class=\"gfield gfield--width-third gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_50_9' >Class Rank<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_9' id='input_50_9' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_50_10\" class=\"gfield gfield--width-third gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label'  >Issue Date of Medical Degree<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div id='input_50_10' class='ginput_container ginput_complex'><div class='gfield_date_dropdown_month ginput_container ginput_container_date' id='input_50_10_1_container'><select name='input_10[]' id='input_50_10_1'   aria-required='true'   aria-label='Month'><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_day ginput_container ginput_container_date' id='input_50_10_2_container'><select name='input_10[]' id='input_50_10_2'   aria-required='true'   aria-label='Day'><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date' id='input_50_10_3_container'><select name='input_10[]' id='input_50_10_3'   aria-required='true'   aria-label='Year'><option value=''>Year<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/fieldset><div id=\"field_50_11\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_50_11' >Post Graduate Internship Training Hospital<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_11' id='input_50_11' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_50_13\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label'  >Awards and Citations During Post Graduate Internship Training<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_list ginput_list'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group'><div class='gfield_list_group_item gfield_list_cell gfield_list_13_cell1' ><input aria-invalid='false' aria-required=\"true\"  aria-label='Awards and Citations During Post Graduate Internship Training, Row 1' data-aria-label-template='Awards and Citations During Post Graduate Internship Training, Row {0}' type='text' name='input_13[]' value=''   \/><\/div><div class='gfield_list_icons'>   <button type=\"button\"  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)'>Add<\/button>   <button type=\"button\"  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><fieldset id=\"field_50_14\" class=\"gfield gfield--width-full field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label'  >Physician Board Licensure Examination Date Taken If none, leave blank.<\/legend><div id='input_50_14' class='ginput_container ginput_complex'><div class='gfield_date_dropdown_month ginput_container ginput_container_date' id='input_50_14_1_container'><select name='input_14[]' id='input_50_14_1'   aria-required='false'   aria-label='Month'><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_day ginput_container ginput_container_date' id='input_50_14_2_container'><select name='input_14[]' id='input_50_14_2'   aria-required='false'   aria-label='Day'><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date' id='input_50_14_3_container'><select name='input_14[]' id='input_50_14_3'   aria-required='false'   aria-label='Year'><option value=''>Year<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/fieldset><div id=\"field_50_16\" class=\"gfield gfield--width-full field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_50_16' >Physician Board Licensure Examination Rate If none, leave blank.<\/label><div class='ginput_container ginput_container_text'><input name='input_16' id='input_50_16' type='text' value='' class='large'      aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_50_17\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label'  >What is your status of application for Orthopedic Residency? (Choose one)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_50_17'>\n\t\t\t<div class='gchoice gchoice_50_17_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='Undergoing\/Ongoing Pre-residency already'  id='choice_50_17_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_50_17_0' id='label_50_17_0'>Undergoing\/Ongoing Pre-residency already<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_50_17_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='Applying\/Choosing a Training program'  id='choice_50_17_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_50_17_1' id='label_50_17_1'>Applying\/Choosing a Training program<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_50_32' class='gform_previous_button button' value='Previous'  onclick='jQuery(\"#gform_target_page_number_50\").val(\"1\");  jQuery(\"#gform_50\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_50\").val(\"1\");  jQuery(\"#gform_50\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_50_32' class='gform_next_button button' value='Next'  onclick='jQuery(\"#gform_target_page_number_50\").val(\"3\");  jQuery(\"#gform_50\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_50\").val(\"3\");  jQuery(\"#gform_50\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_50_3' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_50_3' class='gform_fields top_label form_sublabel_below description_below'><div id=\"field_50_21\" class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_visible\" ><h3 class=\"gsection_title\">Your Answer: Undergoing\/Ongoing Pre-residency already<\/h3><\/div><div id=\"field_50_19\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_50_19' >Institution where you are undergoing Pre residency? (Please choose one.)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_19' id='input_50_19' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='BAGUIO GENERAL HOSPITAL AND MEDICAL CENTER' >BAGUIO GENERAL HOSPITAL AND MEDICAL CENTER<\/option><option value='BATANGAS MEDICAL CENTER (PROVISIONAL)' >BATANGAS MEDICAL CENTER (PROVISIONAL)<\/option><option value='BICOL MEDICAL CENTER (PROVISIONAL)' >BICOL MEDICAL CENTER (PROVISIONAL)<\/option><option value='CHONG HUA HOSPITAL' >CHONG HUA HOSPITAL<\/option><option value='CORAZON LOCSIN MONTELIBANO MEMORIAL REGIONAL HOSPITAL' >CORAZON LOCSIN MONTELIBANO MEMORIAL REGIONAL HOSPITAL<\/option><option value='CAGAYAN VALLEY MEDICAL CENTER' >CAGAYAN VALLEY MEDICAL CENTER<\/option><option value='DE LA SALLE UNIVERSITY MEDICAL CENTER' >DE LA SALLE UNIVERSITY MEDICAL CENTER<\/option><option value='DR. JOSE N. RODRIGUEZ MEMORIAL HOSPITAL &amp; SANITARIUM (PROVISIONAL)' >DR. JOSE N. RODRIGUEZ MEMORIAL HOSPITAL &amp; SANITARIUM (PROVISIONAL)<\/option><option value='DAVAO REGIONAL MEDICAL CENTER (PROVISIONAL)' >DAVAO REGIONAL MEDICAL CENTER (PROVISIONAL)<\/option><option value='EAST AVENUE MEDICAL CENTER' >EAST AVENUE MEDICAL CENTER<\/option><option value='EASTERN VISAYAS MEDICAL CENTER (PROVISIONAL)' >EASTERN VISAYAS MEDICAL CENTER (PROVISIONAL)<\/option><option value='GOV. CELESTINO  GALLARES MEMORIAL MEDICAL CENTER' >GOV. CELESTINO  GALLARES MEMORIAL MEDICAL CENTER<\/option><option value='ILOCOS TRAINING &amp; REGIONAL MEDICAL CENTER' >ILOCOS TRAINING &amp; REGIONAL MEDICAL CENTER<\/option><option value='JOSE B. LINGAD MEMORIAL GENERAL HOSPITAL' >JOSE B. LINGAD MEMORIAL GENERAL HOSPITAL<\/option><option value='JOSE R. REYES MEMORIAL MEDICAL CENTER' >JOSE R. REYES MEMORIAL MEDICAL CENTER<\/option><option value='MAKATI MEDICAL CENTER' >MAKATI MEDICAL CENTER<\/option><option value='MARIANO MARCOS MEMORIAL HOSPITAL AND MEDICAL CENTER (PROVISIONAL)' >MARIANO MARCOS MEMORIAL HOSPITAL AND MEDICAL CENTER (PROVISIONAL)<\/option><option value='NORTHERN MINDANAO MEDICAL CENTER' >NORTHERN MINDANAO MEDICAL CENTER<\/option><option value='QUIRINO MEMORIAL MEDICAL CENTER (PROVISIONAL)' >QUIRINO MEMORIAL MEDICAL CENTER (PROVISIONAL)<\/option><option value='PHILIPPINE ORTHOPEDIC CENTER' >PHILIPPINE ORTHOPEDIC CENTER<\/option><option value='REGION 1 MEDICAL CENTER (PROVISIONAL)' >REGION 1 MEDICAL CENTER (PROVISIONAL)<\/option><option value='SOUTHERN PHILIPPINES MEDICAL CENTER' >SOUTHERN PHILIPPINES MEDICAL CENTER<\/option><option value='ST. LUKE&#039;S MEDICAL CENTER - Institute of Orthopedics and Sports Medicine' >ST. LUKE&#039;S MEDICAL CENTER - Institute of Orthopedics and Sports Medicine<\/option><option value='THE MEDICAL CITY' >THE MEDICAL CITY<\/option><option value='UNIVERSITY OF CEBU MEDICAL CENTER  (PROVISIONAL)' >UNIVERSITY OF CEBU MEDICAL CENTER  (PROVISIONAL)<\/option><option value='UP-PHILIPPINE GENERAL HOSPITAL' >UP-PHILIPPINE GENERAL HOSPITAL<\/option><option value='UNIVERSITY OF SANTO TOMAS HOSPITAL' >UNIVERSITY OF SANTO TOMAS HOSPITAL<\/option><option value='VETERANS MEMORIAL MEDICAL CENTER - Dept of Orthopaedic Surgery' >VETERANS MEMORIAL MEDICAL CENTER - Dept of Orthopaedic Surgery<\/option><option value='V Luna Medical Center, AFP Health Service Command' >V Luna Medical Center, AFP Health Service Command<\/option><option value='VICENTE SOTTO MEMORIAL MEDICAL CENTER - Orthopedic and Traumatology' >VICENTE SOTTO MEMORIAL MEDICAL CENTER - Orthopedic and Traumatology<\/option><option value='&lt;span class=&quot;vRMGwf oJeWuf&quot;&gt;WESTERN VISAYAS MEDICAL CENTER&lt;\/span&gt;' >&lt;span jsslot=&quot;&quot; class=&quot;vRMGwf oJeWuf&quot;&gt;WESTERN VISAYAS MEDICAL CENTER&lt;\/span&gt;<\/option><option value='WEST VISAYAS STATE UNIVERSITY MEDICAL CENTER (PROVISIONAL)' >WEST VISAYAS STATE UNIVERSITY MEDICAL CENTER (PROVISIONAL)<\/option><\/select><\/div><\/div><div id=\"field_50_20\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_50_20' >Second option for Orthopedic Residency Training?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_20' id='input_50_20' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='BAGUIO GENERAL HOSPITAL AND MEDICAL CENTER' >BAGUIO GENERAL HOSPITAL AND MEDICAL CENTER<\/option><option value='BATANGAS MEDICAL CENTER (PROVISIONAL)' >BATANGAS MEDICAL CENTER (PROVISIONAL)<\/option><option value='BICOL MEDICAL CENTER (PROVISIONAL)' >BICOL MEDICAL CENTER (PROVISIONAL)<\/option><option value='CHONG HUA HOSPITAL' >CHONG HUA HOSPITAL<\/option><option value='CORAZON LOCSIN MONTELIBANO MEMORIAL REGIONAL HOSPITAL' >CORAZON LOCSIN MONTELIBANO MEMORIAL REGIONAL HOSPITAL<\/option><option value='CAGAYAN VALLEY MEDICAL CENTER' >CAGAYAN VALLEY MEDICAL CENTER<\/option><option value='DE LA SALLE UNIVERSITY MEDICAL CENTER' >DE LA SALLE UNIVERSITY MEDICAL CENTER<\/option><option value='DR. JOSE N. RODRIGUEZ MEMORIAL HOSPITAL &amp; SANITARIUM (PROVISIONAL)' >DR. JOSE N. RODRIGUEZ MEMORIAL HOSPITAL &amp; SANITARIUM (PROVISIONAL)<\/option><option value='DAVAO REGIONAL MEDICAL CENTER (PROVISIONAL)' >DAVAO REGIONAL MEDICAL CENTER (PROVISIONAL)<\/option><option value='EAST AVENUE MEDICAL CENTER' >EAST AVENUE MEDICAL CENTER<\/option><option value='EASTERN VISAYAS MEDICAL CENTER (PROVISIONAL)' >EASTERN VISAYAS MEDICAL CENTER (PROVISIONAL)<\/option><option value='GOV. CELESTINO  GALLARES MEMORIAL MEDICAL CENTER' >GOV. CELESTINO  GALLARES MEMORIAL MEDICAL CENTER<\/option><option value='ILOCOS TRAINING &amp; REGIONAL MEDICAL CENTER' >ILOCOS TRAINING &amp; REGIONAL MEDICAL CENTER<\/option><option value='JOSE B. LINGAD MEMORIAL GENERAL HOSPITAL' >JOSE B. LINGAD MEMORIAL GENERAL HOSPITAL<\/option><option value='JOSE R. REYES MEMORIAL MEDICAL CENTER' >JOSE R. REYES MEMORIAL MEDICAL CENTER<\/option><option value='MAKATI MEDICAL CENTER' >MAKATI MEDICAL CENTER<\/option><option value='MARIANO MARCOS MEMORIAL HOSPITAL AND MEDICAL CENTER (PROVISIONAL)' >MARIANO MARCOS MEMORIAL HOSPITAL AND MEDICAL CENTER (PROVISIONAL)<\/option><option value='NORTHERN MINDANAO MEDICAL CENTER' >NORTHERN MINDANAO MEDICAL CENTER<\/option><option value='QUIRINO MEMORIAL MEDICAL CENTER (PROVISIONAL)' >QUIRINO MEMORIAL MEDICAL CENTER (PROVISIONAL)<\/option><option value='PHILIPPINE ORTHOPEDIC CENTER' >PHILIPPINE ORTHOPEDIC CENTER<\/option><option value='REGION 1 MEDICAL CENTER (PROVISIONAL)' >REGION 1 MEDICAL CENTER (PROVISIONAL)<\/option><option value='SOUTHERN PHILIPPINES MEDICAL CENTER' >SOUTHERN PHILIPPINES MEDICAL CENTER<\/option><option value='ST. LUKE&#039;S MEDICAL CENTER - Institute of Orthopedics and Sports Medicine' >ST. LUKE&#039;S MEDICAL CENTER - Institute of Orthopedics and Sports Medicine<\/option><option value='THE MEDICAL CITY' >THE MEDICAL CITY<\/option><option value='UNIVERSITY OF CEBU MEDICAL CENTER  (PROVISIONAL)' >UNIVERSITY OF CEBU MEDICAL CENTER  (PROVISIONAL)<\/option><option value='UP-PHILIPPINE GENERAL HOSPITAL' >UP-PHILIPPINE GENERAL HOSPITAL<\/option><option value='UNIVERSITY OF SANTO TOMAS HOSPITAL' >UNIVERSITY OF SANTO TOMAS HOSPITAL<\/option><option value='VETERANS MEMORIAL MEDICAL CENTER - Dept of Orthopaedic Surgery' >VETERANS MEMORIAL MEDICAL CENTER - Dept of Orthopaedic Surgery<\/option><option value='V Luna Medical Center, AFP Health Service Command' >V Luna Medical Center, AFP Health Service Command<\/option><option value='VICENTE SOTTO MEMORIAL MEDICAL CENTER - Orthopedic and Traumatology' >VICENTE SOTTO MEMORIAL MEDICAL CENTER - Orthopedic and Traumatology<\/option><option value='&lt;span class=&quot;vRMGwf oJeWuf&quot;&gt;WESTERN VISAYAS MEDICAL CENTER&lt;\/span&gt;' >&lt;span jsslot=&quot;&quot; class=&quot;vRMGwf oJeWuf&quot;&gt;WESTERN VISAYAS MEDICAL CENTER&lt;\/span&gt;<\/option><option value='WEST VISAYAS STATE UNIVERSITY MEDICAL CENTER (PROVISIONAL)' >WEST VISAYAS STATE UNIVERSITY MEDICAL CENTER (PROVISIONAL)<\/option><\/select><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_50_22' class='gform_previous_button button' value='Previous'  onclick='jQuery(\"#gform_target_page_number_50\").val(\"2\");  jQuery(\"#gform_50\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_50\").val(\"2\");  jQuery(\"#gform_50\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_50_22' class='gform_next_button button' value='Next'  onclick='jQuery(\"#gform_target_page_number_50\").val(\"4\");  jQuery(\"#gform_50\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_50\").val(\"4\");  jQuery(\"#gform_50\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_50_4' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_50_4' class='gform_fields top_label form_sublabel_below description_below'><div id=\"field_50_26\" class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_visible\" ><h3 class=\"gsection_title\">Your Answer: Applying\/Choosing a Training program<\/h3><\/div><div id=\"field_50_23\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_50_23' >What is your preferred Training Program?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_23' id='input_50_23' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='BAGUIO GENERAL HOSPITAL AND MEDICAL CENTER' >BAGUIO GENERAL HOSPITAL AND MEDICAL CENTER<\/option><option value='BATANGAS MEDICAL CENTER (PROVISIONAL)' >BATANGAS MEDICAL CENTER (PROVISIONAL)<\/option><option value='BICOL MEDICAL CENTER (PROVISIONAL)' >BICOL MEDICAL CENTER (PROVISIONAL)<\/option><option value='CHONG HUA HOSPITAL' >CHONG HUA HOSPITAL<\/option><option value='CORAZON LOCSIN MONTELIBANO MEMORIAL REGIONAL HOSPITAL' >CORAZON LOCSIN MONTELIBANO MEMORIAL REGIONAL HOSPITAL<\/option><option value='CAGAYAN VALLEY MEDICAL CENTER' >CAGAYAN VALLEY MEDICAL CENTER<\/option><option value='DE LA SALLE UNIVERSITY MEDICAL CENTER' >DE LA SALLE UNIVERSITY MEDICAL CENTER<\/option><option value='DR. JOSE N. RODRIGUEZ MEMORIAL HOSPITAL &amp; SANITARIUM (PROVISIONAL)' >DR. JOSE N. RODRIGUEZ MEMORIAL HOSPITAL &amp; SANITARIUM (PROVISIONAL)<\/option><option value='DAVAO REGIONAL MEDICAL CENTER (PROVISIONAL)' >DAVAO REGIONAL MEDICAL CENTER (PROVISIONAL)<\/option><option value='EAST AVENUE MEDICAL CENTER' >EAST AVENUE MEDICAL CENTER<\/option><option value='EASTERN VISAYAS MEDICAL CENTER (PROVISIONAL)' >EASTERN VISAYAS MEDICAL CENTER (PROVISIONAL)<\/option><option value='GOV. CELESTINO  GALLARES MEMORIAL MEDICAL CENTER' >GOV. CELESTINO  GALLARES MEMORIAL MEDICAL CENTER<\/option><option value='ILOCOS TRAINING &amp; REGIONAL MEDICAL CENTER' >ILOCOS TRAINING &amp; REGIONAL MEDICAL CENTER<\/option><option value='JOSE B. LINGAD MEMORIAL GENERAL HOSPITAL' >JOSE B. LINGAD MEMORIAL GENERAL HOSPITAL<\/option><option value='JOSE R. REYES MEMORIAL MEDICAL CENTER' >JOSE R. REYES MEMORIAL MEDICAL CENTER<\/option><option value='MAKATI MEDICAL CENTER' >MAKATI MEDICAL CENTER<\/option><option value='MARIANO MARCOS MEMORIAL HOSPITAL AND MEDICAL CENTER (PROVISIONAL)' >MARIANO MARCOS MEMORIAL HOSPITAL AND MEDICAL CENTER (PROVISIONAL)<\/option><option value='NORTHERN MINDANAO MEDICAL CENTER' >NORTHERN MINDANAO MEDICAL CENTER<\/option><option value='QUIRINO MEMORIAL MEDICAL CENTER (PROVISIONAL)' >QUIRINO MEMORIAL MEDICAL CENTER (PROVISIONAL)<\/option><option value='PHILIPPINE ORTHOPEDIC CENTER' >PHILIPPINE ORTHOPEDIC CENTER<\/option><option value='REGION 1 MEDICAL CENTER (PROVISIONAL)' >REGION 1 MEDICAL CENTER (PROVISIONAL)<\/option><option value='SOUTHERN PHILIPPINES MEDICAL CENTER' >SOUTHERN PHILIPPINES MEDICAL CENTER<\/option><option value='ST. LUKE&#039;S MEDICAL CENTER - Institute of Orthopedics and Sports Medicine' >ST. LUKE&#039;S MEDICAL CENTER - Institute of Orthopedics and Sports Medicine<\/option><option value='THE MEDICAL CITY' >THE MEDICAL CITY<\/option><option value='UNIVERSITY OF CEBU MEDICAL CENTER  (PROVISIONAL)' >UNIVERSITY OF CEBU MEDICAL CENTER  (PROVISIONAL)<\/option><option value='UP-PHILIPPINE GENERAL HOSPITAL' >UP-PHILIPPINE GENERAL HOSPITAL<\/option><option value='UNIVERSITY OF SANTO TOMAS HOSPITAL' >UNIVERSITY OF SANTO TOMAS HOSPITAL<\/option><option value='VETERANS MEMORIAL MEDICAL CENTER - Dept of Orthopaedic Surgery' >VETERANS MEMORIAL MEDICAL CENTER - Dept of Orthopaedic Surgery<\/option><option value='V Luna Medical Center, AFP Health Service Command' >V Luna Medical Center, AFP Health Service Command<\/option><option value='VICENTE SOTTO MEMORIAL MEDICAL CENTER - Orthopedic and Traumatology' >VICENTE SOTTO MEMORIAL MEDICAL CENTER - Orthopedic and Traumatology<\/option><option value='&lt;span class=&quot;vRMGwf oJeWuf&quot;&gt;WESTERN VISAYAS MEDICAL CENTER&lt;\/span&gt;' >&lt;span jsslot=&quot;&quot; class=&quot;vRMGwf oJeWuf&quot;&gt;WESTERN VISAYAS MEDICAL CENTER&lt;\/span&gt;<\/option><option value='WEST VISAYAS STATE UNIVERSITY MEDICAL CENTER (PROVISIONAL)' >WEST VISAYAS STATE UNIVERSITY MEDICAL CENTER (PROVISIONAL)<\/option><\/select><\/div><\/div><div id=\"field_50_24\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_50_24' >What is your second preferred Training Program?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_24' id='input_50_24' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='BAGUIO GENERAL HOSPITAL AND MEDICAL CENTER' >BAGUIO GENERAL HOSPITAL AND MEDICAL CENTER<\/option><option value='BATANGAS MEDICAL CENTER (PROVISIONAL)' >BATANGAS MEDICAL CENTER (PROVISIONAL)<\/option><option value='BICOL MEDICAL CENTER (PROVISIONAL)' >BICOL MEDICAL CENTER (PROVISIONAL)<\/option><option value='CHONG HUA HOSPITAL' >CHONG HUA HOSPITAL<\/option><option value='CORAZON LOCSIN MONTELIBANO MEMORIAL REGIONAL HOSPITAL' >CORAZON LOCSIN MONTELIBANO MEMORIAL REGIONAL HOSPITAL<\/option><option value='CAGAYAN VALLEY MEDICAL CENTER' >CAGAYAN VALLEY MEDICAL CENTER<\/option><option value='DE LA SALLE UNIVERSITY MEDICAL CENTER' >DE LA SALLE UNIVERSITY MEDICAL CENTER<\/option><option value='DR. JOSE N. RODRIGUEZ MEMORIAL HOSPITAL &amp; SANITARIUM (PROVISIONAL)' >DR. JOSE N. RODRIGUEZ MEMORIAL HOSPITAL &amp; SANITARIUM (PROVISIONAL)<\/option><option value='DAVAO REGIONAL MEDICAL CENTER (PROVISIONAL)' >DAVAO REGIONAL MEDICAL CENTER (PROVISIONAL)<\/option><option value='EAST AVENUE MEDICAL CENTER' >EAST AVENUE MEDICAL CENTER<\/option><option value='EASTERN VISAYAS MEDICAL CENTER (PROVISIONAL)' >EASTERN VISAYAS MEDICAL CENTER (PROVISIONAL)<\/option><option value='GOV. CELESTINO  GALLARES MEMORIAL MEDICAL CENTER' >GOV. CELESTINO  GALLARES MEMORIAL MEDICAL CENTER<\/option><option value='ILOCOS TRAINING &amp; REGIONAL MEDICAL CENTER' >ILOCOS TRAINING &amp; REGIONAL MEDICAL CENTER<\/option><option value='JOSE B. LINGAD MEMORIAL GENERAL HOSPITAL' >JOSE B. LINGAD MEMORIAL GENERAL HOSPITAL<\/option><option value='JOSE R. REYES MEMORIAL MEDICAL CENTER' >JOSE R. REYES MEMORIAL MEDICAL CENTER<\/option><option value='MAKATI MEDICAL CENTER' >MAKATI MEDICAL CENTER<\/option><option value='MARIANO MARCOS MEMORIAL HOSPITAL AND MEDICAL CENTER (PROVISIONAL)' >MARIANO MARCOS MEMORIAL HOSPITAL AND MEDICAL CENTER (PROVISIONAL)<\/option><option value='NORTHERN MINDANAO MEDICAL CENTER' >NORTHERN MINDANAO MEDICAL CENTER<\/option><option value='QUIRINO MEMORIAL MEDICAL CENTER (PROVISIONAL)' >QUIRINO MEMORIAL MEDICAL CENTER (PROVISIONAL)<\/option><option value='PHILIPPINE ORTHOPEDIC CENTER' >PHILIPPINE ORTHOPEDIC CENTER<\/option><option value='REGION 1 MEDICAL CENTER (PROVISIONAL)' >REGION 1 MEDICAL CENTER (PROVISIONAL)<\/option><option value='SOUTHERN PHILIPPINES MEDICAL CENTER' >SOUTHERN PHILIPPINES MEDICAL CENTER<\/option><option value='ST. LUKE&#039;S MEDICAL CENTER - Institute of Orthopedics and Sports Medicine' >ST. LUKE&#039;S MEDICAL CENTER - Institute of Orthopedics and Sports Medicine<\/option><option value='THE MEDICAL CITY' >THE MEDICAL CITY<\/option><option value='UNIVERSITY OF CEBU MEDICAL CENTER  (PROVISIONAL)' >UNIVERSITY OF CEBU MEDICAL CENTER  (PROVISIONAL)<\/option><option value='UP-PHILIPPINE GENERAL HOSPITAL' >UP-PHILIPPINE GENERAL HOSPITAL<\/option><option value='UNIVERSITY OF SANTO TOMAS HOSPITAL' >UNIVERSITY OF SANTO TOMAS HOSPITAL<\/option><option value='VETERANS MEMORIAL MEDICAL CENTER - Dept of Orthopaedic Surgery' >VETERANS MEMORIAL MEDICAL CENTER - Dept of Orthopaedic Surgery<\/option><option value='V Luna Medical Center, AFP Health Service Command' >V Luna Medical Center, AFP Health Service Command<\/option><option value='VICENTE SOTTO MEMORIAL MEDICAL CENTER - Orthopedic and Traumatology' >VICENTE SOTTO MEMORIAL MEDICAL CENTER - Orthopedic and Traumatology<\/option><option value='&lt;span class=&quot;vRMGwf oJeWuf&quot;&gt;WESTERN VISAYAS MEDICAL CENTER&lt;\/span&gt;' >&lt;span jsslot=&quot;&quot; class=&quot;vRMGwf oJeWuf&quot;&gt;WESTERN VISAYAS MEDICAL CENTER&lt;\/span&gt;<\/option><option value='WEST VISAYAS STATE UNIVERSITY MEDICAL CENTER (PROVISIONAL)' >WEST VISAYAS STATE UNIVERSITY MEDICAL CENTER (PROVISIONAL)<\/option><\/select><\/div><\/div><div id=\"field_50_25\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_50_25' >What is your third preferred Training Program?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_25' id='input_50_25' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='BAGUIO GENERAL HOSPITAL AND MEDICAL CENTER' >BAGUIO GENERAL HOSPITAL AND MEDICAL CENTER<\/option><option value='BATANGAS MEDICAL CENTER (PROVISIONAL)' >BATANGAS MEDICAL CENTER (PROVISIONAL)<\/option><option value='BICOL MEDICAL CENTER (PROVISIONAL)' >BICOL MEDICAL CENTER (PROVISIONAL)<\/option><option value='CHONG HUA HOSPITAL' >CHONG HUA HOSPITAL<\/option><option value='CORAZON LOCSIN MONTELIBANO MEMORIAL REGIONAL HOSPITAL' >CORAZON LOCSIN MONTELIBANO MEMORIAL REGIONAL HOSPITAL<\/option><option value='CAGAYAN VALLEY MEDICAL CENTER' >CAGAYAN VALLEY MEDICAL CENTER<\/option><option value='DE LA SALLE UNIVERSITY MEDICAL CENTER' >DE LA SALLE UNIVERSITY MEDICAL CENTER<\/option><option value='DR. JOSE N. RODRIGUEZ MEMORIAL HOSPITAL &amp; SANITARIUM (PROVISIONAL)' >DR. JOSE N. RODRIGUEZ MEMORIAL HOSPITAL &amp; SANITARIUM (PROVISIONAL)<\/option><option value='DAVAO REGIONAL MEDICAL CENTER (PROVISIONAL)' >DAVAO REGIONAL MEDICAL CENTER (PROVISIONAL)<\/option><option value='EAST AVENUE MEDICAL CENTER' >EAST AVENUE MEDICAL CENTER<\/option><option value='EASTERN VISAYAS MEDICAL CENTER (PROVISIONAL)' >EASTERN VISAYAS MEDICAL CENTER (PROVISIONAL)<\/option><option value='GOV. CELESTINO  GALLARES MEMORIAL MEDICAL CENTER' >GOV. CELESTINO  GALLARES MEMORIAL MEDICAL CENTER<\/option><option value='ILOCOS TRAINING &amp; REGIONAL MEDICAL CENTER' >ILOCOS TRAINING &amp; REGIONAL MEDICAL CENTER<\/option><option value='JOSE B. LINGAD MEMORIAL GENERAL HOSPITAL' >JOSE B. LINGAD MEMORIAL GENERAL HOSPITAL<\/option><option value='JOSE R. REYES MEMORIAL MEDICAL CENTER' >JOSE R. REYES MEMORIAL MEDICAL CENTER<\/option><option value='MAKATI MEDICAL CENTER' >MAKATI MEDICAL CENTER<\/option><option value='MARIANO MARCOS MEMORIAL HOSPITAL AND MEDICAL CENTER (PROVISIONAL)' >MARIANO MARCOS MEMORIAL HOSPITAL AND MEDICAL CENTER (PROVISIONAL)<\/option><option value='NORTHERN MINDANAO MEDICAL CENTER' >NORTHERN MINDANAO MEDICAL CENTER<\/option><option value='QUIRINO MEMORIAL MEDICAL CENTER (PROVISIONAL)' >QUIRINO MEMORIAL MEDICAL CENTER (PROVISIONAL)<\/option><option value='PHILIPPINE ORTHOPEDIC CENTER' >PHILIPPINE ORTHOPEDIC CENTER<\/option><option value='REGION 1 MEDICAL CENTER (PROVISIONAL)' >REGION 1 MEDICAL CENTER (PROVISIONAL)<\/option><option value='SOUTHERN PHILIPPINES MEDICAL CENTER' >SOUTHERN PHILIPPINES MEDICAL CENTER<\/option><option value='ST. LUKE&#039;S MEDICAL CENTER - Institute of Orthopedics and Sports Medicine' >ST. LUKE&#039;S MEDICAL CENTER - Institute of Orthopedics and Sports Medicine<\/option><option value='THE MEDICAL CITY' >THE MEDICAL CITY<\/option><option value='UNIVERSITY OF CEBU MEDICAL CENTER  (PROVISIONAL)' >UNIVERSITY OF CEBU MEDICAL CENTER  (PROVISIONAL)<\/option><option value='UP-PHILIPPINE GENERAL HOSPITAL' >UP-PHILIPPINE GENERAL HOSPITAL<\/option><option value='UNIVERSITY OF SANTO TOMAS HOSPITAL' >UNIVERSITY OF SANTO TOMAS HOSPITAL<\/option><option value='VETERANS MEMORIAL MEDICAL CENTER - Dept of Orthopaedic Surgery' >VETERANS MEMORIAL MEDICAL CENTER - Dept of Orthopaedic Surgery<\/option><option value='V Luna Medical Center, AFP Health Service Command' >V Luna Medical Center, AFP Health Service Command<\/option><option value='VICENTE SOTTO MEMORIAL MEDICAL CENTER - Orthopedic and Traumatology' >VICENTE SOTTO MEMORIAL MEDICAL CENTER - Orthopedic and Traumatology<\/option><option value='&lt;span class=&quot;vRMGwf oJeWuf&quot;&gt;WESTERN VISAYAS MEDICAL CENTER&lt;\/span&gt;' >&lt;span jsslot=&quot;&quot; class=&quot;vRMGwf oJeWuf&quot;&gt;WESTERN VISAYAS MEDICAL CENTER&lt;\/span&gt;<\/option><option value='WEST VISAYAS STATE UNIVERSITY MEDICAL CENTER (PROVISIONAL)' >WEST VISAYAS STATE UNIVERSITY MEDICAL CENTER (PROVISIONAL)<\/option><\/select><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_50_27' class='gform_previous_button button' value='Previous'  onclick='jQuery(\"#gform_target_page_number_50\").val(\"3\");  jQuery(\"#gform_50\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_50\").val(\"3\");  jQuery(\"#gform_50\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_50_27' class='gform_next_button button' value='Next'  onclick='jQuery(\"#gform_target_page_number_50\").val(\"5\");  jQuery(\"#gform_50\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_50\").val(\"5\");  jQuery(\"#gform_50\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_50_5' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_50_5' class='gform_fields top_label form_sublabel_below description_below'><div id=\"field_50_28\" class=\"gfield gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible\" ><p>The Philippine Board of Orthopaedics (PBO) through the National Orthopaedic Residency Assistance Program (NORAP) will be conducting a research study with the general objective of determining the predictability of the National Orthopaedic Aptitude (NOA) Examination results with the performance of residents during the orthopedic residency training. I am Henry P. Tupas, MD, MHA  FPOA, current trustee and head of the NORAP Committee of the PBO, and principal investigator for this study. I am respectfully inviting you to participate in this endeavor. <\/p>\n<p>\nThe study is entitled, <b>\"ASSESSING THE UTILITY OF THE NATIONAL ORTHOPAEDIC APTITUDE (NOA) EXAMINATION AS PREDICTOR OF THE PERFORMANCE OF RESIDENTS DURING ORTHOPAEDIC RESIDENCY TRAINING\"<\/b>. My fellow investigators in this study includes Harem P. Deiparine, MD, FPOA (V. Sotto Medical Center, Cebu City), Arnaldo S. Favila, MD, FPOA (Adventist Hospital \u2013 Palawan, Puerto Princesa City), Isagani E. Garin, MD, FPOA (Baguio General Hospital & Medical Center, Baguio City), Leonardo T. Khu, MD, FPOA (Northern Mindanao Medical Center, Cagayan de Oro City) and, Reynaldo V. Lopez, MD, FPOA (Angeles University Foundation Medical Center, Angeles City). We would like to disclose that all investigators are not associated with any company related to the study that may cause any conflict of interest. \n<\/p><p>\nThis Informed Consent will give you the information why this study is being conducted and why you are being invited to participate. It will also describe what you will need to do to participate and any known risks, inconveniences or discomforts that you may encounter while participating. If you decide to participate  you will be asked to sign this Informed Consent form and it will be a record of your voluntary agreement to participate. The decision to participate  in the study is yours. It is important to read all the information below for your better understanding.<\/p>\n<a target=\"_blank\" href=\"https:\/\/drive.google.com\/file\/d\/124jNTFtIA34Fk0rdBhLU7cDXuNKuW8mt\/view\">INFORMED CONSENT<\/a><\/div><div id=\"field_50_30\" class=\"gfield gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible\" ><p>I have read this Informed Consent form or had this form read to me about the purpose of the research study and its possible risks and benefits. I have been able to ask questions about the study and have had my questions answered. I understand that my participation is voluntary and I can refuse to participate in this research study anytime, even after signing this form, and it will not affect my status as orthopedic resident in training or my future career as a practicing orthopedic surgeon once I completed my orthopedic residency training.<\/p><\/div><fieldset id=\"field_50_31\" class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\" ><legend class='gfield_label'  >Thus, I give my consent to the use of the data I provided for the use by the Philippine Board of Orthopaedics for purpose of this research study  I agree voluntarily to participate in this research study:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_50_31'>\n\t\t\t<div class='gchoice gchoice_50_31_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_31' type='radio' value='YES'  id='choice_50_31_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_50_31_0' id='label_50_31_0'>YES<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_50_31_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_31' type='radio' value='NO'  id='choice_50_31_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_50_31_1' id='label_50_31_1'>NO<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_50_34\" class=\"gfield gform_validation_container field_sublabel_below field_description_below gfield_visibility_visible\" ><label class='gfield_label' for='input_50_34' >Phone<\/label><div class='ginput_container'><input name='input_34' id='input_50_34' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_50_34'>This field is for validation purposes and should be left unchanged.<\/div><\/div><\/div><\/div>\n        <div class='gform_page_footer top_label'><input type='submit' id='gform_previous_button_50' class='gform_previous_button button' value='Previous'  onclick='if(window[\"gf_submitting_50\"]){return false;}  if( !jQuery(\"#gform_50\")[0].checkValidity || jQuery(\"#gform_50\")[0].checkValidity()){window[\"gf_submitting_50\"]=true;}  ' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_50\"]){return false;} if( !jQuery(\"#gform_50\")[0].checkValidity || jQuery(\"#gform_50\")[0].checkValidity()){window[\"gf_submitting_50\"]=true;}  jQuery(\"#gform_50\").trigger(\"submit\",[true]); }' \/> <input type='submit' id='gform_submit_button_50' class='gform_button button' value='Submit'  onclick='if(window[\"gf_submitting_50\"]){return false;}  if( !jQuery(\"#gform_50\")[0].checkValidity || jQuery(\"#gform_50\")[0].checkValidity()){window[\"gf_submitting_50\"]=true;}  ' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_50\"]){return false;} if( !jQuery(\"#gform_50\")[0].checkValidity || jQuery(\"#gform_50\")[0].checkValidity()){window[\"gf_submitting_50\"]=true;}  jQuery(\"#gform_50\").trigger(\"submit\",[true]); }' \/> \n            <input type='hidden' class='gform_hidden' name='is_submit_50' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='50' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_50' value='WyJ7XCIzMy4xXCI6XCJjYWU1NjkwNjQ3MWRhNDJlZTY1MDM2ZWRkZWE3NTM5YVwiLFwiMzMuMlwiOlwiZjlkMmRlYzllN2M5ZDU5MWZhM2RjZWU5YjZhYjY4YzhcIixcIjMzLjNcIjpcImE1OTNiNGQ1ZGI3ZmQyNWU1NTRmMTY4NWRkYzYyYTA4XCIsXCIxN1wiOltcImQ5ZDI1NWFlYTk1MzE1NWU4NDk5ZjUxYjBiZDExMzUwXCIsXCJjZGZiNGY5YmNiN2IyNjg1MTA5OWVlOTY1YWFmMWY1OFwiXSxcIjMxXCI6W1wiOTQyYTEwZjU5MGZmZTg0NTI3NGZmOWEwZGM4NDYyNzZcIixcIjlhOGYzMTA5YTkyMDFiODYyY2FjMzU2NmQ0ODUyNmNjXCJdfSIsIjM3ZDZjNjFhNWJkMTlhMTYyOGVlNmYwNDMxMTEwMzA1Il0=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_target_page_number_50' id='gform_target_page_number_50' value='2' \/>\n            <input type='hidden' class='gform_hidden' name='gform_source_page_number_50' id='gform_source_page_number_50' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n                        <\/div><\/div>\n                        <\/form>\n                        <\/div>\n","protected":false},"excerpt":{"rendered":"Step 1 of 5 20% The PBO is committed to protecting your privacy and ensuring that your personal information is","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"_links":{"self":[{"href":"https:\/\/www.pbo.net.ph\/landing_page\/wp-json\/wp\/v2\/pages\/2057"}],"collection":[{"href":"https:\/\/www.pbo.net.ph\/landing_page\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.pbo.net.ph\/landing_page\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.pbo.net.ph\/landing_page\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.pbo.net.ph\/landing_page\/wp-json\/wp\/v2\/comments?post=2057"}],"version-history":[{"count":3,"href":"https:\/\/www.pbo.net.ph\/landing_page\/wp-json\/wp\/v2\/pages\/2057\/revisions"}],"predecessor-version":[{"id":2060,"href":"https:\/\/www.pbo.net.ph\/landing_page\/wp-json\/wp\/v2\/pages\/2057\/revisions\/2060"}],"wp:attachment":[{"href":"https:\/\/www.pbo.net.ph\/landing_page\/wp-json\/wp\/v2\/media?parent=2057"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}