GPST affiliate membership application

About you

Our affiliate membership is free and designed for GPSTs working in England where indemnity for claims has already been arranged by their Local Education and Training Board (LETB).

Affiliate membership offers many benefits to support you during your GPST years in preparation for when you practice as a GP.

As an organisation, we understand that data must be handled securely. For more information about how we collect, store and use data please see our privacy policy at themdu.com/privacy

1. First Name *This question is required.

2. Surname *This question is required.

3. Date of birth *This question is required. This question requires a valid date format of MM/DD/YYYY.

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4. GMC number *This question is required.

5. Postcode *This question is required.

6. Address *This question is required.

7. Email address *This question is required. This question requires a valid email address.

8. Mobile number

9. Gender *This question is required.

10. Anticipated completion date of training *This question is required. This question requires a valid date format of DD/MM/YYYY.

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11. Have any concerns been raised about your personal or professional conduct, your clinical work, your probity or your educational progress, or are you aware of any incidents or circumstances that could lead (or have led) to an investigation, complaint, disciplinary action or which could affect your registration. *This question is required.

12. Please provide further details *This question is required.

MDU Services Limited (MDUSL) is authorised and regulated by the Financial Conduct Authority for insurance mediation and consumer credit activities only. MDUSL is an agent for The Medical Defence Union Limited (MDU). MDU is not an insurance company. The benefits of MDU membership are all discretionary and are subject to the Memorandum and Articles of Association. MDU Services Limited, registered in England 3957086. Registered Office: One Canada Square, London E14 5GS