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Application: HIV Diploma Upskilling Bursary

The HIV Clinical Skills Bursary supports South African clinicians who want to strengthen their HIV knowledge and prepare more confidently for the CMSA HIV Diploma. The bursary provides to Four Minute Medicine's HIV Diploma Course Bundle inclusive of the HIV Diploma Review and Practice Course (35 hours, 30 CPDs) and HIV Diploma Mock exam (3 hour, timed preparation exam). This bursary currently prioritises applicants from historically disadvantaged groups.

If you would like to be considered, please complete the form below. The information collected is used to assess eligibility and meet funder reporting requirements. If you do not hear from us within four weeks, please consider your application unsuccessful. Due date: Monday 15 December 2025, 16h30 (SAST). - Extended to 23 Dec 2025 (22h00)

What is your full name?

Date of birth

ID Number

Biological Sex (as recorded at birth)

Biological Sex (as recorded at birth)
A
B
C
D

HPCSA registration number

Email address

Phone Number

Province of residence

Province of residence
A
B
C
D
E
F
G
H
I

Population group (As per Stats SA categories)

Population group (As per Stats SA categories)
A
B
C
D
E

Citizenship status

Citizenship status
A
B
C

Current Professional Role

Current Professional Role

Are you currently employed

Are you currently employed
A
B
C

Area of Interest

Area of Interest

Have you previously attempted the CMSA HIV Diploma exam?

Have you previously attempted the CMSA HIV Diploma exam?

What motivates you to pursue advanced training in HIV medicine?

Which areas of HIV care do you find most challenging and why

Are you willing to share your course progress, assessment performance, final HIV Diploma exam results, and detailed feedback with the 4MM team for the purpose of programme improvement?

Are you willing to share your course progress, assessment performance, final HIV Diploma exam results, and detailed feedback with the 4MM team for the purpose of programme improvement?

How confident are you in your current HIV clinical knowledge

How confident are you in your current HIV clinical knowledge
Not confidentConfident

If selected, are you willing to serve as a peer-support ambassador for future bursary recipients (sharing study tips, insights, or short reflections)?

If selected, are you willing to serve as a peer-support ambassador for future bursary recipients (sharing study tips, insights, or short reflections)?
A
B

I confirm I am committed to completing the course by 31 March 2026

I confirm I am committed to completing the course by 31 March 2026
A
B

Applicant Declaration

Applicant Declaration

Consent for Personal Data Storage and Processing In order to provide you with relevant information and updates, we will need to store and process the personal data you submit. If you consent to us storing and processing your personal data for this purpose, please tick the checkbox below.

Consent for Personal Data Storage and Processing In order to provide you with relevant information and updates, we will need to store and process the personal data you submit. If you consent to us storing and processing your personal data for this purpose, please tick the checkbox below.

Acknowledgement Disclaimer Please note that completing this form does not guarantee bursary acquisition. Four Minute Medicine will review all applications and selected candidates will be contacted directly once the programme is finalised. By submitting this form, you acknowledge that if you are shortlisted, your basic identifying information will be shared with the investor for programme reporting requirements. This may include your name and basic demographic data.

Acknowledgement Disclaimer Please note that completing this form does not guarantee bursary acquisition. Four Minute Medicine will review all applications and selected candidates will be contacted directly once the programme is finalised. By submitting this form, you acknowledge that if you are shortlisted, your basic identifying information will be shared with the investor for programme reporting requirements. This may include your name and basic demographic data.