The undersigned (the “Applicant”) makes application to The American Board of Obstetrics & Gynecology, Inc. (ABOG or Board) for admission to take the examination of the ABOG, all in accordance with, and subject to the requirements of the ABOG pursuant to the Articles of Incorporation, By-Laws, rules, regulations, and other qualifications, as may be amended, by the ABOG. The Applicant is aware that the ABOG is a not for profit corporation whose principal place of business is located in Dallas, Texas. The Applicant understands that the ABOG is not affiliated with and is not an agency of the U.S. or any state.
2. Representations of Applicant.
Applicant represents and warrants that the information and answers provided on this Application are true, correct, and complete to the best of his/her knowledge and agrees that any information that is false, misleading or otherwise misrepresents the true state of facts, or any significant omissions made regardless of whether such information was provided by the Applicant in ignorance or in good faith or because of misunderstanding, may disqualify the Applicant from having his/her Application accepted and/or from allowing him/her to take the examination and may disqualify him/her from any entitlement he/she may have had previously. Applicant understands that the ABOG is relying upon the accuracy of all of the information that he/she has supplied in this Application, although the ABOG is free to, and he/she expect that it will, independently attempt to verify the information contained in this Application. Applicant understands that he/she does not have any right to submit this Application and participate in the examination for which he/she is applying and that this privilege has been afforded to him/her by the ABOG to submit such Application and to participate in the examination subject to the Articles, Bylaws, Resolutions, Rules and Regulations of the ABOG.
Furthermore, if the Applicant is permitted to participate in the examination. and it is learned by the ABOG that any information furnished in his/her Application or otherwise which resulted in him/her being permitted to participate in the examination is false, misleading, a misrepresentation, or contains omissions, regardless of whether such information was furnished in ignorance of the true facts, in good faith, or because of any misunderstanding the applicant may have had, then, and in that event: the Applicant will not be allowed to take the examination for a minimum of three years. If the information is gained after the Applicant is certified, the Applicant’s certification may be revoked.
3. Understandings, Agreements, Covenants, and Warranties of Applicant.
Applicant understands and agrees that the decision as to whether his/her grades and other performances on the ABOG's examination qualify him/her for, and any entitlement he/she may have to continue to qualify for, a certification of qualification rests solely and exclusively in the ABOG, and that its decision is final.
Applicant further acknowledges, represents, warrants, and agrees that acquiring Diplomate status in the ABOG is not necessary for him/her to practice medicine in any jurisdiction in which he/she is or may become licensed to practice medicine and that any such membership or qualification in or by the ABOG is an honor or privilege, not a right. Applicant further agrees, represents, and acknowledges that Diplomate status in the ABOG generally, or in any specialty or subspecialty group of the ABOG, does not affect his/her ability to engage in the practice of medicine or interfere with or affect his/her ability to earn a living and engage in his/her profession although attaining Diplomate status in the ABOG generally or in any specialty or subspecialty group of the ABOG would enhance his/her standing in the medical community.
After completing or nearing completion of an ACGME-approved residency program in Obstetrics and Gynecology and meeting all of the requirements of the ABOG for such program, Applicant agrees to complete an application to begin the certification process. Upon those conditions Applicant understands, consents to, and irrevocably agrees that the results of his/her examinations may be made available to the Program Director of any residency program in which he/she has participated, or is currently involved and/or the American Council of Graduate Medical Education (ACGME) for any and all purposes. Furthermore, Applicant hereby releases and agrees to indemnify and hold the ABOG and its officers, directors, agents and employees harmless of and from any and all claims Applicant may have with regard to the effect or impact upon Applicant of the release of his/her examination results and waive any rights he/she may have, if any, to have the examination results maintained in confidence.
4. Release and Exoneration of ABOG.
Applicant waives, releases, exonerates and agrees to indemnify and hold harmless the ABOG and its directors, officers, division members, committees, committee members, employees, examiners, and agents from, against, and with respect to, any and all demands, claims, losses, costs, expenses, damages, of any kind, including for reasonable or other attorney's fees, and judgments, of any kind or character, alleged to have arisen from, arising from, resulting from, out of, with respect to, or in connection with, any action which they, or any of them, take or fail to take, as a result of or in connection with this Application or otherwise, any examination conducted by, the ABOG, any examination which the ABOG determines, in its sole discretion that the Applicant has failed to qualify for, and if applicable, the failure of the ABOG to issue the Applicant a certificate, diploma, or other emblem of qualification, or the ABOG's revocation of any certificate, diploma or emblem of qualification previously issued to the Applicant. Applicant further agrees to release, exonerate, indemnify and hold harmless the ABOG and its directors, employees, division members, committee members, examiners, officers, agents, from any claims for liability or damages or complaint of whatever kind or character whatsoever, by reason of any action, they, or any of them, may take in connection with this Application, such examination, the grade or grades given in respect to any such examination, and/or the failure of said Board to issue the Applicant a Diploma of Qualification, or by reason of the forfeiture or revocation thereof because of the Applicant’s failure to comply with the Articles, Bylaws, Resolutions, Rules and Regulations of the ABOG, as may from time to time exist or be revised.
5. Venue and Jurisdiction.
Applicant agrees that if any dispute arises between the Applicant and the ABOG with regard to the Applicant’s qualification for participating in the examination process, taking the exam, the results of the examinations, and/or any decision made by the ABOG with regard to the Applicant’s qualification for, and any entitlement the Applicant may have to continue to qualify for, a Certificate or Diploma, that dispute shall be had, held, and adjudicated in an appropriate court in Dallas County, Texas. Applicant consents to the personal jurisdiction and the laws of the State of Texas and exclusive venue in Dallas County, Texas with regard to any dispute that may arise with regard to the conduct of the examinations or Applicant’s qualification for, and any entitlement the Applicant may have to continue to qualify for, a Certificate or Diploma or in connection with the manner of conducting any examination or the results thereof, or the Applicant’s rights to participate in the ABOG examination process or to any privileges of such certification. Applicant further agrees that if, and to the extent, he/she may have any legitimate claims concerning his/her qualification for, and any entitlement he/she may have to continue to qualify for, or the conduct of any such examination, he/she will first exhaust all administrative remedies available to him/her under the rules and policies of the ABOG, and after first doing so, if, and to the extent, he/she may have any claims that can be heard in a court of law under the terms hereof, such claims shall thereafter be addressed exclusively to the attention of an appropriate court in Dallas County, Texas where the ABOG maintains its principal place of business. Applicant acknowledges that the examination application and examination fees that the ABOG charges and that Applicant has agreed to pay would be higher if he/she, and other applicants, did not agree to these venue provisions.
6. Adjudication of Disputes, Forum: Waiver of Right to Jury Trial.
In the event that any dispute arises between the Applicant and the ABOG whether under the terms hereof or as a result of any action taken by the ABOG or the Applicant as a result or consequence of his/her submitting this Application, his/her right or privilege to become or remain a Diplomate of the ABOG, his/her use of the ABOG website or any documents or materials he/she downloaded, viewed or referred to on the ABOG's website, or by reason of any Application, request for information or other contact between him/her or a representative of his/her and the ABOG or any representative of the ABOG, the Applicant and the ABOG expressly agree to waive and do waive any rights we each may have to a trial by jury of any and all issues arising in any action or proceeding between the Applicant and the ABOG or our respective successors, representatives, assigns, or heirs. In addition, any claim, dispute, or controversy ("claim") by the Applicant or the ABOG against the other shall be resolved in an appropriate court of law located in Dallas County, Texas, as described above.
7. Continuing Requirements upon Receipt of Diploma.
In the event Applicant successfully completes the examination requirements, meets all of the requirements and conditions for, and receives a Diploma, Applicant hereby agrees to comply with all of the provisions of the Articles of Incorporation, Bylaws, Bulletins, Rules and Regulations of the ABOG, including all of the requirements for Maintenance of Certification, and the qualifications for, and any entitlement Applicant may have to continue to qualify for, the receipt and retention of that Diploma, as they currently exist or may hereafter be revised, and further agrees that in the event Applicant ever violates any of the terms and provisions of the Articles, Bylaws, Bulletins, Rules and Regulations of the ABOG, as they may exist from time to time, that any Diploma issued to me may be revoked or forfeited in accordance with the terms and provisions of such Articles, Bylaws, Bulletins, and Rules and Regulations of the ABOG.
8. Authorizations for Release of Information.
Applicant authorizes the ABOG or any employee, agent, director, officer, representative, member, examiner, or any other person with whom the ABOG may have dealings to obtain any and all information from schools, current or former employers, criminal justice agencies, individuals, medical institutions, hospitals, medical associations, medical organizations, or other organizations or persons, concerning his/her history, his/her history in the medical profession, and relating to any and all of my activities. Applicant authorizes and directs the medical organizations and associations, hospitals, and other medical professionals named in this Application and the responsible officials thereof to furnish the ABOG such information as it may request to verify the accuracy of the information contained in this Application and of his/her medical professional history, and agrees to release and hold all such organizations harmless from any liability or damages for providing such information to the ABOG. This information may include, but is not limited to, academic, employment, achievement, performance, personal history, arrest and conviction records, as well as any other information pertaining to his/her professional credentials or history in the medical profession or his/her history, generally. Applicant authorizes and directs such third parties to release such information upon request of the bearer of this Authorization or a counterpart thereof. Applicant understands that the information released is for official use by the ABOG and may be disclosed to such third parties as may be necessary in the ABOG's sole discretion in the fulfillment of the responsibilities of the ABOG. Applicant releases and agrees to indemnify and hold harmless any individual, person, organization, association or other entity including records custodians, as well as any corporation, partnership or other legal entity, from any and all liability for damages of whatever kind, character or nature whatsoever which may at any time result to him/her or he/she may incur on account of compliance or any attempts to comply with this Authorization. Any third party furnishing information to the ABOG may rely upon a signed copy of this document as if it were an original. Applicant specifically authorize the ABOG and its employees, officers, directors, agents and representatives, to the extent required by any federal, state or local law, ordinance or regulation, or by any lawful subpoena or other legal process served upon it or them, to reveal the facts of this or any other application he/she has submitted to it, the nature and results of any examination Applicant has taken, and any other information regarding Applicant’s professional standing, knowledge, qualifications and/or competence.
Applicant has read the contents of this Application and all of the terms, conditions and provisions contained herein. Further, Applicant understands these terms, conditions and provisions and agrees to be bound by them in consideration of the willingness of the ABOG to receive this Application and he/she acknowledges that such consideration is sufficient and valid. Applicant understands that in the absence of his/her agreement to these terms, conditions and provisions, the ABOG would not have received the application nor, if his/her application is accepted, allow Applicant to participate in the examination for which he/she is applying.
The terms, provisions, covenants and remedies contained in this Application shall be enforceable to the fullest extent permitted by law. If any such term, provision, covenant, or remedy of this Application or the application thereof to any person, association, entity, or circumstances shall, to any extent, be construed to be invalid or unenforceable in whole or in part, then such term, provision, covenant, or remedy shall be construed in a manner so as to permit its enforceability under the applicable law to the fullest extent permitted by law. In any case, the remaining provisions of this Application or the application thereof to any person, association, entity, or circumstances other than those to which they have been held invalid or unenforceable, shall remain in full force and effect.
To request special assistance or a test modification for the examination due to a disability, documentation of the disability and specific accommodations requested will be required. Please refer to the current examination bulletin for further information.
All Examination materials are confidential, proprietary or copyrighted by the American Board of Obstetrics and Gynecology, Inc. Any disclosure of the questions or answers or their substance, in whole or in part, to any person, organization or entity, public or private, orally, in writing, or by other form of communication is strictly prohibited. In the event that the ABOG determines that any unauthorized disclosure has been made by any person granted access to this examination, it reserves the right to refuse participation credit to such person or revoke its participation credit, if already granted, and, in addition, to seek monetary and injunctive relief in court, submitting to the exclusive personal jurisdiction and venue in the appropriate court located in Dallas County, Texas.