Application for Membership on Committees, Taskforces and other WABIP Groups


ARTICLES:
  1. Personal Information
  2. Apply
  3. Committee Policy
  4. Conflict of Interest Policy, Rules and Disclosure
  5. Agreement

  1. I. Personal Information

  2. Name: *
    Please type your full name.
  3. Email Address: *
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  4. Country: *
    Please type your institution.
  5. Institution: *
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  6. II. Apply


    Submissions are closed

    Read committee descriptions here

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  7. III. Committee Policy


    • Every committee shall have 5-6 members: the Chair, Past-chair, and 3-4 general members.

    • A single term is defined as the full or partial period in between our WCBIP world congresses, which are held approximately once every two years.

    • Every general committee member shall serve a maximum of two terms (approx. 4 years).

    • Every committee chair must complete one (1) full term as chair.

    • Immediately after term as Chair, he or she shall serve an additional term as Past-chair of the committee to ensure continuity and to provide guidance to the new Chair and members.

    • After Past-chair term, tenure in the committee shall end regardless of number of terms served as a general committee member or otherwise.

    • Service on a committee, special section or Academy section presumes the person will do their very best to attend the WABIP World Congress.

    • It is the responsibility of the committee chair to contact by phone and email all members of his/her committee in order to get to know all committee members.

  8. IV. Conflict of Interest Policy, Rules and Disclosure

    a. Policy
    b. Rules
    c. Disclosure (please fill out)
  9. a. Policy

    The World Association for Bronchology and Interventional Pulmonology is a global organization dedicated to promoting the art and science of bronchology and interventional pulmonology. This goal warrants that the WABIP expands areas of interest, scope of practice, products and services beyond procedure-related medicine to also include radiology, otorhinolaryngology, thoracic surgery, oncology, infectious disease, global health, and radiation oncology.

    Considering the engagement of such an international group of practitioners, it is essential that the WABIP maintain credibility and integrity. The WABIP is, therefore, dedicated to ensuring scientific independence and unbiased objectivity to its educational, scientific, and research activities by advocating appropriate disclosure of real, perceived, or potential conflicts of interest.

    The WABIP Conflict of Interest Disclosure Policy was designed to ensure transparency while protecting the integrity of individuals participating on WABIP taskforces, guidelines panels, writing committees or participating in other ways in the development and implementation of WABIP products or services. This policy thus provides a framework from which the WABIP and its COI/Guidelines Oversight Committee (COI/GOC) might evaluate and manage disclosures that could be viewed as potential, real, or perceived conflicts.

    1. For purposes of the WABIP and the below COI Disclosure form, a COI is defined as any financial or other relationship with an entity that might have or be thought to have an effect on the participant’s judgment or conduct.
    2. In addition, a COI is defined as any relationship with an entity whose products or services are the focus of a WABIP-related activity, and where the entity’s products or services are in direct competition with those of the WABIP.
    3. Furthermore, a COI is defined for any participant with a financial interest or shared income (i.e spouse or family member) with a person or entity having a commercial interest in a related WABIP product or service.

    This WABIP Conflict of Interest Disclosure Policy applies to all WABIP members or staff who:

    1. Serve on WABIP Board of Regents, Executive Board, Committees, Administration, or Taskforces
    2. Submit to or make presentations in a WABIP-sponsored activity or publication.

    Please note that disclosure of a real, potential or perceived COI helps protect the integrity of the interested party and activity. Once COI is disclosed, the WABIP will be able to evaluate its possible effect or influence on WABIP products and services. If warranted, and upon recommendation from the COI/GOC, subjects may be asked by the WABIP Executive Board to refrain from participation in certain WABIP products or services.

    This COI Disclosure Policy was approved by the WABIP Executive Board and accepted by the WABIP Board of Regents.

  10. b. Rules

    WABIP leaders are bound by COI rules according to their respective leadership levels during their term. Real or perceived COI changes depend on the level of leadership activities in the WABIP, and a person's decision making or advisory function in other professional organizations.

    RULES FOR LEVEL III LEADERS
    Applies to: Members of WABIP committees, taskforces, workgroups (including Chairs and Vice-chairs), section editors, associate editors and other leadership positions of the WABIP Academy or WABIP Newsletter.

    • Level III leaders must disclose any potential COI and recuse themselves from discussions when appropriate.
    • Persons working on a WABIP-sponsored activity must submit a current COI disclosure form before, and sometimes, during the activity.

  11. c. Disclosure

    Please provide disclosure to the best of your ability. The WABIP COI oversight committee will evaluate your answers for possible COI pertaining to existing or planned WABIP products and/or services.

  12. 1) Currently have full or part time employment, leadership, board member (in a non-WABIP member society), or advisory position in a commercial or nonprofit entity?
    Must choose one.
  13. If “Yes” please state the name of the entity and your specific role including dates of engagement and expected term of office or engagement:
    Please type details.
  14. 2) Currently receive royalties or other benefits (travel, accommodations, honoraria, gifts) from a commercial or nonprofit entity?
    Must choose one.
  15. If “Yes” please state the name of the entity and the type of royalty or benefit:
    Please type details.
  16. 3) Currently obligated to provide expert testimony or other legal assistance on behalf of a commercial or nonprofit entity?
    Must choose one.
  17. If “Yes” please state the name of the entity:
    Please type details.
  18. 4) Currently involved with research funding or grant support (regardless whether payment is made to individuals or institutions) by a commercial or nonprofit entity?
    Must choose one.
  19. If “Yes” please state the name of the entity and indicate the level of support. Without disclosing proprietary information, please give a brief description of the research goals:
    Please type details.
  20. 5) Will receive honoraria for speaking engagements, presentations, or other services if paid directly to the individual by a commercial or nonprofit entity?
    Must choose one.
  21. If “Yes” please state the name of the entity, when the presentations or services are to be provided, and the general subject of presentations or services:
    Please type details.
  22. 6) Currently own patent rights or patents pending?
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  23. If “Yes” please provide patent numbers and a description of any existing patents. For pending patents please provide a general area of clinical medicine to which the patent may be pertinent (i.e. genomic analysis, diagnostic endoscopy, etc) without disclosing specific details which may compromise the integrity of the patent application.
    Please type details.
  24. 7) Currently own stocks or stock options in a privately or publically held start-up, technology or pharmaceutical company?
    Must choose one.
  25. If “Yes” please state the name(s) of the companies or corporations from which you currently own stock or stock options:
    Please type details.
  26. Please list additional comments, conflict of interest and disclosures here if necessary:
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  27. WABIP CASE EXAMPLES

    1. Honoraria paid directly to an individual from third party CME providers do not need to be disclosed.
    2. Honoraria paid directly to an individual from a company sponsoring or endorsing a CME event must be disclosed.
    3. Honoraria paid by a company sponsoring research or education, and paid directly to the individual’s academic institution or department must be disclosed if the funds relate to the individual’s WABIP activity.
    4. Honoraria and consulting fees paid by investment firms should be disclosed because these may have an impact on stock prices of pharmaceutical or manufacture companies.

  28. V. Agreement

    By providing my signature below, I hereby confirm and declare the following three points:

    • I have read and understood the entirety of this Application (Articles I – IV).
    • I agree to comply with the Conflict of Interest Rules (Article III.b).
    • All information that I have submitted and disclosed to the WABIP in this Application is, to the best of my knowledge, true, accurate, and complete.
  29. Signature: *
    Please type your signature.
  30. Click: *