Faculty Research Proposal

* 1. Faculty Sponsor

* Name:
 
* Degrees:
* Title:
 
* Organization:
 
* Address:
 
Apt/Suite:
 
* City:
 
* State:
 
* Zipcode:
 
* Office Phone:
 
* Email Address:
 

2. Daily Supervisor

Name:
 
Degrees:
Title:
 
Organization:
 
Address:
 
Apt/Suite:
 
City:
 
State:
 
Zipcode:
 
Office Phone:
 
Email Address:
 

* 3. Project Title (250 words limit)


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* 4. Up to three faculty publications (within the last three years). Projects without recent publications are unlikely to be filled.

* 5. Sponsor's Research Focus:

Anatomy Gastroenterology Ophthalmology
Anesthesiology Genomics Pediatrics
Biochemistry Geriatrics Pharmacology
Cancer Infectious Disease Psychiatry
Cardiology Kidney Pulmonology
Dermatology Neurology Radiology
Emergency Medicine Obstetrics/Gynecology Surgery
Endocrinology

* 6. Sponsor's translational level

* (Please select ONE)

* 7. Hypotheses (200 word limit)


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* 8. Project goals and measureable objectives (e.g. number of patient records, assays completed) (200 word limit).


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* 9. Overall design of the research project (500 word limit). Please describe time frame and breakdown of activities.

Selection criteria include:

  • The project design makes it likely that the objectives will be achieved
  • The project is likely to result in a report of interest to other scholars
  • The project fulfills discovery/original research

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* 10. Describe the student's role in the project (200 word limit)


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* 11. Describe the mentor's role in the project. (200 word limit)


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* 12. Describe the current and previous medical student training by your mentor team. Indicate any Gill Fellows. (200 word limit)


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* 13. Do you have or will you obtain IRB approval for this project?
Please note: Students cannot begin a human subjects project without IRB approval.


* (Please select ONE)

Yes
No (Pending)
No (Not required)