SMIP IR Host Site Application

Are you interested in participating in the Summer Medical Internship Program as a host site? Please complete this form.

Please provide your institution's name

Mentoring physician's full name

Mentoring physician's address

Mentoring physician's preferred email address

The internship should last 8 weeks and be at least 40 hours per week. Can you commit to the internship requirements?

Please describe the following curriculum elements:

Mandatory elements: 1. Concept development – a distillation of a clinical question into elemental components; 2. Experimental design and statistics, including proof of concept and steps in validation of new technique; 3. Techniques in the basic science lab 4. Data collection, statistics, and meaningful analysis of data 5. Constructing a well-written scientific paper Suggested elements: 1. Clinical trials design and regulatory approval/obstacles/legal considerations 2. Design and conduct of animal research and observation of animal research.

Please provide the following details:

Please provide the details on the instructional setting and methodology (laboratory, classroom), description of any educational resources (PowerPoint presentations, textbooks, selected readings), and assessment techniques (question and answer sessions, tests) to be used in the process of instruction.

Please provide a brief outline of the following:

Please provide a brief outline of available research topics, one of which the student will select for completion as part of the program. The projects should be of a scope appropriate for completion within the limited time frame provided.

Contact Information