Summer Medical Internship IR Host Site Application

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* 1. Please provide your institution's name

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* 2. Mentoring physician

Name *

Address

City/Town

Email Address *

Phone Number *

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* 3. The length of the internship should be 8 weeks and at least 40
hours per week. Can you commit to this?

Yes

No

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* 4. Please provide a brief description of how each of the following curriculum elements will be demonstrated/taught through your programs.

Mandatory elements:
1. Concept development – a distillation of a clinical question into elemental components:
2. Experimental design and statistics, including proof of concept, 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

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* 5. 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.

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* 6. 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.