Preview of 2012 Medical Scholars Program (MSP) Student Application

Please prepare information for application and submit through the MSP website. Applications need to be filled out at one sitting. Applications are due January 31, 2013.

Instructions

This form contains essay questions. We suggest you complete those in a word processor first and then copy and paste them into this form. Submission of this form is final. For more information, please contact Richard S. Cameron at rcameron@georgiahealth.edu. An asterisk(*) indicates required data.

 

• Name *
• Birth Date *
• Address *
• Phone Number *
• Cell Phone
• School Email *
• Alternate Email
• Citizenship

o   If not a US Citizen, of what country are you a citizen?

o   If you have a permanent resident alien "green card", please provide the number on the card:

• Educational Background:Beginning with the institution you are currently attending, please list the colleges/universities you have attended.

o   School Name

o   Major

o   Expected Degree

o   Expected Grad Date
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• Mentor Information

o   Name * (Title, First, Last, Suffix)

o   Department *

o   Mentor Email *

o   Mentor Phone Number

o   Location where work will be performed *

• Research Plan Narrative

o   Project Title *

o   Project Aims * (Maximum of 250 words) Briefly state Project Specific Aims.

o   Project Background and Significance * (Maximum of 500 words) Summarize previous studies in the field and point out what additional studies, especially your proposed work, would add knowledge to the field.

o   Research Methods and Design * (Maximum of 500 words) Outline exactly what you propose to do during the summer with some brief experimental details.

o   Relevance of Research to Medicine * (Maximum of 250 words)

o   Please discuss what you hope to learn from participation in the Medical Scholars Program and how your participation will benefit you in meeting your future education and career goals (maximum of 250 words).

o   Selective References * (enter up to 10 references) List journal articles that are referenced in the research proposal/application - i.e., the published work that supports the ideas/approach of proposed work.

• Previous Research Experience
  • Have you had any previous research experience(s)? * Yes or No

• Suggested Proposal Review Group (please check your primary choice)

§  Children's Summer Scholars Program - Chair, Dr. Bernard Maria.

§  Dean's Summer Scholars Program - Chair, Dr. Donna Londino (Augusta).

§  Dean's Summer Scholars Program - Chair, Dr. Barbara Schuster (Athens).