NHLBI-T35 Trainee Progress Report Form

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The NHLBI-T35 Trainee Progress Report Form is provided to the IUSM NIH T35 IMPRS and research alumni periodically via email distribution, Twitter and website. The purpose for the survey is to collect data from the students who participated in the summer research program as part of the NIH T35 Training Grant.

All surveys are available at https://md.mednet.iu.edu/research/.

STUDENT'S FIRST NAME

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STUDENT'S LAST NAME

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Email Address (current)

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Email Address (permanent)

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ORCID ID

Training Period as an NIH NHLBI T35 (IMPRS)

T35_IMPRS Project Title

T35_IMPRS Project Description or Abstract

What is your current position?

Medical Student

Resident

Post-Doc Fellow

Degrees working toward or received? e.g. MD, MD/MS, MD/PhD etc

LIST ANY CAREER DEVELOPMENT ACTIVITIES (E.G. INDIVIDUALIZED COURSEWORK; WORKSHOPS ATTENDED ETC)

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Have you presented your research at conferences?

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Yes No

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LIST ALL CONFERENCE PRESENTATIONS

LIST ALL RELEVANT PUBLICATIONS (ABSTRACTS, MANUSCRIPTS)

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LIST HONORS, AWARDS, FELLOWSHIPS YOU MAY HAVE RECEIVED.

Are you currently or are you interested in continuing some sort of research?

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Yes No

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Are you currently or are you interested in incorporating research or scholarship as part of your medical career?

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Yes No

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If you are interested in incorporating research as part of your medical career, please describe.

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To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.