Medical Student Research Interest Form

UT Southwestern medical students who may be interested in conducting clinical or translational research studies are asked to provide the information below in order for the Department to appropriately connect faculty with medical students. With the guidance of the faculty mentor, students will be required to complete all required IRB related training and documentation.

Your Name (required)

Your Email (required)

Briefly list any prior experience with bench or clinical research and your role: (required)

Are you interested in using this experience to satisfy one of the scholarly activity tracks that our department is able to support?
YesNo

If so, which:
Basic Science Track
Clinical Sciences Track
Global Health Track
Quality Improvement Track
Medical Education Track
Community Health Track
Biomedical Ethics Track

If not, how much time would you like to spend with us? When?

Do you have specific interests within anesthesia-related research or within one of the anesthesia sub-specialties (Pain/Regional Anesthesia, OB Anesthesia, Cardiac Anesthesia, Pediatric Anesthesia, Quality/Patient Safety)?

Do you have a research question in mind?