Advanced Biomedical Sciences Experience Requirement
Pre-Approval Form
The Registrar must have on file documentation that your plans for fulfilling the Advanced Biomedical Sciences (ABS) Experience Requirement
were reviewed and approved by the appropriate administrative official. All students must file either this form or a Request for Exemption form.
Additional Information about the ABS Requirements and the exemption policy, as well as forms for download, can be found on the
ABS Requirements website: http://www.med.cornell.edu/education/curriculum/fourth/adv_bio.html
Deadline:
This form should be submitted at least two weeks before the start of your ABS Experience, with the last possible submission date
corresponding to the due date of your 4th year Plan of Study form (typically mid-March of your 3rd year).
Instructions:
This form MUST be completed in Adobe Acrobat Pro, which can be found on the medical library computers. The form MUST be
downloaded before it is filled out. DO NOT enter data into form while in web browser, Adobe Reader, or viewer modes.
For Teaching Elective (Option I): Complete Date, Student Information and Option Selection fields. Follow the instructions provided by the
Associate Director of OCED (Dr. Carol Capello, cfc2002@med.cornell.edu), save a copy of your completed form, and submit to Dr. Capello
for signature.
For Tutorial Elective (Option II) or Research Experience (Option III): 1) Complete all form fields; 2) Save form and rename it as
PreApp_Class_YourLastName.pdf (e.g. ,PreApp_2012_Doe.pdf); 3) Mentor's digital signature required (a scanned copy of the signature
page may be attached separately); 4) Submit the completed, signed form to the Director of Medical Student Research (Dr. Brian Lamon,
medstudentresearch@med.cornell.edu).
Date:
Student Information:
Last Name:
First Name:
Class (YYYY):
Sex (check one):
Email Address:
Male
Female
Option Selection:
It is my intention to fulfill the ABS Experience Requirement with the following (please check one):
Option I: 4th Year Teaching (4 weeks)
Option II: Tutorial Course (4 weeks)
Option III: Biomedical Research Experience (8 or more continuous weeks in years 1-4)
Note: All options satisfy the ABS Experience Requirement. Students who choose the Biomedical Research Experience option (Option III)
can also receive 4 credits toward elective requirements by completing the Elective Evaluation Form. Completion of the activities above
does not exempt the student from the ABS course given at the end of the year. See the ABS requirements policy for exceptions and
further information: http://www.med.cornell.edu/education/curriculum/fourth/adv_bio.html
Plan of Study: (required for Options II and III only)
Proposed Dates
Start Date:
End Date:
Mentor Information
Name:
Address:
Title:
Department:
Institution:
Phone Number:
Email Address:
Continued on next page.
Plan of Study: (continued)
Background/
Significance:
For Option II, provide a brief description of the area of study and reason why it is important for your career.
For Option III, describe why the problem to be studied is scientifically/clinically important.
Aims/
Hypotheses:
For Option II, explain in more detail the area that you will explore in the tutorial.
For Option III, explicitly state the principal aims of the study and any hypotheses that you are testing.
Methods:
For Option II, describe generally what topics you will review and the likely sources you will consult.
For Option III, describe sample selection, inclusion criteria, study type, materials, study variables, outcome measures, experimental design, etc.
Continued on next page.
Plan of Study: (continued)
Tutorial Plan/
Data Analysis/
Anticipated
Involvement:
For Option II, briefly describe your plan for meeting with your mentor and gauging your progress during the tutorial.
For Option III, briefly describe the anticipated results and how you will analyze these results.
How will this work be funded? Check all that apply:
Federal Work-Study Program
CTSC Award
Mentor/PI/Lab Funding
Extramural Agency (Foundation/Society/NIH), Please specify:
What is the nature of this project? Check all that apply:
Basic Science
Clinical Medicine
Community Health
Global Health
Epidemiological
Medical Ethics
Other (Specify):
Mentor Approval: Click here to learn how to easily create a digital signature.
By signing this form, I certify that I have read and approve of the above plan of study and I agree to serve as a mentor for the student
submitting the form for the duration of the proposed project dates. I also certify that I have read the learning objectives associated
with the ABS Experience Option the student has indicated on this form. The learning objectives for each ABS Experience Option can
be found at http://www.med.cornell.edu/education/curriculum/fourth/adv_bio.html
Date:
Name:
Signature:
Plan Approval: (For use by Office of Medical Student Research or Curriculum Office only.)
Name:
Brian D. Lamon, Ph.D.
Date:
Signature: