East Carolina Heart Institute Research Program
Research skills are an important asset for those students who plan to enter a health-science
related field. Many of the daily tasks performed by healthcare professionals require complex
critical thinking, fluent communication, and excellent writing skills. The best way to foster these
skills is to conduct research. With time and increased experience, students can attain research skills
that will be critical on their road to success. The East Carolina Heart Institute at East Carolina
University is a leading research institute in eastern North Carolina where physicians and researchers
are now accepting qualified students to assist in their research projects via the East Carolina Heart
Institute (ECHI) Research Program.
The objective of the ECHI Research Program is to provide students with the opportunity to
participate in a medical research experience, in basic science or clinical research, by working with a
mentor physician at the East Carolina Heart Institute. Students will earn two semester hours of
biology credit per semester for their research project. The time commitment required for this
program is two semesters; therefore, students must leave room in their class schedules to
accommodate this program.
As part of this experience, students will have the chance to attend a professional conference
where they will be able to present their research findings to the medical community. The goal of
this program is to provide students with an outlet to gain insight into the research aspect of medicine.
The experience they gain will be indispensable to their success as a future physician or any other
endeavor they plan to pursue.
Requirements
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Eligible candidates will be required to have completed 42 semester hours.
Have a minimum cumulative GPA of 3.3.
Be enrolled as a full-time undergraduate student for the duration of the program.
Selected students will be registered for a Biology or Chemistry research course.
Must be able to allocate 2 semester hours for 2 consecutive semesters.
For office use only:
ECHI Research Program
Date received:
_____________
Name ________________________________
GPA: ________
ECU (Banner) ID _______________________
Year in school:
_____________
Birth Date ____/____/______
Local Address ___________________________________________________
_______________________________________________________________
Number (Cell Phone) (_____) _____-______
ECU Email Address ______________________________________________
Completion of biology
course and lab:
___________________
Verifier initials and
dates:
________________
_____________
How did you hear about this program?
________________________________________________________________________________
________________________________________________________________________________
ELIGIBILITY
Number of semester hours you have completed in college, including AP, CLEP, and
community college work, (not including the current semester) __________
Grade Point Average (*A minimum cumulative GPA of 3.3 is required
at the time of selection as well as during the semester you research.) __________
ADDITIONAL INFORMATION
College attended, city and state ____________________________________________________
Number of credit hours completed (not including the current semester) __________
Course of study/major ____________________
List completed Biology & Chemistry courses
ECHI Research Program
Are you registered with the PCMH / Vidant Volunteer Center? ________
Have you been convicted of or pleaded no contest to a felony within the last five years? ________
If yes, please explain:
Have you been convicted of, pleaded guilty to, or pleaded no contest to, an act of dishonesty, or
breach of trust or moral turpitude, such as misdemeanor petty theft, burglary, fraud, and other
related crimes within the last five years? ________
If yes, please explain:
*Conviction of a crime, or pleading guilty to a criminal charge, will not necessarily disqualify you
from consideration for the ECHI Research Program.
VOLUNTEER HISTORY
List previous Shadowing or Volunteer experiences. (May submit on a separate page)
LEADERSHIP EXPERIENCE
Please list any leadership experiences that you have had in the past three years (May submit on a
separate page)
ECHI Research Program
CONDITIONS OF ACCEPTANCE TO THE PROGRAM
The program has high standards for its participants, and compliance with these standards is a
condition of participation in the program. Students are expected to represent East Carolina
University in a positive manner upholding the following standards of professionalism:
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Dress professionally at every research session
Have professional manners and behavior
Be on time for every session
Respect the work of the researchers
Follow Brody School of Medicine’s policies and procedures
Represent ECU in a positive light
Complete the HIPAA Privacy quiz and all other required paperwork
Are you willing and able to comply with all the requirements listed? ___YES ___NO
REFLECTION QUESTION
Why do you wish to be a participant in the East Carolina Heart Institute Research Program? What
do you hope to gain from this experience? Please submit your response to these questions on a
separate attachment.
I agree that the information provided by me in this application is true, correct, and complete to the
best of my knowledge. I understand that if selected for the program, any falsification, misstatement,
or omission of fact in connection with my application, whether on this document or not, may result
in immediate termination of participation. I authorize you to verify any and all information that I
have provided.
Signature: ___________________________________________________
Printed Name: ________________________________________________
Date: _________________________
Applications are due by 8 am on Tuesday, March 29th, to Sam Wilson in the
Pre-Professional Advising Center, 2500 Old Cafeteria Complex (or by e-mail, ppac@ecu.edu).