Medicine, Nursing and Health Sciences
2015 Direct Admission Form –
Honours degree of Bachelor of
Medical Science (0041)
This is an application form only and does not constitute project authorization. The form should
be completed and lodged with your Supervisor and the head of the appropriate academic unit in
which candidature is sought. Following signed endorsement by the Supervisor and head of the
academic unit, the candidate is required to apply for a place via E-Admissions. This form must be
uploaded in portable document format (pdf) to your application.
Application to: https://applicant.connect.monash.edu.au/connect/webconnect
Submission deadline: 01 September, 2014
Please CLEARLY fill out each section of this form, as the information supplied is required by the BMedSc administration team.
Section 1
To be completed by the Applicant
ID No:
Current year of Medical Course:
Family name:
Title:
Given name:
Mailing address:
Email address:
Contact telephone:
Mobile number:
Academic Unit in which candidature is sought (Department of Main Monash Supervisor) and School:
Potential intercalation to PhD:
Yes
No
Maybe
Student Declaration:
(please strike out the relevant clause below if you do not consent) If selected for the Honours degree of Bachelor of Medical Science:
1. I consent to my fellow students and Supervisors having access to a listing including my full name, title of project and Monash
student e-mail address.
2. I consent to the Medical Research Student Society (MRSS) having access to my Monash student e-mail address for distribution
of upcoming meetings, etc.
3. I warrant that the information on this form, or provided in support of my application, is correct and complete.
4. I acknowledge that the provision of incorrect information or the withholding of relevant information relating to my application, including
academic transcript/s, might invalidate my application and that the University may withdraw an offer of a place or cancel my enrolment in
consequence.
5. Should the University determine that I have submitted a false document, I consent to the University disclosing this information to other
relevant tertiary institutions.
6. I consent to any educational institution at which I am or have been a student and/or any current or past employer providing Monash
University with any information which that institution or employer holds about me concerning my attendance, conduct, grades and/or
qualifications or experience to assess my suitability for an offer and/or enrolment.
7. I have read the University’s statement on privacy and the purposes for which my personal information will be used (available at
www.privacy.monash.edu.au/guidelines/collection-personal-information.html).
8. If sponsored, I permit Monash University to release details of my academic progress to my sponsoring body on their
request. I agree to abide by the statutes, regulations and policies of Monash University.
9. If I am an international student from a partner university, I confirm that I will not undertake any activities as part of this
course which include :
1.
2.
Undertaking exposure prone procedures; or
Requiring patient interaction in a hospital environment
Signature:
Date:
Privacy Statement:
The information on this form is collected for the primary purpose of assessing your application. Other purposes of collection include
attending to administrative matters, statistical analyses and the creation of an enrolment record on the student database corresponding
with you. If you choose not to complete all the questions on this form, it may not be possible for the Faculty of Medicine, Nursing and
Health Sciences to assess your application. You have a right to access personal information that Monash University holds about you,
subject to any exceptions in relevant legislation. If you wish to seek access to your personal information or inquire about the handling of
your personal information, please contact the University Privacy Officer on (03) 9905 6011.
2015 Direct Admission Form – Honours degree of Bachelor of Medical Science (0041) | 1
Section 2: Honours degree of Bachelor of Medical Science – Research Title and Synopsis
To be completed by the Applicant
Proposed research title:
School or Academic Unit:
Project Synopsis:
Please provide a summary of approx. 200 words below.
Note: ALL BMedSc(Hons) projects, including those with external research institutions and universities, require ethics clearance or an exemption from the relevant
Monash ethics committee. Please note BMedSc(Hons) candidates do NOT undertake quality reviews, they are doing RESEARCH.
Proposed Name of Supervisor:
Proposed Name of Co-Supervisor:
Student signature:
Date:
2015 Direct Admission Form – Honours degree of Bachelor of Medical Science (0041) | 3
Section 3
To be completed by the Monash Head of Academic Unit/School in consultation with Main Supervisor
Research proposal
Please comment on the candidate’s proposed research program with particular reference to its feasibility and the methods to be
employed, including any requirement for particular facilities (such as travel, library, equipment or other resources). Please indicate whether
the candidate is expected to use material and resources outside Monash University. Give details of any outside sources (eg name of
institution) and travel that will be necessary. Please attach additional documentation where necessary.
Location of BMedSc(Hons) Project:
Physical site from where student will work:
If any of the work to be undertaken will be conducted at a location other than a Monash University academic unit or recognised affiliated
site, please indicate below what supervision arrangements will apply whilst the student is at that location.
FMNHS School:
Please state which Monash School you are attached to:
2015 Direct Admission Form – Honours degree of Bachelor of Medical Science (0041) | 4
Ethics Clearances
Monash Ethics Research Approval is required for all BMedSc placements.
Human Ethics (human, tissue, data)
Authorisation Number (or anticipated submission date)
Animal Ethics (animal, tissue, data)
Authorisation Number (or anticipated submission date)
Ionising Radiation ethics
Authorisation Number (or anticipated submission date)
Biosafety*
*(recombinant DNA technology)
Authorisation Number (or anticipated submission date)
Ethics Authorisation
Will the project require ethics clearance from the relevant committee? (projects involving questionnaires, interviews and surveys are subject
to human ethics clearance).
Approval required
Approval obtained (if necessary)
Human ethics
Yes
No
To be determined
Yes
No
Animal ethics
Yes
No
To be determined
Yes
No
Ionising radiation
Yes
No
To be determined
Yes
No
Yes
No
To be determined
Yes
No
Biosafety*
*(recombinant DNA technology)
Research Project and Ethics confirmation
Signature:
Date:
Head of Monash S c h o o l / Academic Unit
Name (please print):
Signature:
Date:
Main Monash Supervisor
Name (please print):
Position Title:
Mailing Address:
State:
Postcode:
Email:
Phone: (w)
Mobile:
2015 Direct Admission Form – Honours degree of Bachelor of Medical Science (0041) | 5
Section 4
Additional information for the Monash Head of Academic Unit and Chief Monash Super visor to
consider before approving placement.
Supervision Agreement
Once a candidate confirms acceptance of a place in the course, the Course Administrator will coordinate the Supervision Agreement between
the Course Management Committee and Monash Supervisor for authorization. This agreement outlines the minimum expectations of the
CMC with regards to BMedSc(Hons) supervision. Course Guides and dates will be posted on Moodle by the end of January 2015.
Examiners (Literature Review and Thesis)
One appropriate examiner is to be to be arranged by the Monash Supervisor (Requests for nomination of suitable examiner will be sent
to supervisors later in the year), the second examiner will come from 2015 BMedSc(Hons) supervisors as allocated by the CMC. Please
note the honours year literature review and thesis is an exercise in communication, supervisors can mark any literature review or thesis
(except that of their own student) they do not need to be an expert in the research field that they are examining.
Unit Guide
The 2015 Unit Guide will be available to view from Moodle by the end of February 2015.
Assessment Details – MBBS stream
Literature Review and Examiners (27 May, 2015)
In addition to the research component all students must undertake a literature review. At least two examiners, other than the supervisor or
any person who has worked with the student (eg: in the same laboratory) or contributed to the research, are required to assess the thesis.
Oral Presentations (1st Oral Examination 27 May, 2015 / 2nd Oral Examination 23 September, 2015)
Students are also expected to make 2 department oral presentations on the research project throughout the course of the year.
Presentations to the department (or equivalent) will need to be assessed by at least 3 members other than the supervisor. The examination
panel must be arranged by the Monash-Linked Supervisor and the examiner reports sent to the course administrator by the due date.
Mid- Year Progress Report (26 June, 2015)
The report must be read by and discussed with the student before signing and submitting.
Thesis and Examiners (7 October, 2015)
The research component is to be assessed by minor thesis. At least two examiners, other than the supervisor or any person who has
worked with the student (eg: in the same laboratory) or contributed to the research, are required to assess the thesis. One appropriate
examiner is to be to be arranged by the Monash Supervisor, (requests for nomination of suitable examiner will be sent to supervisors
later in the year). The second examiner will come from the current 2015 BMedSc(Hons) Supervisor group as allocated by the Course
Management Committee (CMC). Please note honours year thesis is an exercise in communication, supervisors can mark any thesis
(except that of their own student) they do not need to be an expert in the research field that they are examining.
Faculty Presentation and Scientific Poster 3rd, 4th and 5th November, 2015
A final presentation and scientific poster will be made to the Faculty over three days: 3, 4 and 5 November, 2015.
*Oral Presentation (5 min) will be assessed by CMC members and appointees.
**Scientific Poster (10 min) examiners to comprise CMC members, 2015 BMedSc(Hons) supervisors and expert examiners as
identified by the CMC.
2015 Direct Admission Form – Honours degree of Bachelor of Medical Science (0041) | 6
Department Approval to host BMedSc(Hons) student
Please CLEARLY fill out each section of this form, as the information supplied
is required by the BMedSc(Hons) administration team.
Note to Staff:
Submission of the form indicates your agreement to host a BMedSc(Hons) candidate, should their application be successful,
and to meet all associated project and infrastructure costs. Faculty subsidies are paid directly to Monash Schools. The Faculty
distributes funding for the BMedSc(Hons) in an identical fashion to the distribution of other teaching funding. Monies are distributed in
the year following the student’s candidature, following the appropriate deduction of Central and Faculty charges.
The BMedSc(Hons) Course Management Committee, Course Convenor and Course Administrator have no role in the distribution
of these funds and are unable to answer questions regarding these matters as it not part of their purview. If you have a query about
funding, it is suggested you take this matter up with your Head of School, Head of Department or School/Department Finance Office,
as appropriate.
**If you are an Adjunct Monash staff member and you are based at the Baker IDI, Burnet Institute or the Alfred, please ensure you indicate which
Monash School you are attached to (in most cases this will be Central Clinical School or The School of Public Health and Preventive Medicine.
FMN&HS School:
Head of Department
Name (inc. title):
Date:
Signature:
Academic Unit:
Mailing Address:
State:
Postcode:
Email address:
Phone: (w)
Mobile:
2015 Direct Admission Form – Honours degree of Bachelor of Medical Science (0041) | 7
All BMedSc(Hons) Supervisory teams must have at least (1) team member with level 1 accreditation from the Monash Institute of
Graduate Research (MIGR).
I certify that one at least member of the Supervisory team has achieved level 1 accreditation.
For projects jointly Supervised with non-Monash academic staff, the following MUST be completed for the project to proceed.
I certify that I have a pre-existing collaboration with the non-Monash Supervisor. Please tick the relevant box/es below that apply:
Co-Authorship of a publication
Co-Authorship of a report
Joint supervision of HDR or honours student
A research collaboration
Other (please specify)
Chief Supervisor (Must be Monash staff member)
If I have an international student from a partner university, I confirm that the student will not undertake any activities as part of this course
which include:
1. Undertaking exposure prone procedures; or
2. Requiring patient interaction in a hospital environment
Name (inc. title):
Signature:
Date:
Academic Unit:
Mailing Address:
Postcode:
State:
Email address:
Phone: (w)
Mobile:
Should the student be completing the BMedSc(Hons) outside of Monash University, please ensure the External Co Supervisor or the
Monash-linked Co-Supervisor details are completed.
If applicable, please CLEARLY fill out each section of this form, as the information supplied is required by the
BMedSc(Hons) administration team.
Co-Supervisor
Monash University
External
Name (inc. title):
Signature:
Date:
Academic Unit:
Mailing Address:
State:
Postcode:
Email address:
Phone: (w)
Mobile:
Applications close: 1 September, 2014
2015 Direct Admission Form – Honours degree of Bachelor of Medical Science (0041) | 8