2016 Bachelor of Medical Science (Honours) (0041) Application Form Application Closing Date for Semester 1 2016 commencement: Thursday, September 3rd, 2015 You must apply online at E-Admissions: http://applicant.connect.monash.edu/connect/webconnect You are required to upload your completed BMedSc (Hons) application form in portable document format (pdf) into E-Admissions. Admission Requirements Monash MBBS students may take leave from their course to pursue a BMedSc research program in a discipline area offered by the Faculty of Medicine, Nursing and Health Sciences in order to qualify for the Bachelor of Medical Science (Honours), provided they have: External students must supply a certified copy of their academic record through e-admissions. If you are currently undertaking studies, forward final results and evidence of completion as soon as these are available. An offer cannot be completed until this information is received. Please do NOT send original documents. External applicants will have their entire academic record considered. Further information can be found at: http://www.med.monash.edu.au/bmedsci/ International Applicants In addition to the requirements for external students, international students MUST apply through Monash International by completing the application form at: https://applicant.connect.monash.edu.au/connect/webconn ect successfully completed at least the first two years of the Monash undergraduate-entry Bachelor of Medicine and Bachelor of Surgery Course Commencement The commencement date for successful applicants commencing BMedSc(Hons) in 2016 is week 0: 22 February 2016. successfully completed the first year of the graduateentry Bachelor of Medicine and Bachelor of Surgery graduated from a Monash University Bachelor of Medicine and Bachelor of Surgery YOU WILL NEED TO ATTEND COMPULSORY TRAINING SESSIONS IN WEEK 0 (22– 26TH FEBRUARY, 2016) BEFORE YOU CAN START WORKING ON YOUR PROJECT. NO EXCEPTIONS. in all cases have achieved a credit average. The number of available domestic BMedSc(Hons) placements in 2016 will be capped at 75. If the demand for BMedSc placements is higher, academic performance criteria will be used to cap domestic BMedSc(Hons) offers. External Applicants Students who are studying or have completed a medicine program at a university other than Monash must have completed studies with a credit average corresponding to a minimum of two years of the Monash undergraduate MBBS program in a medicine program with equivalent curriculum content, learning outcomes and academic standards as determined by the Faculty of Medicine, Nursing and Health Sciences, Monash University. Applicants Please Note ONLY the BMedSc(Hons) Office can make an offer for the Honours program. Completion of this form and any recommendation(s) made by the School/Department do not constitute an offer for the Honours program, nor does it classify the applicant as a student of the University. Further enquiries Further information about the Honours program can be found at http://www.med.monash.edu.au/bmedsci/ Administration queries can be address to: Ms Cathy Nolan-Shaw phone: +61(3) 9902 0853, email: bmedsc@monash.edu Section 1: To be completed by applicant PERSONAL DETAILS Monash Student ID: Title: Date of Birth: Family Name: / / Gender: F M Given Name(s): Are you an international student? Yes No Postal Address for Correspondence Number and Street: Suburb: State: Postcode: Telephone (BH): Telephone (Mobile): Email (Monash student account if applicable): Details of Previous or Current Course Name of Institution/University: Campus: No Course Completed? Yes Year Completed: Semester and Year Expected to Complete: If Monash MBBS student please state your current MBBS YEAR __________ The information on this form is collected for the primary purpose of assessing your application. Other purposes of collection include creating or changing enrolment records on the student database, attending to administrative matters, corresponding with you and statistical analyses. If you choose not to complete all the questions on this form, it may not be possible for the Bachelor of Medical Science (Honours) office to assess your application. Personal information may also be disclosed to relevant bodies for the verification of qualifications. 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 9905 6011. I declare that the information supplied on this form and information given in support of my application is correct and complete. I acknowledge that the provision of incorrect information or the withholding of relevant information relating to my application and/or academic transcript may result in the withdrawal of an offer of a place in the course. I acknowledge Monash University reserves the right to seek from other relevant bodies verification of the standing of my claimed qualifications. I have read the University’s statement on privacy and the purposes for which my personal information will be used (www.privacy.monash.edu.au/pc_privacy_coll.htm) I agree to be bound by the statutes, regulations and policies of the University as amended from time to time and agree to pay all fees, levies and charges directly arising from my enrolment. I consent to receiving information electronically and agree to access the correspondence of my Monash University email account on a regular basis. Student Declaration: (please strike out the relevant clause below if you do not consent) If selected for the Honours Degree of the 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 : Undertaking exposure prone procedures; or Requiring patient interaction in a hospital environment ref: https://www.nhmrc.gov.au/book/australian-guidelines-prevention-and-control-infection-healthcare-2010/b5-3-exposure-prone-proc 10. I understand that it is the Course Management Committee expectation that I will be in attendance (Mon – Fri) ~9.00am – 5.00pm at my research placement or as negotiated with my supervisor. 11. I understand that I am required to attend the BMedSc(Hons) foundation skills orientation program including the OH&S session before I can commence work at my research placement. Applicant’s Signature Date / / 2 BMedSc(Hons) Course Overview and Important Dates MED4301 (12 credit point unit) Foundation Skills – Orientation (Compulsory) Commencement at Research Placement Progress Report – (Hurdle) 1st Department Oral Presentation – (25% of unit) Literature Review – 7,500 words (75% of unit) 2016 Important Dates 24-26/02/2016 29/02/2016 13/04/2016 By 29/04/2016 11/05/2016 MED4302 (36 credit point unit) 2nd Department Oral Presentation – (5% of unit) Thesis – up to 20,000 words (80% of unit) Faculty Oral – (7.5% of unit) Scientific Poster – (7.5% of unit) By 23/09/2016 5/10/2016 19th & 20th /10/2016 19th & 20th /10/2016 Section 2: Project details (to be completed by applicant and potential supervisor) The purpose of this form is for you to indicate the project of your choice. PROJECT Please write print these details clearly Project Title: Main Supervisor: School/Department/Institute: Phone: E-mail: Does the supervisor hold MIGR accreditation? ref: http://www.monash.edu.au/migr/supervisors/membership/ YES NO Co-Supervisor: School/Department/Institute: Phone: E-mail: Does the co-supervisor hold MIGR accreditation? YES NO ref: http://www.monash.edu.au/migr/supervisors/membership/ Please note: Quality reviews and systematic reviews are not acceptable for BMedSc(Hons) projects. The project that BMedSc students undertake, must be ORIGINAL RESEARCH. Project outline (~ 200 words) 3 Physical Location of BMedSc(Hons) Honours Project: Location where proposed project will be undertaken (Indicate School and Department or location of research site and where relevant, state or overseas). THE SECTION BELOW MUST BE FILLED IN IF THE RESEARCH PLACEMENT IS NOT BASED AT ONE OF THE MONASH UNIVERSITY FMNHS SCHOOLS, OR ASSOCIATED RESEARCH INSTITUTES. 1. Monash Main Supervisor to explicitly outline reason the reason why the student is required to study at the external and/or overseas research site. The supervisor must make a strong case for placements that are overseas. 2. Monash Main Supervisor to explicitly state the previous working collaboration with the Associated External Supervisor. If the student will be placed overseas, the Monash Chief Supervisor must clarify how they will maintain regular contact with the student and with the external supervisor while the student is at their placement. The Monash Main Supervisor will also be responsible for: 1) ensuring Monash ethics is obtained in a timely manner, 2) assigning examiners for their student and 3) for examining the literature review and thesis for another student within the BMedSc cohort. Monash Main Supervisor to tick which FMNHS School they are attached to (this data will be used to determine oversight of student assessments and to direct the faculty funding to the appropriate school) ARMI CENTRAL CLINICAL SCHOOL EASTERN HEALTH CLINICAL SCHOOL HUDSON INSTITUTE OF MEDICAL RESEARCH – (previously known as MIMR-PHI) SCHOOL OF BIOMEDICAL SCIENCES SCHOOL CLINICAL SCIENCES SCHOOL OF PRIMARY HEALTH CARE SCHOOL OF PUBLIC HEALTH & PREVENTIVE MEDICINE SCHOOL OF RURAL HEALTH OTHER (please state):________________________________________ 4 Main Supervisor to complete (MUST BE SIGNED). (1) I have discussed this project with the student and, YES NO from within the cohort (this is an expectation of all supervisors) YES NO Have the appropriate ethics approvals been granted or applied for? YES NO I have agreed to supervise the student on this project. (2) (3) I agree to mark another student’s literature review and thesis If yes, please provide approval number. If no, please provide expected submission date: _________ Note: ALL BMedSc(Hons) projects, including those with external research institutions and universities, require Monash ethics clearance unless no humans, animals, tissues or database data will be used in the project (eg projects only using immortalised cell lines). (4) Do you anticipate being absent for any periods in excess of 2 weeks during the academic year? YES NO If yes, please advise time and duration of absence: ____________________________ (5) How many Honours students have you supervised? BMedSc(Hons) ___________ Other_________ Signature: ___________________________________________ Date: ________________________ Co- Supervisors to complete (MUST BE SIGNED). All students are required to have a co-supervisor. (1) I have discussed this project with the student and, I have agreed to co-supervise the student on this project. (2) YES NO YES NO Do you anticipate being absent for any periods in excess of 2 weeks during the academic year? If yes, please advise time and duration of absence: ____________________________ (3) How many Honours students have you supervised? ? BMedSc(Hons) ___________ Other_________ Signature: ___________________________________________ Date: ________________________ SECTION 3 This section (MUST BE SIGNED) by the appropriate BMedSc(Hons) School Representative for students whose Main Supervisor is associated with CCS, SCS or SPHPM. For all other students, this form must be signed by the Head of School or Department, to which the Monash Main Supervisor is attached. I fully support this application and I am satisfied that appropriate resource/s, permit/s and supervision is/are available in this Department/School/Institute for successful completion of the above named project. Signature: ________________________________________________________ Date: ________________________ Print Name: _______________________________________________________School /Dept___________________ 5 Contacts: BMedSc(Hons) School Representatives and BMedSc(Hons) School Contacts SCHOOL BMedSc(Hons) SCHOOL REPRESENTATIVES and BMedSc(Hons) School Contacts CENTRAL CLINICAL SCHOOL CCS BMedSc(Hons) REPRESENTATIVE: Professor Jennifer Hoy – email: Jennifer.Hoy@monash.edu Phone: +61 3 9076 6900 PA: Mary Bowes 9076 5436 SCHOOL OF CLINICAL SCIENCES HUDSON INSTITUTE OF MEDICAL RESEARCH (previously known as MIMR-PHI) EASTERN HEALTH CLINICAL SCHOOL SCS BMedSc(Hons) REPRESENTATIVE: Dr Anthony White – email: anthony.white@monash.edu SCHOOL OF BIOMEDICAL SCIENCES ARMI SCHOOL OF PRIMARY HEALTH CARE School Contacts: A/Professor Jan Coles – 990 24461 email: Jan.Coles@monash.edu BMedSc(Hons) Chief Examiner - bmedsc@monash.edu SCHOOL OF PUBLIC HEALTH & PREVENTIVE MEDICINE SPHPM BMedSc(Hons) SCHOOL REPRESENTATIVE: Professor Allen Cheng email: allen.cheng@monash.edu SCHOOL OF RURAL HEALTH School Contact: BMedSc(Hons) Chief Examiner - bmedsc@monash.edu OTHER Contact: BMedSc(Hons) Chief Examiner - bmedsc@monash.edu School Contacts: Dr Carmel Pezaro – email: carmel.pezaro@monash.edu BMedSc(Hons) Chief Examiner - bmedsc@monash.edu School Contacts: Dr Melanie Pritchard - 990 29221 - email Melanie.Pritchard@monash.edu BMedSc(Hons) Chief Examiner - bmedsc@monash.edu Applications to be submitted online at: https://applicant.connect.monash.edu.au/connect/webconnect Applications close 3rd September, 2015 6