Graduate School of Medical Sciences (GSMS)
REGISTRATION FORM GSMS
1.
Institute:
BCN (choose Faculty)
CRCG
GUIDE
Kolff
SHARE
Faculty of Medical Sciences
Faculty of Arts
Faculty of Mathematics and Natural Sciences
Faculty of Philosophy
Faculty of Behavioural and Social Sciences
IMPORTANT! PLEASE INDICATE THE RESEARCH PROGRAM(S) ON PAGE 4!
2. Doctoral candidate
2a. Last name and initials:
First name:
Gender:
(male/female)
Date and place (country) of birth:
Address (please mention your address in Groningen)
Home address:
Postal code and city:
Telephone number:
E-mail address:
2b. Work address (please mention the department of your present position at the UMCG or Faculty)
Department:
UMCG Sector:
Telephone number:
Internal postal code (HPC):
E-mail address:
(you need to have a regular UMCG or Faculty e-mail address)
P-number:
(6 numbers)
U-number:
(5 numbers)
(you need a RuG-registration number (p-number). Ask the Manager of your Department)
3.
Level of education/university degree
Discipline:
(Please mention the studies you graduated in)
Degree:
Ba
University:
Graduation date:
4.
Start of project on:
End of project on:
5.
Education
Ma
(dd-mm-yyyy)
(dd-mm-yyyy)
(dd-mm-yyyy)
You are expected to take part in the Graduate School’s education programme.
6.
Project title:
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GSMS Registration form October 2014
Graduate School of Medical Sciences (GSMS)
7.
Promotor 1*:
Promotor 2*:
Promotor 3:
E-mail:
E-mail:
E-mail:
Co-promotor 1*:
Co-promotor 2:
E-mail:
E-mail:
(*each PhD must be supervised by at least two formal supervisors, namely two full professors (promotors) or
one full professor (promotor) and one co-supervisor (copromotor))
Please fill in maximum 3 in total.
8a. Type of PhD contract:
Employee UMCG/RUG
o PhD research is main task
□1.0 fte
□ 0.8 fte
□ < 0.8 fte
o PhD research is NOT the main task
Scholarship student
o (internal) ATTP
o (external) name Scholarship:
o 4 years
o 2 years (sandwich)
MD/PhD-student
HBO teacher
Extraneous
o receives limited time or money from own organization other than UMCG/RUG
o does not receive time or money from any source
Other, namely:
8b. Funding:
GS-1: Direct funding by University or UMCG
GS-2: Governmental funding obtained in (inter)national competition (NWO, ZonMW, etc)
GS-3: Charity, Industry or other EU funding
GS-5: Personal funding (of any source e.g. Governmental funding or other scholarship from PhD
student’s home country or other personal funding)
GS-0: None of the above
9.
Goal of the doctoral candidate’s appointment
The goal is to do scientific research resulting in a dissertation. To achieve this goal the University of
Groningen (RUG) agrees to register the doctoral candidate for four years (100% position)* and to provide
adequate education and supervision. The doctoral candidate agrees to perform the appointed tasks and
obligations in this program.
*4 years – 100% is the standard PhD contract. There are several other categories of PhD-students and researchers.
These PhD-students and researchers agree to perform the appointed tasks and obligations in this specific
programme. Please indicate your type of contract ad 8a.
10. Teaching activities
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GSMS Registration form October 2014
Graduate School of Medical Sciences (GSMS)
The candidate may be involved in teaching activities to a maximum of 25% of his/her appointment.
Note: no teaching activities for ‘bursary’ students and MD/PhD-students.
11. Progress reports
The doctoral candidate is obliged to report on his/her activities regarding research as well as on the
(re-adjustment of the) research programme on a regular basis. Results of discussions, reports and
publications must be registered.
Each year, the doctoral candidate is obliged to submit a report to his/her research supervisors and project
leader(s) describing the work done during the previous year. This report should contain at least the
following:
- Progress and results of the research;
- Nature and amount of teaching activities;
- Information on the courses attended during the previous year and number of credits attained.
12a. Supervision
The supervisor(s) undertake(s) action to supervise the doctoral research by discussing and monitoring the
candidate's research plan and results.
12b. On average, this supervision will take
→ Please indicate the number of hours.
hours per week.
13. Assessments
The research supervisor will assess the doctorate candidate after the first year. The outcome of this
assessment will be authorised by the director of the research school. Its aim is to examine whether the
candidate will, in all likelihood, achieve the goal of the training programme: successfully completing his
or her doctoral research project and attaining a doctor's degree. A negative outcome may result in
termination of the appointment. A positive outcome commits those responsible to enable the doctoral
candidate to complete his or her project and thesis.
The assessment after the first year may give cause for a second assessment at a later date. In addition, a
performance appraisal interview is to be held each year.
Important! Please indicate the research program on page 4.
14. As agreed upon
Place:
Date:
(dd- mm-yyyy)
1st Promotor:
........................................
(name and signature)
Doctoral candidate:
(signature)
........................................
Signature director GSMS: .......................................
pp the post-graduate training committee:
........................................
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GSMS Registration form October 2014
Graduate School of Medical Sciences (GSMS)
15. Research programs
Important! The promotor may participate in one or several research programs, but the doctoral candidate can only
participate in one research program. Please indicate below the relevant program the doctoral candidate belongs to,
based on the candidate’s research topic.
BCN-BRAIN
o ANDDI
o CMI
o ICPE-2
o MOLAR
o PCN
o TN
CRCG
o DARE
o GUTS
o SALL
o TARGON
GUIDE
o 3GI
o BDDD
o CAPE
o CLDM
o CVC
o GKC
o GIOT
o GRIAC
o LM
o MHD
o MCB
o TRIGR
o VAP
KOLFF
o BIOBI
o NANOBIOMAT
o MOHOF
o REGENERATE
SHARE
o EXPAND
o HPR
o ICPE-1
o LCE
o M20
o PHR
o ROAHD
o SMART
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GSMS Registration form October 2014