ITHS TL1 Multidisciplinary Pre-doctoral Clinical Research Training Program
Summer Research Application Packet (Due March 24th, 2014)
Application instructions:
The applicant must complete and review sections 1-4 and return to the following email address by March 24th,
2014:
ithsedu@u.washington.edu
Please include the following in the subject line:
2014 TL1 Summer Research Application Packet
The mentor(s) must be copied when submitting the completed application.
The primary mentor must complete section 5 and return to the following email address by March 24th, 2014:
ithsedu@u.washington.edu
Please include the following in the subject line:
2014 TL1 Summer Mentor Statement
1. Student Commitment to Training Period & Report
If accepted into the TL1 Program, I agree to fulfill all NIH training obligations including but not limited to
completing PHS biomedical ethics training and completing and submitting NIH appointment and termination
letters.
Acceptance of funds entails an obligation to submit a report of activities carried out during the funded period. This
report should be in the form of a scientific abstract following the guidelines provided by the ITHS, and it should be
submitted to Robert DeSpain at ithsedu@uw.edu by January 15, 2015.
Approval/Acceptance Signatures
________________________________
Student Applicant
________________________________
Mentor/Preceptor
2. Required Curriculum and Attendance:
Specific coursework is required of students in the summer program. UCONJ 517, Interdisciplinary Clinical Research
Methods Seminar, is offered in the summer and attendance is required of all TL1 trainees. Tuition support is
provided for this course. One additional NIH requirement is the completion of the entire 2014 summer Biomedical
Research Integrity (BRI) Series.
I understand that I will be required to register for UCONJ 517 during the summer quarter and attend the summer
BRI series as part of my appointment.
________________________________
Student Applicant
I agree to serve as Director for the student’s independent study for the Research Project.
________________________________
Mentor/Preceptor
3.
Project Description
Please provide a description of the proposed research project. You should include:
 Summary of proposed project (not to exceed 200 words). Indicate how this project relates to
interdisciplinary clinical research.
 An introduction containing a review of published literature and other observations which serve as the
basis for the project.
 A statement of rationale and research objectives for the project.
 A description of the experimental protocols to be carried out.
 An explanation of how the data will be managed and processed, including statistical analysis where
appropriate.
 A statement of the significance of the work relative to the knowledge in that general area. The proposal
should not be more than a maximum of 5 pages, double-spaced typing (items 2-6 above). It should
include sufficient detail for satisfactory review by the Recruitment and Selection Committee. Please
provide a bibliography with citations for referenced items.
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4.
Budget Information
Will this project require funds for supplies, equipment, local travel, publication costs, Xerox, telephone costs,
subject participation payments, or other costs? (Up to $400 may be requested). Please itemize and show total
funds requested. Please note that the items/services requested will still need to be approved upon acceptance
into the TL1 program and must be consistent with NIH guidelines on allowable research costs.
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5.
Mentor/Preceptor's Statement
The primary mentor must complete this and return to the following email address by March 24th, 2014:
ithsedu@u.washington.edu
Please include the following in the subject line:
2014 TL1 Summer Mentor Statement
In the space provided, please provide a description of the following:
 How long and in what capacity have you known the applicant?
 What is the expected clinical/translational learning experience provided to the student, i.e.,
specific learning objectives?
 Please evaluate the student’s potential for a career in clinical/translational research. (If
applicable, indicate you do not know the applicant well enough to provide an answer.)
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Mentor/Preceptor's Assurance:
I take responsibility to assure that the student is provided the clinical/translational opportunity described herein.
________________________________
Mentor/Preceptor
________________________________
Date