DAGMEC Abstract Title*Required Resident Name*RequiredFirstLast Residency Program/Fellowship*Required Resident E-mail*Required Program Director E-mail*Required Sponsor (if applicable) Other Authors with Affiliation or Residency Program Level in Current Program*RequiredSelect valueR1R2R3R4R5R6F1F2F3Research Year Faculty Advisor Name*Required Faculty Advisor Email *Required Faculty Advisor Primary Affiliation *Required Type of Project*RequiredPatient Safety/Quality ImprovementClinical ResearchCase Reports/Case SeriesFELLOW's ProjectsClick here for more information about the category descriptions Is this research still in progress?*RequiredYesNo Will the research be completed before the date of the forum? *RequiredYesNo This project is eligible for submission, and if accepted will be included in the judging so that you will have the benefit of judges’ feedback (if any), however, it will not be eligible for any of the prizes.*RequiredI understand. IRB Approved?Wright State UniversityKettering Medical CenterPremier Health PartnersMilitary/VAChildren's Medical Center, Dayton N/APlease be aware IRB approval is required for all projects except case reports/case series, unless the research is NOT classified as human subjects research. Date IRB Approved (if necessary) Abstract (900 character Minimum, 3000 character maximum)*RequiredOnce you submit your application, it will be sent to your program director for approval. If you do not receive confirmation of acceptance from DAGMEC within one week of submitting your application, please check with your program director to confirm that they have submitted approval for the project, please contact heidi.sowl@wright.edu.SubmitReset
