DAGMEC

Abstract Title*Required

Resident Name*Required

First

Last

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*Required

Faculty Advisor Name*Required

Faculty Advisor Email *Required

Faculty Advisor Primary Affiliation *Required

Type of Project*Required

Patient Safety/Quality Improvement

Clinical Research

Case Reports/Case Series

FELLOW's Projects

Click here for more information about the category descriptions

Is this research still in progress?*Required

Yes

Will the research be completed before the date of the forum? *Required

Yes

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.*Required

I understand.

IRB Approved?

Please 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)*Required

Once 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.