Department of Medicine Annual Research Day

NOTE: Only use this form if you are part of the MSRP (Medical Student Research Program).

MSRP Abstract Submission Form

* - Required Field

Abstract Presenter Name*	*
Is the Abstract Presenter also the 1st Author?*	Yes No *
Name of Faculty Mentor*	*
Faculty Mentor UMMC email address*	*Invalid Email
Please list the department, division, or school your research is associated with:*	*
MSRP Academic Rank*	MSRP Medical Student M1 MSRP Medical Student M2 MSRP Medical Student M3 MSRP Medical Student M4 *
Primary Research Area*	Basic Science Research Translational Research Clinical Research Population-Based Research Vignette/Case Report Unsure *
Secondary Research Area*	Basic Science Research Translational Research Clinical Research Population-Based Research Unsure *
Abstract Title*	*
Author(s) Name(s), Institutional Affiliation, UMMC Departmental/Divisional Affiliation(s).*	*
Summary Statement* Provide a 25-word summary of the research with key points highlighted, providing a basis for discussion and interaction.	*
Abstract Text* Word limit is 250 words. For Basic, Translational, Clinical, and Population abstracts, include the following headings: Introduction, Methods, Results, and Conclusion. For Vignettes/Case Reports, include the following headings: Introduction, Case Description, and Discussion.	*
Upload complete Abstract in MS Word format.*	* *.txt,*.doc,*.docx,*.xls,*.xlsx,*.pdf, *.gif,*.jpg,*.jpeg,*.bmp,*.png,*.tif,*.tiff
Abstract Presenter UMMC Email Address* (confirmation email and all communication will go to this email address)	*
Abstract Presenter Phone Number	() - ext.***