Resident Research Scholar Award Application - Society of University Surgeons (SUS)

Resident Research Scholar Award

Do not start this form unless you have all the necessary documents.

I am applying for the following award:(Required)

The SUS FOUNDATION funded award is intended for residents in any of the surgical disciplines who are doing basic/translational, clinical, health services, surgical education, or bioengineering/information technology research

The KARL STORZ funded award is intended for residents or fellows in any of the surgical disciplines who are working with an SUS member doing research in one of the following topics:
Digital Technology in the OR
Augmentation (often referred to as Artificial Intelligence in the OR) on clinical outcomes and operating room efficiency.

Resident Research Scholar- FOUNDATION

Resident Research Scholar- KARL STORZ

Please describe how your research meets the criteria for the KARL STORZ funded award (Digital Technology or Artificial Intelligence in the OR)(Required)

General Information

Name(Required)

First Last Degree(s)

Email(Required)

Post Grad Year(Required)

If other, enter Post Grad Year

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Post Grad Year(Required)

Institution(Required)

Primary Institution Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Primary Institution Phone Number(Required)

Primary Institution Department(Required)

Are you doing your research year at another (secondary) institution?(Required)

Yes

Secondary Institution(Required)

Secondary Institution Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Secondary Institution Phone Number(Required)

Secondary Institution Department(Required)

Project Title(Required)

Grant Category(Required)

Basic/Translational

HSR/Outcomes

Education

Letters of Recommendation

The following TWO letters of support must be included with your application:

1. SUS MEMBER RESEARCH MENTOR: To meet the eligibility requirements, the SUS Member Research Mentor must be a member in good standing. They may check their member status by contacting the SUS Membership Department at [email protected].

2. DEPARTMENT CHAIR.

Your Research Mentor and Department Chair may be the same person. They must upload two separate letters. In this case, the letter from the Department Chair may be kept short.

SUS Member Research Mentor Letter of Recommendation(Required)