NOSM U PGME- Request for Access to Residents for Research Purposes

Request edit access

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Associated policy can be found on our Policy & Procedures site

Email *

Date of request *

YYYY

By when are you hoping to have this circulated?

(Note: This request may take up to 20 business days for review and approval)

YYYY

Title of Research Project *

Name of researcher(s) involved *

Name of affiliated organization(s) involved in research *

Type of research study *

Please identify your intended participants (is there a specific discipline, year you are wishing to target in this study)? *

Intended audience for research *

Research Ethics Board Approval has been obtained *

Yes

REB* Approval date

(*Approved REB & any associated documentation should be submitted to postgrad@nosm.ca as part of approval review)

YYYY

Have you obtained any additional required institutional approvals? (e.g. biosafety)

Note: Please submit any copies of additional approvals to postgrad@nosm.ca as part of NOSM U PGME approval review

Have you received any source of in-kind or actual funding for the research project? If so, please disclose and detail below.

As the requestor, I/We are advising of the following:

(Please select all that apply)

Any actual or perceived COI is included in the invitation to participants

Residents in the role of research participants will do so in accordance with the TCPS

The proposed study represents an acceptable safety risk

The research study is not intended to promote the use of a commercial product

The research protocol has measures in place to protect the anonymity & privacy of participants

The following is a checklist of documents which must accompany this application and be sent directly to postgrad@nosm.ca :

A copy of the research protocol approved by the REB including associated documentation

A copy of any other institutional approvals required (e.g. Biosafety)

Written disclosure of the source of any in-kind or actual funding for the research project or COI

A detailed summary of expected resident participation and associated timelines/deadlines

A copy of the proposed invitation for resident participants

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