IR Interest Group Registration with SIR
Medical school name: *
Current student IRIG leader(s): *
Primary contact email for IRIG: *
This will be the contact email posted on the SIR MSC site. Put "none" if there is an issue with this. Please follow all addresses, even if just one to enter, with a semicolon ";";;
Year founded (If known):
Founding member(s) (If known):
RIG, IRIG, or combined? *
Faculty advisor(s): *
For RIGs: name of IR-specific advisor, or mark (DR) if not
Resident/fellow mentor (if any):
Estimated month of IG leadership turnover (eg. every May): *
Reply with expected annual month
Anticipated new leadership name and email (if available):
Number of active interest group members: *
Approximate to nearest 10 if possible
Number of IR-specific events held in past calendar year: *
e.g. LTTs, DTTs, workshops, other
Have you hosted a symposium/local-regional conference in the past year? *
Does your group and/or school provide IR-specific RESEARCH opportunities? *
(including simply aiding interested members connect with faculty)
Does your group and/or school provide IR-specific SHADOWING opportunities? *
(including simply aiding interested members, esp. 1st and 2nd years, connect with faculty)
Does your school have a specific IR clerkship/elective for M3s and M4s? *
Does your school or your group have any social media accounts? *
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy