SPL and NCIGT Radiology Research Training/Visiting Scholar Request                        
The SPL and NCIGT in the Department of Radiology of Brigham and Women's Hospital, a teaching affiliate of Harvard Medical School, welcome qualified investigators who are interested in training or performing research with us. Please note that we are not a degree granting program. Students working on projects with us are typically enrolled in a degree granting program at universities elsewhere. Visiting faculty have positions in their own institutions. If you are interested in training or performing research with us, please fill out this form.  It will help us assess the fit between your skills/interests and our program.


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Full Name *
Email Address *
Institution *
Your current supervisor's name *
Your current supervisor's email address *
Videoconference ID  
For a possible video conferenced interview.  Google Hangout or Skype ID are preferred.
Please specify the degree(s) you have completed *
Required
Current Enrollment/Position *
Please specify what educational/degree program you are currently enrolled in or what position you currently hold.
Required
Your Proficiency in 3D Slicer Programming
Please visit http://www.slicer.org to learn about 3D Slicer. Knowledge of this platform will greatly increase your productivity in our environment.
Clear selection
Your Proficiency in Algorithm Development for Image Segmentation, Registration, or Machine Learning
None
Expert
Clear selection
Your Proficiency in Surgical Navigation Technology
None
Expert
Clear selection
Your Proficiency in Robotics Technology
None
Expert
Clear selection
Your Experience in Radiology (for medical graduates)
None
Attending/consultant at home institution
Clear selection
Your Proficiency in Surgery (for medical graduates)
None
Attending/Consultant at home institution
Clear selection
If a medical graduate intending to apply for residency in the US eventually, please provide USMLE scores
Your CV *
Pllease include a url to your CV.
What are your research or training goals for this time at Brigham and Women's Hospital? *
This is your cover letter to us. The one you would otherwise send in an email to individual faculty members in our institution. 5 sentences are usually adequate.
Please specify your visa needs/status *
If you are coming for less than 2 weeks to visit (not perform research) you do not need a special visa. We are not a degree granting institution so we can not provide an F1 visa. These are training or visiting researcher positions that are only eligible for J1 visas.  
Please select all the relevant options regarding your funding for the duration of your stay. *
If applicable, when do you expect to hear the decision about your institutional/government funding?
Please note that for international applicants, the earliest start date will be 4 months after we obtain confirmation of this funding.
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What is your target start date? *
Please note that for international applicants, the target start date may not be earlier than 6 months after this initial application.
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What is the expected duration of your stay? *
Please select 1 to 5 faculty whose work you are interested in. You can select more but that usually doesn't help us make a good match. *
For more information on investigators, please visit: https://spl.harvard.edu/ or https://ncigt.org 
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