The University of Iowa

Medical Scientist Training Program

Carver College of Medicine

SUMR Program Application Instructions

  1. Complete the SUMR Program application below.
  2. Submit the following to SUMR@uiowa.edu:
    • A.   Your CV or Curriculum Vitae
             (view a sample CV)
    • B.   A copy of your transcript(s) from your undergraduate institution(s).
            Unofficial copies are acceptable. Official copies will be requested later, if needed.
  3. Submit 2 Letters of Recommendation (One letter must come from your primary research mentor).
  4. Letters should be emailed to SUMR@uiowa.edu. Hard copies scanned and emailed from your mentor or mentor's office are acceptable.

    If mailing is preferred, please send to the address below:

    SUMR Program
    University of Iowa
    2206 MERF
    Iowa City, IA 52242

    The application deadline is February 3, 2014 (applications received after midnight, central standard time, will not be accepted).  This deadline DOES NOT APPLY to letters of recommendation or transcripts.

NOTE: You are unable to save this application for completion at a later time. We recommend you use this WORKSHEET to assist you in gathering information prior to starting the application.

Please print a copy (paper or .pdf) of this application before hitting the "submit" button at the bottom.



2014 SUMR Program Application

How did you hear about the Iowa SUMR Program:

Other:


PERSONAL INFORMATION:

First Name:
Last Name:
E-Mail:
Permanent Address:
Address Line 2
City
State Zip Code
Phone:
( )
Address at Undergraduate Institution:
Address Line 2
City
State
Zip/Postal Code
Phone:
( )
Are you a United States Citizen?
Yes No
If "no," are you a permanent U.S. Resident?
Yes No
Date of Birth:
(MM/DD/YYYY)
Sex:
Male Female
Race and/or Ethnic Origin (optional):
African American
Latino (a)
Latino (a)
White
Native American/American Indian
Native Pacific Islander
Other (please specify)

Expected date of graduation: (MM/DD/YYYY)

Undergraduate Institutions Attended (List in chronological order, most recent first)
Current Undergraduate Institution attended (ONE)
Institution
Location
Dates Attended
Major
GPA
  Degree  
Undergraduate Institution (TWO)
Institution
Location
Dates Attended
Major
GPA
  Degree  
Undergraduate Instiution (THREE)
Institution
Location
Dates Attended
Major
GPA
  Degree  
Previous Research Experience (List in chronological order, most recent first)
Most Recent Research Experience (ONE)
Dates of Research Experience
Average Hours Per Week
Research Mentor and Institution

Description of the Project Including any Project Accomplishments and/or findings
Current number of words remaining:

Your role in the Project
Current number of words remaining:

Abstract or Publication reference or citation associated with this research experience if applicable
Current number of words remaining:

Previous Research Experience (TWO)
Dates of Research Experience
Average Hours Per Week
Research Mentor and Institution

Description of the Project Including any Project Accomplishments and/or findings
Current number of words remaining:

Your role in the Project
Current number of words remaining:

Abstract or Publication reference or citation associated with this research experience if applicable
Current number of words remaining:

Previous Research Experience (THREE)
Dates of Research Experience
Average Hours Per Week
Research Mentor and Institution

Description of the Project Including any Project Accomplishments and/or findings
Current number of words remaining:

Your role in the Project
Current number of words remaining:

Abstract or Publication reference or citation associated with this research experience if applicable.
Current number of words remaining:

Please tell us from whom we should be expecting your letters of recommendation.

1st Recommender
Name:
Title:
Address (line 1)
Address (line 2)
City
State
Zip/Postal Code
Telephone Number:
( )
Email:
2nd Recommender
Name:
Title:
Address:
Address Line 2:
City:
State
Zip/Postal Code
Telephone Number:
( )
Email:

Please rank the three top research areas you would like to pursue in our program:
First:

Second:

Third:

Are there any faculty members you are interested in working with or other information that can help us
identify a research mentor? (Note: we cannot guarantee placement in any specific lab)
Current number of words remaining:

Discuss briefly your educational and/or career plans and your reason for interest in MD/PhD training:
Current number of words remaining:

Add any additional information that may help us evaluate your application:

I certify that the information in this application is true and correct to the best of my knowledge.

Date: (MM/DD/YYYY)

IMPORTANT: Please take a moment and either print or save your application in case there is a problem with the submission.

After pressing "Submit Application," you should see a screen displaying the information you entered. You will also receive an automated email confirming your application was submitted. If you do not, please email SUMR@uiowa.edu.