FormBRecommendation&StatementofSupportfromApplicant'sHOD_2011intake.doc

1、Yong Loo Lin School of MedicineDivision of Graduate Medical StudiesBlock MD5, Level 3, 12 Medical Drive, Singapore 117598Tel: (65) 6516 3300 Fax: (65) 6773 1462Email: dgmsnus.edu.sgWebsite: www.med.nus.edu.sg/dgmsCompany Registration No: 200604346EFORM B RECOMMENDATION AND STATEMENT OF SUPPORT FROM

2、APPLICANTS HEAD OF DEPARTMENT CONFIDENTIALName of applicant: Degree applied for: MASTER OF CLINICAL INVESTIGATIONTo applicants Head of Department: The person named above is applying for admission into the Master of Clinical Investigation (MCI) programme conducted by the Division of Graduate Medical

3、Studies, National University of Singapore. The Division would appreciate receiving a confidential report from you on the applicant, as well as a confirmation of your institutions support for the applicant to pursue the MCI course. All information will be kept confidential. The MCI programme is compl

4、eted in 2 years, and comprises both coursework and research components. In the first year, students will complete 12 weeks of full-time coursework at NUS (6 weeks in Aug-Sep, and another 6 weeks in Feb-Mar). In the second year, there will be regular meetings and mentoring from a panel of experts, an

5、d students are expected to submit a grant proposal by 31 March of the second year. A grant of S$5,000 will be provided towards consumables and other costs incurred by the students research project. This fund will be managed by the host institution, and the Head of Department is required to counter-s

6、ign all claims submitted by the student.Please send your report in a sealed envelope bearing your signature across the seal, to: Course Administrator, Master of Clinical Investigation, Division of Graduate Medical Studies, National University of Singapore, MD 5, Level 3, 12 Medical Drive, Singapore

7、117598. Thank you. 1. How long have you known the applicant and in what capacity?5 years2. Among the staff at a similar level you have known in recent years, how would you rate the applicant? Exceptional (highest 5%) Average (next highest 25%)Outstanding (next highest 5%) Below Average (lowest 50%)A

8、bove average (next highest 15%) Unable to judge3. What is your recommendation concerning admission?The applicant has my highest recommendationI recommend the applicant with confidenceI recommend the applicant with some reservationI do not recommend the applicant4. The applicant has the support of th

9、e department to incorporate research into his work.Yes No5. The applicant will be given protected time to complete his/her training in MCI.Yes No6. Personal report on the applicant (please comment on the applicants talent, aspiration, track record in research and future career plan)Name: Institution & Department: E-mail Address: Contact Number: Mailing address: Signature: Date: