NATIONAL MEDICAL RESEARCH COUNCIL

Annual Progress/Final Report for Scholarship/Fellowship

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All information is treated with confidence. The information is furnished to the National Medical Research Council with the understanding that it shall be used or disclosed for evaluation, reference and reporting purposes.

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All sections must be completed. Indicate “NA” where a particular section is not applicable.

For Final Reports, please provide information for entire period of training.

Fellow/Scholar must submit one hardcopy and one softcopy through the research coordinator of his/her institution.

For institution(s) without research coordinator(s), please submit directly to:

National Medical Research Council

11 Biopolis Way,

#09-10/11

Singapore 138667

Type of Scholarship/

Fellowship:

/ /

NRF-MOH Healthcare Research Scholarship

/

NMRC Research Training Fellowship

/

Master of Clinical Investigation (MCI)

Type of Report

/ /

Annual Progress

/ /

Final

Period of Report

(dd/mm/yyyy to dd/mm/yyyy) / to
Start Date
(dd/mm/yyyy)
Expected Completion Date
(dd/mm/yyyy)
Scholar/Fellow / Name:
Employing Department:
Employing Institute:
Clinical Designation:
AST/BST and Year:*
Academic Designation:
Place of Training / Department:
Institute:
Research Supervisor / Name:
Designation:
Department:
Institute:

*Please indicate if applicable.

SECTION 1: Coursework

1.1 Please indicate if you have completed the required coursework modules:

Yes No Not applicable

1.2 Please provide the list of coursework modules taken in the reported duration.

1.3 If you have not completed the required coursework modules, please state the reasons.

SECTION 2: RESEARCH COMPONENT

2.1  Title of research project:

2.2 Abstract

Please provide an abstract of 200-300 words of your research work. It should include the aims, hypotheses and summaries of methodology, result(s) and discussion (if any).

2.3 Problems or Challenges encountered

Please highlight any problems or challenges encountered in the course of research and suggest reasons (if any) and solutions.

2.4 Change(s) from original proposal

Please highlight any change in the aims and/or methodology (if any) from the original proposal and justify for the deviation(s).

2.5 Outcome/Output Indicators

Please fill in the table (only if relevant or applicable).

Indicators / Expected / Achieved / Remarks
(i) Publications
- For each publication accepted, in press or published, please provide the details as per Appendix 1.
(iii) Conferences
- For each presentation at conferences, please provide the details as in Appendix 1.
(iii) Awards (National and International)
- For each award for research, please provide the details as in Appendix 1.
Others - Please specify (e.g., grants won, patents filed.)
- Please provide the details as in Appendix 1.

2.6 Suggestions and feedback

Please highlight any other significant observations and lessons learnt from the research training program; e.g. the challenges, best practices encountered and etc. Please provide suggestions for improvement, feedback and etc (if any).

2.7 Research plan upon completion of training (For candidate doing the final year only)

For candidate into the final year, please indicate your research continuity plan upon successful completion of your research training (i.e., for at least next 5 years).

SECTION 3: DECLARATION BY SCHOLAR/FELLOW

I declare that the information furnished in this report is true and accurate.

______Signature of Fellow/Scholar / ______
Date
(dd/mm/yyyy)

SECTION 4: COMMENTS AND ENDORSEMENT BY RESEARCH SUPERVISOR

4.1 Comments by Research Supervisor

Please provide comments on the progress of the Scholar/Fellow. A separate piece of paper may be used if required.

4.2 Endorsement by Research Supervisor

______
Signature of Research Supervisor
Name: / Date
(dd/mm/yyyy)

SECTION 5: COMMENTS AND ENDORSEMENT BY HEAD OF DEPARTMENT AND INSTITUTION / MEDICAL SCHOOL

5.1 Comments by Head of Department (HOD)

Please provide comments on the progress of the Scholar/Fellow. A separate piece of paper may be used if required.

5.2 Endorsement by HOD

______
Signature of HOD
Name: / ______
Date
(dd/mm/yyyy)

5.3 Comments by Director/CEO of Institution or Dean of Medical School

Please provide comments on the progress of the Scholar/Fellow. A separate piece of paper may be used if required.

4.3 Endorsement by Institution / Medical School

______
Signature of Director/CEO of Institution OR Dean of Medical School*
Name: / ______
Date
(dd/mm/yyyy)

APPENDIX 1: Format for reporting outcome/output of research

Please indicate only if relevant or applicable. Please add boxes where required.

Publication

Status: Published In Press Accepted Submitted

Author Names:

1st Author Nationality:

Title of Article:

Journal Name:

Publisher:

Year/ Issue/No.:

Page No.:

Impact Factor (if any):

Please provide softcopy and 1 hardcopy of each published articles.

Conference

Author Names & Nationalities:

Title of Article:

Conference Name:

Page No. of Abstract:

Organiser/Publisher:

Country/State:

Date:

Please provide softcopy and 1 hardcopy of each published articles.

Award (International/Local)

Title of Article:

Name of Award:

Awarding Authority:

Date awarded:

Patent

Status: Filed Awarded

Author Names & Nationalities:

Title of Patent:

Covering Countries:

Filing Office:

Date of Filing:

Date of Award:

Invention Disclosure

Inventor Names & Nationalities:

Co-Inventor Names & Nationalities:

Title of Invention Disclosure:

Date of Invention Disclosure:

Grants

Status: Applied Awarded

Title of Research:

Role: Co-PI Co-Investigator Collaborator

Funding Agency:

Funding Amount:

Support Period (DD/MM/YY to DD/MM/YY):

Please indicate Names and Institutions of other PIs, Co-Investigators, Collaborators:

No. of Spin-offs & Start-ups from results of Research:

Spin-offs of a pilot collaborative study:

No. of new products/ processes/ services commercialized:

Royalties and Licensing Revenue from Research:

Industry Funding

Title of Research:

Name of Industry Partner:

Funding Amount:

Support Period (DD/MM/YY to DD/MM/YY):

Please indicate Names and Institutions of other PIs, Co-Investigators, Collaborators:

No. of Spin-offs & Start-ups from results of Research:

No. of new products/ processes/ services commercialized:

Royalties and Licensing Revenue from Research:

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