APPLICATION FORM (DUE BY August 15th

, 2012)

METODOS EN EPIDEMIOLOGÍA CLÍNICA RESPIRATORIA

(MECOR)

MÉTODOS EM EPIDEMIOLOGIA CLÍNICA RESPIRATÓRIA (MECOR)

METHODS IN EPIDEMIOLOGIC, CLINICAL & OPERATIONS

RESEARCH (MECOR)

November 5

th thru 10

th, 2012 – Pelotas, Brasil

LEVEL 2: ADVANCED CLINICAL RESEARCH METHODS Is a continuation of the Level 1 Course and focuses on clinical epidemiology and advanced

clinical research methods. Level 2 is recommended for all in pulmonary medicine who are

interested in advancing their skills in clinical research. It is also appropriate for individuals

who wish to improve their skills in reading the literature and research design. Prerequisite is

the IRE Basic/MECOR Level 1 Course or equivalent in experience in basic research methods.

The textbook used is Designing Clinical Research: An Epidemiologic Approach 3rd

Edition by

Stephen Hulley (2nd Edition, Lippincott, Williams & Wilkins). Older editions will also suffice.

LAST NAME FIRST NAME

NUMBER & STREET ADDRESS APT/SUITE/ROOM

CITY STATE ZIP CODE

COUNTRY HOME TELEPHONE # FAX#

*** Please include country and city codes

ATS MEMBER # (if member) ALAT NUMBER# (if member)

E-MAIL:

Important : MECOR staff COMMUNICATES with applicants by e-email. You **MUST** provide a reliable

email address and check it frequently!! PLEASE WRITE CLEARLY !!

INSTITUTION/HOSPITAL/AGENCY WORK TELEPHONE# DEGREE

LEVEL

2

Requirement : Those of you living in Pelotas area must consider dedicating your full attention to the

course during this week You will not be able to attend to your normal work and family activities. The

course is very intense.

I. CURRICULUM VITAE

Please attach a brief C.V. that describes your training, degrees held, experience, publications, and

previous experience with IRE/MECOR Courses.

II. ESSAY (English only)

Please attach a brief summary of your interests, responsibilities and experience (if any) with research,

teaching, public health and epidemiology. Include a brief paragraph about your expectations for this

course, your professional goals and indicate how you expect to be able to use the information you gain

in this course in your professional life. Please be as specific as you can. Also, please describe how you

have used the experience gained in any previous MECOR Courses in your professional life.

III. TUITION

Tuition for Introduction to Clinical Research Methods is $200 US. Payment will be due on

September 15th

after you have been notified of your acceptance. Applicants will be notified of their

acceptance within fifteen days of the application deadline. Credit card payments (Visa, MasterCard, and

American Express) are preferred.

Comments or Questions :

________________________________________________________________________________________________________

________________________________________________________________________________________________________

Please Complete Online Application form with Curriculum Vitae, Essay for receipt by August 15th

, 2012.

(Once received by Application Assistant, applications will be forwarded to Dr.Cecilia Patino-Sutton, Course

Director, and Dr. Ana Menezes, MECOR LA Director)

Applicants will be notified of the decision by August 31st,

2012

For more information contact:

Gabriela Patiño, Application Assistant

e-mail: gpatinoire@yahoo.com

fax : 54-351-485-3316