public defence application - Karolinska Institutet · Web view2017/12/08 · KTH Royal Institute...

Form 9; D1-D7

PUBLIC DEFENCE APPLICATION FORM

The purpose of the application is to ensure that the doctoral student meets all the requirements for defending a thesis at Karolinska Institutet and to propose an Examination Board and an opponent. The application is sent to the Dissertation Committee, which is appointed by The Committee for Doctoral Education to ensure compliance with the examination rules.

The application comprises:

Part 1

1A – to be submitted electronically to [email protected]

APPLICATION FORM, D1-D7 in word format

ONE (1) PDF-file containing the following in the order indicated below:

1. APPLICATION FORM, D1-D7 (with all signatures)

2. First page / title page of all constituent papers (incl. author list and affiliations).

3. Copy of transcript from half-time/licentiate seminar.

4. Copy from ISP point 4 supervisors. As well as possible changes in the supervisor's constellation.

5. From LADOK: Certificate of Registration and Official Transcript of Records6. OTHER ATTACHMENTS (if required: see instructions)

1B – ORIGINAL hard copy to be sent by regular mail to the address indicated below or handed in.

APPLICATION FORM, D1-D7 with signatures

Any attachments containing signatures

Part 2 (for ethical review) to be submitted electronically to [email protected]

ONE (1) PDF-file containing the following in the order indicated below:

1. Copy of application form D1-D7.

2. Copies of all ethical applications and permits (decision with approval) stated in D4.

3. All constituent papers, including manuscripts (not necessarily in finished form), in full text.

Remember to retain a copy of your fully signed application form, which you will need later to send to the Examination Board and present to the faculty representative.

E-mail your application part 1A and part 2 to: [email protected]

Send your application part 1B to: or submit part 1B in person:Disputationskommittén 5th floor, BZ Karolinska Institutet Berzelius väg 3171 77 STOCKHOLM KI Solna campus

(marked “Disputationskommittén”)

Questions? Please contact the Dissertation Committee administrators: [email protected]

mailto:[email protected]




How to fill in the form

Part 1 First pageThis page contains a summary of the most important information needed for the Dissertation Committee to make its decision. When D1 has been signed by the chairperson of the committee, the application is considered approved. A copy of the signed D1 is to be presented to the faculty representative in connection with the “nailing” procedures.

Contact detailsMake sure to give an email address that you check regularly, as all decisions are announced by email. Note that instruction for the electronic “nailing” will be sent to your KI mail regardless of which e-mail address you state here.

KI-ID is the user name (usually five or six letters) for logging in to the KI web. The administration officer needs it to register you in the thesis database.

Degree titleState your desired degree title. Doctoral graduates at KI normally acquire the Swedish title “medicine doktor” (Med.Dr). Doctoral students at the Department of Dental Medicine may receive the degree title “odontologie doktor”. Students wishing to receive another Swedish degree (Fil.dr or Tekn.dr) must state the reasons for this and attach an attested copy of their first/second-cycle degrees. The English degree title is always PhD in the subject you are registered to, regardless of the Swedish title.

Examination Board and opponentFor rules regarding the Examination Board, see instructions for D3 below. Make sure to ask the person you choose as coordinator, as it is a more demanding commitment than for the other members of the Examination Board. ThesisNote that the entire title, including any subtitle, is to be given as it will appear on the printed thesis. At least two of the constituent papers must have been published or accepted for publication when the application is submitted.

DefenceState both room and department/hospital etc. (merely stating MEB, M63 or Karolinska University Hospital is insufficient). The defence should take place during the dissertation periods (see the KI website) and at a location in the Stockholm region that is convenient for KI’s students and staff to attend. The date and time is booked through your own department.

The time interval between the meeting of the Dissertation Committee and the defence should be about 10 weeks. This is to protect you from being forced to postpone the public defence at a later stage should the process be delayed for some reason. The defence chairperson must hold a PhD and a teaching position at KI. Note that the chairperson may not simultaneously take on the role of examiner (opponent) or sit on the Examination Board. The supervisors are recommended not to be chairperson.

Supervisors Main departmental affiliation is to be stated here (not clinic etc.). Correct contact details, particularly email addresses, are essential to swift processing. If correspondence is to be maintained with a co-supervisor instead of the principal supervisor please indicate this in the application.

Examination Board and opponent When assembling the Examination Board, the aim is for their combined expertise to cover the entire scope of the thesis. The members must be free in their judgement in order to eliminate any doubt that their decision was entirely objective.

At least one member must belong to another university than the doctoral student, principal supervisor and co-supervisors. This external member of the examination board may not currently be associated with KI i n any way (or the university of the principal supervisor or co-supervisors, in cases when either of them belongs to a different university than the doctoral student). The coordinator shall not belong to the same department as the doctoral student, the principal supervisor or any of the co-supervisors.

One member may come from the student’s own department (or the principal supervisor if he/she belongs to another department than the student). If possible, at least one member is to have been present on the board

D1

D3

D2

during the half-time seminar. There are normally three members, but in exceptional circumstances (e.g. if the thesis is explicitly cross-disciplinary) the number of members may be increased to five (in which case another copy of D3 must be made).

All members must hold the position of docent or professor. In exceptional cases, should there be special reason to do so, the Dissertation Committee may approve a member of the Examination Board who is not a docent or professor. To apply for such an exemption, a letter explaining the reasons and a CV (including a complete list of publications) must be appended to the application for the proposed member.

Note that you are presenting a proposal for Examination Board. The Dissertation Committee can decide that one or more members have to be replaced.

The university, departmentThe academic seat and departmental affiliation (not clinic etc.) of the members must be stated in the application. This information is necessary for deeming whether the requirement of external members has been met, and whether a possible conflict of interest exists.

Scientific expertise/reasonsThis information is needed by the Dissertation Committee to allow it to judge whether the Examination Board is properly composed. Each member is to be justified with a detailed description of his/her expert knowledge of the thesis field. Do not provide a simple CV with information about previous academic positions, number of doctoral students, number of publications etc.

The opponentThe opponent must be a researcher holding a PhD degree, possess expert knowledge of the thesis field, and have no conflict of interest in relation to the student, supervisors and project. The opponent need not hold a docentship. An exception to the PhD requirement may be made for a well-qualified professor, in which case a CV containing a complete list of publications for the proposed opponent must be submitted.

List of papers and ethical permits Factors such as number of constituent papers, personal contribution, place in list of authors, and impact factor of the journal are all taken into consideration when the Examination Board determines if the thesis meets the requirements for scope and quality expected after four years of doctoral studies.

The constituent papers must be presented in the same order and with the same title as in the intended thesis. If more than 5 papers, please use a copy of the form page.

Ethical permitsEthical permits are to be given with reference numbers (or similar) for each constituent paper. If for some reason the study has not undergone ethical review, the reason must be stated here.

Brief summary The Dissertation Committee, which does not have access to the full text of the constituent papers, needs this information to determine if the Examination Board possesses the proper competence.

The student’s personal contribution This account is important, as a doctoral student’s contributions to a study are not always obvious from the order of authors. A detailed account of the student’s contributions to all parts of the study must be made in relation to other co-authors. If the work also forms part of another student’s thesis, both their contributions must be described so that the input of the one is clearly distinguishable from the other.

D4 (prel.res.) – Preliminary resultsThis page is included so that an ethical review may also be made of any preliminary or unpublished results that are presented in the thesis, but that do not appear in any of the constituent papers. This only applies to results for which an ethical permit is required.

However, note that since the thesis frame is published and spread on the internet (e-nailing), subsequent publication might be difficult as the results have already been published.

The student’s knowledge, development and independence The aim of doctoral education is that the student develops into an independent researcher with the knowledge, aptitude and approach described by the Higher Education Ordinance in the intended learning outcomes for a doctoral degree. The principal supervisor must describe the student’s development during his/her course of doctoral studies. The signature certifies that he/she judges the student to have attained the intended learning outcomes and that the student may defend his/her thesis.

D4

D5

COI declaration signatures Conflict of interest declarationHere, the supervisors and the student certify that they are unrelated in any way to the proposed Examination Board members and opponent.

IMPORTANT: If undeclared co-publication (including multicentre studies and review articles) within the past five years is discovered, the application will automatically be rejected unless a letter is attached explaining why a conflict of interest does not exist despite these circumstances. Therefore, make sure to thoroughly search for co-publications (e.g. in the PubMed database for all supervisors before the application is submitted.

SignaturesExaminerFor all doctoral students on programmes other than medical science, general and subject-specific knowledge is assessed by an examiner who should be a docent or professor with knowledge of the subject and without ties to the project, student or supervisors. The examiner may come from the student’s own department, but this is not necessary.

OTHER ATTACHMENTS The printed first page of published articles and the title pages of manuscripts must be attached. These

documents are needed to check that the information given in the application form is correct and that the student is affiliated with KI on at least half of the constituent papers. The student must always appear as affiliated to KI on the title page of unpublished manuscripts.

If the papers have been accepted but not yet published, a confirmatory letter/email from the editor of the journal must be attached.

Please check that the details given in Ladok are correct.- Have all the courses you have attended been registered?- Have you accumulated all the credits stated in the general study plan? Do not forget to register participation in seminars/journal clubs and international conferences.- How much research activity has been registered? To defend your thesis, you must have the equivalent of four year’s full time study, which means 800% (max 100% per semester).

If the registered research activity at the time of public defence is below 800%, a signed statement from your principal supervisor must be attached describing the time, location and extent (%) of the activity not included in the Ladok extract.

Copy from ISP point 4 where supervisors are listed. All exchanges of supervisors must be reported with a copy on form 15.

A copy of the transcript from the half-time (or licentiate) seminar must be attached to the application so that the comments and recommendations contained within can be taken into account in the assessment of the student’s development.

Part 2 (for ethical review)Part 2 of the application consists of the documents needed for an ethical review of the constituent paper:

- A copy of the application form (pages D1 – D7)- Copies of all ethical applications and ethical permits (decision with approval) stated in D4- All constituent papers, including manuscripts, in full text. This applies even if the studies do not require an ethical permit. Incomplete manuscripts are to be submitted as they are (the most important part is the method section). Manuscripts need not have been completed until being submitted to the Examination Board for preliminary review.

Do not request documents from the Ethical Review Board (EPN) unless absolutely necessary. An unsigned copy of the application for ethical permits may be used. Should an ethical permit be written in a language other than English or Swedish, the permit holder must write a note certifying that it pertains to the research presented in the paper.

D6

D7

Received on (date) Ref No. (Dnr)

.............................................. ..................................................

D1

Public defence application Doctoral student Non-Swedish speaker

First name

Family name

Civil identity number

Department

Choose departmentSection/unit

Telephone no.

Email (for receipt of decision)

KI ID

Basic education (e.g. MSc in Biochemistry, Medicine, Nursing)

Desired Swedish degree title. English title is always PhD, regardless

“Medicine doktor“ Other*:

Examination Board (see D3)1. Coordinator, Name

University

2. Name

University

3. Name

University

Opponent (see D3)Name

University

ThesisTitle

Total number of constituent papers: of which number published or accepted for publication:

DefenceDate (yymmdd)

Venue, address

Defence chairperson (PhD with teaching position at KI, must not be opponent or Examination Board member.)

*See instructions for how to fill in the form.

DECISION OF THE DISSERTATION COMMITTEE

Application: granted granted after additions/amendments rejected

Date Chair of the Dissertation Committee

KV 2011-08-02JR 2013-08-01EB 2016-02-18GHM 2017-12-08

KAROLINSKA INSTITUTETPublic defence application

Name of student:

D2

SUPERVISORS

Principal supervisor Non-Swedish speakerName

Email (for receipt of decision)1

Department, section/unit, university

Telephone no.

Co-supervisor Non-Swedish speakerName

Email



Email



Email


1 If the decision is to be sent to one of the co-supervisors, please make a note of this on the form.

Double degree #

If the student is registered on a double-degree programme, please indicate the other university

Makerere University Stellenbosch University National University of Singapore Nanyang Technological University

Joint degree #

If the student is registered on a joint-degree programme, please indicate the other university

KTH Royal Institute of Technology

# Special rules may apply. For details please contact the administrators of the Dissertation Committee or the person at the central administration of Karolinska Institutet responsible for the relevant double- or joint degree programme

.KAROLINSKA INSTITUTETPublic defence application

Name of student

D3

EXAMINATION BOARD AND OPPONENT For rules regarding board composition see the instructions for D3.Examination Board coordinator (may not belong to the same department as the student)Name

Academic title (must be docent or professor)

Docent Professor Other# University, department

Non-Swedish speaker

Telephone no.

Email

Detailed description of scientific expertise in the thesis subject field

Member of the Examination BoardName



Non-Swedish speaker

Telephone no.

Email


Member of the Examination BoardName



Non-Swedish speaker

Telephone no.

Email


Opponent Name

Academic title (must hold PhD or be a well-qualified professor)

University, department

Email


See instructions for how to fill out the form.


Name of student:

D4 (1)

LIST OF CONSTITUENT PAPERS AND ETHICAL PERMITS

Paper IAuthors (Name of student in BLOCK CAPITALS)

Title

Status

Published: Journal, year, volume, page: Accepted for publication (endorsed with confirmatory letter from journal) Manuscript / submitted

Ethical permitsRef no. (or similar) or reason why permit not required

Description of paperBrief summary of the methods, materials and results.

Description of student’s contribution:Describe in detail the student’s contribution, in relation to the other co-authors. If the work also forms part of another student’s thesis, both their contributions must be described so that the input of the one is clearly distinguishable from the other . a) Scientific hypothesis/question:

b) Study design:

c) Generation, analysis and communication of results:

d) Manuscript composition and correspondence with journals

Impact of paper on student’s learning experiences/personal development:

The paper will NOT form part of another student’s thesis

The paper is already included in this person’s thesis (name, university): The paper might be included in this person’s thesis (name, university):


Name of student:

D4 (2)


Paper IIAuthors (Name of student in BLOCK CAPITALS)

Title

Status





b) Study design:





Name of student:

D4 (3)


Paper IIIAuthors (Name of student in BLOCK CAPITALS)

Title

Status





b) Study design:





Name of student:

D4 (4)


Paper IVAuthors (Name of student in BLOCK CAPITALS)

Title

Status





b) Study design:







Name of student:

D4 (5)


Paper VAuthors (Name of student in BLOCK CAPITALS)

Title

Status





b) Study design:





Name of student:

D4 (prel.res)

Preliminary results (This applies only to results not included in a constituent paper and if ethical permits are required)

Ethical permitsRef no. (or similar)

Description of the study (methods/material + results) (The box will expand when written in)

KAROLINSKA INSTITUTETThesis defence application

Name of student:

D5

SUPERVISOR’S ASSESSMENT OF STUDENT’S KNOWLEDGE, DEVELOPMENT AND INDEPENDENCE

Supervisor’s account of how the student has developed during his/her course of doctoral studies.

Principal supervisor’s signature

I judge the student to have attained the intended learning outcomes for a PhD as set out in the Higher Education Ordinance.Date Signature


Name of student:

D6

COI DECLARATION

Declaration of no Conflict of Interest (COI)

We hereby certify that the proposed Examination Board members and proposed opponent (see page D3) are impartial, objective and without any ties whatsoever to the student, the supervisors or the project.

A conflict of interest arises if there has been scientific collaboration over the past five year period. A conflict of interest may arise for periods longer than five years if the collaboration has been particularly close. Such collaboration includes a significant number (two-digit according to Dissertation Committee praxis) of joint publications, joint grants and applications, shared supervision etc. A relationship between a doctoral student and his/her supervisor is considered a matter of conflict of interest, regardless of how long ago the collaboration took place. Other collaboration older than five years may, if particularly close, also render the person unsuitable to sit on the Examination Board.

IMPORTANT: If undeclared co-publication (including multicentre studies and review articles) within the past five years is discovered, the application will automatically be rejected unless a letter is attached explaining why a conflict of interest does not exist despite these circumstances. Therefore, make sure to thoroughly search for co-publications (e.g. in the PubMed database) for all supervisors before the application is submitted.

A statement is attached explaining why we do NOT consider a conflict of interest to have arisen despite co-publication within the past five years.Doctoral student, name

Date Signature

Principal supervisor, name

Date Signature

Co-supervisor, name

Date Signature

Co-supervisor, name

Date Signature

Co-supervisor, name

Date Signature


Name of student:

D7

SIGNATURES

Director of doctoral studies In my capacity as the departmental director of doctoral studies, I have reviewed and judged that the completed courses and other credit-bearing items comply with the prevailing general study plan. (To be signed by the deputy departmental director if the ordinary departmental director is also the student’s supervisor.)Date Signature Name

Examiner (Does not apply to students registered for medical science)

I hereby certify that I have examined the student’s knowledge of his/her doctoral education subject. I judge this knowledge to be satisfactory.Date Signature Name

Head of Department (‘prefekt’)

Application approved by head of department. (To be signed by the deputy head of department if the ordinary head of department is also the student’s supervisor.)Date Signature Name

Doctoral student

I hereby apply to defend my thesis at Karolinska Institutet

Date Signature

public defence application - Karolinska Institutet · Web view2017/12/08 · KTH Royal Institute...

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