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Department of Medicine Annual Research Day

Abstract Submission Form

All abstracts must be received by February 21, 2018.

* - Required Field

Abstract Presenter First Name* 
Abstract Presenter Last Name* 
Abstract Presenter Suffix (Check all that apply)


Please check Student if you are a medical or other student

Are you entering the General Poster Session or Judged Poster Session?

(Only presenters who are also 1st authors AND trainees
within the Department Of Medicine will be judged.)
Is the Presenter also the 1st Author?
Name of DOM Faculty Mentor
If MSRP student or other student/trainee, please name your Faculty mentor:
If MSRP student or other student/trainee, please list the department or division with which your research is associated:
Presenter Phone Number() - ext.
Presenter UMMC Email Address* 
Presenter Academic Rank
If academic rank "Other" please specify:
If Research Staff, Specify Title
Primary Research Area*
Secondary Research Area*
Clinical Discipline
Abstract Title* 
Author(s) Name(s), Institutional Affiliation, UMMC Departmental/Divisional Affiliation(s).* 
Summary Statement*

Provide a 25-word summary of the research with key points highlighted, providing a basis for discussion and interaction.
Abstract Text*

Word limit is 250 words.

Include the following headings: Introduction, Methods, Results, and Conclusion.

Tables and figures may be added using the "Upload Graphics and Tables" buttons below.
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Upload complete Abstract in MS Word format*