SSTP 2022 Application Form

Surgeon Scientist Training Program Application

Updated July 2022
DEADLINE: May 15th

To complete this form you will need signatures and information from both the trainee and supervisor. To send this form to a supervisor for a signature or other information, scroll to the bottom and click "Save". You will be prompted to sign-up for a free JotForm account which will allow you to continue completing this form at a later date, as well as get a shareable link to this form that you can send to your supervisor for their signature/content.
Part 1: Trainee Application
Name of trainee:*

First NameLast Name
Program:*

MScPhDOther
Research start date:

MonthDayYear
Copy of Trainee CV

Browse Files
Click Browse Files to upload trainee CV Cancelof
Name of proposed supervisor who has agreed to act as your supervisor:

First NameLast Name
Name of external agency to whom you have applied for funding:
Funding Agency Name
Name of Institute/Graduate Department to which you have applied or will apply for admission as a graduate student in the School of Graduate Studies (it is the responsibility of the student to complete this application process prior to starting date of research):
Institute/Graduate Department
Letter of support from Division Program Director:

Browse Files
Click Browse Files to upload letter of support Cancelof
Name of University Division Chair with whom you have discussed this application and whom you have asked to forward a letter of support:

First NameLast Name
Letter of support from University Division Chair:

Browse Files
Click Browse Files to upload letter of support Cancelof
Why do you wish to join the Surgeon Scientist Training Program?

Maximum - 150 words0/150
Description of research to be performed:

Maximum - 500 words0/500
Trainee's Signature*

Clear
**University DIVISION Head Signature*

Clear
Denotes approval of financial support of student according to Department guidelines.
Part 2: Supervisor Application
Name of proposed trainee:*

First NameLast Name
Program:*

MScPhDOther
Trainee research start date:

MonthDayYear
Name of proposed supervisor:*

First NameLast Name
Branch of graduate school in which you are a member:
Branch of graduate school
Supervisor's current grants:
Indicate agency, title of grant, amounts for current and subsequent years, and whether sufficient funds are available for research to be performed by trainee
Location of proposed research:
Indicate whether sufficient space is available for the trainee's research
Proposed source(s) of personal salary support for surgeon scientist trainee:
Description of research to be performed by trainee:

Maximum - 500 words0/500
Supervisor's Signature

Clear
Part 3: New Surgeon Scientist Contact Information
Trainee's Name:*

First NameLast Name
Trainee's Home Address:

Street Address

Street Address Line 2

CityProvince

Postal Code
Trainee's Home Phone Number:

Area CodePhone Number
Trainee's Email Address:*
example@example.com
Supervisor's Name:

First NameLast Name
Supervisor's Office Phone Number:

Area CodePhone Number
Supervisor's Email Address:
example@example.com
Lab Address:

Street Address

Street Address Line 2

CityProvince

Postal Code
Lab Phone Number:

Area CodePhone Number
Part 4: SSTP Application Checklist
Completed Application Sections (Please check boxes if completed)

Part 1: Trainee ApplicationTrainee CVCopy of Application to External Granting AgencyLetter of Support from Division Program DirectorLetter of Support from University Division ChairPart 2: Supervisor ApplicationPart 3: New Surgeon Scientist Contact InformationClinician Investigator Program Application (deadline January 15th for enrolment in September) - Sent to CIP Office (c/o CIP Office, Faculty of Medicine, University of Toronto, Ste. 2366 Medical Sciences Bldg., Toronto M5S 1A8)
If any documents are missing from this online application, please make a note below and send when available to:

Michael G. Fehlings, Vice Chair Research
c/o Research Program Manager
Department of Surgery Research Office, University of Toronto, Stewart Building
149 College Street, 5th Floor, Room 503J Toronto, ON Canada M5T 1P5
tel: 416-978-8909
fax: 416-978-3928
email: research.surgery@utoronto.ca
Missing documents to follow, notes and/or comments:
Deadlines

Surgeon Scientist Training Program application deadline – May 15th

Health Policy, Mangaement & Evaluation application deadline – November 15th

Clinical Investigator Program application deadline – January 15th

Institute of Medical Science application deadline – April 1st

Other graduate school application deadlines – Please check the UofT website
Should be Empty:

Surgeon Scientist Training Program Application

Part 1: Trainee Application

Part 2: Supervisor Application

Part 3: New Surgeon Scientist Contact Information

Part 4: SSTP Application Checklist