Medical Student Honors Program
Applications are due by 5:00 pm on August 29th. Please direct all questions to SoMHonorsProgram@lsuhsc.edu
1. Personal Information
First Name
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Middle Name
Last Name
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Current Address
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City
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State
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Zip Code
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E-mail Address
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Alternate E-mail
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Home Phone Number
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Area Code
Phone Number
Cell Phone Number
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Area Code
Phone Number
Emergency Contact
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First Name
Last Name
Emergency Contact Phone Number
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Area Code
Phone Number
Relationship to Emergency Contact
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2. Demographics
LSUHSC is an equal opportunity/affirmative action employer. Our training programs are supported in part through funding from the National Institutes of Health (NIH). The items below are useful to us in order to assess and report to the NIH the diversity of applicants and participants in our program. Responses are voluntary and will in NO way influence assessment of your application.
Race
African American/Black
American Indian or Alaskan Native
Asian
Caucasian or White
Native Hawaiian/Pacific Islander
Middle Eastern
Choose not to answer
Ethnicity
Hispanic, Latino or Spanish origin
Not Hispanic, Latino or Spanish origin
Gender
Male
Female
Other
Choose not to answer
Do you have a disability?
Yes
No
Choose not to answer
Are you from a disadvantaged background? (For example, are you first-generation to attend college?)
Yes
No
Choose not to answer
3. Academic Information
In order to participate in the Honors Program, you must be in good academic standing at the time of application and maintain it throughout the program. Please confirm that you are currently in good academic standing.
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Yes
No
Unknown
If you are not a current LSUHSC medical student, please name your institution
Name of undergraduate institution
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Degree awarded
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Other Degrees (Degree Received/Institution)
4. Research Interest Information
Please check the areas of research that you are interested in.
Biochemistry
Bioinformatics
Cardiology
COVID-19
Diabetes/ Obesity
ENT
Epidemiology
Gastroenterology
Genetics
Health Disparities
Hematology
Immunology
Microbiology
Molecular Biology
Nephrology
Neurology
Neuroscience
Neurosurgery
OB/GYN
Orthopaedics
Pediatrics
Pharmacology
Physiology
Pulmonology
Surgery
Other
Faculty Mentor (if known)
Have you participated in the LSUHSC Summer Research Internship Program as a high school or undergraduate? If so, what year?
Have you participated in the LSUHSC Summer Research Internship Program as a medical student? If so, what year?
Have you done research at LSUHSC as part of the research elective course (MCLIN198)? If so, what year?
Please list laboratory experience, previous internships, and/or lab rotations (if any).
Do you object to doing animal research?
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Yes
No
5. Required Attachments
Please attach a cover letter explaining your interest in applying to the Honors Program (PDF, DOC, or DOCX format only).
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Please attach a resume describing schools attended, previous job experience, and relevant accomplishments (PDF, DOC, or DOCX format only).
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Browse Files
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Please copy your cover letter describing your research interests and career goals.
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Please copy your resume describing schools attended, previous job experience and relevant accomplishments.
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Submit
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