Application The application form is only available when the respective call is open. You must have JavaScript enabled to use this form. Applicant First Name Last Name Function Contact Email Applicant Employer to receive the funding (Partner Hospital): Centres and attending physicians accredited at a partner hospital are assigned to the corresponding partner hospital. Kantonsspital Aarau Kantonsspital Baden Hirslandenklinik Aarau Administrative contact First Name Administrative contact Last Name Administrative contact email Clinical manager Formal address Street, no Postal code City Are you an applicant in postgraduate or continuing education? Yes No Supervisor/Mentor (for applicants in postgraduate or continuing education) First Name Last Name Function Institution Research Partner First Name Last Name Function Research Partner Institution ETH Zürich Empa PSI Do you have further project partners? Yes No List Further Project Partner Re-order Institution Involved personnel Type (research institution, hospital, SME, others) Poids Actions Institution Involved personnel Type (research institution, hospital, SME, others) Item weight Ajouter more items more items Short Biographie Project Start Projects must start within 6 months of receipt of the award letter. The actual start date must be confirmed with the ForME Management Office after notification of the award and prior to the project start. Requested start date Project Duration Projects requesting funding for more than 12 months must submit an interim progress report. 6 months 12 months 18 months 24 months Funding requested (in CHF) Only financial compensation for the Partner Hospital amounting to a maximum of 20% of the Applicant's salary in accordance with the usual rules of the Partner Hospital employing the Applicant is eligible for funding. The maximum annual amount per payment is CHF 25,000 for assistant physicians and CHF 35,000 for senior physicians. Salary compensation for a assistant physician senior physician Percentage of the applicant salary to be compensated % (maximum 20%) Requested funds in CHF per year CHF Requested total funds in CHF for the project: CHF Details of the resources provided by the Partner Institutions to ensure that the project costs are covered: Ethics Does the proposed research involve Questions Yes No Human participants? Yes No Human embryons/foetuses? Yes No Clinical trials? Yes No Sampling/use of biological material from human participants? Yes No Collecting or processing of personal data? Yes No Animal Experiments? Yes No Does the proposed research raise any other ethical issues? Yes No If you answered “YES” to any of the above questions, please describe in detail the aspects of the project that raise ethical issues and how you will ensure that the necessary institutional, cantonal and/or national approvals are obtained prior to the project start and the relevant guidelines adhered Please describe in detail the aspects of the project that raise ethical issues? Further information is available here:Authorization requirements for research on humans: Authorisation of research projects | KofamFederal information on research with animals: Application and authorisation (admin.ch)ETH Zürich Information on ethical questions in research: Ethical questions | ETH ZurichEmpa Ethics Commission: Empa - Ethics CommitteePSI Information on research using animals and humans: Research using animals and humans | Research Integrity | PSI Intranet Research Proposal Please provide us with your research proposal (max. 5 pages, min. font size: 11pt) by completing the following five sections and uploading it along with all the other documents described below.Ambition and objectivesWhat is the main challenge addressed by this project and why is it important to address this now? What are the objectives of this project? Current state of research in the fieldWhat is the state of the field in Switzerland and internationally? What is the starting point for this project? Which knowledge gap does the proposed research close? Detailed research planWhat specific investigations are planned during the course of the project? What methods will be used and why are they the most appropriate? How will the project be organised? How will clinical expertise contribute to the research project? Where will the research be carried out? What are the main risks and how will they be managed?Applicant and project teamWhat is the expertise of the Applicant and how will his/her track record and skills benefit this project? How will this project benefit the aspirations of the Applicant? Are appropriate supervision and mentoring measures in place to support the Applicant during the project? What is the role of each member of the research team in this project team? What is the expertise of each member of the project team and why are they the right people to achieve the goal of this project? How will the team work together to ensure that each team member can contribute their expertise to the maximum benefit of the project?Promotion of synergies between clinic and researchHow will the project support cooperation between Partner Hospitals and Research Partners? How will the project help to accelerate the translation of new knowledge into clinical practice? Please upload the following documents in one single pdfResearch proposal (max 5 pages, min. font size: 11pt)CVs of the applicant and all senior members of the Project Team (Please use the provided CV template)Completed and signed letter of commitment template from the Partner Hospital employing the applicant (Please use the provided template)Completed and signed letter of commitment template from the Research Partner (Please use the provided template)Commitment letters from further project partners describing their commitment (financial, mentoring, laboratory space, technical support, etc.) to the project (no template provided)Un seul fichier. Limité à 128 Mo. Types autorisés : pdf. Lay summary: Please provide us with a lay summary for publication on the ForMe website