1: Your Particulars
First name:
Last name:
Date of birth (dd/mm/yy):
School
Enrolled in
Medicine
Dentistry
Nursing
Occupational Therapy
Physical Therapy
Optometry
Undergraduate Studies
Other
Graduation year:
Email address:
Do you have any special dietary needs?
Part 2: Your Arrangements
Would you like us to arrange a billet for you?
Saturday Night
Sunday Night
Both
None
Part 3: Your current level of pre-departure training
Please select the option that best describes you:
I have traveled to at least one developing country to engage in a participatory learning experience and prior to departure or immediately upon arrival, I participated in a formal pre-departure training program.
I have traveled to a least one developing country to engage in a participatory learning experience but I have not participated in a formal pre-departure training program at any time.
I have participated in a formal pre-departure training program but have not traveled to a developing country to engage in a participatory learning experience.
I have neither traveled to a developing country in order to engage in a participatory learning experience nor have I participated in a formal pre-departure training program.
None of the above? Please explain:
Do you have an elective in a resource-poor setting already set up, or do you have one in mind?
Yes
No
Unsure
If yes:
Where are you going?
When do you plan to be gone?
From (dd/mm/yy):
until
What kind of elective are you doing? (Choose the most applicable)
Clinical
Research
Humanitarian/Volunteering
Personal Travel
Who are you travelling with? (Name the group or individuals)
As a delegate of the pre-departure conference, you're invited to participate in a research study investigating the effectiveness of translating skills and knowledge for international electives. The research study will take place the day before PDT and immediately after PDT and will be in the form of an objective structured clinical exam (OSCE).
The OSCE sessions are meant to be fun and to help you gauge your level of training before and after PDT. We encourage everyone to participate just as a self-evaluation tool! Your performance in these scenarios will not be shared with anyone outside of the PDT researchers and will have no impact on the training session or funding requests. Participation is entirely voluntary.
In return for your time and assistance, you will be offered lunch or dinner following the completion of your session. Shortly after registering, you will receive an email with more information about the opportunity to participate in the study.
Part 4: Payment
In order to confirm numbers in advance, and to make fee payment easier for those students travelling from other schools, we have introduced an online payment system. Your $20 registration fee must be paid in order to confirm your spot in this year’s conference.
Once you have submitted your registration form, you will be given a link to pay the registration fee via PayPal.
