UPPSALAUNIVERSITY
The Disciplinary Domain of Medicine and Pharmacy
APPLICATION
PUBLIC DEFENCE OF DOCTORAL THESIS
Subject:
Candidate:
National registration number:
Thesis title:
Date of admission to postgraduate programme: Year: Month: Day:
Public defence planned for.Year:Month: Day: Time:
Completed postgraduate courses
All postgraduate students admitted to the Medical Faculty after 1 July 1992 must complete an obligatory course module; see
At the Pharmaceutical Faculty, courses in laboratory animal science and ethics and in radiation protection are obligatory if the project so requires.
Obligatory courses as specified in the enclosed UPPDOK extract and/or course certificate, annex no:
Other courses as specified in the enclosed UPPDOK extract, annex no:and/or as specified below:
Projects with human trials are included in the thesis
Projects with animal trials are included in the thesis
The scientific projects in question have been examined by a research ethics committee
The scientific projects in question don't have to be examined
Half-time review:Year:Month: Day:
Licentiate degree:Year:Month: Day:
Half-time reviews (can be substituted for a licentiate degree) are obligatory for postgraduate students registered at the Pharmaceutical Faculty after 1 April 1998, and for postgraduate students registered at the Medical Faculty after 1 January 1999.
Programme controller (examiner) 1 e-mail:
1Specially appointed teacher (appointed in the individual syllabus) whose task is to control that a postgraduate programme of 160 credit points has been carried out in accordance with faculty guidelines. The examiner and the tutor should not be the same person.
Main tutor:e-mail:
Other tutor:e-mail:
Other tutor:e-mail:
Department/Departments:
Proposed faculty opponent
Name and title:e-mail:
Work address:
Post code:Town:
Grounds:
Proposal for chairperson at the public defence: (may not be any of the candidate’s tutors, fellow writers or any other person who participated in the work on the thesis):
Name and title:e-mail:
Department and address:
Proposal for three or five members of the evaluation committee:
If you opt for three members, only one may be from your own department and at least one must be from another disciplinary domain, a different university or an external organisation. If you opt for five members, a maximum of two may be from your own department and at least one must be from another disciplinary domain, a different university or an external organisation. When the candidate is external, none of the members of the evaluation committee should be from the same industry/group of companies as the candidate.
N.B. If a preliminary examination is to take place, the evaluation committee must have five members.
(Evaluation committee members shall have ”docent” or equivalent qualifications).
Name and title:e-mail:
Department:
Work address:
Post code:Town:
Grounds:
Name and title:e-mail:
Department:
Work address:
Post code:Town:
Grounds:
Name and title:e-mail:
Department:
Work address:
Post code:Town:
Grounds:
Name and title:e-mail:
Department:
Work address:
Post code:Town:
Grounds:
Name and title:e-mail:
Department:
Work address:
Post code:Town:
Grounds:
No challenge exists against the opponent or the members of the evaluation committee (For further reference, see “Jävsregler”, a publication [in Swedish] on rules for challenges at Uppsala, prepared by the university’s Legal Affairs Office in 2001)
Consultations regarding the opponent and the evaluation committee have been held with a member of the Medical and Pharmaceutical faculties’ postgraduate programmes committee
(see
N.B. Consultations must be per e-mail.)
YesName:
......
Head of Department’s signature and name in block letters
Annexes:
1Candidate’s summary (one page) of the components of the thesis and information on whether any of these have been published, accepted for publication, or submitted to a periodical.
Note that for such work as has been accepted for publication but not yet published, certification (e.g. a letter from a periodical) must be supplied which shows that the work has been accepted for publication and will be published.
2Examiner’s/tutor’s brief summary regarding the new ground broken by the thesis, and the candidate’s contribution.
If asked to do so by the postgraduate programmes committee, examiners or tutors shall certify that published work has been peer reviewed.
3One copy of each component (not the summary) of the thesis; for monographs, a copy of the monograph thesis must be enclosed (manuscript).
4Reporting card for postgraduate students, including a report on activity points during the postgraduate program.
5UPPDOK extract of postgraduate courses completed with a pass grade, or course certificates.