ADMSEP 2015 Meeting eRegistration and ePayment

Directions:   Meeting eRegistration is a 3 step process. 

Step 1:  Please provide the information below, review, then click "submit" at bottom.  Questions?  

Is this membership reneal for 2015/2016? (y or n)         
Is this for a different year? If so enter the year         
Membership Renewal (if you are unsure, please view membership policy and/or comment in note at bottom)   
From the choices at right, please enter the item number you desire (#1-5)
Active (Voting) Member (benefits include a subscription to Academic Psychiatry, listserv access, ADMSEP Newsletter, & members-only ADMSEP web access)
US Dues $295
2.  International Dues $350
Associate (Non-voting) Member (benefits include access to listserv, ADMSEP Newsletter, members-only ADMSEP web access)
3.  House Officer Dues $20
4. Associate (Non-voting): Coordinator/Administrator Dues $20

5. Emeritus (Voting)- $135
Last Name      
First Name      
Title (MD, PhD, Ed.D. etc)
Institution Name:      
Street Address      
Address (cont)
Phone  (e.g.. 223-446-5000)      
Fax (e.g.. 223-446-5000)      
Medical School Affiliation (if different than institution):     
Current position (please check as many as apply)    
Lecturer in Human Behavior, Psychopathology, or Clerkship
Clinical Attending for Psychiatry Clerkship  
Director or Site Coordinator, Clerkship in Psychiatry  
Director, Psychopathology or equivalent course    
Director, Human Behavior, Interviewing or equivalent course  
Asst or Assoc Director, Medical Student Education  
Director, Medical Student Education     
Director or Vice-Chair, Psychiatry Education    
Chair, Dept of Psychiatry        
  Other (fill in the blank)      
Please check the groups to which you belong currently as a member of:    
Meeting registration:  Begin the process of meeting registration
Please let us know the names of the guest(s) you will be bringing to the meeting (separate by comma; meal charges apply, as per next screen):
Please specify the # of persons (you and/or guests) wanting vegetarian lunch/dinners 
Please specify the # of persons (you and/or guests) wanting gluten-free meal                  
Note (optional):   
Preliminary Preference for Workshops/Panel Discussions
(Your preference does not require attendance for the session, but helps presenters anticipate number of attendees at their session. Please check all sessions you plan to attend.)

Toolkit for Early Educators

Workshop Session 1 (11:00 AM.12:15 PM)
A1. RIME and Reason: Coherent Description of Student Progress (Louis Pangaro MD)
A2. Integrating Psychotherapeutic Teaching into Medical Education (David Mintz MD et al)
A3. Using TBL to Teach Professionalism to First Year Medical Students (Beth Choby MD et al)
A4. Using Role Play to Teach Effective Feedback Skills (Howard Liu MD)
A5. You Gave Me a "Good"??? Grading in the 21st Century, Where All of the Students Are Above Average (Abigail Kay MD et al)
A6. The Role of a Chief Resident of Medical Student Education in Pre-Clinical and Clinical Psychiatry Experiences (Katharine Dalke MD)

Workshop Session 2 (9:15.10:30 AM)
B1. Chalk Talk Boot Camp: Using Concept Maps to Bring Teaching Back to the Clinical Seting (Shelley Holmer MD et al)
B2. The "How To" on Training Medical Students on Culture and Diversity: Interviewing Tips, Brief Cultural Formulation,
        Biopsychosociocultural Treatment Planning , and Psych OSCE Options (Don Hilty MD et al)
B3. The Development of Psychiatric Specific EPAs for Evaluation of the Prospective Psychiatric Resident (Benjamin Griffeth MD et al)
B4. Mindfully Targeting Medical School (Jonathan "Jonny" Gerkin MD et al)
B5. Curricular Innovations in Addiction Medicine: Strategies, Successes, and Challenges (Wynne Lundblad MD)
B6. Integrated Scholarship Programs for Students, Residents and Faculty: a Collaborative "Win-Win-Win" (Janna Gordon-Ellioti MD et al)

Workshop Session 3 (10:45 AM.12:00 PM)
C1. The Residency Interview: Preparing and Assessing Students (Jason Rosenstock MD et al)
C2. How to Learn from a Medical Error (Julia Frank MD)
C3. Developing as a Faculty Educator and Geting Promoted, Too! (Brenda Roman MD et al)
C4. Active Classroom Learning for Introduction and Longitudinal Teaching of Pre-Clinical Medical Students (Brenda Talley MD et al)
C5. Building a Vibrant Psychiatry Interest Group: A Toolkit for Success (Dana Raml et al)
C6. Discussion Group:
         Professionalism: Bringing New Life to an Abstract Concept (Cristina Montalvo MD et al)
         Lapses in Professionalism during the Clerkship: Interventions by Coordinators and Directors (Sarah Johnson MD, MSc et al)
         Playing Well with Others: Managing Professionalism and Feedback in a Complex Learning Environment (Melissa Jacob et al )

Abstracts may be found meetings.

**Before you click submit below, could you please
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Now click submit below

Please note:
-After clicking submit, you should see a web page which echos your responses.  The payment page link will be revealed at that time at the page's bottom.
-You will recieve a confirmation email which includes your submission content above

-About the application process:   Dr. Gary Beck.
-If you have a question about the form itself, please contact webmaster.