ADMSEP 2016 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 2016/2017? (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 Concurrent Workshops
Please pick one session from each cluster below that you plan to attend (stated preferences do not compel attendance, but rather helps presenters anticipate number of attendees at their session).  The unabridged descriptions of workshop abstracts are here

Thursday, June 16, 2016 | 3:00PM
Toolkit for Early Educators
yes, I will attend    no thank you   not sure yet

Friday, June 17, 2016 | 11:00 AM-12:15 PM
A1. The Power of Utilizing Temperaments to Enhance Your Leadership Capabilities (Thorndyke)
A2. Evaluation of Third Year Medical Students: Which Tools, How Many, and What Matters? (Marcangelo, Schilling, Agarwal)
A3. Reflection Rounds: Teaching Meaning, Purpose, and Connectedness in Medical Practice (Camp, Trello-Rishel, Thomas)
A4. ADMSEPís Clinical Simulation Initiative Ė 5 Years Later (Hawa, Lehmann, Smith, Foster, Marcangelo, Klapheke)
A5. Burnout, Resilience and Wellness: Walking the Walk (Malloy, Agarwal, Fox, Stagno, Stuber)

Saturday, June 18, 2016 | 9:45 Ė 11:00 AM
B1. Before You Send Out that Survey! The Nuts and Bolts of Implementing a Medical Student Survey Study (Rakofsky, Lewis, Beck)
B2. Mid-Career Faculty Development: Mentoring, Balancing Responsibilities and Leadership Skills (Hilty, Malloy, Ton, Levine, Vaidya)
B3. The Role of Chief Resident of Medical Student Education in Pre-Clinical and Clinical Psychiatry Experiences (Dalke, Finelli, Dube, Sacco)
B4. Six Things Every Clerkship Student Should Know about Geriatric Psychiatry (and How to Teach Them) (Wilkins, Blazek, Brooks, Lehmann, Liptzin, Wagonaar)
B5. Engaged Learning: Itís More Clear with a Peer (Roman, Allison)

Workshop Session 3 (Saturday, June 18, 2016 | 10:45 AM.12:00 PM)
C1. Writing for Publication (Roberts, Tennier, Coverdale, Balon)
C2. Psychiatry Superpowers: Teaching Students to Use Emotions as Data and Its Impact on Burnout (Holmer, Maeda)
C3. Integration of Mental Health Care into Student Run Clinics: Benefits, Challenges, and Practical Application (Raml, Inbarasu, Martinez, Preston, Jareczek, Barkil-Oteao)
C4. Coordinators and Directors: Perspectives on the Roles and Responsibilities of the Psychiatry Clerkship Team (Sacco, Dube, Crisafio, Khin Khin, Knight, Rakofsky)
C5. Thinking About Integration? Toolkit for Integrating Psychiatry and Neurology in Clinical Clerkships (Malloy, Griffeth, Lowenhaupt, Brannan)

The unabridged descriptions of workshop abstracts are here

**Before you click submit below, please
take a moment to seperately email us a photo of yourself so we may include it with your entry in the admsep online directory?  (in the "members only" area)

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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.