ISMICS: Co-Sponsorship Application

The International Society for Minimally Invasive Cardiothoracic Surgery is pleased to offer co-sponsorship for qualified educational programs in the cardiothoracic and cardiovascular specialties. In order for an organization or course to receive co-sponsorship from ISMICS, the standards contained within this sample application must be met. Should the application for co-sponsorship be approved, ISMICS will assess a co-sponsorship fee of $350 USD.

Part A: Organization/Institution Requesting Approval
This Application must be completed by a member of the physician organization/institution* that developed or co-developed this event.

*Physician Organization/Institution: A group of health professionals with a formal governance, and structure, accountable to and serving, among others, physicians and surgeons through continuing professional development, the provision of health care, and basic or clinical research. This definition includes (but is not limited to) the following groups:

Faculties of Medicine
Hospital Departments or Divisions
Medical Societies
Medical Associations
Medical Academies
Health branch of Government agencies including Armed Forces

This definition excludes pharmaceutical and medical device companies.

Note: all fields are required

Event Title
Location of Event (city, province)
Event Dates (start m/d/yyyy - end m/d/yyyy)	-
Name of Organization/Institution
Course/Program Director(s)
Are you a member of ISMICS?	Yes No

Event Contact
	Name
	Email
	Phone Number

Part B: Learning Objectives
Specific learning objectives that address identified needs must be created for the overall event and individual sessions. The learning objectives must be printed on the program brochure or posted on the organization/institution website, and also must be included on any printed handout materials.

Please attach/upload a program brochure for this event that includes overall and session specific learning objectives, or provide the link to the electronic brochure for this event.

Please respond to the following questions:

1. What are the specific learning objectives developed for:

a. The overall event?

b. Specific sessions?

2. Do the stated objectives express what the participants will be able to learn or achieve by participating in the event?
Yes No

3. Is there an evaluation form/post meeting survey for the individual sessions and overall event?
Yes No

4. How are the learning objectives linked to the evaluation strategies for this event?
For example, does the evaluation form/post meeting survey list the learning objectives or pose questions to participants about whether the learning objectives were met?

5. Submit a program brochure for this event that includes overall and session specific learning objectives.
Brochure full URL:
or
Upload your brochure

Part C. Meeting Ethical Standards for Continuing Professional Development
Given its international nature, ISMICS does not require that events requesting co-sponsorship offer Continuing Medical Education credits. However, ISMICS does require that events must meet the following criteria:

1.	The organization/institution must have control over the topics, content, and speakers selected for this event. Yes, we comply with this standard No, we do not comply with this standard Please describe the process by which the topics, content, and speakers were selected for this event.
2.	The organization/institution must assume responsibility for ensuring the scientific validity and objectivity of the content of this event. Yes, we comply with this standard No, we do not comply with this standard Please describe the process used to ensure validity and objectivity of the content for this event.
3.	The organization/institution must disclose to participants all financial affiliations of faculty, moderators or members of the planning/program committee with any commercial organization(s), regardless of its connection to the topics discussed or mentioned during this event. Yes, we comply with this standard No, we do not comply with this standard Describe how conflict of interest information is collected and disclosed to participants.
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