INDEPENDENT STUDY CONTRACTUniversity of Maryland, School of Public Health

Public Health Science Program

Please note that it is the student’s responsibility to: � � �

Complete this form Obtain required signatures Provide copy to Nancy Smith (nsmith10@umd.edu)

Street

City State Zip

Student Name: UID:

Email: Phone:

Semester of Independent Study:

Beginning and end dates:

Number of credits:

Independent Study Mentor (include Dr., Ms., Mr.):

Job Title:

Phone Number:

Email Address:

Independent Study Site (name of department/organization):

Address:

Terms of Independent Study• Students registered for this course will engage in research activities under the supervision of a mentor.• Students registered for 1 credit will complete 3 hours of research per week (45 hours per semester);

students registered for 2 credits will complete 6 hours of research per week (90 hours per semester);students registered for 3 credits will complete 9 hours of research per week (135 hours per semester);students registered for 4 credits will complete 12 hours of research per week (180hours per semester);students registered for 5 credits will complete 15 hours of research per week (225 hours per semester);students registered for 6 credits will complete 18 hours of research per week (270 hours per semester).

• Students must be accountable for their responsibilities and research hours throughout the semester.• In order to receive credit, students must enroll in the independent research study course (PHSC389).

Weekly Schedule

Date

Date

Having discussed your role for the Individual Study with your mentor, describe the potential activities in which you will participate and the responsibilities you will have. These must reflect the Public Health Science Core Competencies:

1. Discuss the history and philosophy of public health as well as its core values, concepts, and functions across the globe and insociety.2. Use basic public health concepts, methods, and tools for data collection and analysis.3. Identify the major health-related needs and concerns of populations and formulate basic processes, approaches, andinterventions as possible solutions.4. Describe the underlying science of human health and disease including opportunities for promoting and protecting healthacross the lifespan.5. Examine the socio-economic, behavioral, biological, environmental, and other factors that impact human health andcontribute to health disparities.6. Demonstrate the fundamental concepts and features of project implementation, including planning, assessment, andevaluation.7. Compare and contrast the fundamental characteristics and organizational structures of the health systems of the UnitedStates and other countries.8. Characterize the basic concepts of legal, ethical, economic, and regulatory dimensions of health care and public policy.9. Illustrate the basic concepts of public health-specific writing and communication.

10. Interpret and synthesize scientific knowledge to propose evidence-based approaches and solutions to public health problems.

Signature of Site Supervisor

Signature of Student Intern

Submission Instructions• Submit the completed Independent Study Contract to Nancy Smith, Independent Study Coordinator at

nsmith10@umd.edu. If approved, you will be cleared to register for PHSC389.• Please provide a copy of the contract to your research mentor and keep a copy for yourself.• The contract must be submitted to PHSC prior to the first day of class in the semester in which the

independent study is to be done.• Questions should be addressed to Nancy Smith (nsmith10@umd.edu).