PIRN Trainee Membership Form

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Pediatric Inpatient Research Network (PIRN) is a group of physicians and researchers in Canada who work with children and families to generate evidence that improves care and outcomes for hospitalized children in general pediatric setting. We invite you to become a PIRN trainee member and receive updates about various events and opportunities offered by PIRN and PIRN Trainee Advisory Committee.

For more information, please visit the PIRN website.

First name *

Last name *

Email address *

What is your current level of training? *

Medical student

PGY1 pediatric resident

PGY2 pediatric resident

PGY3 pediatric resident

PGY4 pediatric resident

PGY5+ pediatric resident

1st year pediatric fellow

2nd year pediatric fellow

3rd year pediatric fellow

Master's student (e.g. MSc, MPH, MedEd)

PhD student

Other:

If you are currently a fellow, which fellowship are you in?

Pediatric hospital medicine

Academic general pediatrics

Other:

Clear selection

At which institution are you doing your training?
*

How did you hear about PIRN? *

Program director

Faculty

Trainee colleague

Conference/presentation

Social media (e.g. Twitter)

PIRN website

Link on a survey

Other:

Required

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