[Revised April 2020]

Doctoral Dissertation Procedures

Program: Doctoral Degree

Asahikawa Medical University Graduate School of Medical Research(Page 2)
Dissertation Procedures (Doctoral Program)To receive a doctoral degree, students should follow detailed procedural rules that govern the processfrom the submission of a dissertation to its publication, along with other general procedures, such as theofficial regulations related to graduate school. Please read this booklet thoroughly before beginning thesteps on submitting your dissertation work and follow its procedures carefully.
Ⅰ． Before Starting Dissertation Submission Procedures
1. Qualifications for the Submission of a Doctoral Dissertation
Only those students who have been enrolled in the doctoral program at the Graduate School of
Medical Research for more than three years, are on pace to acquire the necessary credits on the courses
stipulated in the school’s regulations, and have attended the presentation of doctoral dissertations morethan once by the time of submission are eligible to submit a dissertation.
2. Dissertation
A doctoral dissertation refers to a single-author or co-authored original paper or a paper that cites theoriginal dissertation, which has been or is to be published in an academic journal or other publication.
An applicant can submit a co-authored dissertation only if the following two requirements are met:
(1) The submitter of the dissertation is the principal author. However, even if the submitter is not the
principal author, the co-author can still apply for its assessment as a dissertation if it is clearly statedin the text that the submitter has provided an equal contribution.
(2) In any case, co-authors cannot submit the same text as a dissertation to obtain a degree as thesubmitter. In this case, the co-authors/s' consent form (Form No. 19) must be attached.
３． Publication of the Dissertation
Article 11 of the Degree Program Regulations requires those who are awarded a doctoral degree topublish the full text of their doctoral dissertation via the internet. This can be done by posting thedissertation at the Asahikawa Medical University Academic Achievement Repository site.
Hereinafter, the word “publication” in Dissertation Procedures refers to posting at the Asahikawa
Medical University Academic Achievement Repository site.
Please note that students can submit as dissertations only those papers that are published in academic
journals or other publications or those whose publication the students can confirm with a certificationthat shows the publication schedule.

(Page 3)
Ⅱ． Submission Procedures for a Dissertation and Other Rules.
1. The Submission of a Dissertation⑴ When to Submit the Dissertation
Possible submission dates for a dissertation are listed as follows, but if these fall on a Saturday or
Sunday, they shall be taken to refer to the Friday immediately before that day. (Deadlines in all cases
are at 5 pm.)
1) Those who are scheduled to finish their program in March must submit by December 5 of thepreceding year2) Those who are scheduled to finish their program in June must submit by March 5 of the same year3) Those who are scheduled to finish their program in September must submit by June 5 of the sameyear4) Those who are scheduled to finish their program in December must submit by September 5 of thesame year(2) Where to Submit the Dissertation
The dissertation must be submitted to the International Students Section of the Student Support
Department of the Graduate School. The applicant must submit his/her dissertation in person, as errors
in the submission documents, if any, can be corrected on the spot.
The applicant should ensure that the academic advisor has inspected the manuscript in advancefollowing completion but before submission.
(3) Documents to be Submitted
1) Application Form for the Assessment of the Dissertation (Form No. 7) one copy
2) Dissertation Catalog (Form No. 9) three copies
3) Dissertation※1 (three sets of the original, three copies) six copies
4) Reference Documents (three sets of the original per document) three copies
5) Abstract of the dissertation (Form No. 14) 120 copies
6) Resumé (Form No. 10) three copies
7) Academic Advisor's Approval Form (Form No. 16)
8) Co-Author's/s' Consent Form (s) (if the dissertation was co-authored) (Form No. 19) one copy9) A certificate showing that the dissertation is scheduled to be published in an academic journal (ifapplicable) one copy10) Indication of the date when the applicant will publish the dissertation (full text) on the internet(Form No. 21) *2
1 copy11) Application for the publication of the dissertation (full text) on the internet pending approval (Form
No. 22) *2
1 copyFor items 1) to 8), 10), and 11) above, please refer to the notes on the preparation (given below).
*1 The applicant must submit the full text of the dissertation to the International Students Section of theStudent Support Department of the Graduate School after the confirmation of the conferment of thedoctoral degree but before the date of the conferment.
・ Files should be submitted in PDF format without password protection.
・ The file name should be The Name of the Recipient of the Doctoral Degree.pdf.

・ The file should retain the text information.
・ The file should be submitted as an e-mail attachment (gaku-inryu@asahikawa-med.ac.jp) or recorded
on a CD-R for submission.
*2 (1) If the applicant cannot publish the full text of the dissertation immediately following the date thatthe degree was received, one of the following forms should be submitted according to the date ofpossible publication.
・ Form 21 is to be submitted when the date of the possible publication is within one year of the datethat the student receives the degree
・ Form 22 is to be submitted when the possible publication date falls more than one year from the dateon which the applicant received the degree or if the date is undecided＊ If the applicant publishes the dissertation immediately following receipt of the degree, the applicant
does not need to submit any forms.

(Page 4)(2) If the applicant submitted Form 22, the Graduate School Doctoral Program Committee determines
whether the reason the applicant cannot publish the full text of the dissertation on the internet
immediately after the date of receiving the degree is unavoidable. If the committee considered thereason to be unavoidable, the applicant can publish a Summary of the Doctoral Dissertation instead
to hold the time until the full dissertation can be published. In this case, the applicant must create a
Summary of Doctoral Dissertation, following the guidelines below, and submit the relevant data
electronically to the International Student Section of the Student Support Department of the
Graduate School after confirmation of the conferment of the degree and before the date of receipt ofthe degree as follows:
・ The applicant must create a cover page, following the model dissertation cover page shown on
page 4 but changing the title to Doctoral Dissertation (Summary).
・ The applicant should write the main text in about 3,000 characters, ensuring that the readers will
be able to understand the structure and overall content of the dissertation from it. The applicant
cannot use the abstract of the dissertation as the summary.
・ The PDF format should be used for the file with no password protection.
・ The file name should be The Name of the Receiver for the Doctoral Degree (Summary).pdf.
・ The file should retain the text information .
・ Submit the file as an e-mail attachment (gaku-inryu@asahikawa-med.ac.jp) or record it on a CDR and submit it.
(3)Those who have submitted an application for the publication of the dissertation (full text) on theinternet pending approval(Form 22) and have received approval for it must submit the notification of the elimination of thereason for the suspension of the publication from the full text of the dissertation on the internet(Form 23) if the unavoidable reason has been eliminated. The full text of the dissertation shall be
published at the repository site upon the submission of Form 23.
2. Explanation of the Dissertation and Q & A
The submitter of a dissertation will be asked to give a presentation of about 15 minutes in length atthe open presentations of the doctoral dissertation.
Please prepare the materials for such a presentation using PowerPoint or by another means.
3. Methods of the Assessment of the Doctoral Dissertation and the Final Exam
(1) The Examination Committee of the Doctoral Program Committee will examine the dissertation. The
applicant should keep in touch with the Committee and be ready to respond to its messages, as its
members may have questions on the content of the dissertation during the assessment period.
(2) The final examination will be conducted by the Examination Committee in the form of an oral or awritten examination in fields related to the dissertation.
4. Conferment of the Degree

The Examination Committee conducts the dissertation assessment and final examination and reports
the results to the Doctoral Program Committee. After the Committee certifies that the applicant hascompleted the doctoral program and it is decided that the degree should be conferred, the president inprinciple will present the diploma on the following days:
1) March 25
2) June 30
3) September 304) December 25(Page 5)
Ⅲ． Points to Note when Preparing a Dissertation and Reference Documents
The applicant must prepare his/her dissertation and reference documents as follows:
1. Dissertation(1) Cover1) The title should indicate the content of the dissertation concretely and concisely. If the dissertation
is written in Japanese, the title should be in Japanese, and if it is written in a foreign language, thetitle should be given in that language. In the second case, a Japanese translation of the title should
be given in parentheses below the title.
2) As a general rule, do not use nonstandard abbreviations in the title.
3) The applicant may add a subtitle but avoid such expressions as "The First report ..." and ensurethat it is as concise as possible.
4) The name of the author should be given with no title and no abbreviation. (Give the name as it isgiven in the family register.)
The Form of the Cover (A4 Paper)
Ａ

Ａ．Differentiate the title of the dissertation and that of the○○○○○ reference document (if there are two or more reference documents, number them in the order that they are listed in the dissertation cataloＢg.)○○○○○○○○○

Example：Reference Document1, Reference Document2・・・
Ｂ．The title

Ｃ

Ｃ．The title of the major(Asahikawa Medical University Graduate School of Medical

Ｄ（）

Research Doctoral Program ○○ Major)
Ｄ．Author name（・・・

） Coauthor name/s in parentheses(2) Main Text（
）内に共著者名
1) Dissertations in Japanese should be printed on A4-size paper horizontally using a personal computer.
2) Dissertations in a foreign language should be printed on A4-size paper with double spacing using apersonal computer.
3) Use plain white paper. Do not use overly thin sheets or paper marked with the any letterhead orother corporate markings.
4) Keep all charts, figures, etc. within the frame of the A4-size paper.

5) The applicant’s dissertation must be submitted complete and after careful revision and editing suchthat no corrections will be necessary after submission.
6) The applicant must submit each copy of the dissertation in a separate envelope closed with a double
clip.
7) Accepted dissertations will not be returned; hence, it is advisable to make a copy before thesubmission.
(3)The applicant can substitute an offprint of the dissertation if it has already been published elsewhere.
However, in this case, a separate cover page must be attached if the original cover does not meet theprescribed format.

(Page 6)
２． Reference Documents(1) The applicant may submit a paper that supplements the dissertation or a paper on a related field as areference document.
(Reference documents so designated can only include papers already published by the applicant.)(2) For all other matters, the dissertation guidelines must be conformed to.
Ⅳ． Points to Note When Preparing Other Documents for Submission
１． Dissertation Catalog (Form No. 9)(1) If the title of the dissertation is in a foreign language, a Japanese translation must be given inparentheses.
(2) In principle, if the dissertation or reference document has not been published in an academic
journal or similar venue, the applicant must state that it is scheduled to be published. If it is notcertain whether it will be published, the applicant must state that it has not been published.
(3) The applicant must list all reference documents.
(4) Other guidelines indicate how documents must be prepared.
２． Resumé (Form No. 10)(1) The applicant must describe his/her year-by-year academic career following graduation fromuniversity.
(2) Other examples indicate how documents should be prepared.
３． Abstract of the Dissertation (Form No. 14)(1) If the title of the dissertation is in a foreign language, a Japanese translation must be given inparentheses.
(2) The abstract cannot be longer than 3,000 characters, written using a personal computer in a
typeface size of about 10 points.
(3) In the abstract, the applicant must separately describe the research objective, materials andmethods used, results, main idea, and conclusion.
⑷ Do not insert charts or photographs in the abstract.
(5) Put the name of the academic journal, etc., in which the applicant plans to publish the dissertationon the cover of the abstract.
⑹ Give the name/s of the co-author/s (if any) on the cover of the abstract.
⑺ Add up to three important citations at the end of the abstract.
⑻ Add up to five reference documents at the end of the abstract.
４． Academic Advisor Approval Form (Form No. 16)
The applicant must attach an approval form by the academic advisor when submitting the dissertation.
５． Co-Author Consent Form (Form No. 19)

If the applicant co-authored the dissertation, be sure to attach the consent form/s of the co-author/s.
If there are multiple co-authors, submit one form for each co-author.
6. Evidence That the Dissertation is Scheduled to be Published
If the dissertation has not been published in an academic journal, etc., attach a document that showsthat it is scheduled to be published.

(Page 7)
Form No. 7

Request for Dissertation Assessment

Date:__________________________(Month/Day/Year)

To: The President of Asahikawa Medical University
Full name: __________________________________

I submit my dissertation with the following documents for an assessment according to the provisions ofArticle 4, Paragraph 2 of the Asahikawa Medical University Degree Regulations.

Description
１． Dissertation Catalog

3 copies

２． Abstract of the Dissertation

120 copies

３．Resumé

3 copies

Notes
The applicant shall submit three original sets and three copies of the dissertation. The applicant
shall submit three original sets of reference papers.
The paper size shall be A4.
(Note) The applicant must sign the document himself/herself.

(Page 8)
Form No. 9 (example entries)
Dissertation
1, Title: A study on ○○○○○○○○○○○○○○○
Co-authored with ○○○○ and ○○○○ (excluding the submitter of the dissertation)
2. Method and Time of the Publication
Example 1. Medical journal ○○○○, Vol. ○○, pp. ○ - ○, Year (if the study has already been published)
Example 2. Medical journal ○○○○ Vol. ○○, Scheduled to be published in Year(If the study has not been published yet, the applicant should attach a publication certificate from thepublisher, including the projected date)
Example 3. Unpublished (other than the above two examples)
3. Number of Dissertations

1

Reference Paper 1
1. Title: A study on ○○○○○○○○○○○○○○○
Co-authored with Jiro Otsuno and x (number) others(“x others” here would exclude Jiro Otsuno and the submitter of the dissertation)
2. Method and Time of the Publication
Same as the above example entries for the dissertation.
Reference Paper 2

Date:_______________(Month/Day/Year)
The Applicant: ○○○※The size of the paper shall be A4, and it must fit within the frame of 23 x 17 cm.
※The applicant must prepare the form him/herself.
(Note) The applicant must write the signature himself/herself.

○

(Page 9)Form No. 14 (example entries)
Type of Degree

Doctorate

Name

○ ○

○ ○

Title
○○○○○○○○○○○○○○○○○○○○○

Name/s of the Co-Author/s
Example 1. Medical journal ○○○, Vol. ○○, pp. ○-○Year (If the dissertation has already been published)
Example 2. Medical journal ○○○, Vol. ○○Year Publication schedule(The applicant can attach a publication certificate from thepublisher, even though the paper has not been published yet)
Example 3. Unpublished (other than the above two examples)

Research objective
・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・

Materials and methods used・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・(Insert a page)※The paper must be of XX size and fit within 23 x 17 cm. The applicant must complete the form on a
personal computer.
※The applicant must prepare the form him/herself.

(Page 10)(The 2nd and subsequent sheets)
Achievements
・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・

Ideas
・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・

Conclusion
・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・(Insert a page)(Page 11)(the final article)
Important citations(List up to three important citations.)

Reference documents(List up to three reference papers.)(Insert a page)(Page 12)
Form No. 10 (example entries)
Resumé
Full Name○○○○○○○○○○○○(Male/Female)

Date of Birth:_____________________________

Registered Domicile: ○○○○○○○○○○○○○○○
Current Address: ○○○○○○○○○○○○○○○
Education
Date:________________ Graduated from Asahikawa Medical University School of Medicine
Date:___________________ Enrolled in the Doctoral Program of the Asahikawa Medical
University Graduate School of Medical Research
Date:_____________________ Expected to completed the above
Employment History
None
Research History
None
Qualifications
Date:__________________ Granted medical doctor’s license (No. ○○○○○)
Academic Awards and Disciplinary Actions
None

I hereby declare that the above information is true and accurate.

Date:________________________(Month/Day/Year)
Full Name:____________________________※The paper size must be A4 and the page must fit within the frame of 23 x 17 cm.
※The applicant must prepare the form him/herself.

(Note) The applicant must write the signature himself/herself.

(Page 13)
Form No. 16

Approval by the Academic Advisor
Date:_________________________(Month/Day/Year)

To: The President of Asahikawa Medical University

The academic advisor for the dissertation
Full Name:________________________

I hereby approve the submission of the following dissertation as the applicant's doctoral dissertation.
Description

The Title of the Dissertation:_____________________________________

Major:_____________________________The Field:__________________________
Related Courses, etc.:_________________
Full Name:__________________________

Notes
Enter the name of the applicant's original course, etc. and the name of the course in which the applicant iscurrently receiving academic advice in the section on "Related Courses, etc." Under the heading "Courses,
etc." are included academic subjects, faculties, departments, and centers.

(Page 14)
Form No.1 9

Co-Author's Consent Form
Date:_________________________(Month/Day/Year)
To: The President of Asahikawa Medical University
Full Name:________________________________(signature)
Department:
Telephone () - () Current Address:
Telephone (
) - (
) -

I hereby allow __________________(name of the applicant) to submit the following work to your
Graduate School of Medicine as his/her doctoral dissertation.
I shall not use the dissertation to apply for my own degree.

Description

Title of the Dissertation

Notes
The co-author/s must prepare this consent form.

(Page 15)
Form No.21

Date:________________________ (Month/Day/Year)
To: The President of Asahikawa Medical University

Notification of the Possible Date for the Online Publication of the Doctoral
Dissertation (full text)
Please publish the full text of my doctoral dissertation on the internet promptly on or after the possible
publication date below once I have received confirmation of the conferment of my doctoral degree.

Description

Possible Date of the Publication: ___________(Month/Day/Year)

The Name of the Applicant: Asahikawa Taro (signature)※The name seal can be replaced with the applicant's signature.

Expected Date for Receiving a Doctoral Degree:_____________The Confirmation of
the Academic
AdvisorName: 〇 〇〇 〇 (name seal)* The name seal can be replaced with the applicant’s signature.

※ Publication on the internet here means posting the dissertation at the Asahikawa Medical University
Academic Achievement Repository site.
※ The applicant submits this form when it is necessary to suspend the publication for a certain period
within one year of the expected date for the conferment of his/her doctoral degree.

(Page 16)
Form No.22
Date:_______________________(Month/Day/Year)
To: The President of Asahikawa Medical University

Application for the Approval of the Suspension of the Online Publication of
the Dissertation (full text)
If I apply for the publication of a summary of my doctoral dissertation upon the conferment of my doctoral degree
due to my inability to publish the full text on the internet within one year of the expected date of the conferment for
the following reason:
then I shall promptly notify you if the reason for not publishing the dissertation is no longer operative.
1. The reason that the applicant cannot publish the full text of the dissertation on the internet is□ Because the dissertation contains content that cannot be published on the internet for more than one year fromthe expected date for the conferment of my degree due to copyright protection, personal information protection,or similar.
□ Because the online publication of the full text of the dissertation will result in a clear disadvantage beyond one
year from the date for the conferment of the doctoral degree in connection with a publication, a publication inacademic journals that prohibit multiple publications, a patent application, or similar.
□ Because the dissertation is under submission to an academic journal, and there is no guarantee that it will be
published.
□ Because there is another particular unavoidable reason.
２． The specific details of the reason why the applicant cannot publish the full text are as follows.

3． The probability that the reason for the inability of the applicant to publish the dissertation will cease to exist is
as follows.
Possible Time □Date:_______________(Month/Day/Year)□ Unknown

The reason for stating the possible
time as above

Name of the Applicant:__________________(name seal)※The name seal can be replaced with the applicant's signature.

Expected Date for the Conferment of the Doctoral Degree:_________________________(Month/Day/Year)
Confirmation by the Academic Advisor(name seal)※The name seal can be replaced with the academic advisor's signature.
※ Online publication refers to posting the dissertation at the Asahikawa Medical University Academic
Achievement Repository site.

Form No.22（example entries）
Date:________________________(Month/Day/Year)
To: The President of Asahikawa Medical University

Application for the Approval of the Suspension of the Online Publication of
the Dissertation (full text)
I hereby apply for the publication of the summary of my doctoral dissertation upon the conferment of my doctoral
degree because I will not be able to publish the full text on the internet within one year of the expected date of theconferment for the following reason:
I shall promptly notify you if the reason for not publishing the dissertation has ceased to exist.
1. The reason that the applicant cannot publish the full text of the dissertation on the internet is□ Because the doctoral dissertation contains content that cannot be published on the internet beyond one year fromthe expected date for the conferment of the degree due to copyright protection, personal information protection,or similar.
☑ Because an online publication of the full text of the dissertation would result in a clear disadvantage beyond one
year from the expected date for the conferment of the degree in connection with a publication, a publication inacademic journals that prohibits multiple publications, a patent application, or similar.
□ Because the dissertation is under submission to an academic journal, and there is no guarantee that it will be
published.
□ Because there is another particular unavoidable reason.
Please tick the one which applies. (the applicant can tick more than one)
２． Specific details of the reason that the applicant cannot publish the full text are as follows.

(example entries)
Although it was published in XX magazine of XX company, the company does not allow publications on the internet, etc.
for X years after the publication of a dissertation.
(Please describe the specific details of the reason you identified in 1.)

３． The probability that the reason for the inability of the applicant to publish the dissertation will cease to exist is
as follows.
Possible time

☑ Date:_____________ (Month/Day/Year)The reason for stating the possible
time as above

Because of the reason stated in 2. above□ unknown

The Name of the Applicant: Asahikawa Taro (name seal)※The name seal can be replaced with the applicant's signature.

Expected Date for the Conferment of the Doctoral Degree:_________________________(Month/Day/Year)
Confirmation by the Academic Advisor

〇

〇

〇

〇

(name seal)※The name seal can be replaced with the applicant's signature.

※Publication on the internet means posting the dissertation at the Asahikawa Medical University
Academic Achievement Repository site.

(Page 18)
Form No.23

Date:________________________(Month/Day/Year)

To: The President of Asahikawa Medical University

Cancellation of the reason for suspending the online publication of thedissertation (full text)

I hereby notify you that it has become possible to publish the full text of my doctoral dissertation on theinternet immediately after the following date.
Description

Possible Date of the Publication: 〇〇〇〇〇〇 (Month/Day/Year)

Name of the Notifier: Asahikawa Taro (name seal)※The name seal can be replaced with the notifier's signature.

Date of Receiving the Doctoral Degree: 〇 〇 〇 〇(Month/Day/Year)
The Number of the Degree Certificate: 〇〇〇〇

Confirmation by the Academic Advisor

Name: 〇 〇〇 〇 (name seal)※The name seal can be replaced with the academic advisor's signature.

※Publication on the internet here refers to posting the dissertation at the Asahikawa Medical University
Academic Achievement Repository site.