TL1 Clinical Fellow Application

I would like to be considered for the following awards:
Please read eligibility guidelines.

Your middle name:
(Enter "N/A" if none)

ORCID:
* These will be required for federal training grants beginning in early 2020. To create one, visit https://orcid.org/

Disadvantaged?
Criteria:
1) comes from low-income background and/or
2) comes from social/ cultural/ educational environment (i.e.: certain inner-city/rural that demonstrably and recently directly inhibited individuals from obtaining knowledge, skills and abilities necessary to develop and participate in research careers) https://era.nih.gov/commons/disadvantaged_def.htm

Citizenship:

Eligible applicants must be citizens or non-citizen nationals of the United States, or must be lawfully admitted to the United States for permanent residence and have in their possession a currently valid Permanent Resident Card (USCIS Form I-551) or other legal verification of such status. Non-citizen nationals are persons born in lands that are not States but are under U.S. sovereignty, jurisdiction, or administration (e.g., American Samoa). Individuals on temporary or student visas are not eligible.

Prior Full-Time Research Experience
* Prior Full-Time Research Experience: Report the number of months of full-time research following college. Do not include labs associated with a course

Receive Funding from Your Current Program?
* Fellows who have previously been on institutional or individual NRSA grants are eligible only if they had completed one year of funding through these mechanisms regardless of the institution. (This TL1 is for two years. Per NIH policy, no individual trainee may receive more than three years of aggregate Kirchstein-NRSA support at the post-doctoral level)

Receiving Funding Explanation
Example: T32, R01, non-federal foundation, etc.
If applicable, please provide the grant #.

How many publications do you currently have? (Include original research, reviews, case studies, letters, and book chapters. No need to list citations, just a count.)

The proposed research is: (check all that apply)
Is your proposed research clinical, translational or CER? 

Please enter your PRIMARY mentor name (Last Name, First Name)
* If you are proposing a mentor who is not listed, please read the Approved Mentor section carefully for an understanding of the qualifications required to be an NIH-approved mentor. Once you have read this information, contact us directly at crtc@wustl.edu to request the approval of your proposed mentor. You will not be able to submit your application form until a mentor has been selected.

Mentor No. 2 (Please select your mentor from the list)
* Prior approval is not needed if mentor 2 is not listed.  

Please enter your mentor no. 2 name (Last Name, First Name)
* Prior approval is not needed.

Mentor No. 3 (Please select your mentor from the list)
* Optional and does not require prior approval

Please enter your mentor no. 3 name (Last Name, First Name)
* Optional and does not require prior approval

Mentor No. 4 (Please select your mentor from the list)
* Optional and does not require prior approval

Please enter your mentor no. 4 name (Last Name, First Name)
* Optional and does not require prior approval

Mentor No. 5 (Please select your mentor from the list)
* Optional and does not require prior approval

Please enter your mentor no. 5 name (Last Name, First Name)
* Optional and does not require prior approval

Current Biosketch. Please see NIH biosketch guidelines.   

The file name format should follow; "TL1 ClinicalFellowApp_Biosketch_Applicant last name_First name" 

Please upload your Project Narrative

Describe how, in the short or long term, the research would contribute to: the fundamental knowledge about the nature and behavior of living systems, and/or the application of that knowledge to enhance health, lengthen life, and reduce illness and disability.

The file name format should follow; "TL1 ClinicalFellowApp_ProjectNarrative_Applicant last name_First name" 

Please upload your Individual Development Plan 

The file name format should follow; "TL1 ClinicalFellowApp_IndDevPlan_Applicant last name_First name" 

Limit 3-5 page individual development plan (no more than 5 pages; references are not included in page count) that includes, but is not limited to, the following:
   - Career goals
   - Past research experience and past graduate coursework that is relevant
   - Who your mentors are and why you have selected them
   - Coursework you are planning to take and why
   - The number of years you anticipate being on the TL1 award
   - Your plans for the next 2-3 years if you do not receive the award
   - How the award will change or affect your career plans

Please upload your Research Plan
The required Research Plan should follow the standard NIH format (PHS 398).
Please note the new NIH requirements for this section around Rigor and Reproducibility.

The file name format should follow; "TL1 ClinicalFellowApp_ResearchPlan_Applicant last name_First name" 

The Research Plan includes:
   - Project Summary/Abstract (1 page limit, The Project Summary must contain a summary of the proposed clinical and translational research for the Tl1 Program. It is meant to serve as a succinct and accurate description of the proposed work when separated from the application. State the application’s broad, long-term objectives and specific aims, making reference to the multidisciplinary nature of the project. Describe concisely the research design and methods for achieving the stated goals. This section must be no longer than 4,000 characters.)
   - Introduction – Resubmission only; NIH PHS 398 form is NOT required (1 page limit)
   - Specific Aims & Research Strategy (Significance, Innovation, and Approach) (5 page limit)
   - Protection of Human Subjects, Inclusion of Women and Minorities, Inclusion of Children, Vertebrate Animals (3            page limit)
   - Targeted/Planned Enrollment Table (1 page limit)
   - Bibliography and References Cited/Progress Report Publication List (include PMCID # if applicable)                               - Consortium/Contractual Arrangements (If applicable. No page limit)