3B NRSA Data Table Format

PHS Applications and Pre-award Related Reporting (OD)

Attachment 3B PHS 398 NRSA Data Table Format

398 Forms and Instructions (Paper)

OMB: 0925-0001

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Complete List of Tables



Table 1 Membership of Participating Departments/Programs (New Applications)

Table 1 Membership of Participating Departments/Programs (Renewal/Revision Applications)

Table 2 Participating Faculty Members

Table 3 Institutional Training Grant Support Available to Participating Faculty Members, Departments, or Programs

Table 4 Grant and Contract Support of the Participating Faculty Members

Table 5A Predoctoral Trainees of Participating Faculty Members

Table 5B Postdoctoral Trainees of Participating Faculty Members

Table 6A Publications of Research Completed by Predoctoral Trainees (New Applications)

Table 6B Publications of Research Completed by Postdoctoral Trainees (New Applications)

Table 6A Publications of Research Completed by Predoctoral Trainees (Renewal Applications)

Table 6B Publications of Research Completed by Postdoctoral Trainees (Renewal Applications)

Table 7A Admissions and Completion Records for the Participating Departments and Programs During the Past Five Years (Predoctoral Applicants)

Table 7B Admissions and Completion Records for the Participating Departments and Programs During the Past Five Years (Postdoctoral Applicants)

Table 8A Qualifications of Recent Predoctoral Applicants

Table 8B Qualifications of Recent Postdoctoral Applicants

Table 9A Qualifications of the Current Predoctoral Trainees Clearly Associated with the Training Program (New Applications)

Table 9B Qualifications of the Current Postdoctoral Trainees Clearly Associated with the Training Program (New Applications)

Table 9A Qualifications of the Current Predoctoral Trainees Clearly Associated with the Training Program (Renewal/Revision Applications)

Table 9B Qualifications of the Current Postdoctoral Trainees Clearly Associated with the Training Program (Renewal/Revision Applications)

Table 10 Admissions and Completion Records for Underrepresented Minority (URM), Trainees with Disabilities, and Trainees from Disadvantaged Backgrounds Clearly Associated with the Training Program (Renewal Applications, Optional for New Applications)

Table 11 Appointments to the Training Grant For Each Year of the Past Award (Renewal Applications Only)

Table 12A Predoctoral Trainees Supported by this Training Grant (Renewal Applications Only)

Table 12B Postdoctoral Trainees Supported by this Training Grant (Renewal Applications Only)

Table 1. Membership of Participating Departments and Programs (New Applications)

Participating

Department

or Program

Faculty

Members





In

Department

or Program

Faculty

Members





Participating

in This

Application

Predoctoral

Trainees

in

Department

or Program

[Supported by Any NIH Training Grant]

Predoctoral

Trainees



With Participating Faculty
Total (TGE)

A/B/C

Leave Column

Blank

Postdoctoral Trainees

in Department

or Program
[Supported by Any NIH Training Grant]

Postdoctoral Trainees



With Participating Faculty
Total (TGE)
A/B/C

Leave

Column

Blank




























Totals

Need not sum

Need not sum









Table 1. Membership of Participating Departments and Programs (Renewal/Revision Applications)

Participating

Department

or Program

Faculty

Members





In

Department

or Program

Faculty

Members





Participating

in This

Application

Predoctoral

Trainees

in

Department

or Program

[Supported by Any NIH Training Grant]

Predoctoral

Trainees



With Participating Faculty
Total (TGE)

A/B/C

Predoctoral

Trainees



Supported by This Training Grant
Total (TGE)
A/B/C

Postdoctoral Trainees

in Department

or Program
[Supported by Any NIH Training Grant]

Postdoctoral Trainees



With Participating Faculty
Total (TGE)
A/B/C

Postdoctoral Trainees



Supported by This Training Grant
(TGE)
A/B/C




























Totals

Need not sum

Need not sum









Table 2. Participating Faculty Members
(Alphabetically by Faculty Member)

Name/Degree(s)

Rank

Primary (& Secondary) Appointment(s)

Role in Program

Research Interest























Table 3. Institutional Training Grant Support Available to Participating Faculty Members, Department(s), or Program(s)

Title of Training Grant

Funding Source Including Identifying Number

Active or Pending Project Period

Program Director
(Department)

Predoctoral Trainees Supported This Year

Postdoctoral Trainees Supported This Year

Short-Term Trainees Supported This Year

Total No. of Participating Faculty

(Number Overlapping)

Names of Overlapping Faculty














































Totals

N/A

N/A

N/A




N/A

N/A



Table 4. Grant and Contract Support of the Participating Faculty Members
(Alphabetically by Faculty Member)

Faculty Member

Faculty Member Role on Project and Grant Title

Source of Support Grant Number

and Status

Project Period

Current Year Direct Costs Awarded
(Total Direct Costs for Awards With Substantial Future Changes)






































Table 5A. Predoctoral Trainees of Participating Faculty Members
(Alphabetically by Faculty Member for the Past Ten Years)

Faculty Member

Past / Current Trainee

Trainee Name
(Where Training Occurred)

Training Period

(Degree)

Prior Academic Degree
Institution(s)

Prior Academic Degree(s)

Prior Academic Degree
Year(s)

Title of Research Project

Current Position of Past Trainees /
Source of Support of Current Trainees
















































Table 5B. Postdoctoral Trainees of Participating Faculty Members
(Alphabetically by Faculty Member for the Past Ten Years)

Faculty Member

Past / Current Trainee

Trainee Name
(Where Training Occurred)

Postdoc Research Training Period

Prior Academic Degree(s)

Prior Academic Degree
Year(s)

Prior Academic Degree
Institution(s)

Title of Research Project

Current Position of Past Trainees /
Source of Support of Current Trainees











































































Table 6A. Publications of Research Completed by Predoctoral Trainees (New Applications)
(Group Past and Current Trainees Separately, then sort by Year of Entry)

Mentor(s)

Past / Current

Name of Trainee
(Years in Program)

Publication (Authors, Year, Title, Journal, PMCID)





























Table 6B. Publications of Research Completed by Postdoctoral Trainees (New Applications)
(Group Past and Current Trainees Separately, then sort by Year of Entry)

Mentor(s)

Past / Current

Name of Trainee
(Years in Program)

Publication (Authors, Year, Title, Journal, PMCID)



























Table 6A. Publications of Research Completed by Predoctoral Trainees (Renewal/Revision Applications)
(Group Past and Current Trainees Separately, then sort by Year of Entry)

Name of Trainee
(Years in Program)

Past / Current

Mentor(s)

Publication (Authors, Year, Title, Journal, PMCID)



























Table 6B. Publications of Research Completed by Postdoctoral Trainees (Renewal/Revision Application)
(Group Past and Current Trainees Separately, then sort by Year of Entry)

Name of Trainee
(Years in Program)

Past / Current

Mentor(s)

Publication (Authors, Year, Title, Journal, PMCID)



























Table 7A. Admissions and Completion Records for the Participating Departments and Programs During the Past Five Years (Predoctoral Applicants)

Department /
Program

Entering
Year

Applicants Applied (TGE)
A

Applicants Accepted (TGE)
A

Applicants Enrolled
(TGE)
A/B/C

Trainees Still in
Program
(TGE)
A/B/C

Trainees Completed Program
Earned PhD or
MD/PhD
(TGE)
A/B/C

Trainees

Left Program
Earned Other Degree
(TGE)
A/B/C

Trainees Left Program Without Degree
(TGE)
A/B/C

Reason for Leaving Program
(if training was not completed)
















































































































Total All Programs


















































Sums all Years










Average all Years












Table 7B. Admissions and Completion Records for the Participating Departments and Programs During the Past Five Years (Postdoctoral Applicants)

Department /
Program

Entering
Year

Previous

Degree

Type

Applicants Applied
(TGE)
A

Applicants Accepted (TGE)
A

Applicants Entered Program
(TGE)
A/B/C

Trainees Still in
Program
(TGE)
A/B/C

Trainees Completed Program
(TGE)
A/B/C

Trainees Left Program
(TGE)
A/B/C

Reason for Leaving Program
(if training was not completed)














































































































 

Total All Programs








































Sums










Averages












Table 8A. Qualifications of Recent Predoctoral Applicants

Year

Department / Program

Applicant (List by Number)

Previous Institution(s)

Degree(s) & Year(s)

Undergrad
GPA

GRE Scores
V, Q, A, S (Percentiles) and/or MCAT Scores

Interviewed
(Y/N)

Accepted
(Y/N)

Enrolled
(Y/N)

Support from this Grant
(Y/N)






































































































Program Statistics

Total Number of Applicants

Number of TGE Applicants

Applicants Interviewed

Applicants Accepted

Applicants Enrolled

Applicants Supported By This Grant

Average GRE and/or
MCAT Scores

Average GPA











Table 8B. Qualifications of Recent Postdoctoral Applicants

Year

Department/ Program

Applicant (List by Number)

Previous Institution

Degree(s) & Year(s)

Doctoral Thesis or Other Research Experience & Research Advisor
(if relevant)

Residency Training Institution PGY

Offered Position
(Y/N)

Entered Program
(Y/N)

Support from this Grant
(Y/N)





























































































Table 9A. Qualifications of the Current Predoctoral Trainees Clearly Associated with the Training Program

(New Applications)

Department / Program

Trainee
(List by Number)

Previous Institution(s)

Degree(s) & Year(s)

Undergraduate
GPA

GRE Scores
V, Q, A, S

(Percentiles)
and/or
MCAT Scores

Current Research Mentor

Years in Program

Leave Column Blank







































Program Statistics

Total Number of Trainees

Number of TGE Trainees

Average GPA

Average GRE /
MCAT Scores







Table 9B. Qualifications of the Current Postdoctoral Trainees Clearly Associated with the Training Program

(New Applications)

Department / Program

Trainee
(List by Number)

Previous Institution(s)

Degree(s) & Year(s)

Doctoral Thesis or Other Previous Research Experience & Research Advisor (If Relevant)

Residency Training Institution

Current Research Mentor

Years in Program

Leave

Column

Blank

























































Program Statistics

Total Number of Trainees

Number of TGE Trainees





Table 9A. Qualifications of the Current Predoctoral Trainees Clearly Associated with the Training Program

(Renewals/Revisions Applications)

Department / Program

Trainee
(List by Number)

Previous Institution(s)

Degree(s) & Year(s)

Undergraduate
GPA

GRE Scores / (Percentiles)
V, Q, Adv
and/or
MCAT Scores

Current Research Mentor

Years in Program

Calendar Years Appointed to This Grant







































Program Statistics

Total Number of Trainees

Number of TGE Trainees

Average GPA

Average GRE /
MCAT Scores







Table 9B. Qualifications of the Current Postdoctoral Trainees Clearly Associated with the Training Program (Renewals/Revisions)

Department / Program

Trainee
(List by Number)

Previous Institution(s)

Degree(s) & Year(s)

Doctoral Thesis or Other Previous Research Experience & Research Advisor (If Relevant)

Residency Training Institution

Current Research Mentor

Years in Program

Calendar Years Appointed to This Grant

























































Program Statistics

Total Number of Trainees

Number of TGE Trainees





Table 10: Admissions and Completion Records for Underrepresented Minority (URM) Trainees, Trainees with Disabilities, and Trainees from Disadvantaged Backgrounds Clearly Associated With the Training Program

Diversity Recruitment Group

Trainee
(List by Number)

Entering Year
(Pre/Post)

Department / Program

Source of Support and if Support by NRSA Grant

In Training

Completed Training

Left Without Completing Training

Current Status
Career or Employment


































































Table 11. Appointments to the Training Grant For Each Year of the Past Award (Renewal Applications Only)

Grant Year

yyyy-yyyy

yyyy-yyyy

yyyy-yyyy

yyyy-yyyy

yyyy-yyyy

Predoctoral Positions Awarded (Months of Support)






Predoctoral Trainees Appointed (Months of Support Used)






Predoctoral URM Trainees Appointed (Months of Support)






Predoctoral Trainees with Disabilities Appointed (Months of Support)






Predoctoral Trainees from Disadvantaged Background Appointed
(Months of Support)






Postdoctoral Positions Awarded (Months of Support)






Postdoctoral Trainees With MD Appointed






Postdoctoral Trainees With MD/PhD Appointed






Postdoctoral Trainees With PhD Appointed






Postdoctoral Trainees With Other Degree Appointed






Postdoctoral Trainees Appointed (Months of Support Used)






Postdoctoral URM Trainees Appointed (Months of Support)






Postdoctoral Trainees with Disabilities Appointed (Months of Support)






Postdoctoral Trainees from Disadvantaged Background Appointed
(Months of Support)








Table 12A. Predoctoral Trainees Supported by This Training Grant (Renewal/Revision Applications and Non-Competing Continuation Progress Reports Only)

Predoctoral (and MSTP) Trainees (Listed Sequentially by Entering Class)
Enter Source(s) of Support and Academic Year for Each Grant Year

Trainee, Year of Entry, Prior Degree & Institution (Mentor – Department / Program)

Grant Year
-01
_____

Grant Year
-02
_____

Grant Year
-03
_____

Grant Year
-04
_____

Grant Year
-05
_____

Grant Year
-06
_____

Grant Year
-07
_____

Grant Year
-08
_____

Grant Year
-09
_____

Grant Year
-10
_____

Title of Research Project or Research Topic

Degree(s) Received (Year)

Current Position and Institution (Grant Support Obtained)









































































Program Statistics

Percentage of T32 Appointees Entering Graduate School 10 Years Ago That Completed Ph.D.s

Average Time to Ph.D. for T32 Appointees in the Last 10 Years
(not including leaves of absence)





Table 12B. Postdoctoral Trainees Supported by This Training Grant (Renewal/Revision Applications and Non-Competing Continuation Progress Reports Only)

Postdoctoral Trainees (Listed Sequentially by Year of Entry)
Enter Source(s) of Support and Academic Year for Each Grant Year

Trainee, Year of Entry, Prior Degree & Institution (Mentor – Department / Program)

Grant Year
-01
_____

Grant Year
-02
_____

Grant Year
-03
_____

Grant Year
-04
_____

Grant Year
-05
_____

Grant Year
-06
_____

Grant Year
-07
_____

Grant Year
-08
_____

Grant Year
-09
_____

Grant Year
-10
_____

Title of Research Project or Research Topic

Degree or Certification (Year) or Other Relevant Outcome

Current Position and Institution (Grant Support Obtained)















































File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleU.S. DHHS Public Health Service Grant Application, Blank Data Tables
SubjectU.S. DHHS Public Health Service Grant Application, Blank Data Tables
AuthorOffice of Extramural Programs, OER, NIH
File Modified0000-00-00
File Created2021-01-30

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