Form Approved
OMB No. 0920-0765
Exp. Date 01/31/2021
Attachment 2 – FMS Application Module
Fellowship Management System (FMS)
FMS Application Module |
2017 |
Epidemic Intelligence Service (EIS) Application Example |
Privacy Act and Public Burden Information |
Privacy Act Information The Privacy Act applies to this information collection. Information collected will be kept private as noted in the System of Records Notice is 09-20-0112, Fellowship Program and Guest Researcher Records.
Public Burden Information Form Approved OMB No. 0920-0765 Exp. Date 01/31/2021
Public reporting burden of this collection of information varies from 40 minutes to 135 minutes with an estimated average of 105 minutes (1 and 45/60 hours) per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-0765). |
2 Login and Registration Pages 3
2.2 Registration Page (For New Users) 4
2.3 Forgot Your E-mail? Page 5
2.4 Forgot Your Password? Page 6
3 Application Instructions page 9
3.1 Application Instructions 9
4 Application Status and Submission 12
4.1 Application Status Page 12
4.2 Track Your Application Page 13
4.3 Pre-Submission Validation Section 14
4.4 Application Submission Section 15
4.5 Application Withdrawal Section 15
5.1 Contact Information Section 16
5.2 Citizenship Status Section 18
5.3 Emergency Contact Section 19
5.4 Health Insurance Section 19
6.2 Program Eligibility Section 21
6.3 High School Education Section 23
6.4 College/University Education Section 24
6.4.1 Professional License Sub-Section 28
6.5 Additional Coursework Section 29
7 Postgraduate Training and Skills 30
7.1 Postgraduate Training and Skills Page 30
7.2 Clinical Training Section 31
7.3 U.S. Board Certification Section 32
7.4 Additional Training Section 32
8 Work and Volunteer Experience 34
8.1 Work and Volunteer Experiences Page 34
8.2 Work Experience Section 35
8.3 Volunteer Experience Section 38
8.4 Research Experience Section 40
9 Publications, Presentations, Grants 41
9.1 Publications, Presentations, Grants Page 41
9.6 Monograph and Report Section 44
10.1 Honors and Awards Page 45
11.1 Personal Statement Page 46
12.1 Application Survey Page 47
12.2 Program Awareness Section 48
12.3 Interest Areas and Preferences Section 51
12.4 Location Preferences Section 54
13 Letters of Recommendation Page 56
13.1 Letters of Recommendation Page 56
14.1 Special Requirements Section 58
15 Self-Assessments of Skills 58
15.1 Public Health Informatics Fellowship (PHIF) Program Skills 58
15.1.1 Information Systems Skills 60
15.1.2 Information Sciences Skills 61
15.1.3 Computer Sciences Skills 62
15.1.4 Leadership and Project Management Skills 63
15.1.5 Public Health and Health Care Skills 64
15.2 CDC-Hubert and Epi-Elect Program Skills 65
15.2.2 Computer Skills Section 66
15.2.3 Laboratory and Research Skills Section 66
15.3 Prevention Effectiveness Fellowship (PEF) Skills 67
16 Appendix A – EIS Example E-mails 72
16.1 Applicant Reset Password Information 72
16.2 Application Submission Confirmation 72
16.3 Interview Invitation for US Applicants 73
16.4 Interview Invitation for International Applicants 74
16.5 Interview Confirmation for US Applicants 76
16.6 Interview Confirmation for International Applicants 76
16.8 Invitation to Match Letter 78
16.9 Travel Confirmation Letter 78
The purpose of this document is to list all the data elements collected online through the Fellowship Management System (FMS). The FMS online application module is a streamlined mechanism for applicants of the Centers for Disease Control and Prevention (CDC) fellowships to submit their information online and track statuses of the application processes (e.g., all required materials received, invited for interviews). The FMS is a robust flexible framework and the FMS Application Module is tailored successfully for various CDC fellowships:
Epidemic Intelligence Service (EIS)
Public Health Informatics Fellowship (PHIF)
CDC-Hubert Global Health Fellowship (Hubert)
CDC Epidemiology Elective Program for senior medical and veterinary Students (Epi-Elect)
Prevention Effectiveness Fellowship (PEF)
Public Health Associate Program (PHAP)
Science Ambassador Fellowship Program (SA)
The Preventive Medicine Residency and Fellowship (PMR/F)
This document is broken down by the major pages of the FMS Application. In this document, each page of the FMS Application has sections and some sub-sections. In addition, application instructions, login, and registration pages are included. Appendix A provides examples of emails generated by FMS for the EIS application process. The application instructions and emails provided in this document are examples from EIS; instructions and emails in the FMS Application are tailored to each CDC fellowship’s requirements, eligibility criteria, information, and timeline.
The main screenshots of the Application pages, sections, or subsections are from EIS with additional screenshots of additional data elements collected by other CDC fellowships.
Following the screenshots in each section is a table that shows the status of the collection of data elements by each CDC fellowships. The following labels indicate the status of the collection:
“Yes” indicates that the fellowship collects the information and that applicants are required to submit this information.
“Opt” indicates that the fellowship collects the information and that it is optional for applicants to submit this information.
“-” indicates that the fellowship does not collect this information.
In addition, the table shows the data values of each data element, and for ones that have a list of dropdown values, the data value category is hyperlinked to its list located in Appendix B.
The following table (Table 1.1‑a) provides an overview of the major pages and sections in the FMS Application module used by each fellowship program. The “Yes” indicates that the fellowship uses the page or section, whereas, the “-” indicates that the fellowship does not use the page or section.
Table 1.1‑a. FMS Application Page and Section used by Fellowship Programs
Section |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
|
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
|
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
|
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
|
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
|
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
|
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
|
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
|
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
|
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
|
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
|
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
|
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
|
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
|
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
|
- |
- |
Yes |
Yes |
- |
- |
- |
- |
|
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
|
- |
- |
- |
- |
- |
- |
- |
- |
|
Yes |
- |
- |
- |
Yes |
Yes |
- |
- |
|
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
|
Yes |
- |
- |
- |
- |
Yes |
- |
- |
|
- |
- |
- |
- |
- |
- |
- |
Yes |
|
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
|
Yes |
- |
- |
- |
- |
Yes |
- |
- |
|
Yes |
- |
- |
- |
- |
Yes |
- |
- |
|
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
- |
|
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
|
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
|
Yes |
Yes |
Yes |
Yes |
Yes |
- |
- |
Yes |
|
- |
- |
- |
- |
Yes |
- |
- |
- |
|
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
|
|
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
|
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
|
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
|
- |
- |
- |
- |
Yes |
- |
- |
- |
|
- |
- |
- |
- |
- |
- |
- |
- |
|
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
|
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
|
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
|
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
|
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
|
Yes |
Yes |
Yes |
Yes |
- |
Yes |
Yes |
- |
|
Yes |
- |
- |
- |
- |
Yes |
Yes |
- |
|
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
|
- |
- |
- |
- |
- |
- |
Yes |
- |
|
- |
Yes |
Yes |
Yes |
Yes |
- |
- |
- |
Figure 2.1‑a. Application Home Page Log In
Figure 2.1‑b. Privacy Act and Public Burden Information
Privacy Act and Public Burden Information |
Privacy Act Information The Privacy Act applies to this information collection. Information collected will be kept private as noted in the System of Records Notice is 09-20-0112, Fellowship Program and Guest Researcher Records.
Public Burden Information Form Approved OMB No. 0920-0765 Exp. Date 01/31/2021
Public reporting burden of this collection of information varies from 40 minutes to 135 minutes with an estimated average of 105 minutes (1 and 45/60 hours) per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-0765). |
Table 2.1‑a
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
Government Warning |
Checkbox |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Alphanumeric |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
|
Password |
Alphanumeric |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Figure 2.2‑a. Registration Page
Table 2.2‑a. Registration Page Data Elements
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
First Name |
Text |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Preferred Name |
Text |
Opt |
Opt |
- |
- |
- |
Opt |
Opt |
Opt |
Middle Name |
Text |
Opt |
Opt |
Opt |
Opt |
Opt |
Opt |
Opt |
Opt |
Last Name |
Text |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
E-mail Address |
Alphanumeric |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Verify E-mail Address |
Alphanumeric |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Country Code |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
|
Primary Phone |
Numeric |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Verify Phone |
Numeric |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Password |
Alphanumeric |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Verify Password |
Alphanumeric |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Secret Question |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
|
Secret Answer |
Alphanumeric |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Confirm Answer |
Alphanumeric |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Figure 2.3‑a. Forgot your Email? Contact Information
Figure 2.3‑b. Forgot your Email? Secret Question
Figure 2.3‑c. Forgot your Email? Email Display
Table 2.3‑a. Forgot your E-mail? Page Data Elements
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
First Name |
Text |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Last Name |
Text |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Country Code |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
|
Primary Phone |
Numeric |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Secret Question |
Selected Secret Question |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Secret Answer |
Alphanumeric |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Figure 2.4‑a. Forgot your Password? Contact Information
Figure 2.4‑b. Forgot your Password? Secret Question
Figure 2.4‑c. Forgot your Password? New Password
Figure 2.4‑d. Forgot your Password? Password Changed
Table 2.4‑a. Forgot your Password Page Data Elements
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
First Name |
Text |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Last Name |
Text |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Login E-mail |
Alphanumeric |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Country Code |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
|
Primary Phone |
Numeric |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Secret Question |
Selected Secret Question |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Secret Answer |
Alphanumeric |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Password |
Alphanumeric |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Verify Password |
Alphanumeric |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Table 2.5‑a. Reset Password
Table 2.5‑b. Reset Password Elements
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
Text |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
|
Current Password |
Text |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
New Password |
Alphanumeric |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Verify Password |
Alphanumeric |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Secret Answer |
Alphanumeric |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Secret Question |
Alphanumeric |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Figure 3.1‑a. Deadline and General Instructions Example from EIS*
*Note: Instructions and information are tailored to each fellowship program’s information.
Figure 3.1‑b. Supporting Material Instructions Example from EIS*
*Note: Instructions and information are tailored to each fellowship program’s information.
Figure 3.1‑c. Submission of Supporting Materials Example from EIS*
*Note: Instructions and information are tailored to each fellowship program’s information.
Figure 3.1‑d. After Submitting Your Application Example from EIS*
*Note: Instructions and information are tailored to each fellowship program’s information.
Figure 4.1‑a. Application Status Page
Figure 4.2‑a. Track Your Application Page
Figure 4.3‑a. Pre-Submission Validation*
*Note: Only collected from applicants with time gaps.
Figure 4.3‑b. Gap Explanation*
* Note: Only collected from applicants with time gaps.
Table 4.3‑a. Pre-Submission Validation Section Data Element
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
Dates from Gap Time |
Date |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
- |
Dates To Gap Time |
Date |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
- |
Explanation for Gaps |
Text |
Yes |
Yes |
- |
- |
Yes |
Yes |
- |
- |
Figure 4.4‑a. Submit Confirmation
Figure 4.4‑b. Application Certification
Table 4.4‑a. Application Submission Section Data Elements
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
Submit Application |
Submit Button |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
Application Certification |
I agree/ do not agree |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
Figure 4.5‑a. Withdraw Application*
*Note: Only collected from applicants who wish to withdraw their applications.
Table 4.5‑a. Application Withdrawal Section Data Elements
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
Reasons for Withdrawal |
Text |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Opt |
Figure 5.1‑a. Contact Information
Table 5.1‑a. Contact Information Section Data Elements
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
First Name |
Already Populated |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Last Name |
Already Populated |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Middle Name |
Text |
Opt |
Opt |
Opt |
Opt |
Opt |
Opt |
Opt |
Opt |
Suffix |
Text |
Opt |
Opt |
Opt |
Opt |
Opt |
Opt |
Opt |
Opt |
Other Name |
Text |
Opt |
Opt |
Opt |
Opt |
Opt |
Opt |
Opt |
Opt |
Degree |
- |
- |
- |
- |
- |
- |
Yes |
Yes |
|
Mailing Address Line 1 |
Text |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Mailing Address Line 2 |
Text |
Opt |
Opt |
Opt |
Opt |
Opt |
Opt |
Opt |
Opt |
Mailing Address Line 3 |
Text |
Opt |
Opt |
Opt |
Opt |
Opt |
Opt |
Opt |
Opt |
Country |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
|
State/Province |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
|
City |
Text |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Zip/Postal Code |
Numeric |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Country Code |
Already Populated |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Primary Phone |
Already Populated |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Work Phone |
Numeric |
Opt |
Opt |
Opt |
Opt |
Opt |
Opt |
Opt |
Opt |
Alternate Phone |
Numeric |
Opt |
Opt |
Opt |
Opt |
Opt |
- |
Opt |
Opt |
Fax Number |
Numeric |
- |
Opt |
- |
- |
- |
Yes |
- |
- |
E-mail Address |
Already Populated |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Section Complete |
Yes/No Choice |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Figure 5.2‑a. Country of Citizenship
Figure 5.2‑b. Permanent Residency Status
Figure 5.2‑c. Non-Permanent Residency Status
Table 5.2‑a. Citizenship Status Section Data Elements
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
Country of Citizenship |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
|
Permanent Residence |
Yes/No Choice |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Green Card Number |
Numeric |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Green Card Expiration |
Date |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Live in U.S. |
Yes/No Choice |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Visa Type |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
|
Visa Expiration |
Date |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Figure 5.3‑a. Emergency Contact
Table 5.3‑a. Emergency Contact Data Elements
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
Emergency Contact (EC) |
Text |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
EC Relationship |
Text |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
EC Telephone |
numeric |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
EC Email |
Text |
Opt |
Opt |
Opt |
Opt |
Opt |
Opt |
Yes |
Opt |
Figure 5.4‑a. Insurance Status*
*Only collected by the CDC-Hubert Global Health Fellowship and CDC Epidemiology Elective (Epi-Elect) programs since candidates are current students.
Table 5.4‑a. Health Insurance Data Elements
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
||
Health Insurance Coverage |
Yes/No Choice |
- |
- |
Yes |
Yes |
- |
- |
- |
- |
|
Figure 6.1‑a. Education Page
Table 6.1‑a. Education Page Data Elements
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
Primary Professional Category |
Yes |
Yes |
- |
- |
Yes |
Yes |
- |
Yes |
|
Transcript Upload |
File upload |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
- |
Section Complete |
Yes/No Choice |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Figure 6.2‑a. EIS Program Eligibility*
*Note:
Only collected by the Epidemic Intelligence Service (EIS).
Figure 6.2‑b. PEF Program Eligibility*
*Note: Only collected by the Prevention Effectiveness Fellowship (PEF).
Figure 6.2‑c. PMR/F Program Eligibility*
*Note: Only collected by the Fellowship program of the Preventive Medicine Residency (PMR/F) program.
Table 6.2‑a. Program Eligibility Section Data Elements
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
Qualified Physician |
Yes/No Choice |
Yes |
- |
- |
- |
- |
Yes |
|
|
Qualified Veterinarian |
Yes/No Choice |
Yes |
- |
- |
- |
- |
- |
|
|
Qualified PhD |
Yes/No Choice |
Yes |
- |
- |
- |
- |
- |
|
|
Qualified health professional |
Yes/No Choice |
Yes |
- |
- |
- |
- |
- |
|
|
MPH |
Yes/No Choice |
Yes |
- |
- |
- |
- |
Yes |
|
|
MPH equivalent |
Yes/No Choice |
Yes |
- |
- |
- |
- |
Yes |
|
|
Public Health Experiences |
Yes/No Choice |
Yes |
- |
- |
- |
- |
- |
|
|
U.S. Citizen or Resident |
Yes/No Choice |
Yes |
- |
- |
- |
- |
- |
|
|
Country |
Yes |
- |
- |
- |
- |
- |
|
|
|
J-1 eligible |
Yes/No/Don’t know |
Yes |
- |
- |
- |
- |
- |
|
|
Degree in Decision Science |
Yes/No Choice |
- |
- |
- |
- |
Yes |
|
- |
- |
Willing to Relocate |
Yes/No Choice |
Yes |
- |
- |
- |
Yes |
|
- |
- |
EIS Officer or Alumnus |
Yes/No Choice |
- |
- |
- |
- |
- |
Yes |
- |
- |
Eligible |
Yes/No Choice |
- |
- |
- |
- |
- |
Yes |
|
|
U.S. License Jurisdiction |
Yes/No Choice |
- |
- |
- |
- |
- |
Yes |
|
|
International Medical Graduate |
Yes/No Choice |
- |
- |
- |
- |
- |
Yes |
|
|
ACGME or AOA Postgraduate Training |
Yes/No Choice |
- |
- |
- |
- |
- |
Yes |
|
|
Figure 6.3‑a. High School Education Section*
*Note: Only collected by Epidemic Intelligence Service (EIS) program.
Table 6.3‑a. High School Education Section Data Elements
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
High School |
Text |
Yes |
- |
- |
- |
- |
- |
- |
- |
Country |
Yes |
- |
- |
- |
- |
- |
- |
- |
|
State |
Yes |
- |
- |
- |
- |
- |
- |
- |
|
City |
Text |
Yes |
- |
- |
- |
- |
- |
- |
- |
Attended From |
Date |
Yes |
- |
- |
- |
- |
- |
- |
- |
Attended To |
Date |
Yes |
- |
- |
- |
- |
- |
- |
- |
Grade Point Average |
Numeric |
Opt |
- |
- |
- |
- |
- |
- |
- |
Academic Honor |
Yes/No Choice |
Yes |
- |
- |
- |
- |
- |
- |
- |
Type of Honor |
Yes |
- |
- |
- |
- |
- |
- |
- |
Figure 6.4‑a. College Education Section
Figure 6.4‑b. Science Ambassadors College Education Section*
*Note: Only collected by Science Ambassadors program.
Figure 6.4‑c. Incomplete Degree Status*
*Note: Only collected from applicants who did not complete their degree.
Figure 6.4‑d. Thesis Abstract*
*Note: Only collected by the Prevention Effectiveness Fellowship (PEF) Program.
Figure 6.4‑e. In School Information*
*Note: Only collected by the CDC-Hubert Global Health Fellowship and CDC Epidemiology Elective (Epi-Elect) programs.
Table 6.4‑a. College/University Education Section Data Elements
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
Country |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
|
State/Province |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
|
College/University |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
|
Attended From |
Date |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
Attended To |
Date |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
Status |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
|
Degree |
Yes |
- |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
|
Degree Date |
Month/Year |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Degree Incomplete Reason |
Text |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
Major |
Text |
Yes |
- |
Yes |
Yes |
- |
Yes |
Yes |
Yes |
Major Classification |
Yes |
Yes |
- |
- |
- |
Yes |
- |
- |
|
Minor |
Text |
Opt |
Opt |
Opt |
Opt |
Opt |
Opt |
- |
Opt |
Grade Point Average |
Numeric |
Opt |
Opt |
Yes |
Yes |
- |
Opt |
- |
Opt |
Complete Thesis |
Yes/No Choice |
Yes |
Yes |
- |
- |
Yes |
Yes |
- |
Opt |
Thesis Title |
Text |
Yes |
Yes |
- |
- |
Yes |
Yes |
- |
Opt |
Thesis Abstract |
Text (100 word limit) |
- |
- |
- |
- |
Yes |
- |
- |
- |
Academic Honor |
Yes/No Choice |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Opt |
Academic Honor Type |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Opt |
|
U.S. License |
Yes/No Choice |
Yes |
Yes |
- |
- |
Yes |
Yes |
- |
Yes |
Year in School |
- |
- |
Yes |
Yes |
- |
- |
- |
- |
|
Public/Private |
Public/Private Choice |
- |
- |
Yes |
Yes |
- |
- |
- |
- |
Clinical Rotations |
Text |
- |
- |
Yes |
Yes |
- |
- |
- |
- |
Academic Endorsement |
Form Download |
- |
- |
Yes |
Yes |
- |
- |
- |
- |
Figure 6.4‑f. Expected License Sub-Section*
*Note: Only collected by Epidemic Intelligence Service (EIS) and PMR/F program.
Figure 6.4‑g. Active License Sub-Section*
*Note: Only collected by Epidemic Intelligence Service (EIS) program.
Table 6.4‑b. Professional License Sub-Section Data Elements
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
License Status |
Yes |
- |
- |
- |
- |
Yes |
- |
- |
|
Issuing State |
Yes |
- |
- |
- |
- |
Yes |
- |
- |
|
Expected Date |
Date |
Yes |
- |
- |
- |
- |
Yes |
- |
- |
Expiration Date |
Date |
Yes |
- |
- |
- |
- |
Yes |
- |
- |
License Number |
Numeric |
Yes |
- |
- |
- |
- |
Yes |
- |
- |
Copy of Clinical License |
File Upload |
Yes |
- |
- |
- |
- |
Yes |
- |
- |
Figure 6.5‑a. Additional Coursework Section
*Note: Only collected by Epidemic Intelligence Service (EIS) program.
Table 6.5‑a. Additional Coursework Section Data Elements
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
Country |
Yes |
- |
- |
- |
- |
Yes |
- |
Yes |
|
State/Province |
Text |
Yes |
- |
- |
- |
- |
Yes |
- |
Yes |
College/University |
Text |
Yes |
- |
- |
- |
- |
Yes |
- |
Yes |
Attended From |
Date |
Yes |
- |
- |
- |
- |
Yes |
- |
Yes |
Attended To |
Date |
Yes |
- |
- |
- |
- |
Yes |
- |
Yes |
Course Status |
Yes |
- |
- |
- |
- |
Yes |
- |
Yes |
|
Number of Credits |
Numeric |
Yes |
- |
- |
- |
- |
Yes |
- |
Yes |
Course Name |
Text |
Yes |
- |
- |
- |
- |
Yes |
- |
Yes |
Figure 7.1‑a. Postgraduate Training and Skills Page
Table 7.1‑a. Postgraduate Training and Skills Page Data Elements
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
Post-grad clinical training |
Yes/No Choice |
Yes |
- |
- |
- |
Yes |
Yes |
- |
- |
U.S. Board Certification |
Yes/No Choice |
Yes |
- |
- |
- |
Yes |
Yes |
- |
- |
Additional Training |
Yes/No Choice |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
Language Skills |
Yes/No Choice |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Primary Spoken Language |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
|
Secondary Languages |
Opt |
Opt |
Opt |
Opt |
Opt |
Opt |
Yes |
- |
|
Language - Read |
Proficiencies |
Opt |
Opt |
Opt |
Opt |
Opt |
Opt |
Yes |
- |
Language - Write |
Proficiencies |
Opt |
Opt |
Opt |
Opt |
Opt |
Opt |
Yes |
- |
Language - Speak |
Proficiencies |
Opt |
Opt |
Opt |
Opt |
Opt |
Opt |
Yes |
- |
Section Complete |
Yes/No Choice |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Figure 7.2‑a. Clinical Training Section *
*Note: Only collected by Epidemic Intelligence Service (EIS) program.
Table 7.2‑a. Clinical Training Section Data Elements
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
Clinical Title |
Yes |
- |
- |
- |
- |
Yes |
- |
- |
|
Accredited by ACGME |
Yes/No Choice |
- |
- |
- |
- |
- |
Yes |
- |
- |
Medical Specialty |
Yes |
- |
- |
- |
- |
Yes |
- |
- |
|
Institution Name |
Text |
Yes |
- |
- |
- |
- |
Yes |
- |
- |
Country |
Yes |
- |
- |
- |
- |
Yes |
- |
- |
|
State/Province |
Text |
Opt |
- |
- |
- |
- |
Opt |
- |
- |
City |
Text |
Yes |
- |
- |
- |
- |
Yes |
- |
- |
Date From |
Date |
Yes |
- |
- |
- |
- |
Yes |
- |
- |
Date To |
Date |
Yes |
- |
- |
- |
- |
Yes |
- |
- |
Figure 7.3‑a. U.S. Board Certification Section*
*Note: Only collected by Epidemic Intelligence Service (EIS) program.
Table 7.3‑a. U.S. Board Certification Section Data Elements
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
Certification Body |
Text |
- |
- |
- |
- |
- |
Yes |
- |
- |
Board Status |
Yes |
- |
- |
- |
- |
Yes |
- |
- |
|
Specialty |
Yes |
- |
- |
- |
- |
Yes |
- |
- |
|
Expected Date |
Date |
Yes |
- |
- |
- |
- |
Yes |
- |
- |
Recent Issuance Date |
Date |
Yes |
- |
- |
- |
- |
Yes |
- |
- |
Recent Expiration Date |
Date |
Yes |
- |
- |
- |
- |
Yes |
- |
- |
Figure 7.4‑a. Additional Training and Certifications Section
Table 7.4‑a. Additional Training Section Data Elements
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
Training Program Name |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Change |
|
Description |
Text |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
Institution Name |
Text |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
- |
Country |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
|
State/Province |
Text |
Opt |
Opt |
Yes |
Yes |
Opt |
Opt |
- |
Yes |
City |
Text |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
Date from |
Date |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
Date to |
Date |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
Figure 7.4‑b. Additional Training*
*Note: Only collected by Science Ambassadors program.
Figure 8.1‑a. Work and Volunteer Experiences Page
Figure 8.1‑b. Work and Volunteer Experiences Page*
*Note: Only collected by Science Ambassadors program.
Table 8.1‑a. Work and Volunteer Experience Page Data Elements
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
Work Experience |
Yes/No Choice |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
Community or Volunteer Services |
Yes/No Choice |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
Research Experience |
Yes/No Choice |
Yes |
Yes |
- |
- |
Yes |
- |
- |
- |
PHS Corps Officer |
Yes/No Choice |
- |
- |
- |
- |
- |
Yes |
- |
- |
PHS Corps Rank |
- |
- |
- |
- |
- |
Yes |
- |
- |
|
Section Complete |
Yes/No Choice |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Figure 8.2‑a. Work Experience Section
Figure 8.2‑b. Work Experience Section*
*Note: Only collected by Science Ambassadors program.
Figure 8.2‑c. Reason Opt to Supervisor Contact Section
Table 8.2‑a. Work Experience Section Data Elements
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
Employer |
Text |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
Address Line 1 |
Text |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Opt |
Address Line 2 |
Text |
Opt |
Opt |
Opt |
Opt |
Opt |
Opt |
- |
Opt |
Address Line 3 |
Text |
Opt |
Opt |
Opt |
Opt |
Opt |
Opt |
- |
Opt |
Country |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
|
State/Province |
Text |
Opt |
Opt |
Opt |
Opt |
Opt |
Opt |
- |
Yes |
City |
Text |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
- |
Zip/Postal Code |
Numeric |
Opt |
Opt |
Opt |
Opt |
Opt |
Opt |
- |
- |
Dates From |
Date |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
Dates To |
Date |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
Total Experiences |
Auto-calculated |
- |
Yes |
- |
- |
- |
- |
- |
- |
Job Title |
Text |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
Hours Per Week |
Numeric |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
- |
Job Duties/Responsibilities |
Text |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
Extracurricular Duties/Responsibilities |
Text |
|
|
|
|
|
|
|
Yes |
Accomplishments |
Text |
- |
Yes |
- |
- |
- |
Yes |
- |
Yes |
Reasons for Leaving |
Text |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
- |
Supervisor Name |
Text |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
- |
Contact Supervisor |
Yes/No Choice |
Opt |
Opt |
Opt |
Opt |
Opt |
Opt |
- |
- |
Supervisor Phone |
Numeric |
Opt |
Opt |
Opt |
Opt |
Opt |
Opt |
- |
- |
Supervisor Email |
Alphanumeric |
Opt |
Opt |
Opt |
Opt |
Opt |
Opt |
- |
- |
Reasons No to Contact Supervisor |
Text |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
- |
Figure 8.3‑a. Volunteer Experience Section
Figure 8.3‑b. Reasons Opt to Supervisor Contact Section
Table 8.3‑a. Volunteer Experience Section Data Elements
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
Organization |
Text |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
Address Line 1 |
Text |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
- |
Address Line 2 |
Text |
Opt |
Opt |
Opt |
Opt |
Opt |
Opt |
- |
- |
Address Line 3 |
Text |
Opt |
Opt |
Opt |
Opt |
Opt |
Opt |
- |
- |
Country |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
|
State/Province |
Text |
Opt |
Opt |
Opt |
Opt |
Opt |
Opt |
- |
Yes |
City |
Text |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
- |
Zip/Postal Code |
Numeric |
Opt |
Opt |
Opt |
Opt |
Opt |
Opt |
- |
- |
Dates From |
Date |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
Dates To |
Date |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
Title |
Text |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
Hours Per Week |
Numeric |
Opt |
Opt |
Opt |
Opt |
Opt |
Opt |
- |
- |
Duties/Responsibilities |
Text |
Yes |
Yes |
Yes |
Yes |
Yes |
|
- |
Yes |
Accomplishments |
Text |
- |
- |
- |
- |
- |
Yes |
- |
Yes |
Supervisor Name |
Text |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
- |
Contact supervisor |
Yes/No Choice |
Opt |
Opt |
Opt |
Opt |
Opt |
Opt |
- |
- |
Supervisor Phone |
Numeric |
Opt |
Opt |
Opt |
Opt |
Opt |
Opt |
- |
- |
Supervisor Email |
Alphanumeric |
Opt |
Opt |
Opt |
Opt |
Opt |
Opt |
- |
- |
Reasons No to Contact Supervisor |
Text |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
- |
Figure 8.4‑a. Research Experience Section*
*Note: Only collected by the Prevention Effectiveness Fellowship (PEF) Program
Table 8.4‑a. Research Experience Section Data Elements
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
Title |
Text |
Yes |
Yes |
- |
- |
Yes |
- |
- |
- |
Your Role |
Yes |
Yes |
- |
- |
Yes |
- |
- |
- |
|
Specify Role |
Text |
Yes |
Yes |
- |
- |
Opt |
- |
- |
- |
Dates From |
Date |
Yes |
Yes |
- |
- |
Opt |
- |
- |
- |
Dates To |
Date |
Yes |
Yes |
- |
- |
Yes |
- |
- |
- |
Description |
Text (100 word limit) |
Yes |
Yes |
- |
- |
Opt |
- |
- |
- |
Figure 9.1‑a. Publications, Presentations, Grants Page
Figure 9.1‑b. Working Papers (Job Market Papers) Section*
Figure 9.1‑c. Monographs and Reports Section*
Table 9.1‑a. Publications, Presentations, Grants Page Data Elements
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
Published |
Yes/No Choice |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
Presented |
Yes/No Choice |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
Presentation Citation |
Text |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
Research Grants |
Yes/No Choice |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
Working Paper |
Yes/No Choice |
Yes |
Yes |
- |
- |
Yes |
- |
- |
- |
Monographs and Reports |
Yes/No Choice |
Yes |
Yes |
- |
- |
- |
Yes |
- |
- |
Section Complete |
Yes/No Choice |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Figure 9.2‑a. Publication Section
Table 9.2‑a. Publications Section Data Elements
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
Publications Citation |
Text |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
Figure 9.3‑a. Presentation Section
Table 9.3‑a. Presentation Section Data Elements
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
Type of Presentation |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
|
Presentation Citation |
Text |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
Figure 9.4‑a. Research Grant Section
Table 9.4‑a. Research Grant Section Data Elements
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
Title |
Text |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
Role |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
|
Date |
Date |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
Funding Agency |
Text |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
Amount Awarded |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
Figure 9.5‑a. Working Papers Section*
Table 9.5‑a. Working Papers Section Data Elements
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
Title |
Text |
Yes |
Yes |
- |
- |
Yes |
- |
- |
- |
Abstract |
Text (100 word limit) |
Yes |
Yes |
- |
- |
Yes |
- |
- |
- |
Figure 9.6‑a. Monograph and Report Section
Table 9.6‑a. Monographs and Reports Section Data Elements
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
Citation |
Text |
Yes |
Yes |
- |
- |
Yes |
- |
- |
- |
Figure 10.1‑a. Honors and Awards Page
Figure 10.1‑b. Honor or Award Section
Table 10.1‑a. Honors and Awards Page Data Elements
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
Received Honors/Awards |
Yes/No Choice |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
- |
Yes |
Bestowing Organization |
Text |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
- |
Yes |
Name of Honor/Award |
Text |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
- |
Yes |
Type of Honor/Award |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
- |
- |
|
Date Received |
Date |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
- |
Yes |
Section Complete |
Yes/No Choice |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Figure 11.1‑a. Personal Statement Page
Table 11.1‑a. Personal Statement Page Data Elements
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
Personal Statement |
Text |
Yes 750 words limit |
Yes 750 words limit |
Yes 750 words limit |
Yes 300 words limit |
Yes 1000 words limit |
Yes 1000 words limit |
Yes 750 words limit |
Yes 500 words limit |
Section Complete |
Yes/No Choice |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Figure 12.1‑a Previous Applications Section
Figure 12.1‑b. Other Fellowships Section*
*Note: The “Other Fellowships” Section is only collected by the Epidemic Intelligence Service (EIS) Program.
Figure 12.1‑c. Public Health/Population Based Work Experience Section*
*Note: This section is only collected by the Public Health Informatics Fellowship Program (PHIF).
Table 12.1‑a. Application Survey Page
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
Previous Submission |
Yes/No Choice |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
Yes |
Yes |
Years Applied |
Numeric - YYYY |
Yes |
Yes |
- |
- |
- |
- |
- |
Yes |
Participation in SA |
Yes/No Choice |
- |
- |
- |
- |
- |
- |
- |
Yes |
Year in SA |
Numeric - YYYY |
- |
|
- |
- |
- |
- |
- |
Yes |
Participation in Epi-Elective |
Yes/No Choice |
Yes |
- |
Yes |
- |
- |
- |
- |
|
Year in Epi-Elective |
Numeric - YYYY |
Yes |
- |
- |
- |
- |
- |
- |
|
Participation in CDC Experience |
Yes/No Choice |
Yes |
- |
Yes |
Yes |
- |
- |
- |
|
Year in CDC Experience |
Numeric - YYYY |
Yes |
- |
- |
- |
- |
- |
- |
|
Participation in Hubert GH |
Yes/No Choice |
Yes |
- |
- |
Yes |
- |
- |
- |
|
Year in Hubert GH |
Numeric - YYYY |
Yes |
- |
- |
- |
- |
- |
- |
|
Public Health Experience |
- |
Yes |
- |
- |
- |
Yes |
- |
|
|
Section Complete |
Yes/No Choice |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
|
|
|
|
|
|
|
|
Yes |
|
|
Figure 12.2‑a. Methods Heard About Fellowship *
*Note: Some items in the Awareness Options are tailored to each fellowship program
Figure 12.2‑b. Methods Heard About Fellowship *
*Note: This section is for Science Ambassadors
Figure 12.2‑c. Influences to Decision to Apply*
*Note: Some items in the Awareness Options are tailored to each fellowship program
Table 12.2‑a. Program Awareness Section Data Elements
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
Methods Heard About Fellowship |
Awareness Options with check box and text field* |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Influences to Decisions to Apply |
Awareness Options with check box and text field* |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Figure 12.3‑a. Interest of Assignment Areas Section
*Note: Science Ambassadors refers to this section as Interest Areas and Preferences Section.
Figure 12.3‑b. CDC-Hubert Global Health Project Ranking Example*
*Note: Project list is tailored to available projects submitted by host sites.
Figure 12.3‑c. Epi-Elective Placement Ranking Example*
*Note: Project list is tailored to available projects submitted by host sites.
Table 12.3‑a. Interest Areas and Preferences Section
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
Interest of Assignment Areas |
Yes |
Yes |
Yes |
Yes |
- |
- |
Yes |
Yes |
|
Project Name and Information |
1-5 Ranking Scale |
- |
- |
Yes |
Yes |
- |
- |
- |
- |
First Choice Date From |
Date |
- |
- |
- |
Yes |
- |
- |
- |
- |
First Choice Date To |
Date |
- |
- |
- |
Yes |
- |
- |
- |
- |
2nd Choice Date From |
Date |
- |
- |
- |
Opt |
- |
- |
- |
- |
2nd Choice Date To |
Date |
- |
- |
- |
Opt |
- |
- |
- |
- |
Preferences |
- |
- |
- |
Yes |
- |
- |
- |
- |
Figure 12.4‑a. Location and State Preferences*
*Note: Only collected by Epidemic Intelligence Service (EIS) program.
Figure 12.4‑b. Geographic Constraints*
*Note: Only collected by Epidemic Intelligence Service (EIS) program.
Figure 12.4‑c. Regional Preferences*
*Note: Only collected by Public Health Association Program (PHAP)
Table 12.4‑a. Location Preferences Section
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
Location Preferences |
Yes |
- |
- |
- |
- |
- |
- |
- |
|
State Preferences |
Yes |
- |
- |
- |
- |
- |
- |
- |
|
Geographic Constraints |
Yes/No Choice |
Yes |
- |
- |
- |
- |
- |
- |
- |
Explain Constraints |
Text |
Yes |
- |
- |
- |
- |
- |
- |
- |
Regional Location |
- |
- |
- |
- |
- |
- |
Yes |
- |
Figure 13.1‑a. Letters of Recommendation Page
Figure 13.1‑b. Peer References*
*Note: Only collected by PMR/F
Figure 13.1‑c. Letter of Recommendation Section
Table 13.1‑a. Letters of Recommendations Section Data Elements*
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
Recommendation Letter |
File Upload |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
Name |
Text |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
Dean of Medical School |
Checkbox |
Opt |
Yes |
Opt |
Opt |
Opt |
Opt |
- |
- |
Organization |
Text |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
Title |
Text |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
Phone |
Numeric |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
- |
Alphanumeric |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
|
Mailing Address Line 1 |
Text |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
- |
Mailing Address Line 2 |
Text |
Opt |
Yes |
Opt |
Opt |
Opt |
Opt |
- |
- |
Mailing Address Line 3 |
Text |
Opt |
Yes |
Opt |
Opt |
Opt |
Opt |
- |
- |
Country |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
|
State/Province |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
|
City |
Text |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
- |
Yes |
Zip/Postal Code |
Numeric |
Opt |
Yes |
Opt |
Opt |
Opt |
Opt |
- |
Opt |
Section Complete |
Yes/No Choice |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
Yes |
*Note: Not all fellowships request four letters of recommendation like EIX, SA request one, and PMF/R requests three.
Figure 14.1‑a. Transportation Requirements*
*Note: Only collected by Public Health Association Program (PHAP)
Table 14.1‑a. Special Requirements Section Data Elements
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
Driver's License |
Yes/No Choice |
- |
- |
- |
- |
- |
- |
Yes |
- |
Own Vehicle |
Yes/No Choice |
- |
- |
- |
- |
- |
- |
Yes |
- |
Public Transportation |
Yes/No Choice |
- |
- |
- |
- |
- |
- |
Yes |
- |
Section Complete |
Yes/No Choice |
- |
- |
- |
- |
- |
- |
Yes |
- |
Table 15.1‑a. PHIF Self-Assessment Skills Page*
*Note: Only collected by the Public Health Informatics Fellowship (PHIF) program.
Table 15.1‑b. PHIF Self-Assessment Skills Page
Skills Area |
Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
4 Skills |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
4 Skills |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
7 Skills |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
2 Skills |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
7 Skills |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
Section Complete |
Yes/No Choice |
- |
Yes |
- |
- |
- |
- |
- |
- |
Figure 15.1‑a. Information Systems Skills*
*Note: Only collected by Public Health Informatics Fellowship (PHIF) Program. When “Skill Level” is “Entry”, then the “Experience Description” is required.
Table 15.1‑c. Information Systems Skills and Data Elements
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
Systems development life cycle |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
Experiences Text |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
Strategic Information Systems planning |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
Experiences Text |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
Information systems evaluation |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
Experiences Text |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
Technology management and innovation |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
Experiences Text |
- |
Yes |
- |
- |
- |
- |
- |
- |
Figure 15.1‑b. Information Science Skills*
*Note: Only collected by Public Health Informatics Fellowship (PHIF) Program. When “Skill Level” is “Entry”, then the “Experience Description” is required.
Table 15.1‑d. Information Sciences Skills and Data Elements
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
Knowledge discovery and data mining |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
Experiences Text |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
Human computer interaction |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
Experiences Text |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
Decision support and expert systems |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
Experiences Text |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
Information and knowledge management |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
Experiences Text |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
Analytics and visualization |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
Experiences Text |
- |
Yes |
- |
- |
- |
- |
- |
- |
Figure 15.1‑c. Computer Sciences Skills*
*Note: Only collected by Public Health Informatics Fellowship (PHIF) Program. When “Skill Level” is “Entry”, then the “Experience Description” is required.
Table 15.1‑e. Computer Science Skills and Data Elements
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
Database design and development |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
Experiences Text |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
Computer programming languages |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
Experiences Text |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
Algorithm design |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
Experiences Text |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
Computer networks |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
Experiences Text |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
Distributed computing |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
Experiences Text |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
Knowledge representation |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
Experiences Text |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
Mobile Computing |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
Experiences Text |
- |
Yes |
- |
- |
- |
- |
- |
- |
Figure 15.1‑d. Leadership and Project Management Skills*
*Note: Only collected by Public Health Informatics Fellowship (PHIF) Program. When “Skill Level” is “Entry”, then the “Experience Description” is required.
Table 15.1‑f. Leadership and Project Management Skills and Data Elements
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
Leadership experience (e.g., change management, manage a diverse team) |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
Experiences Text |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
Project management techniques (e.g., plan and deploy multiple-stage projects, agile development methods) |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
Experiences Text |
- |
Yes |
- |
- |
- |
- |
- |
- |
Figure 15.1‑e. Public Health and Health Care Skills*
*Note: Only collected by Public Health Informatics Fellowship (PHIF) Program. When “Skill Level” is “Entry”, then the “Experience Description” is required.
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
Community health |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
Experiences Text |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
Epidemiology |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
Experiences Text |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
Biostatistics |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
Experiences Text |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
Global health |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
Experiences Text |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
Public health policy |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
Experiences Text |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
Coding standards applied to information systems (e.g., HL7, LOINC, ICD9, SNOMED) |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
Experiences Text |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
Public health knowledge applied to information systems |
- |
Yes |
- |
- |
- |
- |
- |
- |
|
Experiences Text |
- |
Yes |
- |
- |
- |
- |
- |
- |
Table 15.2‑a. Computer Skills*
*Note: Only collected by CDC-Hubert Global Health Fellowship and CDC Epidemiology Elective (Epi-Elect) Programs.
Table 15.2‑b. Computer Skills Data Elements
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
||
Computer Skills |
Yes/No Choice |
- |
- |
Yes |
Yes |
- |
- |
- |
- |
|
|
Word Processing (e.g., MS® Word®, WordPerfect®, Word Pro®) |
- |
- |
Yes |
Yes |
- |
- |
- |
- |
|||
Presentation Software (e.g., MS® PowerPoint®, Apple® Keynote®) |
- |
- |
Yes |
Yes |
- |
- |
- |
- |
|||
Spreadsheets (e.g., MS® Excel®, Quattro®) |
- |
- |
Yes |
Yes |
- |
- |
- |
- |
|||
Statistical (e.g., SAS®, STATA®, SPSS®, Epi-Info™) |
- |
- |
Yes |
Yes |
- |
- |
- |
- |
|||
Databases (e.g., MS® Access®, FileMaker Pro®, Paradox®) |
- |
- |
Yes |
Yes |
- |
- |
- |
- |
|||
Web Development (e.g., Dreamweaver®, Adobe® Flash®, DHTML, CSS) |
- |
- |
Yes |
Yes |
- |
- |
- |
- |
|||
Other |
Text |
- |
- |
Yes |
Yes |
- |
- |
- |
- |
Figure 15.2‑a. Statistical Software Skills*
*Note: Only collected by CDC-Hubert Global Health Fellowship and CDC Epidemiology Elective (Epi-Elect) Programs.
Table 15.2‑c. Software Skills Data Elements
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
Statistical Software Skills |
Yes/No Choice |
- |
- |
Yes |
Yes |
- |
- |
- |
- |
SAS® |
- |
- |
Yes |
Yes |
- |
- |
- |
- |
|
STATA® |
- |
- |
Yes |
Yes |
- |
- |
- |
- |
|
SPSS® |
- |
- |
Yes |
Yes |
- |
- |
- |
- |
|
Epi-Info™ |
- |
- |
Yes |
Yes |
- |
- |
- |
- |
|
Other |
Text (limit 250 words) |
- |
- |
Yes |
Yes |
- |
- |
- |
- |
Figure 15.2‑b. Laboratory and Research Skills Section*
*Note: Only collected by CDC-Hubert Global Health Fellowship and CDC Epidemiology Elective (Epi-Elect) Programs.
Figure 15.2‑c Laboratory and Research Skills Data Element
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
Laboratory and Research Skills |
Text (limit 250 words) |
- |
- |
Yes |
Yes |
- |
- |
- |
- |
Figure 15.3‑a. PEF Skills Self-Assessment*
*Note: Only collected by CDC-Hubert Global Health Fellowship and CDC Epidemiology Elective (Epi-Elect) Programs.
Figure 15.3‑b. Skills Self-Assessment Data Elements
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
Computer Software |
Text (limit 250 words) |
- |
- |
- |
- |
Opt |
- |
- |
- |
Economic and Public Health Data |
Text (limit 250 words) |
- |
- |
- |
- |
Opt |
- |
- |
- |
Figure 15.4
Data Elements |
Data Values |
EIS |
PHIF |
Hubert |
Epi-Elect |
PEF |
PMR/F |
PHAP |
SA |
Center/Division/Branch Team Information |
Text |
- |
- |
- |
- |
- |
Yes |
- |
- |
Leadership Opportunities |
Text |
- |
- |
- |
- |
- |
Yes |
- |
- |
PH-TIPP Participant Support |
Text |
- |
- |
- |
- |
- |
Yes |
- |
- |
Major Duties |
Text |
- |
- |
- |
- |
- |
Yes |
- |
- |
Dear $strFname$ $strLname$:
This e-mail provides your $strProgramName$ login information.
E-mail:
$strEmail$
Temporary password: $pw$
$strProgramName$: $strAddress$
Please do not reply to this e-mail. This e-mail address is not monitored.
CONFIDENTIALITY NOTICE: This electronic mail may contain information that is privileged, confidential, or otherwise protected from disclosure to anyone other than its intended recipients. Any dissemination or use of this electronic mail or its contents by persons other than the intended recipients is strictly prohibited. If you have received this communication in error, please delete the original message.
** Please do not reply to this e-mail. It was sent from an unattended mailbox, and replies are not reviewed. See below for contact information.**
Dear strFname strLname,
We have received your online application for the Epidemic Intelligence Service (EIS). Mail supporting materials including your official transcripts and at least four letters of recommendation to the EIS program. These supporting materials must be postmarked by strSubmissionDate. Your application will be reviewed after all supporting materials have been received.
You may track receipt of documents and the status of your application online at: InternetWebAddress.
Mail supporting materials to:
EIS
Program
ATTN: EIS Application
Centers for Disease Control
and Prevention
1600 Clifton Road, NE
MS E-92
Atlanta,
GA 30333
CONFIDENTIALITY NOTICE: This electronic mail may contain information that is privileged, confidential, or otherwise protected from disclosure to anyone other than its intended recipients. Any dissemination or use of this electronic mail or its contents by persons other than the intended recipients is strictly prohibited. If you have received this communication in error, please delete the original message.
Thank you for applying to the Epidemic Intelligence Service (EIS) program beginning July 2015. EIS offers a unique opportunity to learn and practice applied epidemiology as an important member of the CDC team. EIS officers serve in many important roles — from leading field investigations, to conducting epidemiologic analyses of existing data bases, to designing, implementing, and evaluating surveillance systems. The EIS model is training through service and offers an intense, high-energy program.
As the next step in the application process, you are invited to interview at CDC in Atlanta, Georgia. The EIS program is not able to provide reimbursement for any expenses associated with your travel to interview in Atlanta.
In considering whether to interview, please review the following EIS requirements:
Commitment to a full-time, 2-year program beginning in July
Flexibility and willingness to work in any of the five EIS assignments you will rank
Complete attendance at the following:
EIS conference (April 20–24, 2015). This conference occurs before the 2-year assignment begins. Expenses for conference travel will be paid for by the EIS program
Summer EIS course (4 weeks in July)
Regional and national conferences and other meetings, as required
Termination of previous work and school responsibilities
Ability to travel on short notice as needed by CDC (most travel lasts less than one month)
Flexibility in work days and hours to ensure rapid response to public health problems and to meet training requirements (you may be required to work some weekends or holidays)
The interview process takes a full day. The interviewers will inquire about the depth of your interest in public health, epidemiology, and the EIS program. In addition, they will assess personal qualities such as communication and interpersonal skills, professionalism, maturity, flexibility, motivation, and enthusiasm. We encourage you to find out as much as you can about CDC and the EIS program prior to your interviews. We have included an EIS assignment book from last year to assist you.
On the day of your interview, you will participate in five 30-minute interviews. These will consist of interviews with one to two EIS program staff epidemiologists and representatives from other CDC programs. The EIS Interview Request form, with a list of CDC program areas, is attached.
If you are interested in interviewing, complete and return the EIS Interview Request form to [email protected]. Your interview date will be confirmed by e-mail. You are encouraged to schedule your interview as soon as possible.
Please report to the EIS office by 7:30 a.m. on your interview day. The office is located at 2400 Century Parkway NE, Atlanta, GA 30345 (map and hotels in the area included). Be prepared to show a picture ID when entering the building (e.g., U.S. driver’s license, passport). If you have questions about the interview process call the EIS interview coordinator at 404-498-6110 between 9:00 a.m. and 4:30 p.m. (EDT) Monday through Friday.
Sincerely,
Patricia
M. Simone, M.D.
Acting EIS Chief
Centers for Disease
Control and Prevention
Attachments: Host Site Assignments and Interview Schedule
Thank you for applying to the Epidemic Intelligence Service (EIS) program beginning July 2015. EIS offers a unique opportunity to learn and practice applied epidemiology as an important member of the CDC team. EIS officers serve in many important roles—from leading field investigations, to conducting epidemiologic analyses of existing data bases, to designing, implementing, and evaluating surveillance systems. The EIS model is training through service and offers an intense, high-energy program.
As the next step in the application process, you are invited to interview at CDC in Atlanta, Georgia. The EIS program is not able to provide reimbursement for any expenses associated with your travel to interview in Atlanta. Because of the domestic nature of the program, only a limited number of non-U.S. citizens are selected.
In considering whether to interview, please review the following EIS requirements:
Commitment to a full-time, 2-year program beginning in July
Flexibility and willingness to work in any of the five EIS assignments you will rank
Proficiency in reading, writing, speaking, and understanding English
Complete attendance at the following:
EIS conference (April 20–24, 2015). This conference occurs before the 2-year assignment begins. Expenses for conference travel will be paid for by the EIS program
Summer EIS course (4 weeks in July)
Regional and national conferences and other meetings, as required
Termination of previous work and school responsibilities
Ability to travel on short notice as needed by CDC (most travel lasts less than one month)
Flexibility in work days and hours to ensure rapid response to public health problems and to meet training requirements (you may be required to work some weekends or holidays)
For non-U.S. citizens to participate in interviews, security clearance for entry into the CDC building MUST be completed 15 days prior to your scheduled interview. You will receive an e-mail from CDC’s Office of Safety, Security, and Asset Management (OSSAM) Visitor Management System. We advise you to respond to this e-mail immediately to receive security clearance in a timely manner. On the day of your interview, you will be required to show your passport when entering the building.
Interviews take up to one full day. The interviewers will inquire about the depth of your interest in public health, epidemiology, and the EIS program. In addition, they will assess personal qualities such as communication and interpersonal skills, professionalism, maturity, flexibility, motivation, and enthusiasm. We encourage you to find out as much as you can about CDC and the EIS program prior to your interview. We have included an EIS assignment book from last year to assist you in this process.
On the day of your interview, you will participate in five 30-minute interviews. These will consist of interviews with one to two EIS program staff epidemiologists and representatives from other CDC programs. The EIS Interview Request form, with a list of CDC program areas, is attached.
If you are interested in interviewing, complete and return the EIS Interview Request form to [email protected]. Your interview date will be confirmed by e-mail. Schedule your interview as soon as possible.
Please report to the EIS office by 7:30 a.m. on your interview day. The office is located at 2400 Century Parkway, NE, Atlanta, GA 30345 (map and hotels in the area included).
If you have questions about the interview process call the EIS interview coordinator at 404-498-6110 between 9:00 a.m. and 4:30 p.m. (EDT) Monday through Friday.
Sincerely,
Patricia
M. Simone, MD
Acting EIS Chief
Centers for Disease
Control and Prevention
Attachments: Host Site Assignments and Interview Schedule
Your EIS Interview is scheduled for InteviewDate
On the day of your interview, report to the EIS Program office by 7:30 a.m. EST. The EIS Office is located at 2400 Century Parkway, NE, Atlanta, Georgia 30345; the EIS telephone number is 404-498-6110.
You will need to bring a valid, picture ID to enter the building (e.g., U.S. driver’s license, passport). Plan to be available for interviews until 5 p.m. EST.
If you have further questions or need to reschedule your interview, please respond to this e-mail.
Your EIS Interview is scheduled on InteviewDate
This is contingent upon the successful completion of your security clearance.
Security clearance for non-U.S. citizens is required for you to enter the building on the day of the interview. This process must be completed 15 days prior to your scheduled interview.
You will receive an e-mail from the Visitors Management System for an International Visitor Requests at CDC. Respond to this e-mail immediately to receive security clearance in a timely manner.
On the day of your interview, report to the EIS Program office by 7:30 a.m. EST. The EIS Office is located at 2400 Century Parkway, NE, Atlanta, Georgia 30345; the EIS telephone number is 404-498-6110.
You will be required to show a valid passport to enter the building. Plan to be available for interviews until 5 p.m. EST.
If you have further questions or need to reschedule your interview, please respond to this e-mail.
Congratulations! On behalf of the Epidemic Intelligence Service (EIS) Selection Committee, you have been selected for the final phase of appointment as an EIS Officer. In considering your decision, please review the criteria below to ensure you can make a two-year commitment to the Centers for Disease Control and Prevention (CDC) as an EIS Officer.
EIS officers must meet the following requirements:
Rank and match to at least six EIS assignments.
Be flexible in your work days and hours in order to provide rapid response to public health problems and meet training requirements. You may be required to work some weekends and holidays.
Able to travel on short notice as needed by CDC (most emergency travel lasts less than one month).
Accept assignment to CDC, a state/local health department, or other EIS approved federal health position.
Attend 3 Annual EIS Conferences
You are required to attend conference in Atlanta, GA, April 20 – 24, 2015, prior to your July start.
Full conference attendance and participation in the assignment interview/match is required.
Interviews for assignment matches will take place Friday, April 24, 2015; match notification is sent via email on Monday, April 27, 2015.
Travel must be arranged by the EIS office for you to receive reimbursement for travel expenses.
The second and third conferences occur during your EIS assignment.
Attend the following courses and meetings during your 2-year assignment:
Summer EIS Course: July of your first year
Two Fall Courses: dates TBD
Tuesday Morning and Post-Tuesday Morning Seminars; remote access available for officers outside Atlanta.
National and regional conferences and other meetings as required
EIS Rounds as required
Terminate previous work and school responsibilities.
Please note that your appointment is contingent upon verification of credentials and a favorable background check. If applicable, the following must also be confirmed:
US citizens or US permanents resident must provide proof of a valid, unrestricted license if required for your discipline (physician, veterinarian, nurse, dentist, etc.).
Confirmation of qualifying degree if in progress at the time of application. A final transcript showing the conferred qualifying degree must be received by mid-June. Degrees requiring a dissertation must submit proof of defense to the EIS program by March 30, 2015. Acceptable proof of defense includes either official school transcript or letter from Department Chair/Dissertation Advisor).
If you have questions or concerns about meeting any of the above requirements, please contact the EIS program at 404-498-6110, prior to responding to this offer.
Reply within 1 week of the date of this e-mail/letter by accessing the EIS Application at https://fms.cdc.gov/Legacy/Application/EIS . Use the same login information (e-mail address and password) that you used to apply.
After you log in, click the link to review your appointment letter. This provides information regarding salary and benefits. Proceed to the decision screen and indicate your decision, demographic, and conference travel information. If eligible, you may also see a question about interest in a Prematch assignment. Prematch means you can be matched to a particular field assignment in January and need not wait until the April EIS Conference. Select the “see all Prematch assignments” link for information about the Prematch process and detailed position descriptions. Indicating interest in a Prematch assignment(s) does not guarantee a Prematch placement.
Sincerely,
Patricia
M. Simone, MD
Acting EIS Chief
Centers for Disease
Control and Prevention
404-498-6110
[email protected]
Attachment
** Do not reply to this e-mail. It was sent from an unattended mailbox, and replies are not reviewed. **
Dear $strFname$ $strLname$,
Congratulations! Your decision to join the 2015 EIS class and your personnel preference was received. The travel information you submitted will be used to process your itinerary from April 20–24, 2015, for attendance and assignment matching at the 64th Annual EIS Conference. Additional preconference information will be sent to you via e-mail in mid-February.
If there are any questions about the information you submitted, someone from the EIS program will contact you directly. Please monitor your e-mail for correspondence from us and do not hesitate to contact the EIS program if you have any questions or concerns, 404-498-6110.
We look forward to seeing you in Atlanta this April.
Sincerely,
Patricia
M. Simone, MD
Acting EIS Chief
Centers for Disease
Control and Prevention
CONFIDENTIALITY NOTICE: This electronic mail may contain information that is privileged, confidential, or otherwise protected from disclosure to anyone other than its intended recipients. Any dissemination or use of this electronic mail or its contents by persons other than the intended recipients is strictly prohibited. If you have received this communication in error, please delete the original message.
** Do not reply to this e-mail. It was sent from an unattended mailbox, and replies are not reviewed. **
Dear $strFname$ $strLname$,
We have received the information necessary to process your relocation travel and expenses.
If you have any questions about the process, contact the EIS office at 404-498-6110.
CONFIDENTIALITY NOTICE: This electronic mail may contain information that is privileged, confidential, or otherwise protected from disclosure to anyone other than its intended recipients. Any dissemination or use of this electronic mail or its contents by persons other than the intended recipients is strictly prohibited. If you have received this communication in error, please delete the original message.
We hope you enjoyed the EIS Conference and are excited about joining us in July. To complete your appointment, return to the EIS Application (https://fms.cdc.gov/Legacy/Application/EIS) and login using the same information (e-mail address and password) that you used to apply. Complete the requested information within 1 week of the date of this e-mail. This information will be used to arrange your travel to Atlanta in July (and final destination if based outside of Atlanta). Fellows will also be required to complete Form 1436: Fellowship Service Agreement for Travel and Transportation Expenses to ensure timely processing.
If you have any questions, please contact the EIS office at 404-498-6110.
Sincerely,
Patricia
M. Simone, MD
Acting EIS Chief
Centers for Disease
Control and Prevention
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Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont
New Jersey, New York, Puerto Rico, and the Virgin Islands
Delaware, District of Columbia, Maryland, Pennsylvania, Virginia, and West Virginia
Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee
Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin |
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Leadership and Project Management Skills |
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File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Title | FMS Application Data Elements |
Subject | EIS Application Example |
Author | gqd8 |
File Modified | 0000-00-00 |
File Created | 2021-01-20 |