| Directions for Trainees |
|
|
OMB NO.: 0925-0568 |
Exp. Date: 06/30/2019 |
| Please take 10-15 minutes to review this spreadsheet and update or provide any new information that will help us demonstrate |
|
|
|
|
|
|
| the value of the T32 training program. |
|
|
|
|
|
|
|
|
|
|
|
|
|
| If you only have a limited amount of time to provide new information, we ask that you focus on providing information about any employment you have |
|
|
|
|
|
|
| had since leaving the training program (see Tab7 Employment Tab) and on any career highlights (Tabs 6-15) |
|
|
|
|
|
|
| that you would like to report (See Tab 6, Career Higlights). |
|
|
|
|
|
|
|
|
|
|
|
|
|
| Making Changes to Data Imported from IMPAC II (Fields shaded gray ) |
|
|
|
|
|
|
| If a field is shaded gray, that information is imported from the NIH IMPAC II system, via either the Commons profile or the xTrain module. If you |
|
|
|
|
|
|
| need to make changes to information in a gray field, you must do so in IMPAC II not CareerTrac. |
|
|
|
|
|
|
| See the eRA Commons user guide for step by step instructions to enter or edit your personal profile information. The link is listed below |
|
|
|
|
|
|
| http://era.nih.gov/files/personal_profile_userguide.pdf |
|
|
|
|
|
|
|
|
|
|
|
|
|
| Returning the Spreadsheet |
|
|
|
|
|
|
| Please return the form to the Principal Investigator for the [University] T32 program by 03/24/2018. |
|
|
|
|
|
|
|
| PI email address: |
[[email protected]] |
|
|
|
|
|
|
|
|
| Respondent Burden Statement |
|
|
|
|
|
|
| Public reporting burden for this collection of information is estimated to average 30 minutes per response, including the time for reviewing instructions, 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: |
|
|
|
|
|
|
| NIH |
|
|
|
|
|
|
| Project Clearance Branch |
|
|
|
|
|
|
| 6705 Rockledge Drive, MSC 7974 |
|
|
|
|
|
|
| Bethesda, MD 20892-7974 |
|
|
|
|
|
|
| ATTN: PRA 0925-0568 |
|
|
|
|
|
|
| Do not return the completed form to this address. |
|
|
|
|
|
|
|
|
|
|
|
|
|
| This questionnaire includes the following sections: |
|
|
|
|
|
|
| Personal Information------------------------------------------Tab 2 |
|
|
|
|
|
|
|
This section contains questions regarding your personal information, including name and email address. |
|
|
|
|
|
| Contact Information-------------------------------------------Tab 3 |
|
|
|
|
|
|
|
This section contains questions regarding your mailing address and phone number. |
|
|
|
|
|
| Pre-Training Information-------------------------------------Tab 4 |
|
|
|
|
|
|
|
This section contains questions regarding your professional and educational history before your T32 funding / training |
|
|
|
|
|
| In-Training Experience -----------------------------------------Tab 5 |
|
|
|
|
|
|
|
This section contains questions regarding your T32-funded training experience. It also contains questions regarding the degree or certificate earned through your T32-funded training, the start and end date of your funding period, and mentor data etc… |
| Accomplishments-----------------------------------------------Tab 6 - 15 |
|
|
|
|
|
|
|
This section contains questions regarding your personal achievements that can be attributed to your T32-funded training. |
|
|
|
|
|
|
> Career Highlights------------------------------------------------------Tab 6 |
|
|
|
|
|
|
> Employment------------------------------------------------------------Tab 7 |
|
|
|
|
|
|
> Fellowship---------------------------------------------------------------Tab 8 |
|
|
|
|
|
|
> Honor and Awards----------------------------------------------------Tab 9 |
|
|
|
|
|
|
> New Competitive Funding------------------------------------------Tab 10 |
|
|
|
|
|
|
> Post-Training Education---------------------------------------------Tab 11 |
|
|
|
|
|
|
> Posters at Scientific Meeting---------------------------------------Tab 12 |
|
|
|
|
|
|
> Product or Policy Development-----------------------------------Tab 13 |
|
|
|
|
|
|
> Publications-------------------------------------------------------------Tab 14 |
|
|
|
|
|
|
> Students------------------------------------------------------------------Tab 15 |
|
|
|
|
|
In-Training Education
(There are 3 sections on this tab. Please scroll down to make sure you review all 3.) |
|
|
| Trainees Research Project Title (e.g., name of Master’s Thesis or Post-Doctoral Project) |
Date Training Began (may be different from when you entered Graduate School or Post-Doctoral Appointment) (MM/DD/YYYY) |
Date Training Ended (may be different from when you entered Graduate School or Post-Doctoral Appointment) (MM/DD/YYYY) |
Degree Level (Pre-Doc, Post-Doc) |
NIH Field of Training |
|
|
| N/A |
09/01/1996 |
12/31/1996 |
PRE-DOC |
3240 - Toxicology |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| Scientific Technical Emphasis |
Sources of Support |
|
|
|
|
| TOXICOLOGY |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| Research Training Mentor |
| Mentor’s First Name (required) |
Mentor’s Last Name (required) |
Country of Institution (required; please do not use acronyms) |
Institution Name (required; please do not use acronyms) |
Mentor’s Department (required) |
Start Year of Mentoring (please enter date as YYYY) |
End Year of Mentoring (please enter date as YYYY) |
|
|
UNITED STATES |
UNIVERSITY OF MICHIGAN |
ENVIRONMENTAL HEALTH SCIENCES |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| In-Training Education |
| (Please list all the degrees, certificates, or training completed while supported by the ES training program.) |
| Degree or Nature of Training (required; You can enter more than one degree, as applicable) |
Country of the institution that granted the degree (please do not use acronyms) |
Institution that granted the degree (please do not use acronyms) |
When did the education program begin? (required; please enter date in MM/YYYY format) |
When did the educational program end or when is it expected to end? (required;please enter date in MM/YYYY format) |
| PHD - DOCTOR OF PHILOSOPHY |
|
|
|
Current |
| Accomplishments: Employment |
| Please only enter accomplishments that can be attributed to T32-funded training. |
| Training Status While Employed In This Position (required; report your training status when you obtained employment) |
Employment Year Began (required; YYYY) |
Employment Year End (YYYY) |
Job Title (required) |
Country of Employment |
Name of Employer |
Employment Sector (required) |
Major Emphasis of this Position (required) |
Is this a Post-Doc Position? (required; Yes, No) |
Tenure Status (required) |
Topic Area for Position |
| Accomplishments: Post-Training Education |
| Enter data about educational experiences obtained AFTER the trainee left the program. If the main degree program is captured in the In-Training section, please do not repeat it here. This area is for additional educational experiences, POST-DOC, Certificate Program, etc. |
| Country of the Institution Granting the Degree (required) |
Name of Institution Granting the Degree (required) |
Educational Degree or Nature of Training Program (required) |
Year the Degree Earned (required; enter date as YYYY) |
| Accomplishments: Product or Policy Development |
| Please only enter accomplishments that can be attributed to T32-funded training. |
| Training Status When Accomplished (required) |
Resulted in the Development or Implementation of |
URL or Citation for Product or Policy |
Description of the Product or Policy (required) |
Significance of the Product or Policy (required) |
Year of Product or Policy Development (YYYY) |
Resulted in a Non-provisional Patent (Yes, No) |
Patent Number (Answer if awarded a non-provisional patent) |
Country that Issued Patent |
Demonstrable Effects on U.S. Health Science and Public Health Interventions (Yes, No) |
Description of Significance of Effects on U.S. Health Science and Public Health Interventions
|
| Accomplishments: Publications |
|
|
|
|
|
|
|
There are 3 tables on this page. Please make sure you scroll all the way down and review all 3 tables.
Please enter publications that can be attributed to T32-funded training. This includes any work associated with a topic, method, tool or other direct experience from your appointment to this training grant. You may include articles published during or after your training grant appointment.
Table 1 lists publications that are already in CareerTrac and have a Pubmed or Pubmed Central ID. Use Table 1 to add publications, AFTER you have reviewed Table 3 to identify any publications that CareerTrac has found for you. If you do not find your publications listed in Table 3, you need ONLY enter either the PMID or PMCID in Table 1 and the training status when accomplished (Column C) in this table. The system will automatically complete the rest of the information. Please note that only the most recent 10 articles are listed in Table 1.
Table 2 lists publications in CareerTrac that were manually entered entered into the system. Please review these to ensure there is no overlap with the other tables and remove any duplicates. To add more publications that do not have Pubmed or Pubmed Central IDs, you should enter each new publication in a new row and complete the required fields, including training status when accomplished (Column C). It should be rare that you need to enter publications in this table.
Table 3 lists publications that you may want to link to your record in CareerTrac. These were identified using our publication search protocol, based on your first and last name. Review this list and select Add (Column A) for any publications that you would like to add to CareerTrac. Select ignore if the publication is not associated with you or should not be linked to you in CareerTrac. Please include training status when accomplished (Column C). |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| Table 1. Publications Already in CareerTrac that have a PMID/PMCID (Please note that only the most recent 10 articles are listed in Table 1.) |
|
|
|
|
|
|
|
| First, review publications attributed to you: highlight any corrections to existing rows in this table. Then use this table to add publications, AFTER you have used Table 2 to review any publications that CareerTrac has found for you. If you do not find your publications listed in Table 2, you need ONLY enter either the PMID or PMCID and the training status when accomplished (Column C) in this table. The system will automatically complete the rest of the information. |
|
|
|
|
|
|
|
| Author Last, First Name (required) |
Article Title |
Training Status when Research Conducted (required) |
PubMed ID (PMID) |
PubMed Central ID (PMCID) |
Local or International Readership (Local, International) |
Country / Countries in Which Research Took Place |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| Table 2. Publications Manually Entered into CareerTrac that do not have a PMID/PMCID |
| Enter additional publications here when no Pubmed or Pubmed Central ID is available. This should be rare, because all peer reviewed publications should have a Pubmed Central ID to be compliant with NIH Publications policy. Enter each publication on a separate row. Please indicate your training status when the article was published (Column C). |
If you have a PMID/PMCID, please enter the publication in Table 1. |
|
| Article Title (required) |
Journal Name (required) |
Training Status when Research Conducted (required) |
Volume Number |
Journal Publication Month |
Journal Publication Year |
First Author (Last Name, First Name; required) |
Last Author (Last Name, First Name) |
Other Author (Last Name, First Name) |
PMID |
PMCID |
Peer Reviewed Article (Yes, No) |
Local or International Readership (Local, International) |
Country / Countries in Which Research Took Place |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| Table 3. Publications Found by CareerTrac based on Trainee Name - To ADD or IGNORE |
|
|
|
|
|
|
|
|
|
| Select "Add" in column A for each publication in this list that is, in fact, authored by you. Select "Ignore" if you are not an author. If you select Add, indicate the training status when the research in the article was conducted (Column C). |
|
|
|
|
|
|
|
|
|
| Add/Ignore |
Article Title |
Training Status when Research Conducted (required) |
Journal Name |
Publication Date |
|
|
|
|
|
|
|
|
|