Embed Size (px)
Citation preview
1560 Sherman Avenue Evanston, IL 60201-4808 Phone (847) 328-2256 Fax (847) 328-0509 [email protected]
Research Report for all Career Development Awards (Physician Scientist, Dermatologic Surgery, Public Health,
Dermatopathology, Medical Dermatology, Research, Women’s Health, Pediatric, and Science of Human Appearance)
Instructions: ♦ This report is to be completed at the end of third and final year of award funding.♦ Complete all sections of this report as directed, including item 14 in a separate document.♦ Obtain the signature of your Dermatology Division Chief or Department Chair on the final page.♦ Send the Research Report to the Foundation via email to [email protected] no
later than 60 days following completion of your award period. ♦ To confirm that you have met the reporting requirement for your award, you will receive a
return email confirmation from the DF. If you do not receive this confirmation email, this please contact the office at 847-328-2256 or [email protected].
♦ Upon receipt of your Research Report and the Financial Report, your final award payment will be scheduled for disbursement. Please note, funds will not be distributed beyond one year of the award termination date.
1. Research Award Recipient:
2. Academic Affiliation:
3. Title:
4. Current Mailing Address:
5. Current E-mail Address:
6. Title of Research Project:
Start End 7. Research Award Period:
8. Institution Where Research was Performed:
9. Mentor:
10.Award Amount:
Research Report All Career Development Awards
Page 2 of 3 Dermatology Foundation
1560 Sherman Avenue Evanston, IL 60201-4808 Phone (847) 328-2256 Fax (847) 328-0509 [email protected]
11. Briefly, give a short statement of your future career plans, and whether they will be inacademics or in the clinical practice of medicine.
12. List your articles, chapters and abstracts that have resulted from this project. Indicatepublished, in press, submitted or presented. Separate abstracts, presentations, reviews and peer-reviewed articles. Attach copies.
Research Report All Career Development Awards
Page 3 of 3 Dermatology Foundation
13. Briefly state the aims and objectives of the project. Comment on the evolution of theproject and how/why modifications were made. Was any major current dogma contradicted or changed?
14. In language directed to a sophisticated lay or clinical dermatologic audience, attach a summary of the results and conclusions of your research project. We would be most interested in an honest analysis of:
♦ What was learned?♦ What type of intellectual growth or maturity occurred as a consequence of the project?♦ How can this experience benefit those who follow?♦ Suggestions for other researchers, i.e. what mistakes were made?
Please include a short paragraph that summarizes the present and potential significance to the field of dermatology. Do not exceed one page.
Research Certification:
I hereby certify that had the protected time necessary during (award recipient)
the Research Award Period shown on page 1 to complete the project as proposed in his/her award application.
_______________________________________ _____________________________ (Signature of Dermatology Chief/Chair) (Date)
_______________________________________ (Please print name of Dermatology Chief/Chair)
1560 Sherman Avenue Evanston, IL 60201-4808 Phone (847) 328-2256 Fax (847) 328-0509 [email protected]
05/20
