NPGH LEADERs Application

Date doctoral/terminal degree conferred or expected conferral date (MM-DD-YYYY)

Using the format below, provide a brief background on your education and training (specialty)

e.g. Trinity University: BS Biology 2015; Boston University: MD 5/2019; Indiana University: Internal Medicine Residency 6/2023; University of Washington: Infectious Diseases Fellowship (ongoing)

Ensure the information you provide matches information provided in your NIH Biosketch.

Have you previously been funded by a Fogarty Global Health Fellows/LAUNCH program?

APPLICANT ESSAYS

Upload your completed essays in Word document format (do not submit as a PDF).

Please note the word and page limits for each essay. Essays will not be reviewed if they are over the designated word or page limits or if they do not comply with formatting requirements.

NIH-STYLE BIOSKETCH

Upload a Common Form Biographical Sketch (use the instructions provided above). 

Please ensure that you are submitting a Common Form Bio Sketch, and not a previous bio sketch format.

Enter the number of research publications that you have published or that are currently accepted/in press (do not include publications under review or in preparation)

You will be asked to list your research publications in the NPGH Application Essays document.

Enter the number of research publications that you currently have under review.

You will be asked to list your publications under review in the NPGH Application Essays document.

Enter the combined number of conference presentations and abstracts that you have had accepted

You will be asked to list your conference presentations and abstracts in the NPGH Application Essays document.

U.S. Mentor NIH Biosketch

Must be NIH Biosketch format. CVs will not be accepted.

Upload U.S. Mentor Letter of Support

Research Site Mentor NIH Biosketch

Must be NIH Biosketch format. CVs will not be accepted.

2. In your proposed study, are participants prospectively* assigned to an intervention**?

* The term prospectively assigned refers to a pre-defined process (e.g., randomization) specified in an approved protocol that stipulates the assignment of research subjects (individually or in clusters) to one or more arms (e.g., intervention, placebo, or other control) of a clinical trial.

** As related to the definition of a clinical trial, a manipulation of the subject or subject's environment for the purpose of modifying one or more health-related biomedical or behavioral processes and/or endpoints. Examples include: drugs/small molecules/compounds; biologics; devices; procedures (e.g., surgical techniques); delivery systems (e.g., telemedicine, face-to-face interviews); strategies to change health-related behavior (e.g., diet, cognitive therapy, exercise, development of new habits); treatment strategies; prevention strategies; and, diagnostic strategies.

3. Is the proposed study designed to evaluate the effect of the intervention* on the participants?

* An intervention is defined as a manipulation of the subject or subject's environment for the purpose of modifying one or more health-related biomedical or behavioral processes and/or endpoints. Examples include: drugs/small molecules/compounds; biologics; devices; procedures (e.g., surgical techniques); delivery systems (e.g., telemedicine, face-to-face interviews); strategies to change health-related behavior (e.g., diet, cognitive therapy, exercise, development of new habits); treatment strategies; prevention strategies; and, diagnostic strategies.

4. Is the effect being evaluated in the proposed study a health-related biomedical or behavioral outcome*?

* A health-related biomedical or behavioral outcome is defined as the pre-specified goal(s) or condition(s) that reflect the effect of one or more interventions on human subjects' biomedical or behavioral status or quality of life. Examples include: positive or negative changes to physiological or biological parameters (e.g., improvement of lung capacity, gene expression); positive or negative changes to psychological or neurodevelopmental parameters (e.g., mood management intervention for smokers; reading comprehension and /or information retention); positive or negative changes to disease processes; positive or negative changes to health-related behaviors; and, positive or negative changes to quality of life.

5. Is your proposed fellowship study conducted part of a parent NIH award/clinical trial that is responsible for all required registrations and human subjects reporting?

Primary Race and Ethnicity identification 

Do you have a physical or mental impairment that substantially limits one or more major life activities?

Individuals with disabilities, who are defined as those with a physical or mental impairment that substantially limits one or more major life activities, as described in the Americans with Disabilities Act of 1990, as amended.  

Do you come from a disadvantaged background?

Individuals from disadvantaged backgrounds are defined as those who meet two or more of the following criteria:

1. Were or currently are homeless, as defined by the McKinney-Vento Homeless Assistance Act (Definition: https://nche.ed.gov/mckinney-vento/);
2. Were or currently are in the foster care system, as defined by the Administration for Children and Families (Definition: https://www.acf.hhs.gov/cb/focus-areas/foster-care);
3. Were eligible for the Federal Free and Reduced Lunch Program for two or more years (Definition: https://www.fns.usda.gov/school-meals/income-eligibility-guidelines);
4. Have/had no parents or legal guardians who completed a bachelor's degree (see https://nces.ed.gov/pubs2018/2018009.pdf);
5. Were or currently are eligible for Federal Pell grants (Definition: https://studentaid.gov/understand-aid/types/grants/pell); 
6. Received support from the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) as a parent or child (Definition: https://www.fns.usda.gov/wic/wic-eligibility-requirements).
7. Grew up in one of the following areas: a) a U.S. rural area, as designated by the Health Resources and Services Administration (HRSA) Rural Health Grants Eligibility Analyzer (https://data.hrsa.gov/tools/rural-health), or b) a Centers for Medicare and Medicaid Services-designated Low-Income and Health Professional Shortage Areas  (qualifying zipcodes are included in the file). Only one of the two possibilities in #7 can be used as a criterion for the disadvantaged background definition.