BIRCWH | BIRCWH Scholar Application

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Penn State BIRCWH Scholar Application

Interested applicants must meet in person with the Program Director, Dr. Kjerulff, prior to submission of the application.

Contact InformationAll fields are required.

Name:
Office Address:
City/State/Zip:
Office Telephone:
Office Fax:
Email Address:

Eligibility

1.	Do you have an earned doctoral degree in a clinical or research discipline?	Yes No*
2.	Have you had more than 6 years of post-doctoral research training experience beyond your last doctoral degree?	Yes* No
3.	Are you currently, or have you been, a principal investigator (PI) on an NIH R01, R29, or subproject of a Program Project (P01), Center (P50, P60, U54) grant, or mentored career development (K-series) grant?	Yes* No
4.	Are you a U.S. citizen or admitted for permanent residence/citizenship?	Yes No*
	* Not Eligible for BIRCWH scholar position.

Education/Employment

Attach a copy of your current curriculum vitae:

Professional Goals and Research Interests

Attach a 3-5 page typed statement summarizing your academic and research background, your professional goals, and your specific research interests in women's health relevant to one of the core research areas offered in the PSU-BIRCWH program:

(1) Precursors and consequences of obesity
(2) Reproductive health
(3) Sex and gender issues in health and disease
(4) Cancer prevention, screening and treatment

More specificity in the research statement will assist the committee in assessing your candidacy. The research statement should specify a topic of research related to women’s health or sex/gender differences in health, and should include a clear research question or hypothesis. The research statement also should specify how the research approach will be interdisciplinary. Identification of at least two BIRCWH mentors in different disciplines will strengthen the application.

Signature and CV of Primary Mentor

•The designated Primary Mentor must sign and submit the following statement:
"I agree to serve as the Primary Mentor for [name of applicant] for the period of BIRCWH funding."

•The designated Primary Mentor must submit a CV showing current research support.

Letter of Support from Applicant’s Department Chair

The Chair of the department of each applicant must submit a brief letter indicating support of the candidate’s application for the position of PSU-BIRCWH scholar and agreement to decrease the candidate’s clinical and/or teaching responsibilities to no more than 25% of total effort (based on a 60-hour work week) during the 2-3 year period that the candidate will be supported by the BIRCWH program. Please see Prototype Letter of Support as a sample. Upon completion, your Department Chair should mail the letter via the US Postal Service to: Kristen Kjerulff, PhD, Professor, Penn State BIRCWH Program Director. See address below.

The Chair should also indicate that the portion of salary not covered by the BIRCWH program will be covered by the department. The BIRCWH program supports 75% effort (salary, up to $75,000, plus fringe benefits) so that the candidate can devote 75% effort to research training and mentored research. In cases where 75% effort exceeds $75,000, the Chair must ensure that the remaining salary plus fringe will be covered.

References

Provide three professional references, using the Candidate Evaluation Form for Professional Referees. References should include current and past mentors. Please give one blank form to each mentor. Upon completion, the mentor should mail the form via the US Postal Service to: Kristen Kjerulff, PhD, Professor, Penn State BIRCWH Program Director. See address below.

Send supporting materials to:
Kristen Kjerulff, PhD, Professor,
Penn State BIRCWH Program Director
Department of Public Health Sciences
Penn State College of Medicine
600 Centerview Drive A210, Hershey, PA 17033
Phone: 717-531-1258; Fax: 717-531-0839
khk2@psu.edu