Apply for the UNC-Duke Collaborative Clinical Pharmacology T32 Postdoctoral Training Program

First Name ■

Last Name ■

E-Mail Address ■

Street Address ■

City ■

State / Province ■

Country

Postal Code

Phone Number ■

Primary Institution ■

Country of Origin ■

Clinical Training to Date ■

Describe your residency and fellowship training to date. Include details of a current medical license or completion of clinical training that indicates eligibility to take medical board exams.

Research Training to Date ■

List degrees obtained in advanced research areas (MPH, PhD, etc.) as well as classes taken without receipt of a degree.

Your Division

Applicable only for fellows from Duke University or the University of North Carolina at Chapel Hill.

Expected Clinical Commitments During the T32 Fellowship ■

List the clinical commitments you expect to have during your fellowship period, including outpatient clinics, inpatient rounding, and procedure-based training. Estimate the time commitment for each activity.

Name of Primary Mentor and Co-Mentors and Mentorship Plan ■

In one to two paragraphs, describe your mentorship plan and indicate your secondary mentors.

Research Plan ■

In no more than three paragraphs, provide the themes that will guide your research training, your planned research projects, and faculty members with whom you will be working.

Proposed Didactic Training Plan ■

Please list the courses you intend to take and whether you intend to obtain a degree (if so, please state the nature of the degree and what school or institution would be granting it).

Career Objectives ■

In one to two paragraphs, describe your career objectives related to the type of job you expect to obtain after completion of the T32 Clinical Pharmacology Postdoctoral Research Fellowship, as well as your long-term career objectives.