BBDC POSTDOCTORAL FELLOWSHIPS 2019/2020 APPLICATION SUBMISSION INSTRUCTIONS

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1 Name of Applicant (Last Name, First and Middle Names): BBDC POSTDOCTORAL FELLOWSHIPS 2019/2020 APPLICATION SUBMISSION INSTRUCTIONS Format: Single spaced text. Text size must not be smaller than 12-point font, Times Roman or similar. Submit 1 paper copy of the application and 1 electronic application in PDF format on a USB flash drive or CD (which will be returned): The paper copy should include items 1 to 6 below, in the order listed. Double-sided pages are acceptable. Items 7 and 8 (reference letters) should be ed directly to the BBDC. The electronic copy should include items 1 to 6 below, in the order listed as one PDF file. 1. A completed and signed application form. 2. Copy of doctoral degree (PhD) and/or medical degree (MD) if completed. (Note: Applicants must complete a PhD or MD by the time funding commences.) 3. Copy of Canadian license to practice in Canada (applies only to applicants with a medical degree). 4. Scanned official transcript(s) of the candidate s graduate and/or health professional training. Provide a scanned copy of an original, official transcript(s). Both sides of the transcript must be scanned. A transcript printed from a website is not acceptable. If the institution does not provide graduate transcripts or grades, the applicant must provide a letter or from the institution stating this. 5. Proof of applications submitted to national granting agencies for personal support since September 1, 2018 (refer to page 5 of this application form for details). Documentation must include the name of granting agency, funding program applied to, and confirmation of application receipt from the granting agency. 6. Proposed supervisor s CV. Provide a Canadian Common CV in CIHR format (program or academic). Limit information to the past 5 years. If a Common CV is not available, a University of Toronto Web CV printed in curriculum vitae format is acceptable. Limit information to the past 5 years. Items to be forwarded separately: 7. One reference letter from the proposed supervisor. Letter should be ed by the proposed supervisor directly to the BBDC at diabetes.bbdc@utoronto.ca. 8. Reference letters from 2 individuals other than the proposed supervisor (but may include cosupervisor). Letters should be ed by the referees directly to the BBDC at diabetes.bbdc@utoronto.ca. No other attachments will be accepted such as candidate s CV, abstracts, additional reference letters, etc. Applications and reference letters must be received by 4 p.m., February 26, Late or incomplete applications will not be considered. Deliver paper and electronic copy of the application to: Banting & Best Diabetes Centre Located at the Toronto General Hospital 200 Elizabeth Street Eaton Building, 12 th Floor, Room 12E248 Toronto, Ontario M5G 2C4 Inquiries: Rose LaBarbera Phone: (416) diabetes.bbdc@utoronto.ca 1

2 BANTING & BEST DIABETES CENTRE FACULTY OF MEDICINE, UNIVERSITY OF TORONTO BBDC Postdoctoral Fellowships 2019/2020 Sellers Postdoctoral Fellowship 2019/2020 BBDC Fellowship in Diabetes Care (funded by Eli Lilly & Boehringer Ingelheim) 2019/2020 Do not submit more than one application per candidate. Text size must not be smaller than 12-point font, Times Roman or similar. Name of Applicant Last Name: First and Middle Names: Title of Research: Permanent Mailing Address: Phone (home or cell): Phone (work): Date of Birth (DD/MM/YYYY): CITIZENSHIP: Canadian Permanent Resident in Canada Foreign CANDIDATE S STATUS AS OF THE APPLICATION DEADLINE DATE OF FEBRUARY 26, 2019 (select one): Applicants who are unsure of their status should contact the BBDC prior application submission. A. - PhD is pending. - Received a PhD within the last 2 years. - Received an MD and a PhD and has less than 2 years of postdoctoral research training. B. - Received an MD only and has postdoctoral research training or is currently enrolled in a graduate program. C. - Received a PhD 2 or more years ago. - Received an MD and a PhD and has 2 or more years of postdoctoral research training. D. - MD is pending. - Received an MD and has no postdoctoral research training and is not enrolled in a graduate program. LICENSURE (applies only to applicants with a medical degree): Does the applicant hold a license to practice medicine (full or educational) in Canada? Yes No If so, attach a copy of the Canadian license to this application. PRESENT APPOINTMENT, EMPLOYER, AND SUPERVISOR (include department and institution): 2

3 PROPOSED SUPERVISOR (name and full address): Phone: Fax: PROPOSED SUPERVISOR S UNIVERSITY OF TORONTO FACULTY AND PRIMARY DEPARTMENT: CO-SUPERVISOR IF APPLICABLE (name, University of Toronto faculty and department, and address): DEGREES List all degrees and specialty certifications that the candidate currently holds and expects to hold in the next 12 months. Degree or Certification Title Discipline Institution Date Degree Obtained or Expected (MM/YYYY) Is the candidate proceeding or planning to proceed to any additional degree? If so, specify degree, discipline, institute and date expected. If granted, when will the candidate be free to commence this fellowship? 3

4 HONOURS & AWARDS List honours and awards that the candidate holds or held (include undergraduate, graduate and postgraduate): Date Award Type POSTGRADUATE EXPERIENCE List chronologically all postgraduate experience to date (include titles and dates of all appointments held and the institutions concerned). In the case of research experience (including MSc, PhD and postdoctoral training) give the name of the supervisor(s) and the subject of the research. (NOTE: Applicants must have received a PhD after July 2015 or an MD after July 2010 and must be within the first four years of post-graduate research training to be eligible.) 4

5 Location of Proposed Research Training (include name of department/institute and address): State distribution of the time and activities to be undertaken in this training program. Indicate the expected duration of the proposed training and its relevance to the candidate s future career. OTHER APPLICATIONS CANDIDATE SUBMITTED FOR PERSONAL SUPPORT: A. In the space below, list all agencies to which an application for personal support has been or will be made between September 1, 2018 and May 31, Include date of application submission. B. Attach proof of application(s) submitted to date. Documentation must include the name of granting agency, funding program applied to, and confirmation of application receipt from the granting agency. IMPORTANT: The BBDC will not fund applicants who do not apply to national granting agencies such as the CIHR, NSERC, Diabetes Canada, etc. for personal support between September 1, 2018 and May 31, Exceptions may be made for first year postdoctoral fellows who joined the supervisor s lab after September

6 PUBLICATIONS: Provide a numbered list of the candidate s scientific papers. Clearly separate and identify each according to the categories below. (Additional pages may be added to this page if needed. Text size must not be smaller than 12-point font, Times Roman or similar.) A. Papers in peer reviewed journals (published or accepted only). Include the impact factor of the journal. B. Editorials and review articles. Include the impact factor of the journal. C. Chapters and books D. Abstracts (specify whether oral or poster presentations) E. Manuscripts submitted (include name of journal and date of submission) 6

7 RESEARCH PROJECT: Describe the rationale, objective, and give a detailed experimental approach of the proposed research. Clearly explain the relevance to diabetes. (A maximum of 1 page may be added to this page. Figures must be included within the 2-page proposal, while references are restricted to one additional page. Text size must not be smaller than 12-point font, Times Roman or similar.) 7

8 ONE REFERENCE LETTER FROM PROPOSED SUPERVISOR A letter of support for the candidate is required from the proposed supervisor. The letter should be ed directly to the BBDC at diabetes.bbdc@utoronto.ca by the proposed supervisor. Note to Supervisors: Please comment on the candidate s characteristics and abilities (i.e. critical thinking, independence, perseverance, originality, organizational skills, interpersonal skills, leadership, communication skills, initiative, motivation, interest in discovery, research ability) TWO REFERENCE LETTERS In the space below, list the name, professional title, and institution of two individuals (other than the proposed supervisor but may include co-supervisor) whom the candidate has asked to forward assessments of his/her past performance. Letters should be ed directly to the BBDC at diabetes.bbdc@utoronto.ca by the referees. Note to Referees: Please comment on the candidate s characteristics and abilities (i.e. critical thinking, independence, perseverance, originality, organizational skills, interpersonal skills, leadership, communication skills, initiative, motivation, interest in discovery, research ability) NAME OF INSTITUTION AND FINANCIAL OFFICER WHO WILL ADMINISTER THE FUNDS The funds are to be administered by the institution where the research will take place (i.e. the University of Toronto or affiliated hospital). Name of Institution: Name of Financial Officer: Complete Address: Phone: Fax: SIGNATURES: I have reviewed the terms and conditions and agree to abide by the regulations governing this award, if granted. I certify that the information provided in this application is true and complete to the best of my knowledge. I understand that the BBDC will not release funding to successful applicants who: a) Have not applied to national granting agencies for personal support between September 1, 2018 and May 31, 2019 and/or b) Have not completed a PhD or MD degree at the time of commencement of funding. Digital signatures are acceptable. University Department Chair or Candidate Proposed Primary Supervisor Hospital Research Institute Director Print name: Print name: Print name and title: Signature: Signature: Signature: Date: Date: Date: 8