Date Completed: Longitudinal Study: Fellows Exit Survey American Society for Microbiology I. Demographic information - unless otherwise instructed, please check all that apply or fill in the blank: 1. ASM member number 2. Last Name 3. First Name 4. Middle Initial 5. Permanent address 6. Mailing address 7. Country 8. Date of birth 9. Gender (check one) Male Female 10. Ethnicity (check one) Native American Alaskan Native Asian American Pacific Islander African American/Black Hispanic/Latino (incl. Cuban and Mexican Americans, Puerto Rican) Caucasian European/Eastern European Asian Other (specify) 11. Internet address 12. Business telephone number, including extension 13. Home telephone number 14. Fax number 15. ASM fellowship program (check the most recently completed fellowship - one answer) Undergraduate Research Fellowship Minority Undergraduate Research Fellowship Watkins Graduate Research Fellowship 16. ASM fellowship start date (check one) ASM/NCID Postdoctoral Research Fellowship Program Faculty Fellowship International Fellowship 1
Fall Summer Fill in Year 17. Current student status (check one) Sophomore Junior Senior Graduate Graduate, all but dissertation Medical Medical internship Postdoctorate Not a student 18. Highest degree (check one) B.S. or B.A. M.S. or M.A. Ph.D M.D., D.D.S., D.V.M. or D.O. both Ph.D or M.D. no degree received 19. Year of highest degree obtained 20. Last Name of faculty adviser 21. First Name of Faculty Adviser 22. Middle Initial of Faculty Adviser 23. Mailing address faculty adviser 24. Internet address of faculty adviser 25. ASM member number of faculty adviser 2
II. General Plans In the table below, please check the appropriate answer. Yes No QUESTIONS ABOUT GENERAL PLANS 1. Are you planning to continue your studies for the next 12 months? 2. Are you planning to seek a postdoctoral position in the next 12 months or have you been accepted in a postdoctoral position? 3. Are you planning to seek employment in the next 12 months or have you found employment? III. Educational Plans In the table below, please check the appropriate answer. Yes No QUESTIONS ABOUT EDUCATIONAL PLANS 1. Are you planning to attend graduate school in the next 12 months? 2. Are you planning to attend medical school in the next 12 months? 3. Are you planning to attend another professional (e.g. business, law, veterinary) school in the next 12 months? 3
IV. Employment Plans 1. In the table below, please check in the first column (1) if you are seeking a position and the types of positions (all that apply) that you are seeking. Check in the second column (2) if you have accepted or about to accept a position and the primary nature of position (one answer) that you have accepted. Seeking Accepte d TYPE OF POSITION CATEGORY Microbiologist Clinical Medical Technologist Infectious Disease or Postdoctoral Fellow Lab Manager Lab Director Practitioner/Physician Other Faculty Academic Research Scientist/Associate Postdoctoral Fellow Administrator Other Microbiologist Industry Research Scientist/Associate Product Manager Department Head/Director Executive/VP Other Microbiologist Government Medical Technologist Lab Manager Lab Director Practitioner Postdoctoral Fellow Administrator Research Scientist/Associate Other V. Professional Affiliation 1. In the table below, place a check in the first column (1) if the organization is your primary or secondary professional organization (two answers only). Check in the second column (2) if you attended the annual meeting of the organization in the last 12 months. Check in the third column (3) if you presented a paper at the annual meeting of the organization in the last 12 months. Check in the fourth column (4) if you have been invited to present a paper at the annual meeting of the organization in the last 12 months. 4
1 2 3 4 NAME OF PROFESSIONAL ORGANIZATION American Association for the Advancement of Science American Association of Immunologists American Chemical Society American Mosquito Control Association American Public Health Association American Society for Cancer Research American Society for Cell Biology American Society for Microbiology American Society for Rickettsiology and Rickettsial Diseases American Society for Virology American Society of Biochemistry and Molecular Biology American Society of Parasitologists American Society of Plant Physiologists American Society of Tropical Medicine and Hygiene Entomological Society of America Federation of American Societies for Experimental Biology Infectious Diseases Society of America Mycological Society of America New York Academy of Sciences Sigma Xi Society for Industrial Microbiology Society of Protozoologists Other (specify) 5
VI. Publication History 1. In the table of scientific publications listed below, check in the first column (1) if you read regularly the publication. Check in the second column (2) if you have submitted a manuscript for publication in the last 12 months, but it has not been accepted yet. Check in the third column (3) if one of your manuscripts has been accepted in the last 12 months. Multiple answers are possible. 1 2 3 NAME OF PUBLICATION American Journal of Tropical Medicine and Hygiene Antimicrobial Agents and Chemotherapy Applied and Environmental Microbiology Cancer Research CELL Clinical and Diagnostic Laboratory Immunology Clinical Microbiology Reviews Infection and Immunity Journal of the American Medical Association Journal of Bacteriology Journal of Clinical Microbiology Journal of Emerging Infectious Diseases Journal of Immunology Journal of Infectious Diseases Journal of Medical Entomology Journal of Parasitology Journal of Protozoology Journal of Virology Microbiological Reviews Molecular and Biochemical Parasitology Molecular and Cellular Biology Nature New England Journal of Medicine Science Virology Other (name) Other (name) Other (name) 6
VII. Speciality Conferences and Workshops 1. How many specialized conferences and workshops did you attend in the last 12 months? 2. Of the specialized conferences and workshops that you attended in the last 12 months, how many were sponsored or co-sponsored by the American Society for Microbiology? 3. In the table below, please provide the year, city, and name of the specialized conferences and/or workshops. If you attended the conference or workshop, but did not give a presentation, please check column one (1) by the conference or workshop. If you presented a paper or poster, please check column two (2) by the conference or workshop. If you were an invited speaker, please check column three (3) by the conference or workshop. Up to five conferences or workshops may be listed. 1 2 3 Year City NAME OR CONFERENCE OR WORKSHOP 7
VIII. Professional Accomplishments From the list below, please check all the professional accomplishments that you completed in the last 12 months. PROFESSIONAL ACCOMPLISHMENTS Placement in graduate program Placement in medical or veterinarian program Placement in first post-doctoral program Placement in professional program (e.g. law, business, pharmacy) Placement in second or third post-doctoral program Completed coursework in a graduate/medical or professioanl program Attained approval for graduate dissertation Attained internship and/or residency status in medical program Completed successfully doctoral degree Completed successfully medical degree Completed successfully first post-doctoral position Completed successfully 2nd, 3rd or 4th post doctoral program Secured a research position Secured a clinical position Secured a teaching position Secured an administrative position Secured other position Secured a tenure-track position Attained tenure status Attained faculty status Directed a research project and team Received intramural funding to conduct research Received extramural funding to conduct research Published one-to-three journal articles Published more than three journal articles Published review articles 8
Published book chapters Presented an abstract session at scientific meetings Presented in an invited session at scientific meetings VIII. Teaching and Service 1. In the table below, please check all the activities that describe teaching-related activities that you have participated within the last 12 months. 12 mos TEACHING-RELATED ACTIVITIES Team-taught graduate course(s) Taught graduate course(s) by myself Team-taught undergraduate, non-laboratory course(s) Taught undergraduate, non-laboratory course(s) by myself Tean-taught undergraduate laboratory course Taught undergraduate laboratory course by myself Team-taught introductory level course for science majors Taught introductory level course for science majors by myself Team-taught introductory level course for non-science majors Taught introductory level course for non-science majors by myself Taught a workshop or short course for other professionals Mentored post-doctorate fellows Mentored graduate students Mentored undergraduate students Mentored research associates Mentored new faculty members Other (specify) 9
2. In the table below, please check all the service-related activities that you have participated within the last 12 months. 12 mos SERVICE-RELATED ACTIVITIES Mentored and/or coached middle or high school teacher or student Presented at a career fair Judged a science fair Lead science activities for a youth organization Other (specify) Thank you for completing and returning the survey to ASM Fellows Survey, Education Department, American Society for Microbiology, 1752 N St., NW, Washington, DC 20036 Another survey will be sent to you in 12 months. Please send an E-mail to Fellowships- CareerInformation@asmusa.org if you change your postal or Internet addresses. 10