Curriculum Vitae FirstName LastName, M.D., Ph.D., etc. Personal Information Professional Address Phone Fax Email Current Position, Institution and start date Year-present Include faculty appointment with rank as well as academic administrative roles Education Postgraduate training: Postdoctoral Research Fellowship (for clinical appointment) – University Residency - University Internship - University Graduate degree and major, University Dissertation Title and Mentor Undergraduate degree and major, University Previous Professional experience start/end dates (mm/yy format) start/end dates (mm/yy) start/end dates (mm/yy) start/end dates (mm/yy) start/end dates (mm/yy) start/end dates (mm/yy) (Note: in reverse chronological order, include any sabbaticals) Appointment, position held, Institution Hospital and Clinical Staff appointments start/end dates (mm/yy) (Note: in reverse chronological order) Institution, position Board Certification and Licensure start/end dates (mm/yy) start/end dates (mm/yy) Professional Society memberships National Regional Honorary Societies, Honors and Awards Named Lectureships as well as other honors Teaching Awards Professional Services (Note: in reverse chronological order) Committee membership and administrative role (include in the following order): International start/end dates (mm/yy) National (e.g. professional societies, study sections, session moderator, etc.) University Health Center Medical School Department Hospital Community Editorial and Journal review boards (Editorial reviewer, ad hoc reviewer) Last name 2 Current and Past Teaching Responsibilities (Note: in reverse chronological order) (Note: reference Clinical Educator Portfolio, if appropriate) Administration (clerkship, residency, or fellowship program director, etc) Courses and lectures or topics Clinical Teaching Responsibilities Thesis/dissertation Preliminary qualification committees (mm/yy) (mm/yy) (mm/yy) (mm/yy) (mm/yy) Protégé Departmental Dissertation/Thesis, post-doctoral supervision Fellows, residents, medical students Research Support (Note: in reverse chronological order) Current funding: start/end dates (mm/yy) Funding mechanism and agency, grant number and title, award total Contracted studies (formatted as above) start/end dates (mm/yy) All past funding (formatted as above) start/end dates (mm/yy) Bibliography (Note: numbered & in chronological order here only, underline your name in the reference) Peer reviewed articles: (mm/yy) Papers published, in press, or accepted for publication in peer-reviewed journals; all authors, full title, journal, per PubMed format Invited review articles (mm/yy) Book chapters, monographs, case reports, electronic media, non-peer (mm/yy) reviewed articles Books published or in press, role (single author, joint authorship, editor), (mm/yy) all authors, full title, publisher, and year should be referenced Abstracts – include dates (mm/yy) Clarify accepted as Posters/Oral Presentations National/International Meetings Local/Regional Meetings Supplemental Material (Note: in reverse chronological order) Invited Talks/Grand Rounds Seminars and workshops at national meetings Patents and Technology Transfer Community Service/Civic Activities Consulting CVFormat: Revised 11/08/2011, 3/7/12 (Modified based on input from Credentials Committee, Dean’s Staff, Chairs Committee and Faculty Affairs Committee) (mm/yy) (mm/yy) (mm/yy)