Thoracic Surgery Foundation for Research and Education
633 N. St. Clair Street, 23rd Floor
Chicago, IL 60611
312-202-5868
tsfre@tsfre.org
www.tsfre.org
TSFRE Nina Starr Braunwald Research Fellowship Application
Deadline: October 15, 2015 11:59 p.m. CT
Application Guidelines: This document is not an online application and cannot be submitted through the TSFRE
website. To use this application, save to your desktop and submit with attachments to tsfre@tsfre.org. It is preferred
that all application documents are submitted together.
Braunwald Research Fellowship
Support of up to $30,000 per year for up to two years for women cardiothoracic surgery residents or general
surgery residents who are either working in a cardiac surgical laboratory under the mentorship of a cardiac
surgeon, or a general surgery resident working within a research program under the mentorship of a cardiac
surgeon. No additional funds will be paid out for indirect, fringe, or other expenditures.
This award is designed to provide salary and/or direct experimental support for women cardiac surgical trainees
who wish to acquire investigational skills. Although a specific research program is required as the major component
of the application, emphasis in making the award is placed on the potential of the applicant, based on prior
accomplishments, and the quality of the educational experience for the applicant. Particular emphasis is placed on
evidence of supervisory interaction in preparation of the application, the extent to which research training and a
productive educational experience is convincingly described, and the training environment. Additional criteria
include the probability of successful project completion and an assessment of the importance of the particular
educational effort toward the advancement of cardiac surgery.
The TSFRE Nina Starr Braunwald Research Fellowship provides support of up to $30,000 per year for up to two
years. Requests for support for a single laboratory year are discouraged unless this represents the second of two
consecutive research years.
If two years of funding are requested and awarded, a progress report approved by the chairperson of the TSFRE
Research Committee is required prior to release of payment for the second year.
Eligibility
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Women cardiac surgical trainees who intend to pursue a career in investigative cardiac surgery;
Women cardiac surgical trainees whose program director indicates that the applicant will be allowed not
less than 80% protected time for research;
Women cardiac surgeons who have completed their training but wish to acquire an investigative education
with a specified mentor;
Women cardiothoracic surgery residents or general surgery residents who are either working in a cardiac
surgical laboratory under the mentorship of a cardiac surgeon;
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General surgery residents working within a research program under the mentorship of a cardiac surgeon.
*Required fields
General Information
*Title of Project:
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*Duration of Project:
1 Year ☐
*Total Funding Amount Requested:
2 Years ☐
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Individual
Note: Only women cardiac trainees or surgeons are eligible for this award.
*First Name:
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Middle Initial:
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*Last Name:
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Suffix:
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Degree(s):
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*Telephone Number:
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Fax:
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*E-mail Address:
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*Street Address:
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*City:
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*Postal Code: Choose an item.
*State/Province:
*Country:
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Sponsoring Institution
*Institution Name:
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*Your Position at this Institution:
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*Department:
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*Please indicate your role: (e.g. General Surgery Resident, Thoracic Surgery Resident, Surgeon) Choose an
item.
*Please indicate your current level of training: (e.g. PGY1, PGY2, PGY3, PGY4, PGY5, PGY6, PGY7, PGY8,
N/A) Choose an item.
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Attachments
Submit completed application with the following attachments:
*Your Curriculum Vitae (pdf)
*Your Photo (jpeg)
Narrative
*Personal Goals (five sentences or less)
State your personal career goals. Identify exactly what you wish to accomplish in the course of the proposed work.
Logical future studies may be indicated, as well as the potential impact of this work on the field.
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*Background (500 words)
Provide a highly focused presentation of the background and rationale for this project, a critical presentation of the
most important work of others in the field, and the results of any preliminary work by the investigators. This page
should reflect the applicant’s knowledge and critical analysis of the area of interest and provide a foundation for the
proposed project.
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*Experimental Design (750 words)
State the hypothesis that you will test and the methods that you will use. Indicate the design of the study and
outline in logical sequence how you plan to proceed. Indicate the source of biological material that you will study
and the statistical methods you will use in analyzing your data. Excessive methodologic detail is unnecessary,
unless you are developing or applying new and unique techniques.
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*The Educational Environment (750 words)
Organized contributions of a senior investigator and mentor to the development of the trainee must be clearly
identified. A very specific learning program for the trainee must be identified, and the manner in which you
proposed work will interact with the training program should be well delineated.
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*Pending Research Applications
List any other research applications pending or approved and whether any overlap with another TSFRE
application/request. The intent of TSFRE is to enable the applicant by the award, but not to provide redundant
funding for a funded project. If you have no other pending research applications, enter “none.”
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*Literature References (500 words)
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*Proposed Budget for this Award
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Project Participants
List the first and last names and e-mail addresses of all project participants.
*These fields are required if you have project participants. If you do not, you may leave fields blank.
1. First Name:
Last Name:
E-mail Address:
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2. First Name:
Last Name:
E-mail Address:
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3. First Name:
Last Name:
E-mail Address:
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4. First Name:
Last Name:
E-mail Address:
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5. First Name:
Last Name:
E-mail Address:
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Payee of Award
List the institution that will receive the award check.
*Check should be made payable to:
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*Attention (name):
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*Telephone Number:
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Fax:
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*E-mail Address:
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*Street Address:
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*City:
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*Postal Code: Choose an item.
*State/Province:
*Country:
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Institution Tax ID #:
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Chair of the Department of Surgery
This person must be able to attest to your commitment to a career in investigative cardiothoracic surgery.
*Chair Name:
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*Chair E-mail:
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*Letter of Support: Attach Letter of Support pdf with your completed application.
Mentor
*Scientific Mentor Name:
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*Telephone Number:
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*E-mail Address:
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*Letter of Support:
Attach Letter of Support pdf with your completed application.
*Mentor’s CV:
Attach mentor’s CV pdf with your completed application.
Additional Institutional Funding
Complete this section if you are receiving institutional funding for your research.
Name of official authorized to commit additional institutional support: Choose an item.
*Telephone Number:
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*E-mail Address:
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Amount of institutional funding committed to project:
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Additional Outside Funding
Complete this section if you are receiving additional funds supplied by a funding grant from government, or an
industrial, philanthropic, or charitable institution.
Principal Investigator:
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Grant Title:
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Grant ID#:
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Amount of institutional funding committee to project:
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Miscellaneous
Attach any other relevant data, such as figures, additional letters of support, etc.
Attachments Reminder
*Your Curriculum Vitae (pdf)
*Your Photo (jpeg)
*Chair of the Department of Surgery Letter of Support (pdf)
*Mentor Letter of Support (pdf)
*Mentor’s CV (pdf)
Sponsor Letter of Support (if different than Mentor) (pdf)
Program Director Letter of Support (if different than Mentor) (pdf)
Letter of Support from official authorized to commit additional institutional support (if you are receiving institutional
funding for your research). (pdf)
Other relevant data, such as figures, additional letters of support, etc. (pdf)
Submit all application materials to tsfre@tsfre.org by October 15, 2015 11:59 p.m. CT.
Copyright © 2015 Thoracic Surgery Foundation for Research and Education
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