Application for Admission to

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UTISM
ESEARCH
RAINING
Program
APPLICATION FORM
Application Guidelines and Process 2015
Dear Applicant,
Thank you for inquiring about the Autism Research Training (ART) Program.
The ART Program is funded by the Canadian Institutes of Health Research (CIHR), through the Strategic
Training Initiative in Health Research (STIHR), with additional funding the Sinneave Family Foundation,
McGill University, and other in-kind Canadian university contributions.
The training program goal is to recruit and train outstanding researchers in the field of autism, in disciplines
such as genetics, brain imaging, epidemiology, neurology, psychiatry, psychology and others. Upon completing
the program, trainees will be equipped with a broad interdisciplinary knowledge base, a rich repertoire of
research skills, strong connections to a vigorous research community in special populations, and an ability to
translate research into practice.
The program is organized around two central sites, McGill University and University of Alberta, which
coordinates activities with 16 other universities, and 38 faculty members from across Canada. Over the past
decade, ART has had a significant impact in building ASD research capacity nationally, fostering the
development of a new generation of ASD scientists with transdisciplinary training, ready to tackle complex
issues of importance to families, policy makers and other stakeholders.
ART Program training activities include participation to a 5-day intensive Summer School Program, a biennial
Winter Institute, an international guest speaker event at IMFAR, and knowledge translation and dissemination
activities. Trainees receive mentorship from 3 ART faculty members – facilitated by emails, phone calls, faceto-face meetings.
ELIGIBILITY CRITERIA
The Program is open to health professionals, doctoral students, post-doctoral fellows and clinical fellows with a
solid academic disciplinary background in health care, science, social sciences, or humanities. Trainees are
selected based on outstanding academic profiles; commitment to a research career; and the strength,
transdisciplinarity and relevance of their research proposals.
Applicants must be registered at a Canadian university by September 2015, where they complete their core
training and conduct their research at their supervisor’s facility. While candidates must demonstrate support
from at least one ART program mentor with their application, it is not mandatory that the trainee’s main
supervisor be an ART mentor.
FUNDING OPPORTUNITIES
Candidates admitted for the year 2015-16 will:



attend Summer School in August 2015 (travel, food & accommodation paid for by ART Program);
attend Winter Institute in March 2016 (travel, food & accommodation paid for by ART Program);
be eligible to a $1,250 travel allowance to attend conferences such as IMFAR and/or visit their mentor’s
lab;
 receive mentorship from 3 ART mentors over a 1-yr period.
Note: Because of the changes to the funding supports available to the ART Program, we are not able to offer a
student stipend to candidates admitted to the ART Program following this competition.
APPLICATION DEADLINE: March 6, 2015, midnight Eastern Time
All application documents must be received by the application deadline.
Applications are not based on financial need. Criteria for ranking applicants will include: (a) research area in
autism; (b) positive letters from supervisors; (c) support by ART Faculty Member; (d) record showing academic
excellence and research productivity.
ALL APPLICATIONS MUST INCLUDE:
1) ART Program Application Form. Please use Times New Roman font size 11.
Including a detailed summary of your proposed research project (4 pages max, within the
Application Form).
Provide a brief introduction to the issue.
Provide a context for the research question that you will address.
Describe the sample, procedures, analyses, expected results and the implications of those results
for theory or practice.
2) Curriculum Vitae (must include, but not restricted to, the categories below)
a)
Education: Provide the institution name and all degrees obtained including years, starting
with most recent degree.
b)
Research/Clinical Experience
c)
Personal funding support (i.e. fellowship, teaching/research assistantship, scholarship, bursary, stipend)
d)
Research Funding received (Specify total amount received and source of funding)
e)
Publications
3) A copy of your academic transcripts and license
a) Official undergraduate/graduate transcripts (transcripts must be sealed)
b) A copy of your professional license, if applicable.
4) Three (3) letters of recommendation
a) From individuals familiar with your work, preferably in your area of specialization. One letter of
recommendation must be from an ART Faculty member.
b) Provide each of your referees with the Reference Letter Form and a return envelope.
c) Letters of recommendations should be mailed or emailed directly from the referee to the ART
Program Advisory Committee (see address below).
Applicant must email – 1), and 2) to:
ART Program Advisory Committee
melanie.viau@muhc.mcgill.ca
University must mail – 3) to: ART Program Advisory Committee
c/o: Mélanie Viau, Program Coordinator
Montreal Children’s Hospital
4018 Ste-Catherine Street West, Rm. K-205A
Montréal, Québec, H3Z 1P2, Canada
Referees must mail or email – 4) to: see address and email above
Applicant Data
For Correspondence:
Mr.
Ms.
Family Name
Given Name
Gender:
DOB: yyyy-MM-dd
Citizenship:
Dr.
Canadian
Male
Female
Social Insurance Number (If Canadian Resident)
Permanent Resident
Student Visa
Other (Specify)
Country of Citizenship:
Nationality:
Mother Tongue:
Principal Language Used:
English
French
Mailing Address (To be used on all correspondence concerning your application)
Street number, Street Name, Apt.#.
City
Province/State
Postal/Zip Code
Country
Contact Information (To be used on all correspondence concerning your application)
Home Telephone Number
Work Telephone Number
Mobile Telephone Number
(ex. 514-555-0123)
Fax Number
E – mail
Education Information
Highest Degree completed:
Choose
Discipline:
Choose
Year completed:
Choose
Present Status:
Choose
Discipline:
Choose
Year completion expected:
Choose
Research & Career Objectives
1. Chronologically (from most recent) list any research experience you have acquired.
Project
Institution/Company
Director/ Co-Director(s)
Ex. Pathways in ASD
McGill University
Dr. E. Fombonne
From (mo/yr) – To (mo/yr)
01/06 – 01/09
2. What are your general career objectives?
3. What specific knowledge and skills do you hope to acquire during your Autism Research Training?
4. How will the knowledge and skills you acquire during the ART Program help you attain your career objectives?
5. What particular area (s) of autism research would you like to focus on during your training program?
Summary of Curriculum vitae
University Education (including current degree) – please enclose official transcripts
Institution – Country
Ex. McGill-Canada
Discipline
Educational Psychology
From (mo/yr – mo/yr)
01/89 –05/91
Diploma
MA
Funding
Funds REQUESTED: List all research support currently applied for from all sources (e.g. industry, academic...)
Funding Source / Organization
Ex. FRSQ
Project Name
The Gene-A Trial
Amount applied
$250,0000
From (mo/yr)
01/05
To (mo/yr)
01/09
Funds CURRENTLY HELD: List all research support currently held from all sources (e.g. industry, academic…)
Funding Source / Organization
Ex. SSHERC
Project Name
Prevalence of Autism
Amount
$250,0000
From (mo/yr)
01/04
To (mo/yr)
01/05
Funds HELD IN THE LAST FIVE YEARS: List all research support held in the last five years and now
terminated from all sources (e.g. industry, academic...)
Funding Source / Organization
Ex. McGill University Scholarship
Project Name
Depression in Graduate students
Amount
$5,000
From (mo/yr)
09/00
To (mo/yr)
09/01
Publications /Presentations
Please record the total number of presentations/publications (published/accepted and/or in press) for the years
2013 and 2014. A list of all publications should be included in your curriculum vitae.
Total #
1. Total number of peer reviewed publications?
2. How many of the above were published in one of the top five journals
in your field of discipline?
3. How many other reports and/or publications were published with you as an author?
4. How many conference presentations were presented with you as an author?
Program Supervisor
All trainees should have a designated member of their respective university to monitor the trainee’s progress throughout
the graduate program, to ensure that all conditions of admission and requirements are fulfilled, to provide students with
information on their program, their progress through it, sources of and policies on financial support and to advise them
how to resolve problems which may arise during their program. A Program Supervisor is your thesis/project supervisor
from your department/university.
Name & address of proposed Program Supervisor:
Name:
Address:
Number of graduate & postdoctoral trainees in the laboratory of the project supervisor:
Number of graduate students
Number of postgraduates
Specify the title of the research project of each of these individuals.
ART Program Mentors
The ART Program consists of 38 Faculty who will act as mentors for trainees enrolled in the ART Program. The mentors
will work closely with the trainee and provide guidance and supervision during their time in the program. Over the course
of the trainee’s ART Program, a rotation at each of the 3 mentor’s facilities will be facilitated with travel funding. At
least once a year the mentors and trainees will meet to evaluate the trainee’s progress.
From the ART Program Faculty list below, please select 3 you would like to have as mentors. By selecting the mentor you
are also selecting the disciplines / areas of research in which you would like to be trained. Your Program Supervisor
cannot be one of your mentors. One mentor should be from your field of study, and the other 2 should represent
complementary disciplines and expertise (eg. A graduate student in the Department of Educational Psychology at McGill, whose
Program Supervisor is Dr. Burack, might choose Dr. Mirenda as the mentor in his / her area of specialty, and then may want to be
mentored in disciplines such as psychiatry and developmental pediatrics and choose Drs. Bailey and Roberts as his / her 2 other
mentors).
1-Evdokia Anagnostou
UToronto – Clinical Trials /
Neuroimaging / Neurology
2-Anthony Bailey
UBC – Genetics / Neuroimaging /
Psychiatry
3-Armando Bertone
McGill – Visual Perception
4-Michael Boyle
McMaster – Epidemiology / Statistical
Methods
5-Jessica Brian
UToronto – Early Detection /
Intervention
6-Susan Bryson
Dalhousie – Developmental
Neuropsychology / Early Detection /
Intervention
7-Jacob A. Burack
McGill – Educational Psychology /
Neuropsychology
8-Melanie Couture
USherbrooke – Occupational Therapy
9-Mayada Elsabbagh
McGill – Brain Development /
Knowledge Translation
10-James Enns
UBC – Neuroscience / Psychology
11-Alan Evans
McGill – Neuroimaging
12-Margaret Fahnestock
McMaster – Neurochemistry
13-Krista Hyde
UMontreal – Developmental
neurobiology / Neuropsychology
14-Grace Iarocci
SFU – Psychology
15-Shannon Johnson
Dalhousie – Neuropsychology /
Psychology
16-Elizabeth Kelley
Queens – Neuropsychology /
Psychology
17-Tara Kennedy
New-Brunswick – Knowledge Transfer
/ Medical Education / Paediatrics /
Qualitative Research Methods
18-Alan Kingstone
UBC – Neuroscience
19-Pat Mirenda
UBC – Educational Psychology /
Intervention
20-Chris Moore
Dalhousie – Psychology
21-Laurent Mottron
UMontreal – Neuropsychology
22-Gina Muckle
ULaval – Neurobehavioral Teratology
23-Aparna Nadig
McGill – psycholinguistics and social
cognition
24-David Nicholas
UCalgary – Family Experiences /
Knowledge Transfer / Social Work
25-Rob Nicholson
UWO – Neuroimaging
26-Andrew Paterson
UToronto – Genetics
27-Wendy Roberts
UToronto – Developmental Paediatrics
/ Early Detection / Genetics /
Intervention
28-Mel Rutherford
McMaster - Social perception / Early
detection
29-Steve Scherer
UToronto – Genetics and Genomics
30-Isabel Smith
Dalhousie – Clinical / Developmental
Psychology
31-Veronica Smith
UAlberta – Educational Psychology /
Intervention / Speech-Language
Pathology
32-Peter Szatmari
UToronto – Classification / Diagnosis /
Genetics / Outcome Studies /
Psychiatry
33-Jim Tanaka
UVictoria – Intervention /
Neuroscience / Psychology
34-Tracy Vaillancourt
UOttawa – Statistical Methods
35-Joanne Volden
UAlberta – Speech Language
Pathology
36-Jonathan Weiss
York - Psychology / Intervention /
Family Experience
37-Rosanna Weksberg
UToronto – Epigenetics
38-Lonnie Zwaigenbaum
UAlberta – Early Detection /
Paediatrics
Names of proposed ART Program Mentors you would like to train with and why? Please indicate if you have
already worked or have been in communication with the named mentors.
Mentor 1.
Mentor 2.
Mentor 3.
Reference Letters
Please supply names and addresses of 3 referees of whom you will be requesting letters to be forwarded to the Committee.
Please provide each of your referees with the Reference Letter Form provided with this application. Reference Letters
need to be mailed or emailed separately from the application and must come directly from the Referee. One of these
referees must be an ART Faculty Member.
1.
Name:
Relationship:
Contact Information:
2.
Name:
Relationship:
Contact Information:
3.
Name:
Relationship:
Contact Information:
Description of proposed research
Level: Masters
PhD
Postdoctoral
Other (Specify)
Start date:
In which laboratory (ies) will the project take place?
Name of Institution
Name of Lab/Clinic
Ex. Montreal Children’s Hospital
ASD Clinic
Name of Director
Dr. E. Fombonne
Name of Co-Directors
Dr. L. Tidmarsh
Describe the respective contribution of research director, co-director and collaborator(s) to your project.
Will there be anyone else (graduate/undergraduate student), from your lab working with you on your project?
No
Yes
Name of Teammate:
Discipline:
Describe your teammate’s contribution to your project.
What aspect(s) of the project has already been funded? Please indicate the source of funding, name of the funded
individual and the amount of funding.
Description of proposed research
Give a clear description of the objective of a research project you would like to work on during your training. Include relevant
background material. Discuss the significance of the work and its relationship to autism. In order to enable the Program Advisory
Committee to appreciate your proposed research project properly, provide sufficient details. This section must not exceed four (4)
pages.
Title of Research Project (brief but descriptive):
Description of proposed research*
*=Please note: Copy and use this page up to two (2) additional times
UTISM
ESEARCH
RAINING
Program
REFERENCE LETTER
Referee # 1
Note to the Referee:
The information you provide is essential to the ART Program Selection Committee in evaluating the suitability of the applicant for
support. Therefore, you are asked to give detailed information (both positive and negative) about the applicant. You may do so in an
accompanying letter.
Name of Applicant:
Referee Name:
Position/Dept./Institution:
Indicate the period of time and in what capacity you have known the applicant. You may attach a letter, as desired.
Please elaborate on the applicant’s performance during his/her clinical and or research training, as well as your assessment of the
applicant’s potential to perform in a research setting. You may attach a letter as desired.
In your overall assessment would you please indicate the applicant’s merit relative to others with the same level of training:
Exceptional (top 5%)
Excellent (top 10%)
Your assessment should be mailed or emailed directly to:
Very Good (top 20%)
Good (top 30%)
Acceptable (Below 30%)
ART Program Advisory Committee
c/o: Mélanie Viau, Program Coordinator
Montreal Children’s Hospital
4018 Ste-Catherine Street West, Rm. K-205A
Montréal, Québec, H3Z 1P2, Canada
melanie.viau@muhc.mcgill.ca
Thank you for your advice and assistance in this decision-making process.
UTISM
ESEARCH
RAINING
Program
REFERENCE LETTER
Referee # 2
Note to the Referee:
The information you provide is essential to the ART Program Selection Committee in evaluating the suitability of the applicant for
support. Therefore, you are asked to give detailed information (both positive and negative) about the applicant. You may do so in an
accompanying letter.
Name of Applicant:
Referee Name:
Position/Dept./Institution:
Indicate the period of time and in what capacity you have known the applicant. You may attach a letter, as desired.
Please elaborate on the applicant’s performance during his/her clinical and or research training, as well as your assessment of the
applicant’s potential to perform in a research setting. You may attach a letter as desired.
In your overall assessment would you please indicate the applicant’s merit relative to others with the same level of training:
Exceptional (top 5%)
Excellent (top 10%)
Your assessment should be mailed or emailed directly to:
Very Good (top 20%)
Good (top 30%)
Acceptable (Below 30%)
ART Program Advisory Committee
c/o: Mélanie Viau, Program Coordinator
Montreal Children’s Hospital
4018 Ste-Catherine Street West, Rm. K-205A
Montréal, Québec, H3Z 1P2, Canada
melanie.viau@muhc.mcgill.ca
Thank you for your advice and assistance in this decision-making process.
UTISM
ESEARCH
RAINING
Program
REFERENCE LETTER
Referee # 3
Note to the Referee:
The information you provide is essential to the ART Program Selection Committee in evaluating the suitability of the applicant for
support. Therefore, you are asked to give detailed information (both positive and negative) about the applicant. You may do so in an
accompanying letter.
Name of Applicant:
Referee Name:
Position/Dept./Institution:
Indicate the period of time and in what capacity you have known the applicant. You may attach a letter, as desired.
Please elaborate on the applicant’s performance during his/her clinical and or research training, as well as your assessment of the
applicant’s potential to perform in a research setting. You may attach a letter as desired.
In your overall assessment would you please indicate the applicant’s merit relative to others with the same level of training:
Exceptional (top 5%)
Excellent (top 10%)
Your assessment should be mailed or emailed directly to:
Very Good (top 20%)
Good (top 30%)
Acceptable (Below 30%)
ART Program Advisory Committee
c/o: Mélanie Viau, Program Coordinator
Montreal Children’s Hospital
4018 Ste-Catherine Street West, Rm. K-205A
Montréal, Québec, H3Z 1P2, Canada
melanie.viau@muhc.mcgill.ca
Thank you for your advice and assistance in this decision-making process.
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