NAME Page 1 NAME, DEGREE HOME ADDRESS CITY, Hawai‘i, ZIP CODE Cell: (808) NUMBER Phone & Fax: (808) NUMBER E-mail: E-MAIL CURRICULUM VITA Personal Date: Business: DATE CURRENT POSITION(S) Department of Psychiatry, 1356 Lusitana St., 4th Floor John A. Burns School of Medicine, University of Hawai‘i at Mānoa Honolulu, Hawai‘i 96813 Educational History XXXX-XXXX XXXX-XXXX XXXX-XXXX DEGREE, DEPARTMENT, UNIVERSITY/COLLEGE, CITY, STATE DEGREE, DEPARTMENT, UNIVERSITY/COLLEGE, CITY, STATE DEGREE, DEPARTMENT, UNIVERSITY/COLLEGE, CITY, STATE Professional Positions XXXX-present XXXX-XXXX XXXX-XXXX XXXX-XXXX XXXX-XXXX XXXX-XXXX XXXX-XXXX POSITION, DEPARTMENT, UNIVERSITY/COLLEGE, CITY, STATE POSITION, DEPARTMENT, UNIVERSITY/COLLEGE, CITY, STATE POSITION, DEPARTMENT, UNIVERSITY/COLLEGE, CITY, STATE POSITION, DEPARTMENT, UNIVERSITY/COLLEGE, CITY, STATE POSITION, DEPARTMENT, UNIVERSITY/COLLEGE, CITY, STATE POSITION, DEPARTMENT, UNIVERSITY/COLLEGE, CITY, STATE POSITION, DEPARTMENT, UNIVERSITY/COLLEGE, CITY, STATE Certifications for Specialty and Subspecialty: XXXX-RECERTIFICATION DATE [LIST FROM LATEST TO EARLIEST] TYPE OF AMERCIAN BOARD OF MEDICAL SPECIALTIES BOARD CERTIFICATION (E.G., AMERICAN BOARD OF PSYCHIATRY & NEUROLOGY, AMERICAN BOARD OF PEDICATRICS, AMERICAN BOARD OF FAMILY MEDICINE, AMERICAN BOARD OF INTERNAL MEDICINE, ETC.) Teaching, Training, Mentoring [NOTE: KEEP ALL EVALUATIONS] Medical Students: XX/XX-XX/XX POSITION, DEPARTMENT, UNIVERSITY/COLLEGE COURSE TITLE, COURSE ABBREVIATION & COURSE NUMBER NUMBER OF CREDITS, NUMBER OF STUDENTS Residents: XX/XX-XX/XX POSITION, DEPARTMENT, UNIVERSITY/COLLEGE COURSE TITLE, COURSE ABBREVIATION & COURSE NUMBER NUMBER OF CREDITS, NUMBER OF STUDENTS [Template for Vita Geared for Promotion Categories – Version 02/12/06b] NAME Page 2 Master’s & Dissertation Committees: XX/XX-XX/XX NAME OF STUDENT, DEGREE Candidate, “TITLE OF THESIS/DISSERTATION,” DEPARTMENT, UNIVERSITY/COLLEGE, CITY, STATE Others: [E.G., UNDERGRADUATES, GRADUATES, GRAND ROUNDS] XX/XX-XX/XX POSITION, DEPARTMENT, UNIVERSITY/COLLEGE COURSE TITLE, COURSE ABBREVIATION & COURSE NUMBER NUMBER OF CREDITS, NUMBER OF STUDENTS Scholarly/Research & Grant Activities [NOTE: 1ST-AUTHORED SCIENTIFIC PEER-REVIEWED PUBLICATIONS COUNT THE MOST] [NOTE: KEEP FORMAL CORRESPONDENCES THAT SUPPORT QUALITY—E.G., EDITOR’S OR PEER REVIEWERS’ COMMENTS.] Scientific Peer-Reviewed Journal Publications (in order by year) XXXX Fox III, E. C., Waldron, J. A., Bohnert, P., Hishinuma, E. S., & Nordquist, C. R. (1998). Mentoring new faculty in a department of psychiatry. Academic Psychiatry, 22(2), 98-106. (XX% effort) In press Andrade, N. N., Hishinuma, E. S., McDermott, Jr., J. F., Johnson, R. C., Goebert, D. A., Makini, Jr., G. K., Nahulu, L. B., Yuen, N. Y. C., McArdle, J. J., Bell, C. K., Carlton, B. S., Miyamoto, R. H., Nishimura, S. T., Else, I. R. N., Guerrero, A., Darmal, A., Yates, A., Waldron, J. A. (in press). The National Center on Indigenous Hawaiian Behavioral Health Study of Prevalence of Psychiatric Disorders in Native Hawaiian Adolescents. Journal of the American Academy of Child and Adolescent Psychiatry. (XX% effort) Invited Scientific Journal Publications XXXX _____ Other Non-Peer-Reviewed Journal Publications XXXX _____ Monographs XXXX _____ Books & Book Chapters XXXX _____ Newsletter, Bulletin, Newspaper Publications XXXX _____ Unpublished Dissertation XXXX _____ World Wide Web XXXX _____ [On-line]. Available: HTTP://WWW.XXXX. Technical Reports [Template for Vita Geared for Promotion Categories – Version 02/12/06b] NAME XXXX Page 3 _____ Abstracts XXXX _____ National/International Refereed Conference & Symposium Presentations XXXX _____ National/International Invited Conference & Symposium Presentations XXXX _____ Other Non-Local Presentations XXXX _____ Local Refereed Conference & Symposium Presentations XXXX _____ Local Invited Conference & Symposium Presentations XXXX _____ Local Workshops & Seminars XXXX _____ Curriculum Development, Implementation, &/or Dissemination XXXX _____ Editor, Guest Editor, Peer Reviewer, Consultant, Visiting Professor XXXX _____ Grants Awarded & In Progress XX/XX-XX/XX POSITION, TITLE OF PROPOSAL, TOTAL AMOUNT OF FUNDING, FUNDING AGENCY, BRIEF DESCRIPTION OF MISSION OF PROPOSAL, Principal Investigator = _____ [IF NOT YOU] Grants In Review XX/XX-XX/XX POSITION, TITLE OF PROPOSAL, TOTAL AMOUNT OF FUNDING, FUNDING AGENCY, BRIEF DESCRIPTION OF MISSION OF PROPOSAL, Principal Investigator = _____ [IF NOT YOU] Grants In Revision or In Preparation XX/XX-XX/XX POSITION, TITLE OF PROPOSAL, TOTAL AMOUNT OF FUNDING, FUNDING AGENCY, BRIEF DESCRIPTION OF MISSION OF PROPOSAL, Principal Investigator = _____ [IF NOT YOU] Grants Awarded & Completed XX/XX-XX/XX POSITION, TITLE OF PROPOSAL, TOTAL AMOUNT OF FUNDING, FUNDING AGENCY, BRIEF DESCRIPTION OF MISSION OF PROPOSAL, Principal Investigator = _____ [IF NOT YOU] Grants Submitted But Not Funded [Template for Vita Geared for Promotion Categories – Version 02/12/06b] NAME Page 4 XX/XX-XX/XX POSITION, TITLE OF PROPOSAL, TOTAL AMOUNT OF FUNDING, FUNDING AGENCY, BRIEF DESCRIPTION OF MISSION OF PROPOSAL, Principal Investigator = _____ [IF NOT YOU] Services University Services XX/XX-XX/XX POSITION, NAME/TITLE OF SERVICE, DEPARTMENT, SCHOOL, BRIEF DESCRIPTION [NOTE: COULD INCLUDE LEADERSHIP POSITIONS, ADMINISTRATIVE POSITIONS, COMMITTEES, CONSULTATIONS IN AREA OF EXPERTISE] Community Services XX/XX-XX/XX POSITION, NAME/TITLE OF SERVICE, DEPARTMENT, SCHOOL, BRIEF DESCRIPTION [NOTE: COULD INCLUDE COMMUNITY SERVICE, CONSULTATION, PRESENTATIONS, COMMITTEES/BOARDS] Leadership, Professional Growth, & National/International Recognition/Prominence Awards & Honors XXXX _____ [KEEP OFFICIAL DOCUMENTS] Professional Training &/or Certification, including Research Ethics Training XXXX _____ [KEEP OFFICIAL DOCUMENTS] Membership in Professional Associations XXXX-XXXX _____ [KEEP OFFICIAL DOCUMENTS] XXXX-XXXX _____ [KEEP OFFICIAL DOCUMENTS] Professional Interests _____ Professional References _____ Personal Statement/Endeavor General career goals/aims & how these are consistent with & supports the Department, JABSOM, and UH Philosophy on fulfilling goals/aims [Template for Vita Geared for Promotion Categories – Version 02/12/06b] NAME Page 5 Evidence of national/international reputation/prominence (especially for promotion to Full Professor) Evidence of fulfilling goals/aims in major categories: teaching, scholarly/research/grants, service [Template for Vita Geared for Promotion Categories – Version 02/12/06b]