University of Illinois at Chicago
Diabetes, Obesity and Nutrition Research Training Program
Application Form
Instructions:
Please complete this form and submit electronically as a single document or pdf file to:
Terry Unterman, M.D.
c/o Stephanie Thompson, Program Coordinator
Section of Endocrinology, Diabetes and Metabolism (M/C 640)
Department of Medicine
University of Illinois at Chicago
1819 West Polk Street
Chicago, Illinois 60612
sat@uic.edu
1.
Name:
2.
Gender:
3.
Address:
1
Male
2
Female
City, State, Zip:
4.
Telephone: (Office)
5.
Email:
6.
Availability date:
7.
Citizenship:
1
(Home)
U.S. Citizen or Noncitizen National
Non-U.S. Citizen
2
With a Permanent U.S. Resident Visa (“Green Card”)
3
With a Temporary U.S. Visa
If not a U.S. citizen, of which country are you a citizen?
8.
Permanent Mailing Address
E-mail:
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9.
Are you Hispanic (or Latino)?
1
Yes
2
No
3
Do not wish to provide.
10. What is your racial background? (Check one or more.)
1
American Indian or Alaska Native
1
Native Hawaiian or other Pacific Islander
1
Asian
1
Black or African American
1
White
1
Other
1
Do not wish to provide
11. Do you have a disability?
1
Yes
2
No
3
Do not wish to provide
If yes, which of the following categories describe your disability(ies):
1 Hearing
2 Visual
3 Mobility/Orthopedic Impairment
4 Other
12. Are you from a disadvantaged background?
1
Yes
2
No
3
Do not wish to provide
13. Education: [For predoctoral applicants, please include copies of your undergraduate and graduate
school transcripts.]
INSTITUTION,
DEPARTMENT & LOCATION
.
YEARS
ATTENDED
(FROM–TO)
DEGREE
DATE
CONFERED
(MO/YR)
MAJOR FIELD
MINOR FIELD
14. Professional experience:
DATES
JOB TITLE
BRIEF DESCRIPTION
EMPLOYER
(MO/YR)
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ADDRESS
15. Other relevant experience:
16. Professional licensure and board certification: [List type(s) and states of licensure and board
certification(s).]
17. Professional organizations:
18. Scholarly contributions: [List of publications, abstracts, presentations, and other research
activities.]
19. Awards:
20. Program track you are applying for:
1
Basic Science
2
Clinical
3
Community/Epidemiology/Behavioral
21. Please provide the following information:
a. Thesis research topic and/or other research topic (if relevant):
b. Research advisor:
c. Residency Training (if applicable):
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1. Area of Specialization:
2. Institution:
3. Postgraduate Year (PGY):
22. Provide a brief personal statement describing your specific research interests and
reason for pursuing this obesity-prevention training program. (Limit to one page)
23. What are your research/career goals and how do you see this research training
contributing to these goals?
24. Mentor Information: [Indicate the mentor(s) that you are interested in working with. See list of
program faculty at the end of this application.]
• Primary Research Mentor from Program Faculty:
• Co-mentor from Program Faculty:
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• Academic Advisor (if different from primary and co-mentors):
27. References: In evaluating your candidacy, we request that you solicit letters of reference from three
individuals acquainted with your academic experience and research work. We are particularly
interested in their opinion of your research qualifications and potential for an academic and research
career. Please have the letters sent to Dr. Terry Unterman at the address listed on the cover page of
this application.
Please list the names and addresses of those references you have requested:
1.
__________________________________________________________
2.
__________________________________________________________
3.
__________________________________________________________
University of Illinois at Chicago
Diabetes, Obesity and Nutrition Research Training Program
Faculty
Name/Degree(s)
Primary (& Secondary) Appointment(s)
Research Interest
Terry G. Unterman, MD Medicine – Endocrinology, Diabetes and
Metabolism
(Physiology and Biophysics)
(Kinesiology and ] Nutrition)
Regulation of gene expression and
metabolism by insulin and FoxO
transcription factors
Steven J. Ackerman,
PhD
Biochemistry and Molecular Genetics
(Medicine)
Regulation of gene expression
Waddah Alrefai, MD
Medicine – Gastroenterology
Intestinal transport of lipids and bile
acids, gene regulation by insulin
and nutrition
Elena Barengolts, MD
Medicine – Endocrinology, Diabetes and
Metabolism
Diabetes and Vitamin D, Glycemic
Index
Scott T. Brady, PhD
Head, Anatomy & Cell Biology
Neurobiology, axon transport,
mechanisms of neuropathy,
diabetic neuropathy
Carol Braunschweig,
PhD
Kinesiology and Nutrition
Body composition and insulin
sensitivity, nutritional intervention,
obesity prevention
Noel Chavez, PhD
Community Health Sciences
School of Public Health
Nutritional evaluation, community
assessment of nutrition
Scott Cotler, MD
Medicine – Hepatology
Diagnosis, treatment of nonalcoholic steatohepatitis,
pathogenesis hepatocarcinoma
Luisa DiPietro, DDS,
PhD
Director, UIC Center for Wound Healing and Stem/progenitor cell biology, tissue
Tissue Regeneration
repair and regeneration
Samuel Dudley, MD
Medicine - Cardiology
(Physiology and Biophysics)
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Oxidative stress, stem cell therapy
in cardiac disease
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Giamila Fantuzzi PhD
Kinesiology and Nutrition
(Microbiology and Immunology)
Leptin, obesity, inflammation,
adipocyte biology
Marian Fitzgibbon, PhD Medicine – Institute for Health Research and Prevention and behavioral
Policy, School of Public Health
intervention in obesity
Ben Gerber, MD, MPH
Medicine - General Medicine and
Endocrinology, Diabetes and Metabolism
Computer- and community-based
interventions in diabetes and
obesity
Howard Gordon, MD
Medicine – Health Promotion and Research
Healthcare disparities, doctorpatient communication in diabetes,
obesity and chronic disease
Nissim Hay, PhD
Biochemistry and Molecular Genetics
Akt kinases, signaling pathways,
molecular mechanisms of cancer,
aging and diabetes
Rhonda Kineman, PhD
Medicine – Endocrinology, Diabetes and
Metabolism
(Physiology and Biophysics)
Growth hormone – regulation and
function in diabetes, obesity and
metabolism
Timothy Koh, PhD
Kinesiology and Nutrition
Inflammation, muscle regeneration,
wound healing
James Lash, MD
Medicine – Nephrology
Epidemiology of diabetes, kidney
disease and hypertension
E. Douglas
Lewandowski, PhD
Physiology and Biophysics
(Medicine)
Energy metabolism, lipid and
mitochondrial metabolism in heart
Ayako Makino, PhD
Medicine – Endocrinology, Diabetes and
Metabolism
Endothelial biology, endothelial
dysfunction in diabetes
Asrar Malik, PhD
Head, Pharmacology
Endothelial biology, stem cells, cell
signaling
Robin J. Mermelstein,
PhD
Director, Institute for Health Research and
Policy
Health promotion and prevention
Andrew Mesecar, PhD
Center for Pharmaceutical Biotechnology
Structural biology, high throughput
screening, sirtuins, oxidative stress
Richard D. Minshall,
PhD
Pharmacology
Cell signaling, endothelial cell
biology and function
Jose Oberholzer, MD
Surgery, Director of Cell and Pancreas
Transplantation (Medicine – Endocrinology,
Diabetes and Metabolism, Bioengineering)
Pancreatic islet biology and
transplantation
John O’Bryan, PhD
Pharmacology
Cell signaling, caveolae, mitogenic
signaling pathways
Dale A. Pelligrino, PhD
Anesthesiology
Regulation of brain metabolism and
cerebral blood flow in diabetes
Victoria Persky, MD
Epidemiology and Biostatistics
School of Public Health
Epidemiology of endocrine
modifiers, asthma and diabetes
Shane A. Phillips, PhD
Department of Physical Therapy
Endothelial dysfunction in obesity
and insulin resistance: impact of
diet and exercise.
James H. Rimmer, PhD Disability and Human Development
Obesity and obesity-related
conditions in persons with disability
Laurie Ruggiero, PhD
Diabetes self-care, communitybased health promotion/prevention
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Community Health Sciences
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R. John Solaro, PhD
Head, Physiology and Biophysics
Cardiac physiology,
cardiomyopathy, heart failure
Zhenyuan Song, PhD
Department of Kinesiology and Nutrition
Fatty liver disease, alcoholic and
NAFLD, in cell culture systems and
animal models.
Papasani V. Subbaiah,
PhD
Medicine – Endocrinology, Diabetes and
Metabolism
(Kinesiology and Nutrition)
Lipid metabolism and transport,
dyslipidemias, insulin resistance
Angela L. Tyner, PhD
Biochemistry and Molecular Genetics
Gene expression and cell biology in
GI tract and liver
Masuko Ushio-Fukai,
PhD
Pharmacology
Endothelial biology, oxidative stress
and angiogenesis in diabetes
Yong Zhao, PhD
Medicine (Endocrinology, Diabetes and
Metabolism)
Stem cell biology, beta cell
differentiation, circulating islet
progenitor cells
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