Date of release: March 1, 2023

The James T. Lubin Clinician Scientist Fellowship Award supports the post-residency training of clinicians who are committed to careers in academic medicine with a specialization in rare neuroimmune disorders of the CNS (including ADEM, AFM, MOGAD, NMOSD, ON, and TM) clinical care and research. The intent of this program is to support up to two years of clinical care and research training at one of the institutions listed here that specialize in treating individuals with these disorders. It is expected that upon completion of the program, participants will be committed to a combined clinical and research career and will be prepared to direct robust clinical and research programs relevant to ADEM, AFM, MOGAD, NMOSD, ON, and TM in their clinical department.


More about the Siegel Rare Neuroimmune Association, our mission and goals can be found on our website http://www.wearesrna.org.

OBJECTIVES

After completing the fellowship program, the Fellows will have acquired independent research and clinical skills and gained experience necessary to develop into clinician-scientists who:
  • Provide high quality, state-of-the-art, comprehensive clinical care to patients with ADEM, AFM, MOGAD, NMOSD, ON, and TM and other rare neuroimmune disorders
  • Advance the research and understanding of these disorders through clinical research and/ or basic science research
  • Become an active participant and future leader in the rare neuroimmune disorders clinical community

2024-2026 FELLOWSHIP APPLICATION

Open Date – March 1, 2023
Due Date – April 15, 2023
Review and Board approval by – May 18, 2023
Awards announced – May 22, 2023

AWARD NUMBER AND FUNDS

SRNA will award one or two year James T. Lubin Clinician Scientist Fellowship awards for the year 2024-2026.

The objective is to provide salary (based on PGY5 for adult neurologists and PGY6 for pediatric neurologists) and benefits, and research support for up to 2 years of post-doctoral training to ensure a future of well-trained clinician-scientists focused on rare neuroimmune disorders. The total salary and benefits requested must be based on a full-time, 12-month staff appointment. The maximum allowed support through the Fellowship is $80,000 per year. The Fellow should be at least 70% funded through SRNA and no more than $20,000 can be used for non-salary support activities. Acceptable support activities include tuition and fees related to career development, research expenses, such as supplies, equipment and technical personnel and travel to research meetings or training. The SRNA will also consider international candidates who fulfill criteria for clinical training activities in the USA and plan to return to their countries of origin to establish clinical activities focused on rare neuroimmune disorders.

Indirect Costs (also known as Facilities & Administrative [F&A] Costs) are not reimbursed by SRNA.
ELIGIBILITY AND ADDITIONAL GUIDELINES

  • Applicants must have a health professional doctoral degree to be eligible to apply and must have completed their clinical training, including specialty and, if applicable, subspecialty training prior to receiving the Fellowship Award
  • Applicants must identify a mentor at one of the institutions as listed here
  • Applicant must provide a research project consistent with the research and training plan that not only demonstrates the applicant’s strengths, but also helps advance the field forward
  • If accepted, Fellow must agree to participate in SRNA programs, which include the Annual Quality of Life Camp, the Rare Neuroimmune Disorder Symposium, The SRNA Ask the Expert Podcast Series, and SRNA publications
  • High priority will be given to applicants who plan to provide care in areas where there are not currently many neuroimmunology providers
APPLICATION INSTRUCTIONS
  • The deadline for receipt of a completed application is April 15, 2023, for the award to become effective July 1, 2024. Exceptions to the start date should be discussed with SRNA.
  • For any text attachments for the online application form, use standard size black type no smaller than 11 point; do not use photo reduction.
  • Copies of any preprints, reprints, or other additional materials must be submitted with the application.
  • The application must be submitted accompanied by all supporting documents. Please do not submit your application until you have assembled all references, transcripts and other requested materials.
  • The application cannot be considered for review unless signed by the applicant and the mentor. “Per” signatures will be disallowed.
  • The application and all correspondence relating to it must be received by April 15, 2023 to be considered for a fellowship to begin July 1, 2024.
  • For more about the goals of the Fellowship, please visit – https://wearesrna.org/shaping-the-future/our-programs/james-t-lubin-fellowship/
  • If you have any questions about the preparation of your application, please contact Gabrielle deFiebre at gdefiebre@wearesrna.org

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* 1. Applicant Information

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* 2. Institution's Financial Officer Information

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* 3. Award Checks Payable To:

Please attach a budget using your institution’s acceptable format. The fellowship award is payable to the institution on a six-month basis to cover allowable costs as above through a grant agreement. Please refer to SRNA’s Guidelines for Funding and Public Access Policy for information concerning allowable expenses and other instructions concerning the preparation of your budget. No indirect costs or other institutional taxes will be covered by the fellowship per the policies and practices of SRNA. A letter must be attached from the mentor’s institution confirming that the institution has committed to supporting the remaining costs for the fellow candidate, including but not limited to the cost for malpractice insurance, any salary augmentation and a benefits package. These itemized costs should be disclosed in the letter.

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* 4. Budget

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Please attach your biographical sketch in NIH format (include Education, Academic Honors, Professional Experience, Membership in Professional Organizations, Bibliographic citations).

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* 5. Biographical Sketch of Applicant

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Describe your long and short-term career goals. Discuss how the fellowship will advance these goals. Be sure to address how your career goals relate to clinical care and research in the rare neuroimmune disorders. Describe your personal qualifications for this award. (Please limit to one page).

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* 6. Personal Statement

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Using the following outline, describe the training plan that you and your mentor have developed to meet the required components of training. Please limit to two pages.

Components of Training:

1. Direct, supervised ADEM, AFM, MOGAD, NMOSD, ON, and TM patient care (60%)

2. Exposure to multidisciplinary care (20%)

3. Didactic activities (10% - incl. producing a clinical paper, attending lectures, grand rounds, etc.)

4. Other (10%)

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* 7. Clinical Training Plan

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Describe the training plan that you and your mentor have developed to meet the required components of training. Please limit to two pages.

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* 8. Research Training Plan

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* 9. Project Dates

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* 10. Please check all categories that apply to your proposal:

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* 11. Has this project been submitted to or will it be submitted to another agency?

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* 12. If you answered yes, please identify the name of the agency:

The applicant institution has the primary responsibility for protecting the rights and welfare of human subjects and for ensuring the humane care and use of animals in all research activities supported by the Siegel Rare Neuroimmune Association and of informing SRNA of all relevant assurances and certifications. If an award is made as a result of this application, it is the responsibility of the grantee or fellow and the Institution to inform SRNA within a reasonable time of any change in the research protocol. By virtue of the signature of an official authorized to sign for the institution on this application, the institution is declaring that all applicable Federal, State and Local regulations will be followed during the tenure of any grant awarded as a result of this Application. This form must be completed and submitted with any application to SRNA for the support of research or training. In addition, a copy of the approval letters signed by the Chairperson of the Institutional Review Board (IRB) and/or the Institutional Animal Use and Care Committee, as appropriate, must accompany any application.

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* 13. Will human subjects be used?

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* 14. If your research involves human subjects, have you obtained IRB approval or exemption?

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* 15. If you have received IRB approval, what was the approval date?

Date

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* 16. If you have received IRB approval, what is the IRB protocol number?

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* 17. What is The Assurance of Compliance Number issued to the applicant institution by the Federal Office of Protection from Research Risks?

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* 18. Will vertebrate animals be used?

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* 19. If you obtained Institutional Animal Care and Use Committee Approval, what was the approval date?

Date

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* 20. If you have obtained Institutional Animal Care and Use Committee Approval, what is the approval number?

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* 21. What is the animal welfare assurance number?

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* 22. If vertebrate animals will be used, have you obtained Institutional Animal Care and Use Committee Approval?

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* 23. Please provide a summary of your proposed research in language suitable for a news release to the lay public. Please limit your summary to 500 words or less.

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* 24. Please provide a summary of the proposed research. Please limit your summary to 500 words or less. Be certain to address the relevance of the project to ADEM, AFM, MOGAD, NMOSD, ON and/or TM.

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One of the letters of support must be from the mentor or authorized official of the sponsoring institution acknowledging support for employment of the individual for 2 years, for additional salary support to the individual as necessary, the commitment to protect at least 70% of the candidate’s time for clinical care/clinical research/basic science research of rare neuroimmune disorders (general neurology clinic or inpatient service are excluded from the 70% commitment), and support for the applicant covering additional costs, such as for malpractice insurance and fringe benefits.

The letter must also address each of the following issues:

1. What makes the applicant an ideal candidate for this competitive fellowship,

2. How the fellowship fits into the long-term goals of having the candidate become a future leader in the field of neuroimmune diseases, such as ADEM, AFM, MOGAD, NMOSD, ON, and TM.

3. Why the fellowship is important for the applicant at this point in their career.

Instructions: Provide three reference letters from people, including your mentor.

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* 25. Reference Letter from your mentor

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* 26. Second Reference Letter

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* 27. Third Reference Letter

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By the act of submitting an application for an award, it is agreed by the Applicant and the Institution that: 1) Funds awarded as a result of this request are to be expended for the purpose(s) set forth herein and in accordance with the policies and procedures set forth by The Siegel Rare Neuroimmune Association; 2) The information herein is true and complete to the best of our knowledge; 3) The Award may be revoked in whole or in part at any time by SRNA, provided that a revocation shall not include any amount obligated previous to the effective date of revocation if such obligation were made solely for the purposes set forth in this application; 4) All reports of activities supported by any award made as a result of this request shall acknowledge such support.

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* 28. Upload completed signature page. A blank version of the page can be found here.

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