3 Gme

Activity:

GME Alumni Survey - 1 Year Later

Site:

National Institutes of Health

Period:
Time Period:
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Evaluation Type:

Alumni Self Evaluation

Evaluator:
Subject:
Participation Dates:

Participation Dates:

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Graduate Medical Education Alumni Survey
(OMB # 0925-0602; expires 8/31/2012)
Please take a few minutes to complete the survey below, which will ask about your
current work experience and other accomplishments. It will also invite you to
retrospectively evaluate your training program and serve, if you are agreeable, to be
a resource or advisor to current and future trainees in your program.
Through this survey, the NIH Graduate Medical Education Program is collaborating
with your program to (a) identify opportunities that will enhance the clinical research
training we provide our residents and fellows and (b) stay better connected with you
and the other graduates of our clinical training programs.
Please note that the information you share with us will only be accessible to
authorized GME staff. When reported external to the GME office as part of our
quality improvement process, all feedback will be anonymous and reported in the
aggregate.
Thank you for helping us to improve and stay connected.
**If you are accessing this survey at the NIH or another Federal institution, Network
restrictions may prevent you from copying and pasting text directly from Office
documents into this survey via Microsoft Internet Explorer. Please use Google
Chrome or Mozilla Firefox as alternatives to enable copy and paste functions.
Burden Disclosure Statement: Public reporting burden for this collection of
information is estimated to average 20 minutes per survey, including the time for
reviewing instructions, searching existing data sources, gathering and maintaining

the data needed, and completing and reviewing the collection of information. An
agency may not conduct or sponsor, and a person is not required to respond to, a
collection of information unless it displays a currently valid OMB control number.
Send comments regarding this burden estimate or any other aspect of this collection
of information, including suggestions for reducing this burden, to: NIH, Project
Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974,
ATTN: PRA (0925-0602). Do not return the completed form to this address.
To review the NIH/E*Value Privacy Act Notification Statement, please click here
Section 1 of 5: General Information
Are you using a different name than the one you used during training (stated at the
top of this survey)? (Question 1 of 38 - Mandatory )
Yes

No

If you are using a different name than the one you used during training, please state
the name you are currently using. (Question 2 of 38 )

Preferred e-mail address

(Question 3 of 38 - Mandatory )

Alternate e-mail address

(Question 4 of 38 )

(Question 5 of 38 )
In which of the ACGME-accredited training programs below
did you train, if applicable?
Program - Institution
1.

{Select}

2.

{Select}

Year

(Question 6 of 38 )
If you didn’t train in an ACGME-accredited training program,
which of the other clinical and translational programs did you attend?
Program - Institution
1.

{Select}

2.

{Select}

Year

If the clinical and translational training program you attended is not listed above,
please let us know its name: (Question 7 of 38 )

Which Institute/Center sponsored the clinical or translational program that was not
listed. (Question 8 of 38 )

(Question 9 of 38 )
What professional degrees do you hold?
MD. Area(s) of specialty:
PhD. Area(s) of specialty:
JD. Area(s) of specialty:
Master’s. Area(s) of specialty:
Other:

Please list your ABMS (Board) certification(s):

(Question 10 of 38 - Mandatory )

Section 2 of 5: Work Experience
Name of your current employer/institution

Employer/institution type

(Question 11 of 38 - Mandatory )

(Question 12 of 38 - Mandatory )

Academic
NIH
Government regulatory agency
Pharmaceutical
Other research
Private practice
Other

Employer/Institution: Notes

(Question 13 of 38 )

If you selected ‘Other,’ please explain.

What is your current academic status/title?

(Question 14 of 38 )

Dean
Chair
Non-academic
Associate Professor
Professor
Instructor
Assistant Professor
Other

Academic Status/Title: Notes

(Question 15 of 38 )

If you selected ‘Other,’ please explain.

Is your current academic appointment a tenure track position?
Yes

No

(Question 16 of 38 )

Not applicable (do not have an academic appointment)

If your current academic appointment is a tenure track position, do you currently
have tenure? (Question 17 of 38 )
Yes

No, not yet eligible

No

Are you currently performing clinical and/or translational research?
(Question 18 of 38 )
Yes

No

(Question 19 of 38 )
What are your current
funding sources?
ALL FIELDS
REQUIRE
RESPONSE
K01 Mentored Research
Scientist Development
K08 Mentored Clinical
Scientist Development
K12 Mentored Clinical
Scientist Development

What is the dollar amount of your grant(s)?
None

Less
than
$50K

$51K to
$100K

$101K
to
$250K

$251K
to
$500K

$501K Greater
to $1M than $1M

K22 Career Transition
Award
K23 Mentored Patient
Oriented Research
K24 Midcareer Investigator
Award in Patient Oriented
Research
K30 Clinical Research
Curriculum Award
K99/R00 Pathway to
Independence Award
R01 Research Project Grant
Program
R03 Small Group Program
R21 Exploratory
Developmental Research
Grant Award
Intramural NIH Research
Other Federal Funding
Private
University
Pharmaceutical
Other

Funding Sources: Notes

(Question 20 of 38 )

If you selected ‘other federal funding,’ ‘private funding,’ or ‘other funding,’ please explain.

What are the most important clinical research challenges facing you in your career
currently? (Optional) (Question 21 of 38 )

(Question 22 of 38 - Mandatory )
What is your professional title?
What organization and/or department do you work for?
What are your clinical and/or research interests?
Address Line 1
Address Line 2 (optional)
City/Town
State
Zip Code
Country
Phone Number

(Question 23 of 38 )
What proportion of your time is devoted to the following:
Direct patient care ( ___ %):
Research ( ___ %):
Teaching ( ___ %):
Administration ( ___ %):
Total %:

Please note any professional honors or awards you have received.
)
Feel free to copy and paste from your resume or other document.

(Question 24 of 38

**If you are accessing this survey at the NIH or another Federal institution, Network
restrictions may prevent you from copying and pasting text directly from Office documents
into this survey via Microsoft Internet Explorer. Please use Google Chrome or Mozilla
Firefox as alternatives to enable copy and paste functions.

Section 3 of 5: Publications
If you have been published since completing your training program, please share with
us the number of peer-reviewed publications which list you as the first or second
author. (Question 25 of 38 )
1-3

4-6

7-10

11-15

16-20

21-25

>25

None

If you would like, please list your publications. Feel free to copy and paste from your
resume or other document. (Question 26 of 38 - Mandatory )

**If you are accessing this survey at the NIH or another Federal institution, Network
restrictions may prevent you from copying and pasting text directly from Office documents
into this survey via Microsoft Internet Explorer. Please use Google Chrome or Mozilla
Firefox as alternatives to enable copy and paste functions.

Section 4 of 5: Training Experience
What is the overall degree of impact your NIH training program has had on your
professional career? (Question 27 of 38 )
N/A

No
Impact

Little
Impact

Some
Impact

Much
Impact

Considerable
Impact

(Question 28 of 38 - Mandatory )
What degree of impact did your training
No
Little
Some
Much Considerable
program have on your ability to:
Impact Impact Impact Impact
Impact

Successfully complete your Board Exam(s)
Perform typical procedures for specialty
Perform successfully in an academic or
research setting
Perform successfully in a non-academic or
non-research setting
Teach (medical students, residents, fellows,
and/or patients)
Compete successfully for grants
Compete successfully for desired
professional opportunities
Work well with other members of a
healthcare team
Manage and lead others
Stay current in specialty
Network with other key individuals in field
Achieve work-life balance
Become a life-long learner
Be knowledgeable of established and
evolving biomedical, clinical,
epidemiological and social-behavioral
sciences, when applying this knowledge to
patient care (Medical Knowledge)
Provide patient care that is compassionate,
appropriate, and effective for the treatment of
health problems and the promotion of health
(Patient Care)
Effectively exchange information and
collaborate with patients, their families, and

health professionals (Interpersonal &
Communication Skills)
Carry out professional responsibilities and
demonstrate an adherence to ethical
principles (Professionalism & Ethics)
Investigate and evaluate one’s care to
patients, to appraise and assimilate scientific
evidence, and to continuously improve
patient care based on constant self-evaluation
and life-long learning (Practice-based
Learning and Improvement)
Be aware of and responsive to the larger
context and system of healthcare, as well as
the ability to call effectively on other
resources in the system to provide optimal
healthcare (Systems-based Practice)

Were you able to find and begin employment (or additional training) of your choice
within your specialty/subspecialty upon completing your GME training at NIH?
(Question 29 of 38 )
Yes

No

Employment/Additional Training: Notes

(Question 30 of 38 )

If ‘no,’ please explain.

What were the best parts of your GME training at NIH?

(Question 31 of 38 )

What was missing from or could be improved about your training program?
(Question 32 of 38 )

If you could start your GME training again from the beginning, would you choose
NIH for some or all of this training? (Question 33 of 38 )
Yes

Unlikely

Maybe

GME Program Selection: Notes

(Question 34 of 38 )

If ‘Unlikely’ please explain.

How likely are you to recommend NIH for GME training to prospective researchoriented applicants? (Question 35 of 38 - Mandatory )
Unlikely

Somewhat Likely

Likelihood to Recommend NIH GME training: Notes

Likely

(Question 36 of 38 )

If 'Unlikely’ please explain.

Please provide any additional comments about GME or research training at NIH.
(optional) (Question 37 of 38 )

Section 5 of 5: Alumni Network
Would you be willing to serve as a resource for current NIH GME trainees who seek
to learn from your professional experiences? (Question 38 of 38 - Mandatory )

Yes

No

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