Form 12 NIDDK/NHMA Feedback Form

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NIDDK-NHMA Feedback Form
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2016 NIDDK-NHMA Program on Preparing for Careers in Academic Medicine
1st Annual Workshop, Washington D.C.
Feedback Form

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2016 NIDDK-NHMA Program on Preparing for Careers in Academic Medicine
1st Annual Workshop, Washington D.C.
Feedback Form

Please select the appropriate answer and provide additional comments as desired to the following questions regarding the NIDDKNHMA Academic Career Development Program.

* 1. Please rate your overall impression of the folllowing:
Excellent

Good

Fair

Poor

The Academic Career
Development Program
Interaction with research
scientists and
academicians
The small group
discussion with faculty
USB key with program
binder and handouts

2. Additional comments regarding your overall satisfaction with the above components of the program:

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2016 NIDDK-NHMA Program on Preparing for Careers in Academic Medicine
1st Annual Workshop, Washington D.C.
Feedback Form

* 3. Please rate how well the workshop increased your knowledge and awareness of the following topics:
Increased greatly

Somewhat increased

No increase

Strategies and skills
related to obtaining a job
in academic medicine
How to overcome
barriers in academic
career promotion
Strategies for identifying
and selecting a mentor
How to identify
appropriate funding
sources
NIH funding mechanisms
NIH funding
opportunities for various
career levels

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2016 NIDDK-NHMA Program on Preparing for Careers in Academic Medicine
1st Annual Workshop, Washington D.C.
Feedback Form

* 4. Listed below are the major topic areas discussed during the program. Given where you are currently in
your career, rate how important the following topic areas are to you:
Most important

Somewhat important

Least important

Career development
strategies in academic
medicine
How to identify
appropriate NIH funding
opportunities
The components of NIH
grant applications

* 5. What other topic areas would be particularly useful for you at this stage in your career:

* 6. How likely are you to pursue a career in academic medicine?
Extremely likely
Somewhat likely
Not at all likely
Undecided

* 7. How would you rate the influence of the NIDDK-NHMA Fellows Program on your decision?
Great deal of influence
Somewhat of an influence
Very little influence
Unsure

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* 8. To date, approximately how many research papers and/or articles have you authored or co-authored in a
peer reviewed journal?

* 9. To date, have you been supported by an NIH grant or contract?
Yes
No

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2016 NIDDK-NHMA Program on Preparing for Careers in Academic Medicine
1st Annual Workshop, Washington D.C.
Feedback Form

10. If no, have you ever applied for an NIH funding opportunity but were not awarded?
Yes
No

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2016 NIDDK-NHMA Program on Preparing for Careers in Academic Medicine
1st Annual Workshop, Washington D.C.
Feedback Form

* 11. Do you intend to apply and/or reapply for any NIH Funding Opportunities?
Yes
No

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2016 NIDDK-NHMA Program on Preparing for Careers in Academic Medicine
1st Annual Workshop, Washington D.C.
Feedback Form

* 12. If yes, how soon?
0-12 months
12-24 month
24+ months

* 13. What type of funding opportunity?

* 14. Are you a member of the National Hispanic Medical Association?
Yes
No

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2016 NIDDK-NHMA Program on Preparing for Careers in Academic Medicine
1st Annual Workshop, Washington D.C.
Feedback Form

* 15. If no, how likely are you to become a member of the National Hispanic Medical Association?
Extremely likely
Somewhat likely
Not at all likely
Undecided

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2016 NIDDK-NHMA Program on Preparing for Careers in Academic Medicine
1st Annual Workshop, Washington D.C.
Feedback Form

* 16. How would you classify your current career status?
Post graduate
Resident
Acting Instructor
Assistant Professor
Instructor
Fellow

* 17. What is your Primary specialty?

18. What is your Secondary Specialty?

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2016 NIDDK-NHMA Program on Preparing for Careers in Academic Medicine
1st Annual Workshop, Washington D.C.
Feedback Form
General Questions

* 19. Overall, did the program meet your expectations?
Yes
No

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2016 NIDDK-NHMA Program on Preparing for Careers in Academic Medicine
1st Annual Workshop, Washington D.C.
Feedback Form

* 20. If No, please describe how or in what ways did the program not meet your expectations?

* 21. What components of the Academic Career Development Program did you think were most helpful?

* 22. What components of the Academic Career Development Program did you think were least helpful?

* 23. What components of the Academic Career Development Program would you change, and how?

24. Additional comments:

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2016 NIDDK-NHMA Program on Preparing for Careers in Academic Medicine
1st Annual Workshop, Washington D.C.
Feedback Form
Thank you! Your input will help to improve future NIDDK-NHMA Academic Career Development Program.

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