APPLICATION FOR NMRC
CLINICIAN SCIENTIST Award

(Application form forSeniorInvestigator)

How to complete the application form:

  • Applicants are required to submit:
  1. On-line application form through RITAS website (
  1. Completed NMRC Application Form as softcopy attachment through RITA website.
  • The hardcopy package to be submitted to NMRC includes :

NMRC Application form 1 set (with original signatures)

  • In summary: Complete (i) an on-line RITA application form and (ii) attach the softcopy of the NMRC application form through the RITAS website. (iii) Forward 1 hardcopy of the NMRC Application Form to us. Please ensure that information on the soft copy and hard copy submitted are identical. Incomplete submissions will be rejected.

RITA Online Application Form:

  • Follow the instructions closely in every section.
  • Attach the NMRC application form in the details of proposal section.

NMRC Application Form:

Please read the following carefully before completing this form.

  • Follow the instructions closely in every section.
  • Complete all sections in the application. Indicate “NA” where a particular section is not applicable.
  • Use Arial font size 10 for all text. Softcopy to be submitted as 1 file including all the pictures, tables, charts and various attachments in Word DOC or PDF format.
  • Adhere to the number of characters/space provided in each field and the number of pages where specified.
  • The PI/Applicant shall be the point of contact for NMRC, with the stated Department and Institution as the hosting institution. Applicants with multiple appointments at different institutions are to select only one hosting institution for the application.
  • Refer and adhere to the list of non-fundable items(Appendix 2).
  • Include CVs of the PI/ Applicant and collaborator(s) with the email addresses and contact information clearly stated. Please specify and describe clearly the roles of collaborators in the application form.
  • The original signatures of the PI/Applicant, HOD, Dean of Medical School & Institution Director are required.

Where to submit your hardcopy applications

  • Submit through your institution’s research administrators.
  • For applicants from institution without research coordinator, please submit to :

CSA Application

National Medical Research Council

11 Biopolis Way

#09-10/11, Helios

Singapore 138667

  • NO late submission or revision to the submitted application will be entertained after the closing date.
  • Incomplete applications will be rejected

CLOSING DATE:

15 May 2009,5.00pm (Singapore Time)

NATIONAL MEDICAL RESEARCH COUNCIL

Application for Clinician Scientist Award

All information is treated in confidence. The information is furnished to the National Medical Research Council with the understanding that it shall be used or disclosed for evaluation, reference and reporting purposes. If your application is not successful, this form will be destroyed after the retention period deemed as appropriate by the Council.

1Personal Details

Personal Detail

Dr /Assist Prof/ Assoc Prof/ Prof* (Underline Surname)
Current institution, Designation and Address / Office Phone:
Fax:
Email:
NRIC/FIN/Passport No. / Citizenship /
Singapore PR
/ DOB / Gender
Yes / No*
Grade / E.g. (Medical Officer/Registrar / Sr Consultant or Assistant Professor/ Associate Professor/ Professor)

2aRESEARCH PROPOSAL TO BE SUBMITTED UNDER csA AWARD

Project title
Amount requested
Duration (Yr)

2bPROPOSED START AND END DATES

Proposed start should exclude 3 months for the review process.

Start (Mth/Year):
End (Mth/Year):

2cDECLARATION OF ETHICS CONSIDERATION

Fund disbursement is subjected to ethics approval if the project involves any of the below.

Please declare the participating institutions where study requiring ethics approval is

Please tick accordingly if project involves any of the following:conducted:

a)Human Subjects Yes No

b)Use of Human Tissues or Cells Yes No

c)Animal Experimentation Yes No

d)Requirement for Containment Yes No

e)Multi-centre project(s) or trial(s) Yes No

(If yes, please state all participating institutions/centres :

)

A copy of the ethics approval is attached:

Yes No

3aCURRENT MENTORING ACTIVITIES

In not more than 2 pages, please describe your current research activities including science education activities such as mentoring and training of junior clinician-scientists / MBBS-PhD students that you are currently participating or have participated.

.
.

3bFuture REsearch Plan

The CSA Award (Senior Investigator category) aims to provide support for senior clinician-scientists who have demonstrated outstanding research productivity in pursuit of research excellence that is internationally acclaimed.

In no more than 3 pages, please share with the Selection Panel your vision as a senior clinician-scientist*, and describe in detail, your future research plan and specific activities during the period of support (5 years) that would**:

i)benefit your field of research in Singapore,

ii)strengthen or elevate the standard of research in your hospital/cluster,

iii)enthuse young clinicians in pursuing and developing a research career,

iv)contribute to the research community through mentoring junior clinician-scientists/ MBBS-PhD students and other activities.

*This is over and above the research proposal that has been submitted

** Where applicable, indicate targets that you would like to achieve within the 5 years if given the award.

4Best 10 publications

5Academic QualificationS

Please provide details of academic qualifications.

Name of Institution / Degree obtained / Year obtained

6CAREER HISTORY

Please provide details of current position and past employment history. Explain any inactivity between employments.

a) Current Employment (including Adjunct and Joint Appointments)

Name of Institution / Department / From / To / Position/Level of appointment / Academic Track in the affiliated medical school

b)Past Employment (including Adjunct and Joint Appointments)

Name of Institution / Department / From / To / Position/Level of appointment / Academic Track in the affiliated medical school

7Awards

Please provide details of awards received.

Name of Award / Year awarded

8aREFEREES

Please nominate three referees and submit the original letter of recommendation with the application. Please note that two of the three referees must be able to comment on your research work.

Particulars / First Referee / Second Referee / Third Referee
Name of referee
Name of Organisation and address
Designation
E-mail Address
Telephone Number
No. of years known

9DECLARATION

I declare that the particulars in this application are true to the best of my knowledge, and that I have not willfully suppressed any material fact.

I declare that 70-80 % of Full Time Equivalent (FTE) will be committed to research during the period of funding.

Date: / Signature:

10INSTITUTIONAL COMMITMENT

To be completed by Host institution (head of Department)

Describe the actions that will be taken to ensure that the candidate commits 70-80% Full Time Equivalent (FTE) in research, e.g. reduction of clinical activities, administrative assignments, etc. Describe how the necessary facilities, resources and infrastructure will be made available for the proposed research and career enhancement of the candidate

Please elaborate

Availability and location of lab space______

(In sq meters)

Specify the access to facilities & equipment ______

Reduction of clinical duties______

Reduction of administrative assignments______

Career enhancement of the candidate______

Backfilling plans for the candidate’s clinical work______

Others; please specify ______

11a Endorsement by Head of Department
In signing the Clinician Scientist Award Application, the Head of the Department UNDERTAKES, on any Grant Award, to:
  • Provide appropriate institutional support to the Applicant during the grant period to allow the fulfillment of research goals and milestones
  • Read, support and agree to this application and the research proposed being carried out in the Department
  • Ensure that the study complies with all laws, rules and regulations pertaining to animal and human ethics, including the Singapore Good Clinical Practice guidelines
  • Ensure that all necessary licenses and approvals have been obtained or are being sought

------
Name and Signature of Head of Department Date
11b Endorsement by dean of medicalschool
  • In signing the Clinician Scientist Award Application, the Dean UNDERTAKES, the applicant to hold a joint appointment in *Yong Loo Lin (School of Medicine) / Duke-NUS (GraduateMedicalSchool)during the duration of award
  • Please state the proposed/current academic appointment of the applicant :

------
Name and Signature of Dean Date
* Please delete where appropriate
11c Endorsement by the Institution
In signing the Clinician Scientist Investigator Application, the Institution UNDERTAKES, on any Grant Award, to:
  • Provide appropriate institutional support to the Applicant during the grant period to allow the fulfillment of research goals and milestones
  • Ensure that the funds provided are used for the appropriate purposes
  • Ensure that the study complies with all laws, rules and regulations pertaining to animal and human ethics, including the Singapore Good Clinical Practice guidelines
  • Ensure that approval from NMRC has been obtained before engaging in any commercial activity that will exploit the findings of the research funded by the Councils
  • Salary funding provided to the institution should be used to backfill the CS position to allow the CS the protected time to conduct his research activities within 6 months of award.

------
Name and Signature of Director of Institution* Date
* If the Applicant is the Director of the Institution, UNDERTAKING by the Director’s Reporting officer is required.
------
Name, Designation and Signature Date

Clinician Scientist Award

Proposal form for SeniorInvestigator

All information is treated with confidence. The information is furnished to the National Medical Research Council with the understanding that it shall be used or disclosed for evaluation, reference and reporting purposes.

CLOSING DATE:

15 May 2009,5.00pm (Singapore Time)

CSA-ApplnForm-SI1

1 Research Title
2 FIELD OF RESEARCH
( please refer to Appendix 1 attached)
3 Keywords
4 Host Institution
Applicant / Role / Position / Department / Institution
PI
Collaborator

Please elaborate(in one paragraph) the role of the PI and Collaborators involved in the project.

PI
Collaborators
  1. ABSTRACT

In no more than 300 words, concisely describe the specific aims, hypotheses, methodology and approach of the research proposal including its importance to science or medicine in particular clinical significance. The abstract must be self-contained so that it can serve as a succinct and accurate description of the research proposal.

  1. DETAILS OF RESEARCH PROPOSAL

Instructions

In no more than 12 pages (Sections A to D), organize the details of the research proposal under the following headings: Specific aims, Clinical significance, Preliminary studies/Progress reports and Methods. References can be attached as a separate Annex. However, Annexes may or may not be assessed by the panel.

A) Specific Aims

State concisely and realistically what the research described in this application is intended to accomplish and/or what hypothesis is to be tested.

B) Scientific/Clinical Significance

Briefly sketch the background to the current proposal, critically evaluate existing knowledge and specifically identify the gaps which the project is intended to fill. State concisely the importance of the research described in this application by relating the specific aims to the longer term objectives. State the significance of the research to scientific and clinical applications and tangible improvements in life sciences/healthcare that may result from the study. Relevant references should be appended.

C) Preliminary Studies/Progress Reports

For NEW APPLICATIONS, provide an account of the Principal Investigator’s preliminary studies (if any) pertinent to the applications and/or any other information that will help to establish the experience and competence of the investigator pursuing the proposed project.

For RENEWAL APPLICATIONS, give the beginning and end dates of the period covered since the

research project was last reviewed. Provide a succinct account of published and unpublished results, indicating the importance of the findings. Discuss any changes in the project’s specific aims during the periods covered. List the titles and complete references to all publications and completed manuscripts that have resulted from the project.

D) Methods

Discuss in detail the experimental design and the procedure to be used to accomplish the specific aims of the project. Describe the protocols to be used and the tentative sequence of the investigation. Include statistical justification and the means by which data will be analysed and interpreted. Describe any new methodology and its advantage over existing methodologies. Discuss the potential difficulties and limitations of the proposed procedures and alternative approaches to achieve the aims. Point out any procedures, situations or materials that may be hazardous to personnel and the precautions to be exercised. Make every attempt to be succinct.

E) References

Please list in chronological order the titles and complete references to recent representative publications pertinent to this research proposal and the applicants’ publications and patents held related to this research proposal. Highlight Scientific Award(s), if any, of the applicant(s).

7BIOGRAPHICAL SKETCH

Collaborator

In not more than 2 pages per applicant, please use the format below to provide the required information on the co-investigator(s).

  • Name
  • NRIC/Passport No.
  • Office Mailing Address
  • Email
  • Contact No
  • Fax No
  • Current Position (Please provide full details, e.g. joint appointments)
  • Academic qualifications (Indicate institution’s name and year degree awarded)
  • Research Interests
  • Publications of direct relevance to the study
  • Relevant patents held related to the study
  • Recent Awards (Scientific Awards)
  • Current and previous support from NMRC or other sources

(Please also include proposals pending approval)

8BUDGET

You are advised to prepare the budget carefully under each category and provide the justifications for all categories.

Please refer to Appendix 2 for this section. The provision of indirect research cost (IRC) will be computed at the budget revision phase when the project is approved.

8.1 Expenses on Manpower (EOM)

Please budget for all the manpower required for the project including part-time personnel and those to be shared with other projects. State whether they are existing personnel in your institution or new staff to be recruited. Please use salary scales provided by the Bursar’s Office, Hospital Administration or the Ministry of Health as a reference. The cost should include annual increments, National Service increment, staff welfare, medical and other related benefits as per the Human Resource policies of your institution.

Staff Category / Existing/New / No / Justifications and Remarks / Total cost
Others:
(please specify)
Total
/ $0.00

8.2 Equipment

Please budget for all scientific equipment you need to purchase to carry out the project. Indicate sharing of equipment with other projects, if any.

For equipment costing more than $100,000 each, please indicate the estimated utilization of the equipment (e.g. 70% usage through out the project period; only 85% usage in the 2nd year for analysis purpose, etc)

Qty

/

Equipment

/

Justifications and Remarks

/

Unit Cost

/

Sub- Total

Total

/ $0.00

8.3 Other Operating Expenditure (OOE) (Direct costs only)

This category covers other expenses directly related to the project such as the purchase of animals, consumables, laboratory manuals, literature search, and maintenance of equipment. Conference travel will be funded only if a presentation or if an article is presented. The presentation or article must be directly related to the project.

Item Description

/

Justifications and Remarks

/

Cost

Consumables
Animals
Total / $0.00

Grand Total: SGD$0.00

1

9MILESTONES

Please propose Milestones for assessment of the progress of the study. The progress of the project will be taken into consideration for continued disbursements of funds.

Milestones / Targeted Duration/Date of Fulfillment

10PERFORMANCE INDICATORS

Please indicate the final expected targets. Please state ‘NA’ where indicator is not applicable.

Performance Indicators / Indicate number / value
Capability Indicators / Training R&D manpower for industry / Master’s research students trained
PhD students trained
Master’s research and PhD students trained and spun out to local industry as RSEs
Research staff spun out to local industry as RSEs
Post-doctoral (within 3 years of the PhD award) researchers hired
Developing long term R&D capability / Joint programs/projects with local universities
Patents filed
Patents granted
Papers published in international journals
(To state impact factor)
Presentations at international conferences
Awards for research at national and international level
Industry Relevance Indicators / R&D collaboration / R&D projects with industry cash funding
Industry dollars received to fund R&D projects
Outcomes / Revenue from royalties and licensing agreements
Spin-off companies registered
New products or processes commercialized

11OTHER SUPPORT

Please provide the following details for the grants currently held or being applied for by the Principal Investigator. Attach additional pages if necessary. Please attach the scientific abstract of each grant listed below (a) – (c) for Council’s reference.

(a) Grants currently held

Please list the research grant if applicant is the lead or key investigator receiving funding support directly.

Grant Title/ Grant ID / Funding Agency and Amount (S$) / From / To / Specific Aims of Project / Role in project (i.e. PI or collaborator) / Percentage effort

(b) List all grants applied for (e.g. NRF, A*STaR, MOE, Clusters, etc) where outcome is pending

Grant Title/ Grant ID / Funding Agency and Amount (S$) / From / To / Specific Aims of Project / Role in project (i.e. PI or collaborator)

(c) Support not related to specific research projects

Provide below details of ALL other support which are not derived from funds provided for specific research projects, such as departmental technicians, grants from private foundations, start-up funds, donations from charitable organizations and collaborations with industry. You may also attach correspondences showing commitments by other parties in support of your work.