QUALIFICATIONS (Include Degrees and Fellowships)

CURRICULUM VITAE Date

NAME QUALIFICATIONS (include degrees and fellowships)

CONTACT DETAILS Address Email Ph Fax Pager

CURRENT APPOINTMENTS

Major Achievements and Summary

PUBLICATIONS (Annotate any key books, chapters)

Journal publication summary as follows: Published In Press Submitted (MEDLINE) Primary Manuscripts Reviews Letters Group studies* * Listed in paper as part of multinational study group Top 3 papers based on Journal Impact Factor

Top 3 papers based on number of citations

Leadership (Highlight past and present leadership achievements)

Research (One line summary for each key research theme)

Major External Collaborations

Education (List role in undergraduate, postgraduate, non-medical educational activities)

of 4 Professional Service (For example government committees, journal editorial boards, College roles)

International Recognition

CV in detail

FELLOWSHIPS AND MEMBERSHIPS

UNDERGRADUATE AND POSTGRADUATE DEGREES (Include dates obtained and thesis title if relevant)

AWARDS / SCHOLARSHIPS

EXTERNAL PEER REVIEWED FUNDED GRANTS

INTERNAL PEER REVIEWED FUNDED GRANTS

INDUSTRY FUNDED GRANTS

PROVISIONAL/PATENT APPLICATIONS

EDITORIAL/ REVIEWER ROLES

REVIEWER FOR THE FOLLOWING JOURNALS / GRANTING AGENCIES

Journals

Grants

Conferences

TRAINEE SUPERVISION (Include College trainees)

PhD SUPERVISION

of 4 DOCTOR OF MEDICINE SUPERVISION

MASTERS DEGREE SUPERVISION

BACHELOR SCIENCE HONOURS STUDENT SUPERVISION

ADVANCED MEDICAL SCIENCE (Scholarly Selective Students) SUPERVISION (Project title)

NATIONAL/ INTERNATIONAL TRAINING VISITORS

PUBLICATIONS (List in reverse chronological order, most recent first) Optional:  bold your name in author list  show journal impact factor and citation index for each manuscript  note grant support for each publication  % contribution to the manuscript

Books:

Book Chapters:

Manuscripts (Published or in press)

Publications as part of International study groups (Named as member of study group in publication) (while it is not incorrect to just list these within your manuscript list, they may not come up in a PubMed search of your name, so avoids confusion if you list them separately)

Abstracts

Institutional Publications

INVITED PRESENTATIONS

Completed

Chair/Moderator at National/International Conferences

BOARDS:

COMMITTEES:

International

of 4 National

CURRENT MAJOR RESEARCH THEMES:

TEACHING/MEDICAL EDUCATION:

CURRENT CLINICAL ACTIVITIES:

ADDITIONAL TRAINING: (e.g. accreditation courses, management, media or supervisor training)

MEDIA EXPERIENCE

PUBLIC PRESENTATIONS

PREVIOUS EMPLOYMENT HISTORY

ACADEMIC HISTORY (if less than 10 years since graduation)

REGISTRATION