<p> CURRICULUM VITAE Date</p><p>NAME QUALIFICATIONS (include degrees and fellowships)</p><p>CONTACT DETAILS Address Email Ph Fax Pager </p><p>CURRENT APPOINTMENTS</p><p>Major Achievements and Summary</p><p>PUBLICATIONS (Annotate any key books, chapters)</p><p>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</p><p>Top 3 papers based on number of citations</p><p>Leadership (Highlight past and present leadership achievements)</p><p>Research (One line summary for each key research theme)</p><p>Major External Collaborations</p><p>Education (List role in undergraduate, postgraduate, non-medical educational activities)</p><p>Page 1 of 4 Professional Service (For example government committees, journal editorial boards, College roles) </p><p>International Recognition</p><p>CV in detail</p><p>FELLOWSHIPS AND MEMBERSHIPS</p><p>UNDERGRADUATE AND POSTGRADUATE DEGREES (Include dates obtained and thesis title if relevant)</p><p>AWARDS / SCHOLARSHIPS</p><p>EXTERNAL PEER REVIEWED FUNDED GRANTS</p><p>INTERNAL PEER REVIEWED FUNDED GRANTS</p><p>INDUSTRY FUNDED GRANTS</p><p>PROVISIONAL/PATENT APPLICATIONS</p><p>EDITORIAL/ REVIEWER ROLES</p><p>REVIEWER FOR THE FOLLOWING JOURNALS / GRANTING AGENCIES </p><p>Journals </p><p>Grants</p><p>Conferences</p><p>TRAINEE SUPERVISION (Include College trainees)</p><p>PhD SUPERVISION</p><p>Page 2 of 4 DOCTOR OF MEDICINE SUPERVISION</p><p>MASTERS DEGREE SUPERVISION</p><p>BACHELOR SCIENCE HONOURS STUDENT SUPERVISION</p><p>ADVANCED MEDICAL SCIENCE (Scholarly Selective Students) SUPERVISION (Project title)</p><p>NATIONAL/ INTERNATIONAL TRAINING VISITORS </p><p>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</p><p>Books:</p><p>Book Chapters:</p><p>Manuscripts (Published or in press)</p><p>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)</p><p>Abstracts</p><p>Institutional Publications</p><p>INVITED PRESENTATIONS </p><p>Completed</p><p>Chair/Moderator at National/International Conferences</p><p>BOARDS:</p><p>COMMITTEES: </p><p>International </p><p>Page 3 of 4 National </p><p>State </p><p>Local</p><p>CURRENT MAJOR RESEARCH THEMES:</p><p>TEACHING/MEDICAL EDUCATION:</p><p>CURRENT CLINICAL ACTIVITIES:</p><p>ADDITIONAL TRAINING: (e.g. accreditation courses, management, media or supervisor training)</p><p>MEDIA EXPERIENCE</p><p>PUBLIC PRESENTATIONS</p><p>PREVIOUS EMPLOYMENT HISTORY</p><p>ACADEMIC HISTORY (if less than 10 years since graduation)</p><p>REGISTRATION</p><p>Page 4 of 4 </p>