2023 Resident Research Grant Application

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2023 Resident Research Grant Application

In an effort to enhance the development of research skills among physicians in training, the American Academy of Pediatrics (AAP) administers the Resident Research Grant (RRG) Program. This program is designed to give pediatric residents with limited research experience an opportunity to initiate and complete research projects related to their professional interests. Grants of $2000 (plus a $1,000 travel stipend) are available. All fields below are required. For complete instructions for this program, click here.

Deadline Monday, February 28, 2023

GENERAL INFORMATION

Applicant First Name *

Applicant Last Name *

Designation *

Street Address *

Address Line 2

City *

State *

Zip Code *

Primary Phone Number *

Primary Email Address *

Birth Date *

Birth Place *

With what racial or ethnic group(s) do you identify? Please select ALL that apply. *

Gender (assigned at birth) *

Female

Male

Title of Research Project *

EDUCATION AND PROGRAM INFORMATION

Medical School/Date of Graduation *

Residency Training Program Name *

Training Program City *

Training Program State *

Training Program Zip Code *

Are you enrolled in a combined training program? *

Yes

No

If YES, please indicate which program:

Internal Medicine/Pediatrics

Pediatrics/Anesthesiology

Pediatrics/Dermatology

Pediatrics/Emergency Medicine

Pediatrics/Medical Genetics

Pediatrics/Physical Medicine and Rehabilitation

Pediatrics/Psychiatry/Child and Adolescent Medicine

PROJECT MENTOR

Please note that your chosen Project Mentor must be a good-standing member of the AAP.

Project Mentor First Name *

Project Mentor Last Name *

Project Mentor AAP ID# *

Project Mentor Street Address *

Project Mentor Address Line 2

Project Mentor City *

Project Mentor State *

Project Mentor Zip Code *

Project Mentor Phone Number *

Project Mentor Email Address *

PROGRAM DIRECTOR

Program Director First Name *

Program Director Last Name *

Program Director Designation *

Program Director Street Address *

Program Director Address Line 2

Program Director City *

Program Director State *

Program Director Zip Code *

Program Director Phone Number *

Program Director Email Address *

DEPARTMENT CHAIR

Department Chair First Name *

Department Chair Last Name *

Department Chair Designation *

Department Chair Street Address *

Department Chair Address Line 2

Department Chair City *

Department Chair State *

Department Chair Zip Code *

Department Chair Phone Number *

Department Chair Email Address *

PEDIATRIC TRAINING

	Hospital Name	City/State	Dates (From – To)
PGY-1	Hospital Name	City/State	Dates (From – To)

	Hospital Name	City/State	Dates (From – To)
PGY-2	Hospital Name	City/State	Dates (From – To)

	Hospital Name	City/State	Dates (From – To)
PGY-3	Hospital Name	City/State	Dates (From – To)

	Hospital Name	City/State	Dates (From – To)
PGY-4	Hospital Name	City/State	Dates (From – To)

	Hospital Name	City/State	Dates (From – To)
PGY-5	Hospital Name	City/State	Dates (From – To)

Anticipated Date of Completion of Your Residency Program: *

GRANT INFORMATION

Proposals involving human subjects require Institutional Review Board (IRB) approval. Has your IRB approved this proposal? *

Yes

No

Currently Under Review

Not Applicable (no human subjects)

Proposed Starting Date of Research *

Anticipated Date of Completion *

The $3,000 check ($2,000 grant award plus $1,000 travel stipend) will be made payable to the name of the institution. The grant must be used specifically for this project. Funds from grant award should not be used for computer equipment. No indirect charges will be paid to the institution.

Please issue the check to:

Institution Name *

Institution Street Address *

Institution Address Line 2

Institution City *

Institution State *

Institution Zip Code *

Institution Phone Number *

PROPOSED RESEARCH PROJECT

I. OVERALL GOALS, SPECIFIC AIMS * 🛈

0/500 words

II. HYPOTHESIS – RESEARCH QUESTION AND REASON FOR STUDY * 🛈

0/300 words

III. METHODOLOGY AND RATIONALE: (Indicate what components of the research, such as data collection or analysis, you will be performing directly. If a survey will be used, please include a list of key questions.) * 🛈

0/750 words

IV. BIBLIOGRAPHY *

V. BUDGET: (Submit a basic budget that outlines how the grant money will be used. If your budget exceeds $2,000, where will additional funding come from? Please describe.) *

VI. REVELANCE TO PROFESSIONAL CAREER: (Describe how you selected this topic for study and how this proposed project fits into your career plans. Include relevant research, clinical experience, and how the knowledge and skills you will learn will contribute to your future professional goals.) *

If applicable, please describe how the proposed project will advance health equity and/or workforce diversity and/or workforce equity.

Upload a copy of your biographical sketch in standard National Institutes of Health (NIH) format limited to 5 pages. For an example of the NIH format, please refer to the following link: http://grants1.nih.gov/grants/funding/phs398/biosketchsample.doc.

Resident Biographical Sketch, NIH Format, 5-page limit *

ADDITIONAL SUPPORTING MATERIALS

The following documents must also be submitted in order for your application to be complete. It is recommended that you use the Save & Return feature, so you may upload your supporting documents as they are received. You may also email supporting documents to Kristin Reed at kreed@aap.org. All supporting documents must be either uploaded to this form or emailed to Kristin by February 28, 2023.

Chairperson or program director letter of support
Project mentor letter of support
Project mentor biographical sketch in standard NIH format limited to 5 pages. This sketch should include a list of the mentor's research funding.

Program Director or Chairperson Letter of Support

Project Mentor Letter of Support

Project Mentor Biographical Sketch, NIH Format, 5-page limit

How did you hear about this program (choose all that apply)? *

The application and all supporting documents are due by February 28, 2023.

Questions can be directed via email to kreed@aap.org or by calling the Academy at 800-433-9016, extension 6701.