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2027 Jacobson Promising Investigator Award Application
Please contact jacobsonpia@facs.org with any questions.
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1.
Biographical Information
(Required.)
Full Name:
Credentials:
Position Title:
Institution:
Email:
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2.
Please Upload Your Biographical Sketch (from SciENcv)
(Required.)
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3.
Personal Statement
(Required.)
Submit a one-page essay to the committee that explains why you should be considered for the Jacobson Promising Investigator Award and describes the importance of your past and current research. *Your personal statement must not exceed one page, written in Times New Roman, 12 pt. font, 1 inch margins.
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4.
Are you a Fellow or an Associate Fellow of the American College of Surgeons?
(Required.)
Yes
No
ACS ID:
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5.
Are you board-certified in a surgical specialty?
(Required.)
Yes
No
Surgical Specialty
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6.
Have you completed surgical training, including fellowship, in the last six years (2021)? Please provide the year of completion.
(Required.)
Yes
No
Year completed:
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7.
Do you hold a faculty appointment at a research-based academic medical center?
(Required.)
Yes
No
Institution:
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8.
Do you hold a military service position?
(Required.)
Yes
No
Branch:
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9.
Have you received peer-reviewed funding such as a K-series award from the National Institutes of Health (NIH), Veterans Administration, National Science Foundation, or U.S. Department of Defense merit review to support your research?
Please Note: Surgeon-scientists who are well established (for example, recipients of NIH R01 grants or equivalent grants from other agencies) are
NOT
eligible.
(Required.)
Yes
No
Award Received From:
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10.
Are you a well-established surgeon-scientist who has received NIH R01 and Veterans Affairs Merit grants, or equivalent grants from other agencies?
(Required.)
Yes
No
Award Name
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11.
Do you have ongoing research support?
(Required.)
Yes
No
Example:
Date:07/01/2007-ongoing
K08HS017765 Agency for Healthcare Research and Quality (AHRQ) Composite measures of surgical performance Role: PI Award amount: $150,000 The candidate proposes to develop composite measures of surgical morbidity that overcome many of the limitations of existing approaches. This proposal will facilitate his development into an independent scientist focused on optimizing surgical quality measurement.
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12.
Total Number of Peer-Reviewed Publications:
(Required.)
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13.
Please Upload an NIH Other Support Document
(Required.)
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14.
Publications List
(Required.)
From the number selected above, a maximum of 20 peer-reviewed publications may be included in your list. Publications should begin from the first faculty appointment ONLY. Most current entry should appear at the top of the list.
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15.
Number of Publications since your first Faculty appointment:
(Required.)
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16.
Please upload PDFs of the
three most significant
publications from your current faculty position.
(Required.)
Publication #1
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17.
Publication #2
(Required.)
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18.
Publication #3
(Required.)
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19.
Letters of Recommendation:
(Required.)
Department Chair-Required
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20.
Letter of Recommendation #1
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21.
Letter of Recommendation #2
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22.
Letter of Recommendation #3
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23.
Each recipient of the Jacobson Promising Investigator Award is asked to provide a 10-year reflection on their award. Recipients are asked to submit an academic piece for the Journal of the American College of Surgeons, reflecting upon their accomplishments and what the award has meant to their career
(up to 10 pages in length).
Should you receive the award, are you able to provide a 10-year reflection article?
(Required.)
Yes
No
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24.
Thank you for applying for the Jacobson Promising Investigator Award!
Applications will be reviewed by members of the Surgical Research Committee.
A decision will be made in May 2027. Please contact jacobsonpia@facs.org with any questions.
Please review all the information you have submitted and make any changes before completion.
Once the application is submitted, no additional changes can be made.
(Required.)
I have read and understood all the requirements and eligibility criteria.
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