Please answer all questions based on your achievements between September 2017 and August 2018

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* 1. What is your job role?

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* 2. In which geographical area of the UK are you based?

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* 3. What is your area of interest?

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* 4. Please list up to 5 keywords describing your subspecialist interest

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* 5. How many of the following did you achieve between September 2017-August 2018?: Research grants

  0 1 2 >2 N/A
Research grant submitted >£150K as PI
Research Grant submitted < £150K as PI
Research grant submitted >£150K as Co-I
Research Grant submitted < £150K as Co-I
Outline submitted as PI
Outline submitted as Co-I
Research Grants won as PI
Research Grants won as Co-I
Research Fellowship: doctoral/ post doctoral/ investigator/ clinician scientist

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* 6. Peer review

  0 1 2 >2
Editorial board membership - please indicate number of editorial boards
Peer review of papers  - please indicate number of papers reviewed
Peer review of grants - please indicate number grants reviewed

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* 7. How many of the following Committees/ Faculties were you a member of between September 2017-August 2018?

  0 1 2 >2
Committee Chair in own department 
Committee membership in own department 
Clinical trial steering group/ committee member
Recruitment Faculty Role
Faculty/University Committee membership
External grant advisory panel
National research advisory role.
International research advisory role
Other external committees and panels

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* 8. How many of the following publications did you achieve between September 2017- August 2018?

  0 1-2 3-5 >5
Paper submitted as senior author
Paper submitted as first author
Paper submitted as co-author
Reviews / Book Chapters submitted
Published journal article as senior author
Published journal article as first author
Published journal article as co- author
Review published
Book/chapter published

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* 9. How many of the following lectures/ presentations did you deliver between September 2017- August 2018?

  0 1-2 3-5 >5
Keynote lectures
International conference:  Invited symposium speaker
International conference: Poster
International conference: Short talk (selected from abstract) 
National conference: Invited symposium speaker
National conference: Poster
National conference: Short talk (selected from abstract)
Regional/ local conference: Invited symposium speaker
Regional/ local conference: Poster 
Regional/ local conference: Short talk (selected from abstract)
Medical student/ undergraduate / postgraduate course lecturer
Organising Conference

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* 10. How many of the following prizes were you awarded between September 2017- August 2018?

  0 1 2 >2
Nominations to External Bodies and Prizes
Nominations to Local/ University committees and prizes
Awarded / appointed to External Bodies / Prizes
Awarded / appointed to Local/ University Committees / Prizes

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* 11. If you are a member of a research team, how many of the following did you achieve between September 2017-August 2018

  0 1-2 3-5 >5 N/A
Head of research team – number of members
PhD student supervised
MD student supervised
MSc/BSc students supervised
Supervisor of research fellow
Supervisor of medical student project

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* 12. Public engagement and outreach (contribution to event or organisation)

  0 1-2 3-5 >5
Public engagement and outreach (events attended/organised)
Media work (eg. Interviews)
Publicity materials (e.g articles mentioning you)

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* 13. Mentorship/ Supervision

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* 14. Regarding clinical Trials, how many of the following did you achieve between September 2017-August 2018?

  0 1 2 >2 N/A
Commercial clinical trials PI
Commercial clinical trials sub-investigator
Investigator led clinical trial Chief Investigator
Investigator led clinical trial PI
Investigator led clinical trial coPI
Investigator led clinical trial sub investigator
NIHR clinical trial Chief Investigator
NIHR clinical trial PI
NIHR clinical trial co-PI
NIHR clinical trial sub investigator
BRC Lead
BRC project involvement

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* 15. How many independent teams do you collaborate with?

  0 1 2 >2 N/A
Collaborations local
Collaborations regional
Collaborations national
Collaborations international

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* 16. If you have any other significant achievements not covered by the questions above within this time frame (Sept 2017- Aug 2018) or previously that you would like to include, please describe below.

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* 17. Do you feel you have benefited from the network and/or first WVUK meeting already? If yes, please provide details in comment box below.

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* 18. What is the one thing the network could do that would be most helpful to you?

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* 19. What is the one thing the network should/could do that would make the most difference to women in vision’s profiles?

 

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