1

Index Slide

• Name:

• Post applied for:

• Period of FCP (if applicable):

• Date/time of interview:

2

General information

Degree University Year

Academic Qualifications (latest, upto 3)

Professional Record (latest, upto 3)

Fellowships, Memberships and Honors (upto 5) Year Scientific organization/society

Post Organization Period

3

Research projectsInternally funded (list upto 3 during last 5 years/FCP period)

Title Budget

Title Funding agency/Budget

Externally funded (list upto 3 during last 5 years/FCP period)

4

PublicationsTotal number:Number of publications during last 5 years or during the FCP assessment period:Total number of citations:Area(s) of subspecialty interest:List of Publications during last 5 years or FCP period (list upto best 5)

Publication Journal Impact Factor

Use Vancouver style

5

Additional qualifications

• Patents filed/sanctioned: (list upto 3)

• Clinical/research protocols developed: (list upto 3)

• Number of postgraduates/PhDs trained during last

5 years/FCP period:

• Administrative experience: (list upto 3)

• Extracurricular activities: (list upto 3)

6

Self assessment

List upto 5 reasons (bulleted) in your own assessment as to why you qualify for the post/promotion applied for: