The Medical College of Wisconsin

THE MEDICAL COLLEGE OF WISCONSIN

STANDARD FORMAT FOR CV

Date of Document ____________

[Listing of all dates should be with oldest (first) to most recent (last)]

CURRICULUM VITAE

Jane/John G. Doe, M.D., Ph.D.

Associate Professor of Medicine (and include Administrative Title)

Division of Cardiovascular Medicine

HOME ADDRESS: 1234 Mulberry Lane

Anytown, WI 53022

(414) 555-1212

OFFICE ADDRESS: Medical College of Wisconsin

8701 Watertown Plank Road

Milwaukee, Wisconsin 53226

Phone: (414) 555-8888

Fax: (414) 555-9999

E-mail:

PLACE OF BIRTH: Milwaukee, Wisconsin

CITIZENSHIP: U.S.A.

EDUCATION:

09/1991 – 05/1995 B.S., University of Wisconsin, Madison, WI

08/1995 – 12/1998 M.D., Medical College of Wisconsin, Milwaukee, WI

09/1999 – 03/2004 Ph.D., Medical College of Wisconsin, Milwaukee, WI

POSTGRADUATE TRAINING AND FELLOWSHIP APPOINTMENTS:

01/01/1999 - 12/31/1999 Resident, Department of Internal Medicine, Division of Cardiovascular Medicine, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226

2/2003 - 3/2004 Resident, Department of Internal Medicine, Division of Cardiovascular Medicine, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226

01/01/1999 - 12/31/1999 Postdoctoral Fellow, Department of Physiology, Division of Physiology, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226

MILITARY SERVICE:

06/1988 – 05/1992 U.S. Medical Service

FACULTY APPOINTMENTS:

01/1997 – 12/1997 Visiting Scientist, Division of Medicine, Department of Cardiovascular Medicine, University of Wisconsin Medical School, State Street, Madison, WI 53226

01/1998 – 12/1998 Assistant Professor, Division of Medicine, Department of Cardiovascular Medicine, The Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226

01/1998 – present Associate Professor, Division of Medicine, Department of Surgery, The Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226

ADMINISTRATIVE APPOINTMENTS:

06/2005 – 05/2007 Associate Dean for Faculty Affairs, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226

06/2007 – 05/2008 Senior Associate Dean for Faculty Affairs, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226

EDUCATIONAL ADMINISTRATIVE APPOINTMENTS:

11/2002 – 11/2004 Director, Cardiovascular Medicine Residency Program, Department of Internal Medicine, Division of Cardiovascular Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226

11/2004 – 11/2005 Associate, Cardiovascular Medicine Residency Program, Department of Internal Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226

HOSPITAL AND CLINICAL ADMINISTRATIVE APPOINTMENTS:

07/2007 – 06/2008 Administrator, Department of Neurology, Froedtert Memorial Lutheran Hospital, 9200 W. Wisconsin Ave., Milwaukee, WI 53226

07/2008 – 06/2009 Chief of Staff, Froedtert Memorial Lutheran Hospital, 9200 W. Wisconsin Ave., Milwaukee, WI 53226

RESEARCH ADMINISTRATIVE APPOINTMENTS:

04/2008 – 03/2010 Research Administrator, Department of Neuroscience Research Laboratory, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226

04/2010 – 03/2012 Director, Department Neuroscience Research Laboratory, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226

HOSPITAL STAFF PRIVILEGES:

01/2001 – 12/2005 Froedtert Memorial Lutheran Hospital, 9200 W. Wisconsin Ave., Milwaukee, WI 53226

01/2008 – 12/2012 St. Joseph's Hospital, 5000 W. Chambers, Milwaukee, WI 53210

SPECIALTY BOARDS AND CERTIFICATION:

Board Certified Issue Date Expiration

American Board of Internal Medicine 06/2005 05/2015

ABIM - Cardiology

Certificates Issued By Issue Date Expiration

CPR AHA 09/1998 none

ACLS AHA 12/1998 11/2008

Licensure Number Issue Date Expiration

Wisconsin License 123-456-789 02/15/1975 02/14/2012

Other State Licenses WI-98765 07/05/2003 07/04/2007

AWARDS AND HONORS:

05/1986 Phi Kappa Phi

05/1992 Alpha Omega Alpha

08/1997 Best Teaching Service Award, The Medical College of Wisconsin

MEMBERSHIPS IN HONORARY AND PROFESSIONAL SOCIETIES:

07/1997 – 06/1999 Alpha Omega Alpha Medical Honor Society (President of Chapter)

08/1998 – 07/2000 American Society of Cardiology

09/1999 – 08/2001 American College of Physicians

EDITORSHIPS/EDITORIAL BOARDS/JOURNAL REVIEWS:

Editorship

11/2008 – 03/2009 Journal of the American College of Cardiology

Editorial Board

03/2009 – 08/2009 Journal of Clinical Investigation

Journal Review

08/2009 – Present Journal of Clinical Investigation

LOCAL/REGIONAL APPOINTED LEADERSHIP AND COMMITTEE POSITIONS:

01/2008 – 12/2008 Member, Peer Review Committee, AHA Wisconsin Affiliate

01/2008 – 12/2010 Member, Wisconsin Chapter, American College of Cardiology

NATIONAL ELECTED/APPOINTED LEADERSHIP AND COMMITTEE POSITIONS:

03/1981 - 09/1985 Member, NIH Study Section, Biomedical Research and Technology

11/1988 - present Consultant/Ad Hoc Reviewer, NIH Study Section, Biomedical Research and Technology

07/1992 - 09/1994 Member, NIH site visit, Biomedical Research and Technology

05/2003 - present President, American Physiological Society

08/2009 - present Board member, American Association of Medical Colleges

RESEARCH GRANTS/AWARDS/CONTRACTS/PROJECTS:

Active

Peer Review

Title: Control of the heart

Source: NIH

Role: Principal Investigator

Dates: 7/1/2001 – 6/30/2002

Direct Funds: $1,285,000 (total for all years)

Title: Training in Renal Research

Source: NIH

Role: Co-Investigator

PI: Dr. Bill Smith

Dates: 8/1/2010 – 7/31/2014

Direct Funds: $1,285,000 (total for all years)

Non-Peer Review

Title: Cardiovascular Research

Source: Robert Wood Johnson

Role: Principal Investigator

Dates: 2/1/2003 – 1/31/2007

Direct Funds: $50,000

Title: Endocrine Research

Source: Merck Pharmaceuticals

Role: Principal Investigator

Dates: 1/1/2005 – 12/31/2009

Direct Funds: $150,000

Pending

Peer Review

Title: Control of the kidney

Source: NIH

Role: Principal Investigator

Dates: 7/1/1998 – 6/30/2000

Direct Funds: $1,285,000 (total for all years)

Title: Training in Cardiovascular Research

Source: NIH

Role: Co-Investigator

PI: Dr. Mary Smith

Dates: 7/1/2000 – 6/30/2008

Direct Funds: $1,285,000 (total for all years)

Non-Peer Review

Title: Cardiovascular Research

Source: Robert Wood Johnson

Role: Co-Investigator

PI: Dr. Steve Smith

Dates: 7/1/2001 – 6/30/2002

Direct Funds: $50,000

Prior

Peer Review

Title: Training in Cardiovascular Research

Source: NIH

Role: Principal Investigator

Dates: 3/15/2003 – 3/14/2005

Direct Funds: $1,285,000 (total for all years)

Non-Peer Review

Title: Cardiovascular Research

Source: Robert Wood Johnson

Role: Principal Investigator

Dates: 7/1/1999 – 6/30/2001

Direct Funds: $50,000

INVITED LECTURES/WORKSHOPS/PRESENTATIONS (must be invited to participate):

International

Jane Doe, Lecture about my research, Visiting Professor, University of London, 5/5/2005

National

John Doe, New ECG techniques workshop, American Heart Meeting, Dallas, 5/5/2005- 5/9/2005

Jane Doe, Distinguished Lectureship, American Physiological Society, Washington D.C., 5/5/2005-5/9/2005

Regional

John Doe, New ECG techniques workshop, American Heart Meeting, Dallas, 5/15/2006- 5/19/2006

Local

Jane Doe, Distinguished Lectureship, American Physiological Society, Washington D.C., 8/5/2007-8/9/2007

PEER REVIEWED WORKSHOPS/PRESENTATIONS (must have abstract or submission peer reviewed before asked to present):

International

John Doe, International Artificial Heart Workshop, American Heart Meeting, Dallas, 5/1/2005 – 5/4/2005

National

Jane Doe, Heart Valve Replacement Presentation, American Heart Meeting, Chicago, 5/1/2006 – 5/6/2006

Regional

John Doe, New Medical Device Workshop, American Heart Meeting, Washington D.C., 5/5/2007 – 5/9/2007

Local

Jane Doe, A Healthy Heart Talk, American Heart Meeting, Madison, 5/5/2008 – 5/9/2008

John Doe, Pacemaker Improvements Workshop, American Heart Meeting, Milwaukee, 5/5/2009 – 5/9/2009

COMMITTEE SERVICE:

Medical College

01/1999 - 12/2002 Member, Committee on Rank & Tenure, Division of Cardiovascular Medicine, Department of Medicine, Medical College of Wisconsin

07/2002 – 12/2002 Advisor, Committee on Faculty Development, Division of Cardiovascular Medicine, Department of Medicine, Medical College of Wisconsin

Hospital

10/1999 – 04/2005 Member, Credential Committee, Division of Dermatology, Department of Medicine, Froedtert Memorial Hospital

05/2005 - Present Member, Billing Committee, Division of Pulmonary Care, Department of Pediatrics, Children’s Hospital of Wisconsin

MEDICAL COLLEGE TEACHING ACTIVITIES:

Medical Student Education

09/1991 – 05/1998 Taught Introduction to Medical Ethics

Graduate Student Education

09/1998 – 12/2002 Lead Medical Ethics weekly discussion

Resident & Fellow Education

01/2003 – 06/2004 Designed Guidelines for Initial Patient Contact

Postdoctoral Fellow Education

08/2004 – 12/2005 Discussions on Improving Patient Care through technology

Continuing Medical Education

03/2005 – present Medical Ethics

Community/Lay Public

01/1989 – present Open courses for improving patient-doctor relationships

EXTRAMURAL TEACHING (e.g. at Marquette, UWM, etc.):

Graduate Student Education

05/2002 – 08/2002 Marquette University, Medical Ethics Course

Continuing Medical Education

09/2004 – 05/2005 UW-Milwaukee, Medical Terminology in the EMR

MCW STUDENTS, FACULTY, RESIDENTS AND CLINICAL/RESEARCH FELLOWS MENTORED:

Medical Students

Med Student Name, MCW, 01/2001 – 05/2006 Capacity (e.g. summer student mentor/ research mentor/ etc.).

Graduate Students

Ph.D. Students Advised

Student Name 1, MCW, 01/2001 – 06/2003 Dissertation title

Ph.D. Committees

Student Name 2, MCW, 05/2002 – 11/2004 Student (degree)

Residents

Resident Name, MCW, 09/2004 – 08/2005 Capacity (Research/ teaching/ clinical mentor)

Faculty

Faculty Name, MCW, 09/2004 – 08/2005 Capacity (Research/ teaching/ clinical mentor)

EXTRAMURAL STUDENTS, FACULTY, RESIDENTS, AND CLINICAL/RESEARCH FELLOWS MENTORED:

Clinical/Research Fellows

Researcher Name, Marquette, 01/2001 – 05/2006 Capacity (e.g. summer student mentor/ research mentor/ etc.).

Graduate Students

Ph.D. Students Advised

Student Name 3, UW-Milwaukee, 01/2001 – 06/2003 Dissertation title

Ph.D. Committees

Student Name 4, UW-Milwaukee, 05/2002 – 11/2004 Student (degree)

M.S. Students Advised

Student Name 5, UW-Milwaukee, 05/2002 – 11/2004 Student (degree)

Residents

Resident Name, CHW, 09/2004 – 08/2005 Capacity (Research/ teaching/ clinical mentor)

Faculty

Faculty Name, FMLH, 09/2004 – 08/2005 Capacity (Research/ teaching/ clinical mentor)

Undergraduate Students

Undergrad Name, UW-Milwaukee, 09/2004 – 08/2005 Capacity (Research/ teaching/ clinical mentor)

High School Students

Class Name, Milwaukee High School, 09/2004 – 08/2005 Capacity (Research/ teaching/ clinical mentor)

Postdoctoral Students

Postdoc Name, CHW, 09/2004 – 08/2005 Capacity (Research/ teaching/ clinical mentor)

PROGRAMMATIC DEVELOPMENTS

Educational Programs

Student

01/1999 – 12/2001 Student educational program

Resident

01/2002 – 12/2004 Resident educational program 1

05/2003 – 07/2006 Resident educational program 2

Fellow

2003 Fellow educational program

Faculty

2008 Faculty educational program

Research Programs

2007 Research program

Clinical Programs

9/2002 – 9/2003 Clinical checklist program

1/2004 – 5/2004 Clinical workshop

Community Programs

12/2002 – 12/2003 Community workshop

COMMUNITY SERVICE ACTIVITIES:

1999 Advisor on local school board

9/2003 – 6/2004 President local school board

2004 – 2005 Doctors Without Borders

BIBLIOGRAPHY

REFEREED JOURNAL PUBLICATIONS/ORIGINAL PAPERS

1. DOE, J., Jeffrey, A., Daley, J., Robbins, K., Journal of Clinical Investigation. Medical Service Publishing Company, 1997 - 1998.

2. DOE, J., Smith, K., Cohen, J.,: Characterization of normal and abnormal pulmonary surface by reflected ultrasound. J Amer Soc Echo 3:140-145, 2001

BOOKS, CHAPTERS & REVIEWS

Jones, J., DOE, J., Wann, JC., : Stress Doppler echocardiography. Cardio 6:45, 1991.

EDITORIALS, LETTERS TO EDITOR, OTHER

1. DOE, J. and Cohen J: Body weight changes effect on heart. New Eng. J. Med. 541:22-40, 2003.

NON-REFEREED JOURNAL PUBLICATIONS/ORIGINAL PAPERS

ABSTRACTS

1. Jeffrey, A., DOE, J. : Low cardiac output. Clinic Res. p. 108-109, 2004.

PEER REVIEWED EDUCATIONAL PRODUCTS

1. Steve, A., DOE, J. : Low cardiac output. Clinic Res. p. 18-19, 2006.

NON-PEER REVIEWED EDUCATIONAL PRODUCTS

1. Mary, A., DOE, J. : High cardiac output. Clinic Res. p. 81-91, 2008.

DATABASE, VIDEO, OR OTHER RESEARCH/CLINICAL CONTRIBUTIONS

1. PI Names: Video display of cardiac output, www.website.com, 2009-2010

SOFTWARE, SOFTWARE MODULES

1. PI Names: Apple iPad application for display of cardiac output, www.website.com, 2010