Waikato/Bay of Plenty Cancer Society

Clinical Research Fellowship

2017/18APPLICATION FORM

Submit to Waikato Medical Research Foundation

CLOSING DATE: Friday 30 June 2017

TheWaikato/Bay of Plenty Cancer SocietyClinical Research Fellowship

TheWaikato/Bay of Plenty Cancer Society Clinical Research Fellowship provides the opportunity for a clinical healthcare professional to further develop their career in New Zealand through undertaking cancer-related clinical research while based in this region.

TheWaikato/Bay of Plenty Cancer Society is pleased to invite applications for funding for aclinical research fellowshipto start in late 2017 or early 2018.

Research aims:

The research project undertaken during this fellowship must be clinical, patient-oriented research, with the general goal of improving cancer outcomes . Examples of research topics which would be appropriate include:

• Early detection • Prevention of metastasis • Clinical trials of technologies, treatments or proceduresaimed at improved patient outcomes • Addressing gaps or inequalities in existing care• Quality of life • Survivorship • Extended survival for metastatic patients
• Benchmarking / best practice (includingstudies examining the consistency of care in NZ)

In the course of conducting the research the Fellow should aim to acquire a critical understanding of the application of research to clinical care and developthe expertise to be able to establish or lead programmes in the future in management of cancer patients in NZ.

Eligibility and funding:

Applicants must hold professional qualifications in medicine, nursing or allied health.

Medical applicants must have completed advanced training (or be in the final year of advanced training) in a relevant specialty, such as medical or radiation oncology, haematology, surgery, palliative care, public health or general practice.

Nursing or allied health applicants must have completed at least 3 years of postgraduate employment, of which a substantial amount involved care of cancer patients.

Applicants should be enrolled for a postgraduate qualification at masters or doctorate level (MD or PhD) at a NZ tertiary institution over the course of the Fellowship.

Funding will be for a maximum of NZ$80,000for salary, and up to NZ$10,000 + GST towards research-related expenses. The grant will be paid quarterly if working full-time on the research project for one year, or split into four sums paid out at six month intervals if working part-time on the research projectover two years (which may be undertaken alongside other duties). The salary component of the grant must not exceed the salary scale for the position in which the applicant is working at the host institution.

Application Review Process

Applications will be submitted to the Waikato Medical Research Foundation (WMRF) prior to the closing date of their annual grant round, and will be reviewed by the WMRF Grants Committee. Where necessary, an external reviewer knowledgeable in the proposed field of research will also provide a review.Shortlisted applicants may be required to supply further information by phone or email.

The WMRF Grants Committee will make a recommendation to the Waikato/Bay of Plenty Cancer Society, whose Medical Advisory Committee will choose the successful applicant.

The successful applicant will be referred to as the “2017/18Waikato/Bay of Plenty Cancer SocietyClinical Research Fellow”.

Assessment Criteria / Weighting
Track record of the applicant and their supervising team
Track record, research experience and skills commensurate with career stage; plus the career development anticipated from this project / 40%
Quality and feasibility
Quality and feasibility of the proposed project / 40%
Impact and Alignment
Alignment to the stated research aims above and potential impact on the management of NZ cancer patients in the short-to-medium term / 20%

How to Apply

Please complete all sections of the application form:

I Applicant contact details and supervisor contact details

II Abstract – overview of project suitable for non-scientific readers

III Current funding details

IV Summary of proposed fellowship programme, including

-training plan / career development

-project details

-fellowship timetable / milestones

-significance to stated research aims

VReferee

VIBudget details

VII CV of applicant and supervisor

Please email the completed application to . Receipt of your application will be confirmed by email – if you do not receive this confirmation, please contact us ASAP.

Applications close Friday 30th June 2017.

The successful applicant will be notified by October 31st 2017.

Any enquires can be directed toRobyn Fenneman, Administrator, Waikato Medical Research Foundation, c/o Peter Rothwell Academic Centre, Private Bag 3200, Hamilton 3240

Email:

Contact numbers:PHONE 07 856 5241 | Mobile 021 639775

NOTE: Please ensure that the Administrative Agreement and Ethics Agreement(for projects involving human or animal experimentation) at the back of the application form are signed.

(I) CONTACT DETAILS

Fellowship Candidate:

Name:

Address:

Phone (Wk): Fax:

Email: Mobile:

Supervisor:

Name:

Address:

Phone (Wk): Fax:

Email: Mobile:

(II) ABSTRACT OF RESEARCH:

Up to 200 words. Description of research suitable for non-scientific readers, explaining the rationale, research objectives and thesignificance of this project to cancer.

(III) PAST AND CURRENT RESEARCH FUNDING GRANTS:

Please complete the table below providing details on research projects for which you have previously received funding grants (in the last 5 years). Expand the table if necessary.

Title of Research Project / Funding Agency / Duration of Grant / Amount $ / Date Funding Grant Confirmed

RESEARCH PROJECT FUNDING FOR THIS APPLICATION:

Have you applied to other funding sources for this research project? If so, please complete the table below and indicate whether this is confirmed funding; if not confirmed, indicate expected date of decision. Expand the table if necessary. If there is only partial overlap of this project with others for which funding has been received or applied for, please describe this below the table.

Title of Research Project / Funding Agency / Duration of Grant / Amount $ / Confirmed or Expected Date of Decision

(IV) DESCRIPTION OF PROPOSED FELLOWSHIP PROGRAMME:

Clinical Research Details (10 pages maximum including references)

Background Data

Summarise relevant literature, preliminary data, etc., or clinical context, that led to the development of this project.

Rationale for the Project

Why do you want to undertake this project? What do you hope to achieve?How has existing knowledge and/or expertise led to the development of this project?

Hypothesis/Research Question

Identify the key concept(s) to be tested, or the research question to be answered

Objectives

The project should have specific, measurable objectives

Project Design

Demonstrate that the project design is appropriate for the rationale and objectives andthat the data generated will answer the research questions. Where relevant, specify study parameters, the population of interest and inclusion/exclusion criteria.

Research Methodology

Describe methods to be used in sufficient detail to enable reviewers to understand the steps/protocols. Where possible, reference validated instruments or methodologies. Statistically justify sample size, how accrual rates have been determined and reasons for confidence that accrual targets will be met.

Data Analysis

Where appropriate, specify subgroups and stratification parameters for statistical analysis. For qualitative projects, provide justification for chosen analyses

Resources

Demonstrate that you will have access to the resources necessary to complete the project

Risks

Identify risks to completing the project, and strategies to mitigate risk

Fellowship Timetable/Milestones

Provide a timetable for training and/or research activities and identify specific milestones within the project

Relevance to clinical cancer management

Describe the relevance of the proposed project to management of cancer patients in NZ. Indicate the short to medium term potential of this project.

(V) REFEREES

Supervisor’s letter of support

Please attach a signed letter of support from your intended supervisor, who should comment specifically on your professional and research skills and future research potential, as well as the significance of the research project and how it could be developed in the future.

Project Referees

Ensure that the WMRF receives a minimum of two confidential referee's reports from scientists or clinicians that can provide an independent and unbiased assessment of the project. These reports should be from independent scientists; they should not be from the applicant’s own team or department or from scientists with whom the candidate has a working relationship.

Applications with reports from referees who do not fit within the guidelines will receive a reduced score. In addition, the committee may seek additional evaluations from independent reviewers that it chooses. Please advise names of any potential reviewers that the applicant believes, for whatever reason, may not give fair reviews.

Referees should be asked to comment on the following aspects of the proposal:

(a) Relationship with applicant and referee’s ability to give an independent unbiased report.

(b) Prior research performance and competence of the applicant(s)

(d)Its relevance to medicine and health, particularly in the Waikato area

(e)The likelihood the researcher(s) will achieve their stated aims

It is the responsibility of the Applicant to ensure that referees’ reports are sent directly to the WMRF (either by post or e-mail) and are received by the closing date (12 noon, Friday 30th June 2017).

(VI) BUDGET FOR RESEARCH PROJECT:

Please provide details below:

Item / Cost (NZ$)
1. Staff Costs and % FTE
2. Expenses
3. Other (please itemise)
Total $ (maximum $90,000 exc. GST)

Note: The grant may be used solely as salary

Justification of Expenses

(VII) CVs for applicant and supervisor

New Zealand MSI Curriculum Vitae Template

Rows and columns may be expanded or reduced, but a CV must be no more than two pages for part 1 and no more than three pages for part 2. Use Arial 12 point font. Do not alter page margins. Instructions in italics should be deleted before you submit your CV.

PART 1

1a. Personal details
Full name / Title / First name / Second name(s) / Family name
Present position
Organisation/Employer
Contact Address
Post code
Work telephone / Mobile
Email
Personal website (if applicable) /
1b. Academic qualifications

Delete and start typing here. List in reverse date order. Start each qualification on a new line as per the example:

e.g. Year conferred, qualification, discipline, university/institute.

1c. Professional positions held

Delete and start typing here. List in reverse date order. Start each position on a new line as per the example:

e.g. Year-year, job title, organisation.

1d. Present research/professional speciality

Delete and start typing here.

1e. Total years research experience / years
1f. Professional distinctions and memberships (including honours, prizes, scholarships, boards or governance roles, etc)

Delete and start typing here. List in reverse date order. Start each professional distinction on a new line as per the example:

e.g. Year / year-year, distinction.

1g. Total number of peer reviewed publications and patents / Journal articles / Books, book chapters, books edited / Conference proceedings / Patents

PART 2

Part 2 should include information pertinent to your research proposal. The following sections should not total more than three pages.

2a. Research publications and dissemination

Expand/reduce the following table as needed, listing publications relevant to your proposal. List in reverse date order. Bold your name in lists of authors.

Peer-reviewed journal articles
Peer reviewed books, book chapters, books edited
Refereed conference proceedings
Patents
Other forms of dissemination (reports for clients, technical reports, popular press, etc)

Guidelines

Sections

Part 1

1a.This section is for personal details. It identifies who you are and where you can be contacted most readily. A space is provided if you have your own personal website about your research - this is an optional field, not mandatory.

1b.You should list your academic qualifications in this section.

1c.You should list the professional positions you have held in this section.

1d.You should briefly describe your field of expertise in this section.

1e.Please list your total years of research experience in this section. Exclude periods away from research.

1f.This section is for significant achievements, including, but not limited to, honours, prizes, previous grants, scholarships, memberships or board appointments.

1g.This section is to record the total number of peer-reviewed publications and patents you have produced during your career. Only peer-reviewed or refereed publications, or patents should be counted in each section.

Part 2

2a.This section lets you list some of the peer-reviewed publications you have produced and that are relevant to your proposal. Recognising that research dissemination occurs other than through peer-reviewed publications, this section also lets you list other forms of research dissemination, such as technical reports or popular press. You should bold your name in the list of authors.

In total, your CV must not be more than five pages long when submitted. This allows up to two pages for personal and work history information in Part 1, and up to three pages for evidence of track record in Part 2. All instructions in italics should be deleted before you submit your CV. Delete these guidelines before submitting your CV.

ETHICAL AGREEMENT

The undersigned signify that in any research project involving experimentation with animal or human subjects, this proposal will be submitted to a properly constituted university or hospital ethical committee. The undersigned accept that no funding will be forthcoming until the committee has agreed to the ethics of the proposal outlined in this application, and that if such approval is not forthcoming within three months of a fellowship offer from the Waikato/BOP Cancer Society, the Waikato/BOP Cancer Societywill revoke the funding offered.

Signed ......

(Principal Investigator/Supervisor) (date)

Signed ......

(Head of School Faculty/Hospital Department) (date)

Ethics Committee Approval not required [ ]

ADMINISTRATIVE AGREEMENT:

The undersigned agree to abide by the following administrative agreement:

I agree to undertake the research project outlined, abiding by the ethical and statutory requirements of research, and within the regulations of the host institution, and that the grant funds will not be expended for any other purpose than that described in this application.
The host institution agrees and undertakes to bear all risks and claims connected with any operation covered by this application and to indemnify and hold harmless theWaikato/BOP Cancer Society against any and all liability suits, actions, demands, damages, costs or fees on account of death, injury to persons or property, or any other losses resulting from or connected with any act or omission performed in the course of the research.
The applicant(s) agrees to publicity, photographs and acknowledgement of the Waikato/BOP Cancer Society’s sponsorship.

NOTE: This agreement must be signed by individuals with the appropriate institutional delegated authority

Signed by:Date:

Applicant

Supervisor

Dean of Host Faculty/Institution:

Head of Institution:

REPORTING REQUIREMENTS:

Written summary of the project and its outcomes to be submitted to the Waikato/BOP Cancer Society at the end of the 12- or 24-month fellowship.
Further reports to be submitted as data matures, along with copies of any publications resulting from this project
A verbal presentation to the Waikato/BOP Cancer Society’sExecutive/Members of the Medical Advisory Committee by request
Acknowledgement of the Waikato/BOP Cancer Society funding in publications/journals, etc
The Waikato/BOP Cancer Society’sExecutive, Members of the Medical Advisory Committee or other appropriate representative(s) may wish to undertake a site visit and meet with you.
Public Relations - Agree to publicity, media interviews, photographs and acknowledgement of the Waikato/BOP Cancer Society’ssponsorship

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