**Career Development Checklist**

 1. VA Form 10-0102 -- page 1 and 2

2. Table of Contents (Research staff completes after page numbering)

3. Response to prior submission (only necessary if a resubmission) --
(3-page limit)

4. VA Form 10-1313-3 -- Current Funds and First-Year Request

5. VA Form 10-1313-4 -- Estimated Per-Year Expenses for Project

6. VA Form 10-1313-5/6 -- Investigator's Biographic Sketch

7. VA Form 10-1313-7 - Investigator's Total VA and Non-VA Research
Support (current and pending)

8. VA Form 10-1313-8 -- Investigator's Total VA and Non-VA
Research/Development Support

9. Overlap -- separate page

10. Career Plan (CDA-1 & CDA-2 -- 7-page limit) CDTA & CDEA -- 3 pages
limit)

11. Research Plan (CDA-1 and CDA-2 -- 7-page limit); (CDTA -- attach
narrative from pending or previously reviewed Merit Review Proposal);
(CDEA -- 5-page limit)

12. Human Studies Section and/or animal studies section

13. Resources

14. Literature Citations for Narrative

15. Mentor's Letter of Commitment

16. Approved Extended Educational Leave Request (CDEA nominee's only)
(VA Form 10-5503 and VA Form 10-5503a)

17. R&D Letter (Research obtains)

18. Endorsements: 1) LOI acceptance letter; 2) Letter from ACOS/Research
(research will obtain); 3)

Director's Letter (research will obtain); three reference letters

19. Appendices (3 reprints/manuscripts)

**Instructions for Career Development Application *(Items you
provide)***

**I. VA Forms**

a\) *[VA Form 10-0102]{.underline}* -- Page 1 -- self explanatory except
(Box 3 - Facility No is 506)

(<http://www.va.gov/vaforms/medical/pdf/vha-10-0102-fill.pdf>)

b\) *VA Form 10-0102* -- Page 2 -- Summary Description of Program (1
page limit)

1\. Your Name

2\. Proposal title (title must match on all forms)

3\. Minimum of 3 key words (<http://www.nlm.nih.gov/mesh/MBrowser.html>)

4\. Summary Description: Research background, current research
interests, hypothesis, specific objectives, relevance, subject
population, procedures.

c\) *[VA Form 10-1313-3]{.underline}*
<http://www.research.va.gov/funding/process/forms/10-1313-3_edit.pdf>

1\) CDA-1 (mentored research -- salary support up to two years -- \[GS
-13 equivalent\] clinicians and \[GS 11\] non-clinicians) -- 5/8 VA
appointment and 75% research effort

2\) CDA-2 (mentored research for clinician/non-clinician w/research
experience) (non-clinician salary support at GS-12/13 \[minimum 5/8
appointment and 100% VA research effort\]) (clinician salary support);
\$10,000 - \$50,000 in research funds first year (more can be requested
with annual progress report); 3-5 year duration

3\) CDTA -- salary support for clinicians only - up to 3 year duration
(75% effort, 8/8ths temporary, time-limited appointment -- must commit
to provide at least 5/8 clinical appointment upon conclusion of the
award). The budget must include the pages describing the research
support to be obtained from a VA merit review proposal that has been
reviewed and approved (even if it did not receive a fundable score); the
MR approval letter and proposal narrative should be included as an
appendix.

4\) CDEA -- ORD will provide a maximum of 6 months salary support,
including fringe benefits for a period of educational leave approved by
the VA medical center. 100% research effort. No change in pre-award
appointment.
[[http://vaww.va.gov/vaforms/medical/pdf/10-5503.pdf]{.underline}](http://vaww.va.gov/vaforms/medical/pdf/10-5503.pdf)

d\) *[VA Form 10-1313-4]{.underline}* -- CDA-2 only -- salary/fringe
benefits and/or research support

<http://www.research.va.gov/funding/process/forms/10-1313-4_edit.pdf>

e\) *[VA Form 10-1313-5/6, 7 and 8]{.underline}* -- for nominee, each
mentor or sponsor (CDEA). For consultants or content mentors who might
not be part of the formal mentoring team, but who provides expertise in
key areas and who has a 5% effort or more. Non-VA scientists may submit
the NIH comparable PHS 398 Biographical Sketch
(<http://grants.nih.gov/grants/funding/phs398/phs398.html>).

1\) *[VA Form 10-1313-5/6]{.underline}* -- include only most relevant
publications and accepted manuscripts in peer-reviewed journals
<http://www.research.va.gov/funding/process/forms/10-1313-56.pdf>

2\) *[VA Form 10-1313-7]{.underline}* -- include [all]{.underline}
funded and pending support -- if none -- put "None" in the description
box.
<http://www.research.va.gov/funding/process/forms/10-1313-7_edit.pdf>

3\) *[VA Form 10-1313-8]{.underline}* -- If no funding -- put "None";
start with active awards; in the description section follow this format:
Role, Dates of Approved/Pending Project; Annual Direct Costs; Percent
Effort; Major Goals
<http://www.research.va.gov/funding/process/forms/10-1313-8_edit.pdf>

**II Overlap**

Separate page -- headed "Overlap" provide a single summary of any
potential budgetary, scientific, or time commitment overlap between the
research in the proposal and any active or pending research, including
that of the mentor(s). This must be a discussion -- not a simple
statement that there is no overlap.

**III Career Plan** (CDA-1 & CDA-2 (7-page limit); CDTA & CDEA (3-page
limit)

a\) Research background, including training, experience, prior funding
and other accomplishments

b\) Research Interests

c\) VA service and other involvement

d\) Relationship between the nominee's interests, skills, and those of
the proposed mentor/s or sponsor

e\) Potential impact of the proposed career development experience on
the improvement and/or evaluation of veteran health care and/or health
policy

f\) Expected results of the experience in terms of the benefit to VA and
to the nominee in terms of their research program.

g\) Commitment to and/or goals for professional advancement within VA

h\) Specific formal and informal training activities and objectives, and
specific new skills to be attained.

i\) Future research plans and ambitions (explain how the proposed award
enhances these plans).

j\) Percent of time to be devoted to research, and other concurrent
commitments to the local VA medical center.

**IV Research Plan** (CDA-1 and CDA-2 -- 7-page limit) (CDTA attach
Merit Review reviewed narrative-ignore instructions below) (CDEA --
5-page limit)

(See specific instructions at
<http://www.research.va.gov/funding/CDA_Proposal_Instructions.pdf>

a\) Objectives

b\) Background and Significance

1\) Significance

2\) Relevance to Veterans Health

c\) Work Accomplished

d\. Work Proposed

**V Human Studies Section** (not included in narrative page limit) --
see specific instructions at link above

a\) *Risk to Subjects*

1\. Human Subjects Involvement and Characteristics

2\. Sources of Materials

3\. Potential Risk

b\) *Adequacy of Protection from Risks*

1\. Recruitment and Informed Consent

2\. Protection against risk

c\) *Potential Benefit* of the Proposed Research to the Subject and
Others.

d\) *Importance of the Knowledge* to be gained.

**VI Animal Subjects Section** (not included in narrative page limit) -
see specific instructions at link above

a\) Detailed description of the proposed use of the animals

b\) Justify the use of animals

c\) Provide veterinary care information

d\) Describe any procedures

e\) Describe any method of euthanasia

**VII Resources**

a\) Describe facility where work will be done (room number, square feet
and location)

b\) Describe pertinent resources and major pieces of equipment available

c\) If applicable, describe clinical and animal facilities available

**VIII Literature Citations for Narrative**

**IX Mentor's Letter of Commitment**

a\) Mentor's proposed role in training

b\) Planned training activities

c\) Nature of the interactions between mentor and nominee

d\) Percentage of the mentor's effort that would be devoted to the
nominee

e\) The degree and type of interaction that the nominee would have with
other researchers

f\) Explicit description of the mentor's current obligations, including
the number of residents, fellows and other trainees that the mentor is
currently supervising in research as well as past trainees, with
inclusive dates in table form

g\) Description of the mentor's time distribution between research,
patient care, teaching and administration

h\) Plan for the nominee to achieve independence

**X Clinical Statement letter**

**XI Reference letters (3)**

Should be obtained from professional colleagues, former/current
teachers, former mentor, etc. Reference letters should not be limited to
the nominee's institution or affiliated university. The nominee is
encouraged to include letters of support from other institutions willing
to provide support and resources to the development of the nominee's
research career.

**XII Appendices**