CEP and REP Privacy Act Notification Statement

General

This is a government application. The agency's Privacy Policy applies and is located at http://www.nih.gov/about/privacy.htm. This website is hosted by the National Institutes of Health's (NIH) Computer Information Technology (CIT) for the NIH Office of Clinical Research Training and Medical Education (OCRTME).

Authority

Collection of this information is authorized under 42 U.S.C. 282(b) (13), 284(b)(1)(C), 241, 242l, 282(b)(10), 284(b)(1)(K), 42 CFR Part 63, and 42 CFR Part 61, Subpart A.

Purposes and Uses

The primary use of this information is for review of applications for the NIH Clinical Electives Program (CEP) and for review of applications for the NIH Resident/Fellow Electives Program (REP). Information collected via the CEP and REP website training applications is not shared with external parties. Information is disclosed after selection to NIH staff who will serve as course coordinators or their proxy, and to Clinical Center departments in which students/residents will need access. Additional disclosures may be made to law enforcement agencies concerning violations of law or regulation. Information provided is voluntary; however, in order for NIH to review CEP or REP applications, all information requested must be provided. Information collected is used for program evaluation, metrics, student evaluation of the program, and one-year and three- year follow-up of participant's training status.

Information collected for CEP:

  • Name
  • Email Address
  • Home Phone Number
  • Permanent Address
  • Country
  • Citizenship Status
  • Student's Phone Number at School
  • Year at Current Level
  • Current GPA
  • School Grading Scale
  • Academic Test Scores
  • Year Degree Expected
  • Cover Letter
  • Curriculum Vitae/Resume
  • Dean's Letter
  • Recommendation Letter
  • Coursework/Grades (Option to upload transcript)
  • One to Three Elective Application Choices/Dates

Information collected for REP:

  • Name
  • Degree
  • Email Address
  • Current Address
  • Citizenship and/or VISA status
  • Previous Research Experience at NIH
  • Residency/Fellowship Sponsoring Institution/Hospital
  • Specialty or Subspecialty Program
  • Address of Sponsoring Institution/Hospital
  • Phone Number
  • Mobile Phone Number
  • Current PGY Level
  • Cover Letter
  • Curriculum Vitae/Resume
  • Program Director's Name
  • Program Director's Address
  • Program Director's Phone Number
  • Program Director's Email Address
  • Program Director's Letter of Approval to Participate (if accepted)
  • Letter of Recommendation from Faculty (if required for elective rotation-see NIH REP program description)
  • Elective choice
  • From Date and To Date

Effects of Nondisclosure

Failure to supply the information requested will prevent consideration of your application.

Additional information about clinical and research training is available on the NIH website at http://www.cc.nih.gov/training/ Questions pertaining to information collected from this website may be sent to cc-od-ocrtme@mail.nih.gov.