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U.S. Department of Health and Human Services

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CDRH Medical Device Fellowship Program - Application Form

(See Paperwork Reduction Act Statement at the bottom of the form.)

Eligibility Criteria:

  1. Candidates must be US citizens or permanent residents.
  2. Students must be enrolled in an accredited U.S. college or university and have received at least 60 credit hours in undergraduate study.
  3. Candidates must be free of conflict of interest.

Application Tips:

  1. Please visit the MDFP website before completing this online application.
  2. After submitting this form, you will be instructed to submit your updated curriculum vitae and letter of interest in CDRH in order to complete the application. Students must submit an academic transcript.
    • Submit by email: mdfp@fda.hhs.gov
    • Or mail to this address:
      Medical Device Fellowship Program (MDFP)
      Center for Devices and Radiological Health, FDA
      10903 New Hampshire Avenue
      WO 66 - 5406
      Silver Spring, MD 20993-0002
      301-796-6660

Application Deadlines

  • For Professionals:
    • Applications are accepted year-round and should be submitted at least 3 months prior to the desired starting date.
  • For Students:
    • Summer 2014 – With regret, MDFP will not be able to have Summer Interns in 2014 due to budgetary constraints. We plan to continue our Summer Intern Program in 2015. Contact us in Fall 2014 for more information.
    • Students – Please note that for all federal agencies in the US a new program called Pathways is now used as the portal to hire students. There may be Pathways openings at other federal agencies. Please look at www.usajobs.gov, and search for the word Pathways and your geographic area of interest to see if there are announcements. It is typical that these announcements may be posted for one week, so a helpful tip is to check every Monday morning or early in the week. There is no regular routine posting schedule. Another tip is to learn to use the www.usajobs.gov website ahead of time, and have your resume and transcripts available and ready. Follow the announcement instructions carefully and submit all needed documents. If there are several similar announcements, apply individually to each one for which you are qualified.

* = required field


1. Personal Information

Name:
 
     
*Date of Birth:,
 
You can enter up to three degrees. Please list the highest degree as
#1, the second highest as #2, and the third highest as #3.
Degree #1... :
:
:

Degree #2... :
  :
:

Degree #3... :
:
:

:
: (Again, for verification)

* :
 
:

: xxx-xxx-xxxx
:  xxx-xxx-xxxx

: No      Yes

: United States Citizen      Permanent Resident

    If permanent resident::
 :

: No      Yes

:                   No      Yes

If yes... :
  :

2. Academic Information (Note: If not a student, please proceed to item #3)

:

   
 
:

:

:

:

:

:
1:
2:

Intern    Co-op
Note: If seeking co-op position, student must be participating in a formal co-operative program at his/her school.


3. Employment Information (Note: If not currently employed, list most recent employment information.)

:

:

:      : (if applicable)
 
   
   
 
:

:

:

:


4. References

Please provide three references (other than current Supervisor).

Name 1:

:

: *or* :


Name 2:

:

: *or* :


Name 3:

:

: *or*   :


5. Areas of Expertise / Academic Concentration

Please select all that apply:

Engineering:
   BiomedicalChemicalComputerElectrical
   Engineering MechanicsEngineering ScienceHuman FactorsMaterials Science
 LawMechanicalQuality / ManufacturingRegulatory Issues
 Other Engineering or Sub-Specialty:
 
Medicine:
   AnesthesiologyCardiologyCardiothoracic SurgeryDentistry
   EndocrinologyGastroenterologyImmunologyInfection Control
 LawNephrologyNeurologyNeurosurgery
   NursingObstetrics/GynecologyOncologyOphthamology
   Oral surgeryOrthopaedicsPediatricsPlastic Surgery
   PsychiatryPulmonologyRadiation TherapyRadiology
   Regulatory IssuesUrology    
 Other Medicine or Sub-Specialty:
 
Mathematics and Science:
   BiologyBiotechnology / Biomolecular StudiesChemistryComputer Science
   DiabetologyElectrophysiologyEpidemiologyHuman Factors
   GeneticsLawMaterials SciencePhysics
 PsychologyRegulatory IssuesStatistics  
 Other Mathematics & Science or Sub-Specialty:

6. Areas of Interest in CDRH

Please select up to three choices in the order of your preference (one from each column):

PREMARKET REVIEW...PREMARKET REVIEW...PREMARKET REVIEW...
AnesthesiologyAnesthesiologyAnesthesiology
CardiovascularCardiovascularCardiovascular
DentistryDentistryDentistry
Diagnostic RadiologyDiagnostic RadiologyDiagnostic Radiology
Ear Nose and ThroatEar Nose and ThroatEar Nose and Throat
Infection ControlInfection ControlInfection Control
Gastroenterology and RenalGastroenterology and RenalGastroenterology and Renal
General SurgeryGeneral SurgeryGeneral Surgery
Human FactorsHuman FactorsHuman Factors
In Vitro DiagnosticsIn Vitro DiagnosticsIn Vitro Diagnostics
LawLawLaw
NeurologyNeurologyNeurology
NeurosurgeryNeurosurgeryNeurosurgery
NephrologyNephrologyNephrology
Obstetrics and GynecologyObstetrics and GynecologyObstetrics and Gynecology
OphthalmologyOphthalmologyOphthalmology
OrthopaedicsOrthopaedicsOrthopaedics
Plastic SurgeryPlastic SurgeryPlastic Surgery
Radiation TherapyRadiation TherapyRadiation Therapy
Regulatory IssuesRegulatory IssuesRegulatory Issues
RespiratoryRespiratoryRespiratory
Restorative DevicesRestorative DevicesRestorative Devices
UrologyUrologyUrology

LABORATORY INVESTIGATION...

LABORATORY INVESTIGATION...

LABORATORY INVESTIGATION...
Biological Risk AssessmentBiological Risk AssessmentBiological Risk Assessment
Biotechnology and Biomolecular StudiesBiotechnology and Biomolecular StudiesBiotechnology and Biomolecular Studies
Electrical, Electronics and Software EngineeringElectrical, Electronics and Software EngineeringElectrical, Electronics and Software Engineering
Electromagnetics and Wireless TechnologiesElectromagnetics and Wireless TechnologiesElectromagnetics and Wireless Technologies
Electrophysiology and Electrical StimulationElectrophysiology and Electrical StimulationElectrophysiology and Electrical Stimulation
Fluid Dynamics and UltrasonicsFluid Dynamics and UltrasonicsFluid Dynamics and Ultrasonics
Genomic and Genetic DevicesGenomic and Genetic DevicesGenomic and Genetic Devices
Host Response: Tissue-Materials Interactions, Tissue-Device InteractionsHost Response: Tissue-Materials Interactions, Tissue-Device InteractionsHost Response: Tissue-Materials Interactions, Tissue-Device Interactions
Materials Characterization and Polymer DegradationMaterials Characterization and Polymer DegradationMaterials Characterization and Polymer Degradation
Mechanics of Materials and DiagnosticsMechanics of Materials and DiagnosticsMechanics of Materials and Diagnostics
Optical Diagnostics and TherapeuticsOptical Diagnostics and TherapeuticsOptical Diagnostics and Therapeutics
Optical Radiation Safety and DevicesOptical Radiation Safety and DevicesOptical Radiation Safety and Devices
Radiation BioeffectsRadiation BioeffectsRadiation Bioeffects
Radiological Health and Safety ProgramRadiological Health and Safety ProgramRadiological Health and Safety Program

POST-MARKET ACTIVITIES...
 
POST-MARKET ACTIVITIES...
 
POST-MARKET ACTIVITIES...
Postmarket SurveillancePostmarket SurveillancePostmarket Surveillance
EpidemiologyEpidemiologyEpidemiology
BiostatisticsBiostatisticsBiostatistics
LawLawLaw
Manufacturing PracticesManufacturing PracticesManufacturing Practices
Regulatory IssuesRegulatory IssuesRegulatory Issues

7. Dates of Availability

:

:

For Co-op Students:

  

Cancel and Return to MDFP Home Page

 

Paperwork Reduction Act Statement

The public reporting burden for this collection of information is estimated to average one hour per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the necessary data, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information to this address:

Department of Health and Human Services
Food and Drug Administration
Office of Information Management
1350 Piccard Drive; Pi50 Rm 400B
Rockville, MD 20850

An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Information collected for the Medical Device Fellowship Program is approved under OMB Control No. 0190-0551 and expires March 31, 2017.

FORM FDA 3608 (06/05)