Dear Scholarship Applicant:

Thank-you for applying for the Medical Student Chronic Fatigue Syndrome Scholarship offered by the New Jersey Chronic Fatigue Syndrome Association (NJCFSA) and administered through the Foundation of the University of Medicine and Dentistry of New Jersey.  

The purpose of this scholarship is to encourage you to learn about Chronic Fatigue Syndrome (CFS) by writing an essay about this illness during the summer between your first and second years of medical school.  CFS is also known as Chronic Fatigue Immune Dysfunction Syndrome (CFIDS) and ME/CFS.

The NJCFSA Medical Student CFS Scholarship is not a financial need scholarship. 

The NJCFSA Medical Student CFS Scholarship is open to all students who have completed their first year of medical school within the State of New Jersey, are enrolled for their second year of medical school within the State of New Jersey, and are in good academic standing.

The winner of the scholarship shall receive a $3,000 award that will be applied toward the tuition of his/her second year of medical education. 

Completed applications must be postmarked or electronically submitted no later than August 31^st, 2008.

We would also appreciate the opportunity to learn about you, and your goals as specified in the application. 

We hope that the process of writing the essay for this scholarship, and possibly being the winner of it, will contribute to your becoming a physician who is better able to assist and provide compassionate care for patients suffering from CFS and similar, complex illnesses with no known cures.

NJCFSA, Inc. is a registered 501(c)(3) non-profit charitable organization dedicated to supporting CFS patients and their families, and promoting education and research into the causes and cure of Chronic Fatigue Syndrome, also known as CFIDS and ME/CFS.

If you have any questions regarding your CFS Medical Student Scholarship application, please contact Ramona M. Ponce of the Foundation of UMDNJ at 732-235-3305.

 If you have questions about CFS, the NJCFSA, or need assistance in obtaining source material for your essay, please contact Dr. Kenneth J. Friedman, Chair, Medical Student Scholarship Committee, NJCFSA, P.O. Box 477, Florham Park, NJ 07932, or Dr. Kenneth J. Friedman, Associate Professor of Pharmacology and Physiology, New Jersey Medical School, 185 South Orange Avenue, Newark, NJ 07103.  Telephone 973-972-4513, Fax:  973-972-7950, E-mail:  friedman@umdnj.edu.

 Sincerely,

Kenneth J. Friedman, Ph.D.
Chair, Medical Student Scholarship Committee
New Jersey Chronic Fatigue Syndrome Association, Inc.

New Jersey Chronic Fatigue Syndrome Association
Medical Student Scholarship Program
Application/Applicant Requirements

 Please read the application/applicant requirements below carefully:

 Applicants must:

1.        Be a medical student who has successfully completed his/her first year of medical school in one of UMDNJ’s three medical schools, be enrolled for his/her second year, and be in good academic standing. 

2.        Complete the application in every detail.  Incomplete applications will automatically disqualify applicants. 

3.        Research and write an essay on the stated topic concerning Chronic Fatigue Syndrome.  The essay must be written by the applicant during or after the Spring, 2008 semester of medical school.  The work must be the applicant’s and represent original work. 

4.        Not have offered or submitted the essay elsewhere. 

5.        Agree that the submitted essay becomes the property of the NJCFSA, and that the essay may be used by NJCFSA for advertisement purposes, and/or published in any of the Association’s publications. 

6.        Provide a one-page, Biographical/Personal Statement as part of the application.  Include any information that you would like the Scholarship Committee to consider when reviewing your application. 

7.        Provide the name and address of your local newspaper. 

8.        Attach an official transcript from the registrar’s office of your medical school or arrange to have a transcript sent to Ramona Ponce at the Foundation of UMDNJ. 

9.        Submit the application by August 31^st, 2007 to Ramona M. Ponce, Foundation of UMDNJ, 120 Albany Street, Tower II, Suite 850, New Brunswick, NJ 08901. 

The New Jersey Chronic Fatigue Syndrome Association Medical Student Scholarship
at the University of Medicine and Dentistry of New Jersey

APPLICATION FORM  

PART A:  APPLICANT INFORMATION

To be completed by applicant (please type).

 Name:  ________________________________________________________   Sex:  M______  F ______

 UMDNJ School:  ________________________________________________  Class of:______________

 UMDNJ Academic Standing:  ______________            

Date of Birth:  ____________________                      Place of Birth: _________________________________ 

U. S. Citizen:   Y ____   N  ____                      Marital Status:    Single  ________       Married _______ 

Permanent Legal Address:  _______________________________________________________
                                                Number                                    Street

                                          _______________________________________________________
                                                City                              State                             Zip Code

 Mailing Address:                _______________________________________________________
                                                (Leave blank if same as permanent address)

 Home Phone:                     _______________________________________________________
                                                Area Code                                            Number

 Local Newspaper Name:    _____________________________________________________________
                                                 Name                                                        Address

PART B:  APPLICANT’S ACADEMIC ACHIEVEMENTS 
(please list and include awards/honors):

__________________________________________        _____________________________________

__________________________________________        _____________________________________

__________________________________________        _____________________________________

PART C:  APPLICANT’S COMMUNITY INVOLVEMENT
(please list volunteer activities or other forms of community service performed beyond high school)

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

PART D:  APPLICANT’S WORK EXPERIENCE 
(please list work experiences performed beyond high school)

                                                                                     Dates of
Name of Employer                                Position             Employment                  Hours Worked

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

Part E:  STUDENT BIOGRAPHICAL/PERSONAL STATEMENT 
(Please attach optional photo here)

Write a brief biography emphasizing why you decided to pursue a career in medicine and what are your career goals and aspirations. 

Signature of Applicant                                                               Date

Part F:  Essay 

• Write an essay of approximately 4,500 words on the following topic:  How does a physician diagnose Chronic Fatigue Syndrome (ME/CFS) in children and adolescents?   Compare and contrast the adult case definitions of ME/CFS with the pediatric case definition.  How do the symptoms of ME/CFS impact on the education of children and adolescents?  How can the physician help the school systems provide a thorough and efficient education for children and adolescent patients?
   
• Your essay must not exceed 15 double-spaced pages of 12-point type with 1-inch margins.
   
• References should be cited within the text of the essay using standard, medical journal format.
   
• No more than 40 references should be cited.
   
• A bibliography containing all references cited in the essay should be included at the end of the essay.
   
• The bibliography should be formatted using standard, medical journal format.
   
• The document needs to be scholarly and well-referenced.  Citing web sites as references is not acceptable.
   
• The essay must not have been offered or submitted elsewhere.
   
• Essays not conforming to these standards will not be considered.
   
• A committee will be formed by NJCFSA to review the submitted essays and select the winner.  Judging will be on the basis of scholarship, and the demonstration of understanding the difficulties involved in diagnosing and providing compassionate and effective care to CFS patients.

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