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Policies & Guidelinesfor 1st-Year Clinical Fellows

I.   Purpose of Clinical Fellowships

The Cystic Fibrosis Foundation (CFF) offers competitive Clinical Fellowships for physicians interested in chronic pulmonary and gastrointestinal diseases of children, adolescents and adults with cystic fibrosis (CF). The intent of this program is to encourage specialized training in the early career development stage and to prepare young, well-qualified candidates for careers in academic pulmonary or gastrointestinal medicine related to CF.

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II.   Eligibility

Applicants must have completed at least three years of training in an approved pediatric or internal medicine program by the time the fellowship is to begin. Adult caregivers in CF are encouraged to apply.  All applicants must be either a citizen of the United States or have a permanent visa, and applicants are required to submit proof of status at time of application.  Applications are also accepted from Residents completing training sufficient to enable them to compete for American Board of Internal Medicine and American Board of Pediatrics certification (so-called combined Medicine/Pediatric applicants). The applicant institution must be accredited in pulmonary or GI medicine. Applicants must describe career goals related to a long-term commitment to CF research and care.  The institutional status of a fellow (e.g., first, second, or third year) must correlate with the CFF fellowship award (see Table 1).

Table 1.   Adult or Pediatric or Combined Medicine / Pediatrics, Pulmonary or Gastroenterology Subspecialty Applicants Post-residency Status and Appropriate Application Form

Years Post-Residency  CFF Clinical Fellowship Application


  First-Year Clinical Fellowship1


 Second-Year Clinical Fellowship2


 Third-Year Clinical Fellowship3


 Fourth-Year Clinical Fellowship4


 Fifth-Year Clinical Fellowship5


1 3-year renewable award for fellows applying during their last year of residency training
2 2-year renewable award available for fellows applying during their first year of fellowship training
3 1-year renewable award available for fellows applying during their second year of fellowship training
(may include a basic or clinical research project)
4 1-year award available for fellows applying during their third year of fellowship training
(must include a basic or clinical research project)
5 1-year award available for fellows applying during their fourth year of fellowship training
(must include a basic or clinical research project if not completed during applicant’s fourth year of fellowship)

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III.  General Considerations

Training must take place in one of the CF Foundation's recognized CF Care Centers or a Center-affiliated adult CF program, and should provide a thorough grounding in diagnostic and therapeutic procedures, comprehensive care and clinical research.  Fellowships are offered in one of two subspecialties: Pulmonary or Gastroenterology. Every Fellow must have a sponsor. The sponsor will be responsible for the Fellow's training and research activities. If the sponsor is not the CF Center Director, the CF Center Director must be listed as the co-sponsor. Multiple candidates from each institution can be recommended by the institution for a CFF Clinical Fellowship.

Generally it is preferred that the first year provide intensive experience in patient management, diagnostic and therapeutic procedures. For pediatric or adult Fellowships, three-year programs are encouraged, but not required. The second and third year are competitive renewals awarded on the basis of a progress report indicating satisfactory performance for the portion of the first or second year that will have been completed at the time of application.

Third-year and fourth-year clinical fellowships, which include a research project by the Fellow, are also available (see Table 1). For combined Medicine/Pediatric Fellowship applicants, a minimum of 20% of the trainee’s total training time over a five-year period must be spent in research and so documented in the application. Fourth-year and fifth-year clinical fellowships, which include a research project by the fellow, are also available (see Table 1). Clinical fellowships are reviewed by the CF Foundation's Professional Education Committee and are subject to approval by the Medical Advisory Council, which makes recommendations to the Board of Trustees for final approval and funding. All fellowships are awarded subject to the regulations, policies and objectives of the CF Foundation concerning this form of support and are contingent upon the availability of funds. Awarded on the basis of individual and institutional merit, fellowships are not transferable either with respect to the trainee or the trainer.

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IV.   Stipends

First-year fellowships include a stipend of $41,600 and $400 for auxiliary training opportunities such as travel to educational meetings or purchase of materials. If other funds are available to the applicant, partial support may be requested. Supplementary funding from other sources is permissible in accordance with institutional policy and pending notification and approval by the CF Foundation. The CF Foundation will also underwrite the interest payments for educational loans for up to $7,000 per year.

V.   Payback Agreement

After completion of CF Foundation-supported training, it is expected that the recipient of CF Foundation support will engage in biomedical research, teaching and care or a combination of these activities in an academic environment. Failure to commence in such activities, and failure to sustain such activities for a period equal to the support of CFF (12 months – 2nd year; 12 months – 3rd year; 12 months – 4th year; 12 months – 5th year) will subject the trainee to payback provisions as follows:

 1st Year    $ - 0 -
 2nd Year  $23,500
 3rd Year  $33,000
 4th Year  $33,000
 5th Year  $33,000
Further details of these payback provisions are outlined in the attached Letter of Agreement. This agreement must be signed and included with the grant application at the time of submission, but need not be attached to the electronic grant application.

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Payments are made quarterly to the sponsoring institution and not to the individual fellow. The first payment is made at the end of the first quarter. The final quarterly payment (at the end of the total fellowship period) is made only after a final evaluation is received from the fellow and the sponsor(s). No indirect costs are paid to the institution.

Application for a CFF Clinical Fellowship requires a completed, signed application form. The application should include:

  1. Applicant's biographical sketch with copies of all published papers included in the appendix;
  2. Applicant's personal statement, weighed heavily by the Professional Education Committee, describing previous training, achievements and experience in pediatric or adolescent/adult pulmonary or gastrointestinal disease and cystic fibrosis, including plans for utilization of training and demonstration of long-term commitment to CF care;
  3. List of applicant's other support;
  4. A minimum of two letters of reference from individuals with whom the applicant has been closely associated during medical training. The sponsor(s) may not write these letters of recommendation. Letters may accompany the application or be mailed directly to the CF Foundation prior to the application deadline. For combined Medicine/Pediatric Fellowship applications, support letters from the Internal Medicine Subspecialty Program Director and the Pediatric Subspecialty Program Director must be included. These letters of support should detail how the training program, as proposed, will permit the applicant to compete for American Board of Internal Medicine and American Board of Pediatrics certification;
  5. Sponsor(s)'s biographical sketch (limited to 2 pages) that clearly defines results of past CFF support (e.g., invited lectures, publications and other grant support);
  6. Letter(s) from sponsor(s) outlining why the applicant was selected for the fellowship (for first year Fellows);
  7. Detailed description of the proposed training program, submitted and signed by the sponsor(s) with a clear statement regarding the nature of the CF-related experience. Please elaborate as to how coursework relevant to the applicant’s training will impact upon time dedicated to clinical and research commitments. This is weighed heavily by the Professional Education Committee.
  8. List of previous Fellowships under the sponsor(s)'s supervision, including all fellows trained in the program and their source of support;
  9. Completed Budget and Budget Justification
  10. A signed copy of the payback agreement.

It is the responsibility of the candidate, not the CF Foundation, to see that these requirements are met by the various principals of the application.

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VIII.  2nd- & 3rd-Year Fellowship Application

It is recognized that at the time of application for a CFF Second-Year Fellowship, a fellow will only have completed approximately three months of the first-year fellowship training.

Application for the second year fellowship requires a completed, signed application form, with the candidate's appraisal of first year of training (or portion completed to date) included in the personal statement. A description of the proposed research to be engaged in by the applicant should also be included, if applicable. SECOND YEAR RENEWAL IS NOT AUTOMATIC.  Application for the third-year fellowship requires a completed, signed application form, with the candidate’s appraisal of the second year of training included in the personal statement. A description of the proposed research to be engaged in by the applicant should also be included, if applicable.  If a research project is to be included, then additional funding of up to $10,000 for equipment, technician’s salary, supplies, travel to a national scientific meeting, or other expenses related to the research project may be requested in the renewal. THIRD YEAR RENEWAL IS NOT AUTOMATIC, NOR IS APPROVAL OF THE RESEARCH PROJECT.

Fellows funded from other sources for the first one or two years of fellowship training may apply for CF Foundation support for their second or third year of training, respectively. A first-year fellow at the training institution should apply for a Second-year Clinical Fellowship for the following year and a second-year fellow should apply for a Third-year Clinical Fellowship (see Table 1) with or without a research project. An evaluation of the fellow's performance and description of his/her program during the previous training year(s) must be included in the application to the CF Foundation. The rules, policies, and requirements for such applications are identical to renewing support for previously funded CFF Clinical Fellows.

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IX.   Research Involving Human Subjects

CF Foundation policy pertaining to the protection of individuals as research subjects requires that for each proposal submitted, the grantee institution certify in writing that an institutional committee has reviewed and approved the procedures for the use of human subjects, or human organs, tissues and body fluids, in the proposed research, in accordance with Department of Health and Human Services policies. This certification should accompany the application and must be received before activation of any grant. If approval does not accompany the application, there should be a statement in the application indicating that such approval is pending and the date when such approval is expected. The approved certification should be submitted as soon as it is available.

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X.   Research Involving Recombinant DNA

All research involving recombinant DNA techniques supported by the Cystic Fibrosis Foundation must meet the requirements contained in the document NIH Guidelines for Research Involving Recombinant DNA Molecules and The Administrative Practices Supplement. This publication and announcements of modifications and changes to the guidelines are available from the Office of Recombinant DNA Activities, National Institutes of Health, Bethesda, MD, 20892. The purpose of this document is to specify practices for the construction and handling of recombinant DNA molecules and organisms or viruses containing recombinant DNA. As defined by the guidelines, recombinant DNA molecules are either: (1) molecules that are constructed outside living cells by joining natural or synthetic DNA segments to DNA molecules that can replicate in a living cell; or (2) DNA molecules that result from the replication of those described in (1) above.

Many types of studies involving recombinant DNA are exempt from the guidelines while others are prohibited. The applicant organization is required to establish and implement policies that provide for the safe conduct of the research in full conformity with the guidelines. This responsibility includes establishing an Institutional Biosafety Committee to review all recombinant DNA research to be conducted at or sponsored by the applicant organization, and to approve those projects it finds are in conformity with the guidelines. CF Foundation policy pertaining to recombinant DNA research requires that the grantee institution certify in writing that an institutional committee has reviewed and approved the procedures involving recombinant DNA in accordance with NIH guidelines.

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XI.   Research Involving Animals

Grant applications submitted to the Cystic Fibrosis Foundation involving the use of animals must meet the guidelines of the National Institutes of Health, U.S. Public Health Service, which require that all proposed studies be reviewed and approved by an institutional animal care and use committee. Written documentation of approval should accompany the application and must be received before activation of any award. In addition, CF Foundation grantee institutions and laboratories must be accredited by the American Association for Accreditation of Laboratory Animal Care (AALAC) and/or have other verifiable assurances that the institution and laboratory meet appropriate standards. Certification of accreditation should also accompany the application, and a statement must be included in the application indicating that such approval is pending and the date approval is expected. Certification should be submitted as soon as approval is received. Failure to provide these materials will lead to administrative disqualification of an application.

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XII.  Final Evaluation

At the termination of the fellowship, evaluations must be submitted to the CF Foundation by the fellow and the sponsor. Payment of the final installment of the grant is contingent upon receipt of these evaluations.

XIII.  Deadline for Filing Applications

All parts of the application and letters of reference must be postmarked by the first Wednesday of October for first- or second-year fellowships. The start date for these fellowships will be July 1 of the following year. Applications that are incomplete or postmarked after the first Wednesday of October will not be considered. It is the responsibility of the applicant to assure compliance with all requirements.

Send the completed application to:
Cystic Fibrosis Foundation
Office of Grants and Contracts Management
6931 Arlington Road
Bethesda, Maryland 20814
(301) 951-4422

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Submission, Review & Awarding of New Applications


Application Deadline: First Wednesday of October -- hard-copies need to be postmarked by deadline, and electronic applications need to be submitted by NOON (Eastern Time) of deadline.

Late applications will not be accepted and the deadline will not be waived.

Review by Professional Education Committee:  December
Review by Medical Advisory Council:  January
Review by Board of Trustees:  February
Applicant Notified: February
Earliest Start Date:  July 1

To submit an electronic application, please visit: For questions regarding content of application please contact the CFF Office of Grants and Contracts at either (301) 841-2645 or For questions regarding the application website, please contact RAMS at or (800) 875-2562.

Do not submit incomplete applications. If a project will include patients or patient’s materials, the CF Foundation requests prior approval from the applicant’s institutional review board (IRB) before application submission. If the application is awarded and IRB approval has not been granted funding of the award will not commence until the CF Foundation receives proof of IRB approval. An application will be considered incomplete if it fails to comply with instructions or if the material is insufficient to permit adequate review.  Revisions, insertions or appendices to applications will not be accepted after the receipt date unless it is specifically requested and agreed to by the CF Foundation's Office of Grants and Contracts Management.

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Rev. 06/06

The Cystic Fibrosis Foundation is an accredited charity of the Better Business Bureau.