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CODES AND INSTRUCTIONS FOR INVESTIGATOR DATA SHEET (VA FORM 10-5368: PAGE 18)

5a. ACADEMIC RANK: The default Academic Rank for each Series is shown. If actual rank is different, or code is 06, enter name.

01 = Instructor Series

03 = Assistant Professor Series

05 = Professor Series

00 = None

02 = Lecturer Series

04 = Associate Professor Series

06 = Resident/Fellow/Trainee/Other

5b. UNIVERSITY ADMINISTRATIVE TITLE: The default University Administrative Title for each Series is shown.

If actual title is different, or code is 99, enter name.

01 = Department Chair Series 02 = Division Chief Series

03 = Dean Series

99 = Other (Specify) 00 = None

6. DIPLOMATE STATUS, BOARD CERTIFIED: Physicians, Dentists, Psychologists – Check YES or NO.

Non-physicians – Check NOT APPLICABLE.

7. SPECIALTY: Select Board or area of training or expertise. If 99 is selected, enter name in space provided.

01 = Allergy & Immunology

70 = Emergency Medicine

34 = Nursing

51 = Physiology

66 = Anatomic Pathology

16 = Endodontics

35 = Obstetrics/Gynecology

52 = Plastic Surgery

67 = Anatomic & Clinical Pathology

17 = Engineering

71 = Occupational Medicine

53 = Preventive Medicine

02 = Anatomy

18 = Epidemiology

36 = Oncology

54 = Public Health

03 = Anesthesiology

19 = Family Practice

37 = Operations Research

55 = Prosthodontics

04 = Anthropology

20 = General Practice

38 = Ophthalmology

56 = Psychiatry

05 = Audiology

21 = Genetics

39 = Optometry

57 = Psychology

06 = Biochemistry

22 = Geriatrics

40 = Oral Pathology

58 = Radiology

07 = Bioengineering

23 = Health Care Administration

41 = Oral Surgery

59 = Rehabilitative Medicine

08 = Biology

24 = Health Economics

42 = Orthopedic Surgery

60 = Social Work

09 = Biophysics

25 = Histology

43 = Osteopathy

61 = Sociology

10 = Biostatistics

26 = Immunology

44 = Otolaryngology

62 = Speech Pathology

11 = Chemistry

27 = Internal Medicine

45 = Pathology

63 = Surgery (General)

68 = Clinical Pathology

28 = Mathematics

46 = Pediatrics

64 = Thoracic Surgery

12 = Colon & Rectal Surgery

29 = Medical Illustration

47 = Periodontics

65 =Urology

13 = Dentistry (General)

30 = Microbiology

48 = Pharmacology

99 =Other (Specify)

14 = Dermatology

31 = Neurological Surgery

49 = Pharmacy

69 = Diagnostic Radiology

32 = Neurology

72 = Physical Medicine & Rehabilitation

15 = Dietetics

33 = Nuclear Medicine

50 = Physics

8. SUBSPECIALTY: Physicians – Enter code for ONE Board or area of training, or 00 (not applicable). If 99 is selected,

enter name, Non-physicians – enter 00.

29=Addiction Psychiatry

08=Endocrinology

39=Medical Microbiology

23=Physiological Psychology

01=Administrative Medicine

09=Experimental Psychology

40=Medical Oncology

24=Public Health

03=Allergy

10=Forensic Pathology

41=Medical toxicology

25=Pulmonary Disease

30=Cardiac Electrophysiology

35=Forensic Psychiatry

16=Metabolism

26=Rheumatology

04=Cardiovascular Disease

11=Gastroenterology

17=Nephrology

44=Sports Medicine

05=Child Psychiatry

12=General Preventive Medicine

18=Neuropathology

27=Therapeutic Medicine

31=Clinical & Laboratory Immunology 36=Geriatric Medicine

19=Neuropsychology

28=Therapeutic Radiology

32=Clinical Neurophysiology

37=Geriatric Psychiatry

20=Occupational Medicine

45=Vascular Surgery

06=Clinical Psychology

38=Hand Surgery

42=Nuclear Radiology

99=Other (Specify)

33=Critical Care Medicine

13=Hematology

43=Pain Management

00=Not Applicable

34=Dermatopathology

14=Immunology

21=Pediatric Allergy

07=Diagnostic Radiology

15=Infectious Disease

22=Pediatric Cardiology

11. HOSPITAL SERVICE: Select code for the hospital service with which the investigator is identified and/or from which

salary is paid. If salaried from VA research funds, enter code 09, 13, 27, or 41.

01=Administration

08=Education

16=Nuclear Medicine

24=Pulmonary Disease

02=Ambulatory Care

36=Extended Care

17=Nursing

25=Radiology

34=Anesthesiology

09=HSR&D (Program 824)

38=Ophthalmology

26=Rehabilitative Medicine

03=Audiology & Speech Pathology

37=Geriatrics

39=Otolaryngology

27=Rehabilitation R&D (Program 822)

04=Chaplain

10=GRECC

18=Outpatient Clinic

28=Recreation

41=Cooperative Studies (Program 825)

11=Intermediate Care

19=Pathology

30=Social Work

05=Dental

12=Laboratory

20=Pharmacy

31=Spinal Cord Injury

35=Dermatology

13=Medical Research (Program 821)

21=Prosthetics

32=Surgery

06=Dietetics

14=Medical

22=Psychiatry

40=Urology

07=Domiciliary

15=Neurology

23=Psychology

33=Voluntary

99=Other (Specify)

13 and 14. PRIMARY and SECONDARY RESEARCH INTERESTS: Select codes that best define general areas of

primary and secondary interests. Do NOT use 00 for primary research interest.

01=Aging

11=Drug Dependence

52=Neuropsychology

29=Radiology

02=Alcoholism

45=Emergency Medicine

21=Nuclear Medicine & Radiation

61=Rehabilitation

38=Ambulatory Care

12=Endocrinology & Metabolism

22=Nutrition

30=Rehabilitative Medicine

03=Anesthesiology

46=Epidemiology

23=Nursing

31=Respiration & Pulmonary Disease

04=Audiology & Speech Pathology

13=Gastroenterology

24=Oral Biology

32=Rheumatology

05=Basic Sciences

47=Geriatrics

25=Oncology

33=Social work

06=Behavioral Sciences

48=Health Care

53=Ophthalmology

62=Spinal Cord Injuries

07=Biochemistry

49=Health Economics

26=Orthopedic Surgery

34=Surgery

39=Bioenginerring

50=Health Services

27=Pathology

63=Urology

40=Biomechanics

14=Hematology

54=Pharmacology

64=Vascular Surgery

08=Cardiovascular Disorders

15=Immunology

55=Pharmacy

35=Veterinary Medicine

41=Clinical Epidemiology

16=Infectious Diseases

28=Podiatry

36=Virology

09=Computer Science

51=Medical Education

56=Post Traumatic Stress Disorders

37=Vision

42=Critical Care

17=Mental Health

57=Preventive Medicine

99=Other (Specify)

43=Critical Care

18=Molecular Biology

58=Prostatic Disease

00=None

44=Dental Implants

19=Nephrology

59=Prosthetics

10=Dermatology

20=Neurology & Neurobiology

60=Psychiatry

Form 10-5368 - Department Of Veterans Affairs Research And Development Information System Investigator Data - State Of West Virginia Page 2

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