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Gilbert was previously a graduate assistant at Duke, and later held academic appointments at North Carolina State University and the University of North Carolina Medical School. In 1988 he joined the faculty of Mississippi State, and was made a full professor in 1993. He also held a position at the University of Mississippi Medical Center. In 2010 he became provost of Mississippi State. He was appointed President of Marshall University in 2016 following the sudden death of Dr. Stephen Kopp. He is a member of the College of Fellows of the American Institute for Medical and Biological Engineering and of the Fellows of the Institute of Biological Engineering.