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Attachment 2C - 1

ATTACHMENT 2C-1

NAME:

Johns Hopkins University School of Medicine
Class of 1999
EVALUATION OF RESIDENTS

We appreciate your help in assessing the performance of our graduate who is currently a trainee in your program. For this evaluation form you should assume that a score of 3 (good) is average for your current residency class. If you are unable to comment on a specific item, please mark NA (not applicable). Any additional narrative comments concerning the resident’s performance or ways in which we might improve our Dean’s letter would be welcomed.

	Inadequate			Good		Outstanding	NA
Take a complete history	1	2		3	4	5
Perform an accurate physical exam	1	2		3	4	5
Factual knowledge	1	2		3	4	5
Data Interpretation	1	2		3	4	5
Technical Skills	1	2		3	4	5
Integrity	1	2		3	4	5
Maintain accurate records	1	2		3	4	5
Teach effectively	1	2		3	4	5
Interpersonal skills with patient	1	2		3	4	5
Interpersonal skills with other staff	1	2		3	4	5
Motivation	1	2		3	4	5
Performance on standardized tests	1	2		3	4	5
Suitability for a career in clinical practice	1	2		3	4	5
Suitability for a career in academic medicine	1	2		3	4	5
Accepts and responds to criticism	1	2		3	4	5
Overall impression	1	2		3	4	5
Did our Dean’s letter accurately estimate this resident’s ability?			Overestimate Underestimate Accurate
How does this resident rank in comparison to other residents at the same level?			Upper Third Middle Third Lower Third

Comments:

Return to:
H. Franklin Herlong, M.D.
Associate Dean for Student Affairs
School of Medicine Administration
Room 128
720 Rutland Avenue
Baltimore, MD 21205

(Envelope Enclosed)

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