Rating (R) Scale: 1=Poor; 2=Fair; 3=Adequate; 4=Good; 5=Excellent
On the basis of your needs, rate this programs and add comments:
Education
Program Philosophy - R=__ __________________________________________
Accreditation - R=__ _______________________________________________
Overall Curriculum - R=__ ___________________________________________
Rotations/electives - R=__ ___________________________________________
Rounds (educational vs. work) - R=__ ___________________________________
Conferences - R=__ _________________________________________________
# & variety of patients - R=__ ________________________________________
Hospital Library - R=__ _____________________________________________
Resident evaluations - R=__ __________________________________________
Board Certification of graduates - R= _ __________________________________
Attending Physicians/Teaching Faculty
# of full-time vs. part-time - R=__ _____________________________________
Research vs. teaching responsibilities - R=__ _____________________________
Clinical vs. teaching skills - R=__ ______________________________________
Availability/approachability - R=__ ____________________________________
Preceptors in clinic - R=__ ___________________________________________
Subspecialties represented - R=__ _____________________________________
Instruction in patient counseling & education - R=__
______________________
Hospital
Community or university hospital? - R=__ ______________________________
Staff physicians support of program - R=__ _____________________________
Availability of consultation services - R=__ _____________________________
Other residency programs - R=__ _____________________________________
Types of patients - R=__ ____________________________________________
Hospital staff (nursing, lab, path, etc) - R=__ ____________________________
Current House Officers
Number per year - R=__ ____________________________________________
Medical school of origin - R=__ ______________________________________
Personality - R=__ ________________________________________________
Dependability - R=__ ______________________________________________
Honesty - R=__ __________________________________________________
Cooperation/get along together - R= __ ________________________________
Compatibility/Can I work with them? - R=__ ___________________________
Work Load
Average #pts./HO (rotation, clinic) - R=__ ____________________________
Supervision: senior HO, attending - R=__ ______________________________
Call schedule - R=__ _______________________________________________
Rounds - R=__ ___________________________________________________
Teaching/conference responsibility - R=__ _____________________________
"Scut" work - R=__ _______________________________________________
Time for conferences - R=__ ________________________________________
Clinic responsibilities - R=__ ________________________________________
Benefits
Salary - R=__ ____________________________________________________
Professional Dues - R=__ __________________________________________
Meals - R =__ ____________________________________________________
Insurance (malpractice, health, etc.) - R=__
____________________________
Vacation - R=__ __________________________________________________
Maternity/sick leave - R=__ ________________________________________
Outside conferences/books - R=__ __________________________________
Moonlighting permitted - R=__ ______________________________________
Surrounding Community
Size and type (urban/suburban) - R=__ ______________________________
Geographic location - R=__ _______________________________________
Climate and weather - R=__ _______________________________________
Child care and public schools - R=__ ________________________________
Socioeconomic/religious diversity - R=__ ____________________________
Entertainment/Recreation/Culture - R=__ ___________________________
Cost of living (housing/food/utilities - R=__ __________________________
Housing availability & quality - R=__ ________________________________
Economy (industry/growth/recession) - R=__ __________________________
Programs strengths:
Programs Weaknesses:
Reprinted with the permission of Dr. Stokes and the Barberton Citizens Hospital Family Practice Program, Barberton, Ohio.

