Residencies/Internships

Availability of faculty supervision on all rotations

Availability of supervision by senior residents/fellows on all rotations

Appropriateness of responsibilities to my level of training

My interactions with residents from other specialties have been positive

My interactions with faculty from other specialties have been positive

Oklahoma State University
Center for Health Sciences

Resident Survey

Internship and Residency Program Evaluation

Year
Specialty
Institution

Please rate the each of the following program elements, using the scales noted for each section and subsection.

Section I

Faculty and Staff:

0 = No Opinion
1 = Inadequate
2 = Fairly Adequate, but Needs Work
3 = Neutral
4 = Adequate
5 = Exceeded Expectations

0	1	2	3	4	5
						Access to Director of Medical Education
						Access to Program Director
						Availability of attending physicians for supervision
						Appropriateness of full-time faculty teaching for my needs
						Frequency of feedback regarding my performance
						Quality of feedback regarding my performance
						Number of administrative staff supporting the program
						Quality of administrative staff supporting the program
						Participation of OPTI (OMECO) support of the program

Comments on Faculty and Staff:
(please comment and suggest changes if applicable)

.

Section II

Academic Program:
Please answer YES or NO to the following two questions.

Yes	No
		I have received the goals and objectives of the program.
		I am requested to sign-in at departmental conferences.

0 = No Opinion
1 = Completely Inadequate
2 = Fairly Adequate, but Needs Work
3 = Neutral
4 = Adequate
5 = Exceeded Expectations

0	1	2	3	4	5
						Opportunities to participate in research
						Opportunities to evaluate the training program
						Opportunities to evaluate program faculty
						Overall quality of the educational experience
						Frequency of didactic programs
						Attendance by program director & attendings at didactic programs
						Overall quality of didactic programs in your residency

Comments on Academic Program:
(list recommendations for change)

.

Section III

Patient Care:

0 = No Opinion
1 = Insufficient
2 = Neutral
3 = Sufficient
4 = Excessive

0	1	2	3	4
					Number of patients necessary to meet educational needs
					Variability of patients to meet educational needs
					Size of patient load in hospital
					Opportunity to learn procedures relevant to my training area

0 = No Opinion
1 = Disagree
2 = Neutral
3 = Agree

0	1	2	3
				Call duties average no more than 1 of 3 nights (averaged over a 4 week period)
				One day a week (on average) is free of clinical responsibilities
				My average workweek does not exceed 80 hours (averaged over a 4 week period)
				There is an appropriate balance between patient care activities and education

Comments on Patient Care:
(please comment and/or recommend changes)

.

Section IV

Supervision/Consultation

0 = No Opinion
1 = Completely Inadequate
2 = Inadequate
3 = Neutral
4 = Adequate
5 = Exceeded Expectations

Comments on Supervision/Consultation:
(please comment and/or recommend changes)

Section V

What are the best aspects of this residency program?

"If I could change one thing about this residency it would be..."

"I would suggest the following changes to our curriculum..."

Thank you for completing this evaluation!

Please don't hesitate to contact me with any questions or concerns.

Jeffrey J. LeBoeuf, CAE
Executive Director
Osteopathic Medical Education
Consortium of Oklahoma (OMECO)
717 S Houston Avenue, Suite 301
Tulsa, OK 74127
918-586-4626
918-586-4628 (fax)
jeffrey.leboeuf@okstate.edu

Oklahoma State University - Center for Health Sciences
1111 W. 17th St., Tulsa, OK 74107 | 918-582-1972