Program Index

Online Application Form

Mission Statement General Responsibilities of Fellow Salary and Benefits Evaluation Living in Pittsburgh Resident Duty Hour and Moonlighting Policy Resident Duty Hours Department of Pathology Fellow Evaluation Name of Fellow Rotation/Location: Dates of Rotation: Faculty Evaluator: Approximate number of contact hours with trainee:________ (hrs). If zero, circle N/A for all items Please provide your impressions of this trainee by indicating level of performance or acceptability for the indicators below. Before the trainee leaves the rotation please give her/him feedback on your assessment with specific comments on areas of strength or weakness and suggestions for ways to improve. Use N/A if you had insufficient contact to evaluate or have no opinion. Your time and effort in completing the evaluation is important and very much appreciated. Please address questions to the Program Office (648-9699). Note: Please provide specific comments on trainees. Scores of 3 or lower should describe specific problems. It is also very helpful to provide examples of exceptional or unique capability for trainees receiving ratings of 9.   Unsatisfactory Satisfactory Superior No opinion Knowledge in Pathology/Lab Medicine 1      2      3 4      5      6 7      8      9 N/A General Medical knowledge 1      2      3 4      5      6 7      8      9 N/A Ability to apply knowledge 1      2      3 4      5      6 7      8      9 N/A Preparation/follow-up of clinical work 1      2      3 4      5      6 7      8      9 N/A Procedural skills 1      2      3 4      5      6 7      8      9 N/A Record keeping/organizational skills 1      2      3 4      5      6 7      8      9 N/A Presentation skills 1      2      3 4      5      6 7      8      9 N/A Research skills (if applicable) 1      2      3 4      5      6 7      8      9 N/A Comments on knowledge base, application of knowledge and other skills (use reverse if necessary) Ability to work effectively with     Fellow Residents/Faculty/Staff     Clinicians/Nurses/Other Housestaff 1      2      3 1      2      3 4      5      6 4      5      6 7      8      9 7      8      9 N/A N/A Punctuality 1      2      3 4      5      6 7      8      9 N/A Attitude/Motivation 1      2      3 4      5      6 7      8      9 N/A Potential for Growth 1      2      3 4      5      6 7      8      9 N/A Comments on personal attributes and potential (use reverse side if necessary): What is your assessment of this individual's overall capabilities in pathology at this time adjusted for stage of training? Significantly behind Slightly behind Appropriate for stage Slightly ahead Significantly ahead No Opinion Other Comments (use reverse side if necessary): I have discussed my impressions with the trainee _______ Yes _______ No Signature of Faculty Evaluator_____________________________ Date:_____________

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