MCSO/OSU-CHS
Radiology
NAME OF RESIDENT
Monica Woodall, DO
Michael Roach, DO
Thomas Jarvis, DO
Robert Gispanski, DO
Mike Boger, DO
Andrew Hamill, DO
Alex Roby DO
Clay Garrett DO
Robert Moody DO
Tim Newton DO
Rotation Dates
Month
Jan
Feb
March
April
May
June
July
August
Sept
Oct
Nov
Dec
Year
2009
2010
2011
2012
2013
2014
2015
Name of evaluator
Dr. LacKamp
Dr. Lowe
Dr. Mann
Dr. Newman
other
Lichert Scale 1=poor 3=average 5=excellent
CORE COMPETENCY EVALUATION
Did the intern / resident demonstrate Osteopathic Skills during this rotation?
1
2
3
4
5
UE
Did the Intern demonstrate adequate medical knowledge during this rotation?
1
2
3
4
5
UE
Did the intern / resident demonstrate professionalism during this rotation?
1
2
3
4
5
UE
Did the Intern / Resident demonstrate adequate interpersonal and communication skills during this rotation?
1
2
3
4
5
UE
Did the Intern / Resident demonstrate adequate patient care skills for their level of training?
1
2
3
4
5
EU
Did the Intern demonstrate adequate use of resource materials during this rotation?
1
2
3
4
5
UE
Did the Intern / Resident demonstrate punctuality
1
2
3
4
5
UE
ROTATION SPECIFIC QUESTIONS
1
2
3
4
5
UE
Intern/Resident understands the indications and limitations of various imaging techniques
Intern/Resident has a good grasp on preparation of the patient for various imaging studies
Intern/Resident shows the ability to read basic xrays and scans and can recognize basic pathology
Intern/Resident shows the ability to choose between CT, MRI, US and Nuclear scans for workup of a patient
ROTATION SPECIFIC COMMENTS
Comments
Signature of Evaluator
UPIN
SSN
MCSO ID
Date:
Indicates Response Required