MCSO/OSU-CHS
UROLOGY
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
2010
2011
2012
2013
2014
2015
Name of evaluator
involved physician
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 Resident demonstrate adequate medical knowledge during this rotation?
1
2
3
4
5
UE
Did the resident demonstrate professionalism during this rotation? Did they relate to patients in a professional way? Were they dressed acceptably?
1
2
3
4
5
UE
Did the Resident demonstrate adequate interpersonal and communication skills during this rotation?
1
2
3
4
5
UE
Did the Resident demonstrate adequate patient care skills for their level of training?
1
2
3
4
5
EU
Did the Resident demonstrate adequate use of resource materials during this rotation? Did they complete their reading assignments including Smith's General Urology chapters 3,4,5,14,17,19,23,31,47?
1
2
3
4
5
UE
Did the Resident demonstrate punctuality? Were they tardy or absent?
1
2
3
4
5
UE
ROTATION SPECIFIC QUESTIONS
1
2
3
4
5
UE
Shows improved skill sets that allows resident to choose appropriate diagnostic tools and appropriate management for common urologic problems
Has become familiar with the basic urologic physical including the prostate and male genitalia.
Has become comfortable with the urologic laboratory evaluation
Has developed a good sense about when urologic consultation is indicated
Has been exposed to basic urologic procedures and can explain them to a patient
Comfortable with symptoms and disorders of the GU tract
Competent to evaluate and treat bacterial infections of the genitourinary tract
Incontinence, types and treatment
Urologic malignancies, recognition
Recognition and treatment of BPH, recognizing symptoms that should be consulted by urology
Hernias and hydrocoeles, recognition and management
Competent to deal with urinary stone disease
Has become conversant concerning male sexual dysfunction
ROTATION SPECIFIC COMMENTS
Comments
Signature of Evaluator
UPIN
SSN
MCSO ID
Date:
Indicates Response Required