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MCSO/OSU-CHS
UROLOGY
NAME OF RESIDENT
*
Justin Mitchell, DO
Lauren Mitchell, DO
Jacinda (Jaci) Nuttle, DO
Sara Oldham, DO
Ana Crew, DO
Brian Lee, DO
Ashley Lomax-Walker, DO
Luke Records, DO
Justin Walker, DO
Kasey Welch, 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
*
Dr. Henry
Dr. Sofola
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
1
2
3
4
5
UE
Has become familiar with the basic urologic physical including the prostate and male genitalia.
1
2
3
4
5
UE
Has become comfortable with the urologic laboratory evaluation
1
2
3
4
5
UE
Has developed a good sense about when urologic consultation is indicated
1
2
3
4
5
UE
Has been exposed to basic urologic procedures and can explain them to a patient
1
2
3
4
5
UE
Comfortable with symptoms and disorders of the GU tract
1
2
3
4
5
UE
Competent to evaluate and treat bacterial infections of the genitourinary tract
1
2
3
4
5
UE
Incontinence, types and treatment
1
2
3
4
5
UE
Urologic malignancies, recognition
1
2
3
4
5
UE
Recognition and treatment of BPH, recognizing symptoms that should be consulted by urology
1
2
3
4
5
UE
Hernias and hydrocoeles, recognition and management
1
2
3
4
5
UE
Competent to deal with urinary stone disease
1
2
3
4
5
UE
Has become conversant concerning male sexual dysfunction
1
2
3
4
5
UE
ROTATION SPECIFIC COMMENTS
Comments
*
🛈
Signature of Evaluator
*
UPIN
SSN
MCSO ID
MCSO ID
Date:
*
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