Prospective Intern-Resident Evaluation

Prospect's Name: *

Applying For: *

Evaluator: *

Overall, how do you rate this candidate for our training program? *

Medical Skills

Attribute Rating (1 = poor, 3 = average, 5 = excellent, UE = Unable to Evaluate)

	1	2	3	4	5	UE
Possesses required training for position	1	2	3	4	5	UE
Exhibits Medical Knowledge	1	2	3	4	5	UE
Understands requirements of position	1	2	3	4	5	UE
Motivated to learn, read, work	1	2	3	4	5	UE
Is organized	1	2	3	4	5	UE
Addresses problems effectively	1	2	3	4	5	UE
Achieves established goals	1	2	3	4	5	UE
Communication skills	1	2	3	4	5	UE
Appropriate attire	1	2	3	4	5	UE
Self Confidence	1	2	3	4	5	UE
Emotional Maturity	1	2	3	4	5	UE
Understanding / Empathy	1	2	3	4	5	UE

Group Skills (1 = poor, 3 = average, 5 = excellent, UE = Unable to Evaluate)

	1	2	3	4	5	UE
Evidence of being an effective team player	1	2	3	4	5	UE
Evidence of working well with others	1	2	3	4	5	UE
Evidence of leadership	1	2	3	4	5	UE
Accepts responsiblity	1	2	3	4	5	UE
Participates in group discussions	1	2	3	4	5	UE
Displays a positive attitude	1	2	3	4	5	UE
Positively motivates others	1	2	3	4	5	UE
Evidence of stable relationships	1	2	3	4	5	UE

What do you see as the specific or general strengths of this prospect? *

What are the general, or specifically identified, weaknesses of this prospect? *