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MCSO/OSU-CHS
OB/GYN FOR RESIDENTS
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. Allison Taylor
Dr. Cuesta
Dr. Surredi
Dr. Christine Taylor
Dr. Whittington
Dr. Hensley
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
Does the resident have a good grasp on the normal and abnormal PAP?
1
2
3
4
5
UE
Can the resident perform colposcopy and understand indications for same?
1
2
3
4
5
UE
Is the resident competent in birth control methods and products?
1
2
3
4
5
UE
Does the resident show competence in the diagnosis and treatment of vaginitis, cervicitis, PID?
1
2
3
4
5
UE
Can the resident co-ordinate the workup of a breast mass?
1
2
3
4
5
UE
Is the resident competent to work up a pelvic mass?
1
2
3
4
5
UE
Is the resident competent to drain a cystic breast lesion?
1
2
3
4
5
UE
Does the resident show adequate knowledge to treat or prevent osteoporosis?
1
2
3
4
5
UE
Is the resident comfortable in the arena of HRT?
1
2
3
4
5
UE
Rotation Specific Questions
*
1
2
3
4
5
UE
The resident has become competent to deliver the uncomplicated pregnancy
1
2
3
4
5
UE
The resident is competent to refer the complicated pregnancy
1
2
3
4
5
UE
The resident is competent to do adequate pre-partum care
1
2
3
4
5
UE
The resident is competent to do satisfactory post-partum care
1
2
3
4
5
UE
The resident has become competent in all stages of labor and delivery
1
2
3
4
5
UE
Please estimate the number of c-sections attended by the resident
*
Please estimate the number of deliveries attended by the resident during the rotation
*
ROTATION SPECIFIC COMMENTS
Comments
*
🛈
Signature of Evaluator
*
UPIN
SSN
MCSO ID
MCSO ID
Date:
*
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