Residency Manual

VI. Level of Supervision (Select only one Phase) ○1. Initial Phase ○2. Intermediate Phase ○3. Enhanced Phase ○4. Advanced Phase 1. Initial Phase (Direct Supervision): 1A. Minimum of 3 in all areas Clinical Performance and Case Management Skills ○Yes ○No ○NA

1B. Based on above resident to advance to Intermediate Phase ○Yes ○No ○NA 2. Intermediate Phase (Indirect Supervision with Direct Supervision Availabl e): 2A. Minimum of 3- 4 in all areas Clinical Performance and Case Management Skills ○Yes ○No ○NA 2B. Resident shows increased knowledge base, ability to detect, diagnosis and manage difficult cases ○Yes ○No ○NA 2C. Based on the above the resident to advance to Enhanced Phase (emancipation) ○Yes ○No ○NA 3. Enhanced Phase (Indirect Supervision with Direct Supervision Available): 3A. Minimum of 4 in most areas of Clinical Performance and Case Management Skills ○Yes ○No ○NA 3B. Resident has demonstrated clinical skills and thinking for autonomy ○Yes ○No ○NA 3C. Based on the above the resident to advance to Advanced Phase ○Yes ○No ○NA 4. Advanced Phase (Indirect Supervision with Direct Supervision Available): 4A. Minimum of 4-5 in all areas Clinical Perform ance and Case Management Skills ○Yes ○No ○NA 4B. Resident has demonstrated clinical skills and thinking for full autonomy ○Yes ○No ○NA

VII. Advanced Competency 1. Resident is making progress on attaining advanced competencies ○Yes ○No 2. Resident is on track to meet competencies by program completion ○Yes ○No Comment Field (required, minimum 15 characters):

VIII. Strengths/Weaknesses Comment Field (required, minimum 15 characters):

IX. Suggestion for future growth Comment Field (required, minimum 15 characters):

X. Additional Comments :

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