Residency Manual

APPENDIX B:

RESIDENCY INTERVIEW EVALUATION FORM (Sample)

Candidate Name: Interviewer:

Date:

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A. RECORD REVIEW 1. Are there any missing document?

2. Your evaluation of letters of recommendation: _______________________________________ 3. Comment on particular aspects of the record, either positive or negative: B. COMMUNICATION 1. Uses language in a fashion considered unsuitable for a professional (poor grammar, poor diction, sloppy speech, over colloquial).

2. Satisfactory command of the language. Established interpersonal contact. 3. Especially articulate, particularly responsive to specific questions and answers. C. REASONS FOR CHOOSING RESIDENCY

1. Cannot adequately explain how the career decision was reached. 2. Can adequately support the decision to apply with specific examples. 3. An unusually complete understanding of the residency and is enthusiastic about his/her role. D. BEHAVIORAL CHARACTERISTICS 1. Appears dour, overly serious, unresponsive, insecure. 2. Generally pleasant, friendly, at ease, conveys integrity, good rapport with interviewers. E. SCOPE OF INTEREST 1. Very narrowly concentrated, unable to discuss a range of topics. 2. Expresses knowledge of a variety of topics, has had varied experiences. 3. Displays both breadth and depth in a variety of topics. F. OTHER ASPECTS. Please feel free to comment upon anything with impressed you either positively or negatively about the candidate.

Please indicate a score of 1, 2, or 3 for the following categories:

Record Review

1 = Poor

Interview Overall

2 = Good ____ 3 = Excellent____

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