University of Manitoba Family Medicine Residency
_______________________________________________________________________________________________
We know that residents who start in our program bring unique sets of experience and varying levels of knowledge and skill. It helps both teachers and learners to clearly define the baseline, or starting points, of our residents.
This tool is designed to guide the initial assessment of new residents. It will provide some baseline information about a new resident regarding their skills, knowledge and attitudes. The tool is meant to be used in a one-on-one meeting with the primary preceptor scheduled at the start of the academic year. The information will be used as a starting point for developing an individualized learning plan with the resident.
Prior to the meeting, the resident will:
Prior to the new resident intake meeting, the resident will complete Part 1 of the guide, in order to present to their primary preceptor an opinion/self-assessment on their areas of strengths and areas for improvement.
At the meeting:
In addition to reviewing information prepared by the resident (Part 1), the primary preceptor should ask additional questions to develop a richer understanding of needs, experiences and goals of the resident.
The goal of the discussion is to reach consensus regarding areas of strength, areas for improvement/development and to establish an educational plan for the initial segment of the resident’s program, which will be documented in Part 2.
After the meeting:
Following the meeting, the primary preceptor will report at the Site Resident Progress Committee (SRPC) meeting.

University of Manitoba Family Medicine Residency
_______________________________________________________________________________________
Resident Name: Site:
Describe your ideal future practice.
Identify if you have had experience in the following Clinical Domains. Describe strengths and development needs you have in each of the domains:
I have had experience

Maternal Care
Obstetrics
Maternity care in Family
Medicine
Children/Adolescents
Neonatology
Pediatric Emergency
Pediatrics Inpatient
Pediatrics Outpatient
Care of Adults
Emergency Medicine
Hospital Medicine
ICU/CCU
Surgery
Care of the Elderly
Geriatrics
Personal Care Home
Palliative Care
Palliative Care

Care of First Nations, Inuit and Métis peoples
Aboriginal Health
Care of Vulnerable &
Underserved Populations
Addictions
Disabled patients
Immigrants/Global Health
Rural/Remote
Behavioural Medicine
Inpatient sychiatry
Outpatient psychiatry
Continuity: Describe previous opportunities you may have had in ensuring continuity of patient care.
Core Topics: Consider the CFPC’s core 99 topics. Identify specific gaps in your exposure.
Core Procedures: Consider the core procedures list. Identify specific gaps.

Entrustable professional activities: Rate your confidence in performing:
1. Provide periodic health exams and preventative health care to adults.
2.
3.
4.
Assess, manage, and follow-up patients presenting with undifferentiated symptoms.
Assess, manage and follow-up adults presenting with common (key) conditions.
Diagnose and manage common chronic conditions and multiple co-morbidities.
5.
6.
7.
8.
Identify, diagnose, evaluate and manage patients with common mental health issues
Perform common family medicine procedures.
Manage the elderly patient with multiple co-morbidities.
Recognize and provide initial management of common adult emergencies.
9. Determine when an adult patient requires admission and inpatient hospital care.
10.
Assess and appropriately manage the adult patient in hospital
11. Recognize and provide initial management of the medically unstable adult patient in the hospital setting.
12.
Plan and coordinate discharge of adult patients from hospital.
13.
Provide palliative end-of-life care
14.
Provide pre-conception and pre-natal care
15. Provide intra-partum care and perform low-risk deliveries
16.
Recognize and manage common intra-partum emergencies
17.
Provide postpartum care
18.
Provide family medicine-centered care to newborns in their first weeks of life.
19.
Provide periodic health exams and preventative care to infants, children and adolescents.
20.
Assess, manage and follow-up infants, children and adolescents presenting with common (key) conditions.
21. Recognize and provide initial management of common pediatric emergencies
22.
Determine when a child or adolescent requires admission and inpatient hospital care
23.
Assess and appropriately manage the child or adolescent patient in hospital.
24.
Recognize and provide initial management of the medically unstable pediatric patient in the hospital setting.
25.
Plan and coordinate discharge of the child or adolescent from hospital
26.
Provide expert advice and obtain consultation for patients
27.
Facilitate family and interdisciplinary meetings
28.
Optimize the quality and safety of health care through utilization of best practices and application of QI
29.
Provide care to vulnerable and underserved populations.
30.
Provide care to First Nation, Inuit and Métis people.

How do you learn best?
How are you best motivated to learn? What stifles your learning?
What approach to delivering feedback is most effective to you?
Do you have a family physician?
Do you have any wellness concerns?
What challenges, if any, do you anticipate for you in the residency program?
Yes No
Yes No

SUMMARY OF OVERALL AREAS OF STRENGTH
SUMMARY OF AREAS FOR DEVELOPMENT/IMPROVEMENT
EDUCATION PLAN
Set goals for next 6 months. What knowledge and skills to does the resident need to acquire in order to achieve residency objectives and practice goals?
Resident
Primary Preceptor
Date
Date