Residency Program: _____________________________________________
Rating Scale: 1=Poor; 2=Fair; 3=Adequate; 4=Good; 5=Excellent
On the basis of your needs, rate this program’s:
FEATURE
Education
Program Philosophy
Accreditation
Overall Curriculum
Rotations/electives
Rounds (educational vs. work)
Conferences
# & variety of patients
RATING COMMENTS
Hospital Library
Resident evaluations
Board Certification of graduates
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Attending Physicians/Teaching Faculty
# of full-time vs. part-time ________ ____________________________________
Research vs. teaching responsibilities ________ ____________________________________
Clinical vs. teaching skills
Availability/approachability
Preceptors in clinic
Subspecialties represented
Instruction in patient counseling & education
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Hospital
Community or university hospital? ________ ____________________________________
Staff physicians’ support of program ________ ____________________________________
Availability of consultation services ________ ____________________________________
Other residency programs
Types of patients
________ ____________________________________
________ ____________________________________
Hospital staff (nursing, lab, path, etc) ________ ____________________________________

FEATURE
Number per year
Current House Officers
Medical school of origin
Personality
Dependability
Honesty
Cooperation/get along together
RATING COMMENTS
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Compatibility/Can I work with them? ________ ____________________________________
Work Load
Average #pts./HO (rotation, clinic) ________ ____________________________________
Supervision: senior HO, attending ________ ____________________________________
Call schedule ________ ____________________________________
Rounds ________ ____________________________________
Teaching/conference responsibility ________ ____________________________________
“Scut” work
Time for conferences
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Clinic responsibilities
Benefits
________ ____________________________________
Salary
Professional Dues
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________ ____________________________________
Meals ________ ____________________________________
Insurance (malpractice, health, etc.) ________ ____________________________________
Vacation
Maternity/sick leave
Outside conferences/books
Moonlighting permitted
Surrounding Community
Size and type (urban/suburban)
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Geographic location
Climate and weather
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________ ____________________________________
Child care and public schools ________ ____________________________________
Socioeconomic/religious diversity ________ ____________________________________
Entertainment/Recreation/Culture ________ ____________________________________
Cost of living (housing/food/utilities ________ ____________________________________
Housing availability & quality ________ ____________________________________
Economy (industry/growth/recession)________ ____________________________________

Program’s strengths:
Program’s Weaknesses:
Reprinted with the permission of Dr. Stokes and the Barberton Citizens Hospital Family Practice Program, Barberton, Ohio.