THE OMI OBSERVERSHIP - FINAL REPORT FORM
INSTRUCTIONS FOR PREPARING THIS REPORT
Each fellow is required to submit via email a final report to the local Observership Coordinator before leaving
Austria. This report should address the questions listed below.
PERSONAL DATA
Name (First Name / Last Name):
Address:
Phone:
Fax:
Email:
OBSERVERSHIP DATA
Dates of Observership:
Name of Physician – Mentor:
Hospital:
Department:
Topic of Study:
On a separate sheet of paper, please address the following questions fully and in the order in which they
appear below. In the interest of efficiency, please use the subheadings provided in organizing your report.
Activities Undertaken: Briefly summarize activities undertaken during your observership. What
problems did you encounter during the observership and how did they affect your original plans?
1.
Joint Efforts: Please describe any joint efforts or cooperation undertaken during the observership
with Austrian or other foreign physicians, or others.
2.
Recommendations: What suggestions or recommendations do you have to improve the operation or
administration of the OMI observership Program?
3.
Influence on Thinking: In what ways, if any, has your thinking been influenced by your experiences
during this observership? Please explain. Describe any new perspectives you have encountered as a
result of the observership. If none, please explain why you believe this to be so.
4.
Influence on Professional Goals: What services at your hospital do you think can be improved and
how do you plan to implement what you have learned during this observership?
5.
Internship Experience: How has this observership broadened your knowledge of Austrian medicine
and Austrian culture?
6.
Feedback Social Events: Give us a short Pro and Contra list on all Social Events and Workshops
you have attended. And if you suggest any improvement.
7.
Professional Development: Please describe your professional development after the participation in the
Salzburg Medical Seminars or a previously completed Observership (Did it boost your career? Can you
think of any medical improvements/achievements that happened since you first took part in a seminar?)
8.
Evaluate your Mentor or Department: Please give us a brief summery how the social interaction in
your Department and with your Mentor took place. In addition please grade your mentor from 1 (=
excellent) – 5 ( = not satisfied) and explain the grades given.
9.
As per 14.02.2014
THE OMI OBSERVERSHIP
CASE STUDY FORM
INSTRUCTIONS FOR PREPARING THIS REPORT
Each fellow is required to prepare a case study with their mentor before leaving Austria and submit it to
the local Observership Coordinator personally before leaving Austria. It must be signed by your
mentor!
PERSONAL DATA
Name (First Name / Last Name):
Address:
Phone:
Fax:
Email:
OBSERVERSHIP DATA
Dates of Observership:
Name of Physician – Mentor:
Hospital:
Department:
Topic of Study:
On a separate sheet of paper please prepare a case following the guidelines listed below. Please use
the subheadings provided in organizing your case study. If you are completing your Observership in a not
patient related specialty (e.g.: Public Health) you will not be able to answer question (1-6) in this case
please proceed to question 7.
1. Symptoms, case history, the patient’s and his/her family’s medical history. In order to protect the
patients privacy please do not disclose the name of the patient on the case report form.
2. Physical examination, laboratory data, and diagnostic procedures.
3. Clinical diagnosis, clinical course, and therapy.
4. Special tests and pathology.
5. Final diagnosis.
6. Materials submitted (slides, x-rays, images, graphs, etc.) Please also mention these in the text on the
above-listed topics.
7. If you are completing your Observership in a Public Health related Department please give us an
overview of your daily activities (1- 2 pages) and comment on the differences you discovered in
comparison with your home institution.
Comments from your physician-mentor.
Please hand in your Case Study personally to your Local Observership coordinator.
As per 14.02.2014