INTERNAL MEDICINE Savannah CLERKSHIP MANUAL

Student Name:
Internal Medicine 3 rd Year Clerkship
MID-TERM STUDENT EVALUATION
Class of 2016
Clerkship Rotation: Internal Medicine
Clerkship Dates: Beginning: Ending: Midterm Date: __ ___
Bonus Points: H&P’s: ____ Patient Encounters: ____ Absences: ___
Journaling Entries:
A. Overall assessment of student’s performance:
________________________________________________________________
________________________________________________________________
B. Narrative describing student’s performance:
a. Knowledge:
b. Skills:
c. Attitude:
d. Professionalism:
C. CLERKSHIP DIRECTOR’S COMMENTS:
________________________________________________________________
________________________________________________________________
STUDENT’S COMMENTS:
________________________________________________________________
________________________________________________________________
(Use other side if needed)
Clerkship Director: _______________ Student:
(J. David Baxter, MD) Signature Signature
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