Resident Interview Evaluation Form – Jan 2025

Evaluator's Name *

Candidate's Name *

Station Number: *

1. Suitability for Family Medicine: *

The candidate does not appear to have interest/commitment in Family Medicine
Some interest/commitment in Family Medicine is evident from the candidate’s answers
Total interest/commitment to Family Medicine is evident from the candidate’s answers

to Overall doing

2. Communication Skills: *

The candidate’s thoughts and ideas are frequently unclear, and/or they don’t answer questions completely.
The candidate demonstrates good verbal communication skills but has occasional difficulty expressing their thoughts. They address questions asked.
The candidate’s thoughts and ideas are clear and well communicated throughout the interview. Questions are well addressed.

3. Professionalism *

CONCERNS with the candidate’s character such as the ability to take responsibility for oneself, ability to be self-directed, or possess the level of maturity expected of a resident/physician. Or concerns that responses or examples provided are not authentic or genuine.
NO CONCERNS with the candidate’s character such as the ability to take responsibility for oneself, be self-directed, possess the level of maturity needed for residency and the profession. Responses and/or examples provided seemed authentic and genuine.
The responses and/or examples provided demonstrate that this candidate is HIGHLY PROFESSIONAL, takes responsibility for oneself, has the level of maturity expected of a resident/physician, and has integrity. Responses were authentic and genuine.

4. Overall Impression; Suitability (5-point scale) *

Candidate appears to be a POOR FIT and should not be ranked.
Candidate appears BELOW AVERAGE or answers were too vague to assess suitability.
Candidate appears SUITED for family medicine and will likely perform well.
Candidate appears to be a GREAT FIT. Will mutually benefit the program and the candidate.
EXTRAORDINARY CANDIDATE who will be exemplary in our program and a great addition to physician supply. We must take them!

5. Comments (Provide rationale for your scores above so candidate knows what to continue doing and/or areas they may wish to adapt to make their responses better): *