Your first name: Last name: Application ID:

EVIDENCE SUMMARY FORM required forApplication & Evidence Station

You are required to bring any evidence you have quoted on the application form to the assessment centre.The evidence you are required to bring is in two sections.

Firstly you are required to show proof of your eligibility (eg proof of name, address, medical qualification etc). Please follow the deanery instructions regarding the evidence (and number of copies) you are required to bring to the assessment centre. This information will be checked at the ‘document checking’ desk in the assessment centre.

Secondly, you are required to provide evidence for all the achievements you have quoted on your application form. The interviewers will wish to see all the evidence you have quoted on your application form.In order to make the evidence easier to find, and to be fair to all applicants we are asking you NOT to bring your personal training portfolio. Instead, you must bring to the interview an ‘Evidence Folder’ which shows all the evidence you have quoted on your application form, in the order in which it is quoted.You may provide additional evidence if it is relevant to your application, as long as it is listed below and filed clearly. Please try to use any original documents, but copies may be acceptable. It is not necessary to bring duplicate copies for your Evidence Folder.

Evidence folders and personal training portfolios which do not follow the structure as defined may not be looked at.

You should use this check list as the first page in your evidence folder, so the interviewers can see, at a glance, what you have brought and find it easily. You should use dividers, or other markers, to identify the relevant sections.You may bring other evidence of satisfactory training and assessments, but anything you bring must be listed below, and filed in your evidence folder in the order listed below.

You must take the evidence folder into the relevant interview station. It will be returned to you after the interview – please do not leave the assessment centre without it, as it might not be possible to post it back to you.

Description of evidence / Tick if evidence is quoted on your application form / Tick if appears in folder / Page in folder / Confirmed by interview panel & comments
(For interviewers’ use only)
Copy of your application form / n/a
Additional undergraduate degrees and qualifications
Postgraduate degrees and qualifications
Additional achievements e.g. prizes, honours etc
Training courses attended
Achievements outside medicine
Presentations
Publications
Teaching experience
Clinical audit
Commitment to specialty
Other evidence – please list below:
Evidence confirmed by interviewer [name & signature] date:

This form to be retained by interviewing panel

FORM – Evidence Summary for Interviewv1.0 RCP-SRO February 2011