University of New MexicoMD/PhD Fall 2015 Applicant Evaluation
Applicant: By entering your name below, you agree to the following statement:
I agree to waive my right of access to the letter of recommendationand evaluation. I understand that the letters of recommendation and the evaluations will remain confidential.
If you wish to retain your rights to access the letter of recommendation and evaluation, please contact Mary Fenton at for further instruction and do not forward this form to your referees.
Applicant: Please enter your name. (Required)
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Three letters of recommendation are required. Please forward this form to each of the individuals who will be providing a recommendation.
1. To the Referee: Welcome to the UNM MD/PhD Applicant Evaluation
PRIVACY
In accordance with the Family Educational Rights and Privacy Act of 1974 (FERPA), the applicant has agreed to waive his/her rights to access the information provided by his/her referees, and understands that the information provided will remain confidential.
DEADLINE
The applicant who has requested this evaluation and letter of recommendation is trying to meet a November 15 deadline.
QUESTIONS OR CONCERNS
If you have any questions or concerns about the Letter of Recommendation or the applicant evaluation, please email Mary Fenton, MD/PhD Admissions Coordinator, .
We sincerely appreciate your time and consideration in providing areference for this applicant.
2. Contact Information
Please provide your contact information, using your official institutional email and url. Personal web sites will not be sufficient credentials.
We understand that some international faculty members prefer to use a publicly available email provider instead of the institution's email provider. If this is the case, we must be able to verify the email address through the institution's official web site.
1. Please provide your professional contact information. (Required)
Name: Click here to enter text.
Title/Position: Click here to enter text.
Institution/Company: Click here to enter text.
Address: Click here to enter text.
City: Click here to enter text.
State/Province: Click here to enter text.
ZIP/Postal Code: Click here to enter text.
Email Address: Click here to enter text.
Phone: Click here to enter text.
3. The Nature of Your Relationship with the Applicant
1. How long have you known the applicant? Please indicate the time period (dates) during which you were acquainted with the applicant. (Required)
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2. What is the nature of your relationship with the applicant (i.e., research mentor, professor, supervisor, etc.)? (Required)
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4. Evaluation of Skills
The evaluation questionnaire portion of this survey is heavily weighed during the Admission Committee's consideration of the applicant.
Please rate the applicant's skills in the following areas.
1. Research Skills
Please rate the applicant's laboratory and research skills, relative to others at his or her level of experience. (Required)
Technical skills/laboratory technique / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
Curiosity / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
Originality and creativity / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
Indication of individual research potential / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
Ability to conduct independent research / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
Performance on a special project he/she has worked on with you / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
Potential for performing biomedical research / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
2. Academic Ability
Please rate the applicant's academic ability. (Required)
Intellectual ability / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
Critical thinking ability / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
Work/study ethic / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
General knowledge / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
Knowledge in his/her chosen field / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
Quality of publications, abstracts, or other research presentations / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
Ability to assimilate information from a variety of disciplines / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
3. Medical and Graduate School Preparedness
Please evaluate the applicant's preparedness for graduate school. (Required)
Excellent / Very Good / Above Average / Average / Below Average / Inadequate opportunity to observePotential to succeed in medical/graduate school / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
Motivation to pursue a combined MD/PhD degree / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
Mastery of required background information for medical/graduate school / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
Maturity / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
Emotional stability / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
Desire and ability to synthesize new interdisciplinary ideas and concepts / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
Clarity of goals for medical/graduate school / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
4. Personal and Interpersonal Skills
Please evaluate the applicant's personal and interpersonal skills.
Ability to express himself/herself in oral discussion/presentation / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
Ability to express himself/herself in writing / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
Effective communication with others / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
Independence/self-reliance / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
Ability to work effectively in a group / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
Reliability / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
5. Comparison
How would you rate this applicant in comparison to other individuals of the same level at your institution?
If you were the applicant’s mentor while he/she was an undergraduate student or intern in your laboratory, please rate the applicant in comparison to other undergraduate students or interns you have hosted in your lab.
1. Please rate the applicant against others at the same level. (Required)
Top 1% / Top 5% / Top 10% / Top 20% / Top 30% / Top 40% / Top 50% / Bottom 50%Choose: / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
6. Narrative Evaluation(Letter of Recommendation)
Please provide a narrative of any additional information you feel would be helpful for the Admissions Committee to know as they evaluate this candidate's application. (Required)
You may attach the letter to this evaluation and submit both via postal mail, fax, or email. When sending via post, sign your name diagonally across the seal of the envelope.
Postal mail:MD/PhD Program
Attn: Mary Fenton
MSC08 4560
1 University of New Mexico
Albuquerque, NM 87131 / Or,fax to: 505-272-2412 / Or,email as an attachment to: