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Name______Program______
1. Which of the options best describes your internal medicine residency program hospital? (Circle one)
a. University hospital
b. Community teaching hospital
c. Veterans Administration hospital
d. Military hospital
e. Municipal hospital
f. Multi-Specialty clinic hospital
2. For the 2006-2007 academic year, which ended in June 2007, what percentage of all three years of trainees was from medical schools outside the US (i.e. International Medical Graduates)? ______%
3. What is the number of full-time salaried teaching faculty in your Department of Medicine? ______
4. What is the total number of residents [categorical + preliminaries + other (e.g. Med/Peds or other, if considered part of your training program)] in all three years of training at your program? ______
5. Do you, on a regular basis, look at Hopkins ambulatory module group performance scores?
Y N
a. If yes, have youmade any change in your training programspecifically in response to these scores?
Y N
6. Do you look at Hopkins module utilization by your residents?
Y N
a. If yes, have you made anyeffort to improve utilization by residents?
Y N
7. For the 2006-2007 academic year, which ended in June 2007, what was the raw total test score and total test percentile rank on the In-service Training Exam (ITE):
a. For PGY-2 residents? Raw____ Percentile____
b. For PGY-3 residents? Raw____ Percentile____
8. What was the percentage of residents that graduated from your program in the past three years took the ABIM certifying examination and passed it on their first try?
______%
9. When your residency program was most recently certified by the RRC-IM, how many years was that certification valid until the next certification visit? ______years
10. What percentage of your residency program director's work week is spent in clinical activities? Count each half-day (M-F) as 10% of the work week.
______%
a. If your residency program directoronly has annual clinical duties, or has additional annual clinical duties, how many weeks/year are spent in these clinical activities (e.g. ward attending, teaching attending, ICU attending, consult attending)?
______weeks/year
11. Do pharmaceutical companies provide any funds used to support resident education, including provision of food during educational activities? Y N
12. Does your program have a primary care track? Y N
13. Do the majority of your graduates enter a subspecialty fellowship? Y N