Medical Student Education

Family Medicine Interest Group
Files and Forms

Residency Training Program

Faculty Development

Patient Care

Research & Scholarship

Department Information

News

About the Department

Research & Scholarship

Site Map

Quick Links

Files and Forms

	Microsoft Word (.doc)	Adobe Acrobat (.pdf)

Clerkship Course Syllabus	yes	yes

Community Medicine Experiences Report Form I	yes	yes

Group Facilitator’s Assessment of Student	yes	yes

Final Clerkship Feedback and Preceptor Evaluation	yes	yes

FMIS Attending Physician Assessment of Student	yes	yes

FMIS Senior Resident (ACR) Assessment of Student	yes	yes

Information Request	yes	yes

Patient Safety Project	yes	yes

Do you think your preceptor should get the award for “Family Medicine Preceptor of the Year”?	yes	yes

Preceptor's Final Clerkship Evaluation of Student	yes	yes

Preceptor's Mid-Clerkship Evaluation of Student	yes	yes

Do you think a resident you worked with should get the award for “Family Medicine Resident Teacher of the Year”?	yes	yes

Student Evaluation of Small Group Facilitator	yes	yes

Clerkship Course Syllabus 2003-2004	yes	yes

Do you think a lecturer or Small Group Facilitator you worked with should get the award for “Family Medicine Teacher of the Year”?	yes	yes

Time Off Request Form	yes	yes

For more information on Medical Student Education at UB Family Medicine contact Pam Maconaghy
All information © 2005, UB Department of Family Medicine unless otherwise noted.