VA Puget Sound Health Care System

Radiation Oncology Medical Student

Elective Rotation Evaluation Form

_________________________ _____________________

Medical Student Evaluator Rotation Date (from/to)

Please rate the program in the following areas:

Unsatisfactory Satisfactory Superior N/A

1 2 3 4 5 6 7 8 9 N/A

Volume & variety of

radiation oncology cases 1 2 3 4 5 6 7 8 9 N/A

Quality/quantity of

conferences 1 2 3 4 5 6 7 8 9 N/A

Exposure to research 1 2 3 4 5 6 7 8 9 N/A

Administrative resources

& support 1 2 3 4 5 6 7 8 9 N/A

Faculty supervision,

accessibility for teaching &

consultation 1 2 3 4 5 6 7 8 9 N/A

Overall impression of the

VAPSHC rotation 1 2 3 4 5 6 7 8 9 N/A

Comments for Dr. Tony Quang:

Comments for Dr. Kent Wallner:

Overall Comments: