INTERNAL MEDICINE RESIDENCY PROGRAM FINAL SUMMATIVE EVALUATION INOVA FAIRFAX MEDICAL CAMPUS

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INTERNAL MEDICINE RESIDENCY PROGRAM FINAL SUMMATIVE EVALUATION INOVA FAIRFAX MEDICAL CAMPUS The Inova Internal Medicine Residency Program uses multiple, longitudinal evaluation tools on each Internal Medicine Resident to assess knowledge, skills, attitudes and other attributes for each of the ACGME competencies. The Clinical Competency Committee (CCC), working with the Program Director and using data from E-value, maps each resident on the 22 ACGME-approved Internal Medicine Milestones. We expect each graduating resident to be meeting ready for unsupervised practice or higher category in each of the sub-competencies prior to graduation. For any graduating resident who does not get to that level, the CCC may grant an occasional exception if they are otherwise following the trajectory and have successfully met that metric in all but one milestone. DATE: RESIDENT: DATES OF RESIDENCY: PGY-1: PGY-2: PGY-3: FACULTY ADVISOR: SCHOLARLY ACTIVITY: SCHOLARLY/RESEARCH MENTOR: QUALITY IMPROVEMENT PROJECT: CAREER PLANS:

Attached is the competency-based summary performance evaluation for Dr.. He/she has achieved scores in each of the six ACGME Competency areas of competent to proficient, and has successfully passed all rotations. This includes review and confirmation of continuity clinic attendance and procedure log in PxDx. The resident has also achieved procedural competency in areas required by the American Board of Internal Medicine. I verify that Dr. has demonstrated sufficient competence to enter practice without direct supervision. 1 = Outstanding 2 = Very Good 3 = Satisfactory 4 = Marginal 5 = Poor Medical Knowledge Demonstrates ability to critically assess new knowledge and scientific information. Practices analytic thinking in the application of knowledge and scientific information in the clinical environment. Utilizes technology to obtain and manage information. Overall fund of knowledge and the application of this knowledge to patient care. Patient Care Exhibits compassion and genuine concern for patients. Demonstrates sound clinical judgment. Is able to obtain and interpret data to solve problems of increasing complexity; and able to develop and execute efficient, effective care plans. Overall patient care is compassionate, appropriate and effective.

Practice-Based Learning and Improvement Investigates and evaluates his/her own patient care. Displays commitment to lifelong learning. Accepts constructive criticism and makes effort to improve practice outcomes. Involved in investigation and evaluation of patient care. Updated 06 2015 Interpersonal and Communication Skills Demonstrates ability to counsel and educate patients and families. Has good and effective listening skills and elicits information. Maintains accurate, clear and up to date medical documentation. Demonstrates leadership skills and worked effectively as a team member in patient management. Professionalism Maintains high standards of ethical behavior. Demonstrates commitment to continuity of care. Is reliable and punctual. Exhibits sensitivity to age, gender, culture and disabilities of patients of patients and other health care professionals. Has effective and organized work habits. Overall is a model of professionalism at all times. System-Based Practice Is aware and responsive to the larger context and system of health care. Effective calls on system resources to provide care. Aware and understands roles of different specialists in overall patient management. Overall demonstrated awareness and effectively called on system resources that provide patient care.

Overall Evaluation Overall competence as physician: Comments: Signed by Alita Mishra, MD Program Director Internal Medicine Residency Program Date Please see the attached Internal Medicine Milestones and resident s final level achieved. A copy of this final evaluation has been given or sent to the resident at the following address: Street City, State Zip Code