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Medical Student Evaluation Form


A medical student evaluation form is required to be filled by medical students who are applying to medical universities for medical studies or further specialization studies. This type of form contains clinical evaluation information and knowledge of the student in different areas of medicine and health care.

You can Download the Free Medical Student Evaluation Form, customize it according to your needs and Print. Medical Student Evaluation Form is either in MS Word, Excel or in PDF.

Sample Medical Student Evaluation Form

Medical Student Evaluation Form

Download Medical Student Evaluation Form

Medical Student Evaluation Form
Name of the Student Date of Birth
Address Phone
Name of the Evaluator Date of Evaluation
Evaluation
  1. A.  Application of Knowledge of Basic Science to Clinical Studies
    1. Poor knowledge and limited ability in applying knowledge clinically
    2. Limited knowledge and has the potential for improvement
    3. Solid knowledge and is able to apply to clinical problems
    4. Outstanding knowledge, and advanced skills in application to complex problems
  2. B.  Observed in the Medical Student
    1. Disorganized and lacks focus
    2. Organized but important areas and points are often missed
    3. Organized and recognizes important points
    4. Excellent skills and applies focused history
  3. C.  Physical Examination Skills of the Medical Student
    1. Misses out on critical parts of the exam (deficient exam skills)
    2. Normally complete but misses out important and abnormal findings
    3. Complete and is able to recognize abnormal findings
    4. Thorough and accurate
  4. D.  Presentation Skills (Taken during rounds)
    1. Disorganized and incomplete Listeners at the end are uncertain of primary clinical problems. Assistance is required
    2. Generally complete. Fails to highlight abnormal findings. Assistance is required
    3. Organized and logical. Highlights abnormal findings. Some assistance is required
    4. Consistently organized and complete. No assistance is required.
  5. E.   Interaction with Patients
    1. Insensitive to patient needs. No regard for their feelings or values
    2. Uncomfortable during patient interactions.
    3. Interaction is positive with patients and their families.
    4. Extremely compassionate. Extraordinary and highly personal interaction
Comments: (Please specify how the grade for this student was determined and list all test scores)

 

 

 
Suggestions for improvement:

 

 

 
 

 

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Signature of Evaluator                                                                           Date

Category: Medical Forms

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