Internship Assessment Form
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852 Medical Internship Policies and Procedures Manual
APPENDIX 1
MINISTRY OF HEALTH
INTERNSHIP ASSESSMENT FORM
(To be completed in duplicate)
NAME OF INTERN: ………………………………………………………………………
PERIOD UNDER REVIEW: ………………………………………………………………
HOSPITAL: ……………………………………………………………………………….
SPECIALTY: ……………………………………………………………………………...
NAME OF CONSULTANT: ………………………………………………………………
QUALITY OF JOB PERFORMANCE
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Consistently accurate based on sound medical principles
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Usually efficient
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Consistently produces high quality of work
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Occasionally produces high quality of work
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Work requires constant checking. (Requires supervision)
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