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Sample Checklists
| Program: | Date: |
| Overall Rating | |
| (Rating 1 to 5) | |
| 1. Area | 7. Curriculum |
| _____Housing | _____Well Planned |
| _____Schools | _____Accredited Program |
| _____Recreation | _____Variety of Electives |
| _____Climate | _____Conferences |
| _____Distance from Family | |
| _____Practice Opportunities | 8. Evaluation/Advancement |
| _____Cognitive | |
| 2. Facilities | _____Psychomotor |
| _____Modern | _____Feedback |
| _____Well Managed | _____Pyramid |
| _____Efficient | |
| _____Good Staff | 9. Patients |
| _____Adequate Numbers | |
| 3. Faculty | _____All Socioeconomic Levels |
| _____Experienced Clinicians | _____Resident Responsibilities/Call |
| _____Educators | _____Back-Up |
| _____Humanistic | |
| 10. Gut Feelings | |
| 4. Residents | |
| _____Full Complement | All Categories |
| _____Good Attitude | Comments |
| _____Graduates Board Certified | (A) Positive |
| _______________________________ | |
| 5. Benefits | _______________________________ |
| _____Salary | _______________________________ |
| _____Health Insurance | _______________________________ |
| _____Malpractice | _______________________________ |
| _____CME | (B) Negative |
| _____Moonlighting | _______________________________ |
| _______________________________ | |
| 6. Library | _______________________________ |
| _____Accessible | _______________________________ |
| _____Full-time Librarian | _______________________________ |
| _____Adequate Volumes |

