2009 FMIG Survey

Medical School Information
Name of Medical School
Family Medicine Interest Group name
FMIG web site URL
Month that new student leaders are selected/elected
FMIG Primary Faculty Advisor-Physician
Name:
Title:
Mailing address:
City:
State:
Zip:
E-mail:
Number of years serving as advisor:
May we register your primary faculty advisorfor the FMIG Faculty Advisor Listserv hosted by the AAFP FMIG Network?
Yes (be sure to include e-mail address above)
No

FMIG Faculty Advisor or Support Staff - Non-Physician

Name:
Title:
Mailing address:
City:
State:
Zip:
E-mail Address
Number of years serving as advisor

May we register your your non-physican faculty advisor or support staff for the FMIG Faculty Advisor Listserv hosted by the AAFP FMIG Network?
Yes (be sure to include email address above)
No

FMIG Primary Student Leader Contact

Name:
Title:
Mailing address:
City:
State:
Zip:
E-mail:
Is the primary student leader contact an AAFP student member?
Yes
No

Class year of primary student leader

M1
M2
M3
M4

May we register your primary student leader for the FMIG Student Leader Listserv hosted by the AAFP FMIG Network?

Yes (be sure to include email address above)
No

FMIG Alternative Student Leader Contact

Name:
Title:
Mailing address:
City:
State:
Zip:
E-mail:
Class year of alternative student leader
M1
M2
M3
M4

May we register your alternative student leader for the FMIG Student Leader Listserv hosted by the AAFP FMIG Network?

Yes (be sure to include email address above)
No

AAFP Student Membership Coordinator

Name:
Title:
Mailing address:
City:
State:
Zip:
E-mail:

Class year of AAFP student membership coordinator
M1
M2
M3
M4

Is the student membership coordinator a member of the FMIG?

Yes
No

How many meetings did the FMIG host in the 08-09 academic year?

Number of meetings

How many meetings are planned for academic year 09-10?
Number of meetings
Does your FMIG track community service activities?
Yes
No

Approximately how many hours of community service did your FMIG do last year?

Number of hours

Check the types of programming your FMIG will provide in the 09-10 academic year.
Medical student career programming
Structured mentoring program
Medical student financial planning
Clinical skills workshop
Clinical education
Discussion on current trends in family medicine
Community service
Social activities
Residency fair

Did your FMIG address content related to the Patient-Centered Medical Home (PCMH), such as EHRs, communication, multidisciplinary teams and chronic disease management last year?

Yes
No
Unaware of the Patient-Centered Medical Home

Will the FMIG address one or more elements of the Patient-Centered Medical Home in 09-10?

Yes
No

How many FMIG meetings and events does the faculty advisor or faculty representative attend?

All FMIG meetings and events
Most FMIG meetings and events
Some FMIG meetings and events
Few FMIG meetings and events
No FMIG meetings and events

How many M4s are at your medical school?

Number of M4s
Number of M4s who matched into a family medicine residency
Number of M4s who matched into a family medicine residency who were members of the FMIG

Rate your interest group's level of student activity on campus.
Participation by 75% or more of M1 & M2 students
50% to 74% of M1 & M2 students participate
25% to 49% of M1 & M2 students participate
Less than 25% of M1 & M2 students participate
No student interest

Do you measure the success of the FMIG?

Yes, what measures do you track?
No

How many students typically attend FMIG events (not leadership meetings)?

1-5
6-10
11-15
16-25
More than 25

Identify three strengths of your FMIG:

1)
2)
3)

Identify one challenge for your FMIG that will be addressed this year.
-
With what FMIG/student interest issues does your FMIG need help?
-
Rate the value of the Virtual FMIG Web Site as a family medicine and FMIG resource.
Very valuable
Somewhat valuable
Neutral
Not very valuable
Not valuable at all
Not aware of Virtual FMIG Web site

Estimate how much your FMIG will spend this year?

<$1000
$1,001-$1,500
$1,501-$2,500
More than $2,500

What were the key sources of funding for the FMIG?

FM department
Dean's office
AAFP constituent chapter
Fundraising activities, i.e., t-shirt sales
Residency fair
Individual donations
FMIG funding initiative
Other

Estimate what proportion of M3 & M4 FMIG members that participate in two or more FMIG events during the year:

None
1-25%
26% to 50%
More than 50%

Compared to last year, is the number of FMIG members expressing a high level of interest in family medicine...

Increasing
About the same
Decreasing
Don't know

What percentage of students in your FMIG are members of the AAFP?

100%
75-99%
50-74%
25-49%
Less than 25%
Don't know

Do you know who your FMIG Network Regional Coordinator is?

Yes
No

Do you receive communications about the AAFP through him or her?

Yes
No
Don't know

Does your FMIG sponsor residency fairs?

Yes, what month(s):
No

How many different residency programs participated in a collaborative activity with your FMIG?

None
One
Two
Three
Four
Five
More than five

Have you noticed a change in the perception of the value of AAFP student membership since the American Family Physician journal was changed to online-only for student members?

Yes
No