TPI Interview Evaluation Form

Candidate Name*

First NameLast Name

Interviewers Name

First NameLast Name

Position

Date*

MonthDayYear

Please indicate which of the following are true for you (check all that apply):

Read candidate's CVMet or interviewed candidateAttended lunch or dinner with candidateAttended candidate's grand grounds/talk/presentationRead candidate's scholarship or publicationsOther

Residency/Fellowship Training

Fund of Clinical Knowledge

Interpersonal Skills

Ability to Communicate Effectively

Ability to be a Team Player

Leadership Skills

Attitude About Patient Satisfaction

Preparedness for the Interview

Please indicate your observation of the candidate's overall interest in the position:

Very interestedInterestedNot interestedUnable to judge

Do you recommend to pursue further?

YesNo

Additional Comments:

NAME OF POSITION

Please click the "Submit" button below to send your evaluation to the Department of Physician/Faculty Recruitment & Retention.