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FINAL SUMMATIVE EVALUATION
Dr. X
(Please note that this summative evaluation is an example for Dermatology
residency but that your summative evaluation should reflect what is appropriate for
your own GME program. Details are given here to give you a feeling for what a
summative evaluation might include).
The following synopsis of residency performance is based on resident evaluations
within the resident training file.
Dr. X entered the NCC Dermatology Residency on 1 July 2007 and successfully
completed residency on 30 June 2010 (Be sure to list day, month, and year).
Dr. X successfully passed all rotations in the first year of residency. Rotations in
the first year included: 10 months of Outpatient Dermatology Clinic and 2 months of
Patch Test Clinic, HIV Dermatology Clinic, and Laser and Cosmetic Surgery. All
rotations occurred at WRNMMC.
Dr. X successfully passed all rotations in the second year of residency.
Rotations in the second year of residency included: 7 months of Outpatient Dermatology
Clinic, 2 months of Inpatient Consults, Hair Clinic, Melanoma Clinic, and Complicated
Dermatology Clinic, 1 month of Dermatopathology at the Armed Forces Institute of
Pathology, 1 month of Mohs and Procedural Dermatology, and 1 month of elective time
working with both Dr. Y in private practice dermatology in Bethesda, MD. All rotations
occurred at WRNMMC except as noted above.
Dr. X successfully passed all rotations in the third year of residency. Rotations
in the third year of residency included: 2 months of Outpatient Dermatology Clinic, 2
months of Inpatient Consults and Phototherapy, 2 months of Mohs and Procedural
Dermatology, 2 months of Chief Resident Rotation and Pediatric Dermatology, 1 month
of Pediatric Dermatology with Dr. A at Johns Hopkins University, Baltimore, MD, 1
month of Dermatopathology at the Armed Forces Institute of Pathology, and 1 month of
elective time working at the NIH Dermatology Branch, and 1 month of elective time
working with Dr. B in a dermatopathology rotation at the University of Virginia,
Charlottesville, VA. All rotations occurred at WRNMMC except as noted above.
Dr. X fulfilled requirements for her third-year FOCUS PDCA QA project which
consisted of a project entitled: “Enhancement of the NNMC Dermatopathology Slide
Set.”
Dr. X’s in-training examination scores during the first, second, and third year of
residency were: 90nd, 70th, and 76th percentiles, respectively.
Dr. X won a national Women’s Dermatological Society scholarship to work with
Dr. G in a medical dermatology rotation at the University of Pennsylvania, Philadelphia,
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PA. Dr. X was a semifinalist at the Bailey K. Ashford Research Symposium for her
clinical research presentation entitled “XXX” for which she received an ARCOM.
Dr. X obtained competence in the six core competencies and her American Board
of Dermatology final year competency-based evaluation and list of 1 publication and 5
presentations are attached. During residency Dr. X worked on a military unique
manuscript on the treatment of skin and soft tissue injuries arising from OIF/OEF. Dr. X
performed 501 dermatological procedures during her residency and her detailed ACGME
Case Log is attached.
Dr. X has demonstrated sufficient competence to enter practice without direct
supervision.
For the purposes of future verifications of GME training performed by the NCC,
Dr. X is rated as follows at the time of graduation (please check one):
____ I recommend this practitioner without reservation
____ I recommend this practitioner with reservation (please explain)
____ I do not recommend this practitioner (please explain)
Program Director Signature
Program Director Name
National Capital Consortium
GME Program Name
Date Summative Evaluation
Prepared
2 Attachments
Revised 4 Jan 2013
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