American Head & Neck Society

Advancing Education, Research, and Quality of Care for the Head and Neck oncology patient.

American Head & Neck Society | AHNS

The mission of the AHNS is to advance Education, Research, and Quality of Care for the head and neck oncology patient.

AHNS Fellowship – Faculty Evaluation Form

This form is to be completed by the graduating fellow as a prerequisite to receiving your Certificate of Completion.

These responses are in the interest of improving the fellowship and will be kept strictly confidential.

Six evaluation forms are presented below – if you wish to evaluate more than six faculty, please contact the AHNS administrative office for an additional form. You do not need to complete all 6 forms.

ATC - Fellowship Faculty Evaluation

  • 1 = outstanding2 = Good3 = Fair4 = Poor
    Directly worked with during fellowship
    Knowledge of surgical oncology
    Knowledge of head & neck oncology
    Discusses pre-op evaluation & indications for surgery in clinic
    Challenges me to create management plans
    Quality of informal teaching
    Availability for informal consultation
    Stimulates enthusiasm for learning
    Stimulates clinical research projects
    Stimulates basic science research projects
    Faculty member's surgical technique
    Faculty member's intra-operative decision making
    Faculty member allows independent operative teaching
    Faculty member's case load is adequate for teaching
    Faculty member's concern for my educational/future plans
    Faculty member gives constructive feedback
    Faculty member as a role model for fellows
    Faculty member's interpersonal skills with fellows
    Faculty member gives respect
    Overall Assessment
  • 1 = outstanding2 = Good3 = Fair4 = Poor
    Directly worked with during fellowship
    Knowledge of surgical oncology
    Knowledge of head & neck oncology
    Discusses pre-op evaluation & indications for surgery in clinic
    Challenges me to create management plans
    Quality of informal teaching
    Availability for informal consultation
    Stimulates enthusiasm for learning
    Stimulates clinical research projects
    Stimulates basic science research projects
    Faculty member's surgical technique
    Faculty member's intra-operative decision making
    Faculty member allows independent operative teaching
    Faculty member's case load is adequate for teaching
    Faculty member's concern for my educational/future plans
    Faculty member gives constructive feedback
    Faculty member as a role model for fellows
    Faculty member's interpersonal skills with fellows
    Faculty member gives respect
    Overall Assessment
  • 1 = outstanding2 = Good3 = Fair4 = Poor
    Directly worked with during fellowship
    Knowledge of surgical oncology
    Knowledge of head & neck oncology
    Discusses pre-op evaluation & indications for surgery in clinic
    Challenges me to create management plans
    Quality of informal teaching
    Availability for informal consultation
    Stimulates enthusiasm for learning
    Stimulates clinical research projects
    Stimulates basic science research projects
    Faculty member's surgical technique
    Faculty member's intra-operative decision making
    Faculty member allows independent operative teaching
    Faculty member's case load is adequate for teaching
    Faculty member's concern for my educational/future plans
    Faculty member gives constructive feedback
    Faculty member as a role model for fellows
    Faculty member's interpersonal skills with fellows
    Faculty member gives respect
    Overall Assessment
  • 1 = outstanding2 = Good3 = Fair4 = Poor
    Directly worked with during fellowship
    Knowledge of surgical oncology
    Knowledge of head & neck oncology
    Discusses pre-op evaluation & indications for surgery in clinic
    Challenges me to create management plans
    Quality of informal teaching
    Availability for informal consultation
    Stimulates enthusiasm for learning
    Stimulates clinical research projects
    Stimulates basic science research projects
    Faculty member's surgical technique
    Faculty member's intra-operative decision making
    Faculty member allows independent operative teaching
    Faculty member's case load is adequate for teaching
    Faculty member's concern for my educational/future plans
    Faculty member gives constructive feedback
    Faculty member as a role model for fellows
    Faculty member's interpersonal skills with fellows
    Faculty member gives respect
    Overall Assessment
  • 1 = outstanding2 = Good3 = Fair4 = Poor
    Directly worked with during fellowship
    Knowledge of surgical oncology
    Knowledge of head & neck oncology
    Discusses pre-op evaluation & indications for surgery in clinic
    Challenges me to create management plans
    Quality of informal teaching
    Availability for informal consultation
    Stimulates enthusiasm for learning
    Stimulates clinical research projects
    Stimulates basic science research projects
    Faculty member's surgical technique
    Faculty member's intra-operative decision making
    Faculty member allows independent operative teaching
    Faculty member's case load is adequate for teaching
    Faculty member's concern for my educational/future plans
    Faculty member gives constructive feedback
    Faculty member as a role model for fellows
    Faculty member's interpersonal skills with fellows
    Faculty member gives respect
    Overall Assessment
  • 1 = outstanding2 = Good3 = Fair4 = Poor
    Directly worked with during fellowship
    Knowledge of surgical oncology
    Knowledge of head & neck oncology
    Discusses pre-op evaluation & indications for surgery in clinic
    Challenges me to create management plans
    Quality of informal teaching
    Availability for informal consultation
    Stimulates enthusiasm for learning
    Stimulates clinical research projects
    Stimulates basic science research projects
    Faculty member's surgical technique
    Faculty member's intra-operative decision making
    Faculty member allows independent operative teaching
    Faculty member's case load is adequate for teaching
    Faculty member's concern for my educational/future plans
    Faculty member gives constructive feedback
    Faculty member as a role model for fellows
    Faculty member's interpersonal skills with fellows
    Faculty member gives respect
    Overall Assessment

Contact Us

AHNS, 11300 W. Olympic Blvd, Suite 600
Los Angeles, CA 90064
ph: (310) 437-0559 / fx: (310) 437-0585
admin@ahns.info

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