Summary Reports Program InformationFor any questions, please contact grantsupport@surgicalfellowships.orgFCID# or ACGME ID#*HiddenFCID# or ACGME ID#* Program Director* Institution Name* Program Type*BariatricBariatric/MISColorectalHPBMIS General SurgeryThoracicSummary of Fellow ProgressHow many Fellows will you provide Summary Reports for?Summary Reports are required for Fellow(s) who received FSF grant funding for the 2021-2022 cycle. 1 2 3 4 Please evaluate your Fellows based on the Performance Rating Scale criteria below: 1 star - Unsatisfactory 2 stars - Improvement Needed 3 stars - Meets Expectations 4 stars - Exceeds Expectations 5 stars - ExceptionalFellow #1Fellow Name #1* First Last Fellowship Start Date* MM slash DD slash YYYY Fellowship End Date* MM slash DD slash YYYY Medical Knowledge*ExceptionalExceeds ExpectationsMeets ExpectationsImprovement NeededUnsatisfactoryPatient Care-Clinical Judgement*ExceptionalExceeds ExpectationsMeets ExpectationsImprovement NeededUnsatisfactoryPatient Care-Technical Skills*ExceptionalExceeds ExpectationsMeets ExpectationsImprovement NeededUnsatisfactoryInterpersonal and Communication Skills*ExceptionalExceeds ExpectationsMeets ExpectationsImprovement NeededUnsatisfactoryPractice Based Learning and Improvement*ExceptionalExceeds ExpectationsMeets ExpectationsImprovement NeededUnsatisfactorySystem Based Practice*ExceptionalExceeds ExpectationsMeets ExpectationsImprovement NeededUnsatisfactoryProfessionalism*ExceptionalExceeds ExpectationsMeets ExpectationsImprovement NeededUnsatisfactoryOverall Evaluation of Fellow*ExceptionalExceeds ExpectationsMeets ExpectationsImprovement NeededUnsatisfactoryComments*Please elaborate on Fellow's performance in this section.Fellow #2Fellow Name #2* First Last Fellowship Start Date* MM slash DD slash YYYY Fellowship End Date* MM slash DD slash YYYY Medical Knowledge*ExceptionalExceeds ExpectationsMeets ExpectationsImprovement NeededUnsatisfactoryPatient Care-Clinical Judgement*ExceptionalExceeds ExpectationsMeets ExpectationsImprovement NeededUnsatisfactoryPatient Care-Technical Skills*ExceptionalExceeds ExpectationsMeets ExpectationsImprovement NeededUnsatisfactoryInterpersonal and Communication Skills*ExceptionalExceeds ExpectationsMeets ExpectationsImprovement NeededUnsatisfactoryPractice Based Learning and Improvement*ExceptionalExceeds ExpectationsMeets ExpectationsImprovement NeededUnsatisfactorySystem Based Practice*ExceptionalExceeds ExpectationsMeets ExpectationsImprovement NeededUnsatisfactoryProfessionalism*ExceptionalExceeds ExpectationsMeets ExpectationsImprovement NeededUnsatisfactoryOverall Evaluation of Fellow*ExceptionalExceeds ExpectationsMeets ExpectationsImprovement NeededUnsatisfactoryComments*Please elaborate on Fellow's performance in this section.Fellow #3Fellow Name #3* First Last Fellowship Start Date* MM slash DD slash YYYY Fellowship End Date* MM slash DD slash YYYY Medical Knowledge*ExceptionalExceeds ExpectationsMeets ExpectationsImprovement NeededUnsatisfactoryPatient Care-Clinical Judgement*ExceptionalExceeds ExpectationsMeets ExpectationsImprovement NeededUnsatisfactoryPatient Care-Technical Skills*ExceptionalExceeds ExpectationsMeets ExpectationsImprovement NeededUnsatisfactoryInterpersonal and Communication Skills*ExceptionalExceeds ExpectationsMeets ExpectationsImprovement NeededUnsatisfactoryPractice Based Learning and Improvement*ExceptionalExceeds ExpectationsMeets ExpectationsImprovement NeededUnsatisfactorySystem Based Practice*ExceptionalExceeds ExpectationsMeets ExpectationsImprovement NeededUnsatisfactoryProfessionalism*ExceptionalExceeds ExpectationsMeets ExpectationsImprovement NeededUnsatisfactoryOverall Evaluation of Fellow*ExceptionalExceeds ExpectationsMeets ExpectationsImprovement NeededUnsatisfactoryComments*Please elaborate on Fellow's performance in this section.Fellow #4Fellow Name #4* First Last Fellowship Start Date* MM slash DD slash YYYY Fellowship End Date* MM slash DD slash YYYY Medical Knowledge*ExceptionalExceeds ExpectationsMeets ExpectationsImprovement NeededUnsatisfactoryPatient Care-Clinical Judgement*ExceptionalExceeds ExpectationsMeets ExpectationsImprovement NeededUnsatisfactoryPatient Care-Technical Skills*ExceptionalExceeds ExpectationsMeets ExpectationsImprovement NeededUnsatisfactoryInterpersonal and Communication Skills*ExceptionalExceeds ExpectationsMeets ExpectationsImprovement NeededUnsatisfactoryPractice Based Learning and Improvement*ExceptionalExceeds ExpectationsMeets ExpectationsImprovement NeededUnsatisfactorySystem Based Practice*ExceptionalExceeds ExpectationsMeets ExpectationsImprovement NeededUnsatisfactoryProfessionalism*ExceptionalExceeds ExpectationsMeets ExpectationsImprovement NeededUnsatisfactoryOverall Evaluation of Fellow*ExceptionalExceeds ExpectationsMeets ExpectationsImprovement NeededUnsatisfactoryComments*Please elaborate on Fellow's overall performance in this section.Email* Enter a preferred email address to 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