Family Medicine


For Faculty & Preceptors - Part-Time Annual Report Form


Discipline of Family Medicine, Faculty of Medicine
PART-TIME CLINICAL FACULTY - ANNUAL REPORT
Reporting year: 2018-2019

 
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Current Academic Rank:



 
TEACHING
Undergraduate Medical Education (Please select all teaching that you provide)








Postgraduate Medical Education (Please select all teaching that you provide)
1st Year Residents in Family Medicine




2nd Year Residents in Family Medicine





 
CLINICAL PRACTICE
Please provide a synopsis of your special interest or focus of clinical practice (SIFP)
 
PROFESSIONAL DEVELOPMENT
Continuing Professional Development (CPD)
(please list courses for which you were an organizer, speaker or participant)
1.


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3.


4.


Are you reporting CPD activities through the College of Family Physicians of Canada?
Please list any advanced qualifications in medical education that are in progress or have been completed including attendance at a CLIME course, the Harvard course in education or simulation, Masters in Medical Education, Certificate in Health Education, ect.

 
RESEARCH AND PUBLICATIONS







 
OTHER PROFESSIONAL COMMITMENTS (please select all options that apply and provide details)
Do you have a Mentor?:
Do you want a Mentor?:
Are you interested in applying for promotion and receiving information on the criteria for promotion?
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