Forms and Documents
Appendix Items
- Appendix #1 - UCR SOM Competencies
- Appendix #2 - Contact Information
- Appendix #3 - Sample Forms for Patient Care
- Appendix #4 - Presentation Skills and a Pocket Cheat-Sheet
- Appendix #5 - Clerkship Grade Appeals Form
- Appendix #6 - Clerkship Remediation Plan
- Appendix #7 - Clerkship Completion Rules in Year 3
- Appendix #8 - Grading and Evaluations for Pediatrics, OB/GYN, Psychiatry, Internal Medicine, and Surgery
- Appendix #9 - Please see Assessment Forms below
- Appendix #10 - Critical Care Assessment Forms and Grading Rubrics
- Appendix #11 - Grading Rubric (2018 vintage) for SOAP Note, used in OSCEs Only
- Appendix #12 - Research Elective Request Form
- Appendix #13 - School of Medicine MS4 Expectations
- Appendix #14 - Scholarly Activity Elective Request Form
- Appendix #15 - MS4 Advisor Guide
- Appendix #16 - Student Fatigue Mitigation Policy, 2020-2021 Academic Year
- Appendix #17 - Healthcare Conflicts with Religious Days
Assessment Forms
Mid-Clerkship Assessment Forms
- Mid-Clerkship Mini-Assessment by Faculty or Resident Supervisor Form
- Mid-Clerkship Formative Assessment by Student and Faculty Form
- Mid-Clerkship Formative Assessment by Faculty Form