Name: Email:

Please rate the quality of the ambulatory care experience and the didactic session on a 1-5 scale (1= poor, 3=average, 5=excellent).

1. AMBULATORY CARE EXPERIENCE 1 2 3 4 5
   Name of Ambulatory Care Experience:
   Doctor's Name:

2. INTERVIEW SEMINAR: 1 2 3 4 5
   Doctor's Name:
3. DIDACTIC EXPERIENCE:

Personality Disorders: Steve Fritz, M.D. 1 2 3 4 5
Anxiety and Somatoform Disorders: Susan Smith, M.D. 1 2 3 4 5
Child Psychiatry: Bob McKelvey, M.D. 1 2 3 4 5
Introduction to Psychotherapy: James Boehnlein, M.D. 1 2 3 4 5
Geriatric Psychiatry: Linda Ganzini, M.D. 1 2 3 4 5
Schizophrenia: Bill Hoffman, M.D. 1 2 3 4 5
Community Mental Health Issues: David Pollack M.D. 1 2 3 4 5
Mood Disorders: Erick Turner, M.D. 1 2 3 4 5
Psychotherapy: John Beahrs, M.D. 1 2 3 4 5
Substance Abuse: Marian Fireman, M.D. 1 2 3 4 5
Psychopharmacology: Kevin Smith, M.D. / Anthony Cull, M.D. 1 2 3 4 5
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