ACVR Equine Diagnostic Imaging Resident Biannual Assessment

ACVR Equine Diagnostic Imaging Resident Biannual Assessment
Your Name*

First NameLast Name
Your Email*
example@example.com
Institution*
Date*

MonthDayYear
Date
Resident Name*

First NameLast Name
Did this resident satisfactorily complete the past 6 months of training of their residency program?

Answering YES indicates that the past 6 months should be counted towards board exam eligibility for this resident.

Answering NO indicates that the past 6 months should NOT be counted towards board exam eligibility for this resident. In this case, the program director is also required to submit a letter to EDI-RSEC that documents how much of the resident's clinical training has been deemed unsatisfactory and explains or summarizes the resultant deficiencies in resident training. Such a letter must be signed by the resident and program director and then submitted to the EDI-RSEC Chair.
YesNo
YesNo
YesNo
As of the date of the submission, the total number of weeks completed in the program (clinical weeks, research, study, etc) is: *
List number of weeks of training completed.
As of the date of the submission, the resident has completed the total number of weeks listed below of clinical duty.*
List number of weeks on clinical duty.
Additional Comments:
Should be Empty: