HAMAD MEDICAL CORPORATION

Department of Medicine
Medical Intensive Care Unit
Clinical Attachment rotation Assessment for Medical Students

Students Name: _Sinda Dakhlia_________________________

Department Attended: _Medical Intensive Care Unit_______
Period of Rotation: From: _____________________________
Clinical Supervisor: __________________________________

FOR CLINICAL SUPERVISOR

USE ONLY
Comments and Recommendations:
1. Attendance:

2. Knowledge:

3. Attitude

Clinical supervisor
Name: ___________________________ Title: _____________________
This evaluation must be completed by the supervisor to whom the candidate was
assigned
Signature: ________________________ Date: _________________________
Department of Medical Education: 44391732 medicaleducation@hamad.qa Fax:
44391679

HAMAD MEDICAL CORPORATION

Department of Medicine
Medical Intensive Care Unit
Clinical Attachment rotation Assessment for Medical Students

This evaluation must be completed by the supervisor to whom the candidate was
assigned
Department of Medical Education: 44391732 medicaleducation@hamad.qa Fax:
44391679

HAMAD MEDICAL CORPORATION

Department of Medicine
Medical Intensive Care Unit
Clinical Attachment rotation Assessment for Medical Students

This evaluation must be completed by the supervisor to whom the candidate was
assigned
Department of Medical Education: 44391732 medicaleducation@hamad.qa Fax:
44391679