Reference Form Clinical Pathology Residency at NC State University
To help us with our candidate selection process, please complete the following form in place of a letter of recommendation. Please contact Caitlin Falls at with any questions.
Sign in to Google to save your progress. Learn more
Email *
Applicant name:
Your name and position:
Your institution/place of work:
Your email address:
How long have you known the applicant:
In what capacity have you known the applicant:
Please rate the candidate’s following abilities:
Very Good
Knowledge base: Has a firm grasp of discipline-related core knowledge and skills, understands disease processes and pathological mechanisms
Ability to learn: Able to acquire new knowledge and skills with minimal need for repetition
Intellectual curiosity: Eager to learn, asks probing questions, intrigued by processes, challenges and the unknown
Intellectual ability: Capable of synthesizing information from various sources, distilling important facts from papers, objectively analyzing data
Self-­­motivation: Drives own education and projects (e.g. manuscripts, research study, lectures), reads widely and extensively (including primary literature), meets deadlines, independent learner
Multitasking ability: Can juggle clinical duties, teaching, a research project, and independent board study
Flexibility: Adaptable, can respond to varying needs
Work ethic: Hard worker, goes above and beyond expectations, reliable, punctual, trustworthy
Team spirit: Works well with others, volunteers for tasks, does not feel certain tasks are beneath them, willing to help others out on short notice
Personality traits: Optimistic disposition, handles stress well, inclusive, treats others with respect and consideration regardless of rank/title
Research potential: Has the ability to generate hypothesis-­­driven bench research or participate in clinical pathologic­­ related research
Oral: Can communicate complex medical or scientific concepts to clients/co-workers or trainees
Presentation skills: Comfortable presenting to small or large groups of people
Written communication (e.g. cytology reports, manuscripts, lecture or case notes): Can communicate complex medical/scientific concepts, organized
Teaching abilities: Effective and engaging in small group interactions, laboratories, and one-on-one interactions
What are the major strengths of the candidate:
What are the major weaknesses of the candidate:
Please elaborate or clarify above rankings or provide any additional information that you consider worthwhile or important for us when evaluating this  candidate:
If the candidate were applying for a residency in your discipline at your institution, would you rank them as one of the top three applicants?
Clear selection
Please sign and date this form:
Clear form
Never submit passwords through Google Forms.
This form was created inside of North Carolina State University. Report Abuse