1. Default Section

The Office of Pediatric Medical Education would like to recognize our faculty for the educational activities in which they participate. To this end (and to help you maintain an ongoing record of your activities for your educator’s portfolio), we are creating a central repository of faculty educational activities. Your complete list of activities will be reported back to you at the end of the academic year or can be requested at any time from the Office of Medical Education.

Please use this short survey to log your educational activities for the current year. Note, resident and clerkship activities that are arranged through the Office of Medical Education (such as Teaching Attending, Resident Noon Conference presentations, Resident advising, continuity clinic precepting, Joint Fellow lectures, Workshop Precepting, Residency Interviewing, etc.) will be automatically recorded by the Office of Medical Education and therefore DO NOT need to be recorded here.

You will need to complete one form for each activity. When you click "Submit" you will be redirected back to the form to log additional activities.

* 1. What is your name?

* 2. What is your primary division/section in Pediatrics?

* 3. Please select the activity you are currently logging for which you have volunteered time for during the 09-10 Academic Year. (Please note that Teaching Attending time, Resident Advising, Resident Noon Conferences, Joint Fellow Curriculum presentations, and Clerkship activities are automatically recorded for you by the Med Ed Office and so do not need to be additionally recorded here).

* 4. How many hours in PREPARATION TIME have you spent this academic year on this activity?

* 5. How many hours in PRESENTATION TIME have you spent this academic year on this activity?

* 6. Date(s) of activity?

* 7. Title of activity? (if applicable, such as a lecture title)

* 8. Activity outcome? (if applicable, such as residency match, research publications, etc.)