TAR Director's Summary - Form 3 This form is required to be completed and submitted once every six months by the AGES Unit Director. This online form will be automatically submitted to the AGES Secretariat. Trainee* TitleMr.Mrs.MissMs.Dr.Prof.A/Prof.Rev. Prefix First Last AGES Accredited Training Unit Name*SupervisorsSemester1234Training Start Date* DD slash MM slash YYYY Training End Date* DD slash MM slash YYYY Instructions: Collate the responses from the training supervisors (Document 2). At least two are required - one of which one must be the Training Director. For each attribute, indicate the number of consultants who give each rating. Complete the section confirming the training period as satisfactory or unsatisfactory. Ensure that the report is discussed with the trainee and that the trainee has signed the report. For the following table please summarise by placing a number in the box that reflects the number of senior staff assessing the candidate for that domain.ProfessionalismEffectiveness and Compassion in dealing with patients and relativesOccasional major lapse or frequent minor lapsesFew, or occasional lapsesNo significant lapsesAbove average, confidentAn example to others Effectiveness and cooperation in dealing with peersOccasional major lapse or frequent minor lapsesFew, or occasional lapsesNo significant lapsesAbove average, confidentAn example to others Effectiveness and Leadership in dealing with subordinatesOccasional major lapse or frequent minor lapsesFew, or occasional lapsesNo significant lapsesAbove average, confidentAn example to others General AchievementResponsibility and initiative in clinical care, especially quality management and outcomes reviewPassiveOccasionally initiatesInitiating without promptingCoordinates departmental activitiesLeads departmental activities Responsibility and initiative in teachingPassiveOccasionally initiatesInitiating without promptingCoordinates departmental activitiesLeads departmental activities Responsibility and initiative in researchPassiveOccasionally initiatesInitiating without promptingCoordinates departmental activitiesLeads departmental activities Specific Specialty AchievementGynaecological surgery - laparoscopyRudimentary surgical skills, below expected level at this timeGenerally sound skillset, with need of improvement to be independentSound surgical skills that inspire confidence of independenceGood surgical skills that inspire confidence to teach this field of surgeryAuthoritative skillset that inspires progression to mastery Gynaecological surgery - hysteroscopyRudimentary surgical skills, below expected level at this timeGenerally sound skillset, with need of improvement to be independentSound surgical skills that inspire confidence of independenceGood surgical skills that inspire confidence to teach this field of surgeryAuthoritative skillset that inspires progression to mastery Gynaecological surgery – vaginalInsufficient exposure to comment on this type of surgeryRudimentary surgical skills, below expected level at this timeGenerally sound skillset, with need of improvement to be independentSound surgical skills that inspire confidence of independenceGood surgical skills that inspire confidence to teach this field of surgeryAuthoritative skillset that inspires progression to mastery Gynaecological surgery – open abdominalInsufficient exposure to comment on this type of surgeryRudimentary surgical skills, below expected level at this timeGenerally sound skillset, with need of improvement to be independentSound surgical skills that inspire confidence of independenceGood surgical skills that inspire confidence to teach this field of surgeryAuthoritative skillset that inspires progression to mastery Non-Gynaecological surgeryInsufficient exposure to comment on this type of surgeryRudimentary surgical skills, below expected level at this timeGenerally sound skillset, with need of improvement to be independentSound surgical skills that inspire confidence of independenceGood surgical skills that inspire confidence to teach this field of surgeryAuthoritative skillset that inspires progression to mastery Specific Specialty AchievementPlease note: These domains record absolute levels achieved and are not to be relative to the stage of training.Female pelvic surgery (open or vaginal)Rudimentary, stillNeeds improvementMeets speciality objectivesExceeds speciality objectivesAuthoritative Female reproductive surgery (hysteroscopic)Rudimentary, stillNeeds improvementMeets speciality objectivesExceeds speciality objectivesAuthoritative Female reproductive surgery (laparoscopic)Rudimentary, stillNeeds improvementMeets speciality objectivesExceeds speciality objectivesAuthoritative SummaryStrengths of TraineeWeakness of TraineeRecommended course of action for next training periodThe overall performance of the Trainee for this training is deemed to be satisfactory unsatisfactory Training DirectorSignature*Date* DD slash MM slash YYYY Name* TitleMr.Mrs.MissMs.Dr.Prof.A/Prof.Rev. Prefix First Last Confirmation Email* You will receive an automated confirmation email once this form has been submitted. EmailThis field is for validation purposes and should be left unchanged. Δ
