OMB Mapping 12-18-13

OMB Mapping 12-18-13.xlsx

Evaluation and Initial Assessment of HRSA Teaching Health Centers

OMB Mapping 12-18-13

OMB: 0915-0376

Document [xlsx]
Download: xlsx | pdf

Overview

Marticulant
Graduation Survey
Anonymous Graduation
Graduate Survey
Anonymous Graduate


Sheet 1: Marticulant

Marticulant Survey - Mapping Marticulant Survey Mapping



OMB Standard Source Source Question and Answers GW Question and Answers Research Question(s) Notes
Q: What is (name of person talking about)’s sex?
- Male
- Female
HRSA – Performance Measure Q: Select the individual's sex
- Male
- Female
- Not Reported
Q: What is your sex?*
- Male
- Female
1. What are the characteristics of residents who choose THC programs, by demographics, intention to practice in primary care and intention to practice in rural and/or underserved areas? 2. Are there correlations between resident characteristics and the intention to practice primary care and/or practice in underserved settings? *This question has been edited to change the word "gender" to "sex" to correspond with the standardized OMB question.
Q: What is Person 1’s age and what is Person 1’s date of birth?
A: Open ended response
HRSA – Performance Measure Select the individual's age group:
- Under 20 years
- 20-29 years
- 30-39 years
- 40-49 years
- 50-59 years
- 60 years or older
- Not Reported
Q: What is your age (please enter an integer)?
A: Open ended response
1. What are the characteristics of residents who choose THC programs, by demographics, intention to practice in primary care and intention to practice in rural and/or underserved areas? 2. Are there correlations between resident characteristics and the intention to practice primary care and/or practice in underserved settings?
Q: Is Person 1 of Hispanic, Latino, or Spanish origin?
- No, not of Hispanic, Latino, or Spanish origin
- Yes, Cuban
- Yes, Mexican, Mexican Am.,
- Chicano
- Yes, Puerto Rican
- Yes, another Hispanic, Latino, or Spanish origin – Print origin, for example, Argentinean, Colombian, Dominican, Nicaraguan, Salvadoran, Spaniard, and so on – Open ended response
HRSA – Performance Measure Q: Select the individual's ethnicity:
- Hispanic/Latino
- Non-Hispanic/Non-Latino
- Not Reported
Q: What is your ethnicity?
- Hispanic or Latino
- Not Hispanic or Latino
1. What are the characteristics of residents who choose THC programs, by demographics, intention to practice in primary care and intention to practice in rural and/or underserved areas? 2. Are there correlations between resident characteristics and the intention to practice primary care and/or practice in underserved settings?
Q: Please choose one or more races that (NAME/you) (considers yourself/consider NAME/considers himself/considers herself) to be:
- White
- Black or African American
- American Indian or Alaska Native
- Asian
- Chinese
- Filipino
- Japanese
- Korean
- Vietnamese
- Other Asian
- Native Hawaiian
- Guamanian or Chamorro
- Samoan - Other Pacific Islander
HRSA – Performance Measure Q: Select the individual's race (Select All That Apply)
- American Indian or Alaska Native
- Asian
- Black or African American
- Native Hawaiian or other Pacific Islander
- White
- Not Reported
Q: What is your race? Please choose one or more.
- American Indian or Alaska Native
- Asian
- Black or African American
- Native Hawaiian or other Pacific Islander
- White
- Other (please specify) – Open ended response
1. What are the characteristics of residents who choose THC programs, by demographics, intention to practice in primary care and intention to practice in rural and/or underserved areas? 2. Are there correlations between resident characteristics and the intention to practice primary care and/or practice in underserved settings?
Q: Where was this person born?
- In the United States – Print name of state
- Outside the United States – Print name of foreign country, or Puerto Rico, Guam, etc.



Q: What is your country of origin?
A: Open ended response
1. What are the characteristics of residents who choose THC programs, by demographics, intention to practice in primary care and intention to practice in rural and/or underserved areas? 2. Are there correlations between resident characteristics and the intention to practice primary care and/or practice in underserved settings? International medical graduates make up approximately 25% of residents in training and are generally over-represented in primary care specialties.



Q: What language(s) do you feel competent and confident in providing safe and effective care to patients?
A: Open ended response
1. What are the characteristics of residents who choose THC programs, by demographics, intention to practice in primary care and intention to practice in rural and/or underserved areas? 2. Are there correlations between resident characteristics and the intention to practice primary care and/or practice in underserved settings? THCs provide care to diverse populations, many who speak English as a second language. Some THC program offer Spanish immersion courses to their residents.

HRSA – Performance Measure Select whether the individual is from a rural residential background. A rural area is located in a county that is not part of a Metropolitan Statistical Area. Refer to http://datawarehouse.hrsa.gov/RuralAdvisor/
RuralHealthAdvisor.aspx to determine if a county is considered rural.
Q: Please enter the following information for the high school you graduated from:
A: Name
City
County
State
Zip Code
Country
Year of Graduation
1. What are the characteristics of residents who choose THC programs, by demographics, intention to practice in primary care and intention to practice in rural and/or underserved areas? 2. Are there correlations between resident characteristics and the intention to practice primary care and/or practice in underserved settings? High school information is requested to provide an address to determine rural background using the HRSA rural advisor tool. Research suggests high school, college, and permanent addresses are predictive of rural career outcomes. Owen, J., Conaway, M., Bailey, B., & Hayden, G. (2007). Predicting Rural Practice Using Different Definitions to Classify Medical School Applicants as Having a Rural Upbringing. Journal of Rural Health. 22:2. Accessed from http://onlinelibrary.wiley.com/doi/10.1111/j.1748-0361.2007.00080.x/pdf.

HRSA – Performance Measure Q: Select whether the individual reported coming from a financial and/or educational disadvantaged background at the time of matriculation into the program.
(Note: For a definition of disadvantaged, please go to http://www.hrsa.gov/loanscholarships/
scholarships/disadvantaged.html)
Q: Would you consider yourself from an "environmentally disadvantaged background?"
Please answer to the best of your ability.
This means an individual who:
(1) Comes from an environment that inhibited the individual from obtaining the knowledge,
skill and ability required to enroll in and graduate from a health professions school; or
(2) Comes from a family with an annual income below a level based on low income thresholds according to family size published by the U.S. Bureau of the Census, adjusted
annually for changes in the Consumer Price Index, and adjusted by the Secretary for use
in all health professions programs.
A: Yes
No
1. What are the characteristics of residents who choose THC programs, by demographics, intention to practice in primary care and intention to practice in rural and/or underserved areas? 2. Are there correlations between resident characteristics and the intention to practice primary care and/or practice in underserved settings?

National Health Service Corps – criteria for disadvantaged background status Come from an environment that has inhibited them from obtaining the knowledge, skills, and abilities required to enroll in and graduate from a health professions or nursing school (Environmentally Disadvantaged). The following are provided as examples of “Environmentally Disadvantaged” for guidance only and are not intended to be all-inclusive.
Examples:
Person from high school with low average SAT/ACT scores or below the average State test results.
Person from a school district where 50 percent or less of graduates go to college.
Person who has a diagnosed physical or mental impairment that substantially limits participation in educational experiences.
Person for whom English is not his or her primary language and for whom language is still a barrier to academic performance.
Person who is first generation to attend college.
Person from a high school where at least 30 percent of enrolled students are eligible for free or reduced price lunches.
OR
2. Come from a family with an annual income below a level based on low-income thresholds established by the U.S. Census
Bureau, adjusted annually for changes in the Consumer Price Index (Economically Disadvantaged).
Link

Q: Do you fall into any of the following categories? Please choose all that apply.
A: You are from a high school with low average SAT/ACT scores
You are from a school district
where 50% or less of graduates on to college
You have a diagnosed physical/mental impairment substantially limiting participation in education
English is not your primary language and has been a barrier to academic performance
You are the first generation in your family to attend college
You are from a high school where > 30% of students were eligible for free or reduced lunch prices
You come from a family with an annual income < 200% of the Federal Poverty Level (Currently $31,020 for a family of 2; $39,060 for a family of 3; $47,100 for a family of 4; $55,140 for a family of 5)
You come from a family that received public assistance (e.g. Aid to Families with Dependent Children, food stamps, Medicaid, public housing)
You qualified for a need based scholarship
1. What are the characteristics of residents who choose THC programs, by demographics, intention to practice in primary care and intention to practice in rural and/or underserved areas? 2. Are there correlations between resident characteristics and the intention to practice primary care and/or practice in underserved settings?

HRSA – Performance Measure Select whether the individual is from a rural residential background. A rural area is located in a county that is not part of a Metropolitan Statistical Area. Refer to http://datawarehouse.hrsa.gov/RuralAdvisor/
RuralHealthAdvisor.aspx to determine if a county is considered rural.
Q: Do you consider yourself from a rural background?
A: Yes
No
1. What are the characteristics of residents who choose THC programs, by demographics, intention to practice in primary care and intention to practice in rural and/or underserved areas? 2. Are there correlations between resident characteristics and the intention to practice primary care and/or practice in underserved settings?
Q: Has this person ever served on active duty in the U.S. Armed Forces, military Reserves, or National Guard? Active duty does not include training for the Reserves or National Guard, but DOES include activation, for example, for the Persian Gulf War
- Yes, now on active duty
- Yes, on active duty in the past, but not
during the last 12 months
- No, training for Reserves or National Guard only
- No, never served in the military

Follow-up Q: When did this person serve on active duty in the U.S. Armed Forces? Mark (X) a box for EACH period in which this person served, even if just for part of the period.
- September 2001 or later
- August 1990 to August 2001 (including Persian Gulf War)
- September 1980 to July 1990
- May 1975 to August 1980
- Vietnam era (August 1964 to April 1975)
- March 1961 to July 1964
- Korean War (July 1950 to January 1955)
- World War II (December 1941 to December 1946)
- February 1955 to February 1961
- January 1947 to June 1950
- November 1941 or earlier
HRSA – Performance Measure Q: Select the individual's veteran status:
 Active Duty Military
 Reservist
 Veteran-Prior Service
 Veteran Retired
 Individual is not a Veteran
 Not Reported
Q: Please indicate your veteran status.
 Active Duty Military
 Reservist
 Veteran-Prior Service
 Veteran Retired
 Not a Veteran
1. What are the characteristics of residents who choose THC programs, by demographics, intention to practice in primary care and intention to practice in rural and/or underserved areas? 2. Are there correlations between resident characteristics and the intention to practice primary care and/or practice in underserved settings?

AAMC – Graduation Questionnaire Q: Please identify the campus where you spent a majority (more than 14 months) of the first and second year of
medical school:
- State
- Campus Years 1-2
Q: Please identify the campus where you spent a majority (more than 8 months) of the third and fourth year of
medical school:
- State
- Campus Years 1-2
Q: Please enter the following information for your Medical School or Dental School:
- Name
- City
- State
- Country
1. What are the characteristics of residents who choose THC programs, by demographics, intention to practice in primary care and intention to practice in rural and/or underserved areas? 2. Are there correlations between resident characteristics and the intention to practice primary care and/or practice in underserved settings? These questions were adapted to allow the THC resident to add additional information on where they attended medical school and which campus they primarily studied at. In addition, this question was added because research suggests that individuals who attend medical school in regional branch campuses increase the likelihood of practicing primary care medicine in local communities. Brokaw, J., Mandzuk, C., Wade, M., Deal, D., Johnson, M., White, J., & Zollinger, T. (2009) The influence of regional basic science campuses on medical students' choice of specialty and practice location: a historical cohort study. BMC Medical Education. http://www.biomedcentral.com/1472-6920/9/29

Does your Medical School or Dental School have more than one campus?
- Yes
- No
If your Medical School or Dental School had more than one campus, please indicate
which campus you primarily attended? (Enter N/A if not applicable)



Did your Medical School or Dental School have special "paths" or "tracks"?
- Yes
- No
If you participated in a special "track" or "pathway" at your Medical School or Dental School, please indicate that "track" or "pathway" below. – Open ended response
1. What are the characteristics of residents who choose THC programs, by demographics, intention to practice in primary care and intention to practice in rural and/or underserved areas? 2. Are there correlations between resident characteristics and the intention to practice primary care and/or practice in underserved settings? These questions were added because some medical schools have developed special paths or tracks, such as primary care tracks, meant to foster students in particular areas.

AAMC – Graduation Questionnaire Do you expect to have received your M.D. degree by June 30, 2013?
- Yes
- No
What year did you graduate from Medical School or Dental School? – Open ended response 1. What are the characteristics of residents who choose THC programs, by demographics, intention to practice in primary care and intention to practice in rural and/or underserved areas? 2. Are there correlations between resident characteristics and the intention to practice primary care and/or practice in underserved settings? This question was adapted to address differences in the timing of the survey instruments (at entry to residency rather than to medical school) and to add more clarity for the THC residents.

AAMC –Marticulant Questionnaire Has more than a year passed since you graduated from college?
- Yes
- No
Did you enter residency in the academic year immediately following graduation from Medical School or Dental School?
- Yes
- No
1. What are the characteristics of residents who choose THC programs, by demographics, intention to practice in primary care and intention to practice in rural and/or underserved areas? 2. Are there correlations between resident characteristics and the intention to practice primary care and/or practice in underserved settings? This question was adapted to address differences in the timing of the survey instruments ( at entry to residency rather than to medical school) and to add more clarity for the THC residents.

AAMC –Marticulant Questionnaire How did you spend your time between college and medical school? (Select all that apply)
- Worked at another career
- Worked to improve finances
- Continued coursework to fulfill pre-medical requirements
- Took pre-medical courses for the first time
- Pursued graduate studies
- Worked/volunteered internationally
- Worked/volunteered in research
- Helped fulfill family obligations
- Other (please specify)- Open ended response
If you did not enter Residency immediately after graduating from Medical School or Dental School, how did you spend the time in between? – Open ended response
1. What are the characteristics of residents who choose THC programs, by demographics, intention to practice in primary care and intention to practice in rural and/or underserved areas? 2. Are there correlations between resident characteristics and the intention to practice primary care and/or practice in underserved settings? This question was adapted to change the categories of the responses to an open ended response. This is to account for what a THC resident did between Medical or Dental School and residency.



Please enter the following information for any education (degrees or certificate) either before or after Medical School or Dental School, including any undergraduate education.
- Name
- City
- State
- Country
- Study Area
- Degree Conferred
- Start Year
- End Year
1. What are the characteristics of residents who choose THC programs, by demographics, intention to practice in primary care and intention to practice in rural and/or underserved areas? 2. Are there correlations between resident characteristics and the intention to practice primary care and/or practice in underserved settings?

AAMC –Marticulant Questionnaire How many years have passed since you graduated from college?
- Less than 1 year
- 1-2 years
- 3-4 years
- 5 or more years
Did you enter Medical or Dental School in the academic year immediately following graduation from college?
- Yes
- No
1. What are the characteristics of residents who choose THC programs, by demographics, intention to practice in primary care and intention to practice in rural and/or underserved areas? 2. Are there correlations between resident characteristics and the intention to practice primary care and/or practice in underserved settings? This question was adapted to address differences in the timing of the survey instruments ( at entry to residency rather than to medical school) and to add more clarity for the THC residents and for ease of administration.

AAMC –Marticulant Questionnaire How did you spend your time between college and medical school? (Select all that apply)
- Worked at another career
- Worked to improve finances
- Continued coursework to fulfill pre-medical requirements
- Took pre-medical courses for the first time
- Pursued graduate studies
- Worked/volunteered internationally
- Worked/volunteered in research
- Helped fulfill family obligations
- Other (please specify)- Open ended response
If you did not enter Medical School or Dental School immediately after graduating from college, how did you spend the time in between? – Open ended response 1. What are the characteristics of residents who choose THC programs, by demographics, intention to practice in primary care and intention to practice in rural and/or underserved areas? 2. Are there correlations between resident characteristics and the intention to practice primary care and/or practice in underserved settings? This question was adapted to change the categories of the responses to an open ended response. This is to account for what a THC resident did between graduating from undergraduate and Medical or Dental School.



What were your primary reasons for choosing your current Residency Program? – open ended response 1. What are the characteristics of residents who choose THC programs, by demographics, intention to practice in primary care and intention to practice in rural and/or underserved areas? 2. Are there correlations between resident characteristics and the intention to practice primary care and/or practice in underserved settings? The research team asked this question to groups of residents at 9 of the original 11 THCs during the site visits in year one of the THCGME evaluation project. This question is particularly useful in determining the characteristics of residents who choose THC programs, and further support the research goals of the study.

AAMC – Graduation Questionnaire Are you planning on seeking fellowship training after residency?
- Yes
- No
- Undecided
Are you planning to do additional residency or fellowship training after this residency training program?
- Yes
- No
- Not yet decided
If yes, what additional residency/fellowship training are you planning after this residency training program? – Open ended response
1. What are the characteristics of residents who choose THC programs, by demographics, intention to practice in primary care and intention to practice in rural and/or underserved areas? 2. Are there correlations between resident characteristics and the intention to practice primary care and/or practice in underserved settings? This question was adapted to address differences in the timing of the survey instruments ( at entry to residency rather than to medical school) and to add more clarity for the THC residents and for ease of administration.

AAMC – Graduation Questionnaire Where do you plan to practice?
-Drop down locations
Do you know what geographic location you want to work following all
residency/fellowship training?
- Yes
- No
- Unsure
If yes, where do you hope to work after completing your residency/fellowship training program? Complete as much as you know.
- City/town
- States
- Country
1. What are the characteristics of residents who choose THC programs, by demographics, intention to practice in primary care and intention to practice in rural and/or underserved areas? 2. Are there correlations between resident characteristics and the intention to practice primary care and/or practice in underserved settings? This question was adapted to address differences in the timing of the survey instruments ( at entry to residency rather than to medical school) and to add more clarity for the THC residents and for ease of administration.

AAMC - Marticulant Questionnaire Please indicate the setting in which you plan to WORK after the completion of your medical education:
- Large City (Population 500,000 or More)
- Suburb of a Large City
- City of Moderate Size (Population 50,000 to 500,000)
- Suburb of Moderate Size City
- Small City (Population 10,000 To 50,000--Other Than Suburb)
- Town (Population 2,500 to 10,000--Other Than Suburb)
- Small Town (Population Less Than 2,500)
- Rural/Unincorporated Area
- Undecided or No Preference
Please indicate the setting(s) in which you plan to work after the completion of your residency/fellowship training. Choose all that apply.
- Large City (Population 500,000 or More)
- Suburb of a Large City
- City of Moderate Size (Population 50,000 to 500,000)
- Suburb of Moderate Size City
- Small City (Population 10,000 To 50,000--Other Than Suburb)
- Town (Population 2,500 to 10,000--Other Than Suburb)
- Small Town (Population Less Than 2,500)
- Rural/Unincorporated Area
- Undecided or No Preference
1. What are the characteristics of residents who choose THC programs, by demographics, intention to practice in primary care and intention to practice in rural and/or underserved areas? 2. Are there correlations between resident characteristics and the intention to practice primary care and/or practice in underserved settings?

AAMC –Marticulant Questionnaire Do you plan to work primarily in an underserved area?
- Yes
- No
- Undecided
Do you plan to locate your practice in an underserved area?
- Yes
- No
- Undecided
1. What are the characteristics of residents who choose THC programs, by demographics, intention to practice in primary care and intention to practice in rural and/or underserved areas? 2. Are there correlations between resident characteristics and the intention to practice primary care and/or practice in underserved settings?

AAMC –Marticulant Questionnaire What is the likely location?
- Rural community
- Inner-city community
- Other
If you plan to locate your practice in an underserved area, please indicate the likely
location.
- Rural community
- Inner-city community
- Other - open ended response
1. What are the characteristics of residents who choose THC programs, by demographics, intention to practice in primary care and intention to practice in rural and/or underserved areas? 2. Are there correlations between resident characteristics and the intention to practice primary care and/or practice in underserved settings?

AAMC –Marticulant Questionnaire Regardless of location, do you plan to work primarily with minority populations?
- Yes
- No
- Undecided
Regardless of location, do you plan to work primarily with minority populations?
- Yes
- No
- Undecided
1. What are the characteristics of residents who choose THC programs, by demographics, intention to practice in primary care and intention to practice in rural and/or underserved areas? 2. Are there correlations between resident characteristics and the intention to practice primary care and/or practice in underserved settings?

AAMC –Marticulant Questionnaire If yes, indicate the minority population(s).
- Black/African American
- Hispanic/Latino
- Native American
- Asian
- Other
If you plan to work primarily with minority populations, please indicate the minority population you intend to work with. Select all that apply
- Black/African American
- Hispanic/Latino
- Native American
- Asian
- Other – open ended response
1. What are the characteristics of residents who choose THC programs, by demographics, intention to practice in primary care and intention to practice in rural and/or underserved areas? 2. Are there correlations between resident characteristics and the intention to practice primary care and/or practice in underserved settings?

AAMC – Graduation Questionnaire Did you receive any scholarships, stipends, grants (not loans) for medical school?
- Yes
- No

Did you receive a scholarship with a service requirement for medical school (for example, National Health Service Corps Scholarship, State or local scholarship, or private scholarship)?
- Yes
- No
1. What are the characteristics of residents who choose THC programs, by demographics, intention to practice in primary care and intention to practice in rural and/or underserved areas? 2. Are there correlations between resident characteristics and the intention to practice primary care and/or practice in underserved settings?

AAMC – Graduation Questionnaire Select the type of loan forgiveness program in which you plan to participate:
- Department of Education's Public Service Loan Forgiveness
- National Health Service Corps
- Indian Health Service Corps
- Armed Services (Navy, Army, Air Force)
- Uniformed Service (CDC, HHS)
- State loan forgiveness program
- Hospital program (e.g. sign-on bonus)
- Private loan forgiveness program
- Other
If you did receive a scholarship with a service requirement, please indicate the name of the scholarship – open ended response 1. What are the characteristics of residents who choose THC programs, by demographics, intention to practice in primary care and intention to practice in rural and/or underserved areas? 2. Are there correlations between resident characteristics and the intention to practice primary care and/or practice in underserved settings?



Do you plan to apply for National Health Service Corps (NHSC) or other loan repayment program with a service requirement?
- Yes
- No
- Undecided
- Don’t qualify
- Unaware of such programs
1. What are the characteristics of residents who choose THC programs, by demographics, intention to practice in primary care and intention to practice in rural and/or underserved areas? 2. Are there correlations between resident characteristics and the intention to practice primary care and/or practice in underserved settings? This question has been added because research suggests that family medicine physicians that serve in the NHSC are the most likely to stay in the location of their initial rural practice NHSC assignment after completing the program. Cullen, T., Hart, L., Whitcomb, M., & Rosenblatt, R., (1997). The National Health Service Corps; Rural Physician Service and Retention. Journal of the American Board of Family Practice. Accessed from http://www.ncbi.nlm.nih.gov/pubmed/9228622.

AAMC – Graduation Questionnaire* Enter the amount you owe on your premedical/college educational loans
-Open ended response

*Data reported as:
- No debt
- $ 1 to $ 24,999
- $ 25,000 to $ 49,999
- $ 50,000 to $ 74,999
- $ 75,000 to $ 99,999
- $100,000 to $124,999
- $125,000 to $149,999
- $150,000 to $174,999
- $175,000 to $199,999
- $200,000 to $300,000
What is the total amount of your outstanding educational loans for your college/premedical or predental education?
- No debt
- $1 to $ 24,999
- $25,000 to $ 49,999
- $50,000 to $ 74,999
- $75,000 to $ 99,999
- $100,000 to $124,999
- $125,000 to $149,999
- $150,000 to $174,999
- $175,000 to $199,999
- $200,000 to $224,999
- $225,000 to $249,999
- $250,000 to $274,999
- $275,000 to $299,999
- $300,000 or more
1. What are the characteristics of residents who choose THC programs, by demographics, intention to practice in primary care and intention to practice in rural and/or underserved areas? 2. Are there correlations between resident characteristics and the intention to practice primary care and/or practice in underserved settings? This question was adapted to add categories, instead of an open ended response, because the research team believes that having the categories will increase response rates for this question.

AAMC – Graduation Questionnaire* Enter the amount you owe on your medical educational loans.
-Open ended response

*Data reported as:
- No debt
- $1 to $ 50,000
- $ 50,001 to $100,000
- $100,001 to $150,000
- $150,001 to $200,000
- $200,001 to $300,000
- $300,001 to $400,000
- $400,001 to $500,000
What is the total amount of your outstanding educational loans for your medical or
dental education?
- No debt
- $1 to $ 24,999
- $25,000 to $ 49,999
- $50,000 to $ 74,999
- $75,000 to $ 99,999
- $100,000 to $124,999
- $125,000 to $149,999
- $150,000 to $174,999
- $175,000 to $199,999
- $200,000 to $224,999
- $225,000 to $249,999
- $250,000 to $274,999
- $275,000 to $299,999
- $300,000 or more
1. What are the characteristics of residents who choose THC programs, by demographics, intention to practice in primary care and intention to practice in rural and/or underserved areas? 2. Are there correlations between resident characteristics and the intention to practice primary care and/or practice in underserved settings? This question was adapted to add categories, instead of an open ended response, because the research team believes that having the categories will increase response rates for this question.

Sheet 2: Graduation Survey

Graduation Survey - Mapping



Source Source Question and Answers GW Question and Answers Research Question(s) Notes


What are your plans following graduation? – Open ended response 1. What number and percent of the THC graduates practice in primary care (plan at graduation and one year after graduation)?
2. What number and percent of the THC graduates go on to practice in underserved settings (plan at graduation and one year after graduation)?
This question is designed to capture possible plans in addition to clinical practice.
AAMC Graduation Questionnaire If you are planning on specializing in Family Medicine, Internal Medicine, or Pediatrics, do you plan on going into a subspecialty in that field?
- Yes
- No

After all residency and fellowship training, do you plan to practice in Primary Care?
- Yes
- No
- Undecided
1. What number and percent of the THC graduates practice in primary care (plan at graduation and one year after graduation)?

This question was adapted as all THC residents are in primary care fields.
AAMC Graduation Questionnaire Do you plan to practice in an underserved area?
- Yes
- No
- Undecided
After all residency and fellowship training, do you plan to practice in an underserved
area?
- Yes
- No
- Undecided
1. What number and percent of the THC graduates go on to practice in underserved settings (plan at graduation and one year after graduation)?

AAMC Graduation Questionnaire What is the likely location?
- Rural community
- Inner-city community
- Other
If you plan to practice in an underserved area, please indicate the likely location
- Rural community
- Inner-city community
- Other – open ended response
1. What number and percent of the THC graduates go on to practice in underserved settings (plan at graduation and one year after graduation)?



Have you accepted a job (nontraining) following graduation from your current residency program?
- Yes
- No

1. What number and percent of the THC graduates practice in primary care (plan at graduation and one year after graduation)?
2. What number and percent of the THC graduates go on to practice in underserved settings (plan at graduation and one year after graduation)?



Please provide the following information for your post residency job:
- Position title
- Organization name
- Address
- City
- State
- Zip code
- Country
- Primary responsibilities
1. What number and percent of the THC graduates practice in primary care (plan at graduation and one year after graduation)?
2. What number and percent of the THC graduates go on to practice in underserved settings (plan at graduation and one year after graduation)?



How would you classify your employer for this position?
- Academic
- Private Practice
- Community Health Center
- Community-based
- organization/nonprofit - Hospital Non-Academic
- Federal Government
- State Government
- City/County Government
- Unknown
- Other (please specify)
1. What number and percent of the THC graduates practice in primary care (plan at graduation and one year after graduation)?
2. What number and percent of the THC graduates go on to practice in underserved settings (plan at graduation and one year after graduation)?
This question was adapted from two of the existing THC alumni surveys - Lawrence Family Medicine Residency Alumnae Survey and the Conroe Medical Education Foundation Survey


Will you be practicing clinical medicine or dentistry?
- Yes
- No

1. What number and percent of the THC graduates practice in primary care (plan at graduation and one year after graduation)?
2. What number and percent of the THC graduates go on to practice in underserved settings (plan at graduation and one year after graduation)?

WWAMI Network Are you currently practicing in any of the following federally designated areas/practices? Check all that apply:
- HPSA: Federally designated health professional shortage area
- MUA: Federally designated medically underserved area
- MHC: Federally designated migrant health center
- CHC: Federally designated community health center
- RHC: Federally designated rural health clinic
- NHSC: National Health Service Corps
- IHS: Indian Health Service site or tribal clinic
- FQHC: Federally Qualified Health Center
- State qualified health center/clinic
- State or Local Health Department
- Other federally qualified health center/clinic. Please specify:
- Other underserved population. Please specify:
If yes, will you be practicing in any of the following federally designated areas/practices?
Check all that apply
- HPSA: Federally designated health professional shortage area
- MUA: Federally designated medically underserved area
- MHC: Federally designated migrant health center
- CHC: Federally designated community health center
- RHC: Federally designated rural health clinic
- NHSC: National Health Service Corps
- IHS: Indian Health Service site or tribal clinic
- FQHC: Federally Qualified Health Center
- State qualified health center/clinic
- State or Local Health Department
- None of the above
- Other underserved population (please specify)
1. What number and percent of the THC graduates go on to practice in underserved settings (plan at graduation and one year after graduation)?

AAMC Graduation Questionnaire Do you plan to enter into a loan-forgiveness program?
- Yes
- No

Will you be participating in a loan repayment program in this position?
- Yes
- No
- Unsure
1. Describe the characteristics of residents who choose THC programs, by demographics, intention to practice in primary care and intention to practice in rural and/or underserved areas.
2. Examine the relationships between resident characteristics and primary care and underserved practice outcomes?

AAMC Graduation Questionnaire Please list the type of loan forgiveness program in which you plan to participate:
- Department of Education’s Public Service Loan Forgiveness (PSLF)
- National Health Service Corps Scholarship
- National Health Service Corps Loan Repayment
- Indian Health Service Corps
- Armed Services (Navy, Army, Air Force)
- Uniformed Service (CDC, HHS)
- State loan forgiveness program
- Hospital program (e.g. sign on Bonus)
- Private loan forgiveness program:
Other:
If you will receive loan repayment in your next position, please indicate the type of loan repayment program. Choose all that apply.
- Department of Education’s Public Service Loan Forgiveness (PSLF)
- National Health Service Corps Scholarship
- National Health Service Corps Loan Repayment
- Indian Health Service Corps
- Armed Services (Navy, Army, Air Force)
- Uniformed Service (CDC, HHS)
- State loan forgiveness program
- Hospital program (e.g. sign on Bonus)
- Other (please specify)
3. What are the characteristics of residents who choose THC programs, by demographics, intention to practice in primary care and intention to practice in rural and/or underserved areas?
AAMC Graduation Questionnaire Are you planning on seeking fellowship training after residency?
- Yes
- No
- Undecided
Are you planning any additional residency or fellowship training after your current residency program?
- Yes
- No
- Unsure
1. What number and percent of the THC graduates practice in primary care (plan at graduation and one year after graduation)?


If you have a residency or fellowship position, please provide the following information:
- Specialty
- Program name
- City
- State
- Country
1. What number and percent of the THC graduates practice in primary care (plan at graduation and one year after graduation)? Additional fellowship training can indicative of a career choice away from primary care


Please provide the best contact information to follow up with you after graduation.
- Name:
- Address:
- Address 2:
- City/Town:
- State:
- Zip:
- Country:
- Email Address:
- Phone Number:



Sheet 3: Anonymous Graduation

Anonymous Graduation Survey - Mapping



Source Source Question and Answers GW Question and Answers Research Question(s) Notes
Mid-Hudson Family Practice Residency Program Graduate Survey/ Lawrence Family Medicine Residency Alumnae Survey Strong points of your training at Mid-Hudson: / What was the most valuable thing about training in Lawrence? What are the strengths of your residency program? 5. How satisfied are residents with curriculum and enhanced programmatic features of the THC model? 6. How do residents suggest that the THC residency program can be improved? On review of existing THC alumni surveys, program feedback was commonly sought. Feedback is important for continuous quality improvement for resident training and is also important to understand the resident satisfaction with the training model and the potential strengths and weaknesses of the model.
Mid-Hudson Family Practice Residency Program Graduate Survey/ Lawrence Family Medicine Residency Alumnae Survey / Conroe Medical Education Foundation Suggestions for improving the training: / Retrospectively, what was not helpful in the curriculum, or weak? / Is there any training which you feel you did not receive during your residency training that you believe would have been beneficial to you? How do you think your residency program could be improved? 5. How satisfied are residents with curriculum and enhanced programmatic features of the THC model? 6. How do residents suggest that the THC residency program can be improved?


Please describe any career planning/mentorship provided by your residency program. 5. How satisfied are residents with curriculum and enhanced programmatic features of the THC model?


Based on your experience, indicate your level of satisfaction with the career planning/mentorship you received during your residency.
- Very Dissatisfied
- Dissatisfied
- Neutral
- Satisfied
- Very satisfied
5. How satisfied are residents with curriculum and enhanced programmatic features of the THC model?


Please indicate whether you agree with the following statements.
I feel well prepared to practice independently in an inpatient hospital setting.
- Strongly disagree
- Disagree
- Neutral
- Agree
- Strongly Agree
5. How satisfied are residents with curriculum and enhanced programmatic features of the THC model?


Please indicate whether you agree with the following statements.
I feel well prepared to practice independently in an outpatient primary care setting.
- Strongly disagree
- Disagree
- Neutral
- Agree
- Strongly Agree
5. How satisfied are residents with curriculum and enhanced programmatic features of the THC model? 6. How do residents suggest that the THC residency program can be improved?


Please indicate whether you agree with the following statements.
I feel well prepared to practice independently in an underserved setting.
- Strongly disagree
- Disagree
- Neutral
- Agree
- Strongly Agree
5. How satisfied are residents with curriculum and enhanced programmatic features of the THC model?


Please indicate whether you agree with the following statements.
I feel well prepared to practice independently in a rural setting.
- Strongly disagree
- Disagree
- Neutral
- Agree
- Strongly Agree
5. How satisfied are residents with curriculum and enhanced programmatic features of the THC model?

Sheet 4: Graduate Survey

Alumni Survey - Mapping



Source Source Question and Answers GW Question and Answers Research Question(s) Notes
WWAMI Network What board certifications do you maintain? Check all that apply:
- Board certified in Family Medicine - ABFM
- Board certified in Family Medicine - AOA
- CAQ in Adolescent Medicine
- CAQ in Geriatrics
- CAQ in Sports Medicine
- None
- Other, please specify:
Are you currently board certified?
- Yes
- No
1. What number and percent of the THC graduates practice in primary care (plan at graduation and one year after graduation)?
WWAMI Network What board certifications do you maintain? Check all that apply:
- Board certified in Family Medicine - ABFM
- Board certified in Family Medicine - AOA
- CAQ in Adolescent Medicine
- CAQ in Geriatrics
- CAQ in Sports Medicine
- None
- Other, please specify:
If yes, what board certifications do you maintain? Please check all that apply and add any specialty certifications as appropriate.
- Family Medicine ABFM
- Family Medicine AOA
- Internal Medicine ABIM
- Internal Medicine AOA
- Pediatrics ABP
- Pediatrics AOA
- OB/Gyn ABOG
- OB/Gyn AOA
- Psychiatry ABPN
- Psychiatry AOA
- General Dentistry ABGP
- Pediatric Dentistry ABPD
- Other (please specify)
1. What number and percent of the THC graduates practice in primary care (plan at graduation and one year after graduation)? This question was modified to include additional categories for specialty certification as the THC include internal medicine, psychiatry, OB/GYN, pediatrics and dental residency programs.
Conroe Medical Education Foundation Licensure: (States) Do you currently hold an active medical or dental license?
- Yes
- No
1. What number and percent of the THC graduates practice in primary care (plan at graduation and one year after graduation)?
If yes, in what state(s) do you hold an active license? – Open ended response 1. What number and percent of the THC graduates practice in primary care (plan at graduation and one year after graduation)?


Are you currently in a training position, such as a residency or fellowship?
- Yes
- No
Please provide the following information for the training position:
- Specialty of Program
- Training Institution Name
- City/Town
- State
- Country
1. What number and percent of the THC graduates practice in primary care (plan at graduation and one year after graduation)? Additional fellowship training can indicative of a career choice away from primary care


Have you completed any additional training, such as a residency or fellowship, since your primary care residency program?
- Yes
- No
1. What number and percent of the THC graduates practice in primary care (plan at graduation and one year after graduation)?


Are you currently employed in a nontraining position?
- Yes
- No
1. What number and percent of the THC graduates practice in primary care (plan at graduation and one year after graduation)?


If yes, how would you classify your current primary employer?
- Academic
- Private Practice
- Community Health Center
- Community-based
- organization/nonprofit
- Hospital Non Academic
- Federal Government
- State Government
- City/County Government
- Unknown
- Other (please specify)
1. What number and percent of the THC graduates practice in primary care (plan at graduation and one year after graduation)? This question was adapted from two of the existing THC alumni surveys - Lawrence Family Medicine Residency Alumnae Survey and the Conroe Medical Education Foundation Survey


Are you currently practicing clinical medicine or dentistry?
- Yes
- No
1. What number and percent of the THC graduates practice in primary care (plan at graduation and one year after graduation)?
WWAMI Network Answer questions below about your principal practice setting where you spend most of your patient care time.
Q: What is the zip code (or country, if not USA) in which you practice?
- Zip code or country:
Please enter the following information for you PRINCIPAL practice site this is the physical location where you spend most of your patient care time.
- Name:
- Address:
- Address 2:
- City/Town:
- State:
- Zip:
- Country:
1. What number and percent of the THC graduates practice in primary care (plan at graduation and one year after graduation)?
2. What number and percent of the THC graduates go on to practice in underserved settings (plan at graduation and one year after graduation)?



What specialty do you primarily practice in this setting? Choose one.
- General Family Medicine
- General Internal Medicine
- General Pediatrics
- OB/Gyn
- Psychiatry
- Geriatrics
- Dentistry
- Other (please specify)
1. What number and percent of the THC graduates practice in primary care (plan at graduation and one year after graduation)?

WWAMI Network Answer questions below about your principal practice setting where you spend most of your patient care time. Q: What percent of a full-time equivalent (FTE) are you working? Your FTE (Full-time = 100%): What percent of a fulltime equivalent (FTE) are you working at this site (Fulltime =100%; Each half day per week is generally considered 10%)? – Open ended response
1. What number and percent of the THC graduates practice in primary care (plan at graduation and one year after graduation)?
2. What number and percent of the THC graduates go on to practice in underserved settings (plan at graduation and one year after graduation)?

WWAMI Network Which best describes the principal method by which you are paid for clinical work? Check one:
- Salary
- Receipts
- Base salary plus production incentive
- Other, please specify:
Which of the following best describes the principal method by which you are paid in this practice setting? Check one:
- Salary
- Receipts
- Base salary plus production incentive
- Locums
- Other (please specify)
1. What number and percent of the THC graduates practice in primary care (plan at graduation and one year after graduation)?
2. What number and percent of the THC graduates go on to practice in underserved settings (plan at graduation and one year after graduation)?



Which of the following best describes your principal practice setting's reimbursement model?
- Fee for service practice
- Health Maintenance Organization (HMO)
- Accountable Care Organization
- Concierge/Membership
- Other (please specify)
1. What number and percent of the THC graduates practice in primary care (plan at graduation and one year after graduation)?
2. What number and percent of the THC graduates go on to practice in underserved settings (plan at graduation and one year after graduation)?

WWAMI Network Are you currently practicing family medicine, i.e., outpatient continuity of care and broad spectrum of patients?
- Yes
- No If yes, check one of the following which best describes your principal practice setting:
- Locums
- Fee for service practice
- HMO
- Teaching program
- Military
- Other, please specify:
Which of the following best describes your principal practice setting (check all that apply)?
- Community-based
- Health Center
- Private Practice
- Teaching program
- Hospital
- Emergency Medicine
- Urgent Care
- Military
- Other (please specify)
1. What number and percent of the THC graduates practice in primary care (plan at graduation and one year after graduation)?
2. What number and percent of the THC graduates go on to practice in underserved settings (plan at graduation and one year after graduation)?

WWAMI Network Which of the following best describes your practice organization? Check one:
- Solo
- Family Medicine Partnership (two-physician practice)
- Single-specialty group (three or more physicians)
- Multi-specialty partnership or group (two or more physicians)
-Residency or university teaching environment
- Other, please specify
Which of the following best describes the practice organization of your principal practice (check only one):
- Solo
- Partnership (2physician practice)
- Single specialty group (3 or more physicians)
- Multispecialty partnership or group
- Hospital owned
- Academic program
- Other (please specify)
1. What number and percent of the THC graduates practice in primary care (plan at graduation and one year after graduation)?
2. What number and percent of the THC graduates go on to practice in underserved settings (plan at graduation and one year after graduation)?

WWAMI Network Are you currently practicing in any of the following federally designated areas/practices? Check all that apply:
- HPSA: Federally designated health professional shortage area
- MUA: Federally designated medically underserved area
- MHC: Federally designated migrant health center
- CHC: Federally designated community health center
- RHC: Federally designated rural health clinic
- NHSC: National Health Service Corps
- IHS: Indian Health Service site or tribal clinic
- FQHC: Federally Qualified Health Center
- State qualified health center/clinic
- State or Local Health Department
- Other federally qualified health center/clinic. Please specify:
- Other underserved population. Please specify:
Does this practice site fall into any of the following federally designated areas/practices? Check all that apply.
- HPSA: Federally designated health professional shortage area
- MUA: Federally designated medically underserved area
- MHC: Federally designated migrant health center
- CHC: Federally designated community health center
- RHC: Federally designated rural health clinic
- NHSC: National Health Service Corps
- IHS: Indian Health Service site or tribal clinic
- FQHC: Federally Qualified Health Center
- State qualified health center/clinic
- State or Local Health Department
- None of the above
- Other underserved population (please specify)
1. What number and percent of the THC graduates go on to practice in underserved settings (plan at graduation and one year after graduation)?
Lawrence Family Medicine Residency Alumnae Survey Please describe the population of patients within your practice setting, according to the following (approximate): - ____% Black, not of Hispanic origin -_____% White - ____% Alaskan Native - ____% Asian - ____% Pacific Islander - ____% Mexican American/Chicano - ____% Hispanic - ____% American Indian - ____% Other (Please specify) Please describe the ethnicity of your patient population at this site (approx):
- % Hispanic/Latino
- % Not Hispanic/Latino
1. What number and percent of the THC graduates go on to practice in underserved settings (plan at graduation and one year after graduation)?


Lawrence Family Medicine Residency Alumnae Survey Please describe the population of patients within your practice setting, according to the following (approximate): - ____% Black, not of Hispanic origin -_____% White - ____% Alaskan Native - ____% Asian - ____% Pacific Islander - ____% Mexican American/Chicano - ____% Hispanic - ____% American Indian - ____% Other (Please specify) Please describe the race of your patient population at this site (approx):
- % American Indian or Alaska Native
- % Asian
- % Black or African-American
- % Native Hawaiian or other Pacific Islander
- % White
1. What number and percent of the THC graduates go on to practice in underserved settings (plan at graduation and one year after graduation)?


Mid-Hudson Family Practice Residency Program Graduate Survey Approximate percentage of patients who are on Medicaid at practice? - 0-9%
- 10-30%
- 31-50%
- 51-70%
- 71-90%
- 91-100%
- Don't know
What is the approximate percent of patients who are on Medicaid in this practice?
- 0-9%
- 10-30%
- 31-50%
- 51-70%
- 71-90%
- 91-100%
- Don't know
1. What number and percent of the THC graduates go on to practice in underserved settings (plan at graduation and one year after graduation)?




What is the approximate percent of patients who are on Medicare in this practice?
- 0-9%
- 10-30%
- 31-50%
- 51-70%
- 71-90%
- 91-100%
- Don't know
1. What number and percent of the THC graduates practice in primary care (plan at graduation and one year after graduation)?
2. What number and percent of the THC graduates go on to practice in underserved settings (plan at graduation and one year after graduation)?

Mid-Hudson Family Practice Residency Program Graduate Survey Approximate percentage of patients who are uninsured at practice? - 0-9%
- 10-30%
- 31-50%
- 51-70%
- 71-90%
- 91-100%
- Don't know
What is the approximate percent of patients who are uninsured in this practice?
- 0-9%
- 10-30%
- 31-50%
- 51-70%
- 71-90%
- 91-100%
- Don't know
1. What number and percent of the THC graduates go on to practice in underserved settings (plan at graduation and one year after graduation)?


WWAMI Network Answer questions below about your principal practice setting where you spend most of your patient care time. Q: How many patients do you typically see in the office during a whole day of practice? (Please use an integer)
Number of patients:
How many patients do you typically see in this practice setting during a half day of practice? (Please use an integer) – Open ended response
1. What number and percent of the THC graduates practice in primary care (plan at graduation and one year after graduation)?
2. What number and percent of the THC graduates go on to practice in underserved settings (plan at graduation and one year after graduation)?



Are you providing patient care at any other sites?
- Yes
- No
1. What number and percent of the THC graduates practice in primary care (plan at graduation and one year after graduation)?
2. What number and percent of the THC graduates go on to practice in underserved settings (plan at graduation and one year after graduation)?

WWAMI Network On average, how many face to face patient encounters do you have per week in each of the following settings? Enter the number of encounters for each setting: (Please use an integer for each)
- Office
- Hospital
- Nursing home
- Home visit
- Emergency department
- Other
On average, how many face to face patient encounters do you have per week in each of the following settings? (Please use an integer for each)
- Office
- Hospital
- Nursing home
- Home visit
- Emergency department
- Other (Specify setting and number)
1. What number and percent of the THC graduates practice in primary care (plan at graduation and one year after graduation)?
2. What number and percent of the THC graduates go on to practice in underserved settings (plan at graduation and one year after graduation)?

Mid-Hudson Family Practice Residency Program Graduate Survey Post Graduate Employment (check all that apply) I am currently: - Working in a primary care practice with less than 20 patient care hours per week in continuity of care sessions as the physician of record ___# of hours, representing ____% of my total work time - Working in a primary care practice with 20 or more patient care hours per week in continuity of care sessions as the physician of record - Working in a non-primary care practice - Continuing my medical training or fellowship (primary care fellowship, geriatric fellowship, chief resident, other) - Teaching or training medical students - Conducting research - Working as a health facility/program administrator - Other Do you have time in your job reserved for nonpatient
care related activities (such as teaching, research or administration)?
- Yes
- No
1. What number and percent of the THC graduates practice in primary care (plan at graduation and one year after graduation)?

Mid-Hudson Family Practice Residency Program Graduate Survey Post Graduate Employment (check all that apply) I am currently: - Working in a primary care practice with less than 20 patient care hours per week in continuity of care sessions as the physician of record ___# of hours, representing ____% of my total work time - Working in a primary care practice with 20 or more patient care hours per week in continuity of care sessions as the physician of record - Working in a non-primary care practice - Continuing my medical training or fellowship (primary care fellowship, geriatric fellowship, chief resident, other) - Teaching or training medical students - Conducting research - Working as a health facility/program administrator - Other If yes, please indicate what percent FTE, regardless of location, you are working in each of the following areas:
- Teaching
- Research
- Administration
- Other (Please specify area and FTE)
1. What number and percent of the THC graduates practice in primary care (plan at graduation and one year after graduation)?

WWAMI Network Q: What is your involvement in the medical community, i.e. local, regional, or national professional committees and boards? Please choose one.
- None
- Serve on one committee or board
- Serve on two or more committees or boards
- Serve on two or more committees or boards, one of which is at the regional or national level
- Serve on two or more committees or boards, one of which includes leadership at the regional or national level
Q: Comment on type of organization(s) you are involved in?
Are you currently involved in community service related to your position as a health care provider in the community? Examples might include working with a free clinic, conducting health outreach, or working with a local health related agency.
- Yes
- No
1. What number and percent of the THC graduates practice in primary care (plan at graduation and one year after graduation)?
2. What number and percent of the THC graduates go on to practice in underserved settings (plan at graduation and one year after graduation)?
3. Examine the relationships between resident characteristics and primary care and underserved practice outcomes?

WWAMI Network Q: What is your involvement in community service through local organizations (e.g., church, school, coach, free clinic)? Please choose one.
- Am not involved in any service in my community beyond my practice.
- Am not currently but plan to become involved in one local organization in a service capacity in the next year.
- Am currently involved in local service to the community through one local organization on a limited basis.
- Am currently involved in local service to the community through one or more local organizations with active ongoing participation.
- Am currently involved in service to the community with a leadership or board role in at least one
organization. Q: Comments on type of organization(s) you are involved in?
If yes, please describe how you are involved in community service related to your position as a health care provider in the community. – Open ended response 1. What number and percent of the THC graduates practice in primary care (plan at graduation and one year after graduation)?
2. What number and percent of the THC graduates go on to practice in underserved settings (plan at graduation and one year after graduation)?




If you are not practicing clinical medicine or dentistry, what are you currently doing? – Open ended response 1. What number and percent of the THC graduates practice in primary care (plan at graduation and one year after graduation)?
2. What number and percent of the THC graduates go on to practice in underserved settings (plan at graduation and one year after graduation)?

Lawrence Family Medicine Residency Alumnae Survey Jobs, since residency? (Name and location) Have you held any other jobs since graduating from your primary care residency?
- Yes
- No
1. What number and percent of the THC graduates practice in primary care (plan at graduation and one year after graduation)?
2. What number and percent of the THC graduates go on to practice in underserved settings (plan at graduation and one year after graduation)?

AAMC Graduation Questionnaire Please list the type of loan forgiveness program in which you plan to participate:
- Department of Education’s Public Service Loan Forgiveness (PSLF)
- National Health Service Corps Scholarship
- National Health Service Corps Loan Repayment
- Indian Health Service Corps
- Armed Services (Navy, Army, Air Force)
- Uniformed Service (CDC, HHS)
- State loan forgiveness program
- Hospital program (e.g. sign on Bonus)
- Private loan forgiveness program:
Other:
Have you participated in a loan repayment program since finishing your primary care residency?
- Yes
- No
If you have received any kind of loan repayment since completing your primary care
residency program, please indicate the type of loan repayment program. Choose all that apply.
- Department of Education’s Public Service Loan Forgiveness (PSLF)
- National Health Service Corps Scholarship
- National Health Service Corps Loan Repayment
- Indian Health Service Corps
- Armed Services (Navy, Army, Air Force)
- Uniformed Service (CDC, HHS)
- State loan forgiveness program
- Hospital program (e.g. sign on Bonus)
- Other (please specify)
3. What are the characteristics of residents who choose THC programs, by demographics, intention to practice in primary care and intention to practice in rural and/or underserved areas?


Please provide the best contact information to follow up with you after graduation.
- Name:
- Address:
- Address 2:
- City/Town:
- State:
- Zip:
- Country:
- Email Address:
- Phone Number:




Comments – Open ended response


Sheet 5: Anonymous Graduate

Anonymous Alumni Survey - Mapping



Source Source Question and Answers GW Question and Answers Research Question(s) Notes
WWAMI Network Are there areas that should have received MORE emphasis during your residency? – Open ended response Are there areas that should have received MORE emphasis during your residency? – Open ended response 5. How satisfied are residents with curriculum and enhanced programmatic features of the THC model? 6. How do residents suggest that the THC residency program can be improved? On review of existing THC alumni surveys, program feedback was commonly sought. Feedback is important for continuous quality improvement for resident training and is also important to understand the resident satisfaction with the training model and the potential strengths and weaknesses of the model.
WWAMI Network Are there areas that should have received LESS emphasis during your residency? – Open ended response Are there areas that should have received LESS emphasis during your residency? – Open ended response 5. How satisfied are residents with curriculum and enhanced programmatic features of the THC model? 6. How do residents suggest that the THC residency program can be improved?
WWAMI Network For each of the subject areas listed on the following pages, please indicate:
1. How well your residency training prepared you for your practice (1 - 5)
2. Whether or not the item is currently a part of your practice (yes or no) List of numerous procedures, medical knowledge, practice management and other skills to rate
How satisfied are you with your residency training in the following areas?
- Medical Knowledge (likert scale)
- Procedural Skills (likert scale)
- Practice Management (likert scale)
- Communication Skills (likert scale)
- Medical Ethics (likert scale)
- Overall (likert scale)
5. How satisfied are residents with curriculum and enhanced programmatic features of the THC model? 6. How do residents suggest that the THC residency program can be improved?
WWAMI Network Please indicate your level of satisfaction with your principal practice in the following
areas:
- Location (likert scale)
- Colleagues (likert scale)
- Employer (likert scale)
- Hours (likert scale)
- Income (likert scale)
- Overall (likert scale)
Please indicate your level of satisfaction with your principal practice in the following
areas:
- Location (likert scale)
- Colleagues (likert scale)
- Employer (likert scale)
- Hours (likert scale)
- Income (likert scale)
- Overall (likert scale)
5. How satisfied are residents with curriculum and enhanced programmatic features of the THC model?
WWAMI Network In your practice of medicine, what is the greatest source of satisfaction? – Open ended response In your practice, what is the greatest source of satisfaction? – Open ended response 5. How satisfied are residents with curriculum and enhanced programmatic features of the THC model?
WWAMI Network In your practice of medicine, what is the greatest source of dissatisfaction? – Open ended response In your practice, what is the greatest source of dissatisfaction? – Open ended response 5. How satisfied are residents with curriculum and enhanced programmatic features of the THC model? 6. How do residents suggest that the THC residency program can be improved?
WWAMI Network How satisfied are you with your choice of medicine as a profession? Please circle one (likert scale) How satisfied are you with your choice of specialty? Please circle one (likert scale) Please answer the following:
How satisfied are you with
your choice of medicine/dentistry as a profession? (likert scale)
How satisfied are you with
your choice of specialty? (likert scale)
5. How satisfied are residents with curriculum and enhanced programmatic features of the THC model?


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