August 2020 Grand Rounds Pre-assignment
Complete this form as a team by August 25th. Your team only needs to submit one form. A copy of your responses will be emailed to you when you have completed the form.
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Do you believe a post-residency training program in a rural area can train Residency graduates in procedural skills? If yes, which ones? *
How far from your medical school or local hospital is it to the nearest provider for the above procedures? If you work in an urban community, please pick a nearby rural community or your home community.   *
Enter your team name or your site name *
Name of your study site (site you're answering questions about) *
Location of medical school or local hospital (city, state, zip *
Check the boxes if the providers in your county and surrounding counties do the following. (for each procedure, specify if F.P, Gen. Surgeon, OB, etc. and any details about their training you are aware of such as fellowship or not) *
No Providers
F. P.
General Surgeon
O.B.
Other (please specify in the next question)
C-Sections
Endoscopy-Upper
Endoscopy-Lower
Tubal Ligations
D & C
Vasectomy
Ultrasound
Hernias
Appendectomy
Ectopic Tubal
For any of the above procedures, specify if any other medical professionals perform these procedures in your study site. *
For any of the above procedures, provide any details you may have about the professionals' training such as fellowships *
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