STUDENT EXIT INTERVIEW FORM Name: _________________________________ Current email address:__________________________ ID No: _______________________ Intended place of Residency:_______________________________ PRE-MEDICINE Start Date: __________________________________ End Date: _______________________________ Number of Credits: _________________________________ Eligibility for BMSC (Basic Medical Sciences Certificate) Yes No SUBJECTS TAKEN IN PRE-MEDICINE: Biology 1 Yes No – Biology 2 Yes No – Chemistry 1 Yes No – Chemistry 2 Yes No – Organic Chemistry Yes No Inorganic Chemistry Yes No Physics 1 Yes No – Physics 2 Yes No – Cell Biology Yes No Medical Terminology Yes No Molecular Biology Yes No Genetics Yes No Basic Human Anatomy Yes No Basic Bio Chemistry Yes No Basic Physiology Yes No Introductory Microbiology Yes No Immunology Yes No Introduction to Path-Physiology Yes No Basic Behavioral Sciences Yes No English 1 Yes No – English 2 Yes No – Introduction to Statistics Yes No BASIC MEDICAL SCIENCES: Bio Chemistry Yes No Physiology 1 Yes No – Physiology 2 Yes No – Anatomy 1 Yes No – Anatomy 2 Yes No – Molecular Biology Yes No Neurosciences Yes No Histology Yes No Embryology Yes No Behavioral Sciences Yes No Community Medicine & Epidemiology Yes No Pharmacology Yes No Microbiology Yes No Pathology 1 Yes No – Pathology 2 Yes No – History Taking Skills Yes No Physical Diagnosis Yes No Introduction to Clinical Medicine Yes No USMLE Board Review Course Yes No Physician and Global Society Yes No
STUDENT EXIT INTERVIEW FORM Name: _________________________________ Current email address:__________________________ ID No: _______________________ Intended place of Residency:_______________________________ PRE-MEDICINE Start Date: __________________________________ End Date: _______________________________ Number of Credits: _________________________________ Eligibility for BMSC (Basic Medical Sciences Certificate) Yes No SUBJECTS TAKEN IN PRE-MEDICINE: Biology – 1 Yes No Biology – 2 Yes No Chemistry – 1 Yes No Chemistry – 2 Yes No Organic Chemistry Yes No Inorganic Chemistry Yes No Physics – 1 Yes No Physics – 2 Yes No Cell Biology Yes No Medical Terminology Yes No Molecular Biology Yes No Genetics Yes No Basic Human Anatomy Yes No Basic Bio Chemistry Yes No Basic Physiology Yes No Introductory Microbiology Yes No Immunology Yes No Introduction to Path-Physiology Yes No Basic Behavioral Sciences Yes No English – 1 Yes No English – 2 Yes No Introduction to Statistics Yes No BASIC MEDICAL SCIENCES: Bio Chemistry Yes No Physiology – 1 Yes No Physiology – 2 Yes No Anatomy – 1 Yes No Anatomy – 2 Yes No Molecular Biology Yes No Neurosciences Yes No Histology Yes No Embryology Yes No Behavioral Sciences Yes No Community Medicine & Epidemiology Yes No Pharmacology Yes No Microbiology Yes No Pathology – 1 Yes No Pathology – 2 Yes No History Taking Skills Yes No Physical Diagnosis Yes No Introduction to Clinical Medicine Yes No USMLE Board Review Course Yes No Physician and Global Society Yes No