CME (Clinical Education) (Includes: attending rounds, morning report, noon conferences, grand rounds, consultation rounds, etc.) CME (Clinical Education) Program Hours/Year PRECEPTING (Includes: laboratory supervision, supervision in clinic, etc.) Preceptee Group Precepting Activity Preceptee (s) Hours/Year (Resident, Fellow, Post-doc, etc.) OTHER TEACHING ACTIVITY (tutoring, dental students, etc.) Role Contact Hours/Year Teaching Activity (Course Director, Instructor, Lecturer, Institution Lect. Sm. Grp. Lab Teaching Assistant, Other (specify)) MENTORSHIP Mentee Group Mentorship Activity (Junior Faculty, Post-doc, Mentee (s) Medical Student, etc.) TOTALS Hours/Year Lect. Sm. Grp. Lab Clinical Precepting
CME (Clinical Education) (Includes: attending rounds, morning report, noon conferences, grand rounds, consultation rounds, etc.) CME (Clinical Education) Program Hours/Year PRECEPTING (Includes: laboratory supervision, supervision in clinic, etc.) Precepting Activity Preceptee Group (Resident, Fellow, Post-doc, etc.) Preceptee (s) Hours/Year OTHER TEACHING ACTIVITY (tutoring, dental students, etc.) Teaching Activity Role (Course Director, Instructor, Lecturer, Teaching Assistant, Other (specify)) Institution Contact Hours/Year Lect. Sm. Grp. Lab MENTORSHIP Mentorship Activity Mentee Group (Junior Faculty, Post-doc, Medical Student, etc.) Mentee (s) TOTALS Hours/Year Lect. Sm. Grp. Lab Clinical Precepting
form_merit_plan.docx