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Global Medical Education
Elective Eval Form-Global Medical Education
Year of Graduation
Are you an International Research Award recipient?:
Are you in the Global Health track (SCGH)?:
International Elective Travel Site(be specific):
Dates of Travel:
Stony Brook Elective Supervisor/Mentor:
International Site Supervisor/Mentor:
Site Supervisor email/contact information:
NGO Website (if applicable):
For elective credit list 4 goals and objectives:
Did the elective enable you to meet these goals and objectives?
What were your roles and responsibilities on the project/elective?
Describe your living quarters:
Housing Recommendation (if any):
Please Comment on the Safety and Security of your travel and setting:
List any Sponsors, e.g. International Fellowship, Alumni Association Fund, other funding:
Total Cost of Trip: $
Rate Overall Experience:
Rate your mentors/supervisors
Would you recommend this site to another student
Describe in your own words the strengths, weaknesses, caveats, etc. of this experience:
Additional Suggestions for future students at this site:
How would you rate the Office of Global Medical Education?
Are there ways in which the Office of Global Medical Education can be improved? Please comment
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