Columbia University Medical Center

Office of Global Health Training & Education

Student Experience Evaluation Form




Have you just completed an elective, rotation or practicum in another country?  If so, we need your input! 

Many have pull-down menus.

 

Your information and comments will be very useful to fellow CUMC students interested in gaining experience in global health and will be available on the Office of Global Health Training & Education website.

First Name       Middle                    Last Name      

UNI      

Class of

School         Program

Is this opportunity open for students from other CUMC schools? Yes No Don't Know

May a student considering doing a similar elective contact you?
Yes No

 

 

Opportunity Type

Year for Elective

Objective:

Institution

Website

Region

City         Country

Advisor/Mentor

Program Administrator/Contact

Description      

Please specify your main activities:

Columbia Advisor/Mentor

Start Date            End Date

Total Cost          Travel Cost         Living Cost         Misc Costs

Funding Source(s)

What sort of support did the Host Institution provide?

Would you recommend your experience to another student? Yes No

Why or why not?

In what way was this elective valuable (educationally, clinically, culturally, for research, etc.)?

Would you go back? Yes No

Why or why not?

Will you stay in contact with your Advisor/Mentor? Yes No

How well were your objectives and expectations met?

Please comment on the support (monetary or other) you received from Columbia :

Please comment on the support you received from the Host Institution:

Were there other topics that could be explored?

Are there any precautions for the area (medical, cultural, political, etc.)?      

Do you have a slideshow or photos from your trip online?  Yes No   If so, please enter the URL here       or email your presentation along with this survey to Tanya Munroe.

Additional comments:

 

 

THANK YOU!