Medical Student Placement Feedback

1. Please enter your name (required to receive a certificate)

3. Placement start date *

	DD/MM/YYYY

4. Placement end date *

	DD/MM/YYYY

5. Rate the following statements from strongly disagree to strongly agree. *

	Strongly disagree	Disagree	Neither agree nor disagree	Agree	Strongly Agree
The application form was clear	The application form was clear Strongly disagree	The application form was clear Disagree	The application form was clear Neither agree nor disagree	The application form was clear Agree	The application form was clear Strongly Agree
The response time was reasonable	The response time was reasonable Strongly disagree	The response time was reasonable Disagree	The response time was reasonable Neither agree nor disagree	The response time was reasonable Agree	The response time was reasonable Strongly Agree
My queries were responded to clearly and informatively	My queries were responded to clearly and informatively Strongly disagree	My queries were responded to clearly and informatively Disagree	My queries were responded to clearly and informatively Neither agree nor disagree	My queries were responded to clearly and informatively Agree	My queries were responded to clearly and informatively Strongly Agree
I am happy with the department I was placed in	I am happy with the department I was placed in Strongly disagree	I am happy with the department I was placed in Disagree	I am happy with the department I was placed in Neither agree nor disagree	I am happy with the department I was placed in Agree	I am happy with the department I was placed in Strongly Agree
Overall, I am happy with the application process	Overall, I am happy with the application process Strongly disagree	Overall, I am happy with the application process Disagree	Overall, I am happy with the application process Neither agree nor disagree	Overall, I am happy with the application process Agree	Overall, I am happy with the application process Strongly Agree

6. Was all the information you required available on the GOSH undergraduate page? *

Yes
No

If no, what information do you think should be added to page?

7. Do you have any feedback on the application process? *

8. Select your level of satisfaction to the following statements *

	😠 Very dissatisfied	🙁 Dissatisfied	😐 Neutral	🙂 Satisfied	😀 Very satisfied
Clinical Involvement	Clinical Involvement [EMOJI_1] Very dissatisfied	Clinical Involvement [EMOJI_2] Dissatisfied	Clinical Involvement [EMOJI_3] Neutral	Clinical Involvement [EMOJI_4] Satisfied	Clinical Involvement [EMOJI_5] Very satisfied
Supervisor support	Supervisor support [EMOJI_1] Very dissatisfied	Supervisor support [EMOJI_2] Dissatisfied	Supervisor support [EMOJI_3] Neutral	Supervisor support [EMOJI_4] Satisfied	Supervisor support [EMOJI_5] Very satisfied
Timetable and other materials provided for your placement	Timetable and other materials provided for your placement [EMOJI_1] Very dissatisfied	Timetable and other materials provided for your placement [EMOJI_2] Dissatisfied	Timetable and other materials provided for your placement [EMOJI_3] Neutral	Timetable and other materials provided for your placement [EMOJI_4] Satisfied	Timetable and other materials provided for your placement [EMOJI_5] Very satisfied
Theatre session/Ward Work	Theatre session/Ward Work [EMOJI_1] Very dissatisfied	Theatre session/Ward Work [EMOJI_2] Dissatisfied	Theatre session/Ward Work [EMOJI_3] Neutral	Theatre session/Ward Work [EMOJI_4] Satisfied	Theatre session/Ward Work [EMOJI_5] Very satisfied

9. Would you recommend Great Ormond Street Hospital as a placement to others? *

Yes
No
Maybe

Comments:

10. Please feedback on your placement *

11. Following your placement at GOSH, would you consider Paediatrics as a career? *

Yes
No
Unsure

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