School of Medicine

Faculty Education Office

Candidate Name:

UCAS ID:

Interviewer:
Please print name

Criterion
Motivation to study medicine *
Realistic approach to medicine as a
career *
Capacity to deal with stress /personal
resilience *

Strong

Moderate

Weak

Low
Anxiety

Average
Anxiety

High
Anxiety

Evidence of working as a leader*

Evidence of teamwork*
Ability to multi-task *
Potential contribution to Medical
School life
Values-Based Recruitment Scenario
discussed *:
Question # from question bank
Communication skills *
Maturity of character*
Anxiety during interview (please circle)
Overall assessment

* Aligned to the values of the NHS constitution

Remarks:

Personal Recommendation:

Offer

Reserve List

Reject

For Chair only

Consensus Remarks:

Panels Recommendation:

Offer

Reserve List

Reject

Scholarship candidate
Please tick if appropriate

If undecided Admissions Tutors decision: Offer

Reserve

Reject