MEDICAL STUDENT PERFORMANCE EVALUATION

for
Andalib Hossain
November 24, 2014
IDENTIFYING INFORMATION
Mr. Hossain is a fourth-year student in good standing at Duke-NUS Graduate Medical School in
Singapore.
UNIQUE CHARACTERISTICS
Mr. Hossain was born in Dhaka, Bangladesh and raised in Kuwait City, Kuwait. He became a Canadian
Citizen in 2012 after the completion of his undergraduate degree. He chose to do his undergraduate work
at the University of Toronto and graduated with High Distinction, in 2011, with a Bachelor of Science
degree with majors in Biology and Economics, and a cumulative GPA of 3.80.
Mr. Hossain played a leadership role in teaching at the Robert Gillespie Academic Skills Centre. (include
what role of leadership and briefly what your responsibility was; dont list, write sentences)
Mr./Ms. [Last Name] also participated as a research {aide, assistant, technologist} under the mentorship
of {First and Last Name of Mentor followed by academic title, e.g. MD, PhD}, Department of (name of
dept., e.g. Biology), (college, university, medical center, hospital, etc.) The subject of {his/her} work was
(brief description, 1 or 2 short sentences). This study resulted in (presentations and/or publications by
title, where delivered or published, which city, what year). This work was in part funded by {scholarship,
fellowship}.
In the community, Mr./Ms. [Last Name] was active in (names of organizations, what your role was.)
Following {his/her} undergraduate career, Mr./Ms. [Last Name] chose to (insert any activities pursued for
the year(s) prior to matriculating at Duke-NUS; could insert summer activity if relevant and significant).
We were delighted when Mr./Ms. [Last Name] chose to matriculate at Duke-NUS Graduate Medical
School in July 2011.
At Duke-NUS, Mr./Ms. [Last Name] participated in/led/was awarded/etc (insert any accomplishments
(i.e. leadership role, community involvement, and etc) that occurred during the course of study.
Mr./Ms. [Last Name] received (insert awards and achievements) for _______.
His/Her academic performance at Duke-NUS can be found in the Academic Progress Section.

Additional Information for Summary:

1. Specialty (specialties) in which you plan to apply:
2. Reasons for your interest in this specialty:
3. Personal characteristics that make you well-suited for this specialty:
4. Honors received in medical school (awards, scholarships, etc.) Name and describe each one :
5. Any other volunteer, work, special activities not mentioned in Unique Characteristic:
6. Special circumstances we need to explain:
Leave(s) of absence during school
when
reason(s)
Incomplete grade(s)
course(s)
reason(s)
Failing grade(s)
course(s)
reason(s)
Remediation of any course work
course(s)
reason(s)
Disciplinary actions against you:
date(s)
reason(s)
resolution(s)
Significant challenges or hardships you would like mentioned:
7. What do you think should be highlighted about you as a residency candidate and your career at DukeNUS Graduate Medical School?
8. We recommend that the Summary mention the specialty you are applying to. Some students apply to
multiple specialties and as a result may not want the Summary to indicate one specialty in particular.
Do you want the Summary in MSPE to indicate your residency choice? Yes / No