Referee - Specialist Assessment Referee Report
Referee - Specialist Assessment Referee Report
Name of applicant
Name of referee
Address
Telephone
Relationship to Applicant
Please note that this report may be provided to the applicant if they request a copy. Please tick this box if you would prefer that it
Referees are asked to comment on the applicant’s abilities and therefore must be familiar with his/her practice at
consultant/specialist level. You may be contacted by the College for further discussion regarding this report.
This report will assist the RANZCR in making an adequate assessment of the applicant’s clinical, professional and
ethical abilities. The areas addressed in this report are similar to those completed by supervisors within and at the
end of the College’s training program and the report will therefore allow
the Board to compare the applicant’s abilities against those of a consultant radiologist/radiation oncologist trained
in Australia or New Zealand.
There is a five point rating scale for each of a number of areas relating to knowledge, skills, research, attitudes, etc:
Please indicate the basis on which you are primarily making your assessment of the applicant (you may tick
more than one box):
What you would expect based on your knowledge of the applicant in other areas
Responsibility
Accepts responsibility for own actions and understands the limitations of own knowledge and
experience
Clinical Judgement
Demonstrates ability to consider alternatives in making diagnostic and therapeutic decisions
Quality Assurance
Demonstrates ability to initiate and evaluate Quality Assurance programs
Ongoing Education
Shows a resourceful attitude towards continuing education to enhance quality of patient care
Self Assessment
Accepts the limits of own competence and functions within own capabilities; seeks advice and
assistance when appropriate; accepts criticism
Organisation Skills
Demonstrates ability to plan, coordinate and complete administrative tasks associated with radiological
care
Relationships with Medical Staff
Maintains the respect of his/her colleagues
Relationships with Health Professionals
Demonstrates ability to work well and efficiently in the health care team; values the
experience of others
Relationships with Clerical Staff
Relates easily to members of staff; maintains team spirit and encourages cooperation
Research
Understands scientific methodology; participates in research studies by formulating and testing
hypotheses and analysing the results
Please comment on any areas that require improvement which the applicant displays in regards to the
above areas.
Summary Recommendation
Would you recommend that the applicant is a competent consultant capable of providing a high standard of
medical care without supervision?
YES NO
If not, please supply details of critical areas of which require further supervision / assistance.
I am willing to be contacted by the College for further discussion regarding this report: YES
NO
Name of Referee
Signature:
Date: