Reference

Referees Report In Confidence Post Title:

Foundation Programme

Ref No:

M251

Name of Candidate:

Date of interview N/A Dr Hosam Elseknidy

1. Length of time you have known candidate? 12 months………………………………………………………………. 2. Capacity in which the applicant is/was known to you (e.g. employer etc)?............................................ He was known to me as a house officer…………………………….. . ……………………………………… ….……………………………………………. 3. This section should only be completed when the referee is, or was, an employer. (i)

Dates employed by your Organisation: From To

01/09/2007…………………………………………………….. 31/08/2008……………………………………………………..

(ii) Please state the title and main duties of the post held by the applicant in your organisation: … Dr Elseknidy worked in the hospital as a house officer during the internship He had six rotations as Paediatric, Surgery, Medicine, O&G, Anaesthesia, A&E .Dr Elseknidy used to work in a team consisting of consultant and specialty trainings doctors, nurses and paramedics .He used to Review and clerk the patients, and presenting these clerking to the seniors .He used to document safely and clearly. Dr Elseknidy is component and has gained the skills necessary to his level such as blood taking, canulation, catheterization ...………...…………………………………………………………………………… …………………………….. …..……….…………………………………………………………………………………………………………… (iii)

No. of day’s absence and episodes including sickness in the last 12 months (please give reasons):

None…….……….…………………………………………………………………………………………………… …………...…………………………………………………………………………………………………………… (iv) Reason for leaving: Training was for one year only ……………………………………………………… …………………………………... (v)

Would you re-employ /do you know of any reason why we should not employ this applicant YES/NO Yes Reasons: …………….………………………………………………………………………………………………

4. Please express your opinion of the candidate’s suitability for the post outlined in the attached job description and person specification? (It would be helpful if you could comment on the main features of the applicant’s character, with reference to any strength, weaknesses, special aptitudes/abilities, their communication skills and their relationship with others and any other factors which you consider relevant.)

1-Clinical expertise: Excellent 2-Technical skills: Usually capable with most practical procedures 3-Attitude to patients and family: Usually very thoughtful and caring 4-Response to stress: Manages patients well and calmly seeks advice regarding problems promptly and appropriately having thought them through. 5-Organisational skills: Enthusiastic, efficient and innovative 6-Note keeping: Usually keeps well prepared problem-orientated notes 7-Participates in structured teaching/learning: Very keen and active also Looks for and finds opportunity 8-Ability to learn: Learns rapidly from experience and passes on new found knowledge 9-Commitment: Punctual 10-Teaching skills: Fulfils teaching requirements well 11-Audit: Participates actively in audit 12-Research: Not applicable 13-Written and verbal communication: Excellent (Please continue on a separate sheet if necessary) 5. Have there been any disciplinary or capability issues concerning the applicant in the last two years? Yes/No NO If yes, please describe briefly ………………………………………………………………………………… ……………………………………………………………………………………………………………………. 6. Any other comments: ……………………………………………………………………………………… …………………………….

Name: Dr Mohammed KHATAB …………………………………………………………………………………………..………………… Signed: Mohammed Khatab……………

Date: ………06/05/2009…………………………...……

Medical institute of Damanhour Alexandria Teaching Hospital Egypt [email protected] Designation:

Consultant Radiology……………………………………………………………………………………………… …… Telephone No: 002/045/3301815………………………………………………………………………………… ………………… Form G