TO:                  «Div_Chief»                                                                    DATE: May 14, 2003
«Division»

FROM:            Mary Ann Scramstad, Coordinator
Office of Academic Affairs
Department of Medicine

RE:                   Renewal of Secondary Faculty Appointment

Faculty members with Secondary appointments are reviewed for reappointment every three years. This year «First_Name» «Last_Name», «Degree», who has a secondary appointment as «Secondary_Rank», is due for review. A letter was sent out asking if renewal of appointment was wanted and the response indicated reappointment is requested.

Please review the contribution that this faculty member makes to the Department and check any of the activities listed below that this faculty member participates in:

	I supervise Internal Medicine ` students, ` residents or ` fellows [specify students, residents or fellows or any combination] in outpatient offices
	I supervise Internal Medicine ` students, ` residents or ` fellows[specify students, residents or fellows or any combination] in the care of inpatients
	I teach Internal Medicine ` students, ` residents or ` fellows[specify students, residents or fellows or any combination] in the classroom (e.g. lecture or small group preceptor)
	I regularly attend Department of Medicine journal clubs
	I have given a Department of Medicine Grand Rounds or noon conference presentation
	Participate in research with (Creighton faculty) Dr. [name]in [type of research]
	Other contributions

The «Division» Division requests reappointment for «First_Name» «Last_Name», «Degree» for the next three years.

` Yes, Reappoint     `  No, Do Not Reappoint because _____________________

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«Div_Chief»                             Date