2015 Community Teacher of the Year Nomination Instructions and Form The Community Teacher of the Year Award celebrates excellence in a community family medicine preceptor for the academic teaching year 2014‐2015. This award is nominated by Ontario’s Family Medicine Residents and medical school students. Eligible candidates for the award must be a member of OCFP and a community‐based physician. Family physicians who are designated as “geographic full‐time (GFT) physicians” in an academic urban teaching unit are not eligible. The Award will be presented at the OCFP’s Awards Ceremony in November in Toronto and includes a $500 honorarium. Deadline for nominations: April 10, 2015 Instructions Please include the following materials in the Community Teacher of the Year nomination package:  The completed nomination form (see last page).  A nomination letter that describes the nominee and provides evidence and examples of excellence in community family medicine preceptor. The letter should address the following categories:  Describe the practice characteristics (e.g. Nursing home/ER/inpatients/home visits/OB).  Provide specific examples of teaching excellence.  Describe role as a mentor beyond clinical teaching skills (e.g. work/life balance, community involvement, health advocate).  Any other relevant examples of teaching excellence.  Please type the nomination package to ensure it is clear and legible and keep the letter to two pages. Feel free to use bullets where appropriate.  Letters of support from other Family Medicine Residents would be an asset (to a maximum of five letters).  The nominee’s CV. OCFP 2015 Community Teacher of the Year Nomination Form & Instructions 1/2 2015 Community Teacher of the Year Award Nomination Form Please print or type NAME OF THE NOMINEE: ADDRESS: TELEPHONE: EMAIL: NUMBER OF PAGES ATTACHED: NAME OF THE NOMINATOR ADDRESS: TELEPHONE: EMAIL: NOMINATOR’S CFPC MEMBERSHIP # (IF A MEMBER): OR RESIDENCY PROGRAM/ MEDICAL SCHOOL: Deadline for nominations: April 10, 2015 Please send the completed form and nomination package by email, mail or fax to: Attention: OCFP Awards Mail: Ontario College of Family Physicians 400 University Avenue, Suite 2100 Toronto, ON, M5G 1S5 Email: [email protected] Fax: 416‐867‐9990 OCFP 2015 Community Teacher of the Year Nomination Form & Instructions 2/2