Professional Reflection Form

“SELF” / MEANING (What kind of doctor will I be?)

Understanding one’s (unique) path of contribution and service to patients, society, and the profession

1. What kind of doctor will I be? (Self / Meaning)*

2. What matters most to me? (Values)*

3. What are my strengths? (Strengths)*

4. How do I see myself, and how do others see me? (Self-Awareness)*

Understanding how to work effectively with others and influence people to achieve desired results

5. How will I show up for others? (Team / Community)*

6. Who do I need to know? (Network)*

7. How do I connect with others? (Relationships)*

8. How do I communicate with influence? (Communication)*

Developing a desire and capacity to create positive change (in healthcare)

9. How will I contribute? (System / Purpose)*

10. What am I committed to that is greater than myself? (Mission)*

11. How will I define success? (Vision)*

12. What is my next step? (Process)*

Your name*

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