ECVS
ACTIVITY LOG to accompany report July 31st 20____

Residents name:	

Date of rotation (start and finish)	Number of weeks	Category *
	Specify type of rotation **	Supervising Diplomate	Diplomate’s signature	

						

						

						

						

						

						

						

						
						
*Categories:
C: Supervised surgical rotation
O: Other required rotations i.e. diagnostic imaging, anaesthesia, pathology, internal medicine
OC: Time off clinics for academic activities, research, manuscript preparation
CE: Continuing education (Specialist meetings or specialty training)
X: External rotations i.e. to a different institution
H: Holiday

** Type of rotation:  Indicate the type of activity e.g. Lameness clinics, surgery, externship, anaesthesia, specific courses meetings etc

Resident’s/ Trainee Signature:____________________________________________________ 

Supervisor's Signature:___________________________________________DATE: ____________

(Signatures certify that information is true and accurate) 

Revised Feb 2010