DA Form 1970 House Staff Evaluation Report

DA Form 1970 House Staff Evaluation Report

What Is DA Form 1970?

DA Form 1970, House Staff Evaluation Report , is a non-mandatory document associated with the evaluation of progression and performance required for each Graduate Medical Education (GME) program participant.

The latest version of the form - sometimes confused with DD Form 1970, Motor Equipment Utilization Record - was released by the U.S. Department of the Army (DA) on May 1, 2009 , with all previous editions being obsolete. An up-to-date fillable DA Form 1970 is available for download down below or can be found on the Army Publishing Directorate website.


DA Form 1970 Instructions

Filing procedures for the DA Form 1970 are as follows:

  1. The form requires the name, grade, intern status (rotating or straight), and specialty of the participant along with the name of the hospital and the period of service covered by the report.

  2. Part I, Clinical Performance , contains Sections A through F. Each section contains a scale from 1 to 4. The participant's performance is numerically rated on each criterion within the provided range:

    • Section A assesses the level of general medical knowledge;
    • Section B is for evaluating the handling of medical history records;
    • Section C specifies the way physical examinations are performed;
    • Section D evaluates diagnostic acumen;
    • Section E describes how well therapy is planned, implemented and evaluated;
    • Section F refers to the way medical records are kept.
  3. Part II, Assuming Responsibilities , contains three more sections:

    • Section G assesses how well administrative obligations are fulfilled;
    • Section H shows the level of interest in pursuing further medical education;
    • Section I of DA Form 1970 evaluates the participant's ability to establish an effective physician-patient relationship.
  4. Part III, Personal Qualities Assessment , covers Sections J through M:

    • Section J evaluates the participant's attitude and appearance;
    • Section K assesses the way they cooperate with others;
    • Section L is for evaluating their levels of leadership and responsibility skills.
    • Section M is for assessing how accurately they evaluate their own skills and help mentor those around them.
  5. Part IV, Overall Evaluation , requires counseling with the House Officers done by the rater.

  6. Part V, Recommendation for Additional Training , contains suggestions for additional training in case any is needed.

  7. Part VI, Narrative Description , contains an additional block for an in-depth written description of the participant's performance and personal qualities.

DA Form 1970 needs to be verified by the signatures of the Service Chief, the Director of Medical Education, and a hospital or facility commander.

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