Official SealDepartment of Budget and Management


#19-004605-0003
Supplemental Questionnaire

Last Name
First Name
1.

Do you possess a degree in medicine from an accredited college or university?

Yes No
2.

Are you currently licensed to practice medicine by the Maryland Board of Physicians?  (If Yes, please submit a copy of your license or license verification with your application.)

Yes No
3.

This position requires that you possess a Board Certification.  Please indicate the field in which you have your Board Certification.

4.

Describe your clinical experience.

Please include name of employer, job title, dates of employment, and hours worked per week, this information must also be reflected in your application.  If you do not possess experience in this area, put N/A in the box below. 

5.

Describe your clinical experience involving leadership and management in the health care industry.

Please include name of employer, job title, dates of employment, and hours worked per week, this information must also be reflected in your application.  If you do not possess experience in this area, put N/A in the box below. 

6.

Describe your experience making strategic decisions.

This experience must also be included on your application (please include name of employer, job title, dates of employment and hours worked per week). If you do not possess this type of experience, please indicate N/A.

7.

Describe your experience leading staff and engaging stakeholders, including physicians and other health care providers.

This experience must also be included on your application (please include name of employer, job title, dates of employment and hours worked per week). If you do not possess this type of experience, please indicate N/A.


Powered by JobAps