All applicants are required to complete the supplemental questionnaire as part of the on-line application process. The responses in this supplemental questionnaire are mandatory for participation in this recruitment process. The questionnaire will be used to assess each candidate’s possession of the minimum qualifications.
Responses to items on the supplemental questionnaire must be supported by the information provided on the application. This information is subject to verification. Resumes are not used or reviewed to determine whether you meet the minimum qualifications or to determine your score/rank. A resume will not substitute for a completed application. If you write "see resume" on the application or on the supplemental questionnaire, your application may be rejected.
1
Have you successfully completed a residency program accredited by the Accreditation Council for Graduate Medical Education or American Osteopathic Association (i.e. Board Eligible)?
Yes
No
2
In which medical specialty area did you successfully complete your residency?
Occupational Medicine
Emergency Medicine
Internal Medicine
Other
3
If you selected Other in the previous question, please identify in which specialty area you completed your residency. If this question does not apply to you, type N/A in the box below.
4
Do you possess a valid license to practice medicine issued by the Medical Board of California or the Osteopathic Medical Board of California?
Yes
No
5
CERTIFICATION: I hereby certify that I am the author of this questionnaire and that all information is true and based on my education, training, skills, and experience. I understand that any false or incorrect statement may result in my disqualification of the selection process for this position and/or dismissal from employment with the City and County of San Francisco. I also understand and agree that any information provided is subject to verification.
Department of Human Resources