Each trainee receives a formal one-on-one evaluation quarterly from the program director in addition to informal discussions as indicated. The evaluation of the resident's performance consists of comprehensive rotation specific evaluations by the faculty and 360-degree evaluations performed by the ICU nursing and respiratory therapy staff. The resident and program director discuss the resident's progress, clinical and diagnostic skills, technical skills, didactic knowledge, problem-solving ability, judgment, and intra-personal skills as necessary. All patient care and procedures performed by the surgical critical care residents are documented online. As a result, patient and procedure lists can be viewed and printed by the program director and resident at any time to review and monitor the resident's experience and training. The results of the annual Multidisciplinary Critical Care Knowledge Assessment Program (MCCKAP) exam are discussed with each resident as they become available from the Society of Critical Care Medicine. Each surgical critical care resident completes an evaluation of each critical care faculty member on a quarterly basis or following each elective rotation, which is reviewed by the program director. Issues raised are discussed with the faculty members, as necessary, on an anonymous basis.