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Photo
Personal Informations
N0. : ----------------------.
Year of Education-----------------------------------.
From ------/------/------ To------/-----/------.
Physician Name-------------------------------------.
Address: ----------------------------------------------.
Telephone NO. -------------------------------------.
E-mail:-------------------------------------------------.
Date of M.B.C.CH Achievement & Name of University: -------------------------------------------------------------.
Date of registration and type of postgraduate degree: --------------------------------------------------------------.
Name and Place of Work: ------------------------------------------------------------.
Personal Information
Please fill in your personal information required in page 1.
Your personal photo should be attached to the logbook and
you should sign the personal information page.
Procedures Log
You should write down the management of procedures, your level of participation
and the date.
Your supervisor medical staff member should countersign each procedure to
document the event.
Academic Activities
It means attendance of conferences, workshops and lectures.
Any attended activity must be signed by the workshop or conference
organizer/coordinator.
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Level of
Medical Supervisor's
Participation
Neonatology
Normal neonate at delivery room.
Premature infants.
Inra-uterine growth retardation.
Large for gestational age
Post-term infants
Hyaline membrane disease
Transient tachypnea of the newborn.
Neonatal pneumonia.
Meconium aspiration.
Pulmonary hemorrhage
Persistent pulmonary hypertension of
the newborn.
Neonatal cyanosis.
Neonatal jaundice.
Dysmorphic neonates.
Hypoxic- ischemic encephalopathy.
Neonatal convulsions.
Birth trauma( Erb,s palsy,
cephalhematoma)
Hydrocephalus.
Myelomeningiocele.
Necrotizing enterocolitis.
GIT anomalies
Infant of diabetic mother
Hypoglycemia
Hypocalcemia
Neonatal sepsis and meningitis
Congenital infection
Emergency Medicine and ICU: Metabolic Emergency:
Electrolyte disturbance and dehydration
Acid-base disturbances
Diabetic Ketoacidosis
Addisonian Crises
Urea cycle defects
Aminoacidopathies
Hepatic coma
Respiratory Emergency:
Stridor
Wheezy infants and bronchial asthma
Pneumonia, effusion and pneumothorax
Foreign body inhalation
Respiratory failure due to various
causes
Cardiac Emergency:
Cyanotic spell
Cardiogenic shock
Arrythmias
Heart failure
Hematologic Emergency:
Acute hemolytic crises
Febrile neutropenia
Sickle cell anemia in crises
Severe pallor for DD
Hyper-coagulopathy conditions and DIC
Neurological Emergency:
Coma
Convulsions
Increased intracranial tension
Sudden weakness /paralysis
Hypertensive encephalopathy
Stroke
Other Emergencies:
Shock due to different causes
Childhood injuries
Burns and surgical emergencies
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Sepsis.
Allergy and Immunology
Bronchial asthma
Allergic rhinitis
Cow milk allergy
Angioedema
Urticaria
Atopic dermatitis
Insect bite allergy
Recurrent infections
Infections
Febrile children with or without focusfever with rash
Congenital infections
Septicemia and septic shock
Febrile neutropenia
FUO
Infection due to central venous line
Bronchitis, pneumonia and bronchiolitis
Gastroenteritis
Urinary tract infection
Conjunctivitis
Meningitis and encephalitis
Respiratory Problems
URTIs; rhinitis, sore throat and
pharyngitis / tonsillitis and cervical
lymphadenopathy
Croup and stridor
Obstructive sleep apnea
Earache and O.M
Wheezy infant
Congenital anomalies
Chronic lung problems; chronic
cough,C.F, suppurative lung diseases
and interstitial lung disease.
Lower RTIs(pneumonia and
bronchiolitis)-Pleural disorders.
Cardiology cases
Infantile and childhood cyanotic heart
diseases.
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Hypoparathyroidism.
Hematology
Anemia due to nutritional causes.
G6PD
Sickle cell anemia
Thalassemia
Hemophilia
Von willebrand disease
Christmas disease
Immune thrombocytopenia (e.g. ITP).
Platelet function defect
Fanconi anemia
Bone marrow failure
Nutrition and Malnutrition
Infantile and childhood nutritional
assessment.
Rickets and its variants
Marasmus
Kwashiorkor
Iron deficiency anemia
Vitamin A, C, K, B12 and Folic acid
deficiencies.
Rheumatology cases
Joint swelling
Limping
Back pain
Torticollis
Juvenile rheumatoid arthritis
Dermatomyositis
Kawasaki disease
Systemic lupus erythematosus
Henoch Schonlein purpura
Familial Mediterranean fever
Metabolic diseases
Phenylketonuria
Hypoglycemia
Galactosemia
Homocystinuria
Organic acidopathies
Urea cycle defect
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Learning disabilities
Sleep disorders and nocturnal enuresis
Conduct disorders
Suspected child abuse
Dermatology Cases
Cutaneous Drug reaction (SJS)
SSS Syndrome
Epidermolysis bullosa
Eczema
Acne
Erythema nodosum and DD
Seborrheic dermatitis
Hyper-pigmented skin lesions
Fungal Skin lesions
Eye Problems
Red eyes
Squint
Ptosis.
Proptosis.
Abnormal eye movement.
Visual Impairment.
Eye tumors (retinoblastoma).
Congenital cataract.
Congenital Glaucoma.
Lacrimation.
Xerosis.
1: Observed.
2: Managed under supervision.
3: Managed alone.
Head of Pediatric Department
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Procedure's Log
Name of Specialty & Procedure
Level of
Participation
Cases / Signature
/Date/ Evaluation
Neonatology
Neonatal resuscitation.
Stabilization and transport
Assessment of GA, Maturity and
anthropometric measurements.
Intravenous line insertion
Nasal Gastric tube insertion
Oropharyngeal suction
Supra-pubic tap for urine analysis
and culture.
Fluid therapy
Blood product transfusion
Total parenteral nutrition
Endotracheal intubation
Phototherapy
Capillary and arterial sampling
Central venous line insertion
Mechanical ventilation
Exchange transfusion
Emergency and ICU procedures
Cardiopulmonary resuscitation
Urinary catheter application
Fluid therapy
Blood product transfusion
Endotracheal intubation
Cardio-version
Arterial sample
Central venous line insertion
Mechanical ventilation
Ascites tap
Wound dressing
Simple suturing
Chest tube insertion
Infection control procedures
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Academic activities
Date
Signature
Date
Signature
15
Signature
% of attendance of
lectures
Signature of head of
department
Attendance of lectures
Basic
Medical
sciences
(40%)
Genetics &
growth and
development
(20%)
Level of
Assessment
Pretest
Exam.
(30 %)
1st
2nd
3rd
Clinical Assessment
(40%)
Cases
Procedures
30 %
10 %
Conferences
&
Workshops
20 %
Level of
Assessment
Pretest
Exam.
20 %
1st
2nd
3rd
Levels of Assessment
A: > 85 %.
B: 75 % 84 %.
C: 60 % - 74 %.
F: < 60 %.
Comment:---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------.
Decision: -----------------------------------------------------.
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Notes
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