CONTENTS

1. Bio-data

2. Certificate

3. Guidelines

4. Details of Break/Extension

5. Details of Work Done

5.1 Clinical Duties

5.2 Case Presentations

5.3 Bedside Case Presentations

5.4 Seminar Presentations

5.5 Integrated Patient-based Teaching

5.6 Journal Club Meetings

5.7 Synopsis of Dissertation Writing

5.8 Dissertation Writing

5.9 Departmental Duties

5.9.1 Lectures delivered (to U.G. students)

5.9.2 Other assignments

5.10 Record of Lectures

6. Summary of House Job Program

1
 BIO-DATA

1. Name of the P. G. Student

2. Title of the Course

3. Subject Specialty

4. Details of University Registration

a. No.
b. Date
c. Academic year in which registered
5. Date of commencement of the Course

6. Date of Birth & Age

7. Father’s / Husband’s Name

8. Permanent Address in full with Telephone No.

9. Residential Address with Telephone No.

(During House job)

10. Year of passing BHMS course;

College; University

11. Registration No. with name of the Board/

Council and Date of registration

12. Name, designation & address of

a. Guide
b. Co-Guide (if any)

2
 CERTIFICATE

This is to certify that _________________________________________ is registered as a post-

graduate student for the M.D. (Hom.) course in the subject

_________________________________________ at Bakson Homoeopathic Medical College &

Hospital, Greater Noida, U.P. The academic activities recorded in the Log Book have

been carried out under the guidance of the faculty members of the

College/ Hospital, and checked and authenticated by the concerned authorities.

…………………….. ……………………… ………………………

……………………. ………………………. ………………………

Signature &Name of HOD Signature & Name of P.G. Incharge Signature & Name of Principal

Date: Date: Date:

3
 GUIDELINES FOR MD COURSE

MD (Hom.) Course is of three years duration including one year House job. It is mandatory on
the part of each PG student to carry out the duties during this period to the satisfaction of the
competent authority of the College and Hospital after which the student shall be eligible for the
award of MD (Hom.) Degree by the University.

House job is an integral part of the MD (Hom.) course. Each P.G. student who has taken
admission to the MD (Hom.) course must complete the house job before being eligible to
appear at M.D. (Hom.) Part I examination. The House job shall cover the following areas:

1. Training Centre

The House job shall be done in the O.P.Ds., I.P.Ds and POPDs of the Bakson
Homoeopathic Medical College & Hospital.

2. Period of House Job

The House job shall be for a minimum period of one year from the date of
commencement of the M.D. (Hom.) Part-I course.

In the event of a candidate failing to complete the job satisfactorily within a period of 12
months on account of unsatisfactory work or shortage of attendance or otherwise, the
period of House job shall accordingly be extended further.

3. Mode of Training

The House job shall be done on rotation basis in various O.P.Ds. and I.P.D. of the
collegiate hospital and other centers as notified by the concerned authorities. Suitable
postings shall be done in this regard by the Principal/ Medical Superintendent of the
College/ Hospital in consultation with the P.G. Incharge.

4. Duty Time

Basic duty shall be from Monday to Friday between 8:30 a.m. and 3.30 p.m., if required
any time round the week. The P.G. students shall be on duty every day, during the
training program. However, they shall follow the time schedule of the

4
 OPDs/IPD/peripheral OPDs/other centre(s), wherever they are posted, or as per the time
schedule notified by the competent authority.

5. Attendance & Leave

5.1 Each P. G. student shall have not less than 80% of attendance, during PhD
program.

5.2 The student shall mark their attendance twice, on arrival and departure of their duty,
everyday, through biometric machine, installed in the college premises. Besides,
they have to make their attendance in the register maintained in the Unit
concerned. Late arrival and early leaving shall also be noted with time in the
respective column.

The P.G. student shall be eligible to avail Sundays and Public Holidays during the
whole period of House job.

5.3 No leave of any kind can be claimed as a matter of right. However, the PG student
shall have to submit application for leave in the prescribed form sufficiently in
advance and shall get it sanctioned by the competent authority.

6. Duties and Responsibilities

6.1 In OPDs , IPDs of the Hospital & peripheral OPDs, the P.G. students shall take
case histories of the patients in the prescribed format, examine them, make
nosological and miasmatic diagnosis, analyse & evaluate symptoms, draw the
totality of symptoms, repertorise the case and select the remedy for the patient,
based on homoeopathic principles, under the guidance of his/her Unit Head or the
RMO. He/ She shall also advise for the required laboratory
investigations/diagnostic procedures and for the general management/ancillary
measures for the patient including diet, physiotherapy, yoga etc., with the
instruction of Unit Head/RMO.

6.2 In I.P.D., besides doing case-recording and case-processing, as stated above, for the
new admissions, each P. G. student has to record the follow-up of old patients
5
 including routine check-ups. Besides, he/she has to assist the medical, nursing
and laboratory staff in the treatment, general management and laboratory
investigations of the patients. He/she shall also extend all the necessary
assistance to the students to create for effective learning/working environment.

6.3 The P.G. Students shall not prescribe medicines and ancillary measures
independently to the patients, but will work under the direct supervision of the
Unit Head/ RMO. They shall record all the details of medicines administered
(including potency, dose & repetition schedule) and any auxiliary measure(s)
required for the patients, in the case records, to be countersigned by the attending
physician/Unit Head/RMO.

6.4 There shall be Seminar presentations, Case presentations, Journal club meetings
etc., periodically, under the guidance & supervision of the P.G. Incharge, where
they have to actively participate through their own presentations or interactions.
The responsible mentors of such events shall guide and assess the performance of
the presenting Unit of such presentations.

6.5 Students shall gain necessary knowledge and experience in nursing, general
management of patients including auxiliary measures, dispensing of medicines
etc. from the concerned Hospital staff.

6.6 They shall also be given scope to learn the laboratory/ diagnostic techniques in
the Hospital to correlate the findings with clinical diagnosis, and management of
cases.

7. Discipline

The P.G. students shall have to observe strict discipline throughout the MD course. They
shall be bound by the rules and regulations of the college and hospital in this regard.

6
 8. Dress

Each P.G. student shall always be properly dressed with the lab coat.

Dissertation

Each PG student shall choose a topic for their dissertation for study and work on that
particular topic under the guidance of a mentor/guide during the MD course. He/ She has
to submit the synopsis of the dissertation within the time limit notified by the PG
Incharge in consultation with his/her Guide/ Supervisor. After completion of
dissertation, he/she has to submit the dissertation to the Principal duly authenticated by
the Guide and PG Incharge as notified by the PG Incharge.

Maintenance of Work Diary/ Log Book

Every P.G. student shall maintain a Log Book regularly to record various academic
activities he/ she has been exposed to, including clinical training during House job and
get those authenticated by the Unit Head /HOD /Faculty/ Guide concerned. On
successful completion of MD course, the student should summarize the contents and get
the Log Book certified by the Head of Department, P.G. Incharge and Principal.

7
 HAHNEMANNIAN OATH

“On my honour I swear that I shall practice

the teachings of Homoeopathy, perform
my duty, render justice to my patients and
help the sick whosoever comes to me for
treatment. May the teachings of Master
Hahnemann inspire me and may I have
the strength for fulfillment of my mission”.

Signature of PG student

8
 DETAILS OF BREAK/EXTENSION (IF ANY)
S.no Period of Break From To

1. Reason for Break

2. Date of Resumption

3. Period of Extension

4. Remarks, if any
(of the Principal)

Signature of PG student Signature of PG Incharge

S.no Period of Break From To

1. Reason for Break

2. Date of Resumption

3. Period of Extension

4. Remarks, if any
(of the Principal)

Signature of PG student Signature of PG Incharge

S.no Period of Break From To

1. Reason for Break

2. Date of Resumption

3. Period of Extension

4. Remarks, if any
(of the Principal)

Signature of PG student Signature of PG Incharge

9
 DETAILS

OF

WORK DONE

10
CLINICAL

DUTIES

11
 CLINICAL DUTIES
S.No DATE NAME OF THE OPD/IPD/POPD NEW DIAGNOSIS PRESCRIPTION
PATIENT/ AGE/SEX REGN. No. (N)/ OLD
(O)

12
S.No DATE NAME OF THE OPD/IPD/POPD NEW DIAGNOSIS PRESCRIPTION
PATIENT/ AGE/SEX REGN. No. (N)/ OLD
(O)

S.No DATE NAME OF THE OPD/IPD/POPD NEW DIAGNOSIS PRESCRIPTION

13
 PATIENT/ AGE/SEX REGN. No. (N)/ OLD
(O)

S.No DATE NAME OF THE OPD/IPD/POPD NEW DIAGNOSIS PRESCRIPTION

14
 PATIENT/ AGE/SEX REGN. No. (N)/ OLD
(O)

S.No DATE NAME OF THE OPD/IPD/POPD NEW DIAGNOSIS PRESCRIPTION

15
 PATIENT/ AGE/SEX REGN. No. (N)/ OLD
(O)

S.No DATE NAME OF THE OPD/IPD/POPD NEW DIAGNOSIS PRESCRIPTION

16
 PATIENT/ AGE/SEX REGN. No. (N)/ OLD
(O)

S.No DATE NAME OF THE OPD/IPD/POPD NEW DIAGNOSIS PRESCRIPTION

17
 PATIENT/ AGE/SEX REGN. No. (N)/ OLD
(O)

S.No DATE NAME OF THE OPD/IPD/POPD NEW DIAGNOSIS PRESCRIPTION

18
 PATIENT/ AGE/SEX REGN. No. (N)/ OLD
(O)

S.No DATE NAME OF THE OPD/IPD/POPD NEW DIAGNOSIS PRESCRIPTION

19
 PATIENT/ AGE/SEX REGN. No. (N)/ OLD
(O)

S.No DATE NAME OF THE OPD/IPD/POPD NEW DIAGNOSIS PRESCRIPTION

20
 PATIENT/ AGE/SEX REGN. No. (N)/ OLD
(O)

S.No DATE NAME OF THE OPD/IPD/POPD NEW DIAGNOSIS PRESCRIPTION

21
 PATIENT/ AGE/SEX REGN. No. (N)/ OLD
(O)

S.No DATE NAME OF THE OPD/IPD/POPD NEW DIAGNOSIS PRESCRIPTION

22
 PATIENT/ AGE/SEX REGN. No. (N)/ OLD
(O)

S.No DATE NAME OF THE OPD/IPD/POPD NEW DIAGNOSIS PRESCRIPTION

23
 . PATIENT/ AGE/SEX REGN. No. (N)/ OLD
(O)

S.No DATE NAME OF THE OPD/IPD/POPD NEW DIAGNOSIS PRESCRIPTION

24
 PATIENT/ AGE/SEX REGN. No. (N)/ OLD
(O)

S.No DATE NAME OF THE OPD/IPD/POPD NEW DIAGNOSIS PRESCRIPTION

25
 PATIENT/ AGE/SEX REGN. No. (N)/ OLD
(O)

S.No DATE NAME OF THE OPD/IPD/POPD NEW DIAGNOSIS PRESCRIPTION

26
 PATIENT/ AGE/SEX REGN. No. (N)/ OLD
(O)

S.No DATE NAME OF THE OPD/IPD/POPD NEW DIAGNOSIS PRESCRIPTION

PATIENT/ AGE/SEX REGN. No. (N)/ OLD
(O)

27
S.No DATE NAME OF THE OPD/IPD/POPD NEW DIAGNOSIS PRESCRIPTION
PATIENT/ AGE/SEX REGN. No. (N)/ OLD
(O)

28
S.No DATE NAME OF THE OPD/IPD/POPD NEW DIAGNOSIS PRESCRIPTION
PATIENT/ AGE/SEX REGN. No. (N)/ OLD
(O)

29
S.No DATE NAME OF THE OPD/IPD/POPD NEW DIAGNOSIS PRESCRIPTION
PATIENT/ AGE/SEX REGN. No. (N)/ OLD
(O)

30
S.No DATE NAME OF THE OPD/IPD/POPD NEW DIAGNOSIS PRESCRIPTION
PATIENT/ AGE/SEX REGN. No. (N)/ OLD
(O)

31
S.No DATE NAME OF THE OPD/IPD/POPD NEW DIAGNOSIS PRESCRIPTION
PATIENT/ AGE/SEX REGN. No. (N)/ OLD
(O)

32
S.No. DATE NAME OF THE OPD/IPD/POPD NEW DIAGNOSIS PRESCRIPTION
PATIENT/ AGE/SEX REGN. No. (N)/ OLD
(O)

33
S.No DATE NAME OF THE OPD/IPD/POPD NEW DIAGNOSIS PRESCRIPTION
PATIENT/ AGE/SEX REGN. No. (N)/ OLD
(O)

34
S.No DATE NAME OF THE OPD/IPD/POPD NEW DIAGNOSIS PRESCRIPTION
. PATIENT/ AGE/SEX REGN. No. (N)/ OLD
(O)

35
S.No DATE NAME OF THE OPD/IPD/POPD NEW DIAGNOSIS PRESCRIPTION
. PATIENT/ AGE/SEX REGN. No. (N)/ OLD
(O)

36
S.No DATE NAME OF THE OPD/IPD/POPD NEW DIAGNOSIS PRESCRIPTION
PATIENT/ AGE/SEX REGN. No. (N)/ OLD
(O)

37
S.No DATE NAME OF THE OPD/IPD/POPD NEW DIAGNOSIS PRESCRIPTION
PATIENT/ AGE/SEX REGN. No. (N)/ OLD
(O)

38
S.No DATE NAME OF THE OPD/IPD/POPD NEW DIAGNOSIS PRESCRIPTION
PATIENT/ AGE/SEX REGN. No. (N)/ OLD
(O)

39
S.No DATE NAME OF THE OPD/IPD/POPD NEW DIAGNOSIS PRESCRIPTION
PATIENT/ AGE/SEX REGN. No. (N)/ OLD
(O)

40
S.No DATE NAME OF THE OPD/IPD/POPD NEW DIAGNOSIS PRESCRIPTION
. PATIENT/ AGE/SEX REGN. No. (N)/ OLD
(O)

41
S.No DATE NAME OF THE OPD/IPD/POPD NEW DIAGNOSIS PRESCRIPTION
PATIENT/ AGE/SEX REGN. No. (N)/ OLD
(O)

42
S.No DATE NAME OF THE OPD/IPD/POPD NEW DIAGNOSIS PRESCRIPTION
PATIENT/ AGE/SEX REGN. No. (N)/ OLD
(O)

43
44
 CASE
PRESENTATIONS

45
 CASE PRESENTATION

To be filled if case presented:

Date: Tick source: OPD/IPD/POPD/Any other (specify)

Reg. no Provisional Diagnosis / Final Diagnosis

(if any)

Case Summary:

First prescription (Medicine, potency, repetition, duration):

Auxiliary Management :

46
 Accuracy in Case Recording:

Accuracy in Case Processing:

Accuracy in Repertorisation:

Accuracy in diagnosis:

Relevance of prescription, potency & repetition:

Presentation Style:
Remarks by
Evaluator
(Excellent: E
Very Good: V.G. Completeness of Preparation:
Good: G
Poor: P)
Cogency of presentation:

Use of audio-visual aids:

Command on subject presented:

Ability to answer questions:

Signature of Mentors/ Evaluators:

CASE PRESENTATION

47
To be filled if case presented:

Date: Tick source: OPD/IPD/POPD/Any other (specify)

Reg. no Provisional Diagnosis /Final Diagnosis

(if any)

Case Summary:

First prescription (Medicine, potency, repetition, duration):

Auxiliary Management :

48
 Accuracy in Case Recording:

Accuracy in Case Processing:

Accuracy in Repertorisation:

Accuracy in diagnosis:

Relevance of prescription, potency & repetition:

Remarks by Presentation Style:

Evaluator
(Excellent: E
Very Good: V.G.
Good: G Completeness of Preparation:
Poor: P)

Cogency of presentation:

Use of audio-visual aids:

Command on subject presented:

Ability to answer questions:

Signature of Mentors/ Evaluators:

49
 CASE PRESENTATION

To be filled if case presented:

Date: Tick source: OPD/IPD/POPD/Any other (specify)

Reg. no Provisional Diagnosis / Final Diagnosis

(if any)

Case Summary:

First prescription (Medicine, potency, repetition, duration):

Auxiliary Management :

50
 Accuracy in Case Recording:

Accuracy in Case Processing:

Accuracy in Repertorisation:

Accuracy in diagnosis:

Relevance of prescription, potency & repetition:

Remarks by Presentation Style:

Evaluator
(Excellent: E
Very Good: V.G.
Good: G Completeness of Preparation:
Poor: P)

Cogency of presentation:

Use of audio-visual aids:

Command on subject presented:

Ability to answer questions:

Signature of Mentors/ Evaluators:

CASE PRESENTATION

51
To be filled if case presented:

Date: Tick source: OPD/IPD/POPD/Any other (specify)

Reg. no Provisional Diagnosis / Final Diagnosis

(if any)

Case Summary:

First prescription (Medicine, potency, repetition, duration):

Auxiliary Management :

52
 Accuracy in Case Recording:

Accuracy in Case Processing:

Accuracy in Repertorisation:

Accuracy in diagnosis:

Relevance of prescription, potency & repetition:

Remarks by Presentation Style:

Evaluator
(Excellent: E
Very Good: V.G.
Good: G Completeness of Preparation:
Poor: P)

Cogency of presentation:

Use of audio-visual aids:

Command on subject presented:

Ability to answer questions:

Signature of Mentors/ Evaluators:

CASE PRESENTATION

53
To be filled if case presented:

Date: Tick source: OPD/IPD/POPD/Any other (specify)

Reg. no Provisional Diagnosis / Final Diagnosis

(if any)

Case Summary:

First prescription (Medicine, potency, repetition, duration):

Auxiliary Management :

Accuracy in Case Recording:

54
 Accuracy in Case Processing:

Accuracy in Repertorisation:

Accuracy in diagnosis:

Relevance of prescription, potency & repetition:

Presentation Style:

Remarks by
Evaluator Completeness of Preparation:
(Excellent: E
Very Good: V.G.
Good: G
Poor: P) Cogency of presentation:

Use of audio-visual aids:

Command on subject presented:

Ability to answer questions:

Signature of Mentors/ Evaluators:

To be filled if attended:

55
 Name of the Presenter & Date Signature of
Sl. No.
Title of Case Presentation Case
Presentation
In-charge

56
 Name of the Presenter & Date Signature of
Sl. No.
Title of Case Presentation Case
Presentation
In-charge

57
 Name of the Presenter & Date Signature of
Sl. No.
Title of Case Presentation Case
Presentation
In-charge

58
 Name of the Presenter & Date Signature of
Sl. No.
Title of Case Presentation Case
Presentation
In-charge

59
 Name of the Presenter & Date Signature of
Sl. No.
Title of Case Presentation Case
Presentation
In-charge

60
 Name of the Presenter & Date Signature of
Sl. No.
Title of Case Presentation Case
Presentation
In-charge

61
 Name of the Presenter & Date Signature of
Sl. No.
Title of Case Presentation Case
Presentation
In-charge

62
 Name of the Presenter & Date Signature of
Sl. No.
Title of Case Presentation Case
Presentation
In-charge

63
BEDSIDE CASE

PRESENTATION

64
 BED SIDE CASE PRESENTATION

To be filled if Bed side-case presented:

Date: Tick source: OPD/IPD/POPD/Any other (specify)

Reg. no Provisional Diagnosis/Final Diagnosis :

(if any)

Case Summary:

65
Clinical Examination :

First prescription (Medicine, potency, repetition, duration):

Accuracy in Case Recording:

66
 Accuracy in Case Processing:

Accuracy in Repertorisation:

Accuracy in diagnosis:

Relevance of prescription, potency & repetition:

Presentation Style:

Remarks by
Evaluator Completeness of Preparation:
(Excellent: E
Very Good: V.G.
Good: G
Poor: P) Cogency of presentation:

Use of audio-visual aids:

Command on subject presented:

Ability to answer questions:

Signature of Mentors/ Evaluators:

BED SIDE CASE PRESENTATION

To be filled if Bed side-case presented:

67
 Date: Tick source: OPD/IPD/POPD/Any other (specify)

Reg. no Provisional Diagnosis/FinalDiagnosis :

(if any)

Case Summary:

Clinical Examination :

68
First prescription (Medicine, potency, repetition, duration):

Accuracy in Case Recording:

Accuracy in Case Processing:

69
 Accuracy in Repertorisation:

Accuracy in diagnosis:

Relevance of prescription, potency & repetition:

Presentation Style:

Remarks by
Evaluator
(Excellent: E Completeness of Preparation:
Very Good: V.G.
Good: G
Poor: P)
Cogency of presentation:

Use of audio-visual aids:

Command on subject presented:

Ability to answer questions:

Signature of Mentors/ Evaluators:

BED SIDE CASE PRESENTATION

To be filled if Bed side-case presented:

Date: Tick source: OPD/IPD/POPD/Any other (specify)

Reg. no Provisional Diagnosis/Final Diagnosis :

70
 (if any)

Case Summary:

Clinical Examination :

71
First prescription (Medicine, potency, repetition, duration):

Accuracy in Case Recording:

Accuracy in Case Processing:

Accuracy in Repertorisation:

Accuracy in diagnosis:

72
 Relevance of prescription, potency & repetition:

Remarks by Presentation Style:

Evaluator
(Excellent: E
Very Good: V.G.
Good: G Completeness of Preparation:
Poor: P)

Cogency of presentation:

Use of audio-visual aids:

Command on subject presented:

Ability to answer questions:

Signature of Mentors/ Evaluators:

BED SIDE CASE PRESENTATION

To be filled if Bed side-case presented:

Date: Tick source: OPD/IPD/POPD/Any other (specify)

Reg. no Provisional Diagnosis/Final Diagnosis :

(if any)

73
Case Summary:

Clinical Examination :

74
First prescription (Medicine, potency, repetition, duration):

Accuracy in Case Recording:

Accuracy in Case Processing:

Accuracy in Repertorisation:

Accuracy in diagnosis:

Relevance of prescription, potency & repetition:

75
 Remarks by Presentation Style:
Evaluator
(Excellent: E
Very Good: V.G.
Good: G Completeness of Preparation:
Poor: P)

Cogency of presentation:

Use of audio-visual aids:

Command on subject presented:

Ability to answer questions:

Signature of Mentors/ Evaluators:

BED SIDE CASE PRESENTATION

To be filled if Bed side-case presented:

Date: Tick source: OPD/IPD/POPD/Any other (specify)

Reg. no Provisional Diagnosis/Final Diagnosis :

(if any)

76
Case Summary:

Clinical Examination :

77
First prescription (Medicine, potency, repetition, duration):

Accuracy in Case Recording:

Accuracy in Case Processing:

Accuracy in Repertorisation:

Accuracy in diagnosis:

Relevance of prescription, potency & repetition:

78
 Remarks by Presentation Style:
Evaluator
(Excellent: E
Very Good: V.G.
Good: G Completeness of Preparation:
Poor: P)

Cogency of presentation:

Use of audio-visual aids:

Command on subject presented:

Ability to answer questions:

Signature of Mentors/ Evaluators:

To be filled if attended:

Name of the Presenter & Date Signature of

Sl. No.
Title of Bed Side Case Presentation Bed Side Case
Presentation
In-charge

79
 Name of the Presenter & Date Signature of
Sl. No.
Title of Bed Side Case Presentation Bed Side Case
Presentation
In-charge

80
 Name of the Presenter & Date Signature of
Sl. No.
Title of Bed Side Case Presentation Bed Side Case
Presentation
In-charge

81
 Name of the Presenter & Date Signature of
Sl. No.
Title of Bed Side Case Presentation Bed Side Case
Presentation
In-charge

82
 Name of the Presenter & Date Signature of
Sl. No.
Title of Bed Side Case Presentation Bed Side Case
Presentation
In-charge

83
 Name of the Presenter & Date Signature of
Sl. No.
Title of Bed Side Case Presentation Bed Side Case
Presentation
In-charge

84
 Name of the Presenter & Date Signature of
Sl. No.
Title of Bed Side Case Presentation Bed Side Case
Presentation
In-charge

85
 Name of the Presenter & Date Signature of
Sl. No.
Title of Bed Side Case Presentation Bed Side Case
Presentation
In-charge

86
87
 SEMINAR

PRESENTATIONS

SEMINAR PRESENTATIONS
To be filled if presented:

Date

Seminar Title

88
 Aspect of Seminar Presented

Presentation Style

Completeness of Preparation

Cogency of presentation

Use of audio-visual aids

Remarks by Command on subject presented

Evaluator
( Excellent: E
Very Good: V.G. Ability to answer questions
Good: G
Poor: P ) Time scheduling

Review of literature

Recent advances covered

Signature of Mentors/ Evaluators:

SEMINAR PRESENTATIONS
To be filled if presented:

Date

Seminar Title

Aspect of Seminar Presented

89
 Presentation Style

Completeness of Preparation

Cogency of presentation

Use of audio-visual aids

Remarks by Command on subject presented

Evaluator
( Excellent: E
Very Good: V.G. Ability to answer questions
Good: G
Poor: P ) Time scheduling

Review of literature

Recent advances covered

Signature of Mentors/ Evaluators:

SEMINAR PRESENTATIONS
To be filled if presented:

Date

Seminar Title

Aspect of Seminar Presented

Presentation Style

90
 Completeness of Preparation

Cogency of presentation

Use of audio-visual aids

Command on subject presented

Remarks by
Evaluator
( Excellent: E Ability to answer questions
Very Good: V.G.
Good: G
Poor: P ) Time scheduling

Review of literature

Recent advances covered

Signature of Mentors/ Evaluators:

SEMINAR PRESENTATIONS
To be filled if presented:

Date

Seminar Title

Aspect of Seminar Presented

Presentation Style

91
 Completeness of Preparation

Cogency of presentation

Use of audio-visual aids

Command on subject presented

Remarks by
Evaluator
( Excellent: E Ability to answer questions
Very Good: V.G.
Good: G Time scheduling
Poor: P )

Review of literature

Recent advances covered

Signature of Mentors/ Evaluators:

SEMINAR PRESENTATIONS
To be filled if presented:

Date

Seminar Title

Aspect of Seminar Presented

Presentation Style

Completeness of Preparation

92
 Cogency of presentation

Use of audio-visual aids

Command on subject presented

Remarks by
Evaluator
( Excellent: E Ability to answer questions
Very Good: V.G.
Good: G
Poor: P ) Time scheduling

Review of literature

Recent advances covered

Signature of Mentors/ Evaluators:

To be filled if attended:

Seminar Title Date Signature of

Sl. No.
Seminar In-
charge

93
 Seminar Title Date Signature of
Sl. No.
Seminar In-
charge

94
 Seminar Title Date Signature of
Sl. No.
Seminar In-
charge

95
 Seminar Title Date Signature of
Sl. No.
Seminar In-
charge

96
 Seminar Title Date Signature of
Sl. No.
Seminar In-
charge

97
 Seminar Title Date Signature of
Sl. No.
Seminar In-
charge

98
 Seminar Title Date Signature of
Sl. No.
Seminar In-
charge

99
 Seminar Title Date Signature of
Sl. No.
Seminar In-
charge

100
101
JOURNAL CLUB

MEETINGS

JOURNAL CLUB MEETING

102
To be filled if journal article presented:

Date Title of the Article Name of author(s)

presented Strength/Weaknesses (with ‘et al’ if
of the article more than one);
Journal Name;
Volume;
Issue; Page no.

Cogency of presentation

Understanding and delivery

of the purpose of the article

Defense put forward for the

article

Remarks by Explanation of statistics in

evaluator article
( Excellent: E
Very Good: Use of audio-visual aids
V.G.
Good: G
Poor: P ) Level of confidence

Response to questioning

Overall assessment

Signature of Mentors/

Evaluators:

JOURNAL CLUB MEETING

103
To be filled if journal article presented:

Date Title of the Article Name of author(s)

presented Strength/Weaknesses (with ‘et al’ if
of the article more than one);
Journal Name;
Volume;
Issue; Page no.

Cogency of presentation

Understanding and delivery

of the purpose of the article

Defence put forward for the

article

Remarks by Explanation of statistics in

evaluator article
( Excellent: E
Very Good: Use of audio-visual aids
V.G.
Good: G
Poor: P ) Level of confidence

Response to questioning

Overall assessment

Signature of Evaluator/
Journal Club Incharge

JOURNAL CLUB MEETING

104
To be filled if journal article presented:

Date Title of the Article Name of author(s)

presented Strength/Weaknesses (with ‘et al’ if
of the article more than one);
Journal Name;
Volume;
Issue; Page no.

Cogency of presentation

Understanding and delivery

of the purpose of the article

Defene put forward for the

article

Remarks by Explanation of statistics in

evaluator article
( Excellent: E
Very Good: Use of audio-visual aids
V.G.
Good: G
Poor: P ) Level of confidence

Response to questioning

Overall assessment

Signature of Mentors/

Evaluators:

JOURNAL CLUB MEETING

105
To be filled if journal article presented:

Date Title of the Article Name of author(s)

presented Strength/Weaknesses (with ‘et al’ if
of the article more than one);
Journal Name;
Volume;
Issue; Page no.

Cogency of presentation

Understanding and delivery

of the purpose of the article

Defense put forward for the

article

Remarks by Explanation of statistics in

evaluator article
( Excellent: E
Very Good: Use of audio-visual aids
V.G.
Good: G
Poor: P ) Level of confidence

Response to questioning

Overall assessment

Signature of Mentors/

Evaluators:

JOURNAL CLUB MEETING

106
To be filled if journal article presented:

Date Title of the Article Name of author(s)

presented Strength/Weaknesses (with ‘et al’ if
of the article more than one);
Journal Name;
Volume;
Issue; Page no.

Cogency of presentation

Understanding and delivery

of the purpose of the article

Defense put forward for the

article

Remarks by Explanation of statistics in

evaluator article
( Excellent: E
Very Good: Use of audio-visual aids
V.G.
Good: G
Poor: P ) Level of confidence

Response to questioning

Overall assessment

Signature of Mentors/

Evaluators:

107
To be filled if attended:

Title of the Article Name of author(s) Date Signature

Sl. No. (with ‘et al’ if more than one); of Journal
Journal Name; Volume; Club In-
Issue; Page no.
charge

108
 Title of the Article Name of author(s) Date Signature
Sl. No. (with ‘et al’ if more than one); of Journal
Journal Name; Volume; Club In-
Issue; Page no.
charge

109
 Title of the Article Name of author(s) Date Signature
Sl. No. (with ‘et al’ if more than one); of Journal
Journal Name; Volume; Club In-
Issue; Page no.
charge

Title of the Article Name of author(s) Date Signature

Sl. No. (with ‘et al’ if more than one); of Journal
Journal Name; Volume; Club In-
110
 Issue; Page no. charge

Title of the Article Name of author(s) Date Signature

Sl. No. (with ‘et al’ if more than one); of Journal
Journal Name; Volume; Club In-
Issue; Page no.
charge

111
 Title of the Article Name of author(s) Date Signature
Sl. No. (with ‘et al’ if more than one); of Journal
Journal Name; Volume; Club In-
Issue; Page no.
charge

112
113
 INTEGRATED PATIENT
BASED LEARNING

To be filled if attended:

114
 Title of Presentation and Presenters Date Signature of
Sl. No.
Integrated
Patient Based
Teaching In-
charge

Title of Presentation and Presenters Date Signature of

115
Sl. No. Integrated
Patient Based
Teaching In-
charge

116
 SYNOPSIS OF
DISSERTATION

WRITING

SYNOPSIS OF DISSERTATION WRITING

Date & Lecture taken by Portion of Synopsis discussed Signature of

117
Time of faculty
Lecture

Date & Lecture taken by Portion of Synopsis discussed Signature of

Time of faculty
Lecture

118
Date & Lecture taken by Portion of Synopsis discussed Signature of
Time of faculty
Lecture

119
Date & Lecture taken by Portion of Synopsis discussed Signature of
Time of faculty
Lecture

120
Date & Lecture taken by Portion of Synopsis discussed Signature of
Time of faculty
Lecture

121
Date & Lecture taken by Portion of Synopsis discussed Signature of
Time of faculty
Lecture

122
Date & Lecture taken by Portion of Synopsis discussed Signature of
Time of faculty
Lecture

123
Date & Lecture taken by Portion of Synopsis discussed Signature of
Time of faculty
Lecture

124
Date & Lecture taken by Portion of Synopsis discussed Signature of
Time of faculty
Lecture

125
Date & Lecture taken by Portion of Synopsis discussed Signature of
Time of faculty
Lecture

126
127
 DISSERTATION
WRITING

DISSERTATION WRITING
Date Portion of Dissertation Discussion held with Signature of the
discussed ( Faculty Name) concerned faculty

128
Date Portion of Dissertation Discussion held with Signature of the
discussed ( Faculty Name) concerned faculty

129
Date Portion of Dissertation Discussion held with Signature of the
discussed ( Faculty Name) concerned faculty

130
Date Portion of Dissertation Discussion held with Signature of the
discussed ( Faculty Name) concerned faculty

131
Date Portion of Dissertation Discussion held with Signature of the
discussed ( Faculty Name) concerned faculty

132
Date Portion of Dissertation Discussion held with Signature of the
discussed ( Faculty Name) concerned faculty

Date Portion of Dissertation Discussion held with Signature of the

discussed ( Faculty Name) concerned faculty

133
Date Portion of Dissertation Discussion held with Signature of the
discussed ( Faculty Name) concerned faculty

134
Date Portion of Dissertation Discussion held with Signature of the
discussed ( Faculty Name) concerned faculty

135
Date Portion of Dissertation Discussion held with Signature of the
discussed ( Faculty Name) concerned faculty

136
Date Portion of Dissertation Discussion held with Signature of the
discussed ( Faculty Name) concerned faculty

137
Date Portion of Dissertation Discussion held with Signature of the
discussed ( Faculty Name) concerned faculty

Date Portion of Dissertation Discussion held with Signature of the

discussed ( Faculty Name) concerned faculty

138
Date Portion of Dissertation Discussion held with Signature of the
discussed ( Faculty Name) concerned faculty

139
140
 DEPARTMENTAL

DUTIES

LECTURES DELIVERED
Date &
Time of Subject Lecture Topic Evaluation:
Lecture ( Excellent: E, Very Good: V.G, Good: G,
Poor: P )
Cogency of
presentation
Command on the
topic
Fluency of language

Clarification of
students’ doubts
Signature of Faculty
Cogency of
presentation
Command on the
topic

141
 Fluency of language

Clarification of
students’ doubts
Signature of Faculty

Cogency of
presentation
Command on the
topic
Fluency of language

Clarification of
students’ doubts
Signature of Faculty

Cogency of
presentation
Command on the
topic
Fluency of language

Clarification of
students’ doubts

Signature of Faculty

142
 LECTURES DELIVERED
Date &
Time of Subject Lecture Topic Evaluation:
Lecture ( Excellent: E, Very Good: V.G, Good: G,
Poor: P )
Cogency of
presentation
Command on the
topic
Fluency of language

Clarification of
students’ doubts
Signature of Faculty
Cogency of
presentation
Command on the
topic
Fluency of language

Clarification of
students’ doubts
Signature of Faculty

Cogency of
presentation
Command on the
topic
Fluency of language

Clarification of
students’ doubts
Signature of Faculty

Cogency of
presentation
Command on the
topic
Fluency of language

Clarification of
students’ doubts

Signature of Faculty

143
 LECTURES DELIVERED
Date &
Time of Subject Lecture Topic Evaluation:
Lecture ( Excellent: E, Very Good: V.G, Good: G,
Poor: P )
Cogency of
presentation
Command on the
topic
Fluency of language

Clarification of
students’ doubts
Signature of Faculty
Cogency of
presentation
Command on the
topic
Fluency of language

Clarification of
students’ doubts
Signature of Faculty

Cogency of
presentation
Command on the
topic
Fluency of language

Clarification of
students’ doubts
Signature of Faculty

Cogency of
presentation
Command on the
topic
Fluency of language

Clarification of
students’ doubts

Signature of Faculty

144
 LECTURES DELIVERED
Date &
Time of Subject Lecture Topic Evaluation:
Lecture ( Excellent: E, Very Good: V.G, Good: G,
Poor: P )
Cogency of
presentation
Command on the
topic
Fluency of language

Clarification of
students’ doubts
Signature of Faculty
Cogency of
presentation
Command on the
topic
Fluency of language

Clarification of
students’ doubts
Signature of Faculty

Cogency of
presentation
Command on the
topic
Fluency of language

Clarification of
students’ doubts
Signature of Faculty

Cogency of
presentation
Command on the
topic
Fluency of language

Clarification of
students’ doubts

Signature of Faculty

145
 LECTURES DELIVERED
Date &
Time of Subject Lecture Topic Evaluation:
Lecture ( Excellent: E, Very Good: V.G, Good: G,
Poor: P )
Cogency of
presentation
Command on the
topic
Fluency of language

Clarification of
students’ doubts
Signature of Faculty
Cogency of
presentation
Command on the
topic
Fluency of language

Clarification of
students’ doubts
Signature of Faculty

Cogency of
presentation
Command on the
topic
Fluency of language

Clarification of
students’ doubts
Signature of Faculty

Cogency of
presentation
Command on the
topic
Fluency of language

Clarification of
students’ doubts

Signature of Faculty

146
 LECTURES DELIVERED
Date &
Time of Subject Lecture Topic Evaluation:
Lecture ( Excellent: E, Very Good: V.G, Good: G,
Poor: P )
Cogency of
presentation
Command on the
topic
Fluency of language

Clarification of
students’ doubts
Signature of Faculty
Cogency of
presentation
Command on the
topic
Fluency of language

Clarification of
students’ doubts
Signature of Faculty

Cogency of
presentation
Command on the
topic
Fluency of language

Clarification of
students’ doubts
Signature of Faculty

Cogency of
presentation
Command on the
topic
Fluency of language

Clarification of
students’ doubts

Signature of Faculty

147
 LECTURES DELIVERED
Date &
Time of Subject Lecture Topic Evaluation:
Lecture ( Excellent: E, Very Good: V.G, Good: G,
Poor: P )
Cogency of
presentation
Command on the
topic
Fluency of language

Clarification of
students’ doubts
Signature of Faculty
Cogency of
presentation
Command on the
topic
Fluency of language

Clarification of
students’ doubts
Signature of Faculty

Cogency of
presentation
Command on the
topic
Fluency of language

Clarification of
students’ doubts
Signature of Faculty

Cogency of
presentation
Command on the
topic
Fluency of language

Clarification of
students’ doubts

Signature of Faculty

LECTURES DELIVERED
Date &
Time of Subject Lecture Topic Evaluation:

148
Lecture ( Excellent: E, Very Good: V.G, Good: G,
Poor: P )
Cogency of
presentation
Command on the
topic
Fluency of language

Clarification of
students’ doubts
Signature of Faculty
Cogency of
presentation
Command on the
topic
Fluency of language

Clarification of
students’ doubts
Signature of Faculty

Cogency of
presentation
Command on the
topic
Fluency of language

Clarification of
students’ doubts
Signature of Faculty

Cogency of
presentation
Command on the
topic
Fluency of language

Clarification of
students’ doubts

Signature of Faculty

OTHER ASSIGNMENTS
(LIBRARY WORK/ TRAINING PROGRAM/ MEDICAL CAMPS/ FIELD VISITS/ OTHER
ACTIVITIES)

149
 Date Particulars Signature of concerned faculty In-
charge

OTHER ASSIGNMENTS
(LIBRARY WORK/ TRAINING PROGRAM/ MEDICAL CAMPS/ FIELD VISITS/ OTHER
ACTIVITIES)

150
 Date Particulars Signature of concerned faculty In-
charge

OTHER ASSIGNMENTS
(LIBRARY WORK/ TRAINING PROGRAM/ MEDICAL CAMPS/ FIELD VISITS/ OTHER
ACTIVITIES)

151
 Date Particulars Signature of concerned faculty In-
charge

OTHER ASSIGNMENTS
(LIBRARY WORK/ TRAINING PROGRAM/ MEDICAL CAMPS/ FIELD VISITS/ OTHER
ACTIVITIES)

152
 Date Particulars Signature of concerned faculty In-
charge

OTHER ASSIGNMENTS
(LIBRARY WORK/ TRAINING PROGRAM/ MEDICAL CAMPS/ FIELD VISITS/ OTHER
ACTIVITIES)

153
 Date Particulars Signature of concerned faculty In-
charge

OTHER ASSIGNMENTS
(LIBRARY WORK/ TRAINING PROGRAM/ MEDICAL CAMPS/ FIELD VISITS ETC. )

154
Date Particulars Signature of concerned faculty In-
charge

155
RECORD
OF
LECTURES

156
 LECTURES ATTENDED

Date & Subject Lecture taken by topic of the Lecture Signature

Time of of Faculty
Lecture

157
 LECTURES ATTENDED

Date & Subject Lecture taken by topic of the Lecture Signature

Time of of Faculty
Lecture

158
 LECTURES ATTENDED

Date & Subject Lecture taken by topic of the Lecture Signature

Time of of Faculty
Lecture

159
 LECTURES ATTENDED

Date & Subject Lecture taken by topic of the Lecture Signature

Time of of Faculty
Lecture

160
 LECTURES ATTENDED

Date & Subject Lecture taken by topic of the Lecture Signature

Time of of Faculty
Lecture

161
 LECTURES ATTENDED

Date & Subject Lecture taken by topic of the Lecture Signature

Time of of Faculty
Lecture

162
 LECTURES ATTENDED

Date & Subject Lecture taken by topic of the Lecture Signature

Time of of Faculty
Lecture

163
 LECTURES ATTENDED

Date & Subject Lecture taken by topic of the Lecture Signature

Time of of Faculty
Lecture

164
 LECTURES ATTENDED

Date & Subject Lecture taken by topic of the Lecture Signature

Time of of Faculty
Lecture

165
 LECTURES ATTENDED

Date & Subject Lecture taken by topic of the Lecture Signature

Time of of Faculty
Lecture

166
 LECTURES ATTENDED

Date & Subject Lecture taken by topic of the Lecture Signature

Time of of Faculty
Lecture

167
 LECTURES ATTENDED

Date & Subject Lecture taken by topic of the Lecture Signature

Time of of
Lecture Faculty

LECTURES ATTENDED
168
Date & Subject Lecture taken by topic of the Lecture Signature
Time of of Faculty
Lecture

LECTURES ATTENDED

169
Date & Subject Lecture taken by topic of the Lecture Signature
Time of of Faculty
Lecture

LECTURES ATTENDED

Date & Subject Lecture taken by topic of the Lecture Signature

170
Time of of Faculty
Lecture

LECTURES ATTENDED

Date & Subject Lecture taken by topic of the Lecture Signature

Time of of Faculty

171
Lecture

LECTURES ATTENDED

Date & Subject Lecture taken by topic of the Lecture Signature

Time of of Faculty
Lecture

172
 LECTURES ATTENDED

Date & Subject Lecture taken by topic of the Lecture Signature

Time of of Faculty
Lecture

173
 LECTURES ATTENDED

Date & Subject Lecture taken by topic of the Lecture Signature

Time of of Faculty
Lecture

174
 LECTURES ATTENDED

Date & Subject Lecture taken by topic of the Lecture Signature

Time of of Faculty
Lecture

175
 LECTURES ATTENDED

Date & Subject Lecture taken by topic of the Lecture Signature

Time of of Faculty
Lecture

176
 LECTURES ATTENDED

Date & Subject Lecture taken by topic of the Lecture Signature

Time of of Faculty
Lecture

177
 LECTURES ATTENDED

Date & Subject Lecture taken by topic of the Lecture Signature

Time of of Faculty
Lecture

178
 LECTURES ATTENDED

Date & Subject Lecture taken by topic of the Lecture Signature

Time of of Faculty
Lecture

179
 SUMMARY OF HOUSE JOB PROGRAM

Name of the P.G. Student

Date of joining the House Job
Date of completion of House Job

180
 Percentage of attendance
Number of days of break / extension
(if any)
No. of Cases attended during clinical OPD: IPD: POPD:
duties
No. of case(s) Presented: Attended:
No. of Bed side case(s) Presented: Attended:
No. of Seminar(s) Presented: Attended:
No. of Journal article(s) Presented: Attended:
No. of Integrated Patient based Attended:
Teaching Program /Symposium
No. of Lectures delivered
No. of Lectures attended
Title of Dissertation
No. of Medical camp(s) attended
No. of Health surveys / Awareness or
Education programs participated
General Performance Not satisfactory / Good/ Very Good /Excellent

……………………………………… ………………………………………………….. ……………………………………………..

……………………………………… ………………………………………………….. ……………………………………………..

Signature& Name of Hosp. Supdt. Signature & Name of P.G. In-charge Signature & Name of Principal

Date: Date: Date:

181