Pediatrics Logbook fellowship... · Pediatrics Logbook. 2. 3 المستشفيست و سراشف و...

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Pediatrics

Logbook

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وب ردتايسلس ب ردس و فشارس و تسيفشتسملا

فشس وب ردا فشس وب ردا

يفشتسس فابس وب ردا يفشتسس فابس وب ردا (ميفس ل لااس و فشار)

(ميفس ل لااس و فشار)

ىايشسمياشس وب ردا ىايشسمياشس وب ردا

فشس وب ردا فشس وب ردا

يفشتسس فابس وب ردا (ميفس ل لااس و فشار)

يفشتسس فابس وب ردا (ميفس ل لااس و فشار)

ىايشسمياشس وب ردا ىايشسمياشس وب ردا

متالايسمنعتةسصخس وب فشت

س سفش

سياشالس وبتات

سسس وينف ا

سسشششسيبىتلس د لوةس وبلنة

سشششس و اتدفا

سشششس وب بفر

سس ووبافس اود بللت

سسس و نعل

سسياشالس وةوفرسماود اوةس وبعباة

ةيصخش ةروص

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Topic page

Instructions for the use of the logbook 7

Patients’ cases Log 9

Case registry tables 19

Neonatology 20

Emergency 26

Infectious diseases 32

Nutrition 36

Allergy 40

Respiratory 44

Cardiac 48

Gastroenterology 52

Nephrology 54

Endocrine 56

Hematology 58

Genetics 60

Metabolic 62

Neurology 64

Psychiatry 66

Ophthalmic 68

Dermatology 70

Rheumatology 72

Procedures log 75

Procedures registration tables 81

Academic activities 91

Interesting cases 99

Rotation proof 107

CONTENTS...

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Instructions for the use of logbook

Aim of the logbook

The purpose of the logbook is to provide one source of evidence for the specialty scientific council that you attained

the desired level of competency required for licensure. It is the place where you are going to document experiences

and skills you attained during your training.

The logbook is divided into several sections. These instructions will help you completing those sections correctly.

Personnel information

Please fill in all your personnel information required. This will help the Egyptian Fellowship Administrators to proc-

ess your logbook during scientific council evaluation yearly and finally before sitting for the final exam. Your person-

nel photo should be attached to the logbook and you should sign the personnel information page

Clinical case log

1. You will find lists with all required cases in the curriculum. Your level of participation in each case will be deter-

mined by your trainer

2. Please fill in the following information for each case you register in the logbook:

Name, age, hospital serial number, summary of clinical presentations, summery of diagnostic workup, man-

agement , patient final diagnosis and outcome of treatment

3. For each case write the date of the interview

4. Each case should be counter signed by your trainer. His signature is the proof of your actual participation

Procedures’ log

1. The logbook contains tables for required procedures during different stages of training and the level of desired

performance at each stage.

2. You will also find empty tables to write down :

The patient’s name and hospital number

Diagnosis and indications for the procedure

Name of the performed procedure

Level of trainee participation ( Observer, Perform under supervision, Perform independently)

3. You should write the date of the procedure and your trainer should countersign each procedure to document the

event

Academic activities

1. Academic activities that must be documented are journal clubs, lecture, morbidity and mortality meetings and

workshops or conferences attended.

2. You will find a list of required journal clubs in your curriculum. Some scientific councils prefer that you and your

trainer determine the scientific content of the journal club based on your learning needs. In that situation you will

find empty tables, where you will record the topic and date of the journal club and it should be signed by trainer/

supervisor.

3. Workshops and conferences tables are the place where you will record your CME activities whether inside or out-

side the training center. Any attended activity must be signed by the workshop or conference organizer/

coordinator

Rotation Proof

Your scientific council has determined specific rotations in subspecialties that you must go through during the

training period (see your curriculum for details). After you finish each rotation sign its block by the Hospital/

training center manager and stamp officially.

Assessment of logbook activities

1. Your trainer will assess your logbook weekly for completion and provide feedback

2. Your educational supervisor will assess your logbook monthly or every two months, provide verbal or written

feedback and counter sign important activities

3. The examination committee of the scientific council will revise your logbook:

A) Annually before you progress from one year of training to another

B) At the end of training before the final exam

To be noted that unsatisfactory completion of the logbook would lead to delay of training progression.

Unsatisfactory logbook at the end of training will prevent you from entering the final exam

Important Notice:

It is your responsibility to maintain accurate and completed logbook and to regularly update your records. Shall you

meet any difficulty; you must contact your trainer or your specialty administrator at the Egyptian Fellowship Board.

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Patients' Case Log

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Case description

Minimum

Number

of cases

Neonatology

Digestive system Normal neonate at delivery room 30

Necrotizing enterocolitis 10 Premature infants at different age ranges 30

Neonatal jaundice 30 Intrauterine growth retardation 20

Duodenal Artesia, GIT anomalies & dia-

phragmatic hernia 5 Large for gestational age 20

Blood disease Post-term infants 20

Hemorrhagic disease of the

newborn 10 Erbs’ paralysis 5

Haemolytic disease of newborn 20 Neonatal visceral injuries 3

Neonatal anaemia 5 Neonatal skeletal injuries 3

Neonatal thrombocytopenia 5 Neonatal renal anomalies 3

Endocrine and metabolic disorders Hydrocephalus 5

Infant of diabetic mother 01 Myelomeningocele 3

Hypoglycaemia 01 Hypoxic-ischemic

encephalopathy 10

Hypocalcaemia 01 Neonatal respiratory and cardiac problems

Infections Hyaline membrane disease 15

Neonatal sepsis & meningitis 20 Apnoea and Transient

tachypnea of the newborn 30

Congenital infections 10 Meconium aspiration 10

Other neonatal problems Persistent pulmonary

hypertension of the newborn 3

Dysmorphic neonates 10 Neonatal pneumonia 20

Neonatal convulsions 20 Pulmonary haemorrhage 2

Neonatal hypotension and

hypertension 10 Congenital emphysema 2

Neonatal hypothermia and

hyperthermia 10 Neonatal cyanosis 20

12

Case description

Minimum

Number

of cases

Emergency Medicine

Metabolic emergencies Respiratory emergencies

Electrolyte disturbances with or without dehydra-

tion 30 Stridor 20

Acid-base disturbances 20 Wheezy infants and bronchial asthma 30

Diabetic ketoacidosis 10 Pneumonia , effusion and

pneumothorax 40

Addisonian crises 3 Foreign body inhalation 5

Urea cycle defects 1 Respiratory failure due to various causes 10

Aminoacidopathies 1 Cardiac emergencies 5

Hepatic coma 5 Arrhythmias 5

Hematological emergencies Cyanotic spell 10

Acute hemolytic crises 10 Heart failure 5

Sickle cell anemia in crises 5 Cardiogenic shock 2

Febrile neutropenia 2 Neurological emergencies

Severe pallor for D.D 5 Coma 15

Hypercoagulable conditions and DIC 5 Convulsions 30

Other emergencies Stroke 3

Childhood injuries 10 Sudden weakness/ paralysis 3

Burns and surgical emergencies 10 Increased intracranial tension 5

Shock due to different causes 15 Hypertensive encephalopathy 2

Sepsis 10 4 5

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Minimum

Number of cases Pediatric infections

30 Febrile children with and without focus

30 Febrile infants with and without focus

10 Septicemia and septic shock

5 Febrile neutropenia

30 Tonsillitis, pharyngitis, croup and other upper respiratory tract infections

30 Bronchitis , Pneumonia and bronchiolitis

20 Gastroenteritis

10 Urinary tract infection

20 Conjunctivitis and Otitis media

10 Meningitis and encephalitis

5 Congenital infection

2 Infective endocarditis

2 Infection related to central venous line

5 Fever of unknown origin

20 Fever with rash

Minimum

Number of cases Allergy and Immunology

30 Bronchial asthma

10 Allergic rhinitis

5 Cow milk allergy

2 Angioedema

10 Urticaria

10 Atopic dermatitis

10 Insect bite allergy

15 Recurrent infections

14

Minimum

Number of cases Gastroenterology and Hepatology cases

30 Abdominal pain (acute and chronic)

40 Acute & chronic diarrhea with and without dehydration

30 Vomiting in infants, neonates and children

20 Gastroesophageal reflux

20 Abdominal distension

15 Constipation

5 Dysphagia

5 Malabsorption

10 GIT bleeding

5 GIT congenital malformation

10 Cholestatic Jaundice in neonates, infants and children

20 Hepatomegaly for differential diagnosis

10 Portal hypertension and GIT bleeding

5 Liver cell failure

Minimum

Number of cases Cardiology Cases

20 Neonates and children with cyanotic heart disease

20 Child with rheumatic heart disease

5 Infant with arrhythmia

10 Infants and Children with non cyanotic congenital heart disease

5 Child with innocent murmur

5 Child with non-renal hypertension

5 Child with chest pain

5 Infants and children with heart failure

Minimum

Number of cases Pediatric respiratory problems

50 Sore throat, pharyngitis, tonsillitis and cervical lymphadenopathy

20 Croup and stridor

15 Snoring and obstructive sleep apnea

20 Earache

30 Bronchial asthma and the wheezy infant

15 Chronic cough, congenital anomalies and pleural space disorders.

30 Lower respiratory tract infections including bronchiolitis and pneumonia

20 Chronic lung problems including cystic fibrosis, bronchiectasis, interstitial lung diseases & chronic chest infections

15

Minimum

Number of cases Rheumatology cases

10 Joint swelling

10 Joint or bony pains

5 Limping

5 Back pain

3 Bow legs and knock knees

2 torticollis

5 juvenile rheumatoid arthritis

5 systemic lupus erythematosus

10 fever of unknown origin

5 Henoch Schönlein purpura

2 Mediterranean fever

5 Other connective tissue disorders

Minimum

Number of cases Nephrology/ Urology cases

15 Nephrotic syndrome

10 Acute nephritis

10 Acute renal failure

5 Chronic renal failure

5 Hypertension

20 Voiding disorders including nocturnal enuresis, dysuria, frequency and polyuria

20 Urinary tract infection

2 Tubular disorders

10 Hematuria for differential diagnosis

5 Proteinuria for differential diagnosis

5 Congenital anomalies of the kidney and urogenital system

Minimum

Number of cases Metabolic diseases

2 Phenylketonuria

2 Homocystinuria

2 Galactosemia

2 Organic acidopathies

2 Urea cycle defect

5 glycogen storage disease

2 Mucopolysaccaridosis

16

Minimum

Number of cases Neurology cases

30 Seizures in infants and children

30 Headache due to various causes

20 Hydrocephalus and microcephaly

10 Neural tube defects

10 Coma and altered level of consciousness

5 CNS trauma

5 Acute focal neurological signs

15 Cerebral palsy

5 Neurodevelopment regression

5 Acute flaccid paralysis

5 Hypotonia , myopathies and neuropathies

15 CNS infections (meningitis, encephalitis and brain abscess)

10 Chorea, ataxia and other movement disorders

Minimum

Number of cases Hematology cases

30 Nutritional anemia

10 Sickle cell anemia

10 Thalassemia

10 Hemophilia

2 Von Willebrand disease

2 Christmas disease

10 Immune thrombocytopenia (ITP)

2 Platelet function defect

2 Bone marrow failure

2 Fanconi anemia

20 G6PD deficiency

Minimum

Number of cases Genetic Disorders

15 Down syndrome (trisomy 21)

2 Trisomy 18

2 Trisomy 13

2 Turner syndrome

1 Klienfilter syndrome

2 Fragile X syndrome

2 Achondroplasia

1 Neurofibromatosis

2 Marfan syndrome

5 Multiple congenital malformations

5 Dysmorphic features

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Minimum

Number of cases Endocrinology cases

10 Child with diabetes

5 DKA

5 Normal variant short stature

5 Syndromes with obesity

5 Growth hormone deficiency

5 Turner syndrome

5 Hypothyroidism

3 Delayed Puberty

1 Graves’ disease

1 Precocious puberty

5 Tall stature

5 Obesity

2 Diabetes insipid us

5 Ambiguous genitalia

1 Addison disease

Minimum

number of cases Psychiatric problems

3 Autism

5 Attention deficit hyperactivity disorders

3 Antisocial behavior (conduct disorders)

3 Suspected child abuse

5 Sleep disorders and nocturnal enuresis

3 Learning disabilities

Minimum

number of cases Eye Problems

20 Red eye

10 Possible squint

5 Ptosis

3 Proptosis

5 Abnormal eye movement

2 Congenital cataracts

5 Eye trauma and injury

3 Visual impairment due to various causes

1 Eye tumors (retinoblastoma)

18

Minimum

Number of cases Dermatology cases

30 Bacterial skin infection

30 Diaper rash and other fungal skin infection

20 Fever with Maculo-papular rash

10 Chicken pox and other vesicular eruptions

2 Kawasaki syndrome

5 Steven Johnson syndrome and other cutaneous drug reactions

2 Staphylococcal scalded skin syndrome

2 Epidermolysis bullosa

10 Eczema

10 Acne

2 Erythema nodosum

10 Seborrheic dermatitis and cradle cap

5 Hyper-pigmented skin lesions

Minimum

Number of cases Nutrition

30 Nutritional assessment in apparently normal infants

20 Nutritional assessment in apparently normal child

20 Rickets due to various causes

15 Marasmus

5 kwashiorkor

20 Infants with breast feeding problems

20 Iron deficiency anemia

10 Cases with nutritional problems due to various systemic disorders

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Case Registration Tables

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Patients’ case Log

Patient’s Name & age Hospital

Number Summary of Clinical Findings Diagnostic Workup

21

Neonatology

Summary of Management Final Diagnosis Outcome Trainer’s Signature

& date

22

Patients’ case Log

Patient’s Name & age Hospital

Number Summary of Clinical Findings Diagnostic Workup

23

Neonatology

Summary of Management Final Diagnosis Outcome Trainer’s Signature

& date

24

Patients’ case Log

Patient’s Name & age Hospital

Number Summary of Clinical Findings Diagnostic Workup

25

Neonatology

Summary of Management Final Diagnosis Outcome Trainer’s Signature

& date

26

Patients’ case Log

Patient’s Name & age Hospital

Number Summary of Clinical Findings Diagnostic Workup

27

Pediatric emergency

Summary of Management Final Diagnosis Outcome Trainer’s Signature

& date

28

Patients’ case Log

Patient’s Name & age Hospital

Number Summary of Clinical Findings Diagnostic Workup

29

Pediatric emergency

Summary of Management Final Diagnosis Outcome Trainer’s Signature

& date

30

Patients’ case Log

Patient’s Name & age Hospital

Number Summary of Clinical Findings Diagnostic Workup

31

Pediatric emergency

Summary of Management Final Diagnosis Outcome Trainer’s Signature

& date

32

Patients’ case Log

Patient’s Name & age Hospital

Number Summary of Clinical Findings Diagnostic Workup

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Pediatric infectious diseases

Summary of Management Final Diagnosis Outcome Trainer’s Signature

& date

34

Patients’ case Log

Patient’s Name & age Hospital

Number Summary of Clinical Findings Diagnostic Workup

35

Pediatric infectious diseases

Summary of Management Final Diagnosis Outcome Trainer’s Signature

& date

36

Patients’ case Log

Patient’s Name & age Hospital

Number Summary of Clinical Findings Diagnostic Workup

37

Nutrition and nutritional problems

Summary of Management Final Diagnosis Outcome Trainer’s Signature

& date

38

Patients’ case Log

Patient’s Name & age Hospital

Number Summary of Clinical Findings Diagnostic Workup

39

Nutrition and nutritional problems

Summary of Management Final Diagnosis Outcome Trainer’s Signature

& date

40

Patients’ case Log

Patient’s Name & age Hospital

Number Summary of Clinical Findings Diagnostic Workup

41

Allergic diseases

Summary of Management Final Diagnosis Outcome Trainer’s Signature

& date

42

Patients’ case Log

Patient’s Name & age Hospital

Number Summary of Clinical Findings Diagnostic Workup

43

Allergic diseases

Summary of Management Final Diagnosis Outcome Trainer’s Signature

& date

44

Patients’ case Log

Patient’s Name & age Hospital

Number Summary of Clinical Findings Diagnostic Workup

45

Respiratory problems

Summary of Management Final Diagnosis Outcome Trainer’s Signature

& date

46

Patients’ case Log

Patient’s Name & age Hospital

Number Summary of Clinical Findings Diagnostic Workup

47

Respiratory problems

Summary of Management Final Diagnosis Outcome Trainer’s Signature

& date

48

Patients’ case Log

Patient’s Name & age Hospital

Number Summary of Clinical Findings Diagnostic Workup

49

Cardiac problems

Summary of Management Final Diagnosis Outcome Trainer’s Signature

& date

50

Patients’ case Log

Patient’s Name & age Hospital

Number Summary of Clinical Findings Diagnostic Workup

51

Cardiac problems

Summary of Management Final Diagnosis Outcome Trainer’s Signature

& date

52

Patients’ case Log

Patient’s Name & age Hospital

Number Summary of Clinical Findings Diagnostic Workup

53

Gastroenterology problems

Summary of Management Final Diagnosis Outcome Trainer’s Signature

& date

54

Patients’ case Log

Patient’s Name & age Hospital

Number Summary of Clinical Findings Diagnostic Workup

55

Nephrology problems

Summary of Management Final Diagnosis Outcome Trainer’s Signature

& date

56

Patients’ case Log

Patient’s Name & age Hospital

Number Summary of Clinical Findings Diagnostic Workup

57

Endocrine problems

Summary of Management Final Diagnosis Outcome Trainer’s Signature

& date

58

Patients’ case Log

Patient’s Name & age Hospital

Number Summary of Clinical Findings Diagnostic Workup

59

Hematology problems

Summary of Management Final Diagnosis Outcome Trainer’s Signature

& date

60

Patients’ case Log

Patient’s Name & age Hospital

Number Summary of Clinical Findings Diagnostic Workup

61

Genetic problems

Summary of Management Final Diagnosis Outcome Trainer’s Signature

& date

62

Patients’ case Log

Patient’s Name & age Hospital

Number Summary of Clinical Findings Diagnostic Workup

63

Metabolic problems

Summary of Management Final Diagnosis Outcome Trainer’s Signature

& date

64

Patients’ case Log

Patient’s Name & age Hospital

Number Summary of Clinical Findings Diagnostic Workup

65

Neurology problems

Summary of Management Final Diagnosis Outcome Trainer’s Signature

& date

66

Patients’ case Log

Patient’s Name & age Hospital

Number Summary of Clinical Findings Diagnostic Workup

67

Psychiatry problems

Summary of Management Final Diagnosis Outcome Trainer’s Signature

& date

68

Patients’ case Log

Patient’s Name & age Hospital

Number Summary of Clinical Findings Diagnostic Workup

69

Ophthalmic problems

Summary of Management Final Diagnosis Outcome Trainer’s Signature

& date

70

Patients’ case Log

Patient’s Name & age Hospital

Number Summary of Clinical Findings Diagnostic Workup

71

Dermatology problems

Summary of Management Final Diagnosis Outcome Trainer’s Signature

& date

72

Patients’ case Log

Patient’s Name & age Hospital

Number Summary of Clinical Findings Diagnostic Workup

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Rheumatology problems

Summary of Management Final Diagnosis Outcome Trainer’s Signature

& date

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Procedures' Log

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Neonatology

Procedures Year-1 Year-2 Year-4 Year-3

Neonatal resuscitation in the

delivery room

Observe(10), Performs under supervision (10)

then perform independently (20)

Neonatal resuscitation in the

nursery and NICU

Observe(10), Performs under supervision (10)

then perform independently (20)

Stabilization and transport

after resuscitation

Observe(5), Performs under supervision (5)

then perform independently (20)

Assessment of maturity stage

& anthropometric measure-

ment

Observe(5), Performs under supervision (5)

perform independently (20)

Intravenous line insertion Observe (5), perform under supervision (5) then

perform independently (10)

Nasal-gastric tube insertion Observe (5), perform under supervision (5) then

perform independently (10)

Oro- pharyngeal suction Observe (5), perform under supervision (5) then

perform independently (10)

Supra-pubic tab for urine

analysis and culture

Observe (2), perform under supervision (2)

perform independently (2)

Fluid therapy Observe (5), perform under supervision (10)

then perform independently (10)

Blood product transfusion Observe (5), perform under supervision (10)

then perform independently (10)

Total parenteral nutrition Observe (2), perform under supervision (2)

Endotracheal intubation Observe(10), Performs under supervision (10) then perform independently (10)

Phototherapy Observe(5), Performs under supervision (5) then perform independently (10)

capillary sample by heel prick

& arterial blood gas sample Observe(5), Performs under supervision (5) then perform independently (5)

Central venous line insertion Observe(5), Performs under supervision (5)

Mechanical ventilation Observe(10), Performs under supervision (10) then perform independently (10)

Exchange transfusion Observe(3), Performs under supervision (3) then perform independently (3)

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Emergency & ICU procedures Year-1 Year-2 Year-3 Year-4

Cardiopulmonary resuscitation Observe(10), Performs under supervision (10) then perform

independently (10)

Intravenous line insertion Observe (5), perform under supervision (5) then perform

independently (10)

Nasal-gastric tube insertion Observe (5), perform under supervision (5) then perform

independently (10)

Oro- pharyngeal suction Observe (5), perform under supervision (5) then perform

independently (10)

Urinary catheter application Observe (5), perform under supervision (5) then perform

independently (10)

Fluid therapy Observe (2), perform under supervision (10) then perform

independently (10)

Blood product transfusion Observe (2), perform under supervision (10) then perform

independently (10)

Endotracheal intubation Observe(10), Performs under supervision (10) then perform

independently (10)

Cardio version Observe(10), Performs under supervision (10) then perform

independently (10)

Arterial sample Observe(5), Performs under supervision (3) then perform

independently (3)

Central venous line insertion Observe(3), Performs under supervision (3)

Mechanical ventilation Observe(10), Performs under supervision (10) then perform

independently (10)

Ascites tap Observe(5), Performs under supervision (5) then perform

independently (5)

Venous cut down Observe(10), Performs under supervision (5)

Wound dressing Observe (5) perform under supervision(5) and perform in-

dependently (5)

Simple Suturing Observe(10), Performs under supervision (10) then perform independently (10)

Chest tube insertion Observe(10), Performs under supervision (10) and perform independently (3)

79

Infection control procedures Year-1 Year-2 Year-3 Year-4

Practice scrupulous aseptic techniques Observe (5), Performs under supervision (5) then perform independently (20)

Respiratory procedures Year-1 Year-2 Year-3 Year-4

Spirometry interpretation Observe (5) Performs under supervision (5) then perform and interpret independently

(20)

Immunology procedures Year-1 Year-2 Year-3 Year-4

Administration of vaccination Observe (5)Performs under supervision (5) then perform independently (10)

Administer Intravenous immunoglobulin Observe (2)Performs under supervision (2) then perform independently (2)

Cardiology Procedures Year-1 Year-2 Year-3 Year-4

Perform and interpret EKG Performs under supervision (5) then perform and interpret independently (20)

Echocardiography Observe (10)

Gastroenterology

procedures Year-1 Year-2 Year-3 Year-4

Fluid replacement therapy Observe (10) Performs under supervision (5) then perform independently (20)

Upper and lower endoscopy Observe (5)

Haematology Procedures Year-1 Year-2 Year-3 Year-4

Blood product transfusion Observation (5) and supervised performance (5) and independent performance

all through after that (20)

Procedures related to nutrition Year-1 Year-2 Year-3 Year-4

Weight , length and height measurement

according to Egyptian growth curves

Observe (10) Performs under supervision (10) then perform and interpret inde-

pendently (30)

80

Rheumatology Procedures Year-1 Year-2 Year-3 Year-4

Joint aspiration in septic arthritis Observation (2)

Nephrology Procedures Year-1 Year-2 Year-3 Year-4

Blood pressure measurement in all four limbs Observation (5) and supervised performance (5) and independent

performance all through after that (20)

Peritoneal dialysis Observation (5) and supervised

performance (5)

Renal imaging and renal biopsy Observation (5)

Neurology

Procedures Year-1 Year-2 Year-3 Year-4

Cerebrospinal fluid tap Observation (5) and supervised performance (5) and independent performance

all through after that (20)

Interpretation of CT

and EEG

Observation 10, supervised

interpretation 20

Ophthalmology Year-1 Year-2 Year-3 Year-4

Measurement of visual acuity Observe (10) Performs under supervision (10) then perform inde-

pendently (10)

Assessment of visual acuity Observe (10) Performs under supervision (10) then perform inde-

pendently (10)

81

Registration Tables

82

Patients’ Procedures Log

Patient’s Name & age Hospital

Number Diagnosis and indications for the procedure

83

Patients’ Procedures Log

Procedure Name

Level of Trainee’s Performance

Trainer’s Signature

& date Observed

Performed

under

Supervision

Performed

Independently

84

Patients’ Procedures Log

Patient’s Name & age Hospital

Number Diagnosis and indications for the procedure

85

Patients’ Procedures Log

Procedure Name

Level of Trainee’s Performance

Trainer’s Signature

& date Observed

Performed

under

Supervision

Performed

Independently

86

Patients’ Procedures Log

Patient’s Name & age Hospital

Number Diagnosis and indications for the procedure

87

Patients’ Procedures Log

Procedure Name

Level of Trainee’s Performance

Trainer’s Signature

& date Observed

Performed

under

Supervision

Performed

Independently

88

Patients’ Procedures Log

Patient’s Name & age Hospital

Number Diagnosis and indications for the procedure

89

Patients’ Procedures Log

Procedure Name

Level of Trainee’s Performance

Trainer’s Signature

& date Observed

Performed

under

Supervision

Performed

Independently

90

91

Academic Activities Log

92

93

Clinical & Staff Rounds

Title of the meeting Location Date Signature of the

meeting coordinator

94

Courses / conferences / workshops

Title of the meeting/ course Location Date Signature of the

meeting organizer

95

Journal Club Title Date Trainer signature

96

Journal Club Title Date Trainer signature

97

Lecture Title Date Instructor signature

98

Lecture Title Date Instructor signature

99

Interesting Cases Log

100

101

Case 1

Date: ………………………………………………………………………………………………………….

Interesting case description:

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Trainer’s/Supervisor’s Comment:

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Trainer’s Signature Educational Supervisor’s Signature

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102

Case 2

Date: ………………………………………………………………………………………………………….

Interesting case description:

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Rotations finished during the training year

Hospital manager signature after the end of rotation and the signature must be stamped.

Rotation 1 Rotation 2 Rotation 3

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Date

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Hospital Stamp