AFFILIATION INSPECTION PROFORMA (UPTO 50 STUDENTS) · 2019. 3. 11. · form at least 2 months...
Transcript of AFFILIATION INSPECTION PROFORMA (UPTO 50 STUDENTS) · 2019. 3. 11. · form at least 2 months...
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DATE OF VISIT: ________________________________
AFFILIATION INSPECTION PROFORMA (UPTO 50 STUDENTS)
Name, Contact details and address of the College / Institute: -_
____________________________________________________________________________
Name of the Owner / Person / Trust / Foundation / Partners _
__________________________________________________________________________________ Session Timing: _________________Morning/Evening Already Recognized / Not Recognized Since
Name of Technologies (No. of Seats) applied for:
. General Provisions:
1.1 Institution applying for affiliation shall submit the case on the prescribed
form at least 2 months before the beginning of the academic session. The
application shall be entertained up to 30th April and 31st October for July &
January session/semester respectively of the year.
1.2 The institution shall submit a written undertaking on a surety bond viz status of the Institute and to observe the rules and regulations of FPMA from time to time.
1.3 The Institution requesting for affiliation with FPMA will not seek affiliation with any other organization for the sake of Allied Health Science education.
1.4. Provisional affiliation shall be granted for a period of two years. The affiliation granted will automatically expire at the end of this period and the institution will be required to apply for renewal/continuation of affiliation for the next two years by at least 3 months before expiry is due.
1.5. The admissions will be done twice a year and in single shift only. The application
shall be entertained up to 30th October and 30th April for January & July
session/semester respectively of the year. Application shall not be entertained
after expiry of the deadline.
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1. BUILDING/PREMISES
Ownership Name of Owner Remarks
Own
Attach verified Documents of ownership
Lease agreement for minimum 05 years on judicial stamp paper is required.
Lease
None
2. FINANCIAL STATUS
2.a. Working Capital- At least 0.5 million rupees as working capital present in Bank (Yes/No) Attach Attested Bank guarantee/Statement
2.b. Copy of last Audit Report: (Yes/No) (Attach evidence).
3. HOSPITAL
i) Name: __________________
ii) HCC Registration/License No. _________________________________
iii) No of Beds______________
iv) Facility Details ______________________
v) Ownership
How many other Paramedical/other Institutes have MoU with the hospital
Own Hospital with all required disciplines available (attach evidence).
Memorandum of Understanding ( MoU) /Lease/ Contract on requisite judicial Stamp Paper (Valid till passing out of the last admitted student) with Govt: / Autonomous or Private Hospital with all required disciplines available (attach evidence).
4. TEACHING STAFF / FACULTY 4 (a) . Lecturers (Basic Subjects):----
S.No. Subject Required Qualification
Up to50 students
Remarks
1. Anatomy MBBS 1 MBBS - PMDC registered Minimum 3 full time teachers for basic subjects . In case of Government servants, NOC from the relevant officer . Non-Medical faculty e.g. Pharm. D, M.Sc.( Biochem), BSc. Tech. with 05 yrs experience
to be given 2/3rd as that of Medical qualifications. For Pharmacology Pharm D also acceptable
2. Biochemistry MBBS 1
3. Pathology MBBS 1
4. Physiology MBBS 1
5. Pharmacology MBBS 1
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4 .b General Subjects
S.No. Subject Required Qualification
Number Available (Yes / No)
Remarks
1. English M.A 1
2. Pak-Study M.A 1
3. Islamyat M.A 1
4. Computer Science
BS / Diploma in Comp Science
1
4.c. Specialty Specific
S.No. Subject Required
Qualification Up to 50 students Available
(Yes / No) Remarks
MBBS 1 Registered with PM&DC
MBBS 1
MBBS 1
At least one MBBS Lecturer per two specialties is required.
One Assistant Professor and above / Distt. Specialists in the relevant clinical subjects must be given a supervisory role but they will not be counted as replacement of lecturers.
All staff members shall be employed on a written agreement between the employee & the employer stating clearly the terms & conditions of service.
The minimum salary for permanent staff shall not be less than the government
scales. Contract with the clinical supervisor is mandatory.
4.d. . Non Teaching / Administrative Staff
S.No. Name of Post Qualification Available
(Yes / No)
1. Managing Director MBBS /BDS /MBA with experience
2. Principal MBBS/BDS with Health related 05 years experience
3. Superintendent / Accountant MBA/BBA/B.COM
4. Receptionist FA /F.SC with DIT
5. Student Affairs Clerk FA /F.SC
6. Class-IV / Chowkidar Matric
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5. INFRASTRUCTURE
5.a. . General
Structure Capacity Size Available (Yes / No)
Remarks
One Lecture Hall
Seating for all Students of Ist. semester
As per No of Students allowed
The Hall should be properly ventilated and equipped with proper chairs (chairs with side pan for writing) and teaching facilities including rostrum, big white board fixed on the wall, wall clock, fans and Multimedia.
Lecturers’ Office
Common Room (female) 500-700 sqft (Min require)
Cafeteria
Administration office
Hostel
5b. Examination Hall/ Auditorium
15 sq.ft /student For 100-150
5c. CLASS ROOMS
At Least one class room/Technology.Min 05 class rooms each with a minimum capacity of 15-20 students
5d - MUSEUM:
20 students capacity The models to be present in Anatomy museum. (ANNEX I)
5.e . LABORATORY-----
Each Institute must have its own one basic science & one clinical laboratory The equipment to be present in the Laboratory (ANNEX I Minimum Required Size Capacity of Students Available (Yes/No)
15 sq.ft /student 15x50= 450 sqft approximately
25-50 students
5.f. PHARMACY / PHARMACOLOGY (Optional)
Name of equipment /reagents Quantity Available
(Yes/No) Remarks
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6. LIBRARY: 6 (a) General
Internet connection ---- (Compulsory)
Photostat, Fax, Printer
Books - Annex III ((All books must be stamped with Institutes name and Library Number allotted))
Seating arrangement Note:
Reference Books (recent edition), preferably comprehensive books of local Authors
Seating arrangement should be present for 20-25 students with central table 6.b. . Magazines/Newspaper:
S.No. Name of magazines Required Available
(Yes/No) Remarks
1. Health related Magazine 10 2. Urdu Adab 05 3. News paper One Urdu and One English
7. COMPUTER LABORATORY
Minimum Required Capacity of Students Available (Yes/No) 15 sq ft /student 15x50= 450 sq ft approximately
25
should be set up in a separate room with proper seating arrangement.
computers 05
Internet Facilities
Scanning / Printing / FAX Facility
8. Teaching Aids
N ame of Equipment Minimum Required
Available (Yes/No)
Remarks
Multimedia 1
Projectors 1
Teaching Charts Large size on panaafalx
All systems
9.
Miscellaneous 1. Biometric Attendance System - (Yes/No) 2. Water Supply (Bore well / Hand Pump / Public Health water Supply) (Yes/No) 3. Backup light source Generator /UPS (must) ---
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10. SCORE CHART
Spot Max credit
points
Minimum required (70%) Obtained
Essential/Prerequisit
e
Any No will result in No further action
Building/Premises
Financial
Infrastructure
Hospital
Faculty
Max
Note: Excepot in essentials in all others 80% in
individual Parameters is must for qualifying.
CONSENSUS REPORT
Recommended Not Recommended
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Permanent / Regular Members
S.No. Name Designation & Department/Institution Signature
1.
2.
3.
Convener Inspection Committee: Date:
Recommended by the Inspection Team:
Not Recommended for Recognition/ Affiliation:
Recommended for Provisional Recognition/ Affiliation for _Years
The Institute has the facilities for imparting theoretical training / teaching to
students The Number of Students for Each Specialty / Technology / Discipline Shall be fixed /
determined as per availability of clinical facilities in the Associated Hospitals /
Affiliated Hospitals.
CHAIRMAN (Sig)
NAME
DESIGNATION
MEMBER (1) (Sig)
NAME
DESIGNATION
MEMBER (2) (Sig)
NAME
DESIGNATION
MEMBER (3) (Sig)
NAME
DESIGNATION
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Undertaking by
Director/Head of Paramedics Institution*
I, Mr. _____________s/o __________________solemnly affirm that the information provided and facilities noted in Pre-Inspection Proforma are available in this institute and will show continuous maintenance, improvement and strengthening failing which the affiliation granted will be deemed to have been cancelled forthwith.
Name of Director / Principal Signature: CNIC No.
Address:
Witness No.1 Witness No.2
Signature Signature Name: Name: Father Name: Father Name: CNIC No. CNIC No.
*On judicial Stamp Paper
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ANNEX I
Name of Models Minimum required quantity
Available (Yes/No)
Remarks
Upper & lower limb 1
Different loose bones. (Long bones, short bones & falt bones)
1 set
Skeleton (Human)-Large size 1
Liver model (Human) 1 set
Kidneys model(Human) 1
Heart models(Human) 1
Lungs model(Human) 1
Brain model (Human) Separable.
1
Plastic body (Torso) - Large size 01
Eye model 01
Ear model 01
Female pelvis 01
Male pelvis 01
Knee joint 01
Ankle joint 01
Elbow joint 1
Wrist joint 01
Shoulder joint 01
Larynx model 01
Different anatomical charts (large size)----on Panaflax
One each
X-Ray viewer 01
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ANNEX II
Regents / Equipment Minimum required quantity
Availa ble (Yes/ No)
Remarks
Spectrophotometer / ERMA Colorimeter
1
Binocular microscopes 05
Water bath with 1
Centrifuge 1
Autoclave 01
Hot air oven 01
Analytical balance 01
ESR stands with tubes (Wintergreen)
02
Sahli’s Hemoglobinometer 05
Neubar’s chambers 03
RBC, WBC pipits 02 each
Jester ( Automatic pipettes) 01
Pipettes ( 01 ml, 02ml, 05ml & 10 ml)
04 each
Stop watch 02
Slides 06 packets
Different stains (Gram stain, ZN stain, Leishman stain & Gimsa’s stain
One set each
Benedict’s solution 02 bottle
Different chemical reagents for clinical tests
Blood Grouping Anti sera 01 set
Pregnancy kit 01 set
Rheumatoid Arthritis factor Kit 01 set
Syringes 100
Distillation plant 01
Refrigerator 01
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ANNEX III
Subject Books required
Available (Yes/No)
Deficiency Remarks
Anatomy 40-50
Pathology 40-50
Pharmacology 30-40
Bio Chemistry 30-40
Physiology 30-40
English 20-30
Islamiat 20-30
Pak-Study 20-30
Anesthesia 05
Cardiac 05
Dental 10
Dialysis 05
Gastroenterology 10
Health 50
M.C.H 05
Ophthalmology 05
Orthopedic 05
Pathology 30
Pharmacy 10
Physiotherapy 05
Public Health 10
Psychiatry 05
Radiotherapy 05
Surgical 05
Pulmonology 05
Radiology 05
Neurophysiology 05
General Subjects 20
Dictionary 05
Inspection Proforma for Paramedical Institution (9-16)
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Computers/scanners 01
Thermometers 10
Weight machines 1
Malaria charts 1
Kidney trays 02
Tongue depressor 10
Racks for small twelve test tubes & holders
04
Racks for large test tubes & holders 04
Glassware. Beakers, cylinders, flasks & Petri dish
Sufficient number