MS Surgery Logbook

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LOG BOOK For

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MS RESIDENCY PROGRAMME

DEPARTMENT OF SURGERY BANGABANDHU SHEIKH MUJIB MEDICAL UNIVERSITY

SHAHBAG, DHAKA, BANGLADESH.

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Published By:

Department of Surgery

Bangabandhu Sheikh Mujib Medical University

Shahbagh, Dhaka-1000.

First Edition : Jan 2011

Second Edition: Jan 2012

Printed by –

Department of Surgery, BSMMU

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Name of the Candidate (in block letter) : ………………………………………..………………………………………………………………………………….

Year of entry in to the course : ……………………………………………..…………………………………………………………………………….

PHOTO

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All the entries made in this book by Dr. ………………………………………………………………………………………………………having registration

number ………………………………………… are correct.

Course Manager


Course Coordinator


Course Director


ENDORSEMENT:

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Name : ……………………….…………………….………………………………………………………………………………………………………………………………

Father’s Name : ……………………….…………………….………………………………………………………………………………………………………………………………

Mother’s Name : ……………………..……..……………….………………………………………………………………………………………………………………………………

Date of Birth : ………………….…………….……………………………………………………………………………………………………………………………………………

Address

Permanent : ………………………………………………………………………………………………………………………………………………………………………………

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

For Correspondence : ……………………………………………………………………………………………………………………………………………………………………

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

MBBS (institute) : ………………………………………………………………………………………………………………………………………………………………………………

Year of Passing…………………………………………………… University Registration No.……………..………………………………………………………………

Internship : From……………………………………………………………….………… to ……………………………………………………………………….…….………

Name of Hospital : ………………………………………………………………………………………………………………………………………………………………………………

BMDC Registration No.:………………………………………………………………………………………………………………………………..…………………………………………

Year of entry in to MS General Surgery (Residency Programme) Course: ….…………….………………………………………………………………………………

PARTICULARS OF THE TRAINEE:

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Duration :

Name of the Department :

Unit :

Unit Head :

Designation :

Number of Bed : No. of trainees of the unit :

Signature of the Unit Head:

Duration :


Unit :

Unit Head :

Designation :



Training Detail / Block Detail:

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Duration

:


Unit :

Unit Head :

Designation :



Duration :


Unit :

Unit Head :

Designation :




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Duration

:


Unit :

Unit Head :

Designation :



Duration :


Unit :

Unit Head :

Designation :




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Duration :


Unit :

Unit Head :

Designation :



Duration :


Unit :

Unit Head :

Designation :




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Duration :


Unit :

Unit Head :

Designation :



Duration :


Unit :

Unit Head :

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Explanatory Notes

� This Log Book is intended to help both trainees and trainers keeping them aware of their responsibility.

� This will be a record of all Clinical, Practical, Academic and Research Activities of the trainee with particular reference to different

procedure (operations) performed.

� This Log Book has been designed to record level of achievement or competence in addition to the service.

� Maintenance of Log Book throughout the training period will reflect the overall interest and aptitude of the trainee.

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1. Instructions for the trainee:

� Please read this Log Book carefully. It is an outline of the syllabus for trainees.

� This Log Book has to be maintained by all trainees preparing for MS General Surgery.

� Trainees are advised to make the entries of the activities on the same day. All entries must be signed by supervisor on the same

day and countersigned by the head of the unit as soon as possible.

� Trainees will remain responsible for care of his/her log book.

2. Guideline for trainers:

� The Log Book is a day to day record of the clinical, practical and the academic work done by the trainee.

� Its purpose is to follow the progress of the candidate and assess the achievement and the deficiencies so that they can be

redressed.

� The trainer should ascertain that the entries in the logbook are made immediately after the activities and they are authenticated

by signature of the trainer himself.

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Aims & Objectives of the post graduate training programme:

The aim of the post graduate training programme is to produce a surgeon who shall

1. Provide optimum care to the patients needing surgical service.

2. Teach and train students and junior doctors in medical college and other institutions.

3. Carry out and guide research in surgical science and education

4. Develop knowledge, skills and attitude (Competence) in areas of interest in different surgical specialties.

5. Organize and work effectively as a member of medical team at different levels, in the events of natural disaster and national

need.

6. Develop and maintain ethical and moral values.

7. Develop respect for national needs and expectations.

At the end of the training a candidate shall be able to:

a. Receive and assess the patients with surgical problems prevalent in the country by –

� Eliciting pertinent history

� Performing correct physical examination

� Making a working diagnosis

� Determining the type of care – ambulatory/inpatient or otherwise.

� Starting life saving emergency care including CPR.

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� Starting emergency care.

� Requesting appropriate investigation and interpretation of their result.

� Perform immediate necessary surgical procedures competently.

� Identify promptly the complications and deal with safety.

� Maintain record of patients systematically.

� Seek help from other colleagues where needed.

� Treat patients and their relatives with respect and empathy.

b. Plant scientific research and publish findings.

c. Search the medical information and utilize it.

d. Organize team work and appreciate the role of team members.

e. Make effective communication with patients, their relatives, colleagues and other health professionals.

f. Advice for prevention of diseases and promotion of heath in the community.

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(A) The total training programme is of five years duration

Phase - A

1.

2.

General Surgery 01 year

01 year

Orthopedic Surgery/Casualty Surgery

Urology

Neuro Surgery

Burn & Plastic Surgery

Pediatric Surgery

Cardiac & Vascular Surgery

Thoracic Surgery

Radiology

Nuclear Medicine

ICU

Medical Oncology & Radiation

Pathology

Internal Medicine

Phase – B

03 years

General Surgery

Hepatobiliary Pancreatic Surgery

Colorectal Surgery

Endocrine Surgery

Minimal Access Surgery

Onco Surgery

NB:

1. During the training a candidate is to achieve competence (operative-major/minor, procedure) as mentioned in the logbook.

2. The logbook should be submitted to the University at the time of submission of application for appearing the examination.

3. Preferably the sub-specialty training should be done at least after one year of General Surgery training.

4. Candidate to be evaluated on log book.

TRAINING PROGRAMME

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The objective of the training may be achieved through different modes. As for example

1. Self Learning of basic principles of Surgery.

2. Clinical responsibility

Active involvement in patient management by taking graded responsibilities in

€ Indoor patient management

€ Attending outpatient department and follow up clinics

€ Emergency duties

3. Participations in Practical procedures or surgical procedures, post operative care and subsequent follow up.

4. Academic Activities e.g.

€ Participation in teaching learning process

€ Presentation (Cases or papers) in clinical meeting, seminars, journal club etc.

€ Participation at clinical meeting and CME conferences

€ Participation in different skill courses and workshops

5. Research Activities

€ Writing thesis

€ Monthly Audit of the unit

€ Any publication

MODE OF ACHIEVEMENT OF THE OBJECTIVE:

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The experience and competencies, achieved through these activities will be varied and can be leveled as

1. Observer status

2. Assistant status

3. Performed under direct supervision

4. Performed under indirect supervision (the supervisor in readily available in called for)

5. Performed independently.

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At the end of the training, the trainee shall be able to perform the following procedures with the given level of competence

Sl. No. Patient management 1st

Year 2nd

Year 3rd

Year 4th

Year 5th

Year Total

1 Eliciting patient history 5 5 5 5 5 25

2 Performing physical examination 5 5 5 5 5 25

3 Ordering appropriate investigations 5 5 5 5 5 25

4 Interpreting the results of investigation 5 5 5 5 5 25

5 Assessing fitness & preparation for surgery 5 5 5 5 5 25

6 Deciding & preparation for surgery 5 5 5 5 5 25

7 Post operative management & monitoring 5 5 5 5 5 25

8 Presentation skills: 1 long case & 2 short

cases/per block 12 12 12 12 12 60

A

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Sl.

No.

Surgical knowledge & application

of the following

1st

Year 2nd

Year 3rd

Year 4th

Year 5th

Year Minimum

Number

1 Per-operative preparation for various

surgical procedures (listed below) 10 10 10 10 10 30

2 Aseptic techniques 10 10 10 10 10 30

3

Positioning of patient on operation table

for:

1. Laparotomy

2. Perineal surgery

3. Thoracotomy

4. Surgical procedures on back

5. Renal surgery

6. Head & neck surgery

4

5 5 5 5

50

30

05

05

10

10

4 Common surgical instruments and

appliance including endoscopes. 3 5 5 5 5 10

5 Suture materials 10 10 10 10 10 45

6 Stapling devices and techniques 1 2 3 3 4 05

B

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Sl. No. Surgical knowledge & application

of the following 1

st Year 2

nd Year 3

rd Year 4

th Year

Minimum

Number

1 Airway maintenance and intubation 3 5 10 10 20

2 IPPR and other methods of artificial respiration 4 5 5 5 5

3 Closed cardiac massage 5 5 5 5 5

4 Controlling haemorrhage 5 5 5 5 5

5

Debridement & wound closure

(excluding repair of special tissues)

Application of splints, P.O.P casts, skin traction

4

4

5

5

10

5

15

5

30

10

6 Incision & drainage of abscess (excluding deep seated

abscess in peritoneum and other serous cavities) 5 5 10 15 30

7 Uretheral catheterization using soft & hard catheters 5 5 10 15 30

8 Uretheral dilation 3 4 5 5 10

9 Suprapubic puncture 3 4 5 5 5

10 Meatotomy 3 4 5 5 5

11 Circumcision 5 5 5 5 10

12 Lumber puncture 5 5 5 5 5

13 Placement of CVP line 3 5 5 5 5

14 Venesection 5 5 5 5 10

15 Intercostal drainage 3 4 5 5 10

C

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Sl. No. Procedure 1st

Year 2nd

Year 3rd

Year 4th

Year Minimum

Number

16 Biopsy of lymph node 4 5 5 5 10

17 Biopsy of skin lesions, subcutaneous swellings 3 4 5 5 10

18 Excision of soft tissue tumours and cysts 3 4 10 15 20

19 Split skin graft 5 5 5 5 10

20 Tracheostomy 4 5 5 5 05

21 Opening and closure of abdomen 3 4 15 20 40

22 Proctoscopy and interpretation of findings 3 5 10 15 20

23 Gastroduodenoscopy 1 2 5 10 10

24 Colonoscopy 1 2 5 10 10

25 ERCP 1 2 2 2 5

26 Proctosigmoidoscopy 2 3 10 15 10

27 Liver biopsy 1 2 3 5 2

28 Percutaneous needle aspiration under US/CT guidance 2 2 5 5 10

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Sl. No. Abdominal Operation 1st

Year 2nd

Year 3rd

Year 4th

Year Minimum

Number

1 Hernia repair 3 5 10 20 30

2 Operation on scrotum & testes 3 5 10 10 20

3 Hemorrhoids, fissures, fistulae 3 10 10 15 30

4 Appendicectomy 3 10 10 15 20

5 Cholecystectomy/Choledocholithomy 3 10 10 15 20

6 Oesophagectomy 2 2 3 5 5

7 Intestinal/colonic resection & anastomosis 3 5 10 10 15

8 Laparoscopic surgery 2 5 10 10 15

9 Laparotomy/exploration of abdomen 3 4 10 15 20

10 Colostomy & Ileostomy 2 3 5 10 10

11 Liver procedure 2 1 2 4 3

D

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Sl. No. Orthopedic Surgery 1st

Year 2nd

Year 3rd

Year 4th

Year Minimum

Number

1 Closed treatment of common fractures 3, 4 5 5 5 5

2 Open reduction, plating, nailing, wiring 2, 3 4 5 5 5

3 External fixation 2 5 5 5 2

4 Operative treatment of deformities 2, 3 3, 4 5 5 2

5 Operations on tendons (repair & lengthening) 5 5 5

6 Nerve repair 3 4 5 5 5

7 Amputation 3 4 5 5 10

8 Sequestrectomy 3 4 5 5 5

9 Bone biopsy 3 4 5 5 5

10 Prosthesis/implants 2 5 3

11 Management of compound fractures 3 4 5 5

Sl. No. Head & Neck Surgery and other area 1st

Year 2nd

Year 3rd

Year 4th

Year Minimum

Number

1 Burr hole for cerebral decompression 1 2 3 4 5

2 Intracranial operation & operation for spinal

decompression 1 2 2 2 2

3 Operations on thyroid, salivary gland & jaw 3 4 5 5 10

4 Vascular surgery 3 4 5 5 10

5 Breast Surgery 3 5 10 10 20

E

F

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Sl. No. Thoracic Surgery 1st

Year 2nd

Year 3rd

Year 4th

Year Minimum

Number

1 Lobectomy 1 1 3 4 2

2 Pneumonectomy 1 1 3 4 2

3 Operations for esophageal carcinoma 1 1 3 3 2

4 Decortication 1 1 3 4 2

Sl. No. Paediatric Surgery 1st

Year 2nd

Year 3rd

Year 4th

Year Minimum

Number

1 Cleft lip 1 2 3 4 5

2 Cleft palate 1 2 3 4 5

3 Rectal & umbilical polyp 1 2 3 4 5

4 Imperforate anus 1 2 3 4 5

5 Congenital malformation of abdominal viscera 1 2 3 4 5

6 Hypospadias 1 2 3 4 5

7 Epispadias 1 2 3 4 5

8 Umbilical & inguinal hernia 1 2 3 4 5

9 Hydrocele 1 2 3 4 5

10 Colostomy 1 2 3 4 5

G

H

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Sl. No. Thoracic Surgery 1st

Year 2nd

Year 3rd

Year 4th

Year Minimum

Number

1 Suprapubic Cystostomy 2 3 5 5 5

2 Prostatectomy 1 2, 3 4 5 5

3 Cystolithotomy 1 3 4 5 5

4 Uretheral dilatation 1 4 5 5 5

5 Operations on kidney & ureter 1 3 4 5 5

6 Treatment of bladder & uretheral injuries 1 2 3 5 5

7 TURP/TURBT 1 2 3 5 5

8 Endoscopic Urology 1 1 2 5 2

9 Transvesical and retropubic prostatectomy 1 1 1 5 2

10 Percutaneous nephrolithotomy 1 1 2 5 5

11 ESWL 1 1 1 5 2

Sl. No. Plastic Surgery 1st

Year 2nd

Year 3rd

Year 4th

Year Minimum

Number

1 Skin grafting 1 2 4 5 5

2 Burn care 1 2 4 5 5

3 Myocutaneous flaps 1 2 2 3 5

4 Cleft lip 1 2 2 3 5

5 Cleft palate 1 2 2 4 5

6 Repair of deformities 1 2 3 4 5

7 Cosmetic Surgery 1 2 2 4 5

I

J

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Sl. No. Intensive Care 1st

Year 2nd

Year 3rd

Year 4th

Year Minimum

Number

1 Use of ventilators 5 5 5

2 Cardiopulmonary resuscitation (CPR) 3 4 5 5 5

3 Intubation 2 3 5 5 5

4 CVP lines 2 4 5 5 5

5 Knowledge of monitoring instruments 3 4 5 5 5

6 Care of unconscious patients 1 2 2 5 5

7 ICU complications management 1 2 2 5 5

Sl. No. Anaesthesia 1st

Year 2nd

Year 3rd

Year 4th

Year Minimum

Number

1 Local anaesthesia 5 10 10 10 30

2 Regional anaesthesia 5 5 5 5 10

3 Lumbar puncture and spinal anaesthesia 3 4 5 5 5

4 Epidural block 2 3 4 5 5

5 General anaesthesia 0 3 4 4 10

6 Mangement of pain 3 4 5 5 10

7 Assessing for fitness to undergo surgery 4 10 10 15 30

8 Post operative management & monitoring 10 15 20 25 50

BASIC SURGICAL SKILLS

L

K

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Block:

Duration:

Trainer:

Procedure to be Performed Number Remarks by the Supervisor

Venous Access

Nasogastric Intubation

Indwelling Urinary bladder catheterization

Wound Dressings

Proctoscopic examination

Operation theatre Rituals (Changing dresses, wearing gowns, Gloves, Masks & Caps, maintenance of aseptic techniques)

Organization of Instruments Trolleys

Disposal of wastes

Sending tissues for histopahotlogical examination (10)

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Block:

Duration:

Trainer:


Venous Access



Wound Dressings




Disposal of wastes


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Block:

Duration:

Trainer:


Venous Access



Wound Dressings




Disposal of wastes


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Block: Duration: Trainer:


Venous Access (10)

Nasogastric Intubation (10)

Indwelling Urinary bladder catheterization (10)

Wound Dressings (10)

Proctoscopic examination (10)

Operation theatre Rituals (Changing dresses, hand wash, wearing gowns, Gloves, Masks & Caps, maintenance of aseptic techniques) (20)

Organization of Instruments Trolleys (20)

CU Line Placement (2)


Operation Note writing (5)

Discharge Samary (5)

Referal Note writing (5)

Endo trachid in tubation

Tracje pf form

Local areas thyria

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Block:

Duration:

Trainer:


Venous Access



Wound Dressings




Disposal of wastes


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Block:

Duration:

Trainer:


Venous Access



Wound Dressings




Celine Placement


Upper GI Procedure

Colonoscopy

ERCP

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CLINICAL PERFORMANCE

Case Record / Case Presentation

Note : Only Satisfactory performance will be recorded

FORM ‘A’

Date Name & Age Reg. No Diagnosis Remarks

Minimum presentation – Long Case 20

Minimum presentation – Short Case 40

Signature of Supervisor

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FORM ‘A’





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FORM ‘A’





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FORM ‘A’





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FORM ‘A’





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FORM ‘A’





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FORM ‘A’





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Preoperative Evaluation

FORM ‘Aa’

Date Name & Age Reg. No Ward/

Bed

Type of

Anaesthesia F/UF* Measures Remarks

*F – Fit for Anaesthesia, UF – Unfit for Anaesthesia.

Minimum evaluation – 10 in each block


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FORM ‘Aa’


Bed

Type of





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FORM ‘Aa’


Bed

Type of





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FORM ‘Aa’


Bed

Type of





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FORM ‘Aa’


Bed

Type of





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FORM ‘Aa’


Bed

Type of





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Interpretation of Hematological and Biochemical Report

FORM ‘Ab’


Bed Report Interpretation Remarks

Minimum Interpretation – 05 of each in every block


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FORM ‘Ab’





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FORM ‘Ab’





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FORM ‘Ab’





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FORM ‘Ab’





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FORM ‘Ab’





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Interpretation and Recording of Radiological and Imaging studies

FORM ‘Ac’

Date Name & Age Reg. No Ward/ Bed Report Interpretation Remarks

Minimum Interpretation – 05 in every block


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FORM ‘Ac’




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FORM ‘Ac’




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FORM ‘Ac’




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FORM ‘Ac’




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FORM ‘Ac’




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Attendance at OPD / Emergency / Follow-up Clinics

FORM ‘B’

Date Name & Age Remarks Date Place of Duty Remarks

Minimum Attendance – 75 days


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FORM ‘B’




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FORM ‘B’




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FORM ‘B’




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FORM ‘B’




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FORM ‘B’




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FORM ‘B’




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PRACTICAL PROCEDURES / SURGICAL PROCEDURES

Elective Procedures


FORM ‘C’

Date Name & Age Procedure Level of

Participation Complications Signature

Major Cases –60, Minor Cases - 120

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Elective Procedures


FORM ‘C’




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Elective Procedures


FORM ‘C’




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Elective Procedures


FORM ‘C’




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Elective Procedures


FORM ‘C’




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Elective Procedures


FORM ‘C’




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Elective Procedures


FORM ‘C’




FORM ‘C’

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Elective Procedures





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Elective Procedures


FORM ‘C’




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Elective Procedures


FORM ‘C’




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Elective Procedures


FORM ‘C’




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Elective Procedures


FORM ‘C’




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Elective Procedures


FORM ‘C’




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Elective Procedures


FORM ‘C’




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Elective Procedures


FORM ‘C’




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Emergency Procedures


FORM ‘D’



Minimum (all categories 120 Cases)

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FORM ‘D’




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FORM ‘D’




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FORM ‘D’




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FORM ‘D’




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FORM ‘D’




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FORM ‘D’




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FORM ‘D’




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FORM ‘D’




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FORM ‘D’




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ACADEMIC ACTIVITIES

C 1 Teaching Activities


FORM ‘E’

Date Student of Group Number of

Student Level of Participation Signature

Minimum 30 sessions

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ACADEMIC ACTIVITIES



FORM ‘E’



Minimum 30 sessions

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ACADEMIC ACTIVITIES



FORM ‘E’



Minimum 30 sessions

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ACADEMIC ACTIVITIES



FORM ‘E’



Minimum 30 sessions

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ACADEMIC ACTIVITIES

C 2 Participation in academic programmes

(Seminars, Workshops, Journal Club, etc.)


FORM ‘F’

Date Student of Group Topic Level of

Participation Signature

Minimum 15 sessions

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ACADEMIC ACTIVITIES

C 2 Participation in academic programmes

(Seminars, Workshops, Journal Club, etc.)


FORM ‘F’

Date Student of Group Topic Level of

Participation Signature

Minimum 15 sessions

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Dissertation

Title : …………………………………………………………………………………………………………………………………………………………………………………..

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

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

Guide : ……………………………………………………………………………………………..……………………………………………………………………………………

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

Co – guide : ……………………………………………………………………………………………………………………………………………………………………………………

Publication (If any)

Title : …………………………………………………………………………………………………………………………………………………………………………………..

Journal …………………………………………………………………………………………………………………………………………………………………………………….

Title : …………………………………………………………………………………………………………………………………………………………………………………..

Journal …………………………………………………………………………………………………………………………………………………………………………………….

Title : …………………………………………………………………………………………………………………………………………………………………………………..

Journal …………………………………………………………………………………………………………………………………………………………………………………….

RESEARCH ACTIVITIES: FORM ‘G’

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Venous Access


Indwelling Urinary Bladder Catheterization

Wound Dressings

Proctoscopic Examination

Operation Theatre Rituals (Changing Dresses, Wearing Gowns, Gloves, Masks & Caps, Maintenance Of Aseptic Techniques)

Organization Of Instruments Trolleys

Disposal Of Wastes

Sending Tissues For Histopahotlogical Examination (10)

Signature of Course Co-ordinator

COMPILATION SHEET PHASE ‘A’ FORM ‘H’

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COMPILATION SHEET

Number Remarks by supervisor



Interpretation Of Hematological And Biochemical Report

Interpretation And Recording Of Radiological And Imaging Studies

Practical Procedures / Surgical Procedures

Elective Procedures

Practical Procedures / Surgical Procedures


Academic Activities


Academic Activities

C 2 Participation In Academic Programmes

Research Activities

Signature of Course Co-ordinator

COMPILATION SHEET PHASE ‘A’ FORM ‘H’

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COMPILATION SHEET

Block…………………………………………………………………………………….……………………………..…………………………………

Supervisor ………………………….……………………………………………………………………………………………….……………………

Sl

No. Date Topic Lecture

Signature of

Supervisors

LECTURES ATTENDED PHASE ‘A’ FORM ‘I’

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O MPILATION SHEET

Block………………………………………………………………………………………………………………..……….….………………………

Supervisor ……………………………………………………………………………………………………………………..………………………

Sl


Signature of

Supervisors


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COMPILATION SHEET

Block…………………………………………………………………………………….……………………………….………………………………

Supervisor ………………………….……………………………………………………………………………………………………………………

Sl


Signature of

Supervisors


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COMPILATION SHEET

Block…………………………………………………………………………………….……..……….………………..………………………………

Supervisor ………………………….……………………………………………………………….……………………………………………………

Sl


Signature of

Supervisors


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COMPILATION SHEET

Block…………………………………………………………………………………….………………………………..………………………………

Supervisor ………………………….………………………………………………………………………….…………………………………………

Sl


Signature of

Supervisors


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COMPILATION SHEET

Block…………………………………………………………………………………….………………………………..………………………………

Supervisor ………………………….………………………………………………………………………….…………………………………………

Sl


Signature of

Supervisors


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COMPILATION SHEET

Block…………………………………………………………………………………….………………………………..………………………………

Supervisor ………………………….…………………………………………………………………………….………………………………………

Sl


Signature of

Supervisors


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COMPILATION SHEET

Block…………………………………………………………………………………….………………………………..………………………………

Supervisor ………………………….…………………………………………………………………………….………………………………………

Sl


Signature of

Supervisors


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COMPILATION SHEET

Block…………………………………………………………………………………….………………………………..………………………………

Supervisor ………………………….……………………………………………………………………………………………………………………

Sl


Signature of

Supervisors


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COMPILATION SHEET

Block…………………………………………………………………………………….………………………………..………………………………

Supervisor ………………………….…………………………………………………………………………….………………………………………

Sl


Signature of

Supervisors


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I certify that the information contained in the LOGBOOK (Daily Training Record is a true and accurate record of my training experiences.

Trainee’s signature………………………………………………………………Date:………………………………………………….

FORM K: CERTIFICATION of Satisfactory completion of the logbook

I, to the best of my knowledge, certify that

Dr. ……………………………………………………………………………………………………………………………………….

Has satisfactory completed this logbook as required by the university.

………………………………………… Signature of the Course Coordinator

Name:

Discipline:

Date:

CERTIFICATE OF ACCURACY PHASE ‘A’ FORM ‘J’

MASTER IN SURGERY

110

I certify that the information contained in the LOGBOOK (Daily Training Record is a true and accurate record of my training experiences.

Trainee’s signature………………………………………………………………Date:………………………………………………….

FORM K: CERTIFICATION of Satisfactory completion of the logbook

I, to the best of my knowledge, certify that

Dr. ……………………………………………………………………………………………………………………………………….

Has satisfactory completed this logbook as required by the university.

………………………………………… Signature of the Course Coordinator

Name:

Discipline:

Date:

CERTIFICATE OF ACCURACY PHASE ‘B’ FORM ‘J’

MASTER IN SURGERY

111

MS Surgery Logbook

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Transcript of MS Surgery Logbook