FACULTY – MEDICAL DEPARTMENT LOG BOOK Radiodiagnosis M.D. / D. M.R.D. MAHARASHTRA UNIVERSITY OF HEALTH SCIENCES, NASHIK LOG BOOK (POST GRADUATE) FACULTY – MEDICAL DEPARTMENT Radiodiagnosis M.D. / D. M.R.D.

LOG BOOK (POST GRADUATE DIPLOMA) MAHARASHTRA UNIVERSITY OF HEALTH SCIENCES, NASHIK LOG BOOK (POST GRADUATE DIPLOMA) M.D / D. M. R. D. Name of the P. G. Student: Name of the P. G. Guide: Name of the College :

Department of Radiology Certificate This is to certify that Dr. is registered as a post –graduate student at ---------------------------------------- for M.D /D.M.R.D. All the entries in the Logbook have been checked and authenticated. Signature Signature Post –graduate Teacher Head of Department Name: Date: Date:

INDEX SN Topic Page. No. 1. General Information 1 2. Clinical Posting 3. Procedures 3 4. Presentations 9 Case Presentations Sessions Seminars Journal Club Meetings Inter- hospital Clinical Meetings Inter- Departmental Meetings Other Meetings 5. Teaching Sessions Conducted 6. Workshop, Seminars, Conference and Guest Lecturers Attended 7. Scientific Papers Presented at Conferences 8. Awards, Prizes and Certificates of Appreciation Obtained. 10. Publications in the Books & Scientific Journals` 12. Record of Internal Assessment 13. Assessment of Performance 14. Summary 15. Instructions for the Residents Medical Officers

GENERAL INFORMATION Under –Graduate and Post Graduate Qualification Name: Date of Birth: Address (Permanent): Address (Temporary): Tel. No.: E-mail ID: Date of joining the course: Registered for: Registration Number: Post –Graduate Teacher: Under –Graduate and Post Graduate Qualification Degree/Diploma College & University Year of Passing Attempt Distinction & Prizes Student’s Signature

Signature of unit In- charge CLINICAL POSTING Period POSTING Signature of unit In- charge From TO 1st Year 1st month 2nd month 3rd month 4th month 5th month 6th month 7th month 8th month 9th month 10th month 11th month 12th month 2nd year

3rd Year 1st month 2nd month 3rd month 4th month 5th month 6th month 7th month 8th month 9th month 10th month 11th month 12th month 4th year

SUMMARY POSTING SN POSTING DURATION (IN MONTH) 1. URORADIOLOGY 2. GASTROINTESTINAL RADIOLOGY 3. GENERAL RADIOLOGY 4 ORTHOPAEDIC RADIOLOGY 5. VASCULAR & INTERVENTIONAL RADIOLOGY 6. NEURORADIOLOGY & INTERVENTION 7. ULTRA SONOGRAPHY 8. COMPUTED TOMOGRAPHY 9. MRI 10. EMERGENCY MEDICL SERVICES

Signature Prof / Assoc. Prof URORADIOLOGY SN GU DATE PROCEDURE O/A/P/S Signature Prof / Assoc. Prof /Lecturer 0=Observed A- Assisted P-Performed S- Supervised

Signature Prof / Assoc. Prof GASTROINTESTINAL RADIOLOGY SN GIR DATE PROCEDURE O/A/P/S Signature Prof / Assoc. Prof /Lecturer 0=Observed A- Assisted P-Performed S- Supervised

Signature Prof / Assoc. Prof GENERAL RADIOLOGY SR.NO Rad.No. DATE PROCEDURE O/A/P/S Signature Prof / Assoc. Prof /Lecturer 0=Observed A- Assisted P-Performed S- Supervised

Signature Prof / Assoc. Prof VASCULAR & INTERVENTIONAL RADIOLOGY SN VIR DATE PROCEDURE O/A/P/S Signature Prof / Assoc. Prof /Lecturer 0=Observed A- Assisted P-Performed S- Supervised

Signature Prof / Assoc. Prof NEURORADIOLOGY & INTERVENTION SN INR DATE PROCEDURE O/A/P/S Signature Prof / Assoc. Prof /Lecturer 0=Observed A- Assisted P-Performed S- Supervised

SIGNATURE PROF / ASSOC. PROF ULTRASONOGRAPHY SN NAME OF PATIENT DATE PROCEDURE O/A/P/S SIGNATURE PROF / ASSOC. PROF /LECTURER 0=Observed A- Assisted P-Performed S- Supervised

SIGNATURE PROF / ASSOC. PROF COMPUTED TOMOGRAPHY SN NAME OF PATIENT DATE PROCEDURE O/A/P/S SIGNATURE PROF / ASSOC. PROF /LECTURER 0=Observed A- Assisted P-Performed S- Supervised

SIGNATURE PROF / ASSOC. PROF MRI SN NAME OF PATIENT DATE PROCEDURE O/A/P/S SIGNATURE PROF / ASSOC. PROF /LECTURER 0=Observed A- Assisted P-Performed S- Supervised

SIGNATURE PROF / ASSOC. PROF EMERGENCY MEDICAL SERVICES SN NAME OF PATIENT DATE PROCEDURE O/A/P/S SIGNATURE PROF / ASSOC. PROF /LECTURER 0=Observed A- Assisted P-Performed S- Supervised

Signature Prof / assoc. Prof (A) Case Presentation Sessions SN Date Case Title Signature Prof / assoc. Prof /lecturer Case Presentation: Logical order in presentation Positive & Negative points Interpretation of Radiologic findings Diagnosis / Treatment / Path logical correlation Evaluation of case presentation: Ability to react to questioning Ability to defend diagnosis Ability to justify diagnosis Confidence

Signature Prof / assoc. Prof / Lecturer (B) Seminars Attended SN Date Topic Signature Prof / assoc. Prof / Lecturer

Signature Prof / assoc. Prof / Lecturer (C) Journal Club Meetings SN Date Topic Signature Prof / assoc. Prof / Lecturer Journal Clubs : - Articles presented / choice of article – relevance - Content - Presentation (cogency) - Discussion / review of cross reference - Overall impression of articles: Strong Vs. Weak points

Signature Prof / assoc. Prof / Lecturer (D) Presentation at the Inter- Hospital & Inter – Departmental Clinical Meetings SN Date Title of the Case Presented Signature Prof / assoc. Prof / Lecturer

Signature Prof / assoc. Prof / Lecturer (E) Presentation at other Meetings SN Date Topic Signature Prof / assoc. Prof / Lecturer

Signature Prof / Assoc. Prof / Lecturer TEACHING SESSIONS CONDUCTED SN Date * Student Category Title / Topic Signature Prof / Assoc. Prof / Lecturer

Signature Prof / Assoc. Prof / Lecturer *Student Category: UG / PG / Nurse / OT-PT student / Any other (Please specify) WORKSHOPS / SEMINARS / CONFERENCES / GUEST LECTURERS ATTENDED SN Date Workshop / Seminar / Conference / Lecturer Signature Prof / Assoc. Prof / Lecturer

SCIENTIFIC PAPERS PRESENTED AT CONFERENCES SN Date Title of the paper Conference Signature Prof / assoc. Prof / Lecturer

CERTIFICATES OF APPRECIATION Signature Prof / assoc. Prof / Lecturer AWARDS, PRIZES AND CERTIFICATES OF APPRECIATION SN Date Prize / Certificate Signature Prof / assoc. Prof / Lecturer PUBLICATION IN BOOK & SCIENTIFIC JOURNALS:

Below competence (BC) Competent (C) Above competence (AC) BC C AC RESIDENT EVALUATION Name of Resident Below competence (BC) Competent (C) Above competence (AC) BC C AC Patient care (Residents should provide compassionate, appropriate, and effective patient care) Develop a clinical plan and proper technique based on readiologic findings and clinical Information. Medical Knowledge (Residents should be knowledgeable, scholarly, and committed to lifetime learning) Recognize and describe relevant radio logic findings. Synthesize readiologic and clinical information and form as impression Utilize information technology to investigate clinical questions and for for continuous self – learning Interpersonal / communication skills (Residents should communicate and teach effectively) Show sensitivity to and communicate effectively with clinical colleagues and health care team Appropriately obtain informed consent Recognize, appropriately communicate, and documents in the patient record urgent or unexpected readiologic findings Produce readiologic reports that are accurate, concise, and grammatically correct Effectively teach residents, medical students and other health care professional Practice – based learning and improvement (Residents should investigate and evaluate Patient care practices, and appraises and assimilate scientific evidence in order to improve their practices ) Participate in QI (Quality improvement) / QA (Quality assurance) activities Recognize and correct personal errors

Professionalism (Residents should be altruistic and accountable, and adhere to principles of medical ethics by respecting and protecting patients best interests ) Demonstrate a responsible work ethic with regard to conference attendance and work assignments Demonstrate acceptable personal demeanor and hygiene Overall performance : Comments : (An overall impression of below competence (BC) or above competence requires narrative comments) (AC) Signature /s Date