Operations and Management
Log book
AND
Operative Competence Form
APPENDIX VI B Operations and Management AND Log book AND Operative Competence Form
By the following stages of training the trainee should have done or seen to the level indicated the
number of procedures shown in brackets Eg: Appendicitis 5(10) means 10 appendicitis operations
done alone(level 5)
COMMON SENSE NEEDS TO BE USED TO ENSURE THAT IN PROCEDURES NOT
LISTED HERE BUT DEEMED IMPORTANT IN ANY SPECIALITY ARE
Where level 5 competency is achieved in an early appointment it is expected much more
will be done in the later ones.
This draft is based on the averages of the actual numbers performed.
General Surgery and some Ideal numbers; 80% level of achievement required
specialties
Procedures 1 yr. 6/12 Appt. SR Appt. Other SR speclty
Appt. Appt. (if not gen
surg)
Airway maintenance 5(25)
IPPV 5(15) 5(5) 5(5)
Passage of ET tube 5(5)
Tracheostomy/CT otomy 1(5)
CPR 1(5) CPR
Course
Control of massive limb haemorrhage 5(5)
Use of GA, Spinal, Caudal etc 1(50) 2(15)
Lumbar puncture 5(5)
2(5)
Use of LA 5(50)
Suturing of wounds - face Trauma 5(20)
Suturing of wounds - other Trauma 5(50)
Tendon repair 5(5) 5(10) Ortho ortho
Nerve repair 3(5) 4(5) 5(5) Ortho ortho
POP after closed fracture reductn 5(40)
Skin traction 5(10)
I & D superficial abscesses 5(50)
Split skin graft 5(10) Large
areas : tie
over
dressing
Venous cut down 5(10)
CVP line 5(3)
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Lymph node biopsy 5(15)
Excision of Seb cysts, lipomas etc 5(25)
Excision of ganglion 5(5)
FNA cytology 5(20)
Proctoscopy 5(15)
Sigmoidoscopy 5(15)
Flexible upper GI endoscopy 3(10) 4(15) 5(10) GenS/GI
Flexible lower GI endoscopy 2(5) 3(5) 4(10) GenS/GI
Oesophagoscopy rigid 4(5) 5(5) GenS/GI
ERCP 1(2) 1(5) 3(5) GI
Splenectomy 3(4) 5(5)
Opening and closing of abdomen 5(20)
Appendicectomy 5(15)
Inguinal hernia Adult 5(20)
Inguinal hernia Child 3(10) 4(5) 5(10) GS/Paed
Para Umbilical hernia 5(2) 5(5)
Incisional hernia 3(5) 4(5) 5(5)
Orchidopexy 3(5) 4(5) 5(5) GS/Paed
Hydrocoelectomy 5(10)
Varicocoelectomy 2(4) 3(5) 5(5)
Liver repair 2(3) 5(2)
Exploratory Laparotomy 3(5) 4(5) 5(20)
Colostomies 2(3) 3(3) 5(5)
Small intestinal resection and an. 3(2)5(2) 4(2) 510)
Right Colectomy 3(1) 4(1) 5(2)
Left Colectomy 2(1) 3(1) 5(2)
Anterior resection 2(1) 3(1) 4(2)5(2) GenS/GI
A P resection 2(1) 3(1) 3(2)5(2) GenS/GI
Cholecystectomy 3(2) 4(2) 5(3)
Gastrectomy 2(1) 2(1) 4(2)5(1) GenS/GI
Pancreatic operations (mid cyst) 2(3) 3(2) 4(1)
Other major abdominal 2(8) 3(5) 5(5)
Oesophagectomy 2(3) 2(3) 5(2) GenS/GI
Laparoscopic operations 2(5) 3(3) 5(10)
Closure of Colostomy 5(5)
Anal fissure procedures 5(15)
Haemorrhoid injection/banding 5(10)
Haemorrhoidectomy 5(5)
Fistulectomy 3(5) 4(5) 5(10) GenS/GI
2
Intussusception (reduce/op.) 3(5) 5(5) Gen/Paeds
Urethral catheterization (male) 5(10)
Urethral dilatation 5(5)
Circumcision 5(5)
Meatotomy 5(3)
Suprapubic cystostomy 5(3)
Operations for stone in kidney 5(5) GU
Surgery
Cystolithotomy 5(3)
Nephrectomy 5(3) GU
Surgery
Pyeloplasty 2(2) 2(5) 4(2) Paediatri GU/Paeds
c Surgery
Prostectomy 3(2) 5(2) 5(2)
Opening and closing chest 5(2) 5(5)
Insertion of I/C tube 5(10)
Thyroidectomy 5(2) 5(3) 5(10)
Submandibular sal gl ops 2(5) 3(3) 5(3)
Parotidectomy 2(3) 2(3) 5(1)
Block dissection of neck 2(2) 3(1) 3(2)
BK amputation 2(4) 5(2)
AK amputation 2(4) 5(3)
Digit amputation 5(5)
Foot amputations 3(4) 4(3) 5(3)
Sequestrectomy 2(2) 3(2) 5(3) Ortho
Drainage for osteomyelitis 3(2) 3(2) 5(2)
Drainage for septic arthritis 5(3)
Embolectomy 2(5) 5(5)
Vascular injury repair 3(4) 4(5) 5(5)
Varicose vein operations 5(5) 5(15)
Burr Holes for EDH 2(3) 2(3) 5(5)
Carotid angiograms 2(3) 2(3) 5(5)
Operations for subdural H. 2(3) 2(3) 5(2)
Pyloromyotomy 5(3)
Ops for intussusception 5(3)
DPPV (Paed hydrocoele) 5(3)
3
Column 1 + 2 = 80% before MS II Column III 80% as SR - after MS II before leaving country
Plastic Surgery
Skin graft of extensive areas + Tie over dressing technology
Groin flap - specially the extended one - v. useful this day + age
Cross finger flaps Latissmus dorsi flaps
Rectus abdominis flaps as cover of exposed bone chestwall blood vessels
Gastrocnemius + soleus flaps (optional)
Fillet flaps
THE TRAINEE SHALL KEEP A LOG BOOK
P G I M SURGICAL TRAINING SCHEME
OPERATIONS LOG BOOK
NAME:
ADDRESS:
PGIM TRAINING COMMENCED ON:
POSTS HELD:
Instructions:
1. The log book is intended to be a record of all the operations you perform
or participate in during the training period.
2. Trainees are advised to in their own interest, maintain a more
Detailed “operating Register “ of all operations performed
3. The information required on each operation should be entered as
Whether performed by yourself (P) performed with assistance (PA)
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Or assisted (P).
4. You should obtain the consultant’s signature for each page.
5. The consolidation sheet provides a summary of the work you have
Done. Each operation should be entered under only one heading.
6. Entries should be done on a daily and the Consultant’s signature
Obtained every week
GENERAL SURGERY – CONSOLIDATION SHEET : (TOTAL OPERATION)
(Procedures not listed in type to be written at the end please)
(P) (PA) (A) Total (and remarks)
Abdominalperineal – abdominal end
Perineal end
Amputation – leg, Foot or Toe
Finger
Amputation-Arm , Hand or Finger
Appendicectomy
Aortic-graft or Anastomosis
Arterial (all procedures)
Biopsy
Burr Hole-Emergency
Carpal Tunnel Decompression
Cholecystectomy or Cholecystostomy
Cholecystectomy with choledochostomy on
spincerotomy
Circumscision
Colectomy –Total or Proctocolectomy
Colectomy-hemi or partial
Cystoscopy
Cystoscopy and Instrumentation
Colostomy
Colostomy-closure
Cysts –superficial
Diverticulectomy-Meckels
Duodonal or gastric ulcer perforated/
Bleeding
Embolectomy
Excision of gland of neck
5
Gastrectomy
Gynaecological Operations
Haemorrhoids-all procedures
Hepatic resection of suture
Total Carried Forward
(………General Surgery /2)
(P) (PA) (A) Total
Herniorrhaphy _Femoral
Herniorrhaphy-incisional
Herniorrhaphy-inguinal
Herniorrhaphy-Strangulated
Herniorrhapgy-Umbilical
Hiatus Hernia
Hydrocele or spermatocele
Ileostomy or ileal bladder with
Protocolectomy
Intetinal resection
Laporotomy for periotonitis
Laparotomy (with/without)
Biopsy or drainage
Mastectomy (total or partial)
Neck – Lumps
Nephrectomy(total or partial)
Nephro-or ureterolithotomy
Nodes-Lymph
Oesophagectomy
Oophorectomy
Orchidectomy
Orhidopexy
Pancreatectomy(total or partial)
Perineal abscess
Prostatectomy (TUR or Millin)
Phyelolithotomy or plastic repair
Sigmoidoscopy
Skin Lesions
Total Carried Forward
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Detailed Log Book (sample lines)
Date Hospital Patient’s Nature (P) Complications Outcome Name of
Number Name Of (PA) Consulta
Operation (A) nt
DETAIL TO BE ENTERED HERE AND SO
S ON
Signature of Consultant……………………..
OPERATIVE COMPETENCE ASSESSMENT (for index operations)
Core skills check list for trainers when marking an assessment
▪ Thorough preparation (marking, catheter, antibiotics etc)
▪ Good scrub and aseptic technique
▪ Positions patient correctly on operating table
▪ Makes appropriate incision(s)
▪ Purposeful dissection in correct tissue planes
▪ Demonstrates sound knowledge in anatomy
▪ Familiar with all steps of the procedure
▪ Uses the correct instruments efficiently
▪ Handles dangerous instruments safely
▪ Uses assistant(s) to the best advantage
▪ Possesses good hand-eye co-ordination
▪ Handle tissues gently and dexterously
▪ Reliable suturing and knotting techniques
▪ Sound repair or anastomosis
▪ Uses diathermy appropriately ad safely
▪ Able to control bleeding by suction, clips or sutures
▪ Closes wound neatly and securely
▪ Procedure unhurried with no unnecessary delay
▪ Good documentation (operation note and postop. Instructions)
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‘Basic General Surgery’ Operative Competence Form
Name of Trainee:
Hospital/Post
Trainer(s)
Start date End date
Level of Competence
Procedure U D C B A
Appendicectomy
Upper GI endoscopy
Small bowel resection
Right hemicolectomy
Haemorrhoidectomy
Inguinal hernia repair
Excision of breast lump
U= Unknown
D= Unable to perform the entire procedure
C= Able to perform the procedure with supervision
B= Able to perform the procedure unsupervised
A= Able to teach the procedure
Signature of trainer(s) :
Signature of trainee
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‘Orthopedics’ Operative Competence Form
Name of Trainee:
Hospital/Post
Trainer(s)
Start date End date
Level of Competence
Procedure U D C B A
Compound Fracture
K’ Nails
Application of POP
- Colles
- Above Knee
- Below Knee
Tension Band Wiring
- Pattella
- Olecranon
U= Unknown
D= Unable to perform the entire procedure
C= Able to perform the procedure with supervision
B= Able to perform the procedure unsupervised
A= Able to teach the procedure
Signature of trainer(s) :
Signature of trainee
Name of Trainee:
Hospital/Post
Trainer(s)
Start date End date
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‘More advanced General Surgery’ Operative Competence Form
Level of Competence
Procedure U D C B A
Cholecystectomy
- Laparoscopic
- Open
Left Colon Resection
Recurrent Hernia Repair
Mastectomy and Axillary Clearance
Major Amputation
Saphenofemoral Ligation
Arterial Anastomosis
Paediatric Circumcision
Infantile Herniotomy
U= Unknown
D= Unable to perform the entire procedure
C= Able to perform the procedure with supervision
B= Able to perform the procedure unsupervised
A= Able to teach the procedure
Signature of trainer(s) :
Signature of trainee
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