National House officers’ Training program

Proposed by the Egyptian Medical Board Steering Committee

House Officer’s Logbook

2015- 2016
Personal data of the house officer (trainee)

Name ……………………………………………………………………

E-mail……………………………………………………………………..

Phone……………………………………………………………………..

University & year of graduation………………………………

Training center

Name …………………………………………………………………………

Address……………………………………………………………………..

Program Director………………………………………………………..
Introduction
The training of house officers is an essential component of medical programs. During
this year, medical graduates are expected to use the knowledge and skills, which they
learned in their 6-year curriculum, in real clinical situations, under guidance of their
supervisors. Because of the pivotal role of this year in shaping the medical career, the
Egyptian Medical Board is releasing this House Officer Logbook which includes the 4
essential rounds: Internal Medicine, General Surgery, Pediatrics, and Obstetrics&
Gynecology. In each round, the minimum training requirements are specified.

The other rounds included in this logbook is prepared by the Mansoura university
hospitals’ training program director.

In this logbook, the training requirements are divided into 3 categories which differ as
regards methods of training and evaluation:

1. Clinical competencies: refer to the sequential tasks of the clinical encounter;

namely: history taking, clinical examination, discussing the diagnosis, formulating the
plan of management, and follow-up.

2. Practical, or manual procedures: refer to the manual skills which are necessary to
the practicing physician; such as, venipuncture, wound dressing, stitching wounds.

3. Communication skills: are general skills which should be consciously and

relentlessly developed in the medical graduate in order to improve their professional
performance.

Obviously, there are requirements that are practiced in almost all the rotations, which
are the general manual procedures and the communication skills. To avoid
unnecessary repetition, those common requirements are listed separately before
detailing each rotation.

Each trainee is expected to use this Logbook, on a daily basis, for recording his/her
clinical experience during each round. Each activity should be evaluated and endorsed
by the attending supervisor.

In the near future, submitting the completed Logbook will be one of the requirements
for licensing medical graduates. Until then, this logbook will serve as a guide to
medical schools to implement structured training programs in the house officer’s year,
and to establish the managerial and administrative support for carrying out those
programs.

It is noteworthy that this first version of the Logbook will be reviewed again during its
actual implementation in view of the feedback of trainees, trainers, and programs
directors. Therefore, medical schools are requested to collect such feedback and send
it to the Board.
The main goal of this Logbook is to ensure a minimum level of standardized training
and continuous in-service formative evaluation to all medical graduates in Egypt
during the house officer training year.

To achieve that, the Logbook includes the following:

1. A list of the clinical competencies and practical skills which are related to each
one of the main rotations.

2. A list of general manual skills, and the communication skills which are
commonly practiced in all rotations.

3. A list of the communication skills which should be acquired by the trainees

throughout the training year.

4. Standard forms for documenting the performance of required training

activities, as well as the evaluation of the supervisors.
Instructions to the trainees (House Officers):
Trainees are instructed to:

1- Maintain the logbook throughout the training period.

2- Make the required entries and seek evaluation andsignature of the supervisor
in the same day of the event.

3- Follow the classical paradigm of the stepwise progression along the

competency scale in acquiring the manual skills: observing (1), assisting (2),
doing under supervision (3), doing independently (4).

4- Identify the required level of competence for each manual procedure, listed in
each section, by carefully reading the related statements. Those which start by
a verb that describes a real like “perform”, “do” or “insert”; should be
repeatedly practiced to reach mastery level. Statements which start by verbs
like “observe”, “witness”, or “assist” refer to procedures that the trainee is
required to achieve only level 1 or level 2 respectively .

5- Make use of the given feedback to improve their clinical competencies, manual
procedures, and communication skills.

Instructions to the trainers (supervisors)

Trainers are requested to:

1- Carefully observe the performance of the trainees and point out the
deficiencies; if any, in order to be corrected.

2- Sign the activities done or attended by the trainees in the same day of
performance as possible.

3- Give constructive feedback to each trainee and document improvements in

his/her performance with repeated practice.

4- Observe their progression along the competency scale in acquiring the manual
skills: observing (1), assisting (2), doing under supervision (3), doing
independently (4).
 The common training requirements
These requirements are not limited to a certain discipline, and can be performed in all
rotations. Each trainee is responsible for distributing those skills throughout the whole
training year, and is encouraged to repeatedly practice them in all rotations in order to
ensure mastery in various contexts, with different age groups, and in both sexes.

Practical skills:
By the end of the training year, each graduate should be able to

1. Perform CPR for cases of cardio-pulmonary arrest, either in real situations or

using the CPR model.(5 times)
2. Give different medications by IV, IM or SC routes.(5 times each)
3. Insert IV cannula and give IV fluids (5 times).

4. Give oxygen therapy. (5 times)

5. Insert uretheral catheter. (4 times)

6. Insert a Ryle tube for oral feeding.(3 times)
7. Witness the insertion of a central venous catheter (1 time)
8. Witness the insertion of an endotracheal tube (1 time)

Communication skills
By the end of the training year, each graduate should be able to:

1. Counsel patients suffering from complicated illness

2. Obtain informed consent

3. Respond patiently to the patient’s queries and alleviate his concerns

4. Deliver bad news

5. Respond appropriately to requests of colleagues.

House officer is required to provide evidence of 5 situations, attended by the

supervisor, for each communication skill.
 Common procedures
The trainee is to fill-in the following form and get the evaluation and signature of the
supervisor in the last 2 columns
Skill/ Date Venue Hospital Age & Competence Supervisor
Procedure (OP, record # gender level ’s
Ward, signature
ER, skills
lab)
CPR (5 times) ---------------------
---------------------
---------------------
---------------------
---------------------
Venipuncture ---------------------
(5 times) ---------------------
---------------------
---------------------
---------------------
IV cannulation ---------------------
(5 times) ---------------------
---------------------
---------------------
---------------------
IM injections ---------------------
(5 times) ---------------------
---------------------
---------------------
---------------------
SC injections ---------------------
(5 times) ---------------------
---------------------
---------------------
---------------------
Oxygen therapy ---------------------
(5 times) ---------------------
---------------------
---------------------
---------------------
Insertion of a ---------------------
urethral ---------------------
catheter (4 ---------------------
times) ---------------------
Insertion of a ---------------------
Ryle tube ---------------------
(3 times) ---------------------
Insertion of a ---------------------
central venous
catheter
Insertion of an --------------------
endotracheal
tube
* Level of competence:
1-Observation., 2-Practice with direct supervision, 3-Practice with indirect supervision,
4-Independent practice.

Communication skills
The trainee is to fill-in the following form and to get the evaluation and signature of
the supervisor in the last 2 columns
Skill Date Venue (OP, Hospital Age & Level of Supervisor’s
Ward, ER, record # gender competence signature
skill lab)
Counsel patients -----------------
of complicated -----------------
illness (5 times) -----------------
-----------------
-----------------
Obtain informed -----------------
consent -----------------
(5 times) -----------------
-----------------
-----------------
Respond to the -----------------
patient’s queries -----------------
(5 queries) -----------------
-----------------
-----------------
Deliver bad news -----------------
(5 times) -----------------
-----------------
-----------------
-----------------
Respond to -----------------
requests from -----------------
colleagues -----------------
(5 times) -----------------
-----------------

* Level of competence:
1-Observation., 2-Practice with direct supervision, 3-Practice with indirect supervision,
4-Independent practice.
 Internal Medicine Rotation

(2 months)
Starting date of the rotation:------------------------------------------

Ending date of the rotation:-------------------------------------------

Hospital/ Medical center:----------------------------------------------

Name & Title of the Supervisor: -------------------------------------

I. Clinical competencies
I.i. Expected clinical competencies
By the end of the Internal Medicine Rotation, H.O. should be able to:

1. Carry out a focused history taking, perform physical examination, justify

the diagnosis, discuss management plans, and perform relevant follow-up
of the progress of the following clinical conditions (at least one patient in
each clinical condition)

 Cardiology: Hypertension - Ischemic Heart Disease - Rheumatic

heart disease - Heart failure - Arrhythmias

 GIT/Hepatology :Diarrhea - Vomiting - Abdominal pain -

Hematemesis - Hepatitis - Hepatic encephalopathy

 Nephrology :Nephrotic syndrome - Acid-Base balance and

electrolytes - Acute renal failure - Chronic renal failure

 Hematology : Bleeding tendency-Anaemia-Generalized

lymphadenopathy

 Diabetes/Metabolism: Diabetes Mellitus

 Endocrinology :Thyrotoxicosis – Hypothyroidism- others

 Rheumatology: Arthritis - Systemic Lupus Erythematosis -

Rheumatoid arthritis

 Emergency/ RR :Coma – Shock - Respiratory distress - Acute

abdomen - GIT Bleeding - Diabetic Emergencies - Hypertensive
emergencies - Food poisoning & drug intoxication

2. Prescribe the appropriate diet for patients with diabetes, advanced liver
cell failure, hypercholesterolemia and hypertension.
3. Prescribe, prepare and monitor parenteral fluid therapy.
4. Perform first aid measures for cases with poisoning or intoxication.
5. Write medical reports for referral and requests for investigations.
 I.ii. Documenting the achievement of the expected clinical competencies
Please fill-in the following data for each patient seen. Total number of endorsed case
records in the round should be at least 30. Estimated time required to complete each
record is about 10 minutes.
Part I: To be filled by the trainee
Patient serial # (in the logbook):
Hospital Record #:
Seen at: Outpatient Inpatient ER Other (specify)

Date:
Age & gender:
Main theme of
the case
Case summary

Role of the History taking Discussing the Proposing plan Providing first
trainee (tick & differential of management aid/minor
the Examination diagnosis procedure
appropriate Writing case Writing Prescribing Follow-up
boxes) report referral / appropriate
request for diet/parenteral
investigation fluid therapy
Signature of
the trainee
Part 2: To be filled by the supervisor
Supervisor’s Excellent Very good Satisfactory Unsatisfactory
Evaluation of
the
performance
of the trainee
Suggested areas of improvement (must be written if the evaluation is unsatisfactory):

Supervisor’s name

Supervisor’s signature
 II. Practical Skills and manual procedures:

II.i. Expected practical skills and manual procedures

By the end of the Internal Medicine rotation, the H.O. should be able to:

1. Perform first aid measures for the comatose patients.(3 times)

2. Perform and interpret an ECG.(5 times)
3. Witness pleural aspirationand abdominal paracenthesis.(one time each)

In case a skill is not available in the training department, the training supervisor has to
arrange performing such skill(s) elsewhere including the skill lab and informing the
committee responsible for HO training.

II.ii. Documenting the performance of practical skills and manual

procedures
The trainee is to fill-in the following form &to get the evaluation & signature of the
supervisor in the last 2 columns

Skill/Procedure Date Venue Hospital Age & Level of Supervisor’

(OP, record # gender competence s signature
Ward, ER,
Model)
First aid to comatose
patient
Electrocardiogram ------------
(3 cases witnessed) ------------
------------
Pleural fluid -
aspiration
(One case witnessed)
Abdominal -
paracentesis
(One case witnessed)
Others

Others

* Level of competence:
1-Observation., 2-Practice with direct supervision, 3-Practice with indirect supervision,
4-Independent practice.
 Pediatrics Rotation

(2months)

Start date of the rotation:…………………………………………………

End date of the rotation:…………………………………………………..

Hospital/ Medical center:………………………………………………….

Name & Title of the Supervisor: ……………………………………….

I. Clinical competencies
I.i. Expected clinical competencies
By the end of the Pediatrics Rotation, H.O. should be able to:

1. Carry out a focused history taking, do physical examination, justify the

diagnosis, discuss management plans, and perform relevant follow-up of
the progress of the following clinical conditions (At least one patient for
each clinical condition)

 General: malnutrition, febrile illness in different pediatric age

groups, skin rash, mental retardation

 Chest: respiratory tract infection, asthma

 Cardiology:

 GIT: Gastroenteritis

 Hematology : neonatal jaundice, bleeding tendency-anemia–

 Diabetes/Metabolism: IDDM,

 Endocrinology:- Hypothyroidism

 Rheumatology: musculoskeletal disorders

 Emergency/ RR :Gastroenteritis and dehydration, disturbed level of

consciousness – Shock - Respiratory distress - Acute abdomen -
Bleeding - Diabetic Emergencies - Food poisoning & drug
intoxication

2. Prescribe the appropriate feeding advice for different pediatric age group
(breast, artificial, and weaning)
3. Prescribe, prepare and calculate oral rehydration therapy.
4. Perform first aid measures for cases of poisoning or intoxication.
5. Identify cases that need hospital admission.
6. Write medical reports for referral and requests for investigations.
 I.ii. Documenting the achievement of the expected clinical competencies
Please fill-in the following data for each patient seen. Total number of endorsed case
records in the round should be at least 30. Estimated time required to complete each
record is 10 minutes.

Part I: To be filled by the trainee

Patient serial # (in the logbook):
Hospital Record #:
Age & gender:
Seen at: Outpatient Inpatient ER Other (specify)

Date:
Age & gender
Main theme
of the case
Case summary

Role of the History taking Discussing the Proposing plan Providing first
trainee (tick & differential of management aid/minor
the Examination diagnosis procedure
appropriate Writing case Writing Prescribe Follow-up
boxes) report/ referral / appropriate
referral notes request for diet/parenteral
investigation fluid therapy
Signature of
the trainee
Part 2: To be filled by the supervisor
Supervisor’s Excellent Very good Satisfactory Unsatisfactory
Evaluation of
the
performance
of the trainee
Suggested areas of improvement (must be written if the evaluation is
unsatisfactory):

Supervisor’s name Supervisor’s signature

 II. Practical skills and manual procedures:

II.i. Expected practical skills and manual procedures

By the end of the Pediatrics rotation, the H.O. should be able to:

1. Measure weight, length /height and skull circumference and plot the data on
respective growth curves. (5 times)

2. Measure the blood pressure in different Pediatric age groups. (5 times)

3. Give all the compulsory vaccines.(one time)

4. Give inhalation therapy using a nebulizer.(3 times)

5. Witness pleural aspiration, insertion of endotracheal tube, lumbar puncture

and bone marrow aspiration.(one time each)

In case a skill is not available in the training department, the training supervisor has to
arrange performing such skill(s) elsewhere and informing the committee responsible
for HO training.
 II.ii. Documenting the performance of practical skills and manual
procedures
The trainee is to fill-in the following form & to get the evaluation & signature of the
supervisor in the last 2 columns

Skill/Procedure Date Hospital Venue Age & Competence Supervisor’s

record # (OP, gender Level signature
Ward,
ER,
Skills
lab)
Measuring weight, length ----------------
/height and skull ----------------
circumference and plot -----------------
the data on respective ----------------
growth curves( 5 times) ----------------

Measuring the blood ----------------

pressure in different ----------------
Pediatric age groups -----------------
(5 times) ----------------
----------------
Give all the compulsory ----------------
vaccines(one time each) ----------------
-----------------
----------------
----------------
Give inhalation therapy ----------------
using a nebulizer (5 ----------------
times) -----------------
----------------
----------------
Pleural fluid aspiration -
(One case witnessed)
Insertion of endotracheal -
tube
Lumbar puncture (One -
case witnessed)
Bone marrow aspiration -
(one case witnessed)
* Level of competence: 1-Observation., 2-Practice with direct supervision, 3-Practice with
indirect supervision, 4-Independent practice.
 General Surgery Rotation

(2 months)

Start date of the rotation:………………………………………………….

End date of the rotation:…………………………………………………..

Hospital/ Medical center:…………………………………………………

Name & Title of the Supervisor:…………………………………………

I. Clinical competencies
I.i. Expected clinical competencies
By the end of the General Surgery rotation, H.O. will be able to:

1. Carry out a focused history taking, do physical examination, justify the

diagnosis, discuss management plans, and perform relevant follow-up of the
progress of the following clinical conditions (At least one patient for each
clinical condition)

 Wounds and ulcers

 Swellings
 Common infections (e.g. Hand infections, face infections, erysipelas)

 Anal disorders – Hernias – Breast masses – Jaundice - Acute abdomen

 Inguino-scrotal swellings

 Common neck swellings (thyroid, Lymph nodes)

 Varicose veins

 Foot problems in diabetics

 Dyspepsia

2. Provide 1st aid measures for acute abdomen.

3. Identify common surgical instruments and describe their use.

4. Prepare patients for different operative intervention

5. Provide the appropriate postoperative care
6. Identify cases that need hospital admission.
7. Write medical reports for referral and requests for investigations.
 I.ii. Documenting the achievement of the expected clinical competencies
Please fill-in the following data for each patient seen. Total number of endorsed case
records in the round should be at least 30. Estimated time required to complete each
record is 10 minutes.

Part I: To be filled by the trainee

Patient serial # (in the logbook):
Hospital Record #:
Seen at: Outpatient Inpatient ER Other (specify)

Date:
Age & gender:
Main theme
of the case
Case summary

Role of the History taking Discussing the Proposing plan Providing first
trainee (tick & differential of management aid /minor
the Examination diagnosis procedure
appropriate Writing case Writing Prescribing Follow-up
boxes) report/ referral / appropriate
referral notes request for diet/parenteral
investigation fluid therapy
Signature of
the trainee
Part 2: To be filled by the supervisor
Supervisor’s Excellent Very good Satisfactory Unsatisfactory
Evaluation of
the
performance
of the trainee
Suggested areas of improvement (must be written if the evaluation is
unsatisfactory):

Supervisor’s name Supervisor’s signature

 II. Practical skills and manual procedures:

II.i. Expected practical skills and manual procedures

By the end of the General Surgery rotation, the H.O. should be able to:

1. Manage different wounds and diagnose any complications. (5 times)

2. Perform wound dressing and bandaging to different wounds encountered in the ward
and outpatient clinic including dressing of clean and infected wounds. (5 times)

3. Remove surgical drains in the proper timing. (5 times)

4. Remove stitches and tubes.(5 times)

5. Practice scrubbing, gowning, gloving and proper safety procedures in the O.R. (5
times)

6. Perform and interpret PR examination.(3 times)

7. Perform suturing uncomplicated wounds. (5 times)

8. Do abscess drainage. (2 times)

9. Assist in circumcision. (2 times)

10. Observe at least 2 of the other minor surgical procedures such as lipoma excision, and
ingrown toe nail extraction.(one time each)
 II.ii. Documenting the performance of practical skills and manual
procedures
The trainee is to fill-in the following form, get the evaluation and signature of the
supervisor in the last 2 columns
Skill/Procedure Date Venue Hospital Age & Competenc Supervis
(OP, record # gender e level or’s
Ward, ER, signatur
Model) e
Managing wounds ------------------
& diagnosing ------------------
-------------------
complications (5 ------------------
times) -------------------
Wound dressing ------------------
(5 times) ------------------
-------------------
------------------
------------------
Removal of ------------------
surgical ------------------
drains (5 times) -------------------
------------------
------------------
Removal of ------------------
stitches ------------------
and tubes -------------------
(5 times) ------------------
------------------
Practice aseptic
procedures in the
O.R.
PR examination
Suturing
uncomplicated
wounds
Abscess drainage ------------------
(2 times) ------------------
Circumcision (one -
case witnessed)
Minor procedure -
(one case
witnessed)
Minor procedure -
(one case
witnessed

* Level of competence: 1-Observation., 2-Practice with direct supervision, 3-Practice with

indirect supervision, 4-Independent practice.
 .

Gynecology & Obstetrics Rotation

( 2 months)

Start date of the rotation:----------------------------------------------

End date of the rotation:…………………………………………………….

Hospital/ Medical center:……………………………………………………

Name & Title of the Supervisor:…………………………………………..

 I.i. Expected clinical competencies
By the end of the Gynecology & Obstetrics rotation, H.O. will be able to:

1. Carry out a focused history taking, do physical examination, justify the

diagnosis, discuss management plans, and perform relevant follow-up of the
progress of the following clinical conditions (At least one patient for each
clinical condition)

 Vaginal discharge
 Vaginal bleeding
 Amenorrhea
 Dysmenorrhea
2. Perform antenatal care.

3. Identify high risk pregnancy and write referral reports.

4. Diagnose and provide 1st aid management of postpartum complications

5. Educate the patient of the appropriate means of family planning
I.ii. Documenting the achievement of the expected clinical competencies
Please fill-in the following data for each patient seen. Total number of endorsed case
records in the round should be at least 30. Estimated time required to complete each
record is 10 minutes.

Part I: To be filled by the trainee

Patient serial # (in the logbook):
Hospital Record #:
Seen at: Outpatient Inpatient ER Other (specify)

Date:
Age:
Main theme of the case
Case summary

Role of the trainee (tick History taking & Discussing the Proposing plan of Providing first
the appropriate boxes) Examination differential management aid/minor
diagnosis procedure
Writing case Writing referral Prescribe Follow-up
report/ referral / request for appropriate
notes investigation diet/parenteral
fluid therapy
Signature of the trainee
Part 2: To be filled by the supervisor
Supervisor’s Evaluation of the Excellent Very good Satisfactory Unsatisfactory
performance of the trainee
Suggested areas of improvement (must be written if the evaluation is unsatisfactory):

Supervisor’s name Supervisor’s signature

 Practical skills and manual procedures:
II.i. Expected practical skills and manual procedures

By the end of the Obstetrics & Gynecology rotation, the H.O. should be able to:

1. Perform vaginal examination.(5 times)

2. Insert vaginal speculum.(5 times)

3. Insert and remove commonly used IUDs.(5 times)

4. Manage the process of normal labor. (3 times)

II.ii. Documenting the performance of practical skills and manual

procedures
The trainee is to fill-in the following form, get the evaluation and signature of the
supervisor in the last 2 columns
Skill/Procedure Date Venue Hospital Age Highest Supervisor’s
(OP, record # Level of signature
Ward, competence
ER, attained*
Model)
Perform vaginal -----------------------
examination -----------------------
------------------------
(5 times) -----------------------
-----------------------
Insert vaginal -----------------------
speculum ----------------------
(5 times) ------------------------
-----------------------
-----------------------
Insert and remove -----------------------
IUDs ----------------------
(5 times) ------------------------
-----------------------
-----------------------
Manage normal -----------------------
labor -----------------------
(3 times) ------------------------

* Level of competence: 1-Observation., 2-Practice with direct supervision, 3-Practice with

indirect supervision, 4-Independent practice
 Anesthesia Rotation

(1 month)

Start date of the rotation:----------------------------------------------

End date of the rotation:…………………………………………………….

Hospital/ Medical center:……………………………………………………

Name & Title of the Supervisor:…………………………………………..

 Documenting the performance of practical skills and manual procedures
and other activities
The trainee is to fill-in the following form, get the evaluation and signature of the
supervisor in the last 2 columns
Skill/Procedure Date Venue (OP, Hospital Age Highest Level Supervisor’s
(Activities) Ward, ER, record # of signature
Model) competence
attained*
IV line -------------------
-------------------
(5 times) --------------------
--------------------
-------------------
Endotracheal -------------------
intubation
(once)
Spinal needle -------------------
(once, observation)
Monitors -------------------
------------------
--------------------
------------------

Recovery room -------------------

-------------------
--------------------
------------------

CPR -------------------
-------------------
-------------------
--------------------
--------------------
Pre-anaesthetic -------------------
medication -------------------
Others ------------------

* Level of competence: 1-Observation., 2-Practice with direct supervision, 3-Practice with

indirect supervision, 4-Independent practice
 Emergency Medicine
Rotation

(1 month)

Start date of the rotation:----------------------------------------------

End date of the rotation:…………………………………………………….

Hospital/ Medical center:……………………………………………………

Name & Title of the Supervisor:…………………………………………..

 Documenting the achievement of the expected clinical competencies
Please fill-in the following data for each patient seen. Total number of endorsed case
records in the round should be at least 10 and follow the progress of the case after
being admitted to the corresponding department

Part I: To be filled by the trainee

Patient serial # (in the logbook):
Hospital Record #:
Seen at: ER Inpatient
Date:
Age & gender:
Main theme
of the case
Case summary

Role of the History taking Discussing the Proposing plan Providing first
trainee (tick & differential of management aid /minor
the Examination diagnosis procedure
appropriate Writing case Writing Prescribing Follow-up
boxes) report/ referral / appropriate
referral notes request for diet/parenteral
investigation fluid therapy
Signature of
the trainee
Part 2: To be filled by the supervisor
Supervisor’s Excellent Very good Satisfactory Unsatisfactory
Evaluation of
the
performance
of the trainee
Suggested areas of improvement (must be written if the evaluation is
unsatisfactory):

Supervisor’s name Supervisor’s signature

Documenting the performance of practical skills and manual procedures
and other activities:
The trainee is to fill-in the following form, get the evaluation and signature of the
supervisor in the last 2 columns

Skill/Procedure Date Venue Hospital Age Highest Supervisor’s

(Activities) (OP, record # Level of signature
Ward, competence
ER, attained*
Model)
IV line -----------------------
-----------------------
------------------------
-----------------------
Stitches ------------------------
------------------------
------------------------
Fracture s -----------------------
-----------------------
-----------------------
Care of shocked -----------------------
Patient ------------------------

Care of -----------------------
comatose -----------------------
------------------------

CPR -----------------------
-----------------------
------------------------
Others ----------------------
Others -----------------------

* Level of competence: 1-Observation., 2-Practice with direct supervision, 3-Practice with

indirect supervision, 4-Independent practice
 Specialties Rotation

(2 months)
The trainee will choose from the following specialties,
one month each:
ENT Dermatology

Urology Clinical pathology

Orthopedic Rheumatology & rehabilitation

Cardiothoracic Chest

Neurosurgery Neurology

Ophthalmology Psychiatry

Radio-diagnosis Radiotherapy

Cardiology Tropical medicine

 Specialty Rotation 1

Start date of the rotation:-----------------------------------------

End date of the rotation:………………………………………………

Hospital/ Medical center:………………………………………………

Name & Title of the Supervisor:……………………………………

 Documenting the performance of practical skills and manual procedures
and other activities during the specialty rotation 1: -----------------------------
The trainee is to fill-in the following form, get the evaluation and signature of the
supervisor in the last 2 columns

Skill/Procedure Date Venue Hospital Age Highest Supervisor’s

(Activities) (OP, record # Level of signature
To be planned according Ward, competence
to the type of specialty ER, attained*
Model)
-----------------------
-----------------------
------------------------
------------------------
------------------------
-----------------------
-----------------------
-----------------------
-----------------------

-----------------------
-----------------------

-----------------------
-----------------------

----------------------
-----------------------
* Level of competence: 1-Observation., 2-Practice with direct supervision, 3-Practice with
indirect supervision, 4-Independent practice
 Specialty Rotation 2

Start date of the rotation:--------------------------------

End date of the rotation:……………………………………

Hospital/ Medical center:……………………………………

Name & Title of the Supervisor:……………………………

 Documenting the performance of practical skills and manual procedures
and other activities during the specialty rotation 2: ----------------------------
The trainee is to fill-in the following form, get the evaluation and signature of the
supervisor in the last 2 columns

Skill/Procedure Date Venue Hospital Age Highest Supervisor’s

(Activities) (OP, record # Level of signature
According to the type of Ward, competence
specialty ER, attained*
Model)
-----------------------
-----------------------

------------------------
------------------------
-----------------------
-----------------------
-----------------------
-----------------------

-----------------------
-----------------------

-----------------------
-----------------------

----------------------
-----------------------
* Level of competence: 1-Observation., 2-Practice with direct supervision, 3-Practice with
indirect supervision, 4-Independent practice
Workshops and training courses:
Date Title Signature

ILS
Infection control
Medical ethics
 ‫بيبن الفرتاث التدريبيت ألطببء االمتيبز‬
‫‪.‬‬
‫كليت الطب‬ ‫‪.‬‬
‫‪.‬‬
‫مستشفيبث جبمعت املنصورة‬ ‫‪.‬‬
‫‪.‬‬
‫شئون األطببء‬ ‫‪.‬‬
‫‪.‬‬
‫‪.‬‬
‫طبيب التدريب ‪ ................................ /‬دفعة التخرج ‪........................... /‬‬ ‫‪.‬‬
‫‪.‬‬
‫‪2016 /‬‬ ‫‪/‬‬ ‫إلى ‪:‬‬ ‫‪0215‬‬ ‫‪/‬‬ ‫‪/‬‬ ‫المدة من ‪:‬‬ ‫‪.‬‬
‫مالحظات‬ ‫النسبة المونية‬ ‫اعتماد مدير شـونن اططبـاأ و رسـي‬ ‫المستشفيات‬ ‫المـ ــدة‬
‫‪.‬‬
‫باطرقام‬ ‫و المشــرا العيم ـ لفتــرة‬ ‫القسـ‬ ‫‪.‬‬
‫التى قضى بها فترة التدريب‬ ‫إلى‬ ‫من‬ ‫الدورة‬ ‫‪.‬‬
‫حضنر الدورة بشعار المستشفى‬
‫‪.‬‬
‫نساأ و تنليد‬
‫‪.‬‬
‫‪.‬‬
‫‪.‬‬
‫جراحة عامة‬
‫‪.‬‬
‫‪.‬‬
‫طب طفال‬ ‫‪.‬‬
‫‪.‬‬
‫‪.‬‬
‫باطنة عامة‬ ‫‪.‬‬
‫‪.‬‬
‫‪.‬‬
‫قس الطنارىأ‬
‫‪.‬‬
‫قس التخدير‬ ‫‪.‬‬
‫اطقسام الخاصة‬
‫‪.‬‬
‫‪.‬‬
‫قس‬
‫‪.‬‬
‫قس‬ ‫‪.‬‬
‫‪.‬‬
‫يجب استيفاأ ىذه البيانات من الجهات التى عمل بها الطبيب ثناأ فترة االمتياز حتى يمكن ليمستشفيات منحو شهادة بقضـاأ‬ ‫مالحظات‪:‬‬ ‫‪.‬‬
‫سنة التدريب و عييو ن يتقدم بهذا البيـان مسـتنفيا إلدارة شـونن اططبـاأ بمستشـفيات جامعـة المنصـنرة حتـى يتسـنى لـددارة منحـو شـهادة بقضـاأ‬ ‫‪.‬‬
‫سنة االمتياز‪ .‬ويحفظ ف ميفو‪2‬‬ ‫‪.‬‬
‫‪.‬‬
‫‪.‬‬
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 ‫كلية طب المنصورة‬

‫مستشفيات جامعة المنصورة‬

‫شئون األطباء‬

‫البرنامج القومي لتدريب أطباء االمتياز‬

‫تقرير متابعة التدريب‬
‫)‪)Logbook‬‬