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LOG BOOK
(POST GRADUATE)
FACULTY – MEDICAL
DEPARTMENT
MD PEADIATRICS
MAHARASHTRA UNIVERSITY OF HEALTH SCIENCES, NASHIK
LOG BOOK
(POST GRADUATE DIPLOM )
MD PEADIATRICS
For
M.D. Pediatrics
Under
MUHS
TO
DEPARTMENT OF PEDIATRICS
2.Enable the faculty to have first hand information about the work done by the Resident and suggest
The Resident should make entries regarding personal data immediately after joining the course.
The Resident should obtain the signature of the concerned faculty every week.
The log book should be submitted to Head of Department at the end of every rotation and at the end
of the term.
PERSONAL DETAILS
Photograph
1. Full Name :
2. Age : Date of Birth :
3. Permanent Address :
4. Tel. No. :
5. Local Address :
Remarks of
Date
SN Unit Leave Taken the Head of
From - To -
the Unit
PROCEDURES
Indoor Lecturer’s
SN Name of Patient Procedure Remarks
No. Signature
UNDER GRADUATE TEACHING
Teachers
SN Batch Date Topic
Signature
JOURNAL CLUB PRESENTATIONS
Teacher’s
SN Date Name of journal & Topic
Remarks
CONFERENCES / WORKSHOPS ATTENDED
Name of Paper
SN Date Place Remarks
Conference Presented
MISCELLANEOUS HEALTH RELATED ACTIVITIES
Remarks by
SN Date Place Activity
Teacher
PUBLICATIONS
Topic:
Guide:
Co-Guide:
Abstract :
Remarks by H.O.D.
P.G. PRESENTATION
Unit
From – To
Regularity &
Punctuality
Rapport with
Patients – Colleagues
Initiative
Clinical
acumen
Skills in Procedure
Knowledge
Participation
in P.G. Program
U.G.
Teaching
Total
Signature of
Unit In-charge
Head of
Department
Signature of PG
Student
Assessment of Performance
Score : 1 through 10
Unit
From – To
Regularity &
Punctuality
Rapport with
Patients – Colleagues
Initiative
Clinical
acumen
Skills in Procedure
Knowledge
Participation
in P.G. Program
U.G.
Teaching
Total
Signature of
Unit In-charge
Head of
Department
Signature of PG
Student
Assessment of Performance
Score : 1 through 10
Unit
From – To
Regularity &
Punctuality
Rapport with
Patients – Colleagues
Initiative
Clinical
acumen
Skills in Procedure
Knowledge
Participation
in P.G. Program
U.G.
Teaching
Total
Signature of
Unit In-charge
Head of
Department
Signature of PG
Student
Assessment of Performance
Score: 1 through 10
Unit
From – To
Regularity &
Punctuality
Rapport with
Patients – Colleagues
Initiative
Clinical
acumen
Skills in Procedure
Knowledge
Participation
in P.G. Program
U.G.
Teaching
Total
Signature of
Unit In-charge
Head of
Department
Signature of PG
Student