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LOG BOOK

Junior Residency

Programme for the Postgraduate (M.D.) in

HUMAN ANATOMY
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Name of the P.G.Student ____________________________ Name of the P.G.Guide _____________________________ Name of the Professor & Head __________________________ Name of the Dean / Principal ____________________________ Name of the College _______________________________

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Maharashtra Univrsity of Health Sciences, Nashik

INDEX SN
I. II. 1. 2. 3. 4. III. 1. 2. 3. 4. 5. 6. IV. V. VI. VII. VIII. IX. X

Topic
Personal information Under-graduate teaching Dissection LCD Histology Practical Other teaching PG activities Lectures Practical Seminars Journal club Microteaching Dissertation work Embalming duties M.L.C. work Scientific & Research activities Other activities Evaluation Museum work Course completion certificate

Page Nos.
1 to 7 8 to 11 8 9 10 11 12 to 22 12,13 14 15,16 17,18 19,20 21,22 23 24 25 26 27

28

Note: 1. The PG candidate must keep the logbook updated.


2. The logbook is the property of the department. 3. Separate pages may be added wherever necessary. 4. The PG candidate must maintain a duplicate copy of this logbook.

I] Personal Information
1. 2. 4. 6. 7. 8. Full Name: Date of Birth: Marital Status: Mother tongue: Languages known: Address for Correspondence: _________________________________________ _________________________________________ Phone No. __________________ 9. Permanent Address: _________________________________________ _________________________________________ Phone No. 10. Academic Information: Year M.B.B.S. I M.B.B.S.II M.B.B.S.III Date of completion of the Internship: Date of Permanent Registration of MMC/MCI/SMC: Any other Degree/Diploma: Yes / No; if Yes, give details. 11. PG registration: Selection by: Graduate marks/PGMCET/AIEE/any other Date of selection order & No.: Name of the selecting authority: If through PGMCET, SML No.: Selected for the registration year: 12. Joining the Dept: Registration Year: Date of joining: Date of starting PG course: Registration No.: Institution University No. Of Attempts Month & Year of Passing 3. 5. Sex: Religion:

Provisional date of completion of the course: Joining Report given to Dept: Inward No: Date: Joining report sent to Dean: Outward No: Date:

13.

University eligibility: Application for Provisional Eligibility (for out of university candidate) a) Outward No: Date: b) Fees paid: Receipt No: Date: c) Certificate No: Date: Application for Permanent Eligibility & Enrollment a) Outward No: Date: b) Fees paid: Receipt No: Date: c) Certificate No: Date:

14. Progress Report: Date of starting the course: TERM FROM TO GRANTED / NOT GRANTED REMARK

Provisional Date of Submission of Dissertation: Provisional Month of appearing for University Exam:

15.

Leave Record: i) Earned Leave (PL)

SN

Date of Application

Reason

Period of leave

No. of Days

Granted Remarks (Yes/No)

ii) Casual Leave

SN

Date of Application

Reason

Period of leave

No. of Days

Granted Remarks (Yes/No)

Stipend Record Stipend: Applicable / Not Applicable Sr. No. Period Stipend (Rs/month) Months Total Rs Received Remarks

17. Fees Record i) Tuition Fees If tuition fees not applicable, reason: Year I II III ii) Other Fees SN. Amount Receipt No. Date Nature of Fees Remarks Fees Paid (Rs) Receipt No. Date Remarks

18. i) ii) iii) iv) v) vi) vii) viii)

University Exam Submission of Dissertation Fees paid: Rs. Date: Date: Outward No: Receipt No: Date of submission of form: Date on which eligible to appear: Month of exam conducted: Centre of Theory Exam: Practical Exam: Date of Declaration of Results: Grades / Points obtained with break up: Pass / Fail Roll No:

To the best of my knowledge the above information is true.

Name & Signature of P. G. Student

II] Undergraduate Teaching


1. Dissection

SN 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18

Region

Batch

Date From To

No. of Sessions

Remarks

Signature of PG Guide

Signature of HOD

II] Undergraduate Teaching


2. LCD

SN 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18
Signature of PG Guide

Region

Batch

Date From To

No. of Sessions

Remarks

Signature of HOD

II] Undergraduate Teaching


3. Histology Practical

SN 01 02 03 04 05 06 07 08 09 10 11 12 13

Region

Batch

Date From To

No. of Remarks Sessions

14 15 16 17 18

Signature of PG Guide

Signature of HOD

II] Undergraduate Teaching


4. Other Teaching

SN
01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16

Date

Time

Batch / Class

Topic

Remark

Signature of PG Guide

Signature of HOD

III] POST GRADUATE ACTIVITIES


1. Lectures a. Intra departmental P. G. Lectures Attended

SN
01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16

Date

Time

Topic

Lecture conducted by

Remarks

Total lectures conducted in above period: Signature of PG Guide Signature of HOD

III] POST GRADUATE ACTIVITIES


1. Lectures b. Inter Collegiate P. G. Lecture Series Attended

SN
01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16

Date

Time

Topic

Lecture Venue conducted by

Remarks

Total lectures conducted in above period:

Signature of PG Guide

Signature of HOD

III] POST GRADUATE ACTIVITIES


2. Practicals Attended

SN
01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16

Date

Time

Topic

Practical Conducted by

Remarks

Total practicals conducted in above period:

Signature of PG Guide

Signature of HOD

III] POST GRADUATE ACTIVITIES


3. Seminars a. Presented by the candidate Seminar No. Date Time Topic Remark Signature of Sr. Teacher present

PROFORMA FOR INTERNAL EVALUATION OF SEMINAR SN 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. Points to be considered Presentation Completeness of preparation Cogency of presentation Use of audiovisual aids Understanding of subject Ability to answer questions Time scheduling Consulted all relevant Literature Overall performance Others Signature of Sr. teacher present Grades Seminar Number

Grades: A-Excellent, B-Very Good, C- Good, D- Average, E- Below Average, F-Poor

Signature of PG Guide

Signature of HOD

III] POST GRADUATE ACTIVITIES


3. Seminars b. Conducted in the department Attended SN Date Time Topic Presented by Remark

Total seminars conducted in above period:

Signature of PG Guide

Signature of HOD

III] POST GRADUATE ACTIVITIES


4. Journal club a. Presented by the candidate Journal Club No. Date Time Journal Article No. Topic Signature of Sr. Teacher present

PROFORMA FOR INTERNAL EVALUATION OF JOURNAL CLUB SN. Points to be considered Grades Journal Club Number

1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11.

Choice of articles Cogency of presentation Purpose of articles understood? How well he defend the article? Consulted Cross-references? Consulted relevant Literature? Overall impression of articles Audio-visual aids Response to questioning Others Signature of Sr. teacher present for the journal club

Grades: A-Excellent, B-Very Good, C- Good, D- Average, E- Below Average, F- Poor

Signature of PG Guide

Signature of HOD

III] POST GRADUATE ACTIVITIES


3. Journal Club b. Conducted in the department Attended SN Date Time Topic Presented by Remark

Total journal clubs conducted in above period:

Signature of PG Guide

Signature of HOD

III] POST GRADUATE ACTIVITIES


5. Microteaching a. Presented by the candidate Micro Teaching Session No. Date Time Topic Signature of Sr. Teacher present

PROFORMA FOR INTERNAL EVALUATION OF MICROTEACHING SESSION SN

S
Set Induction a) Aroused interest at the beginning b) Specified objectives of presentation Planning a) Organized material in a logical sequence b) Used relevant content matter Presentation a) Fluency in language b) Used non-verbal cues, eye contact Interaction a) Allowed questions from students b) Asked questions c) Rewarded pupil effort d) Clarified doubts Use of AV aids a) Used proper AV aids b) Used the aid effectively Summarization a) Summarized important points at the end. b) Checked that all students got the points. c) Lesson on the whole was effective. Any suggestions given to the speaker for improvement Signature of the senior teacher present

Grades Microteaching Session No.

1 2 3 4

5 6

7 8

Grades: A-Yes, B-to some extent, C-No

Signature of PG Guide

Signature of HOD

III] POST GRADUATE ACTIVITIES


5. Microteaching b. Conducted in the department Attended SN Date Time Topic Presented by Remark

Total microteaching sessions conducted in above period:

Signature of PG Guide

Signature of HOD

III] POST GRADUATE ACTIVITIES


6. Dissertation Work Presentation a. Presented by candidate Title of Dissertation: Year Period Presentation No. Progress of Dissertation work Sign of PG Guide Remarks

PROFORMA FOR EVALUATION OF DISSERTATION PRESENTATION SN. Points to be considered Grades

1 2 3 4 5 6 7 8 9 10 11 12

Interest shown in selecting a topic Appropriate review Discussion with guide & other faculty Quality of Protocol Preparation collection of case material Regular collection of case material Depth of analysis / discussion Departmental presentation of findings Quality of final output Defense in Viva Others Signature of PG Guide

Grades: A-Excellent, B-Very Good, C- Good, D- Average, E- Below Average, F- Poor Date of Submission of Dissertation:

Signature of PG Guide

Signature of HOD

III] POST GRADUATE ACTIVITIES


6. Dissertation Work Presentation b. Conducted in the department Attended SN. Date Time Topic Presented by Remark

Total dissertation presentation conducted in above period:

Signature of PG Guide

Signature of HOD

IV] Embalming Duty


Period:
SN. Name of Deceased Age (Yrs) Sex (M / F) Date of Embalming Remarks

Signature of PG Guide

Signature of HOD

V] M.L.C. WORK
SN. M.L.C. No. Jurisdiction of the M.L.C. Date of opening Date of completion Remark s Sign of H.O.D.

Signature of P.G. Guide

Signature of H.O.D.

VI] Scientific & Research Activities


1. Scientific Contribution SN Workshop/Symposium Attended Date Time Place Remarks

2. Research Assignment Record of the Conferences Attended & Research Articles published a. Conferences Attended SN Name of Conference Title of Presentation Date Remarks

b. Research Articles Published SN Name of Journal Title of Article Date Remarks

Signature of P.G. Guide

Signature of H.O.D.

VII] Other Activities (Museum work including museum techniques & preparation of minimum 15 to 20 specimens)
SN Nature of Work Period Remark Signature of concerned teacher

Signature of P.G. Guide

Signature of H.O.D.

VIII] Term wise General Evaluation


SN.

Points to be considered
I II Mastery of fundamental knowledge Knowledge of and ability to use basic lab. techniques Knowledge of and ability to use computers Ability to express self in speech and in writing Regularity and punctuality Co-operative / helping nature Self-reliance & independence Ability to accept any challenge on short notice Emotional stability & maturity Motivation toward a successful productive career Participation in extra curricular activities Signature of the P.G. Guide

Grades Term III IV

VI

1 2 3 4 5 6 7 8 9 10 11 12

Grades: A-Excellent, B-Very Good, C- Good, D- Average, E- Below Average, F- Poor

Signature of P. G. Guide

Signature of H.O.D.

IX] Course Completion Certificate