Ortho Log Book

UNIVERSITY RESIDENCY PROGRAM -2019
LOG BOOK FOR ORTHOPAEDIC SURGERY

RAWALPINDI MEDICAL UNIVERSITY RAWALPINDI
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PREFACE
The horizons of Medical Education are widening & there has been a steady rise of global interest in Post Graduate Medical
Education, an increased awareness of the necessity for experience in education skills for all healthcare professionals and the need for some formal
recognition of postgraduate training in Internal Medicine.
We are seeing a rise in the uptake of places on postgraduate courses in medical education, more frequent issues of medical education journals and the
further development of e-journals and other new online resources. There is therefore a need to provide active support in Post Graduate Medical
Education for a larger, national group of colleagues in all specialties and at all stages of their personal professional development. If we were to formulate
a statement of intent to explain the purpose of this log book, we might simply say that our aim is to help clinical colleagues to teach and to help students
to learn in a better and advanced way. This book is a state of the art log book with representation of all activities of the MD/MS Research Elective
program at RMU.A summary of the curriculum is incorporated in the logbook for convenience of supervisors and residents. It also allows the clinicians to
gain an understanding of what goes into basic science discoveries and drug development. Translational research has an important role to play in
medical research, and when used alongside basic science will lead to increased knowledge, discovery and treatment in medicine. A perfect monitoring
system of a training program including monitoring of teaching and learning strategies, assessment and Research Activities cannot be denied so we at
RMU have incorporated evaluation by Quality Assurance Cell and its comments in the logbook in addition to evaluation by University Training
Monitoring Cell (URTMC). Reflection of the supervisor in each and every section of the logbook has been made sure to ensure transparency in the
training program. The mission of Rawalpindi Medical University is to improve the health of the communities and we serve through education, biomedical
research and health care. As an integral part of this mission, importance of research culture and establishment of a comprehensive research structure
and research curriculum for the residents has been formulated and a separate journal for research publications of residents isavailable.
Prof. MuhammadUmar
(Sitara-e-Imtiaz)
(MBBS, MCPS,FCPS,FACG,FRCP
(Lon), FRCP (Glasg),AGAF)
ViceChancellor
Rawalpindi MedicalUniversity
& AlliedHospitals
2
TRIBUTIONS
SR. NAME & DESIGNATION CONTRIBUTIONS IN FORMULATION OF LOG BOOK OF ORTHOPAEDICS

NO
1. Professor Dr Riaz Ahmed Over all synthesis, structuring & over all write up of Log Book of MS
Dean of Orthopaedics, Neurosurgery and ORTHOPAEDIC SURGERY and also Log Book for MS ORTHOPAEDIC
Trauma SURGERY rotations under guidance of Prof. Dr. Riaz Ahmed , Dean of
Head Of Orthopaedics Orthopaedics, Neurosurgery and Trauma
Rawalpindi Medical University & Allied Head Of Orthopaedics Rawalpindi Medical University, Rawalpindi.
Teaching Hospitals, Also Proof reading & synthesis of final print version of Log
Rawalpindi, Pakistan Books of MS ORTHOPAEDIC SURGERY and Rotations Log Book.
2. Dr. Zubair javed Guidance regarding technical matters of Log Book of MS
Associate Professor ORTHOPAEDIC SURGERY& Log Book for MS ORTHOPAEDIC SURGERY
Rawalpindi Medical University & Allied Rotations.
Teaching Hospitals,
Rawalpindi, Pakistan
3. Dr. Rahman Rasool Akhtar Provision of required number of clinical procedures & educational
Senior Registrar Orthopaedics activities for each year separately and rotation of Log Books of MS
Rawalpindi Medical University & Allied ORTHOPAEDIC SURGERY& Log Book for MS ORTHOPAEDIC SURGERY
Teaching Hospitals, rotations.
Rawalpindi, Pakistan
4. Mr. Yasir Sohail Assistance of Professor Dr Riaz Ahmed in formulating the log
Computer Operator books & computer work under her direct guidance &
Department of Orthopaedics supervision.
Rawalpindi Medical University Rawalpindi Medical
University, Rawalpindi
ENROLMENT DETAILS
Program ofAdmission
Session
Registration / TrainingNumber
Name ofCandidate
Father’sName
DateofBirth / / CNICNo.
Present Address
PermanentAddress
E-mailAddress
CellPhone
Date of Start ofTraining
Date of Completion ofTraining
Name ofSupervisor
Designation ofSupervisor
Qualification ofSupervisor
Title of department /Unit
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Name of Training Institute /Hospital
Sr. No Discipline
1. Principles of General Surgery
2. Skin, soft-tissue and breast
3. Upper Gastrointestinal Surgery
4. Lower Gastrointestinal Surgery
5. Endocrine, Head and Neck
6. Urology
7. Plastic / Paediatric Surgery
8. Neurosurgery / Thoracic Surgery
9. General Orthopaedics
10. Infections & Tumors
11. Pediatric Orthopaedic Surgery
12. Traumatology – Fractures & Dislocations
13. Sports Medicine
14. Spine
15. The Hand
16. Foot & Ankle
17. Arthoplasty
18. Plastic surgery / Anaesthesia / Paediatric Surgery (Minor rotation)
19. Rehabilitation (Minor rotation)
INTRODUCTION
It is a structured book in which certain types of educational activities and patient related information is recorded, usually by hand.
Logbooks are used all over the world from undergraduate to postgraduate training, in human, veterinary and dental medicine,
nursing schools and pharmacy, either in paper or electronic format .
Logbooks provide a clear setting of learning objectives and give trainees and clinical teachers a quick overview of the requirements
of training and an idea of the learning progress. Logbooks are especially useful if different sites are involved in the training to set a
(minimum) standard of training. Logbooks assist supervisors and trainees to see at one glance which learning objectives have not yet
been accomplished and to set a learning plan. The analysis of logbooks can reveal weak points of training and can evaluate whether
trainees have fulfilled the minimum requirements of training.
Logbooks facilitate communication between the trainee and clinical teacher. Logbooks help to structure and standardize learning in
clinical settings. In contrast to portfolios, which focus on students documentation and self-reflection of their learning activities,
logbooks set clear learning objectives and help to structure the learning process in clinical settings and to ease communication
between trainee and clinical teacher. To implement logbooks in clinical training successfully, logbooks have to be an integrated part
of the curriculum and the daily routine on the ward. Continuous measures of quality management are necessary.
INDEX OF LOG:
1. MORNING REPORT PRESENTATION/CASEPRESENTATION 13. HANDS ONTRAINING/WORKSHOPS
2. TOPIC PRESENTATION/SEMINAR 14. PUBLICATIONS
3. ORTHOPAEDICS LECTURES/INTERACTIVELECTURES 15. MAJOR RESEARCH PROJECT DURING MSTRAINING/ANY
4. JOURNALCLUB OTHER MAJOR RESEARCHPROJECT
5. PROBLEM CASEDISCUSSION 16. WRITTEN ASSESMENTRECORD
6. EMERGENCY CASES 17. CLINICAL ASSESMENTRECORD
7. INDOORPATIENTS 18. EVALUATION RECORD
8. OPD ANDCLINICS 19. LEAVERECORD
9. PROCEDURES (OBSERVED, ASSISTED,PERFORMED 20. RECORD SHEET OFATTENDANCE/COUNCELLING
UNDER SUPERVISION & PERFORMEDINDEPENDENTLY) SESSION/DOCUMENTATIONQUALITY
10. MULTIDISCIPLINARYMEETINGS 21. ANY OTHER IMPORTANT ANDRELEVANT

INFORMATION/DETAILS
11. CLINICOPATHOLOGICALCONFERENCE
12. MORBIDITY/MORTALITYMEETINGS
MINIMUM LOG BOOK ENTERIES PER MONTH IN GENERAL
(This minimum number is being provided for uniformity of the training and convenience for monitoring of the resident’s performance by
Quality Assurance Cell & University Research Training & Monitoring Cell of RMU but resident is encouraged to show performance above
this minimum required number)
SR.NO ENTRY Minimum cases /Time duration
01 Case presentation 02 per month
02 Topic presentation 01 per month
03 Journal club 01 per month
04 Bed side teaching 25 per month
05 Large group teaching 08 per month
06 Emergency cases 15 per month
07 OPD 80 per month
08 Indoor (patients allotted) 10per month plus participation in

daily Morning & Evening rounds
09 Directly observed procedures 85 per month
10 CPC 02 per month
11 Mortality & Morbidity 02 per month

meetings
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MISSION STATEMENT
The mission of MS Orthopaedic Surgery Residency Program of Rawalpindi Medical University is:
1. To provide exemplary medical care, treating all patients who come before us with uncompromising dedication andskill.
2. To set and pursue the highest goals for ourselves as we learn the science, craft, and art ofsurgery.
3. To passionately teach our junior colleagues and students as we have been taught by those who precededus.
4. To treat our colleagues and hospital staff with kindness, respect, generosity of spirit, andpatience.
5. To foster the excellence and well-being of our residency program by generously offering our time, talent, and energy on itsbehalf.
6. To support and contribute to the research mission of our medical center, nation, and the world by pursuing new knowledge, whether
at the bench orbedside.
7. To promote the translation of the latest scientific knowledge to the bedside to improve our understanding of disease pathogenesis
and ensure that all patients receive the most scientifically appropriate and up to datecare.
8. To promote responsible stewardship of medical resources by wisely selecting diagnostic tests and treatments, recognizing that our
individual decisions impact not just our own patients, but patientseverywhere.
9. To promote social justice by advocating for equitable health care, without regard to race, gender, sexual orientation, social status, or
ability to pay.
10. To extend our talents outside the walls of our hospitals and clinics, to promote the health and well-being of communities, locally,
nationally, andinternationally.
11. To serve as proud ambassadors for the mission of the Rawalpindi Medical University MS Orthopaedic Surgery Residency Program for
the remainder of our professionallives.
CLINICAL COMPETENCIES FOR 1ST, 2ND, 3RD,4THand 5thYEARMS ORTHOPAEDIC SURGERY TRAINEES CLINICAL
COMPETENCIES\SKILL\PROCEDURE
The clinical competencies, a specialist must have, are varied and complex. A complete list of the skills necessary for
trainees and trainers is given below. The level of competence to be achieved each year is specified according to the
key, as follows:
1. Observerstatus
2. Assistant tatus
3. Performed undersupervision
4. Performed under indirect tsupervision
5. Performedindependently
Note: Levels 4 and 5 for practical purposes are almost synonymous

METHODS OF TEACHING & LEARNING DURING COURSE CONDUCTION
1. Inpatient Services: All residents will attend patients in High Dependency Unit , Pre operative ward and Post Operative wards. The
required knowledge and skills pertaining to the ambulatory based training in following areas shall bedemonstrated;
 Sports Medicine
 Hand Surgery
 Paediatric Orthopaedics
 Musculoskeletal Oncology
 Trauma Surgery
 Arthroplasty
S 
p

2. Outpatient Experiences:Residents should demonstrate expertise in diagnosis and management of patients in fracture management,
follow up plan of patients managed with plaster ,Post operative patients follow up ,Backache ,Cervical Spine pathologies ,Malunited
fractures presenting to us after being managed by some Quack.
3. Emergency services:Our residents take an early and active role in patient care and obtain decision-making roles quickly. Within the
Emergency Department, residents direct the initial stabilization of all the trauma patients presenting with fractures and also operate
patients with fractures in ER OT with Senior Registrar.
4. Electives/ Specialty Rotations: In addition, the resident will elect rotations in a variety of electives including Hand Surgery ,Paediatric
Orthopaedics, Spine Surgery ,Arthroscopy. Residents may also select electives at other institutions if the parent department does not offer the
experiences they want.
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5. Interdisciplinary MedicineAdolescent Medicine, Dermatology, Emergency Medicine, General Surgery, Gynecology, Neurology, Occupational
Medicine, Ophthalmology, Otolaryngology, Physical Medicine and Rehabilitation,Urology.
6. Mandatory Workshops: Residents achieve hands on training while participating in mandatory workshops of Research Methodology, Advanced
Life Support, Communication Skills, Computer & Internet and Clinical Audit. Specific objectives are given in detail in the relevant section of
MandatoryWorkshops.
7. Introductory Lecture Series (ILS):Various introductory topics are presented by subspecialty and general faculty to introduce interns to basic
and essential topics in Orthopaedics.
8. Long and short case presentations:Giving an oral presentation on ward rounds is an important skill for medical student to learn. It is medical
reporting which is terse and rapidly moving. After collecting the data, you must then be able both to document it in a written format and
transmit it clearly to other health care providers. In order to do this successfully, you need to understand the patient’s medical illnesses, the
psychosocial contributions to their History of Presenting Illness and their physical diagnosis findings. You then need to compress them into a
concise, organized recitation of the most essential facts. The listener needs to be given all of the relevant information without the extraneous
details and should be able to construct his/her own differential diagnosis as the story unfolds. Consider yourself an advocate who is
attempting to persuade an informed, interested judge the merits of your argument, without distorting any of the facts. An oral case
presentation is NOT a simple recitation of your write-up. It is a concise, edited presentation of the most essential information. Basic structure
for oral case presentations includes Identifying information/chief complaint (ID/CC) , History of present illness (HPI) including relevant ROS
(Reviewofsystems)questionsonly,Otheractivemedicalproblems,Medications/allergies/substanceuse(note:e.ThecompleteROSshould
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not be presented in oral presentations , Brief social history (current situation and major issues only) . Physical examination (pertinent findings
only) , One line summary & Assessment and plan
9. Seminar Presentation:Seminar is held in a non conference format. Upper level residents present an in-depth review of a topic as well as their
own research. Residents are formally critiqued by both the associate program director and their residentcolleagues.
10. Journal Club Meeting (JC):A resident will be assigned to present, in depth, a research article or topic of his/her choice of actual or potential
broad interest and/or application. Two hours per month should be allocated to discussion of any current articles or topics introduced by any
participant. Faculty or outside researchers will be invited to present outlines or results of current research activities. The article should be
critically evaluated and its applicable results should be highlighted, which can be incorporated in clinical practice. Record of all such articles
should be maintained in the relevantdepartment
11. Small Group Discussions/ Problem based learning/ Case based learning:Traditionally small groups consist of 3-4 participants. Small groups
can take on a variety of different tasks, including problem solving, role play, discussion, brainstorming, debate, workshops and presentations.
Generally students prefer small group learning to other instructional methods. From the study of a problem students develop principles and
rules and generalize their applicability to a variety of situations.PBL is said to develop problem solving skills and an integrated body of
knowledge. It is a student-centered approach to learning, in which students determine what and how they learn. Case studies help learners
identify problems and solutions, compare options and decide how to handle a realsituation.
12. Discussion/Debate:There are several types of discussion tasks which would be used as learning method for residents including: Guided
discussion, in which the facilitator poses a discussion question to the group and learners offer responses or questions to each other's
contributions as a means of broadening the discussion's scope; inquiry-based discussion, in which learners are guided through a series of
questions to discover some relationship or principle; exploratory discussion, in which learners examine their personal opinions, suppositions or
assumptions and then visualize alternatives to these assumptions; and debate in which students argue opposing sides of a controversial topic.
With thoughtful and well-designed discussion tasks, learners can practice critical inquiry and reflection, developing their individual thinking,
considering alternatives and negotiating meaning with other participants to arrive at a shared understanding of the issues athand.
13. Case Conference (CC):These sessions are held two days each week; the focus of the discussion is selected by the presenting resident. For
example,somecasesmaybe presentedto discussadifferentialdiagnosis,whileothersare presentedtodiscussspecificmanagementissues.
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14. Grand Rounds (GR):The Department of Orthopaedics surgery hosts Grand Rounds on weekly basis. All residents on inpatient floor teams, as
well as those on ambulatory block rotations and electives are expected toattend.
15. Professionalism Curriculum (PC): This is an organized series of recurring large and small group discussions focusing upon current issues and
dilemmas in medical professionalism and ethics presented primarily by an associate program director. Lectures are usually presented in a
noon conferenceformat.
16. Evening Teaching Rounds:During these sign-out rounds, the inpatient Chief Resident makes a brief educational presentation on a topic related
to a patient currently on service, often related to the discussion from morning report.
17. Clinico-pathological Conferences:Theclinicopathological conference, popularly known as CPC primarily relies on case method of teaching . It is
a teaching tool that illustrates the logical, measured consideration of a differential diagnosis used to evaluate patients. The process involves
case presentation, diagnostic data, discussion of differential diagnosis, logically narrowing the list to a few selected probable diagnoses and
eventually reaching a final diagnosis and its brief discussion. The idea was first practiced in Boston, back in 1900 by a Harvard internist, Dr.
Richard C. Cabot who practiced this as an informal discussion session in his private office. Dr. Cabot incepted this from a resident, who in turn
had received the idea from a roommate, primarily a lawstudent.
18. Evidence Based Learning: Residents are presented a series of noon monthly lectures presented to allow residents to learn how to critically
appraise journal articles, stay current on statistics, etc. The lectures are presented by the programmedirector.
19. Clinical Audit based learning:“Clinical audit is a quality improvement process that seeks to improve patient care and outcomes through
systematic review of care against explicit criteria…Where indicated, changes are implemented…and further monitoring is used to confirm
improvement in healthcare delivery.” Principles for Best Practice in Clinical Audit (2002,NICE/CHI)
20. Peer Assisted Learning:Any situation where people learn from, or with, others of a similar level of training, background or other shared
characteristic. Provides opportunities to reinforce and revise their learning. Encourages responsibility and increasedself-confidence. Develops
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teaching and verbalization skills. Enhances communication skills, and empathy. Develops appraisal skills (of self and others) including the
ability to give and receive appropriate feedback. Enhance organizational and team-workingskills.
21. Morbidity and Mortality Conference (MM):The M&M Conference is held occasionally at noon throughout the year. A case, with an adverse
outcome, though not necessarily resulting in death, is discussed and thoroughly reviewed. Faculty members from various disciplines are
invited to attend, especially if they were involved in the care of the patient. The discussion focuses on how care could have beenimproved.
22. Clinical Case Conference:Each resident, except when on vacation, will be responsible for at least one clinical case conference each month. The
cases discussed may be those seen on either the consultation or clinic service or during rotations in specialty areas. The resident, with the
advice of the Attending Physician on the Consultation Service, will prepare and present the case(s) and review the relevantliterature
.
23. Skill teaching in emergency, ward settings& skill laboratory:Two hours twice a month should be assigned for learning and practicing clinical
skills. List of skills to be learnt during these sessions is asfollows:
 Residents must develop a comprehensive understanding of the indications,
contraindications, limitations, complications, techniques, and interpretation of
results of those technical procedures integral to the discipline (mentioned in the
Courseoutlines)
 Residents must acquire knowledge of and skill in educating patients about the
technique, rationale and ramifications of procedures and in obtaining procedure-
specific informed consent. Faculty supervision of residents in their performance is
required, and each resident's experience in such procedures must be documented by
the programmedirector
 Residents must have instruction in the evaluation of medical literature, clinical
epidemiology, clinical study design, relative and absolute risks of disease, medical
statistics and medicaldecision-making
 Training must include cultural, social, family, behavioral and economic issues, such as
confidentiality of information, indications for life support systems, and allocation of
limitedresources
 Residents must be taught the social and economic impact of their decisions on
patients, the primary care physician and society. This can be achieved by attending
the bioethics lectures and becoming familiar with Project Professionalism Manual su
 Residents should have instruction and experience with patient counseling skills and
communityeducation
 This training should emphasize effective communication techniques for diverse
populations, as well as organizational resources useful for patient and
communityeducation
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
Residents should have experience in the performance of clinical laboratory and
radionuclide studies and basic laboratory techniques including quality control,
quality assurance and proficiencystandards.
24. Bedside teaching rounds in ward:“To STUDy the phenomenon of disease withoUT a book is to sail an UNCHarted sea
whilst to STUDy books withoUT patients is not to go to sea at all” Sir William Osler 1849-1919.Bedside teaching is
regularly included in the ward rounds. Learning activities include the physical exam, psychosocial and ethical themes, and
managementissues
25. Directly Supervised Procedures - (DSP): Residents learn procedures under the direct supervision of an attending or fellow during some
rotations.
26. Self-directed learning:self-directed learning residents have primary responsibility for planning, implementing, and evaluating their
effort. It is an adult learning technique that assumes that the learner knows best what their educational needs are. The facilitator’s role
in self-directed learning is to support learners in identifying their needs and goals for the program, to contribute to clarifying the
learners' directions and objectives and to provide timely feedback. Self-directed learning can be highly motivating, especially if the
learner is focusing on problems of the immediate present, a potential positive outcome is anticipated and obtained and they are not
threatened by taking responsibility for their ownlearning.
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27. Core curriculum meeting:All the core topics of Orthopaedics should be thoroughly discussed during these sessions. The duration of each
session should be at least two hours once a month. It should be chaired by the chief resident (elected by the residents of the relevant
discipline). Each resident should be given an opportunity to brainstorm all topics included in the course and to generate new ideas
regarding the improvement of the coursestructure
28. Annual Grand MeetingOnce a year all residents enrolled for MS Orthopaedics should be invited to the annual meeting at RMU. One full
day will be allocated to this event. All the chief residents from affiliated institutes will present their annual reports. Issues and concerns
related to their relevant courses will be discussed. Feedback should be collected and suggestions should be sought in order to involve
residents in decision making. The research work done by residents and their literary work may be displayed. In the evening an informal
gathering and dinner can be arranged. This will help in creating a sense of belonging and ownership among students and the faculty.
29. Learning through maintaining log book: it is used to list the core clinical problems to be seen during the attachment and to document
the student activity and learning achieved with each patientcontact.
30. Learning through maintaining portfolio:Personal Reflection is one of the most important adult educational tools available. Many
theorists have argued that without reflection, knowledge translation and thus genuine “deep” learning cannot occur. One of the
Individual reflection tools maintaining portfolios, Personal Reflection allows students to take inventory of their current knowledge skills
and attitudes, to integrate concepts from various experiences, to transform current ideas and experiences into new knowledge and
actions and to complete the experiential learningcycle.
31. Task-based-learning:A list of tasks is given to the students: participate in consultation with the attending staff, interview and examine
patients, review a number of new radiographs with theradiologist.
32. Teaching in the ambulatory care setting:A wide range of clinical conditions may be seen. There are large numbers of new and return
patients. Students have the opportunity to experience a multi-professional approach to patient care. Unlike ward teaching, increased
numbers of students can be accommodated without exhausting the limited number of suitablepatients.
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33. Community Based Medical Education:CBME refers to medical education that is based outside a tertiary or large secondary level
hospital. Learning in the fields of epidemiology, preventive health, public health principles, community development, and the social
impact of illness and understanding how patients interact with the health care system. Also used for learning basic clinical skills,
especially communicationskills.
34. E-learning/web-based medical education/computer-assisted instruction:Computer technologies, including the Internet, can support a
wide range of learning activities from dissemination of lectures and materials, access to live or recorded presentations, real-time
discussions, self-instruction modules and virtual patient simulations. distance-independence, flexible scheduling, the creation of
reusable learning materials that are easily shared and updated, the ability to individualize instruction through adaptive instruction
technologies and automated record keeping for assessmentpurposes.
35. Research based learning:All residents in the categorical program are required to complete an academic outcomes-based research
project during their training. This project can consist of original bench top laboratory research, clinical research or a combination of
both. The research work shall be compiled in the form of a thesis which is to be submitted for evaluation by each resident before end of
the training. The designated Faculty will organize and mentor the residents through the process, as well as journal clubs to teach critical
appraisal of theliterature.
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CURRICULUM FOR ORTHOPAEDIC SURGERY
Masters in Orthopaedics (MS)

MS Orthopaedics will be a 5-year program. Those candidates who will complete their training and other requirements will be awarded an MS (Orthopaedics) degree by
the Rawalpindi Medical University.
Recognized Training Centers and supervisors
Three hospitals attached with Rawalpindi Medical University (RMU) and Allied Teaching Hospitals will start with MS program, i.e.
Department of Orthopaedic Surgery (Benazir Bhutto Hospital, Rawalpindi)
Department of Orthopaedic Surgery (Holy Family Hospital, Rawalpindi)
Department of Orthopaedic Surgery (District Head quarter Hospital, Rawalpindi)
Teaching faculty with more than ten years teaching experience in a PMDC recognized teaching hospital will be eligible to act as supervisors for MS program.
Duration of program.
The duration of MS Orthopaedics course shall be five (5) years (first two years in Part I, and next three years in Part II) with structured training in a recognized department
under the guidance of an approved supervisor.
The course is structured in two parts:
Part I is structured for the 1st and 2nd calendar years. The candidate shall undertake clinical training in fundamental concepts of Surgery. At the end of 2nd year the
examination shall be held in fundamental concepts of Surgery.
The clinical training in Orthopaedics shall start from 3rd year onwards in the recognized institutions.
Part II is structured for 3rd, 4th and 5th calendar years in MS Orthopaedics. It has two components; Clinical and Research. The candidate shall undergo clinical training to
achieve educational objectives of MS Orthopaedics (knowledge & skills) along with rotation in relevant fields.
REGISTRATION AND ENROLLMENT
Total number of students enrolled for the course must not exceed 2 per supervisor/year.
The maximum number of trainees that can be attached with a supervisor at a given point of time (inclusive of trainees in all years/phases of MS training), must not
exceed 6.
Beds to trainee ratio at the approved teaching site shall be at least 10 beds per trainee.
The University will approve supervisors for MS courses.
Candidates selected for the courses after their enrollment at the relevant institutions shall be registered with Rawalpindi Medical University (RMU) as per prescribed
Registration Regulation.
AIM OF MS(Orthopaedics) Program
This course is designed to produce specialist in Orthopaedic and trauma surgery, who will have adequate knowledge and skills in Orthopaedic& Trauma surgery and can
recognize and deal safely with a wide range of Orthopaedic and Trauma problems as consultants.
ADMISSION CRITERIA
Admission Criteria
For admission in MS Orthopaedics course, the candidate shall have:
MBBS degree
Completed one year House Job
Registration with PMDC
Passed Entry Test conducted by the University & aptitude interview by the Institute concerned
Having up to the mark credentials as per RMU rules (no. of attempts in each professional, any gold medals or distinctions, relevant work experience, Rural/ Army services,
research experience in a recognized institution, any research article published in a National or International Journal) may also be considered on case to case basis.
Exemptions: A candidate holding FCPS / MRCS / Diplomate / equivalent qualification in Orthopaedic Surgery shall be exempted from Part-I Examination and shall be
directly admitted to Part-II Examinations, subject to fulfillment of requirements for the examination.
Part ;1 Entry test.
A. WRITTEN PAPER
The written examination will consist of 100 Multiple Choice Questions with single best answer. Division of MCQs will be as follows:
Basic Sciences (50 MCQs)
Anatomy (15 MCQs)
Orthopaedic Surgery (35 MCQs)
The applicant scoring a minimum of 60% marks will be considered pass.

B. Objective Structured Clinical Examination (OSCE)
The Objective Structured Clinical Examination will consist of 25 stations.
Each station will consist of data and images based on the subject of General &Orthopaedic Surgery.
Each correct answer will carry 2 marks
The applicant scoring 60 % of marks will be considered pass.
GOALS OF THE COURSE
The goal of MS course in Orthopaedics is to produce a competent Orthopaedic surgeon who is:
Aware of the current concepts in quality care in Orthopaedics and musculoskeletal trauma and also of diagnosis, therapeutic, medical and surgical management of
Orthopaedic problems
Able to offer initial primary management of acute Orthopaedic and trauma emergencies
Aware of the limitations and refer readily to major centres for more qualified care of cases which warrant such referral
Aware of research methodology and be able to conduct research and publish the work done
Able to effectively communicate with patients, their family members, people and professional colleagues
Able to exercise empathy and a caring attitude and maintain high ethical standards
Able to continue taking keen interest in continuing education irrespective of whether he / she is in teaching institution or in clinical practice
Dynamic, available at all times and proactive in the management of trauma victims and Orthopaedic emergencies
OBJECTIVES OF THE COURSE

At the end of MS course, the resident should be adept in the following domains:
Skill to take a proper history for musculoskeletal disorders
Clinical examination of all musculoskeletal disorders
Application of history & clinical findings in making an appropriate clinical diagnosis
Interpretation of investigations
Discussion of options of treatment and follow up rehabilitation for the diagnosis made
Have an in-depth theoretical knowledge of the syllabus with emphasis on current concepts
Learn basic skills in musculoskeletal surgery including training on bone models and on patients by assisting or performing under supervision or perform independently as
required.
Have basic knowledge of common disorders of the spine, degenerative disorders of spine, trauma spine and infections of spine for diagnosis and evaluation of the
common spine disorders
Develop a familiarity to major topics under “Sports Medicine” - to gain exposure to the basic surgery, master the patho-physiology of the conditions usually encountered
and develop a sound foundation to add new knowledge in the future
Learn basic principles of Hand Surgery with emphasis on applied anatomy, understanding patho-physiology of common conditions, planning of treatment and post-
operative protocols
Develop understanding of principles of soft tissue coverage and learn basic techniques used in extremity surgery.
SYLLABUS OF THE COURSE

Theory
General Orthopaedics
Infections
General Principles of Infection
Osteomyelitis
Infectious Arthritis
Tuberculosis and Other Infections
Tumors
General Principles of Tumors
Benign Tumors of Bone
Malignant Tumors of Bone
Soft Tissue Tumors and Non-neoplastic Conditions Simulating Bone Tumors
Congenital Anomalies
Congenital Anomalies of Lower Extremity
Congenital and Developmental Anomalies Of Hip and Pelvis
Congenital Anomalies of Trunk and Upper Extremity
Peripheral Nerve Injuries

Diagnosis and management
Microsurgery
Basic principles and techniques
Imaging in Orthopaedics
Other Non-traumatic Disorders
Osteochondrosis
Rickets and osteomalacia
Metabolic bone disease
Cerebral Palsy
Paralytic Disorders
Neuromuscular Disorders
Genetic disorders
Osteonecrosis
Traumatology
Fractures and Dislocations
General Principles of Fracture Treatment
Fractures of Lower Extremity
Fractures of Hip
Fractures of Acetabulum And Pelvis
Fractures of Shoulder, Arm, and Forearm
Malunited Fractures
Delayed Union and Nonunion Of Fractures
Acute Dislocations
Old Unreduced Dislocations
Fractures, Dislocations and Ligamentous Injuries of the hand
Fractures and Dislocations of Foot
Fractures and Dislocations In Children
Regional Orthopaedics
Spine
Spinal Anatomy And Surgical Approaches
Fractures, Dislocations, And Fracture-Dislocations Of Spine
Arthrodesis Of Spine
Pediatric Cervical Spine
Scoliosis And Kyphosis
Lower Back Pain And Disorders Of Intervertebral Discs
Infections Of Spine
Sports Medicine
Ankle Injuries
Knee Injuries
Shoulder And Elbow Injuries
Recurrent Dislocations
The Hand
Basic Surgical Technique and Aftercare
Acute Hand Injuries
Flexor and Extensor Tendon Injuries
Wrist Disorders
Paralytic Hand
Cerebral Palsy of the Hand
Arthritic Hand
Compartment Syndromes and Volkmann Contracture
Dupuytren Contracture
Carpal Tunnel, Ulnar Tunnel, and Stenosing Tenosynovitis
Tumors and Tumorous Conditions of Hand
Hand Infections
Congenital Anomalies of Hand
The Foot and Ankle

Surgical Techniques
Disorders of Hallux
Pes Planus
Lesser Toe Abnormalities
Rheumatoid Foot
Diabetic Foot
Neurogenic Disorders
Disorders of Nails and Skin Disorders of Tendons and Fascia
Operative Orthopaedics
Surgical Techniques and Approaches
Arthrodesis
Arthrodesis of Ankle, Knee and Hip
Arthrodesis of Shoulder, Elbow and Wrist
Arthroplasty
Arthroplasty of Ankle and Knee
Arthroplasty of Hip
Arthroplasty of Shoulder and Elbow
Amputations
General Principles of Amputations
Amputations about Foot
Amputations of Lower Extremity
Amputations of Hip And Pelvis
Amputations of Upper Extremity
Amputations of Hand
Arthroscopy
General Principles Of Arthroscopy
Arthroscopy Of Lower Extremity
Arthroscopy Of Upper Extremity
Practical
Closed Reduction of Fractures, Dislocations
Mastering Plastering Techniques
Debridement of Open Fractures
External Fixator application
Internal Fixation of minor fractures with K-wires
Closed manipulative correction of congenital problems like CTEV & other skeletal deformities Biopsies – FNAB, FNAC, Trocar needle, open
Excision of benign lesions
Tendon lengthening
Incision and drainage, acute Osteomyelitis / Septic Arthritis
Skull tongs application
Tension band wiring
Interfragmentary compression
Plate Osteosynthesis of Forearm bones
Carpal Tunnel Release
Bone grafting
Soft tissue releases
Interlocking IM Nailing of Tibia & Femur
Humerus Plating
Ankle Fracture Fixations
DHS Fixation
Hemi-arthroplasty Hip
Caudal epidural injections
Facet Block
Vertebroplasty
Exposure of posterior spine
Laminectomy
Anterior and posterior instrumentation of spine
Bone Skills Lab
Tension Band Wiring
Lag Screw Interfragmentary Compression
Broad Plating
Narrow Plating
External Fixation
Cancellous Screw Fixation
Dynamic Hip Screw Fixation
Dynamic Condylar Screw Fixation
Tibia Intramedullary Interlocking Nailing
Femur Intramedullary Interlocking Nailing
Tibial Condyle Fixation
Elbow fractures Fixation
Ankle Fractures Fixation
Pelvis – External Fixation
Pubic Symphysis – ORIF
Acetabulum Fracture Fixation
MIPPO Tibia
Hemiarthroplasty
Spine - Posterior Instrumentation
Spine – Anterior Instrumentation
To clinically diagnose, assess, investigate and initially manage all surgical and medical emergencies To learn to assess ABC and perform CPR
To perform
Endotracheal intubation
Peripheral and Central intravenous cannulation
Intercostal drainage tube insertion
Peritoneal aspiration
Splintage of the spine and limbs for fracture-dislocations
To learn the use of certain emergency drugs – adrenaline, atropine, dopamine, Steroids, analgesics etc.
To learn to apply
Glasgow Coma Scale (GCS)
AO classification of fractures
Gustillo Anderson grading of open fractures
Mangled Extremity Severity Scoring
To learn to communicate with patient’s attendants on death of patient

To learn to handle confidentiality issues
TEACHING PROGRAM
General Principles
Acquisition of practical competencies being the keystone of postgraduate medical education, postgraduate training is skills oriented.
Learning in postgraduate program is essentially self-directed and primarily emanating from clinical and academic work. The formal sessions are merely meant to
supplement this core effort.
Teaching Sessions
Bedside teaching rounds
Journal club
Seminar
PG case discussion
X – Ray discussion
Ortho-radiology meeting
Central session (held in hospital auditorium regarding various topics like CPC, guest lectures, student seminars, grand round, sessions on basic sciences, biostatistics,
research methodology, teaching methodology, health economics, medical ethics and legal issues).
Teaching Schedule
In addition to bedside teaching rounds, in the department there will be daily hourly sessions of formal teaching per week. The suggested time distribution of each session
for department’s teaching schedule as follows:
Journal club Once a week
Seminar Twice a week
PG case discussion Twice a week
Ortho-radiology meeting Once a month
Central session As per hospital schedule
Workshop – once every 3 months
Note:
All sessions are supervised by faculty members. It is mandatory for all residents to attend the sessions except those posted in emergency.
All the teaching sessions are assessed by the faculty members at the end of session and marks are given out of 10 and kept in the office for internal assessment.
Attendance of the residents at various sessions has to be at compulsory.
Modular System
The 5-year MS (Orthoapedics) training will be divided into modules of 03 month duration. First 02 years in General surgery (including minor rotations) and next 03 years
in Orthopaedic Surgery.
Module Training Module Name Duration Credit Hours
No. Year
I 1st Principles of General Surgery 03 months 05
II 1st Skin, soft-tissue and breast 03 months 05
III 1st Upper GastroIntestinal Surgery 03 months 05
IV 1st Lower GastoIntestinal Surgery 03 months 05
V 2nd Endocrine, Head and Neck 03 months 05
VI 2nd Orthopaedics (Minor rotation) 03 months 2.5
Urology (Minor rotation) 02 months
nd
2 Plastic / Paediatric Surgery (Minor 02 months
VII & VIII rotation) 2.5+2.5+2.5
Neurosurgery / Thoracic Surgery (Minor 02 months
rotation)
rd
IX 3 General Orthopaedics 03 months 05
X 3rd Infections & Tumors 03 months 05
XI 3rd Congenital Anomalies 03 months 05
rd
XII 3 Traumatology – Fractures & Dislocations 03 months 05
XIII 4th Sports Medicine 03 months 05
th
XIV 4 Spine 03 months 05
XV 4th The Hand 03 months 05
th
XVI 4 Foot & Ankle 03 months 05
XVII 5th Arthroplasty 03 months 05
th
XVIII 5 Arthroscopy 03 months 05
XIX 5th Plastic surgery / Anaesthesia / Paediatric 03 months 2.5
Surgery (Minor rotation)
XX 5th Rehabilitation (Minor rotation) 03 months 2.5
Total Credit Hours of the module = 90 hours
Research / Thesis credit hours = 10 hours
All modules are compulsory.
Credit hours will be awarded to the candidates after they have attended and cleared the Internal assessment of each module
MS (Orthopaedics) will comprise of 02 exams; one at the end of 2nd year of training and other on completion of 5th year of training.
Examinations
Part-I Examination
All candidates admitted in MS Orthopaedics course shall appear in Part-I examination at the end of second calendar year.
The examination shall be held on biannual basis.
The examination shall have the following components:
Written 200 Marks
OSCE 50 Marks
Clinical examination 100 Marks
Log Book Evaluation 80 Marks (40 marks per year)
There shall be two written papers of 100 marks each:
Papers 1 & 2: Principles of Surgery
The types of questions shall be of Short/Modified essay type and MCQs
(single best).
Oral & practical/clinical examination shall be held in clinical techniques
In Surgery .
To be declared successful in Part-I examination the candidate must secure 60% marks in each component and 50% in each subcomponent.
Only those candidates, who pass in theory papers, will be eligible to appear in the Oral & Practical/clinical Examination.
The candidates, who have passed written examination but failed in oral& practical/ clinical examination, will re-appear only in oral &practical/clinical examination.
The maximum number of attempts to re-appear in oral & practical/clinical Examination alone shall be three, after which the candidate shall have to appear in both
written and oral & practical/clinical examinations as a whole.
To be eligible to appear in Part-I examination the candidate must submit;duly filled, prescribed Admission Form to the Controller of Examinations duly recommended by
the Principal/Head of the Institution in which he/she is enrolled;a certificate by the Principal/Head of the Institution, that the candidate has attended at least 75% of the
lectures, seminars, practical / clinical demonstrations; Examination fee as prescribed by the University.
Part-II Examination
All candidates admitted in MS Orthopaedics course shall appear in Part-II(clinical) examination at the end of structured training programme (end of5th calendar year),
and having passed the part I examination.
However, a candidate holding FCPS / MRCS / Diplomate / equivalent qualification in Orthopaedic Surgery shall be exempted from Part-I Examination and shall be directly
admitted to Part-II Examination, subject to fulfillment of requirements for the examination.
The examination shall be held on biannual basis.
To be eligible to appear in Part-III examination the candidate must submit;
duly filled, prescribed Admission Form to the Controller of Examinations duly recommended by the Principal/Head of the Institution in which he/she is enrolled;
a certificate by the Principal/Head of the Institution, that the candidate has attended at least 75% of the lectures, seminars, practical/clinical demonstrations;
Original Log Book complete in all respect and duly signed by the Supervisor (for Oral & practical/clinical Examination);certificate of having passed the Part-I examination;
Examination fee as prescribed by the University.
The Part-II clinical examination shall have the following components:

Written 300 marks
Oral & practical/clinical examination 300 marks
Log Book Evaluation 120 marks (40 marks per year)
There shall be two written papers of 150 marks each. Both papers shall have problem-based Short/Modified essay questions and MCQs. Oral & practical/clinical
examination shall have 300 marks for:
Long Case 100
Short Cases 100(25 marks each)
OSCE 100
To be declared successful in Part-II examination the candidate must secure 60% marks in each component and 50% in each sub-component. Only those candidates, who
pass in theory papers, will be eligible to appear in the Oral & Practical/ Clinical Examination.
The candidates, who have passed written examination but failed in Oral & Practical/ Clinical Examination, will re-appear only in Oral &Practical / Clinical examination.
The maximum number of attempts to re-appear in oral & practical/clinical Examination alone shall be three, after which the candidate shall have to appear in both
written and oral & practical/clinical examinations as a whole.
The candidate with 80% or above marks shall be deemed to have passed with distinction.
Log Book/Assignments: Through out the length of the course, the performance of the candidate shall be recorded on the Log Book.
The Supervisor shall certify every year that the Log Book is being maintained and signed regularly.
The Log Book will be developed & approved by the Research Board.
The evaluation will be maintained by the Supervisor (in consultation with the Co- Supervisor, if appointed).
The performance of the candidate shall be evaluated on annual basis, e.g., 40 marks for each year in five years MS Orthopaedics course. The total marks for Log Book
shall be 200.The log book shall reflect the performance of the candidate on following parameters:
Year wise record of the competence of skills.
Year wise record of the assignments.
Year wise record of the evaluation regarding attitude &behaviour
Year wise record of journal club / lectures / presentations /clinico-pathologic conferences attended & / or made by the candidate.
Submission / Evaluation of Synopsis

The candidates shall prepare their synopsis as per guidelines provided by the Rawalpindi Medical University.
The research topic in clinical subject should have 30% component related to basic sciences and 70% component related to applied clinical sciences. The research topic
must consist of a reasonable sample size and sufficient numbers of variables to give training to the candidate to conduct research, to collect & analyze the data.
Synopsis of research project shall be submitted by the end of the 3rdyear of MS program. The synopsis after review by an Institutional Review Committee shall be
submitted to the University for Consideration by the Research Board, through the Principal / Dean /Head of the institution.
Or else, if the candidate opts for 02 research publications in PMDC and HEC recognized journals, then he will have to submit 02 research topics along with their synopsis
to the University Research Board for approval. He will undertake the study after approval from the board.
Submission of Thesis
Thesis shall be submitted by the candidate duly recommended by the Supervisor.
The minimum duration between approval of synopsis and submission of thesis shall be one year, but the thesis cannot be submitted later than 8 years of enrolment.
The research thesis must be compiled and bound in accordance with the Thesis Format Guidelines approved by the University and available on website.
The research thesis will be submitted along with the fee prescribed by the University.
Or else, the candidate can submit copies of 02 research articles published in PMDC and HEC recognized journals which had previously been accepted in the University
research board, at least 06 months prior to the examination.
LOG BOOK
The residents must maintain a log book and get it signed regularly by the supervisor. A complete and duly certified log book should be part of the requirement to sit for
MS examination. Log book should include adequate number of diagnostic and therapeutic procedures observed and performed, the indications for the procedure, any
complications and the interpretation of the results, routine and emergency management of patients, case presentations in CPCs, journal club meetings and literature
review.
Proposed Format of Log Book is as follows:

Candidate’s Name: _________________________________
Roll No. _____________
The above mentioned procedures shall be entered in the log book as per format:
Procedures Performed
Sr.# Date Name of Patient, Age, Diagnosis Procedure Supervisor’s
Sex & Admission No Performed Signature
1
2
3
4
Emergencies Handled
Sr.# Date Name of Patient, Age, Diagnosis Procedure Supervisor’s
Sex & Admission No Performed Signature
1
2
3
4
Cases Presented
Sr.# Date Name of Patient, Age, Case Presented Supervisor’s
Sex & Admission No Signature
1
2
3
4
Seminar/Journal Club Presentation
Sr.# Date Topic Supervisor’s
Signature
1
2
3
4
Evaluation Record
(Excellent, Good, Adequate, Inadequate, Poor)
At the end of the rotation, each faculty member will provide an evaluation of the clinical performance of the fellow.
Sr.# Date Method of Evaluation Supervisor’s

(Oral, Practical, Theory) Signature
Rating
1
2
3
4
EVALUATION AND ASSESSMENT STRATEGIES
Assessment
It will consist of action and professional growth oriented student-centered integrated assessment with an additional component of informal internal assessment,
formative assessment and measurement-based summative assessment.
Student-Centered Integrated Assessment It views students as decision-makers in need of information about their own performance. Integrated Assessment is meant to
give students responsibility for deciding what to evaluate, as well as how to evaluate it, encourages students to ‘own’ the evaluation and to use it as a basis for self-
improvement. Therefore, it tends to be growth-oriented, student-controlled, collaborative, dynamic, contextualized, informal, flexible and action-oriented.
In the proposed curriculum, it will be based on:
Self -Assessment by the student
Peer Assessment
Informal Internal Assessment by the Faculty
Self Assessment by the Student

Each student will be provided with a pre-designed self-assessment form to evaluate his/her level of comfort and competency in dealing with different relevant clinical
situations. It will be the responsibility of the student to correctly identify his/her areas of weakness and to take appropriate measures to address those weaknesses.
Peer Assessment
The students will also be expected to evaluate their peers after the monthly small group meeting. These should be followed by a constructive feedback according to the
prescribed guidelines and should be non judgmental in nature. This will enable students to become good mentors in future.
Informal Internal Assessment by the Faculty

There will be no formal allocation of marks for the component of Internal Assessment so that students are willing to confront their weaknesses rather than hiding them
from their instructors.
It will include:
Punctuality
Ward work
Monthly assessment (written tests to indicate particular areas of weaknesses)
Participation in interactive sessions
Formative Assessment
Will help to improve the existing instructional methods and the curriculum in use
Feedback to the faculty by the students:

After every three months students will be providing a written feedback regarding their course components and teaching methods. This will help to identify strengths and
weaknesses of the relevant course, faculty members and to ascertain areas for further improvement.
Summative Assessment
It will be carried out at the end of the programme to empirically evaluate cognitive, psychomotor and affective domains in order to award diplomas for successful
completion of courses.
MS ORTHOPAEDICS EXAMINATION - DETAIL

Part I- MS Orthopaedics Examination
Total Marks: 430
All candidates admitted in MS Orthopaedics course shall appear in Part I examination at the end of second calendar year.
There shall be two written papers of 100 marks each, Oral & practical/clinical examination of 150 marks and log book assessment of 80 marks.
Topics included in papers 1 & 2:

Basic Principles of Surgery
Components of Part I Examination

Theory:
Paper 1: 100 Marks 3 Hours
10 SEQs (No Choice; 05 marks each) 50 Marks
50 MCQs 50 Marks
Paper 2: 100 Marks 3 Hours
10 SEQs (No Choice; 05 marks each) 50 Marks
50 MCQs 50 Marks
Only those candidates, who pass in theory papers, will be eligible to appear in the Oral & Practical/Clinical Examination.
Oral & Practical/ Clinical Examination shall be held in clinical techniques relevant to Surgery .
OSCE 50 Marks
10 stations each carrying 05 marks of 10 minutes duration; each
evaluating performance based assessment with five of them interactive
Clinical 100 Marks
Four short cases (each 15 marks) 60 Marks
One long case: 40 Marks
Log Book 80 Marks

Part II MS ORTHOPAEDICS
Total Marks: 920
All candidates admitted in MS Orthopaedics course shall appear in Part-II examination at the end of structured training programme (end of 5thcalendar year and after
clearing Part I examination).
There shall be two written papers of 150 marks each, Oral & Practical/Clinical examination of 300 marks, log book assessment of 120 marks and thesis examination of 200
marks.
Clinical Examination
Total Marks: 720
Topics included in paper 1

Adult Orthopaedics
Trauma (15 MCQs)
Joints (10MCQs)
Infections (10 MCQs)
Neuromuscular Disorders & Spine (10MCQs)
Hand, Foot and Ankle (10MCQs)
Amputation, Prosthetics and Orthotics (10MCQs)
Tumors (05MCQs)
Sports Medicine & Pain (05MCQs)
Topics included in paper 2

Paediatric Orthopaedics
Congenital Disorders (15MCQs)
Trauma (10 MCQs)
General Affections of Bones (10MCQs)
Infections of Bones and Joints (10 MCQs)
Affections of Joints & Muscles (10 MCQs)
Neuromuscular Disorders & Spine (10MCQs)
Affections of Nervous System (05MCQs)
Tumors (05MCQs)
Components of Part II Clinical Examination

Theory
Paper I 150 Marks 3 Hours
15 SEQs (No Choice) 75 Marks
75 MCQs 75 Marks
Paper II 150 Marks 3 Hours
15 SEQs (No Choice) 75 Marks
75 MCQs 75 Marks
Only those candidates, who pass in theory papers, will be eligible to appear
in the Oral & Practical/ Clinical Examination.
OSCE 100 Marks
10 stations each carrying 10 marks of 10 minutes duration; each
evaluating performance based assessment with five of them interactive
Clinical 200 Marks
Four short cases (each 25 marks) 100 Marks
One long case: 100 Marks
Log Book 120 Marks
Thesis Examination
Total Marks: 200
All candidates admitted in MS Orthopaedics course shall appear in Part-II
Examination at the end of 5th year of the MS programme and not
later than 8th calendar year of enrolment. The examination shall include
thesis evaluation with defense.
RECOMMENDED BOOKS
Core books
Apley’s System of Orthopaedics& Fractures
Campbell’s Operative Orthopaedics
Mercer’s Orthopaedic Surgery
Mc Rae – Clinical Examination
Hamilton Bailey Demonstration of Clinical Signs & Symptoms
Snell’s Anatomy
Pye’s Surgical Handicraft
Stewart’s Manual
Reference books
Rockwood & Green – Fractures in Adults
Rockwood & Green – Fractures in Children
Chapman Orthopaedic Surgery
Turek’s Textbook of Orthopaedics
Hoppen field – Surgical Exposures
Mc Rae – Surgical Exposures
Insall& Scott – Surgery of the Knee
Miller & Cole Textbook of Arthroscopy
Tachdjian Paediatric Orthopaedics
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Section-1
MORNING REPORT PRESENTATION/ CASE PRESENTATION SEEN IN LAST EMERGENCY OR INDOOR
SR# DATE REG# OF BRIEF DESCRIPTION//HISTORY, DIAGNOSIS,TREATMENT SUPERVISOR’S SUPERVISOR’S

PATIENT & OUTCOME IF ANY REMARKS SIGNATURE
(Name/Stamp)
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(Name/Stamp)
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(Name/Stamp)
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(Name/Stamp)
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(Name/Stamp)
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Section-2
TOPIC PRESENTATION/SEMINAR
SR# DATE NAME OF THE TOPIC & BRIEF DETAILS OF THE ASPECTS COVERED SUPERVISOR’S SUPERVISOR’S
REMARKS SIGNATURE
(Name/Stamp)
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SR# DATE NAME OF THE TOPIC & BRIEF DETAILS OF THE ASPECTS COVERED SUPERVISOR’S SUPERVISOR’S
REMARKS SIGNATURE
(Name/Stamp)
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Section-3
JOURNAL CLUB
SR# DATE TITLE OF THE ARTICLE NAME OF JOURNAL DATE OF SUPERVISOR’S SUPERVISOR’S
PUBLICATION REMARKS SIGNATURE
(Name/Stamp)
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SR# DATE TITLE OF THE ARTICLE NAME OF JOURNAL DATE OF SUPERVISOR’S SUPERVISOR’S
PUBLICATION REMARKS SIGNATURE
(Name/Stamp)
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Section-4
PROBLEM CASE DISCUSSION
SR # DATE REG.# OF THE PATIENT BRIEF DESCRIPTION//HISTORY, SUPERVISOR’S SUPERVISOR’S

DISCUSSED DIAGNOSIS,TREATMENT REMARKS SIGNATURE
& OUTCOME IF ANY (Name/Stamp)
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SR # DATE REG.# OF THE PATIENT BRIEF DESCRIPTION//HISTORY, SUPERVISOR’S SUPERVISOR’S
DISCUSSED DIAGNOSIS,TREATMENT REMARKS SIGNATURE
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Section-5
DIDACTIC LECTURES/INTERACTIVE LECTURES
SR # DATE TOPIC & BRIEF DESCRIPTION NAME OF THE SUPERVISOR’S SUPERVISOR’S
TEACHER REMARKS SIGNATURE
(Name/Stamp)
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(Name/Stamp)
Page | 82
(Name/Stamp)
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Section- EMERGENCY CASES (Repetition of Cases Should Be Avoided)
(Estimated 50 cases to be documented/Year)
(8 cases/month)
SR# DATE REG # OF THE BRIEF DESCRIPTION//HISTORY, PROCEDURES SUPERVISOR’S SUPERVISOR’S
PATIENT DIAGNOSIS,TREATMENT PERFORMED REMARKS SIGNATURE
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Section-7
INDOOR PATIENTS (repetition of cases should be avoided)
(Estimated cases to be attended are 50 patients per year)
SR# DATE REG # OF THE DIAGNOSIS MANAGEMENT PROCEDURES SUPERVISOR’S SUPERVISOR’S

PATIENT PERFORMED REMARKS SIGNATURE
(Name/Stamp)
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(Name/Stamp)
Page | 90
(Name/Stamp)
Page | 91
(Name/Stamp)
Page | 92
R# DATE REG # OF THE DIAGNOSIS MANAGEMENT PROCEDURES SUPERVISOR’S SUPERVISOR’S
(Name/Stamp)
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Section-8
OPD AND CLINICS (repetition of cases should be avoided)
(Estimated cases to be attended are 100 patients per month)
SR# DATE REG # OF THE BRIEF DESCRIPTION//HISTORY, DIAGNOSIS,TREATMENT SUPERVISOR’S SUPERVISOR’S
(Name/Stamp)
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(Name/Stamp)
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(Name/Stamp)
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(Name/Stamp)
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(Name/Stamp)
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R# DATE REG # OF THE BRIEF DESCRIPTION//HISTORY, DIAGNOSIS,TREATMENT SUPERVISOR’S SUPERVISOR’S
(Name/Stamp)
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Section-9
MEDICAL PROCEDURES
OBSERVED (O)/ASSISTED (A)/ PERFORMED UNDER SUPERVISION (PUS)/PERFORMED INDEPENDENTLY (PI)
SR.# DATE REGNO. NAME OF (O)/(A)/(PUS)/ DETAIL OF PROCEDURE PLACE OF SUPERVISOR’S SUPERVISOR’S
OF PROCEDURE (PI) PROCEDURE REMARKS SIGNATURE
PATIENT (Name/Stamp)
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SR.# DATE REG NO. OF NAME OF (O)/(A)/(PUS)/ DETAIL OF PROCEDURE PLACE OF SUPERVISOR’S SUPERVISOR’S
PATIENT PROCEDURE (PI) PROCEDURE REMARKS SIGNATURE
(Name/Stamp)
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SR.# DATE REG NO. OF NAME OF (O)/(A)/(PUS)/ DETAIL OF PROCEDURE PLACE OF SUPERVISOR’S SUPERVISOR’S
PATIENT PROCEDURE (PI) PROCEDURE REMARKS SIGNATURE
(Name/Stamp)
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SR.# DATE REG NO. OF NAME OF (O)/(A)/(PUS) DETAIL OF PROCEDURE PLACE OF SUPERVISOR’S SUPERVISOR’S
PATIENT PROCEDURE / (PI) PROCEDURE REMARKS SIGNATURE
(Name/Stamp)
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SR.# DATE REG NO. OF NAME OF (O)/(A)/(PUS) DETAIL OF PROCEDURE PLACE OF SUPERVISOR’S SUPERVISOR’S
PATIENT PROCEDURE / (PI) PROCEDURE REMARKS SIGNATURE
(Name/Stamp)
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SECTION-10
MULTI DICIPLINARY MEETINGS
SR# DATE BRIEF DESCRIPTION SUPERVISOR’S SUPERVISOR’S

REMARKS SIGNATURE
(Name/Stamp)
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SR# DATE BRIEF DESCRIPTION SUPERVISOR’S SUPERVISOR’S
REMARKS SIGNATURE
(Name/Stamp)
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SECTION-11
CLINICOPATHOLOGICAL CONFERENCE (CPC)
(50% attendance of CPC is mandatory for the resident every year)
SR# DATE BRIEF DESCRIPTION OF THE TOPIC/CASE DISCUSSED SUPERVISOR’S

SIGNATURE
(Name/Stamp)
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SIGNATURE
(Name/Stamp)
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SIGNATURE
(Name/Stamp)
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SECTION-12
MORBIDITY/MORTALITY MEETINGS
(Total Morbidity/Mortality Meetings to be attended TWO Morbidity/Mortality Meetings per month)
SR# DATE REG. # OF THE BRIEF DESCRIPTION OF THE CASE SUPERVISOR’S SUPERVISOR’S
PATIENT REMARKS SIGNATURE
DISCUSSED (Name/Stamp)
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SR# DATE REG. # OF THE BRIEF DESCRIPTION OF THE CASE SUPERVISOR’S SUPERVISOR’S
PATIENT REMARKS SIGNATURE
DISCUSSED (Name/Stamp)
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SECTION-13
HANDS ON TRAINING/WORKSHOPS
SR# DATE TITLE VENUE FACILITATOR SUPERVISOR’S SUPERVISOR’S

REMARKS SIGNATURE
(Name/Stamp)
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SR# DATE TITLE VENUE FACILITATOR SUPERVISOR’S SUPERVISOR’S
REMARKS SIGNATURE
(Name/Stamp)
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SECTION-14
PUBLICATIONS
SNO. NAME OF TYPE OF PUBLICATION NAME OF DATE OF PAGE SUPERVISOR’S SUPERVISOR’S

PUBLICATION ORIGINAL ARTICLE JOURANL PUBLICATION NO. REMARKS SIGNATURE
/EDITORIAL/CASE REPORT ETC (Name/Stamp)
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SNO. NAME OF TYPE OF PUBLICATION NAME OF DATE OF PAGE SUPERVISOR’S SUPERVISOR’S
PUBLICATION ORIGINAL ARTICLE JOURANL PUBLICATION NO. REMARKS SIGNATURE
/EDITORIAL/CASE REPORT ETC (Name/Stamp)
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SECTION-15
MAJOR RESEARCH PROJECT DURING MD TRAINING/ANY OTHER MAJOR RESEARCH PROJECT
SNO. RESEARCH TOPIC PLACE OF RESEARCH NAME AND SUPERVISOR’S SUPERVISOR’S

DESIGNATION OF REMARKS SIGNATURE
SUPERVISOR (Name/Stamp)
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SNO. RESEARCH TOPIC PLACE OF RESEARCH NAME AND SUPERVISOR’S SUPERVISOR’S
DESIGNATION OF REMARKS SIGNATURE
SUPERVISOR (Name/Stamp)
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SECTION-1
WRITTEN ASSESSMENT RECORD
S.NO TOPIC OF WRITTEN TYPE OF THE TEST TOTAL MARKS MARKS SUPERVISOR’S SUPERVISOR’S
TEST/EXAMINATION MCQS OR SEQS OR BOTH OBTAINED REMARKS SIGNATURE
(Name/Stamp)
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S.NO TOPIC OF WRITTEN TYPE OF THE TEST TOTAL MARKS MARKS SUPERVISOR’S SUPERVISOR’S
TEST/EXAMINATION MCQS OR SEQS OR BOTH OBTAINED REMARKS SIGNATURE
(Name/Stamp)
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SECTION-17
CLINICAL ASSESSMENT RECORD
SR.# DATE TOPIC OF TYPE OF THE TEST& VENUE TOTAL MARKS SUPERVISOR’S SUPERVISOR’S
CLINICAL TEST/ (OSPE, MINICEX, CHART MARKS OBTAINED REMARKS SIGNATURE
EXAMINATION STIMULATED RECALL, DOPS, (Name/Stamp)
SIMULATED PATIENT, SKILL LAB
e.t.c)
Page | 120
SR.# DATE TOPIC OF TYPE OF THE TEST& VENUE TOTAL MARKS SUPERVISOR’S SUPERVISOR’S
CLINICAL TEST/ OSPE, MINICEX, CHART MARKS OBTAINED REMARKS SIGNATURE
EXAMINATION STIMULATED RECALL, DOPS, (Name/Stamp)
SIMULATED PATIENT, SKILL LAB
e.t.c
Page | 121
SECTION-18
To Be Filled At the End of 1st Year of
Evaluation records Training
RAWALPINDI MEDICAL UNIVERSITY
SUPERVISOR APPRAISAL FORM
Resident’sName: HospitalName:
Evaluator’sName(s): Department: Unit:
1. Use one of the followin g ratings to describ e the p erformance of the individual in each of the categories.
1 Unsatisfactory Performance does not meet expectations forthe job

2 Needs Improvement Performance sometimes meets expectations for the job
3 Good Performance often exceeds expectations for the job
4 Merit Performance consistently meets expectations for the job
5 Special Merit Performance consistently exceeds expectations for the job
I. CLINICAL KNOWLEDGE / TECHNICAL SKILLS 5 4 3 2 1

a) Clinical Knowledge is up to the mark
b) Follows procedures and clinical methods according to SOPs
c) Uses techniques, materials, tools & equipment skillfully
d) Stays current with technology and job-related expertise
e) Works efficiently in various workshops
f) Has interest in learning new skills and procedures
g) Understands & performs assigned duties and job requirements
II. QUALITY / QUANTITY OF WORK 5 4 3 2 1
a) Sets and adheres to protocols and improving the skills
b) Exihibts system based learning methods smartly
c) Exihibts practice based learning methods efficaciously
d) Actively participates in large group interactive sessions for postgraduate trainees
e) Actively takes part in morning& evening teaching and learning sessions & noon conferences
f) Actively takes part in Multidisciplinary Clinic O Pathological Conferences (CPC)
g)Actively participates in Journal clubs
h) Uses resources sensibly and economically
Page | 122
i) Accomplishes accurate management of different medical cases with minimal assistance or
supervision
j) Provides best possible patient care
III. INITIATIVE / JUDGMENT 5 4 3 2 1
a) Takes effective action without being told
b) Analyzes different emergency cases and suggests effective solutions
c) Develops realistic plans to accomplish assignments
IV. DEPENDABILITY / SELF-MANAGEMENT 5 4 3 2 1
a) Demonstrates punctuality and regularly begins work as scheduled
b) Contacts supervisor concerning absences on a timely basis
c) Contacts supervisor without any delay regarding any difficulty in managing any patient
d) Can be depended upon to be available for work independently
e) Manages own time effectively
f) Manages Outdoor Patient Department (OPD) efficiently
g) Accepts responsibility for own actions and ensuing results
h) Demonstrates commitment to service
i) Shows Professionalism in handling patients
j) Offers assistance, is courteous and works well with colleagues
k) Is respectful with the seniors
OVERALL RATINGS/SUGGESTIONS/REMARKS REGARDING PERFORMANCE OF THE TRAINEE
Total Score /155
Date Resident’sName&Signatures Date Evaluator’s Signature &Stamp
Page | 123
RAWALPINDI MEDICAL UNIVERSITY To Be Filled At The End Of 2nd Year Of
SUPERVISOR APPRAISAL FORM Training
1 Unsatisfactory Performance does not meet expectations for thejob

Page | 124
supervision
TotalScore /155
Page | 125
RAWALPINDI MEDICAL UNIVERSITY To Be Filled At the End Of 3rd Year Of


supervision
Page | 126
TotalScore /155
Page | 127
RAWALPINDI MEDICAL UNIVERSITY To Be Filled At The End Of 4th Year Of


Page | 128
supervision
TotalScore /155

Page | 129
SECTION-18
EVALUATION / REMARKS BY UNIVERSITY TRAINING MONITORING CELL (UTMC) WORKING UNDER DEPARTMENT OF MEDICAL
EDUCATION (DME)
(AT THE END OF 1ST YEAR OF TRAINING)
Page | 130
SECTION-18
EDUCATION (DME)
(AT THE END OF 2ND YEAR OF TRAINING)
Page | 131
SECTION-18
EDUCATION (DME)
(AT THE END OF 3RD YEAR OF TRAINING)
Page | 132
SECTION-18
EDUCATION (DME)
(AT THE END OF 4th YEAR OF TRAINING)
Page | 133
SECTION=18
EVALUATION / REMARKS BY QUALITY ENHANCEMENT CELL (QEC) WORKING UNDER DEPARTMENT OF MEDICAL EDUCATION (DME)
(AT THE END OF 1ST YEAR OF TRAINING)
Page | 134
SECTION=18
(AT THE END OF 2ND YEAR OF TRAINING)
Page | 135
SECTION-18
(AT THE END OF 3RD YEAR OF TRAINING)
Page | 136
SECTION-18
(AT THE END OF 4th YEAR OF TRAINING)
Page | 137
SECTION-19
LEAVE RECORD
(Signed & Approved Leave Application/Certificate to Be Kept In Record and To Be Brought In Meetings with URTMC & QEC)
SR.# TYPE OF LEAVE(Casual Leave, YEAR DATE REASON SUPERVISOR’S SUPERVISOR’S

Sick Leave, Ex –Pak Leave, REMARKS SIGNATURE
FROM TO
Maternity Leave, Any Other Kind (Name/Stamp)
Of Leave)
Page | 138
SECTION-20 Year - I
RECORD SHEET OF ATTENDANCE/COUNCELLING SESSION/DOCUMENTATION QUALITY PER YEAR
TO BE FILLED AT THE END OF FIRST YEAR OF TRAINING

ATTENDANCE RECORD DOCUMENTATION QUALITY COUNCELLING SESSION
MONTH
SUPERVISOR’S REMARKS
IF YES THEN SIGNATURE
V.
TOTAL ATTENDED % Poor Average Good Excellent YES NO NUMBER OF (Name/Stamp)
Good SESSIONS
WARD
January
CPC
LECTURE
WORKSHOP

MONTH
V.
Good SESSIONS
WARD
February
CPC
LECTURE
WORKSHOP

MONTH
V.
Good SESSIONS
WARD
March
CPC
LECTURE
WORKSHOP
Page | 139
Year - I
MONTH ATTENDANCE RECORD DOCUMENTATION QUALITY COUNCELLING SESSION
V.
Good SESSIONS
WARD
CPC
April
LECTURE
WORKSHOP

MONTH
V.
Good SESSIONS
WARD
CPC
May
LECTURE
WORKSHOP

MONTH
V.
Good SESSIONS
WARD
CPC
June
LECTURE
WORKSHOP
Page | 140
Year - I
V.
Good SESSIONS
WARD
CPC
July
LECTURE
WORKSHOP

MONTH
V.
Good SESSIONS
WARD
August
CPC
LECTURE
WORKSHOP

MONTH
V.
Good SESSIONS
WARD
September
CPC
LECTURE
WORKSHOP
Page | 141
Year - I
V.
Good SESSIONS
WARD
October
CPC
LECTURE
WORKSHOP

MONTH
V.
Good SESSIONS
WARD
November
CPC
LECTURE
WORKSHOP

MONTH
V.
Good SESSIONS
WARD
December
CPC
LECTURE
WORKSHOP
Page | 142
Year - II
TO BE FILLED AT THE END OF SECOND YEAR OF TRAINING
MONTH
V.
Good SESSIONS
WARD
January
CPC
LECTURE
WORKSHOP

MONTH
V.
Good SESSIONS
WARD
February
CPC
LECTURE
WORKSHOP

MONTH
V.
Good SESSIONS
WARD
March
CPC
LECTURE
WORKSHOP
Page | 143
Year - II
V.
Good SESSIONS
WARD
CPC
April
LECTURE
WORKSHOP

MONTH
V.
Good SESSIONS
WARD
CPC
May
LECTURE
WORKSHOP

MONTH
V.
Good SESSIONS
WARD
CPC
June
LECTURE
WORKSHOP
Page | 144
Year - II
V.
Good SESSIONS
WARD
CPC
July
LECTURE
WORKSHOP

MONTH
V.
Good SESSIONS
WARD
August
CPC
LECTURE
WORKSHOP

MONTH
V.
Good SESSIONS
WARD
September
CPC
LECTURE
WORKSHOP
Page | 145
Year - II
V.
Good SESSIONS
WARD
October
CPC
LECTURE
WORKSHOP

MONTH
V.
Good SESSIONS
WARD
November
CPC
LECTURE
WORKSHOP

MONTH
V.
Good SESSIONS
WARD
December
CPC
LECTURE
WORKSHOP
Page | 146
Year - III
TO BE FILLED AT THE END OF THIRD YEAR OF TRAINING
MONTH
V.
Good SESSIONS
WARD
January
CPC
LECTURE
WORKSHOP

MONTH
V.
Good SESSIONS
WARD
February
CPC
LECTURE
WORKSHOP

MONTH
V.
Good SESSIONS
WARD
March
CPC
LECTURE
WORKSHOP
Page | 147
Year - III
V.
Good SESSIONS
WARD
CPC
April
LECTURE
WORKSHOP

MONTH
V.
Good SESSIONS
WARD
CPC
May
LECTURE
WORKSHOP

MONTH
V.
Good SESSIONS
WARD
CPC
June
LECTURE
WORKSHOP
Page | 148
Year - III
V.
Good SESSIONS
WARD
CPC
July
LECTURE
WORKSHOP

MONTH
V.
Good SESSIONS
WARD
August
CPC
LECTURE
WORKSHOP

MONTH
V.
Good SESSIONS
WARD
September
CPC
LECTURE
WORKSHOP
Page | 149
Year - III
V.
Good SESSIONS
WARD
October
CPC
LECTURE
WORKSHOP

MONTH
V.
Good SESSIONS
WARD
November
CPC
LECTURE
WORKSHOP

MONTH
V.
Good SESSIONS
WARD
December
CPC
LECTURE
WORKSHOP
Page | 150
Year - IV
TO BE FILLED AT THE END OF FOURTH YEAR OF TRAINING
MONTH
V.
Good SESSIONS
WARD
January
CPC
LECTURE
WORKSHOP

MONTH
V.
Good SESSIONS
WARD
February
CPC
LECTURE
WORKSHOP

MONTH
V.
Good SESSIONS
WARD
March
CPC
LECTURE
WORKSHOP
Page | 151
Year - IV

V.
Good SESSIONS
WARD
CPC
April
LECTURE
WORKSHOP

MONTH
V.
Good SESSIONS
WARD
CPC
May
LECTURE
WORKSHOP

MONTH
V.
Good SESSIONS
WARD
CPC
June
LECTURE
WORKSHOP
Page | 152
Year - IV
V.
Good SESSIONS
WARD
CPC
July
LECTURE
WORKSHOP

MONTH
V.
Good SESSIONS
WARD
August
CPC
LECTURE
WORKSHOP

MONTH
V.
Good SESSIONS
WARD
September
CPC
LECTURE
WORKSHOP
Page | 153
Year - IV
V.
Good SESSIONS
WARD
October
CPC
LECTURE
WORKSHOP

MONTH
V.
Good SESSIONS
WARD
November
CPC
LECTURE
WORKSHOP

MONTH
V.
Good SESSIONS
WARD
December
CPC
LECTURE
WORKSHOP
Page | 154
SECTION-21
ANY OTHER IMPORTANT AND RELEVANT INFORMATION/DETAILS
Page | 155
SECTION-21
ANY OTHER IMPORTANT AND RELEVANT INFORMATION/DETAILS
Page | 156

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UNIVERSITY RESIDENCY PROGRAM -2019

LOG BOOK FOR ORTHOPAEDIC SURGERY

SR. NAME & DESIGNATION CONTRIBUTIONS IN FORMULATION OF LOG BOOK OF ORTHOPAEDICS

Date of Start ofTraining

Date of Completion ofTraining

Title of department /Unit

1. MORNING REPORT PRESENTATION/CASEPRESENTATION 13. HANDS ONTRAINING/WORKSHOPS

2. TOPIC PRESENTATION/SEMINAR 14. PUBLICATIONS

3. ORTHOPAEDICS LECTURES/INTERACTIVELECTURES 15. MAJOR RESEARCH PROJECT DURING MSTRAINING/ANY

4. JOURNALCLUB OTHER MAJOR RESEARCHPROJECT

5. PROBLEM CASEDISCUSSION 16. WRITTEN ASSESMENTRECORD

6. EMERGENCY CASES 17. CLINICAL ASSESMENTRECORD

7. INDOORPATIENTS 18. EVALUATION RECORD

8. OPD ANDCLINICS 19. LEAVERECORD

9. PROCEDURES (OBSERVED, ASSISTED,PERFORMED 20. RECORD SHEET OFATTENDANCE/COUNCELLING

UNDER SUPERVISION & PERFORMEDINDEPENDENTLY) SESSION/DOCUMENTATIONQUALITY

10. MULTIDISCIPLINARYMEETINGS 21. ANY OTHER IMPORTANT ANDRELEVANT

SR.NO ENTRY Minimum cases /Time duration

01 Case presentation 02 per month

02 Topic presentation 01 per month

03 Journal club 01 per month

04 Bed side teaching 25 per month

05 Large group teaching 08 per month

06 Emergency cases 15 per month

07 OPD 80 per month

08 Indoor (patients allotted) 10per month plus participation in

09 Directly observed procedures 85 per month

10 CPC 02 per month

11 Mortality & Morbidity 02 per month

Note: Levels 4 and 5 for practical purposes are almost synonymous

Masters in Orthopaedics (MS)

The applicant scoring a minimum of 60% marks will be considered pass.

OBJECTIVES OF THE COURSE

SYLLABUS OF THE COURSE

Peripheral Nerve Injuries

The Foot and Ankle

To learn to communicate with patient’s attendants on death of patient

Research / Thesis credit hours = 10 hours

All modules are compulsory.

The Part-II clinical examination shall have the following components:

Submission / Evaluation of Synopsis

Proposed Format of Log Book is as follows:

Sr.# Date Method of Evaluation Supervisor’s

Self Assessment by the Student

Informal Internal Assessment by the Faculty

Feedback to the faculty by the students:

MS ORTHOPAEDICS EXAMINATION - DETAIL

Topics included in papers 1 & 2:

Components of Part I Examination

Log Book 80 Marks

Topics included in paper 1

Topics included in paper 2

Components of Part II Clinical Examination

SR# DATE REG# OF BRIEF DESCRIPTION//HISTORY, DIAGNOSIS,TREATMENT SUPERVISOR’S SUPERVISOR’S

SR # DATE REG.# OF THE PATIENT BRIEF DESCRIPTION//HISTORY, SUPERVISOR’S SUPERVISOR’S

SR# DATE REG # OF THE DIAGNOSIS MANAGEMENT PROCEDURES SUPERVISOR’S SUPERVISOR’S

SR# DATE BRIEF DESCRIPTION SUPERVISOR’S SUPERVISOR’S

(50% attendance of CPC is mandatory for the resident every year)