PERPETUAL SUCCOUR HOSPITAL

POST GRADUATE INTERNSHIP TRAINING 2020 - 2021

CHECKLIST OF MINIMUM COMPETENCIES

DEPARTMENT OF OBSTETRICS AND GYNECOLOGY

Name: __________________________________ Group: _____ Rotation Dates: __________________________ PGI Monitor: ________________________

Signature Over Printed Name of

Case Initial / Supervised
Procedure Performed Diagnosis Monitor /Resident-in-Charge /
Hospital No. (Yes or No) Consultant
History & PE

1 Date:

2 Date:

3 Date:

4 Date:

5 Date:
 PERPETUAL SUCCOUR HOSPITAL
POST GRADUATE INTERNSHIP TRAINING 2020 - 2021

CHECKLIST OF MINIMUM COMPETENCIES

DEPARTMENT OF OBSTETRICS AND GYNECOLOGY

Name: __________________________________ Group: _____ Rotation Dates: __________________________ PGI Monitor: ________________________

Signature Over Printed Name of

Case Initial / Supervised
Procedure Performed Diagnosis Monitor /Resident-in-Charge /
Hospital No. (Yes or No) Consultant
NORMAL SPONTANEOUS DELIVERIES
Perineal Support
1 Date:
Episiotomy and
Episiorrhapy
2 Date:
PRENATAL CHECK-UPS

1 Date:

2 Date:

3 Date:

4 Date:
PAPSMEAR / KOH / GRAM STAIN SMEARS

1 Date:

2 Date:
 PERPETUAL SUCCOUR HOSPITAL
POST GRADUATE INTERNSHIP TRAINING 2020 - 2021

CHECKLIST OF MINIMUM COMPETENCIES

DEPARTMENT OF OBSTETRICS AND GYNECOLOGY

Name: __________________________________ Group: _____ Rotation Dates: __________________________ PGI Monitor: ________________________

Signature Over Printed Name of

Case Initial / Supervised
Procedure Performed Diagnosis Monitor /Resident-in-Charge /
Hospital No. (Yes or No) Consultant
LEOPOLD’S MANEUVER

1 Date:

2 Date:
PELVIC EXAMINATION

1 Date:

2 Date:
ASSIST IN OB SURGERIES

1 Date:

2 Date:
ASSIST IN GYNECOLOGICAL SURGERIES

1 Date:

2 Date:
 PERPETUAL SUCCOUR HOSPITAL
POST GRADUATE INTERNSHIP TRAINING 2020 - 2021

CHECKLIST OF MINIMUM COMPETENCIES

DEPARTMENT OF OBSTETRICS AND GYNECOLOGY

Name: __________________________________ Group: _____ Rotation Dates: __________________________ PGI Monitor: ________________________

Signature Over Printed Name of

Case Initial / Supervised
Procedure Performed Diagnosis Monitor /Resident-in-Charge /
Hospital No. (Yes or No) Consultant
OTHERS

1 Date:

2 Date:

3 Date:

4 Date:

5 Date:
ADDITIONAL ACTIVITIES
SUTURING WORKSHOP / REMARKS:
1 Date: DEMONSTRATION
MOTHERS’ CLASS TOPICS DISCUSSED / ATTENDED:
2 Date: