AMCMET MEDICAL COLLEGE

AHMEDABAD-380008
GUJARAT, INDIA

LOGBOOK

DEPARTMENT OF
OTORHINOLARYNGOLOGY
 INDEX

SR. NO. TOPIC PAGE NO.

1 CERTIFICATE
2 STUDENTS’ BIODATA
3 INSTRUCTION
4 STUDENTS’ APPRAISAL FORM
5 EXPLANATION OF COMPETENCY TABLES
6 COMPETENCY TABLE
7 CASE HISTORY
8 INSTRUMENTS
9 DAILY ACTIVITY
10 SKILL DEVELOPMENT DETAILS
11 SELF DIRECTED LEARNING
12 REFLECTIVE WRITING
13 ATTENDANCE RECORD
14 ASSESSMENT

AMCMET MEDICAL COLLEGE

AHMEDABAD - 380008
GUJARAT, INDIA
 CERTIFICATE
This is to certify that...............................................................has
undergone the required training for .............................................
from AMCMET MEDICAL COLLEGE Ahmedabad (GUJARAT
UNIVERSITY) from ................. to ................

The procedures and academic activities recorded in log book are as

per the institutional records and have been carried out under
guidance of faculty members of AMCMET MEDICAL COLLEGE.

Co-ordinator Head of
department Dean
 BIODATA

NAME OF STUDENT:
DEPARTMENT:
FATHER/HUSBAND’S NAME:
PERMANENT ADDRESS:

PHONE NUMBER:
DATE OF BIRTH:
COLLEGE/UNIVERSITY/STATE:
YEAR AND MONTH OF JOINING UG:
THE LOG BOOK ADDRESSES PERFORMANCE IN THE FOLLOWING
AREAS:

1. ACADEMICS
 Regularity and performance of UG activities shall be assessed. You are expected
to maintain a record of case presentation, seminars and group discussion.

(2) SKILL DEVELOPMENT

 A record of the procedures observed, assisted and performed shall be
maintained in the log book.

(3) PERSONAL (PROFESSIONAL ATTRIBUTES)

 A student is expected to imbibe professional attributes of honesty, integrity,
accountability, honour, humanism and excellence and demonstrate the same in
his/her day-to-day conduct and dealings with teachers, peers, the nursing and
the paramedical staff and most importantly the patients. To ensure that you are
able to acquire these attributes, your personal conduct shall be keenly observed
by your teachers and you shall be counselled as and when required.

(4) ASSESSMENT
 All the students would be assessed periodically.

(5) GENERAL PRINCIPALS

 The assessment would be valid, objective and reliable.
 It would cover cognitive, psychomotor and affective domains.
 UG Student Appraisal Form (Term …. Sem ….)
Name of Department:
Name of student:
Period of training:

Sr Particulars Not satisfactory More than Remarks

no. satisfactory satisfactory

1 Patient based/Laboratory or
skill based learning

2 Self directed learning

3 Departmental and
interdepartmental learning
activity

4 Log book maintenance

Remarks:..................................................................................................................................

REMARKS: Any significant positive or negative attributes of a student to be mentioned. For

score less than 4 in any category, remediation must be suggested. Individual feedback to
students is strongly recommended.

SIGNATURE OF ASSESSEE SIGNATURE OF CONSULTANT SIGNATURE OF HOD

 UG Student Appraisal Form (Term …. Sem ….)
Name of Department:
Name of student:
Period of training:

Sr Particulars Not satisfactory More than Remarks

no. satisfactory satisfactory

1 Patient based/Laboratory or
skill based learning

2 Self directed learning

3 Departmental and
interdepartmental learning
activity

4 Log book maintenance

Remarks:..................................................................................................................................

REMARKS: Any significant positive or negative attributes of a student to be mentioned. For

score less than 4 in any category, remediation must be suggested. Individual feedback to
students is strongly recommended.

SIGNATURE OF ASSESSEE SIGNATURE OF CONSULTANT SIGNATURE OF HOD

 Explanation of each column in the competency Tables

1. The number of the competency addressed includes the subject initial and number

e.g., EN 2.1

2. Name of activity: e.g., Seminar or Group discussion

3. Date the activity gets completed

4. Attempt at activity by learner: Indicated as:

a. First (F) attempt

b. Repeat (R) of a previously done activity

c. Remedial activity (Re) based on the determination by the faculty

5. Rating - Use one of three grades:

a. Below expectations (B)

b. Meets expectations (M)

c. Exceeds expectations (E)

6. Decision of faculty

a. C: activity is completed, therefore closed and can be

certified, if needed

b. R: activity needs to be repeated without any further

intervention

c. Re: activity needs remedial action (usually done after repetition did not lead
to satisfactory completion)
7. Signature of faculty indicating the completion or other determination

8. Signature of the learner if feedback has been received.1. The number of the
competency addressed includes the subject initial and number e.g., EN 2.1 2. Name of
activity: e.g., Seminar or Group discussion
 Competency Table

Competenc Competency Phase Date Atte Rating Decis Faculty Feedbac

y number name of mpt ion k Recei
signat
of fa ved
com (F/R/ (B/M/ ure wi
culty &
pleti Re) E) th date
on (C/R/R
signature
e)
of learner

EN 1.2 ORIENTATION
ABOUT ENT
EN 2.9 DISEASES

EN 2.1 HISTORY
TAKING
EN 2.12
A) DETAIL
EN 4.1 HISTORY
TAKING
EN 4.2 AND
SYMPTO
EN 4.6
MATOL
OGY
EN 4.12
OF EAR
EN 4.22 B) DETAIL
HISTORY
EN 4.27 TAKING
AND
EN 4.28 SYMPTO
MATOL
EN 4.29 OGY OF
NOSE
EN 4.4 C) DETAIL
HISTORY
TAKING
AND
SYMPTO
MATOL
OGY OF
THROAT
(LARYNX
+
PHARYN
X)
D) COUNSE
LLING
AND
INFORM
ED
 CONSEN
T

EN 2.10 OPD
INSTRUMENTS

EN 2.2 DEMONSTRATIO
N OF CORRECT
USE OF HEAD
LAMP

EN 2.3 EXAMINATION
OF EAR WITH
EN 3.1 OTOSCOPY
EN 4.4

EN 2.4 DEMONSTRATIO
N OF TUNING
FORK TEST

EN 2.5 EXAMINATION
OF NOSE with
EN 3.2 nasal endoscopy

EN 2.8 Audiology

EN 4.16

EN 2.6 EXAMINATION
OF ORAL CAVITY

EN 2.11 EXAMINATION
OF PHARYNX +
EN 3.3 LARYNX WITH
KNOWLEDGE OF
IDLE

EN2.7 EXAMINATION
METHODS OF
NECK WITH ALL
GROUPS OF
LYMPH NODES
AND
 ANATOMICAL
TRIANGLES OF
NECK

EN 2.9 CLINICAL CASE

OF thyroid

EN 2.9 CLINICAL test to

demonstrate
EN 4.7 complication of
EN 4.8 csom

EN 2.9 CLINICAL CASE

OF OTITIS
EN 4.3 MEDIA
EN 4.5

EN 4.6

EN 4.7

EN 4.8

EN 2.9 CLINICAL CASE

OF DEVIATED
EN 4.22 NASAL SEPTUM
EN 4.23

EN 2.9 CLINICAL CASE

OF NASAL
EN 4.22 POLYP
EN 4.25

EN 2.9 CLINICAL CASE

OF ORAL
EN 2.11 ULCERATION/LE
SIONS

EN 2.9 EVALUATION OF
CASE OF
EN 4.42 HOARSENESS OF
VOICE
EN 2.9 EVALUATION OF
CASE OF
DYSPHAGIA

EN 2.9 EVALUATION OF
DIFFERENTIAL
EN 2.11 DIAGNOSIS OF
EN 4.41 NECK
SWELLINGS

EN 2.9 BASIC ENT X

RAYS

EN 2.8 INTERPRETATIO
N OF PURE
EN 4.16 TONE
AUDIOGRAMS

EN 2.14 APPLICATION OF
TOPICAL
MEDICATIONS

EN 2.14 COMMON
DRUGS USED IN
ENT, OTOTOXIC
DRUGS

EN 2.2 REVISION FOR

ENT
EN 2.3 EXAMINATION
EN 2.4

EN 2.5

EN 2.6

EN 2.7

EN 3.1

EN 3.2

EN 3.3
EN 4.22 CASE
PRESENTATION
EN 4.23 OF
EN 4.24 Deviated nasal
septum

EN 4.26 CASE
PRESENTATION
EN 4.39 OF CHRONIC
EN 4.4O TONSILLITIS
ADENOID
HYPERTROPHY

EN 4.2 CASE DISCUSSIN

OF EXTERNAL
EN 4.9 EAR
PATHOLOGIES

EN 4.6 CASE
PRESENTATION
EN 4.7 OF CSOM ( TT
EN 4.10

EN 4.12

EN 4.6 CASE
PRESENTATION
EN 4.8 OF CSOM ( AA )
EN 4.11 ) WITH
DISCUSSION OF
EN 4.12 COMPLICATION
S OF COM
EN 4.18

EN 4.22 CASE
PRESENTATION
EN 4.25 OF NASAL
EN 4.27 polyps

EN 4.28

EN 4.29
EN 4.33

EN 2.13 Epistaxis
(MODALITIES OF
EN 4.30 MANAGEMENT )

EN 4.22 CASE
DISCUSSION OF
EN 4.25 NASAL TUMORS

EN 4.42 CASE
PRESENTATION
OF BENIGN
VOCAL CORD
LESIONS WITH
DISCUSSION OF
STROBOSCOPY
AND SPEECH
THERAPY

EN 2.11 CASE
PRESENTATION
EN 4.38 OF CA LARYNX
WITH
TREATMENT
MODALITIES OF
CHEMOTHERAP
Y/
RADIOTHERAPY

EN 2.11 CASE
PRESENTATION
EN 4.38 OF ORAL CAVITY
LESIONS

EN 4.41 CASE
DISCUSSION-
DIFFERENTIAL
DIAGNOSIS OF
NECK
SWELLINGS
WITH
 TUBERCULOSIS(I
NCLUDING
THYROID
SWELLING)

EN 2.13 CASE
DISCUSSION OF
TRACHEOSTOM
Y

EN 2.10 INSTRUMENTS
AND SURGERY
EN 3.5 FOR EAR
SURGERY WITH
DISCUSSION OF
HEARING AID
AND COCHLEAR
IMPLANT

EN 2.10 INSTRUMENTS
AND SURGERIES
EN 3.5 FOR NASAL
EN 4.24 SURGERIES

EN 2.10 INSTRUMENTS
AND SURGERIES
EN 3.5 FOR TONSIL/
EN 4.40 ADENOIDS/
TRACHEOSTOMI
EN 4.50 ES

EN 4.51

EN 2.10 INSTRUMENTS
FOR
EN 4.38 ENDOSCOPIES

EN 2.9 COMMON X
RAYS OF ENT
 WITH CT SCANS

EN 2.13 ENT
EMERGENCIES
EN 3.4 AND FOREIGN
EN 3.6 BODIES

EN 4.30

EN 4.48

EN 4.49

EN 4.51

EN 2.9 SPECIMENS +
LASERS +
EN 3.5
ROBOTICS

EN 2.8 AUDIOGRAMS/B
ERA/DIFFERENT
EN 4.12 TESTS/COMMO
EN 4.16 N DRUGS IN ENT

EN 4.17

EN 2.9 BONES
CASE HISTORY-1

General History:

Chief Complaints:

Origin, Duration and Progress (ODP) or History of presenting illness (HOPI) Negative
history:

Past history:

Family history:

Personal history (allergy, diet etc.):

Medical/ Surgical History:

General Examination:
 Local examination

Ear examination:

Nose examination:

Throat & Neck examination:

Clinical diagnosis:
Clinical history: 2

General History:

Chief Complaints:

Origin, Duration and Progress (ODP) or History of presenting illness (HOPI) Negative
history:

Past history:

Family history:

Personal history (allergy, diet etc.):

Medical/ Surgical History:

General Examination:
 Local examination

Ear examination:

Nose examination:

Throat & Neck examination:

Clinical diagnosis:
CASE HISTORY-3

General History:

Chief Complaints:

Origin, Duration and Progress (ODP) or History of presenting illness (HOPI) Negative
history:

Past history:

Family history:

Personal history (allergy, diet etc.):

Medical/ Surgical History:

General Examination:
 Local examination

Ear examination:

Nose examination:

Throat & Neck examination:

Clinical diagnosis:
CASE HISTORY-4

General History:

Chief Complaints:

Origin, Duration and Progress (ODP) or History of presenting illness (HOPI) Negative
history:

Past history:

Family history:

Personal history (allergy, diet etc.):

Medical/ Surgical History:

General Examination:
 Local examination

Ear examination:

Nose examination:

Throat & Neck examination:

Clinical diagnosis:
 ENT instruments

S. No Name of instrument Uses

 ENT instruments

S. No Name of instrument Uses

 DAILY ACTIVITY(Term …. Sem ….)

No. Date Case presentation Seminar/Group discussion Self directed learning

Signature of Co-ordinator:
 DAILY ACTIVITY (Term …. Sem ….)
No. Date Case presentation Seminar/Group discussion Self directed learning

Signature of Co-ordinator:
 SKILL DEVELOPMENT DETAILS (Term ……. Sem ……)

No Date Registration Procedures Grading Feedback/Recomme

. number of observed/assisted/p (below/meets/a ndation
patient erformed under bove
guidance of expectations)

Signature of Co-ordinator:
 SKILL DEVELOPMENT DETAILS (Term ……. Sem ……)

No Date Registration Procedures Grading Feedback/Recomme

. number of observed/assisted/p (below/meets/a ndation
patient erformed under bove
guidance of expectations)

Signature of Co-ordinator:
 SELF DIRECTED LEARNING

TOPIC

DATE

FACULTY FEEDBACK

SIGN

SELF DIRECTED LEARNING

TOPIC

DATE

FACULTY FEEDBACK

SIGN
Reflective writing:

Topic name:
Date :
Phase:
…………………………………………………………………………………………………………………………………………………..

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

…………………………………………………………………………………………………………………………………………………
Reflective writing:

Topic name:
Date :
Phase:

…………………………………………………………………………………………………………………………………………………..

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

…………………………………………………………………………………………………………………………………………………
Reflective writing:

Topic name:
Date :
Phase:

…………………………………………………………………………………………………………………………………………………..

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

…………………………………………………………………………………………………………………………………………………
Reflective writing:

Topic name:
Date :
Phase:

…………………………………………………………………………………………………………………………………………………..

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

…………………………………………………………………………………………………………………………………………………
Reflective writing:

Topic name:
Date :
Phase:

…………………………………………………………………………………………………………………………………………………..

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

…………………………………………………………………………………………………………………………………………………
Reflective writing:

Topic name:
Date :
Phase:
…………………………………………………………………………………………………………………………………………………..

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

…………………………………………………………………………………………………………………………………………………
Reflective writing:

Topic name:
Date :
Phase:
…………………………………………………………………………………………………………………………………………………..

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

…………………………………………………………………………………………………………………………………………………
Reflective writing:

Topic name:
Date :
Phase:

…………………………………………………………………………………………………………………………………………………..

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

…………………………………………………………………………………………………………………………………………………
Reflective writing:

Topic name:
Date :
Phase:

…………………………………………………………………………………………………………………………………………………..

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

…………………………………………………………………………………………………………………………………………………
Reflective writing:

Topic name:
Date :
Phase:

…………………………………………………………………………………………………………………………………………………..

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………

…………………………………………………………………………………………………………………………………………………
 Attendance Record

Phase Attendance (%) Remarks

Phase-2 1st Clinical Posting

Phase-2 2nd Clinical Posting

Phase-3 part-1
1st Clinical Posting

Phase-3 part-1
2nd Clinical Posting

Phase-3 part-1
Theory Classes
ASSESSMENT