Palestinian Ministry of Health

Health Education and Scientific

Research Unit

Log Book for Training in the Internship Year for Physicians

The unified national program for Internship Physicians

0
Name of Candidate:

Reference # :

Country and Year of Graduation:

Date of commencement:

Date of completion:

Schedule of Training
Subject Location From To Supervisor’s Signature Remarks
Internal Medicine
General Surgery
&Anaesthesia
Gynaecology &
Obstetrics
Paediatrics
Psychiatry/ Hospital
Psychiatry/ Community
Psychiatric Centre
Community and Public
Health

1
 Content

Subject Page
Doctor data 1
Internship physician training program 3
Training guidelines 4
General objectives of training 5
General competencies of an intern doctor 6
Objectives of training in the departments of internal medicine, general 10
surgery and anesthesia
Internal medicine training 12
Training in general surgery and anesthesia 19
Obstetrics and Gynecology training 28
Pediatric training 34
Public health training 40
Mental health training 48
Medical Codex- Duties and Professional Ethics for Human Medicine 53
Mandatory courses 59

2
 Internship Physician Training Program

The newly graduated doctor must follow a basic training program in hospitals accredited in the country by the Ministry of
Health and the Palestinian Medical Council, as well as in primary health care clinics and facilities for a full year, as follows:

Training programme for internship doctor Duration

Internal medicine 3 months

General Surgical and anaesthesia Two months

Gynecology and obstetrics Two months

Pediatric Two months

Public Health One month

Psychiatry One month

3
 Training Guidelines
1. At the beginning of the training, the trainee is given a program showing the training locations assigned
to him.
2. The intern doctor is obligated to record in this booklet the skills acquired during training and the level
he has reached, which must be approved by the department head and the intern supervisor.
3. It is not permitted to be absent from training with an excuse for a period exceeding 10% of the training
period in the department. In the event of absence exceeding 10%, the doctor will compensate for the
period of absence.
4. The training officer in the department, in coordination with the training officer in the hospital/health
directorate, supervises the progress of the training, evaluates the trainee, and writes a report thereon for
follow-up by the Ministry of Health and the Palestinian Medical Council.
5. The training record is submitted at the end of the training period to the General Administration of
Health Education for review, and then a training completion certificate is issued after the end of its
term and delivered to the trainee.
6. The doctor is obligated to complete the two mandatory training for intern doctors (primary care for
injuries and the online infection prevention course) and bring the certificates to the General
Administration of Health Education.

4
 Training Objectives
At the end of the training program, the intern physician is expected to be familiar with the knowledge, skills, and attitudes
related to the medical profession including the specialty code of ethics that enable him/her to practice medicine and/or seek
an advanced medical specialty. The following are the major objectives of the training:

1. To pay sufficient attention to medical treatment, preventive medicine, research findings, the patient's social situation
and his cultural background in making the medical decision.
2. Be able to assess the quality of information and use analysis to develop skills.
3. Be able to deal effectively with the patient and all members of the medical staff.
4. To understand the relationship and the role of both public health and different disciplines
5. He should be familiar with the outline of the administrative procedures for the admission of patients and patients and
the patient evacuation plan.
6. to be given preventive medicine by birth - death - abortion - and judicial injuries in respect of the laws in force in the
Ministry of Health.
7. Have a sense of responsibility for the treatment of patients and respects the secrets of the patient and his family
8. To be able to offer medical problems in seminars, medical meetings and mass transit and are able to use the necessary
tools for this.
9. Be aware of its ability and limitations and ask for help when necessary.
10. Commitment to the ethics code of the medical profession.
11. Compliance with the rules and procedures of the Medical Association (Constitution)
5
 General Competencies for Intern-physician

General Practice Domains Satisfactory Unsatisfactory Supervisor’s Signature

Essential Competencies
Basic Clinical Skills – History Taking
Basic Clinical Skills – Clinical Examination
Basic Clinical Skills – Therapeutics and Safe Prescribing
Professional Competencies
Time Management
Decision Making and Clinical Reasoning
The Patient as Central Focus of Care
Teaching and Training
Personal Behavior
Patient Safety
Prioritization of Patient Safety in Clinical Practice
Team Working and Patient Safety
Principles of Quality and Safety Improvement
Communication Skills
Relationships with Patients and Communication within a Consultation
Breaking Bad News
Complaints and Medical Error
Communication with Colleagues and Co-operation
Data Collection, Research, and Ethics
Principles of Medical Ethics and Confidentiality
Valid Consent
Legal Framework for Practice
Ethical Research
Evidence and Guidelines
Audit
Health Promotion and Public Health
Infection Control
Managing Long Term Conditions and Promoting Self-care
Reduce Ill Health and Healthcare Inequalities
Understand Patient Care within the Palestinian Healthcare Structure
6
Clinical Practice Competencies Observe Participate Perform Simulate Supervisor’s Signature

Physical Examination Skills

Examine all systems X
Fundoscopy, visual fields, visual acuity X
Mini mental-state examination X
Rinne and Weber tests X
Examination of a lump X
Examination of an ulcer X
Examination of external abdominal hernias X
Digital rectal examination X
Interviewing Skills
Patient-centred consultation X
Holistic bio-psycho-social assessment X
Cope with language barriers X
Sexual history and counselling X
Counsel – HIV test, TOP, sexual assault, termination X
of pregnancy
Motivate behaviour change X
Consultation shared with PHC nurse X
Breaking bad news X
Assess and consult families and couples X
Conduct a family conference X
Counsel a dying patient X
Counsel a pregnant woman with intrauterine fetal X
death

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Clinical Practice Competencies Observe Participate Perform Simulate Supervisor’s Signature
General Lab Investigations
Blood sampling X
Microbiological sampling. X
Examination of blood film. X
Specimens. X
Urine examination. X
Basic ECG interpretation. X
Basic X ray interpretation. X
Radiological Skills
Plain X-rays X
Read Plain X-rays of the skull, chest, abdomen, pelvis, and X
extremities
Special/Contrast Studies
Read contrast images X
Preparation of patients for special procedures including consent X
Do fluoroscopy X
Ultrasound Scan (USS) X
Read abdominal and pelvic USS pictures X
Read trans-esophageal USS X
Read trans-cranial USS X
Do abdominal and pelvis USS X
Do trans-oesophageal USS X
Do trans-cranial USS X
Computerized Tomography (CT) Scan
Read plain and contrast CT scans of the brain X
Read plain and contrast CT scans of the chest, abdomen, and pelvis X
Magnetic Resonance Imaging (MRI)
Read T1/T2-weighted MRI scans of the brain and spine X
Read T1/T2-weighted MRI scans of the chest, abdomen, and pelvis X
Interventional Radiology
Do interventional radiology procedures X
Read images post interventional radiology procedures X

8
Clinical Practice Competencies Observe Participate Perform Simulate Supervisor’s Signature
Administration Skills
Use a problem-oriented medical record X
Write a prescription X
Complete a sick certificate X
Complete a death certificate X
Write appropriate referral letters X
Develop and use flowcharts for chronic care X
Side-Room Tests
Measure finger-prick glucose X
Urine dipstick test X
Measure finger-prick haemoglobin X
Finger-prick (rapid) HIV test X
Urine pregnancy test X
Test stool for occult blood X
Smear test for acid-fast bacilli X
Smear test for Trichomonas vaginalis X
General Skills
Take a peripheral venous blood sample X
Insert a urinary catheter X
Set up intravenous infusion X
Take blood culture samples X
Insert a nasogastric tube X
Take a throat swab X
Administer injection – IV, IM, SC, intradermal X
Perform a lumbar puncture X
Collect a femoral vein blood sample X

9
 Objectives of training in the departments of internal medicine, general surgery and anesthesia

1. Deal with the patient upon admission, including taking a complete demographic data & history and conducting a
physical medical examination.
2. Request diagnostic procedures, refuting them, reading them, and benefiting from them.
3. Read the results of radiological images and laboratory tests and linking them to the medical condition.
4. Determine the patient condition and differential diagnosis.
5. Diagnose and developed a plan to deal with the cases.
6. Educate patients medically and increase awareness about their illness.
7. Deal with emergency cases of patients under supervision, sharing duties and responsibilities.
8. Deal with patients with assistance from specialists on the phone if necessary.
9. Communicate with the patient and family.
10.Use good strategy and communication when giving a patient bad news.
11.Pay the necessary attention to examinations conducted in other departments such as radiology, endoscopy and
pathology.
12.Evaluate medical and administrative notes when patients discharge.
13.Conduct, read and interpret an ECG.
14.Read and interpret chest x-ray, CT, and ultrasound data.
15.Read abdominal x-rays.
16.Do Lumbar puncture procedure.
17.Demonstrate airway management skills in adults.
18.Read and interpret radiographs of the spine and joints.
19.Interpretate arterial blood gas (ABG) reading.
20.Evaluate unconscious patient and deal with them.
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21.Learn the skills of starting pathological solutions and drawing blood samples necessary to conduct medical
examinations.
22.Classify emergency cases and determine priorities for dealing with injuries.
23.Diagnose and participate in the treatment of cardiac arrhythmias.
24.Describe the preparation for major surgical operations.
25.Assist and deal with surgical patients before and after surgeries.
26.Provide treatment for wounds, suture wounds skillfully, and removing surgical sutures.
27.Wound care and dressing.
28.Deal with emergencies and deal with accidents, burns and trauma.
29.Fill the medical files necessary for daily admission and follow-up.
30.Write clinical notes for emergency patients for follow-up as well as surgical treatment.
31.Manage patients who suffer from injuries and injuries (Trauma).
32.Assist in operation and learn about appropriate procedures in the event of an emergency.
33.Identify the mechanism of patient recovery after surgical operations.
34. Monitor the patient after surgeries in the intensive care unit.
35.Participate in administering local anesthesia methods and the medications used in them.
36.Treat fractures and problems of the musculoskeletal system.
37.Familiarity with the judicial and administrative dimension of emergencies such as road accidents falls from heights,
and projectile and gunshot injuries.

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 Internal medicine training (3months)
Skills and procedures:

Knowledge, skills and procedures to be acquired during the training period that an intern-
doctor is expected to master in the Internal Medicine Department Which the supervisor must
directly monitor and inspect during the evaluation
Internal Medicine Skills Observe Participate Perform Simulate Supervisor’s Signature
Perform an electrocardiograph X
Demonstrate inhaler and spacer technique X
Perform peak expiratory flow rate X
Perform pleural paracentesis X
Perform abdominal paracentesis X
Perform lymph node aspiration biopsy X
Set up intraosseous infusion X
Perform skin biopsy – punch or elliptical X
Perform induced sputum collection X
Perform pleural biopsy X
Perform bone marrow biopsy X
Perform liver biopsy X
Administering cardiopulmonary resuscitation. X
Securing patent airway. X
Artificial ventilation. X
Endotracheal intubations PERSONEL X
Inserting a central venous catheter X
Arterial puncture for blood gas analysis. X
Treatment of tension pneumothorax. X
Inserting a thoracic drainage. X
Pericardiocentesis. X
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Cardiac defibrillation. X
Needle aspiration of the knee joint. X
Forensic Medicine Skills X
Document drunk driving and take blood samples X
Document sexual assault and take samples X
Document intimate-partner violence X
Emergency Management for selected cases
-Myocardial infarction. X
-Acute respiratory insufficiency. X
-Intoxication. X
-Status epilepticus. X
-Diabetic coma. X
-Pulmonary embolism. X
-Pulmonary oedema. X
-Meningitis. X
-Septicaemia. X
Discharge planning and report X
Death report X

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 Internal Medicine Case Registry: 10 cases per month
First month
# Date Patient number/ Patient Physical Diagnosis Differential Management Health note Supervisor
age / gender History Examination Tests diagnosis plan education sign

1
2
3
4
5
6
7
8
9
10
14
Second month
# Date Patient Patient Physical Diagnosis Differential Management Health note Supervisor
number/ age / History Examination Tests diagnosis plan education sign
gender

1
2
3
4
5
6
7
8
9
10
15
 Third month
# Date Patient number/ Patient Physical Diagnosis Differential Management Health note Supervisor
age / gender History Examination Tests diagnosis plan education sign

1
2
3
4
5
6
7
8
9
10

16
 Other activities: such as participating in the Journal Club, preparing and giving lectures, attending lectures
(internal Medicine):

Date Activity supervisor supervisor sign

17
Attendance:

Delay:

Daily morning report:

General Notes:

Name and signature of responsible doctor

18
 General surgery and anesthesia training (3 months)
The procedures that the intern doctor is expected to be able to perform. Satisfactorily in the specialty of surgery are listing
below.
The supervisor/ tutor would directly observe and check each of them during the evaluation:
Surgical Skills Observe Participate Perform Simulate Supervisor’s Signature

Incise and drain an abscess X

Perform needle aspiration biopsy of any area X
Fine needle aspiration biopsy of breast lump X
Perform proctoscopy X
Excise lumps/bumps (e.g., sebaceous cyst) X
Perform cryotherapy/cauterization X
Debride wounds or burns X
Incise and drain perianal hematoma X
Apply compression dressing to venous ulcer X
Scrubbing, gowning and suturing. X
Examination of wounds postoperatively. X
Treatment of ingrowing toe nail. X
Irrigation of the ear. X
Anorectoscopy, proctoscopy, sigmoidoscopy. X
Inserting a central venous catheter. X
Incision and closure. X
Intubation and drainage in the operating room. X
Tissue handling. X
Circumcision. X
Endotracheal intubation. X
Treatment of epistaxis. X
Assisting in minor and major operations. X

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Venous cut down. X
Removal of foreign bodies. X
Assisting in appendectomy. X
Skin biopsies, excision of small lumps, and removal of small X
tumours.
Incision and drainage of abscesses and collection of X
suppurations.
Attend rigid sigmoidoscopy to 18 cm X
Ophthalmology Skills
Instil eye drops or apply eye ointment X
Eyelid eversion – remove foreign body X
Washout eye for chemical burns X
Suture an eyelid X
Incise and drain a Meibomian cyst X
Otorhinolaryngology Skills X
Syringe and dry swab an ear X
Cauterize nose for epistaxis X
Pack nose, cauterize for epistaxis X
Remove foreign body from the nose X
Remove foreign body from the ear X
Suture pinna/ear lobe X
Orthopaedic Skills
Apply cast – below knee, below elbow X
Reduce shoulder dislocation X
Apply finger and hand splints X
Reduce closed fracture – hand, forearm X
Set up traction (skeletal or skin) X
Aspirate and inject knee joint X
Anaesthesia Skills
Obtain airway control using an oro-pharyngeal airway X
Monitor patient in recovery room X
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Assist in intubation of patient and ventilate patient using X
mask and Ambubag
Monitor patient during anaesthesia X
Set airflows – McGill, circle, T-piece X
Check Boyle’s machine X
Use laryngeal mask for airway management X
Administer ketamine anaesthesia X
Observe Sterilization of equipment X
Reverse muscle relaxation X
Perform intravenous induction X
Administer general anaesthetic X
Perform inhalation induction X
Observe spinal anaesthesia X
Perform Bier’s block X
Administer local anaesthetic X
Emergency Medicine Skills
Measure Glasgow Coma Scale X
Administer oxygen X
Administer local anaesthesia X
Suture lacerations X
Obtain pressure control of haemorrhage X
Primary survey X
Administer blood transfusion X
Calculate percent body burn injury X
Secondary survey X
Perform advanced CPR – adult X
Relieve choking X
Insert inter-costal chest drain X
Remove splinter or fish hook X
Immobilize spine X

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Perform a ring block X
Transport critically ill patient X
Drain subungual hematoma X
Administer rabies prophylaxis X
Relieve tension pneumothorax X
Perform gastric lavage X
Perform synchronized cardio version X
Perform venous cut down X
Reduce temporomandibular joint dislocation X
Set up external electrical cardiac pacing X
Perform cricothyroidotomy X
Perform endotracheal intubation X
Treat acute asthma X
Offer first-line treatment for tetanus X
Treat hypoglycaemia X
Offer first-line care for hyperglycaemic emergencies X
Offer first-line care for acute stroke X
Offer first-line treatment for acute coronary syndromes X
Offer first-line treatment for status epilepticus X
Offer first-line treatment for hematemesis X
Offer first-line treatment for acute pulmonary oedema X

22
 General surgery and anaesthesia Case Registry: 10 cases per month
First month
# Date Patient Patient History Physical Diagnosis Differential Management Health Note Supervisor sign
number/ age / Examination Tests diagnosis plan education
gender

1
2
3
4
5
6
7
8
9
10
23
 Second month
# Date Patient Patient History Physical Diagnosis Differential Management Health Note Supervisor sign
number/ age / Examination Tests diagnosis plan education
gender

1
2
3
4
5
6
7
8
9

10
24
 Third month
# Date Patient Patient History Physical Diagnosis Differential Management Health Note Supervisor
number/ Examination Tests diagnosis plan education sign
age / gender

1
2
3
4
5
6
7
8
9
10

25
 Other activities: such as participating in the Journal Club, preparing and giving lectures, attending lectures
(Surgical and Anesthesia):

Date Activity supervisor supervisor sign

26
Attendance:

Delay:

Daily morning report:

General Notes:

Name and signature of responsible doctor

27
 .Gynecology and Obstetrics Training (two months)
At the end of the training period, the intern doctor will be able to:

1. Take a medical history and perform a clinical examination for obstetrics and gynecology.
2. Do a perineal examination.
3. Registry information derived from the medical history and clinical examination in a good manner and
sequence.
4. Develop a preliminary vision for the patient’s treatment, including requesting the necessary tests.
5. Know abnormal cases of childbirth and having knowledge of how to deal with them.
6. Diagnosis and initial management of normal obstetrics and gynecology cases.
7. Assist in gynecological and obstetric operations.
8. Pre- and post-operative preparation in obstetrics and gynecology.
9. Deal with medical problems of pregnancy.Providing prenatal care for normal, low-risk pregnancies.
10.Deal with postpartum vaginal and cesarean sections.
11.Deal with postpartum problems.
12. Work as an effective member of the team supervising emergency deliveries.
13. Pledge to adhere to professional ethics and take into account medical and judicial privacy issues with regard to
gynecology and obstetrics.

28
Procedures and Skills
The procedures that the intern is expected to be able to perform satisfactorily in the specialty of Obstetrics and Gynaecology are listed below. The
supervisor / tutor would directly observe and check each of them during the evaluation:
Obstetric Skills Observe Participate Perform Simulate Supervisor’s Signature
Examine a pregnant woman X
Assess progress of labour using partogram X
Perform vaginal speculum examination X
Complete antenatal growth chart X
Assess fetal well-being in labour X
Assess fetal movement/well-being X
Perform normal vaginal delivery X
Perform cardiotocograph X
Perform and suture episiotomy X
Perform evacuation of the uterus X
Perform assisted delivery – forceps X
Perform assisted delivery – vacuum X
Perform manual removal of placenta X
Perform vaginal breech delivery X
Insert catheter into uterus for haemostasis X
Perform caesarean section X
Repair third-degree tear X
Perform Papanicolaou smear X
Perform dilation and curettage of uterus X
Insert intrauterine contraceptive device X
Drain Bartholin’s abscess X
Perform endometrial biopsy/sampling X
Perform tubal ligation X
Perform cervical biopsy X
Drain Bartholin’s cyst X
Insert and remove contraceptive sub dermal implant X

Gynecology and obstetrics Case Registry: 10 cases per month

29
# Date Patient number/ Patient Physical Diagnosis Differential Management Health Note Supervisor
age / gender History Examination Tests diagnosis plan education sign
1

3
4

7
8
9

10

30
 Second month
# Date Patient number/ Patient Physical Diagnosis Differential Management Health Note Supervisor
age / gender History Examination Tests diagnosis plan education sign
1

3
4

7
8
9

10

31
 Other activities: such as participating in the Journal Club, preparing and giving lectures, attending lectures
(Gynecology and Obstetrics):

Date Activity supervisor supervisor sign

32
Attendance:

Delay:

Daily morning report:

General Notes:

Name and signature of responsible doctor

33
 Pediatric Training (two months)

At the end of the training period, the intern doctor will be able to:

1. Extracting the child’s real medical history.

2. Conduct clinical examination of the child and the newborn.
3. Formulate clear priorities for the patient's problem, including a clinical diagnosis.
4. Description and reading of the necessary tests.
5. Develop a plan to deal with common childhood illnesses.
6. Compiling medical information and a management plan add to medical file.
7. Present medical information learned orally concisely.
8. Assisting the patient and his family with medical decisions, necessary recommendations, and existing opportunities .
9. Describe the normal growth and development of the fetus during pregnancy - early childhood - childhood and
adolescence, and identify any abnormality and deviation from normal.
10. Describe the conditions, causes, and clinical symptoms, and diagnose, treat, and rehabilitate common and urgent
children’s problems.
11. Know the adequate amount required for energy, nutrition, fluids, medications, etc.
12. Determine and know of procedures used in pediatrics, neonatology, and intensive care units .
13. Advice patients and their companions on strategic prevention of infectious diseases, nutritional deficiencies, and
diseases transmitted to fetuses, poisoning, and childhood accidents.
14. Recognize the national vaccination programme.
15. Determine the Behavioral change in children and adolescents.
16. Detect a child or teenager at risk and when it occurs?
17.Observe family behavior and lifestyle and its difference from what one lives and its interactions with medical
conditions.

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Skills and procedures
The procedures that the intern is expected to be able to perform satisfactorily in the specialty of Paediatrics are listed below.
The supervisor / tutor would directly observe and check each of them during the evaluation.
Paediatric Skills Observe Participate Perform Simulate Supervisor’ Signature

Insert nasogastric tube X

Developmental assessment X
Insert stomach tube – neonate/child X
Venous blood sampling – peripheral/jugular X
Lumbar puncture – child X
Set up incubator correctly X
Set up intraosseous infusion X
Insert urinary catheter – child/neonate X
Set up phototherapy for jaundiced baby X
Suprapubic bladder puncture – child X
Resuscitate newborn X
Advanced CPR – child X
Lymph node aspiration biopsy – child X
Assess child abuse (sexual/non-sexual) X
Umbilical vein catheterization X
Inter-costal drain – child/neonate X
Ventricular tap for hydrocephalus X
Exchange blood transfusion X
Assess growth and classify malnutrition X
Well newborn check X
Administer medication using aerosol/spacer X
Administer IM injection – child/neonate X
Tine test and Mantoux test X
Obtain capillary blood sample - heel/finger X
Set up intravenous infusion – child X
Assess gestational age at birth X
Kangaroo mother care X

35
 Pediatric Case Registry: 10 cases per month
Date Patient number/ Patient Physical Diagnosis Differential Management Health note Supervisor
# age / gender History Examination Tests diagnosis plan education sign
1

3
4

7
8
9

10

36
 Second month
Date Patient number/ Patient Physical Diagnosis Differential Management Health note Supervisor
# age / gender History Examination Tests diagnosis plan education sign
1

3
4

7
8
9

10

37
 Other activities: such as participating in the Journal Club, preparing and giving lectures, attending lectures
(Pediatric)

Date Activity supervisor supervisor sign

38
 Attendance:

Delay:

Daily morning report:

General Notes:

Name and signature of responsible doctor

39

Training site
The Directorate is under the
supervision of the Director
of the Department or his
authorized representative
Medical committees
Medical institution and
vision examination (the
possibility of simply
examining vision in the
absence of an institution,
and it is preferable to move
to the location of the
institution).
School Health
Public Health Training (Month(
Duration The goal
(day)
1 1. Identify the structure of the directorate and
its branches.
2. Learn about the health insurance system
3. Learn about health programs such as:
health education/nutrition
EPI/STDs/ARI/CDD
1 Learn about the work of committees, their
types, powers, and applicable regulations.
1 1. Get to know the eye examination system.
2. Get to know the organization’s system.
3. Identify the required tests
1 1. Learn about the school health program and 1. Field participation.
its activities.
2. The health status of school students and
the necessary needs.
3. Job description of the school health team.
40
The means
1. An explanation by the department director or his
representative.
2. Touring the sections of the circle.
3. Meeting with health insurance officials,
accounting, pharmacy, statistics, and others
1. Attending committee sessions, listening, and
inquiring by the committee chairman.
2. )2An explanation of the work of the committees,
their importance and types by the director of the
department or the head of the committee.
Medical institution and vision examination (the
possibility of simply examining vision in the absence
of an institution, and it is preferable to move to the
location of the institution).
2. Identify records.
3. Listen to the school health team about their job
through the school health physician.
Department of Preventive
Medicine and
Communicable Diseases
Clinic
Respiratory Diseases Clinic
Women's health / high risk
pregnancy /family planning
clinic
Psychiatric clinic
2 1. Identify the vaccinations used and the
unified Palestinian schedule.
2. Learn about epidemiological monitoring
of diseases:
reporting/questionnaire/reports.
3. Identifying the information system:
computers and statistics.
4. Learn about disease prevention and follow
up on cases and contacts.
5. Learn about AIDS/STDs/EPI/Zoonosis
programs
2 1. Identify the policy followed in treating
patients with tuberculosis (TB).
2. Identifying the care policy in combating
chest diseases.
2 1. Identify the health care administration’s
policy in combating sexually transmitted
diseases.
2. Learn about the pregnancy risk prevention
policy and pregnancy risk factors.
3. Identify the care management policy
regarding family planning.
1. Identifying the mental illnesses present in
1 Palestine.
2. Identifying the policies used in treating
psychological cases.
3. Identify the role of health care in
combating mental illness.
41
1. )Listening to a doctor and a nurse in preventive
and statistical medicine about the department’s
activities.
2. Participate in following up on cases.
3. View records and files.
4. Participate in conducting interviews and filling
out questionnaires for patients.
5. Opening files and making inquiries from workers
in the department.
1. Listen to the center director.
2. Participate in following up on cases and making
inquiries from the center director.
1. Participation of the specialist physician and the
responsible physician in following up the cases.
2. Inquiry from the specialist physician and the
responsible physician.
3. Listening to an explanation of the health
programs by the specialist and the responsible
doctor.
1. Listen to the clinic doctor about the policies
followed.
2. Follow up on cases with the clinic doctor and
listen to the explanation of the doctor responsible
for the cases.
Diabetes clinic 2 1. Identify the epidemiological situation of 1. Hearing from the diabetes doctor about the
diabetes in Palestine. clinic’s goals.
2. Knowing the policy followed in treatment. 2. The doctor’s participation in treating patients.
3. Identify the methods used to prevent
3. Inquire from the doctor about the policies
diabetes.
followed.
Pediatric clinic 2 1. Participation of the doctor in following up 1. Share with the clinic doctor.
on cases and inquiring about any case 2. Inquiry from the clinic doctor
from him.
2. Learn about the application of global
policies CDD/ARI and others
Maternal Child Health 2 1. Learn about the care management policy 1. Share with the clinic doctor.
Clinic in following up on the pregnant mother 2. Inquiry from the clinic doctor.
and the vaccination system.
2. Identifying the care management policy in
child follow-up and the vaccination
system.
Central clinic 3 1. Participation of the doctor in following up 1. Participate with the clinic doctor in following up
on cases and inquiring about any case. on cases.
2. Identify the conversion system 2. Inquiry from the clinic doctor.
3. Learn how to deal with chronic patients. 3. View files and records

Monthly meeting 1 • Recognizing the importance of meetings,
exchanging opinions, and taking health
instructions and policies.
Evaluation Final evaluation by the department director
• Attend the routine monthly meeting or any
meeting that falls during the month for health
program doctors
1. View the trainers’ evaluation during the training
period.
2. Verify any point you are not convinced of
convinced

42
 Cognitive skills
Activity Name of supervisor Signature Comments
Recognize health Directorate: Its departments, structure, objectives and
activities

Recognize the Medical committees and attending its meetings and

inquiring about its work mechanism and decision-making

Recognition Medical institution : Its powers and method of work

Participate in activities School Health and learn about its programs

Attend Monthly meeting And inquire about its mechanism and goals

43
 Clinical skills
Skills activities Name /signature comments
of supervisor
Preventive medicine and 1. Identify the vaccinations used and the unified Palestinian
communicable disease schedule.
department 2. Learn about epidemiological monitoring of diseases:
reporting / questionnaire / reports.
3. Identifying the information system: computers and
statistics.
4. Learn about disease prevention and follow up on cases and
contacts.
5. Get to know the programs AIDS/ STDs / EPI / Zoonosis
...etc
Respiratory clinic 1. Identify the policy followed in treating tuberculosis
patients (TB).
2. Identifying the care policy in combating respiratory
diseases.
Women's health / high risk 1. Identify the health care administration’s policy in
pregnancy /family planning combating sexually transmitted diseases.
clinic 2. Learn about the pregnancy risk prevention policy and
pregnancy risk factors.
3. Identify the care management policy regarding family
planning.
Psychiatric clinic 1. Identifying the mental illnesses present in Palestine.
2. Identifying the policies used in treating psychological
cases.
3. Identify the role of health care in combating mental illness.
Diabetic clinic 1. Identify the epidemiological situation of diabetes in
Palestine.

44
 2. Knowing the policy followed in treatment.
3. Identify the methods used to prevent diabetes
Pediatric clinic 1. Participation of the doctor in following up on cases and
inquiring about any case from him.
2. Learn about the application of global policies
CDD/ARIand others
Maternal and child health clinic 1. Learn about the care management policy in following up
on the pregnant mother and the vaccination system.
2. Identifying the care management policy in child follow-up
and the vaccination system.
Central clinic 1. The doctor participates in following up on cases and
inquiring about any case from him.
2. Identify the conversion system.
3. Learn how to deal with chronic patients

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Other activities: such as participating in the Journal Club, preparing and giving lectures, attending lectures

Date Aactivity Supervisor Supervisor

sign

46
Attendance:
Delay:
Daily morning report:
General Notes:

Name and signature of responsible doctor

47
 Psychiatric and Mental Health Training (one month)
15 days in a psychiatric and mental health hospital
15 days in the community mental health clinic in the General health directorates aim:
The training has to meet the following objectives:

1. To develop ability for good history taking by skillful and sensitive interviewing
2. To be able to recognize and elicit signs, symptoms and syndromes of psychiatric conditions, and to relate them to
past experiences, personality and social circumstances of the patient
3. To become familiar with ‘major’ or psychotic psychiatric conditions (such as schizophrenia, depression, mania…),
but also with ‘minor’ psychiatric disorders (such as anxiety disorders, somatoform disorders, personality
disorders…) encountered in general practice and outpatient clinics
4. To become familiar with mostly used psychopharmacological treatments, their main indications, contraindications
and side-effects; the categories of the relevant drugs are: antipsychotic drugs, antidepressants, benzodiazepines,
mood stabilizers, anti-cholinergic drugs
5. To observe and understand the ECT procedure
6. To be able to recognize and to manage psychiatric emergencies (including suicidal behavior)
7. To be aware of criteria for hospitalizing the patient against his/her will
8. To be able to recognize organic conditions with psychiatric manifestations (organic brain conditions, hormone
imbalances…)
9. To be sensitized to psychological aspects of physical disease (accompanying anxiety, depression, denial…)
10.To become aware of liaison with other relevant disciplines like counseling, social work and clinical psychology

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 Mental Health Skills Observe Participate Perform Simulate Supervisor’s
Signature
Risk assessment – suicide, harm to others X
Certify patient under Mental Health Care Act X
Follow up under Mental Health Care Act X
Identify psychopathologies through history-taking X
and mental state examination
Manage an aggressive or agitated patient X
Demonstrate basic counselling skills X
Conduct specialized psychotherapeutic sessions X
(such as Cognitive Behavioural Therapy)
Diagnose and manage psychiatric conditions X
secondary to general medical conditions (e.g.,
delirium) or in the puerperium
Diagnose and manage drug and alcohol withdrawal X
states
Assess for suicidal tendencies X
Manage suicidal patients X
Psychosocial interventions for dementia X
Conduct electroconvulsive therapy X
Identify and offer psychosocial support for common X
childhood psychiatric conditions (such as ADHD and
autism)

49
 Psychiatric Case Registry: 10 cases
# Date Patient number/ Patient Physical Diagnosis Differential Management Health Note Supervisor
age / gender History Examination Tests diagnosis plan education sign
1
2
3
4
5
6
7
8
9
10

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 Other activities: such as participating in the Journal Club, preparing and giving lectures, attending lectures

Date Activity Supervisor Supervisor sign

51
Attendance:
Delay:
Daily morning report:
General Notes:

The name and signature of the person responsible for training internship doctor in Psychiatric
hospital

Name and signature of the person responsible for training internship doctor in mental health
departments in primary health care clinic.

52
 Medical Codex
Duties of the doctor and professional ethics of human medicine
Article 1- The medical profession is a humanitarian, moral and scientific profession as old as man. Long centuries have given it traditions and
specifications that require whoever practices it to respect the human personality in all circumstances and conditions and to be a good role model in
his behavior and treatment, upright in his work, preserving people’s lives and honors, being merciful to them and making every effort. In their
service, the medical responsibility between the doctor and the patient is based on providing care and not neglecting, not healing
Article 2- Every medical procedure must be aimed at the patient's absolute interest, must be necessary and must be justified, and must be carried
out with his consent and the consent of his guardian, whether he is a minor or unconscious
Article 3- It is not permissible to end the life of a patient suffering from an incurable, incurable disease, regardless of the pain that accompanies this
Whether this is through direct or indirect intervention, with the exception of brain death, which is according to the scientific conditions approved by
the union
General doctor duties
Article 4- A doctor who holds a certain position is prohibited from exploiting this position, whether administrative, political, or social, for
professional purposes aimed at increasing his number of patients. He is also prohibited from exploiting his position to obtain financial gain from
patients
Article 5-
a) It is prohibited for a doctor to advertise himself or carry out direct or mediated propaganda in various forms of publication or publicity, or by
writing titles or specialties that he has not legally obtained on billboards, cards, or prescriptions. However, he may advertise once in
newspapers for a period not exceeding one week when he begins to work, when he moves to another place, or when he obtains a new specialty
b) When a doctor is absent from his work station for a month or when his work hours are changed, he has the right to announce this in the
newspapers for one day, provided that he informs the union about his absence from his work station
Article 6 - It is prohibited for a doctor to perform any action or provide advice that would weaken people’s physical or mental resistance, except
in cases required by medical treatment, such as anesthesia,
Article 7 - its balcony, provided that its size does not exceed 70 x 100 cm. He has the right to place one arrow indicating the location of the clinic
if this sign is On a side street. Only the information permitted to be announced and stated in Paragraph A of Article Five must be recorded on the
sign, taking into account that the sign must be in a decent shape, devoid of decorative decorations. The doctor also has the right to place at the
entrance to his place of residence one sign, provided that its size does not exceed 30 x 40 cm
Article 8 - Prescription papers contain information permitted to be included in newspaper advertisements and banners only. The medical prescription must
include the patient’s name, age, date, and the doctor’s signature, and the prescription must be clear in writing and contain the conditions for using the treatment
Article 9 - It is not permissible to practice in places that are not properly professionally prepared, and the clinic must meet the specifications
decided by the Syndicate Council. The Syndicate Council has the right to inspect doctors ’clinics whenever it deems it necessary, and in order to
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organize. To centralize doctors in buildings, the Council sets appropriate instructions to determine the locations of clinics, specifications, and the
presence of more than one clinic in one building
Article 10 - The doctor is prohibited from:
a) Resorting to methods that can discredit the medical profession, especially those that fall under the category of fraud, deception, and claiming to
have discovered a method of diagnosis or treatment that is not scientifically proven.
b) Writing in newspapers and magazines and using any other means of publication in a manner that is understood as personal propaganda or in a
manner that harms the profession and the rights of medical fellowship and other medical professions.
c) Establishing any type of relationship based on brokerage or medical remuneration with any of his colleagues or with medical institutions or
other medical professions institutions and their individuals, or employing someone who does this work.
d) Selling medical samples, whether to a patient or to any person or institution.
e) Practicing any work that is inconsistent with the dignity of the profession and not performing any of the following actions:
1. Allowing the use of his name to promote medicines, drugs and various types of treatment.
2. Lending his name for commercial purposes in any way.
3. Requesting or accepting a reward or wage, whatever it may be, in exchange for an undertaking to prescribe specific medications or devices
for a disease, or in exchange for sending them to a hospital, therapeutic clinic, nursing home, pharmacy, or specific laboratory inside or
outside Jordan.
4. Conducting consultations in commercial stores or their annexes that are designed to sell medicines or devices with the intention of
advising on their use, whether that is free of charge or in exchange for a salary or reward.
5. It is not permissible for a doctor to share a fee with any of his colleagues except the one who actually participates in the treatment with
him. He is also not permitted to work as a paid intermediary for another doctor, hospital, or laboratory in any way.
6. The doctor is prohibited from giving any certificate or medical report without this being preceded by a medical examination
Article 11 - The doctor must avoid illegal competition in the profession, and protect quacks who commit acts that violate the law in any branch of
medicine .
Doctor's duties towards patients
Article 12- When a doctor accepts care for any person, whether in his private clinic or in any health facility, he must exert all his efforts and energy to provide
care, compassion, and sincerity to all patients same.
Article 13 - In the field of private medical care, the doctor must observe the following traditions:
a. The patient's freedom to choose the doctor.
b. The doctor’s freedom in what he prescribes, taking into account the patient’s financial circumstances.
c. Except in cases of emergency and first aid, the doctor has the right to refuse treatment for professional or personal reasons .
d. A doctor may refrain from treating his patient on the condition that:
54
 1. That this does not harm the patient’s interest.
2. To provide the necessary information to continue treatment.
Article 14 -The practice of medicine sometimes requires the submission of documents, reports, or certifications specified by law, and each
document of this type must bear the signature of the doctor who gives it, written in his own handwriting.
1. When preparing the medical report, the doctor must not forget the professional confidentiality except in cases specified by law.
2. When preparing the report, the doctor must be objective and accurate
3. It is advisable to explain in the report the reasons that necessitated writing it.
4. The information contained in the report must be consistent with the required goal.
5. When writing the report, the doctor must differentiate between the information, which is obtained by observations and examinations that he
conducted and the information given by the patient or any other person. If the doctor is forced to record in the report a diagnosis or an actual
examination, he must record the doctor’s name and address in the report.
6. The doctor must verify the identity of the person requesting the report.
7. The date of the examination should be clearly written in the report, the date it was given and the signature of the doctor who gave it,
mentioning his address.
8. The medical report must contain only medical information.
9. Giving a medical report maliciously or with the intention of being courteous is considered a mistake for which he will be held accountable
Article 15 - It is not permissible for a doctor to give a report on a deceased person who did not witness its removal or did not know about the illness
that preceded his death unless he is convinced of the cause of death according to his medical experience. In incidents suspected of being criminal,
he must be notified:
The judicial authorities who then have the right to authorize burial after a visual or anatomical examination by the forensic physician, and the
treating physician in criminal incidents that end in death must refrain from issuing a death certificate and inform the authorities who have the right
to dispose of the incident
Article 16- Sudden death incidents may occur in private clinics and are the subject of the doctor’s professional responsibility, especially as a result
of medical procedures. In such incidents, the doctor must refrain from issuing a death certificate and inform the nearest competent authority and try
to inform the family immediately if possible.
Article 17- The doctor, regardless of his work or specialty, must provide first aid to a patient whose life is in danger, unless there is force majeure
that prevents this, and when it is not possible to provide him with medical care by a specialist doctor.
Article 18 - If a doctor urgently requests assistance for an incapacitated patient or who has lost his ability to act and he is unable to obtain legal
approval in a timely manner and confirm this at the time, he must carry out the necessary treatment without regard to any other consideration
Article 19- The seriousness of the disease can be hidden from the patient and it is not permissible to reveal to him the possibility of death except with all
caution, but the family must be informed about concealing the matter from the patient.

55
Article 20 - In accordance with the applicable laws, the doctor must inform the competent health reference (specialties) about his treatment of a
patient suffering from a disease that is communicable or contagious or that affects the security of society. He must give health prevention
instructions for the environment in which that patient lives, as well as appropriate advice and procedures to enforce public health rules
Article 21 -
A - Taking into account applicable laws, it is prohibited for a doctor to perform an elective abortion by any means unless the continuation of the
pregnancy a threat to the pregnant woman’s life, in which case it is required that:
1. The abortion must be performed by a specialist doctor and with the approval of another specialist doctor in a licensed hospital.
2. To write a report stating the urgent need for abortion before the procedure is performed.
3. Make four or more copies of it as necessary, signed by the doctors, the patient, and her husband or guardian, and keep a copy in the patient’s
file.
B - If the pregnant woman refuses to undergo the operation despite the doctor explaining to her the seriousness of her condition, he must comply
with her will after confirming her opposition .
Colleague rights
Article 25 - Doctors' relations with each other must be characterized by good collegial relations that ensure mutual respect and trust among them
and facilitate ways of cooperation in everything that serves patients and preserves the status of the profession.
Article 26 -Doctors must avoid anything that would harm collegial relations and seek to resolve any disputes that may arise between them through
amicable understanding. If this is difficult, the matter is referred to the union .
Article 27 - It is absolutely forbidden for a doctor to slander one of his colleagues or to repeat rumors that insult or harm him in the practice of his
profession .
Article 28 - The doctor is prohibited from seeking to lure other patients to him, whether directly or through an intermediary, and it is not acceptable
for him to remain silent about someone who does this for his benefit and with his knowledge.
Article 29 -The doctor has the right to receive all patients in his clinic without any obligation to any other doctor who has previously treated them.
Article 30 - The doctor must suggest conducting a medical consultation if the conditions of treatment require it, and he must accept the consultation
if the patient or his family requests it. In both cases, the treating doctor suggests consulting the doctor whom he deems qualified to do so, taking
into account the patient’s wishes and agreeing in principle to meet with every registered doctor. In the union’s register if he does not have important
reasons justifying non-acceptance, he is responsible for organizing the consultation procedures. If the treating physician does not deem it necessary
to accept what is asked of him, he can withdraw without anyone having the right to request an explanation from him. This applies to the choice of a
surgeon or any other specialist or a therapeutic institution.
Article 31 - The treating physician and the counselor shall refrain from expressing anything that offends either of them regarding the patient or his
family. After the consultation, the conclusions and method of treatment shall be signed, and if this is not written, it means that the counselor shares
his opinion with the treating physician.
56
Article 32 - If points of view differ during the consultation on a matter that cannot be overcome, the treating physician has the right to refuse to
apply the consultant’s method of treatment. If the consultation is accepted by the patient or his guardian, the treating physician has the right to
abandon caring for the patient throughout this period of treatment.
Article 33 - When disagreeing with a colleague regarding the method of treatment, the patient’s reaction must be reduced to a minimum, except in
cases of serious medical error, in which case he has the right to submit a written complaint to the Syndicate Council.
Article 34 - The consulting physician does not have the right to return to visit the patient during the period of illness for which the consultation was
conducted except with the knowledge and approval of the treating physician.
Article 35 - Consultant doctors discuss with the treating doctor the patient’s condition in isolation from him and his family.
Article 36 - A doctor is not allowed to manage a colleague’s clinic temporarily for a period exceeding one continuous month except with the
approval of the Syndicate Council, provided that it does not exceed one year.
Article 37 - A doctor may not be delegated temporarily to monitor and treat his patients except a doctor registered in the Syndicate and licensed to
work in the same specialty.
Article 38 - It is not permissible for a doctor’s clinic to be managed in the event of his absence from it outside the country for a period of more than
six months except with the approval of the Syndicate Council.
Article 39 - A doctor may not have more than one clinic, and it is possible for him to have a second clinic after the approval of the Syndicate
Council, when the interest of the residents of the area requires it. However, this approval must be withdrawn when a clinic of the same specialty is
opened in this area that meets the needs of the population. It is permissible for a doctor - in addition to his main clinic - to have more than one
secondary clinic.
Article 40 - In the event that a patient is treated in a private or public hospital, what is applied in Article (30) regarding medical consultation shall
apply to the participation of another doctor in treating him, taking into account the administrative systems in public hospitals. No doctor may
contact this patient therapeutically except with the approval of the treating doctor or someone else.
Fees and wages
Article 41 The Syndicate has the right to set a minimum and a maximum for medical wages. The doctor is prohibited from receiving wages lower
or higher than the wages set by the Syndicate. However, the doctor is free to provide free services when his conscience prompts him to do so, and
the doctor is prohibited from collecting any fees from his colleague doctors, as is the custom. Doctors should treat the families of their colleagues
and medical students free of charge, provided that demanding their fees does not constitute a behavioral violation.
Article 42- It is not permissible to announce specific times for free treatment, and the doctor has the right to perform his duty free of charge for
compassionate and humanitarian reasons at all times.
Article 43- Contract treatment is prohibited, whether based on the duration of treatment or its result .
Article 44- If another doctor assists the surgeon due to circumstances required by the nature of the operation, he has the right to receive his fees
directly from the operation fee.
57
Article 45 - The treating physician’s meeting with a colleague for medical consultation justifies his obtaining special fees.
Article 46- The doctor organizes a register for his patients in which he records the diagnosis and treatment, and he must keep such a register for a
period of no less than five years .
Physicians' relationship with other medical professions
Article 47- Doctors ’relationships with members of other medical professions must be characterized by cooperation and respect, taking into account
the independence of everyone’s interests, taking care not to offend them financially or morally, avoiding any interference that is not required by the
interests of the patient or the profession, and every defect affecting these relationships should be reported to the relevant professional Syndicates.
Article 48- A practicing physician may not participate in any pharmaceutical or laboratory institution with the exception of public shareholding
companies, nor may he receive any salary, commission, or gift, with the exception of samples and gifts that are generally distributed from any
institution related to medical work.
Article 49 - The doctor must refrain from giving any written certificate regarding a medical preparation except for scientific purposes and in a
scientific manner without mentioning the trade name or the name of the producing manufacturer

58
 Required courses in hospitals and primary health care
1. In hospitals:
1-Primary Trauma Care (PTC)
2- Infection Control (online)
3- Professionalism & Communication for Health Providers (Online)
4- Advanced Cardiac Life Support (online)
5- Basic Life Support (online)
6- Ethics (online)
7- Patient Safety (online)
8-Sexually Transmitted Infections (online)
9- Laboratory, general tests, genetics, and what the doctor needs from laboratory course
10- Most important diseases and Emergency cases in psychiatry course, and other important knowledge courses

2. In the directorates of PHC:

1-Infection and Communicable diseases are more common in Palestine and the national vaccination program course
2- Scientific Research Methodology course

59