The Draft CBME Curriculum for PG Clinical is being Circulated

for Comments and Suggestions. The Suggestions are to be sent

to RGUHS by mail to dcd.rguhs@gmail.com and copy to be
mailed to Chairman BOS PG Clinical ravikdoc@gmail.com
 RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
4th T Block East, Jayanagar, Bengaluru, Karnataka 560041

POST GRADUATE STUDENT

LOG BOOK

(Practical work book in accordance with the MCI Regulations on

Postgraduate Medical Education, 2020)

MD-GENERAL MEDICINE

Name :

Year:

……….. INSTITUTE OF MEDICAL SCIENCES

(Affiliated to RGUHS, Bangalore, Karnataka)
 College
emblem

CERTIFICATE

Certified that the content of this Log Book is the bonafide work of
Dr ................................................................................... Post Graduate
Student of Department of General Medicine of …………………………..
Institute of Medical Sciences, for academic year ..........................

Signature Signature Signature

Name and Seal of Name and Seal of Name and Seal of
Guide Professor and HOD Director

Date: Date: Date:

1. BIO-DATA OF THE CANDIDATE

Student’s Name:

Pass Port
Date of Birth:
Size photo of
MBBS Degree: the student to
be affixed and
Year of passing: attested by
the HOD.
College:

University:

Medical Registration no:

Permanent Address:

Mobile no:

Date of joining PG course:

Name of the Guide:

Signature of candidate:

Signature of Guide: Signature of the HOD:

(Affiliated to RGUHS, Karnataka,

No. CONTENT PAGE NO.

1. Post Graduate Appraisal Form

2. ResearchWork / Thesis

3. Journal Club

4. Subject Seminar

5. Clinical Case Presentation

6. Conferences / CME's / Workshops

7. Ward Rounds

8. Procedures

9. Teaching Programme

10. External Postings

- Cardiology

- Neurology

- Oncology

- Psychiatry
11. Miscellaneous
Postgraduate Students Appraisal Form Pre / Para / Clinical Disciplines
Name of the Department / Unit :

Name of the PG Student :

Period of Training : FROM .......................... TO ..........................

Not More Than
No. Particulars Satisfactory Remarks
Satisfactory Satisfactory
1 2 3 4 5 6 7 8 9
1. Journal based /
recent advances
learning

2. Patient based /
Laboratory or skill
based learning

3. Sell directed learning

and teaching

4. Departmental and
interdepartmental
learning activity

5. External and
Outreach Activities /
CME's

6. Thesis / Research
Work

7. Log Book
Maintenance

Publications Yes / No

Remarks* ....................................................................................................................................................
.....................................................................................................................................................................
.....................................................................................................................................................................
* Remarks : Any Significiant positive or Negative attributes of a post graduation student to be mentioned.
For score less than 4 in any category. remediation must be suggested. Individual feedback to
postgraduate student is strongly recommended.

Signature of Signature of Signature of HOD

Assessee Consultant
Postgraduate Students Appraisal Form Pre / Para / Clinical Disciplines
Name of the Department / Unit :

Name of the PG Student :

Period of Training : FROM .......................... TO ..........................

Not More Than
No. Particulars Satisfactory Remarks
Satisfactory Satisfactory
1 2 3 4 5 6 7 8 9
1. Journal based /
recent advances
learning

2. Patient based /
Laboratory or skill
based learning

3. Sell directed learning

and teaching

4. Departmental and
interdepartmental
learning activity

5. External and
Outreach Activities /
CME's

6. Thesis / Research
Work

7. Log Book
Maintenance

Publications Yes / No

Remarks* ....................................................................................................................................................
.....................................................................................................................................................................
.....................................................................................................................................................................
* Remarks : Any Significiant positive or Negative attributes of a post graduation student to be mentioned.
For score less than 4 in any category. remediation must be suggested. Individual feedback to
postgraduate student is strongly recommended.

Signature of Signature of Signature of HOD

Assessee Consultant
Postgraduate Students Appraisal Form Pre / Para / Clinical Disciplines
Name of the Department / Unit :

Name of the PG Student :

Period of Training : FROM .......................... TO ..........................

Not More Than
No. Particulars Satisfactory Remarks
Satisfactory Satisfactory
1 2 3 4 5 6 7 8 9
1. Journal based /
recent advances
learning

2. Patient based /
Laboratory or skill
based learning

3. Sell directed learning

and teaching

4. Departmental and
interdepartmental
learning activity

5. External and
Outreach Activities /
CME's

6. Thesis / Research
Work

7. Log Book
Maintenance

Publications Yes / No

Remarks* ....................................................................................................................................................
.....................................................................................................................................................................
.....................................................................................................................................................................
* Remarks : Any Significant positive or Negative attributes of a post graduation student to be mentioned.
For score less than 4 in any category. remediation must be suggested. Individual feedback to
postgraduate student is strongly recommended.

Signature of Signature of Signature of HOD

Assessee Consultant
Postgraduate Students Appraisal Form Pre / Para / Clinical Disciplines
Name of the Department / Unit :

Name of the PG Student :

Period of Training : FROM .......................... TO ..........................

Not More Than
No. Particulars Satisfactory Remarks
Satisfactory Satisfactory
1 2 3 4 5 6 7 8 9
1. Journal based /
recent advances
learning

2. Patient based /
Laboratory or skill
based learning

3. Sell directed learning

and teaching

4. Departmental and
interdepartmental
learning activity

5. External and
Outreach Activities /
CME's

6. Thesis / Research
Work

7. Log Book
Maintenance

Publications Yes / No

Remarks* ....................................................................................................................................................
.....................................................................................................................................................................
.....................................................................................................................................................................
* Remarks : Any Significiant positive or Negative attributes of a post graduation student to be mentioned.
For score less than 4 in any category. remediation must be suggested. Individual feedback to
postgraduate student is strongly recommended.

Signature of Signature of Signature of HOD

Assessee Consultant
Postgraduate Students Appraisal Form Pre / Para / Clinical Disciplines
Name of the Department / Unit :

Name of the PG Student :

Period of Training : FROM .......................... TO ..........................

Not More Than
No. Particulars Satisfactory Remarks
.........................................
Satisfactory Satisfactory
Signature of Consultant
.......................
1 2 : 3Any
* Remarks 4 5 6 7 8 9
Significiant positive or
1. Journal based / Negative attributes of
a post graduation
recent advances student to be
learning mentioned. For score
less than 4 in any
category. remediation
2. Patient based / must be suggested.
Individual feedback to
Laboratory or skill postgraduate student
is strongly
based learning recommended.

3. Sell directed learning

and teaching

4. Departmental and Signature of

interdepartmental Assessee
learning activity

5. External and
Outreach Activities /
CME's

6. Thesis / Research
Work

7. Log Book
Maintenance

Publications

Yes / No

Remarks*
........................................
........................................
........................................
............................
........................................
........................................
........................................
........................................
....
........................................
Signature of HOD
Postgraduate Students Appraisal Form Pre / Para / Clinical Disciplines
Name of the Department / Unit :

Name of the PG Student :

Period of Training : FROM .......................... TO ..........................

Not More Than
No. Particulars Satisfactory Remarks
Satisfactory Satisfactory
1 2 3 4 5 6 7 8 9
1. Journal based /
recent advances
learning

2. Patient based /
Laboratory or skill
based learning

3. Sell directed learning

and teaching

4. Departmental and
interdepartmental
learning activity

5. External and
Outreach Activities /
CME's

6. Thesis / Research
Work

7. Log Book
Maintenance

Publications Yes / No

Remarks* ....................................................................................................................................................
.....................................................................................................................................................................
.....................................................................................................................................................................
* Remarks : Any Significiant positive or Negative attributes of a post graduation student to be mentioned.
For score less than 4 in any category. remediation must be suggested. Individual feedback to
postgraduate student is strongly recommended.

Signature of Signature of Signature of HOD

Assessee Consultant
Postgraduate Students Appraisal Form Pre / Para / Clinical Disciplines
Name of the Department / Unit :

Name of the PG Student :

Period of Training : FROM .......................... TO ..........................

Not More Than
No. Particulars Satisfactory Remarks
Satisfactory Satisfactory
1 2 3 4 5 6 7 8 9
1. Journal based /
recent advances
learning

2. Patient based /
Laboratory or skill
based learning

3. Sell directed learning

and teaching

4. Departmental and
interdepartmental
learning activity

5. External and
Outreach Activities /
CME's

6. Thesis / Research
Work

7. Log Book
Maintenance

Publications Yes / No

Remarks* ....................................................................................................................................................
.....................................................................................................................................................................
.....................................................................................................................................................................
* Remarks : Any Significiant positive or Negative attributesof a postgraduation student to be mentioned.
For score less than 4 in any category. remediation must be suggested. Individual feedback to
postgraduate student is strongly recommended.

Signature of Signature of Signature of HOD

Assessee Consultant
Postgraduate Students Appraisal Form Pre / Para / Clinical Disciplines
Name of the Department / Unit :

Name of the PG Student :

Period of Training : FROM .......................... TO ..........................

Not More Than
No. Particulars Satisfactory Remarks
Satisfactory Satisfactory
1 2 3 4 5 6 7 8 9
1. Journal based /
recent advances
learning

2. Patient based /
Laboratory or skill
based learning

3. Sell directed learning

and teaching

4. Departmental and
interdepartmental
learning activity

5. External and
Outreach Activities /
CME's

6. Thesis / Research
Work

7. Log Book
Maintenance

Publications Yes / No

Remarks* ....................................................................................................................................................
.....................................................................................................................................................................
.....................................................................................................................................................................
* Remarks : Any Significiant positive or Negative attributesof a postgraduation student to be mentioned.
For score less than 4 in any category. remediation must be suggested. Individual feedback to
postgraduate student is strongly recommended.

Signature of Signature of Signature of HOD

Assessee Consultant
Postgraduate Students Appraisal Form Pre / Para / Clinical Disciplines
Name of the Department / Unit :

Name of the PG Student :

Period of Training : FROM .......................... TO ..........................

Not More Than
No. Particulars Satisfactory Remarks
Satisfactory Satisfactory
1 2 3 4 5 6 7 8 9
1. Journal based /
recent advances
learning

2. Patient based /
Laboratory or skill
based learning

3. Sell directed learning

and teaching

4. Departmental and
interdepartmental
learning activity

5. External and
Outreach Activities /
CME's

6. Thesis / Research
Work

7. Log Book
Maintenance

Publications Yes / No

Remarks* ....................................................................................................................................................
.....................................................................................................................................................................
.....................................................................................................................................................................
* Remarks : Any Significiant positive or Negative attributesof a postgraduation student to be mentioned.
For score less than 4 in any category. remediation must be suggested. Individual feedback to
postgraduate student is strongly recommended.

Signature of Signature of Signature of HOD

Assessee Consultant
Postgraduate Students Appraisal Form Pre / Para / Clinical Disciplines
Name of the Department / Unit :

Name of the PG Student :

Period of Training : FROM .......................... TO ..........................

Not More Than
No. Particulars Satisfactory Remarks
Satisfactory Satisfactory
1 2 3 4 5 6 7 8 9
1. Journal based /
recent advances
learning

2. Patient based /
Laboratory or skill
based learning

3. Sell directed learning

and teaching

4. Departmental and
interdepartmental
learning activity

5. External and
Outreach Activities /
CME's

6. Thesis / Research
Work

7. Log Book
Maintenance

Publications Yes / No

Remarks* ....................................................................................................................................................
.....................................................................................................................................................................
.....................................................................................................................................................................
* Remarks : Any Significiant positive or Negative attributesof a postgraduation student to be mentioned.
For score less than 4 in any category. remediation must be suggested. Individual feedback to
postgraduate student is strongly recommended.

Signature of Signature of Signature of HOD

Assessee Consultant
Postgraduate Students Appraisal Form Pre / Para / Clinical Disciplines
Name of the Department / Unit :

Name of the PG Student :

Period of Training : FROM .......................... TO ..........................

Not More Than
No. Particulars Satisfactory Remarks
Satisfactory Satisfactory
1 2 3 4 5 6 7 8 9
1. Journal based /
recent advances
learning

2. Patient based /
Laboratory or skill
based learning

3. Sell directed learning

and teaching

4. Departmental and
interdepartmental
learning activity

5. External and
Outreach Activities /
CME's

6. Thesis / Research
Work

7. Log Book
Maintenance

Publications Yes / No

Remarks* ....................................................................................................................................................
.....................................................................................................................................................................
.....................................................................................................................................................................
* Remarks : Any Significiant positive or Negative attributesof a postgraduation student to be mentioned.
For score less than 4 in any category. remediation must be suggested. Individual feedback to
postgraduate student is strongly recommended.

Signature of Signature of Signature of HOD

Assessee Consultant
Postgraduate Students Appraisal Form Pre / Para / Clinical Disciplines
Name of the Department / Unit :

Name of the PG Student :

Period of Training : FROM .......................... TO ..........................

Not More Than
No. Particulars Satisfactory Remarks
Satisfactory Satisfactory
1 2 3 4 5 6 7 8 9
1. Journal based /
recent advances
learning

2. Patient based /
Laboratory or skill
based learning

3. Sell directed learning

and teaching

4. Departmental and
interdepartmental
learning activity

5. External and
Outreach Activities /
CME's

6. Thesis / Research
Work

7. Log Book
Maintenance

Publications Yes / No

Remarks* ....................................................................................................................................................
.....................................................................................................................................................................
.....................................................................................................................................................................
* Remarks : Any Significiant positive or Negative attributesof a postgraduation student to be mentioned.
For score less than 4 in any category. remediation must be suggested. Individual feedback to
postgraduate student is strongly recommended.

Signature of Signature of Signature of HOD

Assessee Consultant
DATE TOPIC MODERATOR

1.

2.

3.

4.

5.

6.

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Sl. No. Topic
Sl. No. TOPIC
Sl. No. Conference/ CME's / Workshop
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SL.
NO. DATE PROCEDURE
SL.
NO. DATE PROCEDURE
Competency list

Note: Figures shown against the items indicate minimum number.

Key PI = Performs independently, PA = Performs under assistance
SL.
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