Master Degree of Ophthalmology Log Book

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Transcription:

الا نشطة " " كراسة اللازمة لحصول المتدرب على درجة الماجستیر في طب وجراحة العین

Contents NO SUBJECT PAGE Personal data 3 2 Instructions to the use of logbook 4 3 Program aims and curriculum structure 6 4 Essential Courses. Course ( Anatomy) 2. Course 2 (Physiology) 3. Course 3 (Optics) 4. Course 4 (General Surgery) 5. Course 5 (Internal Medicine) 5 Specialized Course ) Course 6 ( Ophthalmology) Unit ( Module ) Eye Medicine Unit ( Module ) 2 Eye Surgery Unit ( Module ) 3 Pathology and microbiology 0 Other Scientific Activities 75 Master Degree Thesis pathway 89 0 Declaration: 87 8 3 6 20 23 ٢

Personal Data Name Date of birth Address Place of work.. Telephones Mobile phone(s)... E mail.. Name of hospital Period of work Hospital director signature Academic Information MBBCh / /..University Grade. Grade of Internal Medicine course on graduation.. Others / /..University / /..University ٣

* Aim of the activities book To provide one source of evidence for the assessment committee that you attained the desired level of competency required to gain the award. In this book you will document all clinical, academic and other experiences and skills you attained during your training. Sections of the book For each module / course / rotation You should fill the following sections:- - Clinical case log - You will first find list with all required cases in the concerned module and the minimum number of cases you must get exposed to and level of participation you should achieve for each type of cases. 2- You should record all clinical cases in the module and each case should be signed by you trainer. 2- Clinical case presentation log Record the cases related to the module that you have presented in a seminar of the activity. ٤

3- Procedures / operations log - You will find a list for required procedure, diagnostic therapeutic operations and level of desired performance you should achieve at the end of training. 2- You will find empty tables to write down the procedure, you level of participation and date and signature of supervisor. 4- Rotation / attendance proof You should have evidence of achievement the required training hours within each module. For the whole program fill the following sections. - Academic activities A- Document all academic activities e.g. lecture, journal clubs, workshops, conference, services attended. This documentation should include the level of participation " attendance, preparation, presentation, " 2- Academic achievements A- Document all outcomes you achieved in the field of:- - Audit participation - Research "clinical trial" participation. - Evidence- based medicine "generation of guidelines" protocols -.. 3- Formative assessment log This document all types of formative assessment attended e.g.:- - Mini clinical examination - Quieses ٥

Program aims / Provides the candidates with a fundamental knowledge base as well as clinical experience and competence in the area of Ophthalmology--and making appropriate referrals to a sub-specialist. /2. To graduate certified ophthalmologist who possesses knowledge judgment adaptability, clinical skills, technical facilities and personal characteristics to carry out the entire scope of Ophthalmic practice /3 To introduce candidates to the basics of scientific medical research. /4 Enable candidates to start professional careers as specialists in Egypt but recognized abroad. /5 To enable candidates to understand and get the best of published scientific research and do their own. Curriculum Structure: Duration of program 36 months divided into Program Structure Program Time Table A- Duration of program 2-4 years divided into Part Program-related basic courses (one year) Students are allowed to sit the exams of these courses after 2 months from applying to the M Sc degree. o Thesis Essay; Master essay duration: one year should be officially registered as approved by the department and faculty council, Discussion and acceptance of the essay should not be set before 2 months from registering the MSc subject. No marks are given to this section. o Part 2 Program related specialized science courses and ILOs Students are not allowed to sit the exams of these courses before 2 years from applying to the MSc degree. n.b. Fulfillment of the requirements in each course as described in the template and registered in the log book is a pre-request for candidates to be assessed and undertake part and part 2 examinations. ٦

First Part Academic activities of basic sciences Practice with the Academic for at least 6 months during year Essential Courses. Course ( Anatomy) 2. Course 2 (Physiology) 3. Course 3 (Optics) 4. Course 5 ( Internal Medicine) 5. Course 5 ( General Surgery) ٧

Anatomy Cornea iris Lens Ciliary body Ciliary processes Anterior chamber angle Sclera and episcleral structures Conjunctiva vitreous Optic nerve structure Optic nerve vasculature Anatomy of the macula Retina Choroids orbit ٨

Anatomy Lectures Date Attendance Topic Signature ٩

Anatomy Practical skills Date Attendance Topic Signature ١٠

Physiology Physiology of the followings Precorneal tear film Tears Accommodation Precorneal tear film Corneal sensation Tear secretion basic and reflex Aqueous humor composition Aqueous Formation Biodynamics of Aqueous Ocular circulation IOP Lens Ciliary body Iris aqueous humour Vitreous Cornea Retinal circulation Vitreous types of ocular motility ocular motility control sympathetic innervation parasympathetic innervation physiology of the Lid and conjunctiva physiology of the lacrimal apparatus, secretory and drainage parts Retina Vitreous Choroids Sclera ١١

Physiology Lectures Date Attendance Topic Signature ١٢

Optics Lens formula. Astigmatic lenses. Notation of lenses. Notation of prisms Identification of unknown lenses. Aberrations of lenses. Lens materials. Clinical optics. Visual acuity. Ametropia. Optical parameters affecting retinal image size. Accommodative problems. Refractive errors. Correction of ametropia. Problems of spectacles in aphakia. Calculation of intraocular lens power. Presbyopia (measuring for near adds). Low vision aids. Clinical refraction. Instruments and tests. ١٣

Optics Lecture Date Attendance Topic Signature ١٤

Optics Practical skills Date Attendance Topic Signature ١٥

General Surgery - Total hours 56 (78 hours for lectures and 78 for training) - Minimal rate of attendance of at least 75% of lectures and training) Lectures Basic surgical techniques Thyroid diseases and thyroid eye disease Shock and resuscitation Haemorrhage Types of anesthesia DD of neck swelling Facial fractures Head Trauma - Practice of at least 2 cases of each disease ١٦

H.N كلیة الطب Diagnosis of case General Surgery A-Clinical case log Level of participation * Location Signature of supervisor * Level of participation A- Plan and carry out B- Carry out C- Carry out under supervision ١٧

General Surgery Lectures Date Attendance Topic Signature ١٨

H.N كلیة الطب Diagnosis of case General Surgery Procedure log Level of participation * Location Signature of supervisor * Level of participation A- Plan and carry out B- Carry out C- Carry out under supervision ١٩

Internal Medicine - Total hours 56 (78 hours for lectures and 78 for training) - Minimal rate of attendance of at least 75% of lectures and training) Lectures Diabetes mellitus and its complications Hypertension and its complications Eye manifestations in rheumatological diseases Renal diseases related to eye Hyperviscosity disorders Ophthalmoloplegia and Cranial nerve palsies related to the eye Visual field changes associated with lesion related to the optic pathway Eye manifestations of myasthenia gravis Multiple sclerosis pituitary gland Stroke - Practice with at least 2 cases of each disease ٢٠

Internal Medicine A-Clinical case log H.N Diagnosis of case Level of participation * Location Signature of supervisor * Level of participation A- Plan and carry out B- Carry out C- Carry out under supervision ٢١

Internal Medicine Lectures Date Attendance Topic Signature ٢٢

Second Part ٢٣

Rotation / attendance proof الا ماكن التى تدرب بھا أسم المستشفى التى تدرب بھا توقیع ري یس القسم توقیع مدیر المستشفى Ophthalmology cases log Log of : Case Specialized Course Ophthalmology) Course. Retinoscopy,refraction, contact lenses, refractive surgery, and low vision rehabilitation 2. Cornea, external diseases 3. Glaucoma 4. Cataract 5. Uveitis 6. Eye in systemic diseases 7. Neuro-Ophthalmology 8. Oculoplastic Surgery and Orbit 9. vitreoretinal 0. Pediatric ophthalmology &Strabismus. Ocular Oncology Number 40 45 20 50 5 25 5 30 20 30 0 ٢٤

A-Clinical case log Retinoscopy,refraction, contact lenses, refractive surgery, and low vision rehabilitation Case Refraction in Myopia Refraction in Hypermetropia Refraction in Irregular Astigmatism Refraction in keratoconus Refraction in presbyopia Post operative refraction (Post keratoplasty, Aphakic, post RD) Contact lenses (Contact lenses for difficult cases) Refractive surgery PRK LASIK LASEK (observation) Treatment of amblyopia Number 4 4 4 4 4 4 4 4 4 ٢٥

Cornea, external diseases Case Corneal ulcer Infective bacterial, viral, fungal Non infective allergic,degener ative, ischaemic corneal dystrophies Keratoconus dermatochalasis,blepharochal asis, blepharofimosis inflammatory lesions of the skin of the lid Number 5 2 3 2 0 Case Ectropion Ptosis degenerative lesions pterygium pinguecula xerosis anterior segment trauma blunt trauma perforating trauma chemical injuries Number 4 2 2 2 5 chlazion, stye different types of blepharitis lid margin deformities entropion, trichiasis, 2 2 2 2 ٢٦

Glaucoma Case Primary congenital glaucoma secondary congenital glaucoma Primary angle closure glaucoma secondary angle closure glaucoma Primary open angle glaucoma secondary open angle glaucoma traumatic glaucoma Number 5 0 0 5 Cataract Case Congenital cataract Senile cataract Complicated cataract Drug induced cataract Cataract in systemic diseases Dislocated anterior Posterior dislocation Number 0 25 5 2 3 3 2 ٢٧

Uveitis Case Acute anterior and posterior uveitis. Chronic uveitis Intermediate uveitis pars planitis Number 7 4 4 Eye in systemic diseases Case Ocular changes in diabetes Ocular changes in hypertension and atherosclerosis Ocular changes in Dysthyroid disesase Ocular changes in Blood diseases (Leukaemia, Lymphoma, Anaemia, Sickle cell anaemia) Ocular changes in Collagen diseases, Ocular changes in Connective tissue diseases Number 0 5 5 3 2 ٢٨

Neuro-Ophthalmology Case Congenital optic nerve abnormalitie Nystagmus Pupillary abnormalities Optic neuropathies Oculoplastic Surgery and Orbit Number 2 Case Number congenital eyelid 3 deformities. congenital orbital 2 deformities. common craniosynostoses2 and other congenital malformations. More advanced eyelid, 3 orbital, and lacrimal trauma. Complicated cases of 3 nasolacrimal duct obstruction Epiphora in children 0 canaliculitis, 2 dacyrocystitis, acute and chronic dacryoadenitis, preseptal cellulitis, and orbital cellulitis. Thyroid ophthalmopathy. Orbital inflammatory pseudotumor. orbital tumors 3 2 3 ٢٩

Vitreoretinal Case Retinal detachment primary and secondary macular diseases retinal vascular diseases others Pediatric ophthalmology &Strabismus Case strabismus esotropia, exotropia, vertical deviation Defective vision amblyopia. childhood nystagmus Retinopathy of prematurity ocular anomalies and syndromes Paediatric uveitis. Congenital epiphora Ocular Oncology Case Adenexal neoplasms lid tumours, Conj tumours, Lacrimal gland tumours Retinoblastoma Malignant melanomas of the choroid Number 9 3 5 3 Number 5 Number 5 3 2 4 3 3 2 4 2 5 ٣٠

H N A- Clinical case log Diagnosis of Level of case participation * Location Signature of supervisor * Level of participation A- Plan and carry out B- Carry out C- Carry out under supervision ٣١

كلیة الطب H N A- Clinical case log Diagnosis of Level of case participation * Location Signature of supervisor * Level of participation A- Plan and carry out B- Carry out C- Carry out under supervision ٣٢

كلیة الطب H N A- Clinical case log Diagnosis of Level of case participation * Location Signature of supervisor * Level of participation A- Plan and carry out B- Carry out C- Carry out under supervision ٣٣

H N A- Clinical case log Diagnosis of Level of case participation * Location Signature of supervisor * Level of participation A- Plan and carry out B- Carry out C- Carry out under supervision ٣٤

كلیة الطب H N A- Clinical case log Diagnosis of Level of case participation * Location Signature of supervisor * Level of participation A- Plan and carry out B- Carry out C- Carry out under supervision ٣٥

كلیة الطب H N A- Clinical case log Diagnosis of Level of case participation * Location Signature of supervisor * Level of participation A- Plan and carry out B- Carry out C- Carry out under supervision ٣٦

H N A- Clinical case log Diagnosis of Level of case participation * Location Signature of supervisor * Level of participation A- Plan and carry out B- Carry out C- Carry out under supervision ٣٧

كلیة الطب H N A- Clinical case log Diagnosis of Level of case participation * Location Signature of supervisor * Level of participation A- Plan and carry out B- Carry out C- Carry out under supervision ٣٨

H N A- Clinical case log Diagnosis of Level of case participation * Location Signature of supervisor * Level of participation A- Plan and carry out B- Carry out C- Carry out under supervision ٣٩

كلیة الطب H N A- Clinical case log Diagnosis of Level of case participation * Location Signature of supervisor * Level of participation A- Plan and carry out B- Carry out C- Carry out under supervision ٤٠

B- Clinical case presentation log Diagnosis of case Number Retinoscopy, refraction, contact lenses, refractive surgery, and low vision rehabilitation Difficult cases of refraction Irregular Astigmatism, keratoconus Post operative refraction, Post keratoplasty, Aphakic, post RD Contact lenses for difficult cases (Difficult fitting) Contact lenses for difficult cases (Difficult fitting) Refractive surgery Treatment of amblyopia Low vision aids Cornea, external diseases Red eye Ocular Emergencies Ocular trauma Glaucoma Congenital glaucoma Open angle glaucoma Narrow angle glaucoma Cataract Congenital cataract Complicated cataract Drug induced cataract Cataract in systemic diseases ٤١

Diagnosis of case B- Clinical case presentation log Uveitis Acute anterior and posterior uveitis. Chronic and recurrent uveitis Intermediate uveitis pars planitis. Masquerade syndromes Eye in systemic diseases Ocular changes in diabetes Ocular changes in Hypertension and atherosclerosis Ocular changes in thyroid disesases Ocular changes in Blood diseases (Bleeding disorders Leukaemia Lymphomas Anaemia Sickle cell anaemia) Ocular changes in Collagen diseases Ocular changes in Connective tissue diseases Sarcoidosis Neuro-Ophthalmology Pupillary abnormalities Optic neuropathies Number ٤٢

Diagnosis of case Oculoplastic Surgery and Orbit congenital eyelid deformities B- Clinical case presentation log Number Epiphora in children Thyroid ophthalmopathy Orbital inflammatory pseudotumor eyelid, orbital, and lacrimal trauma Vitreo retinal diseases Retinal detachment primary and secondary macular diseases retinal vascular diseases Paediatric ophthalmology and Strabismus Strabismus esotropia, exotropia. vertical deviation amblyopia. Retinoblastoma Ocular Oncology Adenexal neoplasms lid tumours, Conj tumours, Lacrimal gland tumours Retinoblastoma Malignant melanomas of the choroid ٤٣

H N B- Clinical case presentation log Diagnosis of Level of Location case participation * Signature of supervisor * Level of participation A- Plan and carry out B- Carry out C- Carry out under supervision ٤٤

H N B- Clinical case presentation log Diagnosis of Level of Location case participation * Signature of supervisor * Level of participation A- Plan and carry out B- Carry out C- Carry out under supervision ٤٥

H N B- Clinical case presentation log Diagnosis of Level of Location case participation * Signature of supervisor * Level of participation A- Plan and carry out B- Carry out C- Carry out under supervision ٤٦

H N B- Clinical case presentation log Diagnosis of Level of Location case participation * Signature of supervisor * Level of participation A- Plan and carry out B- Carry out C- Carry out under supervision ٤٧

C- Procedure and Operation log Retinoscopy, refraction, contact lenses, refractive surgery, and low vision rehabilitation procedures Procedure * Level of Number participation Corneal topography 5 Level A 2 B3 Pachometry 5 Level A2 B3 Red reflex examination 0 Level A5 B5 Streak retinoscope use 0 Level A 5 B5 Keratometers 0 Level A 5 B5 Autorefractometer 5 Level A * Level of competency A- Independent performance B- Performance under supervision C- Observed ٤٨

Cornea, external diseases Procedure Fluorescein& Rose pingal staining of the cornea and conj taking conj swabs Placido disc examination keratoscopy Examination by the slit lamp Prepare a smear from the cornea and conj for microbiology study Do shirmer test precorneal tear film break up time Corneal topography Pachometry injection of local anaethsia for the lid and conj surgery removal of corneal &conj FB conj graft or flap or amniotic membrane for corneal ulcers application of corneal glue stromal micropuncture removal of Pterygium subconj injection antibiotic steroid mrdricaine electrocautery of the lashes * Level of competency A- Independent performance B- Performance under supervision C- Observed Number 5 2 3 30 3 5 5 8 8 5 5 3 8 8 3 * Level of participation A A A A20 B0 A2 B A3 B2 A3 B2 A4 B4 A4 B4 A4 B A3 B2 A2 B B B A4 B2 C2 A5 B3 A ٤٩

Cornea, external diseases Procedure correction of ectropion snellens correction of recurrent entropion correction of ectropion correction of symblepharon curette evacuation of chlazion evacuation of stye correction of ptosis Simple repair of ocular trauma Lid conj corneal corneoscleral grafting perforated corneal ulcers therapeutic keratoplasty plastic surgery for madarosis lid reconstruction trauma coloboma afer removal of lid tumours Correction of recurrent ptosis Correction of recurrent pterygium Tarsorrhaphy * Level of competency A- Independent performance B- Performance under supervision C- Observed Number 0 6 6 3 5 3 4 8 8 2 2 2 4 * Level of participation A5 B3 C2 A3 B3 A3 B2 C A2 B A4 B A A2 B C A4 B2 C2 A4 B2 C2 A B A A B B A B A2 B2 ٥٠

Glucoma Procedure Different methods of measurement of the IOP Mastering applanation tonometry Gonioscopy visual field mapping (automated) OCT optic nerve and retina laser iridectomy Trabeculectomy Repeated trabeculectomy * Level of competency A- Independent performance B- Performance under supervision C- Observed Number 40 25 20 20 0 3 5 5 * Level of participation A30 B0 A5 B0 A0 B0 A0 B0 A5 B5 A2 B A0 B5 A2 B3 ٥١

Procedure Cataract Evaluate and classify common types of lens opacities. Perform subjective refraction techniques and retinoscopy in patients with cataract. Perform direct and indirect ophthalmoscopy pre-and post-cataract surgery. Perform Ultrasonography Perform Biometry Local evaluation for cataract extraction ICCE Secondary IOL implantation Management of postoperative complications of cat ext. phacoemulsification Lensectomy Cat. in silicon filled eyes Management of posteriorly dislocated lens fragments Cat. in children Cat. with systemic diseases Cat. in relation to different types of trauma * Level of competency A- Independent performance B- Performance under supervision C- Observed Number 20 20 20 30 30 25 2 3 0 5 2 2 5 2 3 * Level of participation A0 B0 A5 A2 B5 B8 A20 B0 A20 B0 A0 B0 C5 A B A2 A5 A2 A B B B2 B3 A2 B2 C A B A B2 B B5 ٥٢

Uveitis Procedure Number Directed examination of the anterior and 0 posterior segments for uveitis Slit lamp biomicroscopy, scleral 0 depression, magnified posterior segment exam, vitreous evaluation for cells). Perform ancillary testing in the 0 evaluation of uveitis (e.g., fluorescein angiography, ultrasound) Prescribe steroids in the treatment of 5 uveitis by various routes. Evaluate and treat the complications of 8 uveitis therapy (e.g., cataract, glaucoma) Administer immunosuppressive 8 agents in uveitis Eye in systemic diseases Procedure Fluorescein angiography OCT US Proptometry Topical and systemic steroids uses of specific anti microbial drugs antifungal antiviral anti biotic laser photocoagulation simple vitrectomy lid suture tarsorrhaphy * Level of competency A- Independent performance B- Performance under supervision C- Observed Number 5 5 25 0 5 20 3 5 0 * Level of participation A5 B5 A5 B5 A5 B5 A A5 B3 A4 B4 * Level of participation A A A A A A2 B8 A B2 A A5 B5 ٥٣

Neuro-Ophthalmology Procedure Perform a basic pupillary examination: perform basic pharmacologic pupillary testing Perform differential diagnosis of anisocoria Detection of light-near dissociation Perform a basic ocular motility examination: Perform a detailed cranial nerve evaluation Assess ocular alignment using simple techniques Describe and perform basic cover/uncover testing for tropia. Describe and perform alternate cover testing for phoria. Perform simultaneous prism and cover testing. Perform measurement of deviations with prisms. Describe the indications for and apply Fresnel and grind-in prisms. Describe the indications for and perform forced duction and forced generation testing. Perform an assessment of saccade accuracy and pursuit and optokinetic testing. Measurement of eyelid function. Perform confrontational field testing. Describe the indications for and perform basic Goldmann perimetry, and interpret results. Describe the indications for and perform basic automated perimetry, and interpret results Perform and interpret a tangent screen test. Perform basic direct, indirect, and magnified ophthalmoscopic examination of the optic disc. Intravenous edrophonium (Tensilon) and Prostigmin tests for myasthenia gravis. Number 0 5 0 0 0 0 8 4 4 3 3 5 5 8 5 8 5 4 * Level of participation A5 B5 A3 B2 A8 B2 A7 B3 A7 B3 A7 B3 A4 B4 A2 B2 A2 B2 B3 B A A A3 B5 A5 B5 A5 B3 A3 B2 A2 B2 ٥٤

Neuro-Ophthalmology Procedure Describe the evaluation, management, and specific testing of patients with "functional" (non-organic) visual loss (e.g., recognize nonorganic spiral or tunnel visual fields). More advanced interpretation of neuro-radiologic images. CT MRI of the brain Describe the indications for, perform, and list the complications of temporal artery biopsy Dacryocysteography thyroid function tests excision of moderate sized and large benign eyelid lesions). incision and drainage of recurrent or larger chalazia, incision and drainage of multiple chalazion Treat retrobulbar hemorrhage, Lacrimal drainage testing (irrigation, dye disappearance test). Lacrimal intubation. Dacryocystorhinostomy (external). Dacryocystectomy * Level of competency A- Independent performance B- Performance under supervision C- Observed Number 4 8 6 2 4 5 5 5 3 2 8 6 6 6 * Level of participation B B 3A-3B B A2 B2 B A3 B2 A2 B3 A B A3 B5 A3 B3 A2 B4 A3 B3 ٥٥

Oculoplastic Surgery and Orbit Procedure measurement of levator function, orbital ultrasound interpretation Identify indications for and perform more advanced assessment of eyelids and eyebrows. Identify indications for and perform more advanced lacrimal assessment. Identify indications for and perform more advanced assessment of the orbit. Identify indications for and perform more advanced socket assessment. Recognize orbital trauma. Identify common orbital pathology Treat common presentations of preseptal or orbital cellulitus. Exophthalmometry Investigation of epiphora probing syringing orbit magnetic resonance imaging, Computed tomography, ultrasound - * Level of competency A- Independent performance B- Performance under supervision C- Observed 8 8 5 5 5 4 3 3 3 5 0 7 0 Number * Level of participation A4 B4 A4 B4 A3 B2 A2 B3 A2 A B3 B3 A B2 A B2 A B2 A A5 B5 A2 B5 A5 B5 ٥٦

Procedure Fluorescein angiography Vitreo retinal diseases OCT techniques Ultrasound Direct and indirect ophthamoscopy scleral indentation Perform fundus drawings of the retina, showing complex vitreoretinal relationships and findings Using different fundus viewing lenses Amsler Grid * Level of competency A- Independent performance B- Performance under supervision C- Observed Number 20 6 40 40 40 20 7 * Level of participation A0 B0 A3 B3 A20 B20 A20 B20 A25 B5 A0 B0 A5 B2 ٥٧

Paediatric ophthalmology and Strabismus Procedure Perform more advanced measurements of strabismus. Perform assessment of vision in more difficult strabismus patients. Perform preoperative assessment of strabismus EUA for IOP Angle exam Examination of the retina Lens exam Investigation of epiphora US Perform the following strabismus surgeries:resection Recession Number 4 4 8 0 6 5 8 8 20 0 0 * Level of participation A2 B2 A2 B2 A5 B3 A A2 B4 A5 B5 A5 B3 A5 B3 A0 0 A5 B5 A5 B5 ٥٨

Ocular Oncology enucleation Procedure Number 4 * Level of participation A2 B2 excision biopsy vit. tap AC tap excision of lid, conjunctival, and corneal tumours 3 2 3 B B A A2 B * Level of participation A- Plan and carry out B- Carry out C- Carry out under supervision ٥٩

H N C- Procedures and Operations log book Procedure Level of Location competency* Signature * Level of competency A- Independent performance B- Performance under supervision C- Observed ٦٠

H N كلیة الطب Procedure C- Procedures and operations log book Level of competency* Location Signature * Level of competency A- Independent performance B- Performance under supervision C- Observed ٦١

H N كلیة الطب Procedure C- Procedures and operations log book Level of competency* Location Signature * Level of competency A- Independent performance B- Performance under supervision C- Observed ٦٢

H N C- Procedures and operations log book Procedure Level of Location competency* Signature * Level of competency A- Independent performance B- Performance under supervision C- Observed ٦٣

H N كلیة الطب Procedure C- Procedures and operations log book Level of competency* Location Signature * Level of competency A- Independent performance B- Performance under supervision C- Observed ٦٤

H N كلیة الطب Procedure C- Procedures and operations log book Level of competency* Location Signature * Level of competency A- Independent performance B- Performance under supervision C- Observed ٦٥

H N كلیة الطب Procedure C- Procedures and operations log book Level of competency* Location Signature * Level of competency A- Independent performance B- Performance under supervision C- Observed ٦٦

H N كلیة الطب Procedure C- Procedures and operations log book Level of competency* Location Signature * Level of competency A- Independent performance B- Performance under supervision C- Observed ٦٧

H N كلیة الطب Procedure C- Procedures and operations log book Level of competency* Location Signature * Level of competency A- Independent performance B- Performance under supervision C- Observed ٦٨

H N كلیة الطب Procedure C- Procedures and operations log book Level of competency* Location Signature * Level of competency A- Independent performance B- Performance under supervision C- Observed ٦٩

H N كلیة الطب Procedure C- Procedures and operations log book Level of competency* Location Signature * Level of competency A- Independent performance B- Performance under supervision C- Observed ٧٠

H N كلیة الطب Procedure C- Procedures and operations log book Level of competency* Location Signature * Level of competency A- Independent performance B- Performance under supervision C- Observed ٧١

H N كلیة الطب Procedure C- Procedures and operations log book Level of competency* Location Signature * Level of competency A- Independent performance B- Performance under supervision C- Observed ٧٢

H N كلیة الطب Procedure C- Procedures and operations log book Level of competency* Location Signature * Level of competency A- Independent performance B- Performance under supervision C- Observed ٧٣

H N C- Procedures and operations log book Procedure Level of Location competency* Signature * Level of competency A- Independent performance B- Performance under supervision C- Observed ٧٤

Activity Academic activities Lecture, journal club, conference, workshop Your role ** Date Signature of supervisor ** Your role:- A- Attendance B- Organization C- Presentation ٧٥

Activity Academic activities Lecture, journal club, conference, workshop Your role ** Date Signature of supervisor ** Your role:- A- Attendance B- Organization C- Presentation ٧٦

Activity Academic activities Lecture, journal club, conference, workshop Your role ** Date Signature of supervisor ** Your role:- A- Attendance B- Organization C- Presentation ٧٧

Activity Academic activities Lecture, journal club, conference, workshop Your role ** Date Signature of supervisor ** Your role:- A- Attendance B- Organization C- Presentation ٧٨

Activity Academic activities Lecture, journal club, conference, workshop Your role ** Date Signature of supervisor ** Your role:- A- Attendance B- Organization C- Presentation ٧٩

Activity Academic activities Lecture, journal club, conference, workshop Your role ** Date Signature of supervisor ** Your role:- A- Attendance B- Organization C- Presentation ٨٠

* Name: * Period of training From: To: * Site: *Rotation General skills could not strongly strongly judge (0) disagree() (2 ) (3) (4 ) (5) (6) agree (7) Perform practice-based improvement activities using a systematic methodology (share in audits and risk management activities and use logbooks). Appraises evidence from scientific studies. Conduct epidemiological studies and surveys. Perform data management including data entry and analysis and using information technology to manage information, access on-line medical information; and support their own education. ٨١

General skills could not strongly strongly judge (0) disagree() (2 ) (3) (4 ) (5) (6) agree (7) Facilitate learning of students other health care professionals including their evaluation and assessment. Maintain therapeutic and ethically sound relationship with patients. Elicit information using effective nonverbal, explanatory, questioning, and writing skills. Provide information using effective nonverbal, explanatory, questioning, and writing skills. Work effectively with others as a member of a health care team or other professional group. Demonstrate respect, compassion, and integrity; a responsiveness to the needs of patients and society. Demonstrate a commitment to ethical principles including provision or withholding of clinical care, confidentiality of patient information, informed consent, business practices. ٨٢

كلیة الطب General skills could not judge (0) strongly disagree() (2 ) (3) (4 ) (5) (6) strongly agree (7) Demonstrate sensitivity and responsiveness to patients culture, age, gender, and disabilities. Work effectively in relevant health care delivery settings and systems including good administrative and time management Practice cost-effective health care and resource allocation that does not compromise quality of care. Assist patients in dealing with system complexities. ٨٣

Formative assessment Exam Score Date Signature ٨٤

MCQ Assessments - Two MCQ examination at the second year and third year for Ophthalmology Date grade * Signature of Head of the department *Degree A- Excellent B- Very good C- Good D- Pass ٨٥

الرساي ل العلمیة كلیة الطب : : عنوان الرسالة عربي انجلیزي المشرفون :... - ١... - ٢... ٣... - ٤ / / تاریخ القید لدرجة :... تاریخ التسجیل الموضوع:... المتابعة الدوریة :... المتبقي ما تم انجازه من بروتوكول البحث التاریخ توقیع المشرفین ٨٦

Declaration Course Structure Mirror First Part Course Course 2 Course 3 Course 4 Course 5 Second Part Course ٦ - Master Degree Thesis Acceptance Date: - Fulfillment of required contact hours prior to final examination Ophthalmology M Sc Degree Principle Coordinator: Date approved by Council: یعتمد ري یس القسم أ.د/ Responsible (Course ) Coordinator Name: Signature Date ٨٧