LOG BOOK
Fellowship in Assissted Reproductive Techniques (clinical)
Indian fertility society
Certificate
This is to certify that this log book is a bona fide record of all the procedures done and the academic activities participated in, by Dr _ _ during her training in Reproductive Medicine from to ______at------in accordance with the requirement of IFS for the Post Doctoral Fellowship in Reproductive Medicine(Clinical)
COURSE & ACADEMIC COORDINATORS
Name and affiliation:Signature
Candidate
Name:______
Date of Birth:______
Qualification:______
Date of Joining:______
Date of Completion:______
Signatures
Date:-
INSTRUCTIONS
This log book has four sections
Section A: Detailed case records of interesting cases seen during the course, Ten cases in all four categories i.e. OPD, IVF and embryology, endoscopy, High risk obstetrics. The cases need to be discussed with the consultant incharge and signed by them.
Section B: Record of all procedures observed assisted or performed. This log book is intended to be a record of all operations performed or participated in during the course. The information required for each procedure is the date, name, reg no, nature of operation and the level of participation.
Level of participation is categorised as:
P=Principal Operator
PA=Principal operator assisted by senior
A=Assistant
O=Observed.
Use the table format given for IVF, endoscopy obstetric, fetal medicine procedure. The log book need to be signed by coarse co-ordinator at least monthly.
Section C: Records of participation of all academic activities in the prescribed format.
Section D: Detials of participation, publication or presentation of research work during the fellowship tenure.
*This is only a format. Add additional pages as required.
Index
Section A
A Clinical Cases
A (S1-10) – OPD (10 cases, one case per month)Take cases which emparize history, investigations diagnosis and decision making in infertility with different diagnosis.
A (S11-20) IVF cases (10 cases, one case per month) with details of stimulation protocol, OPU, laboratory procedures, ET and embryo freezing (Take details steps of one differentprocedure per case)
A (S21-30) Endoscopy (10 case, one case per month) involving endoscopic diagnostic and therapeutic procedures. Different diagnosis and surgical steps. Write surgical steps, equipment in detail.
A (31-40) IVF pregnancy (10 cases, one case per month) involving different antenatal problem in IVF pregnancies including cases posing problem of antenatal diagnosis.
Add different sheets for each case.
Section B
B1. TVS (at least 50 for IUI and 50 for IVF and 20 color Doppler)
B2. Minor procedures 50 HSG
B3. ART procedure (OPU, ET, IUI) at least 10 each
B4. Endoscopy procedure/infertility surgery at least 50 each
B5. Obstetrical procedures. (High risk pregnancy, cervical encirclage, amniocentesis, Embryo Reduction etc.
Use different sheets and any number of sheets for B1, B2, B3, B4, B5
B. Procedure record
Sr. No. / Hospital Reg. No / Name / Age / Diagnosis / Procedure / Indication / Comments & complications / Participation levelSection C
Academic Activities
Include inhouse meetings, seminars, journal clubs, ward rounds etc. also. At least 60 hours of teaching at the centre and 20 hours from other activities like conference guest lecture.
Sr. No. / Date / Conference/lectures Name / Topic / Speakers / CommentsSection D
Research Work
- Publications: Complete citation along with abstract.
- Paper presented in any conference, Give complete citation, name, place and date of the conference.
- Research project: Give brief summary of the project. A separate paragraph highlighting your contribution. Participation in the centre’s ongoing project may be also included.
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