HEALTH PROFESSIONS

COUNCIL OF ZAMBIA
Approved Log Book for
Medical Licentiate Interns

Regulating Professional Conduct of Health Practitioners, Health

Facilities and Health Training Programmes to Quality Healthcare
Service Provision for the wellbeing of the Public is our Prime Concern 1st Edition, 2024

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 Foreword

Residency training plays a vital role in a Medical Licentiate’s career. This legal requirement allows
a practitioner to acquire critical practical skills that cannot be acquired within the precincts of a
lecture room. During university training, an individual will acquire scientific knowledge and skills
from various avenues.

Residency training provides a platform for the resident to apply the skills learnt practically under
the supervision of a specialist practitioner who is a mentor and a coach. Indeed, the resident's
attitude during this period will determine the knowledge and skills acquired and subsequently bring
out a well-grounded and competent doctor.

The Council has designed a logbook to standardise Residency training with a particular emphasis
on core competencies and skills to be acquired during this period. The assessment report is useful
feedback to the Council, which determines whether or not a resident qualifies for full registration
as Medical Licentiate Practitioner.

These residency logbooks cover what the Council considers important areas to be covered to
ensure adequate knowledge and skills are acquired. They were developed and compiled by a team
of experienced clinicians, teachers and other key stakeholders in the medicine and dentistry field.

The Council has made numerous legal strides to protect all residents during training. The
Guidelines for Approval of Residency Sites, issued under Section 76 of the Health Professions Act
Number 24 of 2009 of the Laws of Zambia, defines residency training and lays down the
framework for residency training in Zambia a mandatory requirement before full registration as a
medical licentiate practitioner.

It is important also to take note of "The Code of Professional Conduct and Discipline", which
outlines the conduct expected of all health practitioners, including medical licentiate and
subsequent
disciplinary action in the event of any transgression of this code.

On behalf of the Council, I wish all users of this Logbook (residents and supervisors alike) an
exciting and fruitful time during the residency training period.

____________________
Prof. Mulindi Mwanahamuntu
Council Chairperson
Health Professions Council of Zambia

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 Acknowledgements

The Health Professions Council of Zambia gratefully acknowledges the parties who have
diligently and committed to developing the Log Book for Medical Licenciate Interns. The Council
further recognizes the valuable contribution and input from the leadership of the Zambia Medical
Licentiate Practitioners Association, Zambia Medical Association, Internship training sites across
the country, and other Regulatory Bodies in Zambia involvement in practice of pharmacy. The
Council also wishes to express profound gratitude to the following individuals and institutions who
provided input to the development of the logbook:
1. Dr Geofrey Phiri – Ministry of Health
2. Ms Mukelabai Chita – Ministry of Health
3. Mr Wisdom Chelu- Ministry of Health
4. Ms Clementina Mukelabai- Zambia Medical Licentiate Practitioners Association
5. Ms Monde Wamunyima- Zambia Medical Licentiate Practitioners Association
6. Dr Oliver Kaoma- Zambia Medical Association
7. Dr Innocent Ngwila- Zambia Medical Association
8. Ms Clementina Mukelabai- Zambia Medical Licentiate Practitioners Association
9. Dr Biete Luke- Pharmaceutical Society of Zambia
10. Ms Martha Chuulu- Pharmaceutical Society of Zambia
11. Dr Sompwe Mwansa- Society of Anaethetists of Zambia
12. Dr Kalenga Kyungu – National Heart Hospital
13. Mr Gift Mukubesa- Clinical Anaethetist Association of Zambia
14. Mr Musonda Kamfwa- Clinical Officers Association of Zambia
15. Dr Priscilla Phiri - Zambia Dental Association
16. Mr John Chama-Representative of the Emergency Care Officers
17. Mr Chipoya Chipoya- Levy Mwanawasa Medical University
18. Mr Grandson Kelvin Jere- Zambia Association of Optometrists
19. Dr David Kasongole- Zambia Ophthalmological Society
20. Mr Fyatilani Chirwa- Health Professions Council of Zambia
21. Mr Andrew Mwamba- Health Professions Council of Zambia
22. Ms Ennie Chipabika- Health Professions Council of Zambia
23. Ms Cynthia Sautu Kachamba- Health Professions Council of Zambia
24. Mr Lloyd Bwalya- Health Professions Council of Zambia
25. Mr Donald Kalolo- Health Professions Council of Zambia
26. Mr Jon Kasalika Masiku- Health Professions Council of Zambia
27. Mr Fannwell Daka - Health Professions Council of Zambia
28. Ms Meah Liseli Konoso- Health Professions Council of Zambia

____________________
Pro. Fastone M Goma
Registrar/Chief Executive Officer
Health Professions Council of Zambia

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 Table of Contents
Foreword ......................................................................................................................................... 2
Acknowledgements ......................................................................................................................... 3
Table of Contents ............................................................................................................................ 4
1 Introduction ............................................................................................................................. 6
1.1 Message to Medical Licentiate Resident .......................................................................... 6
1.2 Message to the Supervisor................................................................................................ 7
1.3 Objectives ......................................................................................................................... 8
2 Outline of the Logbook............................................................................................................ 9
2.1 Personal Details of the Medical Licentiate Resident ....................................................... 9
2.2 Purpose of the Logbook ................................................................................................... 9
2.3 The sections of the Logbook ............................................................................................ 9
2.4 Using the Logbook ........................................................................................................... 9
3 General Surgery Residency Rotation (3½ Months)............................................................... 10
3.1 Introduction: ................................................................................................................... 10
3.2 Vision: ............................................................................................................................ 10
3.3 Supervision of Residents ................................................................................................ 10
3.6 Grading Criteria for the General Surgery Rotation................................................................. 11
3.7 Resident Involvement ...................................................................................................... 11
3.8 Rotation Area Requirements: .......................................................................................... 11
3.9 General Surgery Rotation Procedures ................................................................................. 12
3.4 Evaluation of the General Surgery Rotation .................................................................. 16
3.4.1 Monthly review of the performance ...................................................................... 16
3.4.2 Details of Clinical/Audit Meetings Presented......................................................... 17
3.4.3 Details of Teaching Rounds Attended .................................................................... 18
3.4.4 Overall Assessment at the end of the rotation ........................................................ 19
4 Obstetrics & Gynaecology (Reproductive Health) Rotation (3 Months) .............................. 21
4.1 Introduction: ................................................................................................................... 21
4.2 Vision: ............................................................................................................................ 21
4.3 Supervision of Residents ................................................................................................ 21
4.3.1 Grading: .................................................................................................................. 22
4.3.2 Resident Involvement ............................................................................................. 22
4.3.3 Rotation Area Requirements:.................................................................................. 22
4.4 Obstetrics & Gynaecology Rotation Procedures ............................................................ 23
4.4.1 Obstetric Rotation Procedures ................................................................................ 23
4.4.2 Gynaecology Rotation Procedures .......................................................................... 26
4.5 Evaluation of the Obstetrics & Gynaecology Rotation .................................................. 28
4.5.1 Monthly review of the performance ....................................................................... 28
4.5.2 Details of Clinical/Audit Meetings Presented......................................................... 29
4.5.3 Details of Teaching Rounds Attended .................................................................... 30
4.5.4 Overall Assessment at the end of the rotation ........................................................ 31
5 Paediatrics And Child Health Rotation (2½ Months)............................................................ 33
5.1 Introduction: ................................................................................................................... 33
5.2 Vision: ............................................................................................................................ 33
5.3 Supervision of Residents ................................................................................................ 33
5.4 Paediatrics and Child Health Rotation ........................................................................... 34
5.4.1 Basic Information.................................................................................................... 34
5.4.2 Grading: .................................................................................................................. 34
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 5.4.3 Resident Involvement ............................................................................................. 34
5.4.4 Rotation Area Requirements:.................................................................................. 34
5.5 Paediatrics and Child Health Rotation Procedures and Case Management ................... 35
5.5.1 Paediatrics and Child Health Rotation Procedures ................................................. 35
5.5.2 Paediatrics and Child Health Rotation Case Management ..................................... 39
5.6 Evaluation of the Paediatrics and Child Health Rotation ............................................... 41
5.6.1 Monthly review of the performance ....................................................................... 41
5.6.2 Overall Assessment at the end of the rotation ........................................................ 42
6 Internal Medicine Rotation (2½ Months) .............................................................................. 44
6.1 Introduction: ................................................................................................................... 44
6.2 Vision: ............................................................................................................................ 44
6.3 Supervision of Residents ................................................................................................ 44
6.3.1 Basic Information.................................................................................................... 45
6.3.2 Grading: .................................................................................................................. 45
6.3.3 Resident Involvement ............................................................................................. 45
6.3.4 Rotation Area Requirements:.................................................................................. 45
6.4 Internal Medicine Rotation Procedures and Case Management .................................... 46
6.4.1 Internal Medicine Rotation Procedures .................................................................. 46
6.4.2 Internal Medicine Rotation Case Management....................................................... 47
6.5 Evaluation of the internal Medicine Rotation ................................................................ 48
6.5.1 Monthly review of the performance ....................................................................... 48
6.5.2 Overall Assessment at the end of the rotation ........................................................ 49

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1 Introduction

A residency is a prescribed employment period during which graduates work under supervision to
fulfil full registration requirements. During this period, the graduates can consolidate their
knowledge, skills and attitudes to be competent practitioners. This Logbook will be used to
document the progress of the Residency. It is an official document with a resident's collective
performance, a record of all the work done, procedures conducted, and targets achieved provides
criteria for the continuous assessment program of a residency. It is a snapshot of all the progress
that the learner has had to move to the next phase in his medical practice journey.

1.1 Message to Medical Licentiate Residents

This Logbook will help to record your experiences and achievements on this placement. It is
required to be filled in completely for you to be fully registered by the Council as a Medical
Licentiate. You are expected to spend specified rotation time in the following medical service areas
translating into 12 months for you to complete the Internship as follows:
S/n Rotation Site Duration
In-Service Direct Entrants
1 Internship Medicine Two & half (2½) months Four (4) months
2 General Surgery Three & Half (3½) months Five (5) months
3 Paediatrics and Child Health Two & half (2½) months Four(4) months
4 Obstetrics and Gynaecology Three & Half (3½) months Five (5) months

As a Medical Licentiate Resident, your responsibilities include the following: -

1. Clerking patients where applicable
2. Performing relevant investigations
3. Guiding patients and relatives with regard to diagnosis, treatment and follow-up
4. Documenting and regularly updating patients' notes
5. Writing accurate and informative case summaries.
6. Appropriate handing over of patients
7. Presenting cases concisely, coherently and competently during ward rounds, grand rounds
or any other appropriate fora.
8. Participating in the development and implementation of community health programmes
under the supervision
9. Reporting to and consulting with the resident Supervisor
10. Participating in continuing professional development activities
11. Maintaining professional demeanour and conduct
12. Participating in the activities of the relevant committees in the rotation sites
13. Performing any other relevant duties assigned by the Supervisor

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The following as some the Hints & Tips: Your Residency:

1. Get there in plenty of time

2. Dress smart
3. Make sure that you take this Logbook with you
4. Ask about your weekly roster
5. Check what work you will be doing
6. Make a note of your Supervisor's contact details
7. Regarding health and safety, here are a few common-sense rules you should follow while
on your Residency to ensure that you do not become involved in an accident at work or
that you are not the cause of an accident.
a. Obey Any Safety Rules: Find out if there are any particular rules where you work,
such as wearing the correct clothing, where the fire exits are, etc., to know the rules
and obey them. Listen carefully to the advice or instructions of your Supervisor, and
don't be afraid to ask questions.
b. First Aid: If you injure yourself in any way, report it to your Supervisor immediately
and obtain treatment.
c. Cleanliness: Always keep your work area clean and tidy. Remember to wash your
hands regularly.
8. Help: What if the unexpected happens? For instance, Phone your Supervisor as soon as
you know you will be late. It is the polite, professional thing to do

1.2 Message to the Supervisor

Please help the residents to complete the appropriate pages of this Logbook to enable them to
reflect on their experiences and to have a record of the progress of the Residency. As a Supervisor,
you are responsible for the overall supervision of the residents in that rotational or placement unit
or department and shall:
1. Maintains resident Progression Records for the rotation site
2. Update Residency Coordinator regularly on resident progress
3. Update Management and Residency Coordinator on matters administrative issues touching
on ,resident supervisors or departments within the institution that hinder the
implementation of the programme
4. Ensure the residents comply with ethics in the health profession as required by statutory
laws
5. Ensure there is an appropriate orientation for the residents upon reporting to the rotation
site
6. Organise minutes of monthly progress meetings with residents
7. Ensure objective and fair Assessment of the resident. Further, ensure that residents are
evaluated, and residency logbooks are filled appropriately during and at the end of each
rotation.
8. Identify and recommend to management or residency coordinator exceptional residents for
recognition or award
9. Participate in disciplinary proceedings for residents
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1.3 Objectives

At the end of the Residency Training programme, a resident Medical Licentiate should be able to:

1. Perceive the nature of the problems presented to them by the patients and make appropriate
decisions.
2. Communicate effectively with the patients, their relatives, doctors and other health care
providers at their working places(Hospital, Primary Health Centres and in the community)
3. Take and record the Patient's history
4. Perform clinical examinations competently.
5. Use laboratory and other diagnostic facilities efficiently.
6. Plan and carry out treatment, including rehabilitation if required and follow-up.
7. Use available facilities for disease prevention and health promotion.
8. Adopt safe practices in the laboratory, and X-ray room, in relation to radiation and during
patient care with due regard to all concerned.
9. Recognise his/her limitations in patient care with an appropriate referral.
10. Behave appropriately (attitude) with the patients and with their relatives-
11. Considering Ethical and legal issues.
12. 11. Continue Professional Development (CPD) & improve skills to deliver.
13. 12. Diagnose the community problem and suggest appropriate measures.
14. 13. Recognise emergencies and handle them appropriately.

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2 Outline of the Logbook

2.1 Personal Details of the Medical Licentiate Resident

Resident Name___________________________________HPCZ Registration No ____________

Residency Centre___________________________ ______ HPCZ Licence No ____________

Period of Rotation: Start:________________________ End:____________________

Name of Supervisor___________________________ Sign and Stamp: ____________________

2.2 Purpose of the Logbook

This log book is a documentary of the structured Residency Training Program. The Logbook aims
to help you monitor your competence, recognise gaps, and address them. Further, it helps to
describe the minimum competence level expected of you by the end of your residency rotation.

2.3 The sections of the Logbook

The Logbook contains Five (5) sections representing the disciplines covered in the residency
training period. Each section is laid out in to cover the following domains:
1. Requirements of the discipline
2. The level of competence required and their interpretation:
a. Level 1: Observe the activity being carried out by a supervisor
b. Level 2: Assist in the procedures
c. Level 3: Carry out the whole activity/procedure under the direct supervision of a
senior colleague, i.e. the senior colleague is present throughout
d. Level 4:Carry out the whole activity under indirect supervision, i.e. the senior
colleagues need not be present throughout but should be available to provide
assistance and advice
e. Level 5: Independent competence, no need for supervision
3. A log of the procedures to be completed
4. Assessment of the monthly progress in each discipline
5. Evaluation of the rotation performance and recommendations made

2.4 Using the Logbook

The residents are expected to fill the competence levels daily as they achieve them and enter the
appropriate date. The Supervisor shall sign off on all accomplished targets. Every month, the
resident, the Supervisor and the resident coordinator shall review progress in the rotation to ensure
the resident is on course to achieving the set requirements for the rotation. At the end of the

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rotation, the resident shall be assessed by the Supervisor, the resident coordinator and the medical
director/superintendent on the performance during the rotation.
3 General Surgery Residency Rotation (3½ Months)

3.1 Introduction:
Surgery is a medical specialty that uses manual and instrumental techniques on a patient to investigate
and/or treat a pathological condition such as disease or injury, or to help improve bodily function or
appearance. An act of performing surgery may be called a surgical procedure, operation, or simply
surgery. There are various sub-specialties of Surgery with which the resident doctor has to be conversant
in order to provide optimum care to patients.

3.2 Vision:
The residency program in Surgery is meant to ensure that the newly qualified doctors acquire the necessary
surgical competences to enable them provide quality clinical care to patients.

3.3 Supervision of Residents

The following are supervisory strategies for the residents in Surgery

• Consultant led major rounds minimum 8 hours/week

• Clinical experience (OPDs and In-patient under GMO/Specialist)
• Theatre experience 6 hours/week
• Morning reports (ML on call) 2.5 hours/week
• Clinical Meetings 4/month
• Morbidity/Mortality Audit Monthly

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3.5 Basic Information
Resident Names__________________________________HPCZ Registration No ____________

Residency Centre___________________________ ______ HPCZ Licence No ____________

Period of Rotation: Start:________________________ End:____________________

Name of Supervisor___________________________ Sign and Stamp: ____________________

3.6 Grading Criteria for the General Surgery Rotation

• 3- The resident meets most of the criteria without assistance

• 2- The resident requires some assistance to meet the stated criteria
• 1- The resident requires considerable assistance to meet the stated criteria
• 0- Unable to meet the criteria completely

NB: Where the grading shall be on a scale of 0 or 1 above, the Supervisor shall be required to give
reasons for the said finding and make recommendations in the best interest of the resident and the public.

3.7 Resident Involvement

• Performed (P)- The resident does the work as the primary Medical Licentiate
• Assisted (A)- The resident assisted the primary Medical Licentiate doctor in the procedure
or treatment
• Observed (O)- The resident observed the procedure or treatment

3.8 Rotation Area Requirements:

In this rotation, the Medical licentiate resident shall:

1. Be able to clerk, investigate and present patients during ward rounds
2. Be able to prepare patients undergoing various surgical procedures adequately
3. Be able to follow up with patients after surgery till discharge and be able to write a proper
discharge summary
4. Participate in daily ward rounds, attend theatres and attend the surgical outpatient clinic
5. Attend and participate/present in all departmental CPD Programmes

In addition to the above, at the end of the rotation, one is expected to have participated in the
following procedures:

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3.9 General Surgery Rotation Procedures

# of Resident Supervisors
Operations File No. Date Supervisors Name
Cases involvement Signature
1.
2.
3.
4.
Surgical toilet- 5.
10(p) 6.
7.
8.
9.
10.
1.
2.
3.
4.
Suturing Wound- 5.
10(p) 6.
7.
8.
9.
10.
1.
2.
3.
4.
Incision and
5.
drainage of
6.
Abscess 1 (O) 2(p)
7.
8.
9.
10.
1.
Insertion of chest 2.
tubes 3.
3(p) 4.
5.
1.
2.
3.
4.
Removal of stitches
5.
10(p)
6.
7.
8.
9.

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 # of Resident Supervisors
Operations File No. Date Supervisors Name
Cases involvement Signature
10.
1.
Appendicectomy
2.
2(A) and 1(P)
3.
1.
Repair of inguinal 2.
hernias 3.
3(a) 2(p) 4.
5.
1.
2.
Exploratory
3.
laparotomies
4.
5(a) 1(p)
5.
6.
1.
2.
Incision or Excision
3.
biopsy 5(P)
4.
5.
1.
Proctoscopy
2.
2(o) 1(p/a)
3.
Haemorrhoid or 1.
Thrombosed 2.
Haemorrhoids
management 3.
3(P)
Gut resection and 1.
anastomosis 2(o/) 2.
Colostomy 1.
fashioning 2(o/a) 2.
Closure of 1.
colostomies 2(o/a) 2.
1.
Cut down for venous
2.
access 1 (o) 2(p)
3.
1.
2.
3.
4.
Urethral
5.
catheterization
6.
10(p)
7.
8.
9.
10.
1.
Suprapubic
2.
catheterization
3.
2 (O) 2(P)
4.

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 # of Resident Supervisors
Operations File No. Date Supervisors Name
Cases involvement Signature
5.
6.
1.
Hydrocelectomy
2.
2(A) and 1(P)
3.
Tracheostomy 1.
2(a) 2.
Circumcision 1.
2(p) 2.
1.
Skin graft 2.
3(a) 1 (p) 3.
4.
Burr holes 1.
2(a) 1 (p) 2.
1.
Epistaxis 2.
management 3.
3(a) 2(p) 4.
5.
1.
Endotracheal 2.
intubation 3.
5(a) 3(p) 4.
5.
1.
POCUS 2.
2(o) 2(p) 3.
4.
1.
2.
3.
4.
Splinting of lower 5.
limb fractures 10(p) 6.
7.
8.
9.
10.
1.
2.
3.
4.
Splinting of upper
5.
limb fractures
6.
10(p)
7.
8.
9.
10.
1.

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 # of Resident Supervisors
Operations File No. Date Supervisors Name
Cases involvement Signature
Application of 2.
plaster of Paris 3.
(POP) upper limb 4.
5(p) 5.
1.
Application of 2.
plaster of Paris
3.
(POP) lower limb
5(p) 4.
5.
1.
Residential 2.
(Internal) fixation of
3.
fractures
5(a) 4.
5.
1.
Any paediatric 2.
surgical Procedure 3.
5(a) 4.
5.
1.
Prostatectomy
2.
3(a/o)
3.
Skin traction 1.
2(p) 2.
Limb amputation 1.
2(a/o) 2.

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3.4 Evaluation of the General Surgery Rotation
Instructions on completion of the Monthly review of performance table below
1. Comment by resident should cover the residents experience and availability of adequate
teaching and learning resources of the residency program during that month
2. Comment by Supervisor should state the residents performance during the month
3. Comment by resident coordinator should take into account the residents and supervisors
comment
3.4.1 Monthly review of the performance

Comment by resident
Month Comment by Resident Comment by Supervisor
Coordinator

ONE (1) Sign Sign Sign

Date Date Date

STAMP

TWO (2) Sign Sign Sign

Date Date Date

STAMP

Sign Sign Sign

THREE (3)
Date Date Date

STAMP

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 3.4.2 Details of Clinical/Audit Meetings Presented
Each resident is required to make at least 1 presentation in all the systems

Date Topic Venue Consultant Signature

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3.4.3 Details of Teaching Rounds Attended

Date Ward Round Residents Consultant/ Supervisor Signature

Signature

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3.4.4 Overall Assessment at the end of the rotation
Key
1. Grade shall be as provided 3.6
2. Remarks (Satisfactory or Unsatisfactory)

Assessment Area Competence Grade Remarks

Basic Sciences
Theoretical Knowledge in
Knowledge the Discipline
Participation in CPD

History Taking

Clinical examination
Interpretation of
laboratory Data and X-
Ray Findings
Basic Sciences
Clinical Skills Theoretical Knowledge in
the Discipline
Participation in CPD

Patient notes

Use of drugs

Patient Management

To patients and caregivers

To seniors, colleagues and
other health workers
Manifests sincerity,
Professional integrity and honest in
Conduct acts and deeds
To the public
Punctuality, availability
and Time management
Takes initiative
Knowledge and adherence
Leadership to institutional policies
qualities
and regulations
Mentorship of juniors and
other professionals
Average Overall Grade (Total Grade/20)
Note: An average overall grade of 30 and below is unsatisfactory performance and the resident’s
rotations shall be extended.
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Supervisor's Comment
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Name _________________________ Qualification________ Reg. No. ________

Signature___________________ Stamp_______________ Date_________________

Coordinator's Comment
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Name _____________________________Qualification_____________Reg. No. ________

Signature___________________ Stamp____________________ Date_________________

Head of Department Comment

______________________________________________________________________________
______________________________________________________________________________

Grading Tick what Applies

Successfully Completed Rotation
Unsatisfactory
*Note that where a rotation has been graded as “Unsatisfactory”, the resident shall proceed to the next department
then after completion of the next department, shall be required to return the that departments considered
unsatisfactory. The Extension shall only be for the competencies where the Resident is deemed unsatisfactory and
shall not exceed 3 months.

Name __________________________ Qualification_________ Reg. No. ________

Signature___________________ Stamp_________________ Date______________
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 4 Obstetrics & Gynaecology (Reproductive Health) Rotation (3 Months)

4.1 Introduction:
Obstetrics and Gynaecology is the medical specialty dealing with the fields of obstetrics and gynaecology.
Obstetrics deals with pregnancy, childbirth and postpartum period, including care of the newborn, whereas
gynaecology deals with the health of the female reproductive and sexual systems. The rotation in this
combined medical specialty prepares the resident doctor to be conversant with the health care of the female
reproductive organs and with the management of obstetric complications, which may involve surgery.

4.2 Vision:
The residency programme in obstetrics and gynaecology is meant to ensure that newly qualified doctors
acquire the necessary competences that will enable them provide quality care to patients.

4.3 Supervision of Residents

The following are supervisory strategies for the residents in Surgery

• Consultant led major rounds minimum 8 hours/week

• Clinical experience (OPDs and In-patient under GMO/Specialist)
• Theatre experience 6 hours/week
• Morning reports (ML on call) 2.5 hours/week
• Clinical Meetings 4/month
• Morbidity/Mortality Audit Monthly

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3.5 Basic Information
Resident’s Names_________________________________HPCZ Registration No ____________

Residency Centre___________________________ ______ HPCZ Licence No ____________

Period of Rotation: Start:________________________ End:____________________

Name of Supervisor___________________________ Sign and Stamp: ____________________

4.3.1 Grading:
• 3- The resident meets most of the criteria without assistance
• 2- The resident requires some assistance to meet the stated criteria
• 1- The resident requires considerable assistance to meet the stated criteria
• 0- Unable to meet the criteria completely

NB: Where the grading shall be on a scale of 0 or 1 above, the Supervisor shall be required to give reasons
for the said finding and make recommendations in the best interest of the resident and the public.

4.3.2 Resident Involvement

• Performed (P)- The resident does the work as the primary medical licentiate
• Assisted (A)- The resident assisted the primary medical licentiate in the procedure or
treatment
• Observed (O)- The resident observed the procedure or treatment

4.3.3 Rotation Area Requirements:

In this rotation, the Medical Licentiate resident shall:

1. Be able to clerk, investigate, make a diagnosis and develop a treatment plan for the patient.
2. Be able to demonstrate broad based knowledge and understanding of the basic sciences
relevant to the principles and practice of OBGYN.
3. Be able to adequately prepare patients planned or emergency OBGYN procedures or treatment.
4. Be able to identify obstetric and gynaecological emergencies and institute appropriate
treatment.
5. Be able to follow up patients till successful discharge from treatment and be able to write a
proper discharge summary.
6. Be able to present patients during the ward rounds, departmental clinical mortality and
morbidity meetings, and acquire surgical skills.
7. Attend and participate/present in all departmental CPD Programmes

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In addition to the above, at the end of the rotation, one is expected to have acquired the following skills and
competences :

4.4 Obstetrics & Gynaecology Rotation Procedures

4.4.1 Obstetric Rotation Procedures

# of Resident Supervisors Supervisors

Operations File No. Date
Cases involvement Name Signature
1.
2.
3.
4.
1. Normal 5.
delivery 10(p) 6.
7.
8.
9.
10.
1.
2.
3.
4.
2. Episiotomy / 5.
Repair- 5 (P) 6.
7.
8.
9.
10.
1.
2.
3.
4.
3. Management of 5.
PPH 3(a) 5(p) 6.
7.
8.
9.
10.
1.
2.
3.
4.
4. Delivery 5.
by Caesarean 6.
Section10(p) 7.
8.
9.
10.
11.
23 | P a g e
 # of Resident Supervisors Supervisors
Operations File No. Date
Cases involvement Name Signature
12.
13.
14.
15.
1.
5. vacuum Delivery
2.
3(p)
3.
6. Delivery of 1.
multiple 2.
pregnancies 3.
2(a) or 2(p) 4.
1.
7. McDonald Stitch 2.
insertion 3(a) and 3.
2(p) 4.
5.
1.
2.
8. McDonald 3.
Stitch Removal 4.
3(a) 2(p) 5.
6.
7.
Postpartum family 1.
2.
planning: PP-
3.
IUD Insertion
4.
1.
2.
3.
9. Counselling 4.
clients on family 5.
planning methods 6.
8(p) 7.
8.
9.
10.
10. Performing the 1.
following FP 2.
procedures 1. 3.
Norplant/Jadelle 4.
insertion and 5.
Removal 6.
2. IUCD 7.
insertion/removal 8.
3. Prescribing oral or 9.
injectable FP 3.
10.
5(a) and 5(p)
1.
11. Be able to
2.
clerk, investigate
3.
24 | P a g e
 # of Resident Supervisors Supervisors
Operations File No. Date
Cases involvement Name Signature
and manage 4.
patients with 5.
pre-eclampsia 6.
3(a) and 5(p) 7.
12. Add 8.
management of 9.
Malaria in
10.
pregnancy 3(P)
13. Be able to 1.
clerk, investigate
and manage
patients with
eclampsia 2(p) 2.
14. Management of
Anemia in
pregnancy 5(p).
15. Investigate & 1.
manage pregnant
patients with
2.
cardiac disease
2(p)
16. Be able to 1.
clerk, investigate 2.
and manage 3.
patients with 4.
HIV in
pregnancy 5(p) 5.
(EMTCT)
17. Manual removal 1.
of retained 2.
placenta 2(a) and 3.
2(p) 4.
1.
18. Repair of 2.
perineal tears 3.
5(p) 4.
5.
1.
19. Repair of
2.
cervical tears all
3.
degrees 2(a),2(p)
4.
20. Obstetric 1.
ultrasound 5(p) 2.
(Fetal 3.
presentation, 4.
placenta location,
Fetal viability, 5.
liquor volume).

25 | P a g e
4.4.2 Gynaecology Rotation Procedures

# of Resident Supervisors Supervisors

Operations File No. Date
Cases involvement Name Signature
1.
2.
1. Pap Smear 5(p) 3.
4.
5.
1.
2.
2. Diagnostic
3.
curettage 5(p)
4.
5.
1.
2.
3.
4.
5.
6.
7.
8.
9.
3. Suction Curettage 10.
(MVA) 10 (p) 11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
4. Marsupialization 1.
for Bartholins 2.
abscess 2(p) 3.
1.
5. Laparatomy for 2.
ectopic pregnancy 3.
3 (p) 4.
5.
6. Laparotomy for 1.
pelvic abscess 2(p) 2.
1.
7. Ovarian
2.
cystectomy 3(a)
3.
1.

26 | P a g e
 # of Resident Supervisors Supervisors
Operations File No. Date
Cases involvement Name Signature
2.
8. VIA (visual 3.
inspection with 4.
acetic acid) and 5.
VILI (visual 6.
inspection using 7.
Lugol's iodine) 8.
5(p) 9.
10.
1.
2.
9. Tubal ligation
3.
surgery 3(a/p)
4.
5.
1.
2.
10. Exploratory
3.
laparotomy 5(a)
4.
5.
11. Laparoscopic 1.
surgery 2(a) 2.
1.
12. Total 2.
abdominal 3.
hysterectomy 5(a) 4.
5.
1.
13. Vaginal
2.
hysterectomy 3
3.
1.
14. 2.
15. Myomectomy 3.
5(a) 4.
5.
16. Vescicle Vaginal
1.
Fistula repair 1(a)

27 | P a g e
4.5 Evaluation of the Obstetrics & Gynaecology Rotation

4.5.1 Monthly review of the performance

Comment byresident
Month Comment by Resident Comment by Supervisor
Coordinator

ONE (1) Sign Sign Sign

Date Date Date

STAMP

TWO (2) Sign Sign Sign

Date Date Date

STAMP

Sign Sign Sign

THREE (3)
Date Date Date

STAMP

28 | P a g e
 4.5.2 Details of Clinical/Audit Meetings Presented
Each resident is required to make at least 1 presentation in all the systems

Date Topic Venue Consultant Signature

29 | P a g e
4.5.3 Details of Teaching Rounds Attended

Date Ward Round Residents Consultant/ Supervisor Signature

Signature

30 | P a g e
4.5.4 Overall Assessment at the end of the rotation
Key
1. Grade shall be as provided 4.31 (1,2,3 or 4)
2. Remarks (Satisfactory or Unsatisfactory)

Assessment Area Competence Grade Remarks

Basic Sciences
Theoretical Knowledge in
Knowledge the Discipline
Participation in CPD

History Taking

Clinical examination
Interpretation of
laboratory Data and X-
Ray Findings
Basic Sciences
Clinical Skills Theoretical Knowledge in
the Discipline
Participation in CPD

Patient notes

Use of drugs

Patient Management

To patients and caregivers

To seniors, colleagues and
other health workers
Manifests sincerity,
Professional integrity and honest in
Conduct acts and deeds
To the public
Punctuality, availability
and Time management
Takes initiative

Leadership Knowledge and adherence

qualities to institutional policies
and regulations
Mentorship of juniors
and other professionals
Average Overall Grade (Total Grade/20)

31 | P a g e
Note: An average overall grade of 30 and below is unsatisfactory performance and the resident’s
rotations shall be extended.

Supervisor's Comment
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Name _________________________ Qualification________ Reg. No. ________

Signature___________________ Stamp_______________ Date_________________
Coordinator's Comment
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Name _____________________________Qualification_____________Reg. No. ________

Signature___________________ Stamp____________________ Date_________________

Head of Departments’ Comment

______________________________________________________________________________
______________________________________________________________________________

Grading Tick what Applies

Successfully Completed Rotation
Unsatisfactory
*Note that where a rotation has been graded as “Unsatisfactory”, the resident shall proceed to the next department
then after completion of the next department, shall be required to return the that departments considered
unsatisfactory. The Extension shall only be for the competencies where the Resident is deemed unsatisfactory and
shall not exceed 3 months.

Name __________________________ Qualification_________ Reg. No. ________

32 | P a g e
Signature___________________ Stamp_________________ Date______________

5 Paediatrics And Child Health Rotation (2½ Months)

5.1 Introduction:
Paediatrics And Child Health deals with the art of diagnosis and medical management of diseases affecting
children. There are various sub-specialties of Paediatrics and Child Health with which the resident doctor
needs to be conversant in order to provide optimum care to patients.

5.2 Vision:
The vision of the residency program in Paediatrics and Child Health is to ensure that quality patient care is
provided by newly qualified doctors whilst imparting good clinical values in the doctors. This is achieved
by close supervision of the resident doctors who shall be apprentices.

5.3 Supervision of Residents

The following are supervisory strategies for the residents in Paediatrics and child health

• Consultant led major rounds minimum 8 hours/week

• Clinical experience (OPDs and In-patient under GMO/Specialist)
• Morning reports (ML on call) 2.5 hours/week
• Clinical Meetings 4/month
• Morbidity/Mortality Audit Monthly

33 | P a g e
5.4 Paediatrics and Child Health Rotation

5.4.1 Basic Information

Resident Names__________________________________HPCZ Registration No ____________

Residency Centre___________________________ ______ HPCZ Licence No ____________

Period of Rotation: Start:________________________ End:____________________

Name of Supervisor___________________________ Sign and Stamp: ____________________

5.4.2 Grading:
• 3- The resident meets most of the criteria without assistance
• 2- The resident requires some assistance to meet the stated criteria
• 1- The resident requires considerable assistance to meet the stated criteria
• 0- Unable to meet the criteria completely

NB: Where the grading shall be on a scale of 0 or 1 above, the Supervisor shall be required to give
reasons for the said finding and make recommendations in the best interest of their resident and
the public.

5.4.3 Resident Involvement

• Performed (P)- The resident does the work as the primary medical licentiate
• Assisted (A)- The resident assisted the primary Medical Licentiate in the procedure or
treatment
• Observed (O)- The resident observed the procedure or treatment

5.4.4 Rotation Area Requirements:

In this rotation, the Medical Licentiate resident shall:

1. Be able to clerk, investigate and present patients during ward rounds
2. Be able to follow up patients from admission till discharge and be able to write a proper
discharge summary
3. Participate in daily ward round and attend paediatric outpatient clinics (POPC)
4. Attend and participate/present in all departmental CPD Programmes

In addition to the above, at the end of the rotation, one is expected to have participated in the
following procedures:
34 | P a g e
5.5 Paediatrics and Child Health Rotation Procedures and Case Management

5.5.1 Paediatrics and Child Health Rotation Procedures

# of File Resident Supervisors Supervisors

Operations Date
Cases No. involvement Name Signature
1.
2.
1. Lumbar puncture 3(p) 3.
4.
5.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
2. IV cannulation 10(p)
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
1.
2.
3. NG Tube insertion
3.
(NBU) 10(p)
4.
5.

35 | P a g e
 # of File Resident Supervisors Supervisors
Operations Date
Cases No. involvement Name Signature
6.
7.
8.
9.
10.
1.
2.
3.
4. Intravenous 4.
cannulation 5(p) 5.
5. Intraosseus 6.
cannulation 1(p) 7.
8.
9.
10.
1.
2.
3.
4.
6. Phlebotomy 10(p) in
5.
neonates (5) and older
6.
children (5)
7.
8.
9.
10.
1.
2.
7. Urinary
3.
Catheterisation 5(a)
4.
5.
1.
8. Ascitic tap 2(p)
2.
9. Exchange transfusion 1.
2(p) 2.
1.
2.
3.
4.
10. Blood 5.
transfusion 10(p) 6.
7.
8.
9.
10.
1.
11. Clinical Presentation 2.
9(p) 3.
(At least one 4.
presentation from 5.
6.
36 | P a g e
 # of File Resident Supervisors Supervisors
Operations Date
Cases No. involvement Name Signature
each system). 7.
8.
9.
# of File Resident Supervisors Supervisors
Operations Date
Cases No. involvement Name Signature
1.
2.
1. Lumbar puncture 3(p) 3.
4.
5.
1.
2.
3.
4.
5.
2. IV cannulation 10(p)
6.
7.
8.
9.
10.
1.
2.
3.
4.
3. NG Tube insertion 5.
(NBU) 10(p) 6.
7.
8.
9.
10.
1.
4. Intravenous 2.
cannulation 5(p) 3.
5. Intraosseus 4.
cannulation 1(p) 5.
6.
1.
2.
3.
4.
6. Phlebotomy 10(p) in
5.
neonates (5) and older
6.
children (5)
7.
8.
9.
10.
7. Urinary 1.
Catheterisation 5(a) 2.

37 | P a g e
 # of File Resident Supervisors Supervisors
Operations Date
Cases No. involvement Name Signature
3.
4.
5.
1.
8. Ascitic tap 2(p)
2.
9. Exchange transfusion 3.
2(p) 4.
1.
2.
3.
4.
10. Blood 5.
transfusion 10(p) 6.
7.
8.
9.
10.
11. Clinical Presentation 1.
9(p)
(At least one
presentation from 2.
each system).

38 | P a g e
5.5.2 Paediatrics and Child Health Rotation Case Management

Case History Examination Investigations Management Consultant Sign Date

Meningitis

Epilepsy

Acute
Coronary
Syndrome
Heart failure

Pneumonia

Asthma

Liver failure

GI bleeding

DKA

Rheumatoid
arthritis
Renal failure

TB

HIV

PCP

CMV

Severe malaria

Severe
Anemia
Sepsis

Jaundice

Convulsi

Sickle cell
crisis
Septic shock

39 | P a g e
Neonatal
hypothermia
Neonatal
Hypoglycemia
mia
Birth
Asphyxia
Severe Acute
Malnutrition
Comatose
Child
Neonatal
resuscitation
Status
epilepticus
Pulmonary
edema

40 | P a g e
5.6 Evaluation of the Paediatrics and Child Health Rotation

5.6.1 Monthly review of the performance

Comment by resident
Month Comment by Resident Comment by Supervisor
Coordinator

ONE (1) Sign Sign Sign

Date Date Date

STAMP

TWO (2) Sign Sign Sign

Date Date Date

STAMP

Sign Sign Sign

THREE (3)
Date Date Date

STAMP

41 | P a g e
5.6.2 Overall Assessment at the end of the rotation
Key
1. Grade shall be as provided 5.4.2 (1,2,3 or 4)
2. Remarks (Satisfactory or Unsatisfactory)

Assessment Area Competence Grade Remarks

Basic Sciences
Theoretical Knowledge in
Knowledge the Discipline
Participation in CPD

History Taking

Clinical examination
Interpretation of
laboratory Data and X-
Ray Findings
Basic Sciences
Clinical Skills Theoretical Knowledge in
the Discipline
Participation in CPD

Patient notes

Use of drugs

Patient Management

To patients and caregivers

To seniors, colleagues and
other health workers
Manifests sincerity,
Professional integrity and honest in
Conduct acts and deeds
To the public
Punctuality, availability
and Time management
Takes initiative

Leadership Knowledge and adherence

to institutional policies
qualities and regulations
Mentorship of juniors
and other professionals

42 | P a g e
 Average Overall Grade (Total Grade/20)
Note: An average overall grade of 30 and below is unsatisfactory performance and the resident’s
rotations shall be extended.

Supervisor's Comment
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Name _________________________ Qualification________ Reg. No. ________

Signature___________________ Stamp_______________ Date_________________
Coordinator's Comment
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Name _____________________________Qualification_____________Reg. No. ________

Signature___________________ Stamp____________________ Date_________________

Head of Departments’ Comment
______________________________________________________________________________
______________________________________________________________________________

Grading Tick what Applies

Successfully Completed Rotation
Unsatisfactory
*Note that where a rotation has been graded as “Unsatisfactory”, the resident shall proceed to the next department
then after completion of the next department, shall be required to return the that departments considered
unsatisfactory. The Extension shall only be for the competencies where the Resident is deemed unsatisfactory and
shall not exceed 3 months.

Name __________________________ Qualification_________ Reg. No. ________

43 | P a g e
Signature___________________ Stamp_________________ Date______________

6 Internal Medicine Rotation (2½ Months)

6.1 Introduction:
Internal medicine deals with the art and science of diagnosing managing of diseases affecting adults without
the use of surgical operations. There are various diseases and procedures the resident doctor needs to be
conversant with in order to provide optimum care to patients.

6.2 Vision:
The vision of the residency program in internal medicine is to ensure that quality patient care is provided
by newly qualified doctors whilst imparting good clinical values in the doctors. This is achieved by close
supervision of the resident doctors who shall be apprentices.

6.3 Supervision of Residents

The following are supervisory strategies for the residents in Surgery

• Consultant led major rounds minimum 8 hours/week

• Clinical experience (OPDs and In-patient under GMO/Specialist)
• Morning reports (JRMO on call) 2.5 hours/week
• Clinical Meetings 4/month
• Morbidity/Mortality Audit Monthly

44 | P a g e
6.3.1 Basic Information

Resident Name__________________________________HPCZ License No ____________

Residency Centre______________________

Period of Rotation: Start:________________________End:____________________

Confirmed by (Supervisor) Sign and Stamp: ____________________________________

6.3.2 Grading:
• 3- The resident meets most of the criteria without assistance
• 2- The resident requires some assistance to meet the stated criteria
• 1- The resident requires considerable assistance to meet the stated criteria
• 0- Unable to meet the criteria completely

NB: Where the grading shall be on a scale of 0 or 1 above, the Supervisor shall be required to give reasons
for the said finding and make recommendations in the best interest of the resident and the public.

6.3.3 Resident Involvement

• Performed (P)- The resident does the work as the primary medical licentiate
• Assisted (A)- The resident assisted the primary medical licentiate in the procedure or
treatment
• Observed (O)- The resident observed the procedure or treatment

6.3.4 Rotation Area Requirements:

In this rotation, the Medical resident shall:

1. Be able to clerk, investigate and present patients during ward rounds
2. Be able to follow up with patients from admission till discharge and be able to write a proper
discharge summary
3. Participate in daily ward rounds, attend theatres and attend the internal medicine outpatient
clinic
4. Attend and participate/present in all departmental CPD Programmes

In addition to the above, at the end of the rotation, one is expected to have participated in the
following procedures:

45 | P a g e
6.4 Internal Medicine Rotation Procedures and Case Management

6.4.1 Internal Medicine Rotation Procedures

Operations # of File Date Resident Supervisors Supervisors
Cases No. involvement Name Signature
1. Lumbar puncture 5(p) 1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
2. Pleural tap 5(p) 1.
2.
3.
4.
5.
3. Bone marrow aspirate 1.
2(a) 2.
4. Lymph node biopsy 1.
5(p) 2.
3.
4.
5.
5. Diabetic foot care 5(p) 1.
2.
3.
4.
5.
6. ECG 5(p) 1.
2.
3.
4.
5.
7. Ascitic tap 5(p) 1.
2.
3.
4.
5.
8. Central venous 1.
catheter insertion 2(a) 2.

46 | P a g e
9. Dialysis catheter 1.
insertion 2(a) 2.
10. Arterial blood gases 1.
5(p) 2.
3.
4.
5.
11. Post-mortem 1(o) 1.
12. CPR (a and P) 1.
13. NGT insertion (P) 2.
14. Femoral Tap (P) 3.
15. JVP cannulation (P) 2.
16. Nebulization (p) 5.
17. Fundoscopy (p) 3.
18. Urethral 4.
Catheterization (p)
19. ECG (p) 5.
20. Pericardiocynthesis 1.
(a)

6.4.2 Internal Medicine Rotation Case Management

Case History Examination Investigations Management Consultant Date
Sign

Meningitis

Epilepsy

ACS

Heart
failure
Pneumonia

Asthma

Liver
failure
GI
bleeding
DKA

Rheumato
id arthritis
Renal
failure
TB

HIV

47 | P a g e
 PCP

CMV

6.5 Evaluation of the internal Medicine Rotation

6.5.1 Monthly review of the performance

Comment byresident
Month Comment by Resident Comment by Supervisor
Coordinator

ONE (1) Sign Sign Sign

Date Date Date

STAMP

TWO (2) Sign Sign Sign

Date Date Date

STAMP

Sign Sign Sign

THREE (3)
Date Date Date

STAMP

48 | P a g e
6.5.2 Overall Assessment at the end of the rotation
Key
1. Grade shall be as provided 6.3.2 (1,2,3 or 4)
2. Remarks (Satisfactory or Unsatisfactory)

Assessment Area Competence Grade Remarks

Basic Sciences
Theoretical Knowledge in
Knowledge the Discipline
Participation in CPD

History Taking

Clinical examination
Interpretation of
laboratory Data and X-
Ray Findings
Basic Sciences
Clinical Skills Theoretical Knowledge in
the Discipline
Participation in CPD

Patient notes

Use of drugs

Patient Management

To patients and caregivers

To seniors, colleagues and
other health workers
Manifests sincerity,
Professional integrity and honest in
Conduct acts and deeds
To the public
Punctuality, availability
and Time management
Takes initiative

Leadership Knowledge and adherence

to institutional policies
qualities and regulations
Mentorship of juniors
and other professionals

49 | P a g e
 Average Overall Grade (Total Grade/20)
Note: An average overall grade of 30 and below is unsatisfactory performance and the resident’s
rotations shall be extended.

Supervisor's Comment
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Name _________________________ Qualification________ Reg. No. ________

Signature___________________ Stamp_______________ Date_________________
Coordinator's Comment
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Name _____________________________Qualification_____________Reg. No. ________

Signature___________________ Stamp____________________ Date_________________
Head of Departments’ Comment
______________________________________________________________________________
______________________________________________________________________________

Grading Tick what Applies

Successfully Completed Rotation
Unsatisfactory
*Note that where a rotation has been graded as “Unsatisfactory”, the resident shall proceed to the next department
then after completion of the next department, shall be required to return the that departments considered
unsatisfactory. The Extension shall only be for the competencies where the Resident is deemed unsatisfactory and
shall not exceed 3 months.

Name __________________________ Qualification_________ Reg. No. ________

Signature___________________ Stamp_________________ Date______________

50 | P a g e
51 | P a g e