FACULTY OF MEDICAL SCIENCES

UNIVERSITY OF DELHI

Name of College………………………………………………

INTERNSHIP RECORD BOOK

Name……………………………………………………………………………………

Period: From ………………………………..To……………………………………..

1
GUIDELINES

1. The booklet provides proforma(s) in various specialities which indicate

knowledge and skills to be acquired while undergoing that specific posting.

2. The record of the achievements should be verified by the Head of the Units,
countersigned by the Head of the Department, immediately after the
completion of the Posting.

3. For Elective posting, indicate the deptt. in the space provided.

4. Responsibility of safe custody of the booklet rest on the Interns.

5. On completion of all postings (the total period of one year), the booklet is to
be returned to the academic Incharge/Coordinator, Internship Training
programme, for issue of the completion certificates.

6. The privilege of internship will start only from the date of joining to the
internship posting; hence the interns are not eligible to avail any leave before
joining as an intern.

7. During the period of Internship of one year, an intern may be allowed upto a
maximum of 12 (Twelve only) days leave provided that he she completes
atleast 80% of prescribed period of training for each department.

8. Completion certificate will be issued only on submission of this Record

book.

2
 INTERNSHIP – TIME DISTRIBUTION as per Medical Council of India,
vide notification No. MCI-7(1)/2008-Med. Misc/3309 dated 22 November,
2008.

Compulsory

Community Medicine 2 Months

Medicine including 15 days of Psychiatry 2 Months
Surgery including 15 days Anaesthesia 2 Months
Obstt./Gynae. Including Family welfare Planning 2 Months
Paediatrics 1 Month
Orthopaedics including PMR 1 Month
ENT 15 days
Ophthalmology 15 days
Casualty 15 days

Elective Postings (1 x 15 days) 15 days

Subjects for Elective posting will be as follows:

i) Dermatology and Sexually Transmitted diseases
ii) Tuberculosis and Respiratory Diseases
iii) Radio-Diagnosis
iv) Forensic Medicine
v) Blood Bank
vi) Psychiatry

Note: Structure internship with college assessment at the end of the internship.

3
 DEPARTMENT OF MEDICINE

1. Unit of Posting …………………………………………………………………

2. Period of posting: From …………………..To……………………………….
3. No. of days absent with leave………………….without Leave………………..
4. Attendance: a) Regular/Irregular
b) Punctuality – Yes No

5. Capacity to work in a team (Behaviour with colleagues, nursing staff and

relationship with paramedical) Score 0-5.

Training in Medical Wards:

i) Approx. number of case record written …………………………………….
ii) Approx. number of ward rounds attended and cases presented on the round

Training in Routine procedures

Sr. Particulars Recommended Approx No. Scoring

No. number Performed (0-5)
1. I.V. Injection 20
2. Setting up of I.V. Drip 10
3. Blood transfusion with its 04
management
4. Passing of Ryle’s tube 05
(stomach tube)
5. Sputum Examination for AFB 10
6. Estimation of Hb, TLC, DLC, 30
ESR
7. Complete Urine Examination 30
Training in Special Procedures
1. Open methods (cut down) 04
2. Stomach wash 02

4
3. Lumbar puncture and 02
examination of CSF
4. Pleural aspiration 02
5. Abdominal paracentesis 04
6. Bone Marrow Aspiration 02
7. Liver Biopsy 02
Training in Emergency Procedures and Treatment
1. Assisting in external cardiac 04
massage
2. Management of
i) a case having convulsions 04
ii) a case in coma
04
3. Acute myocardial infection 10
4. Diabetic coma and poisoning 04
5. Poisoning 04

Date
Signature of the Head of Unit with Stamp

Signature of the Head of Deptt. with Stamp

5
 DEPARTMENT OF SURGERY

1. Unit of Posting …………………………………………………………………

2. Period of posting: From …………………..To……………………………….
3. No. of days absent with leave………………….without Leave………………..
4. Attendance: a) Regular/Irregular
b) Punctuality – Yes No
5. Capacity to work in a team (Behaviour with colleagues, nursing staff and
relationship with paramedical) Score 0-5.

Training in Surgical Wards

i) Approx. number of case record written …………………………………….
ii) Approx. number of ward rounds attended and cases presented on the round
………………………………………………………….……………………………….
Training in surgical procedures

Sr. Particulars Recommended Approx No. Scoring

No. number Performed (0-5)
1. Incision and draining of 10
abscess
2. Suturing of superficial wounds 10
3. Excision of small cysts , 10
nodules
4. Circumcision and reduction of 5
paraphimosis
5. Vasectomy 5
6. Manage anal fissure 5
7. Injections for piles 5
8. Administration of nerve blocks 15
and local anaesthesia
9. Dressing of wounds and burns 10
10. Biopsy of surface tumors 5

6
Training of surgical emergency procedures
1. Resuscitate a critically injured 5
patient and severe burns
patient
2. Control surface bleeding and 5
surface wounds
3. Manage patients of chest, 3
abdomen and head spine injury
4. Institute first line management 3
of acute abdomen
Training in Operating Room
Techniques
Major 5
Minor 10

Date:

Signature of the Head of Unit with Stamp

Signature of the Head of Deptt. with Stamp

7
 DEPARTMENT OF OBSTETRICS AND GYNAECOLOGY
1. Unit of Posting …………………………………………………………………
2. Period of posting: From …………………..To……………………………….
3. No. of days absent with leave………………….without Leave………………..
4. Attendance: a) Regular/Irregular
b) Punctuality – Yes No
5. Capacity to work in a team (Behaviour with colleagues, nursing staff and
relationship with paramedical). Score 0-5.
Training in Obs/Gyn Wards:
i) Approx. number of case record written …………………………………….
ii) Approx. number of ward rounds attended and cases presented on the round
Training in routine procedures

Particulars Recommended Approx No. Scoring

Sr. number Performed (0-5)
No.
5
1. Vaginal examination
in Pregnant Women
2. Gynecological 5
examination
3. Vaginal smear taking
4. Taking of blood 10 Remove number-
samples recommended to do as
5. I.V. Infusion 5 many as required
6. Blood transfusion 5
7. Suture removal
8. Management of 10
normal labor
9. Oxytocin drip 10
under supervision
10. Artificial rupture of 5
membrane under
supervision
11. Urethral
catheterisation
12. Suture removal in
postoperative cases
13. Evaluate and 10
prescribe oral Interns are posted in family planning
contraceptive through PSM department

Minor Procedures

8
1. Doing episiotomies 5
and suturing them
under supervision
2. Tubectomy under 2
supervision
3. Pudendal block
4. Cervical biopsies 5
5. Dilatation and 5
curettage
6. Endometrial biopsy 5
7. Endometrial 3
aspiration
8. Pap smear 10
9. Intra uterine Posting of Interns in FP through PSM
contraceptive devices
insertion
10. Cervical punch
biopsy
Emergency
procedures
Emergency
1. management of A. P. 1
H.
2. Management of 1
P.P.H.
3. Management of 1
eclampsia if
available
Assistance in Surgical Procedure
1. Assisting in breech 1
deliveries
2. Evacuation under 2
supervision
3. Assisting in 2
Caesarean section
and hysterectomies
4. Vacuum aspiration of Posting of Interns in FP through PSM
M.R.
5. Assisting at forceps 2
and vacuum
extraction

Bold and underline – changes recommended

x - is not needed

9
 DEPARTMENT OF COMMUNITY MEDICINE

1. Unit of Posting …………………………………………………………………

2. Period of posting: From …………………..To……………………………….
3. No. of days absent with leave………………….without Leave………………..
4. Attendance: a) Regular/Irregular
b) Punctuality – Yes No
5. Capacity to work in a team (Behaviour with colleagues, nursing staff and
relationship with paramedical) Score 0-5.

Training in Community Medicine

S. Particular I II III IV V Urban

No. Health
Centre
1. Date of Posting
2. No. of Days absent/total days
3. Punctual /Not Punctual
4. Rapport with
a) Community
b) Staff
5. Medical Care (No. of cases seen)
6. No. of Special clinics or setting
attended/held (if applicable)

a) AN clinic
b) PN clinic
c) Immunization
d) Anganwadi
e) School Health
f) Child Home
g) Any other (specify)

10
7. Communicable disease
a) TB cases seen
b) Malaria cases seen
c) Diarrhoea disease,
d) Other (specify)

8. Family Planning
a) Motivation for
Tubectomy/vasectomy (give
numbers)

b) Motivation for OC/IUD/CC

(If applicable)
9. Record keeping
(Satisfactory/Unsatisfactory)
10 Family visits (give numbers)
11. Seminar presentations
Health Education/
IEC Sessions

a) attended/Held
b) presented/assigned

12. Any other (specify)

11
 DEPARTMENT OF ORTHOPAEDICS

1. Unit of Posting …………………………………………………………………

2. Period of posting: From …………………..To……………………………….
3. No. of days absent with leave………………….without Leave……………….
4. Attendance: a) Regular/Irregular
b) Punctuality – Yes No
5. Capacity to work in a team (Behaviour with colleagues, nursing staff and
relationship with paramedical) Score 0-5.
Training in Orthopedics Wards:
i) Approx. number of case record written …………………………………….
ii) Approx. number of ward rounds attended and cases presented on the round
Training in Routine procedures
Sr. Particulars Recommended Approx No. Score
No. number Performed (0-5)
1. Upper Ext. Fracture 2
2. Lower Ext. Fracture 2
3. Dislocation 2
4. Osteomyelitis 1
5. Polio 1
6. Congenital 1
Deformities
7. Application of POP 5
Slabs
8. Application of skeletal 2
traction
9. Application of Skin 2
traction
10. Fracture reduction : 2
Colles fracture
11. Splintage of limb 2
Fracture
12. Emergency care of 2
multiple injury patient
13. Precaution in transport 2
and bed care In spinal
injury patients

12
 Training in
Operating Room
Techniques
1. Observed/ assisted 1
internal fixation of
long bones long
2.. Application of external 1
fixation
3. Seqestrectomy 1
4. Drainage of acute 1
osteomyellitis

Date
Signature of the Head of Unit with Stamp

Signature of the Head of Deptt. with Stamp

13
 DEPARTMENT OF PAEDIATRICS

2. Unit of Posting …………………………………………………………………

3. Period of posting: From …………………..To……………………………….
4. No. of days absent with leave………………….without Leave……………….
5. Attendance: a) Regular/Irregular
b) Punctuality – Yes No
6. Capacity to work in a team (Behaviour with colleagues, nursing staff and
relationship with paramedical) Score 0-5.
Training in Pediatrics Wards:
i) Approx. number of case record written …………………………………….
ii) Approx. number of ward rounds attended and cases presented on the round
Training in routine procedures
Sr. Particulars Recommended Approx No. Score
No. number Performed (0-5)
1. Thoracocentesis 2
2. Ascitic Tap 2
3. Lumbar Puncture 8
4. Sternal Puncture 2
5. Liver Biopsy 3
6. I.V. Fluids 30
Administration
7. Intravenous Inj 10
8. Blood Transfusion 2
with its Management
9 Passing Neso Tube 2
10 Passing Gastric tube 2
11 Laboratory
Investigation
Blood
TLC 10
DLC
Hb%
RBC
Urine
10
Stool
CSF

14
12. Taking blood 30
Samples
13 Introduction of 5
intracath
14 Tuberculin testing 10
Training in Emergency Procedures and Treatment
1 Resuscitation at Birth 5
2. Care of children 5
receiving intensive
care
3. Acute meningitis 2
4 Febrile convulsions 2

Date
Signature of the Head of Unit with Stamp

Signature of the Head of Deptt. with Stamp

15
 DEPARTMENT OF OPHTHALMOLOGY

1 Unit of Posting …………………………………………………………………

2 Period of posting: From …………………..To……………………………….
3 No. of days absent with leave………………….without Leave……………….
4 Attendance: a) Regular/Irregular
b) Punctuality – Yes No
5. Capacity to work in a team (Behaviour with colleagues, nursing staff and
relationship with paramedical) Score 0-5.
Training in Ophthalmology Wards:
i) Approx. number of case record written - 05
ii) Approx. number of ward rounds attended and cases presented on the round
Training in routine procedures
Sr. Particulars Recommended Approx No. Score
No. number Performed (0-5)
1. Basic of Refraction 4
Fundus examination 2
Diagnosis and 4
Management of
conjunctivitis
Diagnosis and 2
management of
Dacrococystitis
Diagnosis and 4
Management of
Cataract and
gulocoma
Investigative Procedures carried out / assisted
Tonometry 10
Syringing 10
Subconjuctival 5
Injection, under
Supervision
Ocular bandaging 10
Removal of 1
concreations
Epilation and 1
electroysis
Corneal foreign body 1
removal

16
 Cauterization of
corneal ulcers
Chalazion removal
Entropion correction 1
Suturing conjuctival 1
tears
Operative procedures assisted
Glaucoma surgery 2
Enucleations of eye 2
in cadaver
Cataract 2

Date

Signature of the Head of Unit with Stamp

Signature of the Head of Deptt. with Stamp

17
 DEPARTMENT OF E.N.T.
1. Unit of Posting …………………………………………………………………
2. Period of posting: From …………………..To……………………………….
3. No. of days absent with leave………………….without Leave……………….
4. Attendance: a) Regular/Irregular
b) Punctuality – Yes No
5. Capacity to work in a team (Behaviour with colleagues, nursing staff and
relationship with paramedical) Score 0-5.
Training in ENT Wards:
i) Approx. number of case record written …………………………………….
ii) Approx. number of ward rounds attended and cases presented on the round

Training in routine procedures

Sr. Particulars Recommended Approx No. Score
No. number Performed (0-5)
1. Syringeing 2
2. Antral washout 2
3. F B Removal 2
4. Nasal Packing 2
5. LN Biopsy 1
6. Tracheostomy 1
Diagnosis and Management of the following
1 Acute tonsillitis 2
pharyngitis
2. Chronic tonsillitis 2
3. Acute & Chronic 2
laryngeal conditions
4 Deviated nasal septum 1
5 Nasal polyp 1
6 ASOM 1
7 CSOM 1
8 Pre & Post operative 1
management of patients

Date

Signature of the Head of Unit with Stamp

Signature of the Head of Deptt. with Stamp

18
 DEPARTMENT OF ANESTHESIA

1. Unit of Posting …………………………………………………………………

2. Period of posting: From …………………..To……………………………….
3. No. of days absent with leave………………….without Leave……………….
4. Attendance: a) Regular/Irregular
b) Punctuality – Yes No
5. Capacity to work in a team (Behaviour with colleagues, nursing staff and
relationship with paramedical) Score 0-5.
General training in Anaesthesia
Maintenance of anaesthetic records
Monitoring of patients during anaesthesia and post-operative period
Training in routine procedures
Sr. Particulars Recommended Approx No. Score
No. number Performed (0-5)
1. Pre-anaesthetic check up
and medications
2. Venepuncture and iv
drip
3. Larynogoscopy
4. Endotracheal
5. Spinal anesthesia
6. Simple nerve blocks
Emergency Procedure
1 CPBR 2
2. Manage problems 2
associated with
anaesthesia

Date
Signature of the Head of Unit with Stamp

Signature of the Head of Deptt. with Stamp

19
 DEPARTMENT OF FORENSIC MEDICINE

Comments:-

1. Details of training in elective subjects has not been specified.

2. The Word emergency can be included in page 4 sub section VI line 2.

20
 NO DUES CERTIFICATE
Signature of
Sr. No Department Head of unit Head of Deptt.
01. Medicine

02. Paediatrics

03. Surgery

04. Obstetrics and Gynaecology

05. Orthopaedics

06. Ophthalmology

07. E.N.T.

08. Community Medicine

09. Causality

10. Elective Subject

11. Library

12. Treasurer

13. Treasurer students aid fund

14. Warden boys Hostel

15. Warden girls Hostel

16. Account Branch

17. Sports

21
 CASUAL LEAVE RECORD
Interns are entitled to a maximum of 12 days leave throughout the year. Not more
than 6 days leave will be permitted in a posting of two months. Not more than 4 days
leave will be permitted in a posting of one month. Not more than 2 days leave will be
permitted in a posting of 15 days. Fill in date, sign and indicate department with the
signature of Head of Unit

Sr. Name of Department Leave taken No. of days Signature of Head

no. with date Signature of of Department
Head of Unit
01. Medicine

02. Psychiatry

03. Paediatrics

04. Surgery

05. Anaesthesia

06 Obstetrics and
Gynaecology
07. Orthopaedics

08. Ophthalmology

09. E.N.T.

10. Community Medicine

11. U.H.C.

12. Family Planning

13. Elective Posting

22
 INTERNSHIP COMPLETION CERTIFICATE

Name………………………………………………………………………………….

Period: From ………………………………..To……………………………………

Eligibility for receiving completion certificate YES/NO

(if No, reason to be given)

Signature
Academic Incharge of Internship Programme

23