Guidelines

for

Competency Based Training Programme

in

DNB- Endocrinology
(Draft Version)

NATIONAL BOARD OF EXAMINATIONS

Medical Enclave, Ansari Nagar, New Delhi-110029, INDIA
Email: mail@natboard.edu.in Phone: 011 45593000

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 CONTENTS

I. AIM

II. OBJECTIVES OF THE PROGRAMME

a) Programme goal
b) Programme objective

III. ELIGIBILITY CRITERIA FOR ADMISSION

IV. TEACHING AND TRAINING ACTIVITIES

V. SYLLABUS

VI. THESIS & THESIS PROTOCOL

VII. LOG BOOK

VIII. NBE LEAVE GUIDELINES

IX. EXAMINATION –

a) FORMATIVE ASSESSMENT
b) FINAL THEORY & PRACTICAL

X. RECOMMENDED TEXT BOOKS AND JOURNALS

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AIM

The aim of the course is to develop human resources and personnel in the field
of Endocrinology who shall

1. Provide the health care to the patients needing endocrine care

2. Introduce trainees to the principles of clinical research, and prepare them
to analyze data, write investigative protocols and collect data in a
scientific, organized manner.
3. Teach and train future undergraduate and postgraduate medical students
and junior doctors in Endocrinology in Medical Colleges, Institutions and
other Hospitals.
4. Acquire a spirit of scientific enquiry and carry out and guide research to
improve the practice of the art and science of Endocrinology
5. Have management capabilities to make health care more cost-effective.
6. Recognize the health needs of the community and carry out professional
obligations ethically and in keeping with the objectives of the national
health policy.
7. Be aware of the contemporary advances and developments in the field of
Endocrinology.
8. Provide a comprehensive knowledge base to prepare the trainee to care
for patients suffering from endocrine and metabolic diseases.
9. To ensure exposure to a wide variety of patients suffering from diverse
endocrine problems to give the candidate experience in diagnosing and
treating patients suffering from disease in all areas of endocrinology.
10. Provide a diverse experience through rotations in areas related to
diagnostic procedures and imaging modalities used in endocrinology.
11. Prepare the trainee in the art of interacting with patients, patient
education and counselling.
12. Prepare the trainee to continue his/her education throughout his/her life
by giving him/her training in critically reading the medical literature,
understanding medical informatics, medical economics, medical research
methods, medical statistics, clinical decision-making, outcome
assessment, health promotion, practice management and medico-legal
issues.

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PROGRAMME GOAL

The goal of postgraduate medical education shall be to produce specialists of

Endocrinology who shall have the following competencies
 To diagnose endocrine diseases based on clinical methods.
 To interpret relevant laboratory and radiological investigations for the
purpose of diagnosis
 To arrive at a treatment plan/s and discuss the pros and cons with the
patient and his family.
 To keep abreast of the current knowledge and recent advances in the field
by self learning and /or participating in continuing Medical Education
programmes.
 To deliver preventive and rehabilitative care.
 To organize and manage administrative responsibilities for routine day to
day work as well as emergent /urgent situations

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PROGRAMME OBJECTIVES

By the end of training, trainees should have the requisite knowledge of, skills in,
and attitudes towards the situations listed in order to manage:

 Newly presenting disease in the outpatient and inpatient hospital settings

in a way that restores health and well-being efficiently and effectively.
 The long term care of patients in a way that minimises the impact on
health and optimises long-term disease outcomes.
 Risk factors for a poor outcome, for example: hypertension, smoking,
obesity, and hyperlipidaemia.
 Emergencies and short-term loss of disease control in a hospital setting in
order to minimise the period of hospital admission while making efficient
use of resources.
 Disease pre-dating or newly arising in pregnancy in both the outpatient
and inpatient settings to optimise maternal and foetal outcomes.
 Adolescent, adult and elderly inpatients and outpatients.
 Screening for, and the prevention and treatment of, complications to
optimise intermediate and final health outcomes.
 The application of nationally accepted guidelines in their own practice.
 The whole patient’ taking account of personal, social and cultural as well
as biomedical factors.
 Social and professional implications such as restrictions on driving and
certain types of employment or activity
 Clinical services at department, hospital, district and population level in a
way that makes efficient and effective use of resources to optimise health
outcomes

All the candidates will be involved in the direct care of the patients admitted to the
endocrine services. This will include taking a complete history and performing a
comprehensive examination.
Additionally residents will be required to attend outpatient endocrine clinics where
consultants will be available for on spot consultations.
Training in nuclear medicine will be coordinated with the department of nuclear
medicine.
The residents will be given training in principles of scanning of various endocrine organs
and interpretation of data.

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ELIGIBILITY CRITERIA FOR ADMISSIONS TO THE PROGRAMME

(A) DNB Endocrinology Course:

1. Any medical graduate with MD/DNB in General Medicine or Paediatrics

qualification , who has qualified the Entrance Examination conducted by
NBE and fulfill the eligibility criteria for admission to DNB Super Specialty
courses at various NBE accredited Medical Colleges/ institutions/Hospitals
in India is eligible to participate in the Centralized counseling for allocation
of DNB Endocrinology seats purely on merit cum choice basis.

2. Admission to 3 years post DNB Endocrinology course is only through

Entrance Examination conducted by NBE and Centralized Merit Based
Counseling conducted by National Board of Examination as per
prescribed guidelines.

Duration of Course : 3 Years

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TEACHING AND TRAINING ACTIVITIES

The fundamental components of the teaching programme should include:

1. Case presentations & discussion- once a week
2. Seminar – Once a week
3. Journal club- Once a week
4. Grand round presentation (by rotation departments and subspecialties)-
once a week
5. Faculty lecture teaching- once a month
6. Clinical Audit-Once a Month
7. A poster and have one oral presentation at least once during their training
period in a recognized conference.

The rounds should include bedside sessions, file rounds & documentation of case
history and examination, progress notes, round discussions, investigations and
management plan) interesting and difficult case unit discussions.

The training program would focus on knowledge, skills and attitudes (behavior), all
essential components of education. It is being divided into theoretical, clinical and
practical in all aspects of the delivery of the rehabilitative care, including methodology of
research and teaching.

Theoretical: The theoretical knowledge would be imparted to the candidates through

discussions, journal clubs, symposia and seminars. The students are exposed to recent
advances through discussions in journal clubs. These are considered necessary in view
of an inadequate exposure to the subject in the undergraduate curriculum.

Symposia: Trainees would be required to present a minimum of 20 topics based on the

curriculum in a period of three years to the combined class of teachers and students. A
free discussion would be encouraged in these symposia. The topics of the symposia
would be given to the trainees with the dates for presentation.

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Clinical: The trainee would be attached to a faculty member to be able to pick up
methods of history taking, examination, prescription writing and management in
rehabilitation practice.

Bedside: The trainee would work up cases, learn management of cases by discussion
with faculty of the department.

Journal Clubs: This would be a weekly academic exercise. A list of suggested Journals
is given towards the end of this document. The candidate would summarize and discuss
the scientific article critically. A faculty member will suggest the article and moderate the
discussion, with participation by other faculty members and resident doctors. The
contributions made by the article in furtherance of the scientific knowledge and
limitations, if any, will be highlighted.

Research: The student would carry out the research project and write a thesis/
dissertation in accordance with NBE guidelines. He/ she would also be given exposure
to partake in the research projects going on in the departments to learn their planning,
methodology and execution so as to learn various aspects of research.

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SYLLABUS

Basic Sciences as related to Clinical Endocrinology:

a. Hormone receptors / receptor biology

b. Genetics in Endocrinology
c. Molecular biology
d. Hormonal assays

Section I: Hormones and Hormone Action

1. Principles of Endocrinology
2. The endocrine patient

3. Principles of Hormone Action

4. Genetics of Endocrinology and control of peptide hormone formation

Mechanism of action of harmones that act on nuclear receptors and on cell

surface

5. Health Care Reform, Population Health, and the Endocrinologist

6. Laboratory Techniques for Recognition of Endocrine Disorders

Section II: Hypothalamus and Pituitary

7. Neuroendocrinology

8. Pituitary Physiology and Diagnostic Evaluation

9. Pituitary Masses and Tumors

10. Posterior Pituitary Gland

Disorders of the Neurohypophysis .

Section III: Thyroid

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11. Thyroid Physiology and Diagnostic Evaluation of Patients with Thyroid
Disorders

12. Hyperthyroid Disorders

13. Hypothyroidism and Thyroiditis

14. Nontoxic Diffuse Goiter, Nodular Thyroid Disorders, and Thyroid

Malignancies

Section IV: Adrenal Cortex and Endocrine Hypertension

15. The Adrenal Cortex

16. Endocrine Hypertension

Section V: Reproduction

17. Physiology and Pathology of the Female Reproductive Axis

18. Hormonal Contraception and fertility control- current approaches and global
aspects

19. Testicular Disorders and male reproductive tract

20. Sexual Dysfunction in Men and Women

Menstrual Disorders and Pelvic Pain

The Menopause Transition and Postmenopausal Hormone Therapy

Hirsutism and Virilization

Gynecologic Malignancies

Section VI: Endocrinology and the Life Span

a. Endocrine changes in pregnancy

b. Endocrinology of fetal development

c. Normal and aberrant growth

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 d. Puberty, ontogeny, neuroendocrinology, physiology disorders

Section VI A: Maternal-Fetal

21. Endocrine Changes in Pregnancy

22. Endocrinology of Fetal Development

Section VI B: Childhood

Growth and maturation

23. Pediatric Disorders of Sex Development

24. Normal and Aberrant Growth in Children

25. Physiology and Disorders of Puberty

Section VI C: Adult

26. Hormones and Athletic Performance

27. Endocrinology and Aging

Section VII: Mineral Metabolism

28. Hormones and Disorders of Mineral Metabolism

29. Osteoporosis and Bone Biology

30. Kidney Stones

Section VIII: Carbohydrates and Fat Metabolism

31. Type 2 Diabetes Mellitus

32. Type 1 Diabetes Mellitus

33. Complications of Diabetes Mellitus

34. Hypoglycemia

35. Neuroendocrine Control of Energy Stores

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36. Obesity

37. Disorders of Lipid Metabolism

38. Gastrointestinal Hormones and Gut Endocrine Tumors

Section IX: Polyendocrine and Neoplastic Disorders

39. Multiple Endocrine Neoplasia

40. The Immunoendocrinopathy Syndromes

41. Endocrinology of HIV/AIDS

42. The Long -Term Endocrine Sequelae of Multimodality Cancer Therapy

43. Neuroendocrine Gastrointestinal and Lung Tumors (Carcinoid Tumors) and

the Carcinoid Syndrome, and Related Disorder

Section X: Pregnancy

44.Thyroid and parathyroid disorders

 Maternal hyperthyroidism
 Maternal hypothyroidism
 Post-partum thyroid dysfunction
 Thyroid cancer in pregnancy

45. Parathyroid disorders

46. Pituitary disorders

 Prolactinoma in pregnancy
 Management of prolactinoma
 Cushing’s syndrome - Management of Cushing’s syndrome
 Acromegaly - Non-functioning pituitary tumours
 Hypopituitarism in pregnancy

47.Adrenal disorders

 Addison’s disease in pregnancy

 Congenital adrenal hyperplasia
 Phaeochromocytoma
 Management of phaeochromocytoma

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Other areas in which knowledge is to be acquired:
 Biostatistics, Research Methodology and Clinical Epidemiology
 Ethics
 Medico legal aspects relevant to the discipline
 Health Policy issues as may be applicable to the discipline

STRUCTURED TRAINING PROGRAMME

1 st Year

Out patient / Inpatient management

 Endocrine testing
 Patient education
 Assisting & managing emergencies
 Starting research activity & Biomedical Statistics
 Computer data entry
 Teaching Undergraduate and diploma students

2 nd Year

In addition to patient management

 Patient counseling
 Endocrine testing
 Attending surgeries
 Radiology & pathology training
 Nuclear Medicine
 Laboratory methods
 Computer data entry
 Teaching Undergraduate (MBBS), diploma, Postgraduate (MD Medicine)
and 1 st year DM students

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3 rd Year

Out patient / Inpatient management

 Patient counseling
 Finalization & submission of research projects
 Teaching and Guiding Undergraduate (MBBS), diploma, Postgraduate
(MD Medicine) and 1 st year & 2 nd year DM students

TRAINING PROGRAMME:

Postings:
 General ward – 12 months

 Private ward – 12 months

 Consults for admitted patients – 10 months

Interdepertmental posting

 Biochemistry -2 weeks

 Reproductive Medicine Unit – 1 week

 Pediatric Endocrinology – 4 weeks
 Statistics – 2 weeks
 Molecular biology- 1 week
 Thyroid USG – 1 day
 FNAC – 4 days (2 hours each day)

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 Speciality Clinics:

a. Foot clinic once a week 50 weeks

b. Adult Young diabetes clinic once a week 20 weeks
c. Menopause clinic once a week 50 weeks
d. Ophthalmology clinic once a week 4 weeks
e. Metabolic bone clinic once a week 8 weeks
f. Thyroid clinic once a week 8 weeks

Multi-departmental meetings:

a. Nuclear Medicine – Endocrine surgery - Endocrinology once a week 50

meeting weeks
b. Pathology - Endocrine surgery - Endocrinology once in 2 20
meeting weeks weeks
c. Neurosurgery - Endocrinology meeting once a week 50
weeks

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THESIS PROTOCOL & THESIS
The candidates are required to submit a thesis at the end of three years of
training as per the rules and regulations of NBE.

Guidelines for Submission of Thesis Protocol & Thesis by candidates

Research shall form an integral part of the education programme of all

candidates registered for DNB degrees of NBE. The Basic aim of requiring the
candidates to write a thesi protocol & thesis/dissertation is to familiarize him/her
with research methodology. The members of the faculty guiding the
thesis/dissertation work for the candidate shall ensure that the subject matter
selected for the thesis/dissertation is feasible, economical and original.

Guidelines for Thesis Protocol

The protocol for a research proposal (including thesis) is a study plan, designed
to describe the background, research question, aim and objectives, and detailed
methodology of the study. In other words, the protocol is the ‘operating manual’
to refer to while conducting a particular study.

The candidate should refer to the NBE Guidelines for preparation and
submission of Thesis Protocol before the writing phase commences. The
minimum writing requirements are that the language should be clear, concise,
precise and consistent without excessive adjectives or adverbs and long
sentences. There should not be any redundancy in the presentation.

The development or preparation of the Thesis Protocol by the candidate will help
her/him in understanding the ongoing activities in the proposed area of research.
Further it helps in creating practical exposure to research and hence it bridges
the connectivity between clinical practice and biomedical research. Such
research exposure will be helpful in improving problem solving capacity, getting
updated with ongoing research and implementing these findings in clinical
practice.

Research Ethics: Ethical conduct during the conduct and publication of research
is an essential requirement for all candidates and guides, with the primary
responsibility of ensuring such conduct being on the thesis guide. Issues like
Plagiarism, not maintaining the confidentiality of data, or any other distortion of
the research process will be viewed seriously. The readers may refer to standard
documents for the purpose.

The NBE reserves the right to check the submitted protocol for plagiarism, and
will reject those having substantial duplication with published literature.

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PROTOCOL REQUIREMENTS

1. All of the following will have to be entered in the online template. The
thesis protocol should be restricted to the following word limits.

 Title : 120 characters (with spacing) page

 Synopsis [structured] : 250-300
 Introduction : 300-500
 Review of literature : 800-1000
 Aim and Objectives : Up to 200
 Material and Methods : 1200-1600
 10-25 References [ICMJE style]

2. It is mandatory to have ethics committee approval before initiation of the

research work. The researcher should submit an appropriate application to
the ethics committee in the prescribed format of the ethics committee
concerned.

Guidelines for Thesis

1. The proposed study must be approved by the institutional ethics

committee and the protocol of thesis should have been approved by NBE.

2. The thesis should be restricted to the size of 80 pages (maximum). This

includes the text, figures, references, annexures, and certificates etc. It
should be printed on both sides of the paper; and every page has to be
numbered. Do not leave any page blank. To achieve this, following points
may be kept in view:

a. The thesis should be typed in 1.5 space using Times New

Roman/Arial/ Garamond size 12 font, 1” margins should be left on
all four sides. Major sections viz., Introduction, Review of Literature,
Aim & Objectives, Material and Methods, Results, Discussion,
References, and Appendices should start from a new page. Study
proforma (Case record form), informed consent form, and patient
information sheet may be printed in single space.
b. Only contemporary and relevant literature may be reviewed.
Restrict the introduction to 2 pages, Review of literature to 10-12
pages, and Discussion to 8-10 pages.
c. The techniques may not be described in detail unless any
modification/innovations of the standard techniques are used and
reference(s) may be given.
d. Illustrative material may be restricted. It should be printed on paper
only. There is no need to paste photographs separately.

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 3. Since most of the difficulties faced by the residents relate to the work in
clinical subject or clinically-oriented laboratory subjects, the following
steps are suggested:
a. The number of cases should be such that adequate material,
judged from the hospital attendance/records, will be available and
the candidate will be able to collect case material within the period
of data collection, i.e., around 6-12 months so that he/she is in a
position to complete the work within the stipulated time.
b. The aim and objectives of the study should be well defined.
c. As far as possible, only clinical/laboratory data of investigations of
patients or such other material easily accessible in the existing
facilities should be used for the study.
d. Technical assistance, wherever necessary, may be provided by the
department concerned. The resident of one specialty taking up
some problem related to some other specialty should have some
basic knowledge about the subject and he/she should be able to
perform the investigations independently, wherever some
specialized laboratory investigations are required a co-guide may
be co-opted from the concerned investigative department, the
quantum of laboratory work to be carried out by the candidate
should be decided by the guide & co-guide by mutual consultation.

4. The clinical residents are not ordinarily expected to undertake

experimental work or clinical work involving new techniques, not hitherto
perfected OR the use of chemicals or radioisotopes not readily available.
They should; however, be free to enlarge the scope of their studies or
undertake experimental work on their own initiative but all such studies
should be feasible within the existing facilities.

5. The DNB residents should be able to freely use the surgical

pathology/autopsy data if it is restricted to diagnosis only, if however,
detailed historic data are required the resident will have to study the cases
himself with the help of the guide/co-guide. The same will apply in case of
clinical data.

6. Statistical methods used for analysis should be described specifically for

each objective, and name of the statistical program used mentioned.

General Layout of a DNB Thesis:

 Title- A good title should be brief, clear, and focus on the central theme of
the topic; it should avoid abbreviations. The Title should effectively
summarize the proposed research and should contain the PICO elements.

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 Introduction- It should be focused on the research question and should
be directly relevant to the objectives of your study.

 Review of Literature - The Review should include a description of the

most relevant and recent studies published on the subject.

 Aim and Objectives - The ‘Aim’ refers to what would be broadly achieved
by this study or how this study would address a bigger question / issue.
The ‘Objectives’ of the research stem from the research question
formulated and should at least include participants, intervention,
evaluation, design.

 Material and Methods- This section should include the following 10

elements: Study setting (area), Study duration; Study design (descriptive,
case-control, cohort, diagnostic accuracy, experimental (randomized/non-
randomized)); Study sample (inclusion/exclusion criteria, method of
selection), Intervention, if any, Data collection, Outcome measures
(primary and secondary), Sample size, Data management and Statistical
analysis, and Ethical issues (Ethical clearance, Informed consent, trial
registration).

 Results- Results should be organized in readily identifiable sections

having correct analysis of data and presented in appropriate charts,
tables, graphs and diagram etc.

 Discussion–It should start by summarizing the results for primary and

secondary objectives in text form (without giving data). This should be
followed by a comparison of your results on the outcome variables (both
primary and secondary) with those of earlier research studies.

 Summary and Conclusion- This should be a précis of the findings of the

thesis, arranged in four paragraphs: (a) background and objectives; (b)
methods; (c) results; and (d) conclusions. The conclusions should strictly
pertain to the findings of the thesis and not outside its domain.

 References- Relevant References should be cited in the text of the

protocol (in superscripts).

 Appendices -The tools used for data collection such as questionnaire,

interview schedules, observation checklists, informed consent form (ICF),
and participant information sheet (PIS) should be attached as appendices.
Do not attach the master chart.

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Thesis Protocol Submission to NBE

1. DNB candidates are required to submit their thesis protocol within 90 days
of their joining DNB training.

2. Enclosures to be submitted along with protocol submission form:

a) Form for Thesis Protocol Submission properly filled.
b) Thesis Protocol duly signed.
c) Approval letter of institutional Ethical committee. (Mandatory, non
receivable of any one is liable for rejection)

Thesis Submission to NBE

1. As per NBE norms, writing a thesis is essential for all DNB candidates
towards partial fulfillment of eligibility for award of DNB degree.
2. DNB candidates are required to submit the thesis before the cut-off date
which shall be 30th June of the same year for candidates appearing for
their scheduled December final theory examination. Similarly, candidates
who are appearing in their scheduled June DNB final examination shall be
required to submit their thesis by 31st December of preceding year.
3. Candidates who fail to submit their thesis by the prescribed cutoff date
shall NOT be allowed to appear in DNB final examination.
4. Fee to be submitted for assessment (In INR): 3500/-
5. Fee can be deposited ONLY through pay-in-slip/challan at any of the
Indian bank branch across India. The challan can be downloaded from
NBE website www.natboard.edu.in
6. Thesis should be bound and the front cover page should be printed in the
standard format. A bound thesis should be accompanied with:
a. A Synopsis of thesis.
b. Form for submission of thesis, duly completed
c. NBE copy of challan (in original) towards payment of fee as may be
applicable.
d. Soft copy of thesis in a CD duly labeled.
e. Copy of letter of registration with NBE.

7. A declaration of thesis work being bonafide in nature and done by the

candidate himself/herself at the institute of DNB training need to be
submitted bound with thesis. It must be signed by the candidate
himself/herself, the thesis guide and head of the institution, failing which
thesis shall not be considered.

The detailed guidelines and forms for submission of Thesis

Protocol & Thesis are available at
www.natboard.edu.in.thesis.php.

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LOG BOOK

A candidate shall maintain a log book of operations (assisted / performed) during

the training period, certified by the concerned post graduate teacher / Head of
the department / senior consultant.

This log book shall be made available to the board of examiners for their perusal
at the time of the final examination.

The log book should show evidence that the before mentioned subjects were
covered (with dates and the name of teacher(s) The candidate will maintain the
record of all academic activities undertaken by him/her in log book .

1. Personal profile of the candidate

2. Educational qualification/Professional data
3. Record of case histories
4. Procedures learnt
5. Record of case Demonstration/Presentations
6. Every candidate, at the time of practical examination, will be required to
produce performance record (log book) containing details of the work done by
him/her during the entire period of training as per requirements of the log
book. It should be duly certified by the supervisor as work done by the
candidate and countersigned by the administrative Head of the Institution.
7. In the absence of production of log book, the result will not be declared.

21
Leave Rules
1. DNB Trainees are entitled to leave during the course of DNB training as per the
Leave Rules prescribed by NBE.
2. A DNB candidate can avail a maximum of 20 days of leave in a year excluding
regular duty off/ Gazetted holidays as per hospital/institute calendar/policy.
3. MATERNITYLEAVE:
a. Afemale candidate is permitted a maternity leave of 90 days once during
the entire duration of DNB course.
b. The expected date of delivery (EDD) should fall within the duration of
maternity leave.
c. Extension of maternity leave is permissible only for genuine medical
reasons and after prior approval of NBE. The supporting medical
documents have to be certified by the Head of the Institute/hospital where
the candidate is undergoing DNB training. NBE reserves its rights to take
a final decision in such matters.
d. The training of the candidate shall be extended accordingly in case of any
extension of maternity leave being granted to the candidate.
e. Candidate shall be paid stipend during the period of maternity leave. No
stipend shall be paid for the period of extension of leave.
4. Male DNB candidates are entitled for paternity leave of maximum of one week
during the entire period of DNB training.
5. No kind of study leave is permissible to DNB candidates. However, candidates
may be allowed an academic leave as under across the entire duration of training
program to attend the conferences/CMEs/Academic programs/Examination
purposes.
DNB COURSE NO. OF ACADEMIC LEAVE
DNB 3 years Course (Broad & Super Specialty) 14 Days
DNB 2 years Course (Post Diploma) 10 Days
DNB Direct 6 years Course 28 days

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6. Under normal circumstances leave of one year should not be carried
forward to the next year. However, in exceptional cases such as
prolonged illness the leave across the DNB training program may be
clubbed together with prior approval of NBE.
7. Any other leave which is beyond the above stated leave is not permissible
and shall lead to extension/cancellation of DNB course.
8. Any extension of DNB training for more than 2 months beyond the
scheduled completion date of training is permissible only under extra-
ordinary circumstances with prior approval of NBE. Such extension is
neither automatic nor shall be granted as a matter of routine. NBE shall
consider such requests on merit provided the seat is not carried over and
compromise with training of existing trainees in the Department.
9. Unauthorized absence from DNB training for more than 7 days may lead
to cancellation of registration and discontinuation of the DNB training and
rejoining shall not be permitted.
10. Medical Leave
a. Leave on medical grounds is permissible only for genuine medical
reasons and NBE should be informed by the concerned
institute/hospital about the same immediately after the candidate
proceeds on leave on medical grounds.
b. The supporting medical documents have to be certified by the Head
of the Institute/hospital where the candidate is undergoing DNB
training and have to be sent to NBE.
c. The medical treatment should be taken from the institute/ hospital
where the candidate is undergoing DNB training. Any deviation
from this shall be supported with valid grounds and documentation.
d. In case of medical treatment being sought from some other
institute/hospital, the medical documents have to be certified by the
Head of the institute/hospital where the candidate is undergoing
DNB training.

23
 e. NBE reserves its rights to verify the authenticity of the documents
furnished by the candidate and the institute/hospital regarding
Medical illness of the candidate and to take a final decision in such
matters.
11.
a. Total leave period which can be availed by DNB candidates is
120+28 = 148 days for 6 years course, 60+14=74 days for 3 years
course and 40+10 = 50 days for 2 years course. This includes all
kinds of eligible leave including academic leave. Maternity /
Paternity leave can be availed separately by eligible candidates.
Any kind of leave including medical leave exceeding the
aforementioned limit shall lead to extension of DNB training. It is
clarified that prior approval of NBE is necessary for availing any
such leave.
b. The eligibility for DNB Final Examination shall be determined strictly
in accordance with the criteria prescribed in the respective
information bulletin.

24
EXAMINATION

FORMATIVE ASSESSMENT

Formative assessment includes various formal and informal assessment

procedures by which evaluation of student’s learning, comprehension, and
academic progress is done by the teachers/ faculty to improve student
attainment. Formative assessment test (FAT) is called as “Formative “as it
informs the in process teaching and learning modifications. FAT is an integral
part of the effective teaching .The goal of the FAT is to collect information which
can be used to improve the student learning process.

Formative assessment is essentially positive in intent, directed towards

promoting learning; it is therefore part of teaching. Validity and usefulness are
paramount in formative assessment and should take precedence over concerns
for reliability. The assessment scheme consists of Three Parts which has to be
essentially completed by the candidates.

The scheme includes:-

Part I:- Conduction of theory examination

Part-II :- Feedback session on the theory performance
Part-III :- Work place based clinical assessment

Scheme of Formative assessment

Candidate has to appear for
CONDUCT OF THEORY
PART – I Theory Exam and it will be
EXAMINATION
held for One day.
FEEDBACK SESSION ON Candidate has to appear for
PART – II THE THEORY his/her Theory Exam
PERFORMANCE Assessment Workshop.
After Theory Examination,
WORK PLACE BASED
PART – III Candidate has to appear for
CLINICAL ASSESSMENT
Clinical Assessment.

The performance of the resident during the training period should be monitored
throughout the course and duly recorded in the log books as evidence of the
ability and daily work of the student

1. Personal attributes:
 Behavior and Emotional Stability: Dependable, disciplined, dedicated,
stable in emergency situations, shows positive approach.
 Motivation and Initiative: Takes on responsibility, innovative,
enterprising, does not shirk duties or leave any work pending.

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  Honesty and Integrity: Truthful, admits mistakes, does not cook up
information, has ethical conduct, exhibits good moral values, loyal to the
institution.
 Interpersonal Skills and Leadership Quality: Has compassionate
attitude towards patients and attendants, gets on well with colleagues and
paramedical staff, is respectful to seniors, has good communication skills.

2. Clinical Work:

 Availability: Punctual, available continuously on duty, responds promptly

on calls and takes proper permission for leave.
 Diligence: Dedicated, hardworking, does not shirk duties, leaves no work
pending, does not sit idle, competent in clinical case work up and
management.
 Academic ability: Intelligent, shows sound knowledge and skills,
participates adequately in academic activities, and performs well in oral
presentation and departmental tests.
 Clinical Performance: Proficient in clinical presentations and case
discussion during rounds and OPD work up. Preparing Documents of the
case history/examination and progress notes in the file (daily notes, round
discussion, investigations and management) Skill of performing bed side
procedures and handling emergencies.

3. Academic Activity: Performance during presentation at Journal club/

Seminar/ Case discussion/Stat meeting and other academic sessions.
Proficiency in skills as mentioned in job responsibilities.

FINAL EXAMINATION
The summative assessment of competence will be done in the form of DNB Final
Examination leading to the award of the degree of Diplomate of National Board in
Endocrinology. The DNB final is a two-stage examination comprising the theory
and practical part. An eligible candidate who has qualified the theory exam is
permitted to appear in the practical examination.

Theory Examination
1. The theory examination comprises of Three/ Four papers, maximum
marks 100 each.
2. There are 10 short notes of 10 marks each, in each of the papers. The
number of short notes and their respective marks weightage may vary in
some subjects/some papers.
3. Maximum time permitted is 3 hours.
4. Candidate must score at least 50% in the aggregate of Three/ Four
papers to qualify the theory examination.

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 5. Candidates who have qualified the theory examination are permitted to
take up the practical examination.

6. The paper wise distribution of the Theory Examination shall be as follows:

PAPER 1: Basic sciences applied to the specialty, Principles of

Endocrinology and hormone signaling, Neuroendocrinology and
Pituitary disease, Growth and Maturation, Obesity , Anorexia and
nutrition, Polyglandular syndromes, Research methodology

PAPER 2: Diabetes Mellitus, Parathyroid gland , Calciotropic hormones

and bone metabolism, Thyroid Adrenal gland and adrenal hormones

PAPER 3: Cardiovascular endocrinology, Endocrine changes in

critically ill patients, Reproductive endocrinology and sexual function
Male and female reproduction, Endocrinology of pregnancy, Recent
advances and Investigations

a) Practical Examination:
1. Maximum Marks: 300.
2. Comprises of Clinical Examination and Viva.
3. Candidate must obtain a minimum of 50% marks in the Clinical
Examination (including Viva) to qualify for the Practical Examination.
4. There are a maximum of three attempts that can be availed by a
candidate for Practical Examination.
5. First attempt is the practical examination following immediately after the
declaration of theory results.
6. Second and Third attempt in practical examination shall be permitted out
of the next three sessions of practical examinations placed alongwith the
next three successive theory examination sessions; after payment of full
examination fees as may be prescribed by NBE.
7. Absentation from Practical Examination is counted as an attempt.
8. Appearance in first practical examination is compulsory;
9. Requests for Change in center of examination are not entertained, as the
same is not permissible.
10. Candidates are required not to canvass with NBE for above.

Declaration of DNB Final Results

1. DNB final is a qualifying examination.

2. Results of DNB final examinations (theory & practical) are declared as
PASS/FAIL.
3. DNB degree is awarded to a DNB trainee in the convocation of NBE.

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RECOMMENDED TEXT BOOKS AND JOURNALS

BOOKS

 Williams Textbook of endocrinology Wilson &Foster

 Textbook of Endocrinology Felig, Baxter and Broadus
 Endocrinology Cachill & Bradley
 Josline Diabetes Mellitus Ellenberg & Rifts
 Diabetes Mellitus Ellenberg & Rifts
 Metabolic basis of Inherited disease Stanbury, Wtngard et al
 The Thyroid Sydeay SIngbar and Braverman
 Reproductive Endocrinology Jaffe and yen
 Reproductive Endocrinology Speroff & Kase
 Neuroendocrinology Martine & Besser
 Handbook of Endocrinology Dillon
 Immunoassay a practical Guide Brian’s Law
 RIA, Principles and Practice Pillai and Bhandarkar, 1998, BARC
 Antibodies A laboratory manual Ed. Harlow and David lane
 Text book of Clinical Chemistry eitz.
 Nutritive value of Indian Foods C. Gopalan, ICMR
 Hypothalamic pituitary development Ed. Rapheel Rappaport serge
Amselem
 Adrenal diseases in childhood I A Hughes A J L Clark
 Genetic disorders of Endocrine Neoplasia Patricia Dahia Charis Eng.

 Textbook of Diabetes (Holt’s)

 Metabolic basis of inherited disease (Stanbury)
 The Thyroid (Ingbar)
 Reproductive Endocrinology (Speroff)
 Textbook of Clinical Chemistry (Tietz)
 Nutritive value of Indian Foods (Gopalan, ICMR)
 Endocrinology (Lesl
 Pediatric Endocrinology (Hindmarsh and CGD Brook)

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JOURNALS

 Journal of Clinical Endocrinology & Metabolism

 European Journal of Endocrinology

 Diabetes
 Diabetes Care
 Fertility and sterility
 Nature
 Science
 New England Journal of Medicine
 The Lancet
 Annals of Internal Medicine
 Hormone and Metabolic Research
 American Journal of Clinical Nutrition
 British Medical Journal
 Journal of Bone and Mineral Research
 Clinical Endocrinology
 Endocrine and Metabolic Clinics of North America
 Endocrine Reviews

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