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