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Website:
Bangladesh College of Physicians and Surgeons (BCPS)
rrrrww.bcpsbd.ore
Mohakhali, Dhaka 1212
Training Accreditation form -01
Email: bcps@bcps-bd'ore
(To be filled in bY the lnstitutes)
Part-A: General lnformation
(Please tick (V) the appropriate Box)
1. Name of the institute:
2. Name of the department:
r--l
n
3. Status of the institute: Government
Non-Government A.
B.
F"-] rffiil rffil F*;_l
4" A.*Recognition of BMDC:
Recogni zed
Not Recognized
Not applicable
(lf yes, ptease provide supporting document)
s. License by DGHS: Ll;-l l-----l Not Applicable
(lf Yes)
License No.
6. Affiliation with UniversitY:
t-'"'l r;-l
(lf yes)
Not Applicable
7. lnstitutional Research monitoring Committee:
8. lnformation about Hosfrital Ued:
Total number of beds of the institute
Number of paying beds
Number of non-paying beds
Number of Cabins
I
,
Updated on 1.6/02/2015
9. A. Availability ot emergency services' [l;-l F;l
till
B. Availability of ICU services:
Ef E
lf yes,
Number of beds I I
Number of Ventitators E
r---l
Number of tcu doctor Number of tcU Nurse & Paramedics
f--j
C. Availability of CCU services:
10. Present Accreditation status :
Etr]Accredited Not Accredited
A. lf Accredited, Please give details:
Name of the departments Period of training Recognized Valid Upto-
by BCPS
(Use seporate sheet ds required)
Applicable Not Applicable
l-1. Observation made at last inspection by BCPS team:
lf opplicable, pleose submit copy of the observation for each department seporately.
12. Measures taken to address the observations: Applicable Not Applicable
lf applicoble, please mention measures taken using separate sheet for eoch department.
uxfl:
Updated on 16102/201.5
Paft-B tnformation about the relevant Department
t. The department applied previously
E
[. The department was accredited previously but required re-accreditation
E [;;,.*"l
il1. The department was NOT CONSIDERED for accreditation due to short comings
E r"*ffiI
1. Number of beds in the department :
Total number of beds
Number of paying beds
Number of non-paying beds
Number of Cabins
2. A. Availability of the sub-specialty of the relevant department:
F;--ltr;--l
B. lf yes, name of the sub-specialties:
c. Number of beds in the sub-specialtv departments : (use separate sheet if
Total number of beds
Number of non-paying beds
Number of paying beds
Number of Cabins
3. A. Facilities for emergency admission in the department requesting for accreditation
B" *Availability of ICU service
F'-l E
EE
lf yes
Number of beds L
ir Number of ventitators
I [-]
Number of tCU doctors Number of tcU Nurse & Paramedics
t__l |-]
4. Records:
4.1. ln-patient records of the department (last one year):
Number of non-paying beds
Number of paying beds
Number of cabins
L;Q:
updated ont6lo2l2ol5
Number of patients admitted in non-paying beds
Number of patients admitted in paying beds
Number of patients admitted in cabins
4.2. Disease profile of in-patients in the department (last one year): (Please use separate sheet)
4.3. *Out-patient records of the department applying for accreditation (last one year)
Duration of OPD patient care (ln hours per week)
Numbers of patients attending the OPD per day
Number of minor operations done in OPD per week (For surgery)
4"4 Disease profile of patients of OPD in last year (please use separate sheet)
5.1 Operation theater:
i.
ii.
Separate sterillzation area:
Sterilization facilities:
EE lf yes, provide details
iii^ ResuscitationequiPment: lf yes, provide details
iv"
v.
AnestheticsequiPment:
Etr-J lf yes, provide details
surgical instrument : provide list with number (please use separate sheet)
vi specialty surgical instrument:
ta] itr rf ves, provide list
vii. Recovery ,.oc,,n, | ;; I t *" I lf ves, mention number of beds E
viii" Number of operating sessions per week:
ix.Averagenumberofmajoroperationsperformedpersession;
X.Averagenumberofminoroperationsperformedpersession:
xi. Average number of [mergency operation done per week:
ll
5.2 Procedure records (please use seporate sheet if required)
Records of lnvasive procedure/investigation done in the department (last one year):
Period: From ------ to ----------
Name of invasive procedurc done in the dcpartment Number of procedures
ua"Q;
Updated on 1,610212015
-7
5.3 Following parts are to be filled in by only Sureerv and allied deoartments
for which
accreditation is requested:
Total number of operations performed by the department during the
last year:
Period: From ................ to........... I f
A' Records of Major operation of the department (last one year) (use
separate sheet)
Period: From ................. to
Name of Major operations done in the departmeni
No, of operations
B. Records of Minor operation of the department (rast one year) (use
separate sheet)
Period: From-------------- to
Name of Minor operations done in the department
Nos. of operations
C' Records of the Emergency operation of the department (last
one year) (use separate sheet)
Period : From ---:-------to-----------
rtlame or Emergency operations done in the department
Nos. of operations
D' Records of the Minors operation in oPD of the department (last
one year) (use separate sheet)
Period: From ------------to-----------
Name of Minor operations done in OpD in ihe depa.trnert
Nos. of operations
5. Following parts are to be firted by basic science departments:
A' Records of routine work of the department applying for accreditation: (last
one year), (use separate sheet if needed)
Period: From-------------- to
Name of routine laboratory work done in it,e a"partrr,"r*
Total no.
B' Records of the Emergency laboratory work of the department (last one year) (use
separate sheet if needed)
Period: From ------------to-----_____
rmergency raooratory work done in the department
Total no.
Updated on 161021201,5
-7
Part-C: Faculty lnformation (Use separate sheet for each faculty member)
7. *Academic staff of the department:
Designation Full Qua lif ication BMDC Reg. No Teaching List of publications
Name
lparl With validity experience in
time the rank of Asst.
Prof. and above"
8, * Work load of academic Staff -
Duties working hours ( per week)
n-nati pnt
I
Ward rorrnd
Laboratory work load
On call frequency
Fmersencv attendance
Teaching (and related works)
a. Number of teaching unit of the department
LI
b. *No. of beds in each of the service/teaching unit of the department:
9. Research retated information
fuL] rcil lf yes, provide detailed information
A.No.ofon-goingResearchB'No'ofresearchconductedlastyear
9.1 Research projects conducted by the department.
(Please use separate sheet if required)
Sponsoring agency O n -going/proposed
SI,NO Narne of project
L4^-?;
Updated on 1,610212015
tment in the last 3 years: 'ate sheet if needed)
the faculty members of the
*Trainees' Clinical/Laboratory work ttachment
Duti es Frequency/Week
OPD care
ln-patient care
History taking
Follow up
Emergency
OT
rcu
CCU
Post Operative care
Laboratory work
11 *Trainers'Academic lnvolvement
Duties Frequency per month
Lecture
Tutorial
Croup discussion
Bed side teaching
'ieaching at OT
Journals Club
Seminar
\"x^i{"
Updated on 1,6/0212015
,
t'
Part-D: Support services of the department
n.ece::ary)
Departments and seruices (For clinical dPpartments on,ly) (Use :epqrate sheet-if
Service offered to dePartment
Radiology and imaging
Nuclear medicine
2. LrVl
4. Libraqr Yt
Library Services
Number of seats
/day
Hours of service available
Journals / Periodicals Titles Total books
Books /
Books (Title of books)
Journals
Periodicals
(Use separate sheet)
Electronic version of books
Students' accessibility to the internet
E
E E
E
Does
Access
the library have any link with other library?
to electronic journal and publications
E M
Lq tr]
Link to WHO web site (lllNARl)
3. Teaching lnfrastructures:
&l E_l
Number Accommodation/Seats
Phvsical facilities
Class room
Seminar room
Students'common room
Museum
Name and number of audio-visual aids
Skill Lab
Head/Chairman of the dePartment Head of the lnstitute
(Official Seal)
(OfficialSeal)
t"^;1:
Updated on 1,6102/2015
