1

MEDICAL COUNCIL OF INDIA

ASSESSMENT FORM FOR ______ - MBBS ADMISSIONS REPORT
(INCREASE IN ADMISSION CAPACITY FROM _____ TO ______ )

Part A-II (2018-19)

(to be filled by the Assessors)
1.1 Type of Assessment

U/S 10A-regular/compliance: Letter of Permission ( ),1st renewal ( ), 2nd renewal ( ), 3rd renewal ( ), 4th renewal ( )

U/S 10A- Increase Admission Capacity: Regular/Compliance: Letter of Permission ( ),1st renewal ( ), 2nd renewal ( ),
3rd renewal ( ),4th renewal ( )

U/S 11- Recognition - Regular/Compliance

Continuation of Recognition - Regular / Compliance

Any Other: _________________________________________________________________________________________________

Name of the Institution :

Address :

Telephone No. :

E-mail :

College Website :

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Council Letter No. & Date :

Assessment Date: Last Assessment Date :

PG Courses : Yes/No

Particulars of Assessors

Name of the Assessors Correspondence Address Contact No. Email

1.2. The College has following

The campus plot is. unitary/divided into ____________parts

if divided, Please give details.

Building Plan approval from the competent authority. Name--------------------- No.----------------------- Date----------------

Building Use/ Occupancy Certificate from the competent Name--------------------- No.----------------------- Date----------------
authority.

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1.3 Dean/Principal: Dr._________________, M.D.,/M.S. with __________ years of teaching experience - ______________yrs of
professor & _____________ yrs of experience of Asso Prof and _________. He is also holding the post of Professor in the
Department of _____________.

Dean Office is located in _______________________of the college/building along with the administrative block. Adequate
space (as per MSR guidelines by MCI) and other required facilities (as given in the table below) are provided/not provided to
the administrative staff.

Office Space Requirement Requirement Space (mts) Available

Dean/Principal Office 36
Staff Room 54
College Council Room 80

1.4 Medical Education Unit (MEU):

Available as per Regulations : Yes/No

Name of the MEU coordinator :

Name, Designation & Experience of affiliated faculty :

Name of the MCI Regional ( Nodal) Centre where above training :

has been undertaken

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Details of the Orientation programme and Basic Course Workshop :

undergone by MEU(No. of programmes organized during
Academic year, No. of People attended, proceedings (to be
verified at the time of assessment)
Date/s of the above workshops :

Details & Duration of Workshops in Medical Education :

Technology conducted by MEU

Details of faculty who have undergone basic course workshop in :

Medical Education Technology at the allocated MCI Regional Centre

Details of faculty who have undergone advanced course :

workshop in Medical Education Technology at the allocated MCI
Regional Centre

Feedback evaluation of workshops and action taken reports on the :

basis of feedback obtained

1.5 Continuing Medical Education :

No and Details of CMEs/workshop organized by the college held in :

the past 1 year

Details of the credit hours awarded for the past one year :

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1.6 College Council :

Name, designation, contact no. and address of the President & :

Secretary.

Composition of the Council (HODs as members & Principal / Dean as :

chairperson)

No. of times the College Council meets per year (min 4) :

Details of college Council meetings where students Welfare was :

discussed and Action taken report (details / comments in annexure II)

1.7 Pharmacovigilance Committee: Present/Absent

No. of meeting in the previous yrs. _______________(Minutes to be checked)

1.8 Examination Hall:

Requirement Available
No. – 1/2/3
Area - 250 Sq. mt.
Capacity - 250

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1.9 Lecture Theatres:

Medical college Hospital
Req Available Req Available Comments
Number
Capacity
Type Yes / No Yes / No
(Gallery)
A.V. Aids Yes / No Yes / No
1.10 Library
Air-conditioned – Yes/No
Working Hours:
a. Stack room : ______________
b. Reading room : _________________

Required Available Remarks

Area _____ Sq.m. ________ Sq.m.

Student Reading Room _______ Capacity _______ Capacity

(Inside)
Student Reading Room ________ Capacity ________ Capacity
(Outside)
Staff Reading Room _______ Persons _______ Persons
Room for Resident/PG
reading room
Particulars Required Nos. Available Nos. Remarks
No. of Books

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Journals (Indian)
Journals (Foreign)
Internet Nodes

1.11 Common Room for Boys & Girls

Area Required Sq. Mt. Available Area Sq. Mt. Toilet – Attached Y/N
Boys
Girls

1.12 Central Photography Section: Available Yes/No

Staff Yes/No
Equipments Yes/No
1.13 Hostel: Location – Within campus
Visitor room, AC
Study room with
Available
internet &
Capacity Toilet Hygiene of
Computer,
Hostel Required (No Rooms X Furnished Facility Mess Hostel
Recreation room Remarks
Category Capacity capacity of each (Y/N) Adequate/ (Y/N) campus
with
room = Total Inadequate Y/N
TV, Music, Indoor
capacity)
Games
Y/N
UG Students @ Boys
(75% Capacity)
Girls
Interns @ 100%
Capacity
Resident @
100% Capacity
including PG
Nurses @ 20%

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Capacity

Residential Quarters:

Category Required Nos. Available Nos. Remarks

Teaching Staff @ 20%
Capacity
Non-Teaching Staff @
20% Capacity

1:14 Recreational Facilities:

Outdoor games Yes/No

Play field/s
Type of games
Indoor games facilities Yes/No
Gymnasium Available /Not available.

1.15 Gender Harassment Committee -: Yes/No (Documents to be seen at the time of assessment)

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TEACHING HOSPITAL

2.1 Name of the Hospital:

Owned by: Government/Trust/Society/Company

2.2 Name of the Medical Superintendent: , MD/MS ( ), with years administrative experience.

Space Requirement Availability

Medical Supdt’s Office 36 sq. mt.

Administrative Office 150 sq. mt

2.3 Teaching and other facilities :

OPD Timings : _______ A.M. to ________P.M.

Separate Registration areas for male/female : yes/no

patients available

Separate Registration counters for OPD/IPD : available/not available

Are the Registration counters computerized : yes/no

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Staff for registration center : adequate / inadequate (on the basis of OPD
attendance)

Waiting areas for above patients available : yes/no

No. of rooms for examination of patients available : yes/no

Capacity of teaching area in each department : yes/no

Enquiry Desk : yes/no

2.4 Facilities available in OPD

Medicine
E.C.G. Room
Injection room Yes/No
- Male Yes/No
- Female Yes/No
Surgery
Dressing room -
- Male Yes/No Minor OT Yes/No
- Female Yes/No
Orthopaedics
Plaster room Yes/No
Dressing room -
Plaster cutting room Yes/No
- Male Yes/No
- Female Yes/No
Ophthalmology Refraction Rooms Yes / no
Dark Rooms Yes / no
Dressing Rooms / Minor Procedure Room Yes / no

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ENT Audiometry (AC & Sound proof) Yes / no

Speech Therapy Yes / no
Pediatrics Yes / no
Child Welfare Clinic
Yes / no
Immunization Clinic
Yes / no
Child Rehabilitation Clinic
Yes / no
OBS & GYN Antenatal Clinic Yes / no
Sterility Clinic Yes / no
Family Welfare Clinic Yes / no
Cancer Detection Clinic Yes / no

Comments :

2.5 Total Number Of Teaching Beds (Distance between two beds should be 1.5 m.)
Teaching Hospitals in Campus with Total Beds ________.
Teaching Hospitals in Outside the Campus (______Kms. from the campus ) with Total Beds ________.

Facilities Available in Each Ward

Total Exam/
Ward Beds Nursing Store Duty Demo Room
Department Beds Treat Pantry Remarks
Nos. Required Station Room Room (25 Capacity)
Available Room Y/N
Y/N Y/N Y/N Y/N
Y/N
Gen. Medicine
Pediatrics
TB & Respiratory
Medicine
Psychiatry
Dermatology
Gen. Surgery
Orthopedics
Ophthalmology

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Facilities Available in Each Ward
Total Exam/
Ward Beds Nursing Store Duty Demo Room
Department Beds Treat Pantry Remarks
Nos. Required Station Room Room (25 Capacity)
Available Room Y/N
Y/N Y/N Y/N Y/N
Y/N
ENT
OB & GYN
Total

2.6 Clinical material (*Random verification to be done by the Assessor).

On the Day of
Item Remarks
assessment
O.P.D. attendance at 2.00 PM
On first day
Casualty attendance
(24 hrs. data)
No of admissions
No. of discharges
Bed occupancy% at 10.00AM on
first day
Operative Work
No, of major surgical operations
No. of minor surgical operations
No. of normal deliveries
No. of caesarian sections

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On the Day of
Item Remarks
assessment
Radiological Investigations
O.P. D I.P.D
( No. of patients )
X-ray
Ultrasonography
Barium, IVP etc.
C.T. Scan

On the Day of
Item Remarks
assessment
Laboratory Investigations – No. of
O.P. D I.P.D
Patients/ samples
Biochemistry
Microbiology

Serology

Hematology

Clinical pathology
Histopathology

Cytopathology

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2.7 Medical Record Section:

Manual / Computerized _______
ICD X classification of diseases followed for indexing : yes/no

2.8 Central casualty services :

No of Beds: Required____________ Available__________________
 Number of CMO posted/Shift :____ No. of CMO present during Assessment round________
 Number of nurses posted / Shift: ____ Total No. of CMO _________
 Separate casualty for OBGY cases: available, if yes No. of beds _______/ not available,

Equipment Availability Number

Y/N
Central Oxygen & suction facility
Pulse oximeter
Ambu bag
Disaster trolley
Crash Cart
Emergency Drug Tray
Defibrillator
Ventilator
X-ray Unit – (Mobile)
Minor OT

Comments:

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2.9 Clinical Laboratories

Central Clinical Laboratory: Under control of department of : ________________

Separate sections for pathology, microbiology, hematology & biochemistry: available/not available.

2.10 Operation theatres

Type Requirement Available Remarks
Major
Minor

2.11 Equipment available in O. T. Block (Specify numbers)

Central
Multipara
Oxy / Anesthesia Defibrill Infusion
Theatres A/C Monitor with
Dept Nitrous Machine ators Pumps Remarks
Nos. Y/N Capnograph
Oxide Y/N Y/N Y/N
Y/N
Y/N
Gen
Surgery
ENT
Ophthal
Ortho
OBS & GYN
Emergency
Septic

No. of Pre-operative Beds available___________

No. of Post Operative Beds available___________

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2.12 Intensive Care: Following intensive areas are available –

Central Major Equipment

Patients on
Beds Beds AC Oxygen/ (Monitor, Ventilator, ABG,
Type day of Remarks if any
(Required) (Available) Y/N Suction Pulse Oximeter etc.)
assessment
Y/N Y/N
ICCU 5
ICU 5
SICU 5
NICU/PICU 5

2.13 Labor Room

Rooms Beds Remarks

Clean Cases
Septic Cases
Eclampsia

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2.14 Radiological Facilities:

Equipment Required Available AERB Functional Status at Remarks if any

no. no. Approval the time of assessment
Y/N Y/N
Mobile X Ray
60 mA
100 mA
Static X Ray
300 mA
600mA
800/1000 mA
CT Spiral Minimum 16
slice

Equipment Required Available PNDT Functional Status at Remarks if any

no. no. Approval the time of assessment
Y/N Y/N
USG

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2.15 Blood Bank:

Available and functional: Yes / No
Number of units dispensed in a day _______________
Number of units stored on day of assessment _______________
License valid up to:____________(LICENCE NUMBER AND COPY TO BE APPENDED AS ANNEXURE-VII)
Blood Separation Facility – Available/Not available

2.16 Pharmacy : Pharmacist/Staff available: List to be included

 No. of sub-stores located in different parts of hospital:__________________

2.17 Central sterilization Department :
 Timings ________ & Shifts: ______
 Equipment: Horizontal autoclaves _____ / Vertical autoclaves________, ETO Sterilisers: _______No.
 Separate receiving and distribution points - Yes/No

2.18 Intercom: Available : yes/no
No. of incoming lines _______ No. of extension lines: _________

2.19 Central laundry/Alternative Arrangements:

In House/Outsourced:
Type of Laundry: Mechanized / Manual

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2.20 Kitchen/ Alternative Arrangements

 In-House/Outsourced _________
 Food free of charge: yes/no Number of patients ___
 Provision of special diet: yes/no
 Services of a nutritionist/dietician: available/not available

2.21 (a) Total no. of Canteens: ____________. For staff__________ For students _______For Patients/Relatives:________
(b)Total no. of Mess in campus :____________

2.22 Arrangements for Biomedical Waste Management.

 Outsourced/in-house : (if outsourced, append MOU) (If in-house, please specify details of facilities available)

2.23 Central Research Lab:

 Available – Yes/No
 Facilities – Adequate/Not Adequate
 Research Projects:
o Completed Nos _____
o Ongoing Nos ____

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2.24 Nursing and Paramedical staff :

Nursing staff: No of Beds ______

Category Required Nos. Available Nos.
Staff Nurses
Sister Incharge
ANS
DNS
Nursing
Suptd
Total

Paramedical Required Nos. Available Nos.

And
Non teaching
staff

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MEDICAL COLLEGE
3.1 College Website:

Sr. No. Details of information Yes/No

1. Details of Dean / Principal and Medical Superintendent Including their name,
qualification complete address with telephone and STD code, fax and E-mail etc.
2. Teaching staff, Resident doctors ,non-teaching staff , Technical staff , Nursing staff---
(a)department & designation wise with joining date (b) Unit wise faculty & resident list
3. Details of the affiliated university and its Vice-Chancellor and Registrars.
4. Citizen Charter
5. List of students admitted merit-wise category-wise (UG & PG) for the current and
previous year.
6. Result of all the examinations of last one year.
7. Details of members of the Anti Ragging Committee with contact details including
landline Phone, mobile, email etc...
8. Details of members of the Gender Harassment Committee with contact details including
landline Ph. mobile, email etc...
9. Toll free number to report ragging.
10. Details of the sanctioned intake capacity of various courses UG as well as PGs by the
MCI. (with the scan copies of permission letter)
11. Any research publication during the last one year.
12. Details of any CME programmes, conferences and/or any academic activities conducted
by the institution.
13. Details of any awards and achievements received by the students or faculty.
14. Detailed status of recognition of all the courses(with the scan copies of permission
letter)
15. Details of clinical material in the hospital
16. unit /dept .wise beds distribution

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3.1 (a) College timings___________To_____________

3.2 Teaching Programme:

Didactic teaching Yes/no
Demonstration Yes/no
Integrated teaching Yes/no
(Horizontal/Vertical teaching)
Clinical posting Yes/no
Clinical Pathological Conference Yes/no
Grand Rounds Yes/no
Statistical Meeting Yes/no
Seminars Yes/no

Teaching Facilities:

3.3 Anatomy

Required Available Required Available

Demonstration Room/s AV Aids:
 No ____
 Capacity - 75 to 100 students
 Histology practical laboratory - Museum: ____ seating
 Number of Lab seats _____ capacity
 Number of microscopes_____  Mounted specimens
 Dissection Microscopes _______  Models – Wet & Dry
 Dissection Hall  Bone Sets – Articulated-__
& Disarticulated- ___
 MRI & CT

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Required Available Required Available

Number of dissection tables - ______ Number of cadavers - ___
Cold store / cooling chambers –Capacity Storage tank - __
of______ Bodies
Embalming room – Band saw

Lockers - _____ Departmental Library-

(80-100 Books.)

Adequate exhaust, light, water supply and drainage facilities - Available/not available.

3.4 Physiology

Required Available Required Available

Demonstration Room/s AV Aids:
 No – _______
 Capacity - ________
Mammalian laboratory Haematology laboratory

Amphibian Laboratory Clinical Physiology Lab.

Departmental Library – 80-100 Books

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3.5 Biochemistry

Required Available Required Available

Demonstration Room/s AV Aids:
 No _____
 Capacity - ______
Number of practical laboratory/ies – Library / Seminar rooms –
80-100 Books
Number of Lab seats - ____

3.6 Pathology

Required Available Required Available

Demonstration Room/s AV Aids:
 No – ________
 Capacity - _________
Practical labs – Museum: _____, Seating Capacity-
 Morbid Anatomy/Histopath./ Cytology – _____ ______ students
Microscopes____________ Specimens:
 Clinical Pathology/Hematology – _____ Microscopes_____  Mounted
Departmental library – 80-100 Books  Unmounted
 Catalogues

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Service Lab –
Histopathology/Cytopathology/Hematology/Any
specialized work

3.7 Microbiology

Required Available Required Available

Demonstration Room/s AV Aids:
 No – _______
 Capacity - _____ students
practical laboratory__ Media preparation facility
Number of Lab seats - ______ Autoclaving, Washing and drawing room
Number of microscopes/laboratory - _____
Number of service laboratories - __7___ Museum:
Specimen, Charts, Models & Catalogue
seating capacity- ________
Departmental library - 80-100 Books,

3.8 Pharmacology

Required Available Required Available

Demonstration Room/s AV Aids:
 No – ______
 Capacity - ______ students
Experimental Pharmacology Museum: _____ seating capacity
Clinical pharmacology/pharmacy  Specimens

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Departmental Library - 80-100 Books  Charts

 Models
 History of Medicine
 Catalogues

3.9 Forensic Medicine

Required Available Required Available

Demonstration Room/s AV Aids:
 No – _______
 Capacity - _______ students
Forensic Medicine Practical Lab Museum :
Autopsy Block.  Medico-Legal Specimens________
Location – In/Near hospital in a separate structure.  Charts________
 Prototype fire arms________
Cold storage -_ Capacity of______ Bodies
 Slides_________
Departmental library – 80-100 Books
 Poisons _______
 Photographs________
Catalogues__________
3.10 Community Medicine

Required Available Required Available

Demonstration Room/s AV Aids:
 No – ______
 Capacity - ______ students
Museum: Practical lab - 1
 Charts
 Models
 Specimens

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 Catalogues
Departmental Library - 80-100 Books

3.11 Health Centers (Department of Community Medicine)

RHTC: _____________(place) ______________ (Distance from the college)

Population covered by the RHTC

It is affiliated to College Yes/No

No. of Students_______Visit per batch throughout the year

No. of Interns________Posted per batch throughout the year

Separate blocks for accommodating boys in ______rooms having

________beds. Girls ______ rooms having _______ beds.(For Interns)

Facilities for cooking & dining – Yes/No

Daily OPD

Specialist visits if any

Cold chain equipment available

Survey/MCH/Immunization/FP registers

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Activities under the National Health Programmes

3.12 Details of U.H.T.C.: ___________ Place___________________ Distance from college

Population covered by the UHC

It is affiliated to College Yes/No

Daily OPD

Diagnostics camps

Survey/MCH/Immunization/FP registers

Specialist visits if any

No. of Students and interns posted in batches of

Deficiency if any

3.13 CONDUCT OF III MBBS EXAMINATION (only for recognition under 11(2))

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 University which conducts Examination:

 No. of Candidates appeared in Examination:
 The III MBBS examination (Part-II)was conducted satisfactorily: yes/no
 Centre for written/practical examination: _______________________________.
 Was the standard sufficient for MBBS Examination as required by Regulations of the Medical Council of
India?_______________________________________________________________________________________________

3.14 Medical College-Staff Strength:

Name of College:
Number of students - PG Courses (Yes/No)
Calculation Sheet (Date:____________)

Additional faculty
Requirement required for
Total
Department Designation as per MSR running PG Accepted Deficiency
(UG + PG)
(UG) courses
(if any)
Professor
Assoc. Prof.
Anatomy
Asstt.Prof.
Tutor
Professor
Assoc. Prof.
Physiology
Asstt.Prof.
Tutor
Professor
Biochemistry
Assoc. Prof.

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Additional faculty
Requirement required for
Total
Department Designation as per MSR running PG Accepted Deficiency
(UG + PG)
(UG) courses
(if any)
Asstt.Prof.
Tutor
Professor
Assoc. Prof.
Pharmacology
Asstt.Prof.
Tutor
Professor
Assoc. Prof.
Pathology Asstt.Prof.
Tutor
Professor
Assoc. Prof.
Microbiology
Asstt.Prof.
Tutor
Professor
Assoc. Prof.
Forensic Medicine
Asstt.Prof.
Tutor
Professor
Assoc. Prof.
Asstt.Prof.
Community
Epidemio-Logist-Cum-
Medicine
Asstt.Prof.
Statistician-Cum-Tutor
Tutor
Professor
General Medicine
Assoc. Prof.

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Additional faculty
Requirement required for
Total
Department Designation as per MSR running PG Accepted Deficiency
(UG + PG)
(UG) courses
(if any)
Asstt.Prof.
Sr. Resident
Jr. Resident
Professor
Assoc. Prof.
Paediatrics Asstt.Prof.
Sr. Resident
Jr. Resident
Professor
Tuberculosis & Assoc. Prof.
Respiratory Asstt.Prof.
Diseases Sr. Resident
Jr. Resident
Professor
Dermatology, Assoc. Prof.
Venereology & Asstt.Prof.
Leprosy Sr. Resident
Jr. Resident
Professor
Assoc. Prof.
Psychiatry Asstt.Prof.
Sr. Resident
Jr. Resident
Professor
Assoc. Prof.
General Surgery
Asstt.Prof.
Sr. Resident

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Additional faculty
Requirement required for
Total
Department Designation as per MSR running PG Accepted Deficiency
(UG + PG)
(UG) courses
(if any)
Jr. Resident
Professor
Assoc. Prof.
Orthopaedics Asstt.Prof.
Sr. Resident
Jr. Resident
Professor
Assoc. Prof.
Oto-Rhino-
Asstt.Prof.
Laryngology
Sr. Resident
Jr. Resident
Professor
Assoc. Prof.
Ophthalmology Asstt.Prof.
Sr. Resident
Jr. Resident
Professor
Assoc. Prof.
Obstetrics &
Asstt.Prof.
Gynaecology
Sr. Resident
Jr. Resident
Professor
Assoc. Prof.
Anaesthesiology Asstt.Prof.
Sr. Resident
Jr. Resident
Radio-Diagnosis Professor

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Additional faculty
Requirement required for
Total
Department Designation as per MSR running PG Accepted Deficiency
(UG + PG)
(UG) courses
(if any)
Assoc. Prof.
Asstt.Prof.
Sr. Resident
Professor
Assoc. Prof.
Dentistry
Asstt.Prof.
Tutor/JR

Notes:
For purpose of working out the deficiency:
(1) The deficiency of teaching faculty and Resident Doctors shall be counted separately.

(A) For Teaching Faculty:

(a) For calculating the deficiency of faculty, Prof., Assoc Prof., Asst. Prof & Tutor in respective departments shall be counted
together.
(b) Any excess teaching faculty in higher cadre can compensate the deficiency of lower cadre of the same department only.
(c) Any excess teaching faculty of lower cadre/ category in any department cannot compensate the deficiency of any teaching
faculty in the higher cadre/category of the same department or any other department. e.g. excess of Assistant Professor
cannot compensate the deficiency of Associate Professor or Professor.
(d) Excess/Extra teaching faculty of any department cannot compensate the deficiency of any teaching faculty in any other
department.

(B) For Resident Doctors:

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(a) Excess of SR can be compensated to the deficiency of JR of the same department only.
(b) Excess SR/JR of any department cannot compensate the deficiency of SR/JR in any other department.
(c) Any excess of JR cannot compensate the deficiency of SR in same or any other department.
(d) Any excess/ extra teaching faculty of same or any other department cannot compensate the deficiency of SR/JR.
e.g. excess of Assistant Professor cannot compensate the deficiency of SR or JR.

(2) A separate department of Dentistry/Dental faculty is not required where a dental college is available in same campus/city
and run by the same management.

(3) Colleges running PG program require additional staff, beds & other requirements as per the PG Regulations – 2000.

3.15 Details of Faculty/Residents not counted/accepted.

(Only faculty/residents who signed attendance sheet before 11:00 am on the first day of assessment should be verified. (In case of Junior
Residents/Senior Residents on night duty, 12:00 noon.) No verification of Declaration forms should be done for the faculty/residents coming after
11:00 am of the first day of assessment)

Sr. Name Designation Department Remarks/Reasons for Not Considering

No

3.16 1) Deficiency of Teaching Faculty:________%

2) Deficiency of Resident doctors:________%

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Summary of Assessment
1. __________________________________________________________________________(College Name),

is run by Government/ Trust/ Society/Company

2. The college has got LOP from GOI/MCI with intake of ___ seats for last academic year 2017-18.

3. Type of assessment: No. of seats: ______________

4. PG courses : Yes/ No

5. Deficiency of teaching staff if any:

Shortage of teaching faculty is ____%

6. Deficiency of resident doctors if any:

Shortage of resident doctors is ____%

7. Deficiency of the infrastructure of college and hospital If any: Pl. mention category wise;

8. Deficiency of clinical material If any: Pl mention category wise;

9. Any other Remarks

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