Log book

For
District Residency Program

Shri Jagannath Medical College & Hospital, Puri

 Log Book For District Residency Program
Personal Details

1. Name of the District Resident: Photograph

2. Age:

3. Contact Number:

4. Local Address:

5. Date of joining of District Residency Program:

6. Date of completion of District Residency Program

7. Department:

8. Name of Guide / Mentor:

9. Designation of Guide / Mentor:

10. Current Institution of DRP Programme:

11. Name of the District Hospital:

12. Institution of Junior Residency:

13. Medical Council Registration Number:

PART 1 - Introduction

● The Logbook of the District Residency Program is intended for the resident trainee to

document training activities regularly.

● This helps in knowing the experience gained in different aspects of the training at the

end of the program.

● The resident should consider this a diary to record all activities during the period.

● Each documentation needs to be countersigned by the concerned supervisor/s.

● The logbook also aims to help the Postgraduate teacher/ guide follow up the resident's

progress.

● The District Residency Program Coordinator (DRPC) of the District Residency

Program should be responsible for verification of the entries in this book.

PART 2 – OBJECTIVES

● The objectives of the Training Logbook are to ensure that the trainees have

adequately covered all the concerned areas of the concerned specialty in which the

trainee is doing MD/ MS.

1. The Trainees will be trained in and contribute to the diagnostic/laboratories

services, pharmacy services, forensic services, general clinical duties, managerial

roles and public health programmes, etc., as applicable. They may also be posted in
 research units/facilities, laboratories, and field sites of the Indian Council of Medical

Research and other national research organizations.

2. The Trainee and Training Committee will be able to identify deficiencies in their

training and arrange for these to be met as appropriate.

3. The Training Logbook will serve as part of the summative assessment processes

during on completion of the district residency training programme.

● Postgraduate students will be trained by the District Hospital and Health System

teams within the available avenues in coordination with the District Health

Officer/Chief Medical Officer.

● The District Resident will work under the direction and supervision of the District

Residency Programme Coordinator (DRPC).

● The District Resident will work under the direction and supervision of the District

Residency Programme Coordinator (DRPC).

Details of Training
Sl Day /Date Place of Activity Done Signature of
No. Activity Guide / Mentor

Details of Training
Sl Day /Date Place of Activity Done Signature of
No. Activity Guide / Mentor

Details of Training
Sl Day /Date Place of Activity Done Signature of
No. Activity Guide / Mentor

Details of Training
Sl Day /Date Place of Activity Done Signature of
No. Activity Guide / Mentor

Details of Training
Sl Day /Date Place of Activity Done Signature of
No. Activity Guide / Mentor

Details of Training
Sl Day /Date Place of Activity Done Signature of
No. Activity Guide / Mentor

Details of Training
Sl Day /Date Place of Activity Done Signature of
No. Activity Guide / Mentor

Details of Training
Sl Day /Date Place of Activity Done Signature of
No. Activity Guide / Mentor

Details of Training
Sl Day /Date Place of Activity Done Signature of
No. Activity Guide / Mentor

Details of Training
Sl Day /Date Place of Activity Done Signature of
No. Activity Guide / Mentor

Details of Training
Sl Day /Date Place of Activity Done Signature of
No. Activity Guide / Mentor

Details of Training
Sl Day /Date Place of Activity Done Signature of
No. Activity Guide / Mentor

Details of Training
Sl Day /Date Place of Activity Done Signature of
No. Activity Guide / Mentor

Details of Training
Sl Day /Date Place of Activity Done Signature of
No. Activity Guide / Mentor

Reflections and Learnings

Signature of Guide/ Mentor Signature of Head of Department

Reflections and Learnings

Signature of Guide/ Mentor Signature of Head of Department

Reflections and Learnings

Signature of Guide/ Mentor Signature of Head of Department

Reflections and Learnings

Signature of Guide/ Mentor Signature of Head of Department

Reflections and Learnings

Signature of Guide/ Mentor Signature of Head of Department

Reflections and Learnings

Signature of Guide/ Mentor Signature of Head of Department

Reflections and Learnings

Signature of Guide/ Mentor Signature of Head of Department

Reflections and Learnings

Signature of Guide/ Mentor Signature of Head of Department

Suggestions / Feedback based on the Experience obtained from Entire

Program
Signature of Guide/ Mentor Signature of Head of Department

Certificate of Completion of District Residency Program

It is certified that Dr. ________________________________________________________

has satisfactorily completed the District Residency program w.e.f. ___________________to

______________________. During his/her District Residency Program training at

_________________ District, his / her performance has been reported to be

_________________________.

Department:

Date:

Place:

Signature of Guide / Mentor Signature of Head of Department

Signature of District Residency Program Coordinator

Signature of Medical Superintendent

Signature of Dean and Principal