MBBS Intern Logbook

MBBS graduates, after their graduation, undergo a 1-year compulsory rotating internship (a period where medical graduate undergoes training period to acquire skills & practice of medicine under supervision to prepare them for independent, unsupervised primary care), thus enabling them to become doctors of first contact.

Duration: It is a period of 12 months, which must be completed within two years of passing the final MBBS examination.

Intern Logbook

This is one of the most important criteria of the continuous assessment program of an internship. MBBS graduates have to maintain a logbook—an official document with the collective performance of an intern, a record of all the work done, procedures conducted, and targets achieved. Basically, it is a snapshot of all the progress that the learner has had in order to move to the next phase in his medical journey.

Important Features of logbook

• The logbook is an important tool to be applied at the end of phase summative examination
•   All the Indian institutes are allowed to follow their own procedure & records as per their own local requirement but must cover all essential elements  
• Faculty decides the competencies/skills that need to be part of logbook

o Skills that are performance-based are ultimately qualified to be in the logbook

o Selected skill competencies with Shows How (SH) in the psychomotor & communications domain will require logbook entry

o There are other skills that are documented by self-learning, narratives, or group participation

o Also, clinical laboratory experiences and community interaction in field visits are also included in the logbook

o Foundation course skills are to be entered in the logbook of the first professional year. AETCOM (Attitude, Ethics & Communication Manual) is a long program that is included in the logbook of each professional year. You could also have a separate 

logbook for this.

• Individual Universities can decide whether logbook to be maintained phase-wise or subject-wise
•  Individual university faculties decide the criteria for skill completion & help students to acquire a specific skill

o   They can either use scores (0-10) or grades to evaluate MBBS graduates & decide their pass or fail

o   They decide whether students meet particular criteria or not & enters the grade, enter the grade & score of individual learners in their respective logbook on the respective date

•   Logbook can be used for each phase. A subject with has more than 1 phase  can have a logbook covering various skills in all phases. Then, it is to be submitted to the university examiner for reviewing
•  Every logbook has a final summary page that talks about the achievement of a learner of various skills at various levels. This can be repeated after every phase

Time Distribution: Community medicine-2 months;  General medicine-1.5 Months; Psychiatry-2 weeks, Pediatrics- 1 month;  General Surgery-1.5 Months; Anesthesiology & Critical care-2weeks; Obstetrics & Gynecology including family well-fare planning-1.5 Months; Orthopaedics-2weeks; Emergency /trauma/Casuality-2weeks; Forensic Medicine & toxicology-1 week; dermatology, venerology & leprology-1 week; Otorhinolaryngology-2weeks; Opthalmology-2weeks; Laboratory science& hospital support science-2weeks each; Broad specialties Group-2 weeks, Super specialists group – 1 week each & Indian systems of medicine-1week each

Logbook Feature

The logbook includes the following features:

1. Student details (Name; date of admission to MBBS; date of beginning current phase; college id; university id)

2. Certificate

3. General instructions

4. Index

5. Separate Logbook page for different subjects

6. Final summary

Log book Templates

Example 1:

Logbook

Subject:

Sub Item:

Competency addressed	Activity Name/Skill	ObservedDate/ completed(d/m/y)	AssistanceOr Attempt at activityFirst only (IF)Repeat (R)Remedial (Re)	Rating(B)Below Expectation(M)Meets expectation(E) Exceeds expectationOr Numerical score	FacultyDecision	Initial of Faculty & date	Feedback received
1.
2.

Example 2:

Skill	Observed	Assisted	Done under supervision	Able to do impudently	Remarks

Explanation of Template

1. No of competency or skill addressed includes subject initial & number. Skills can be decided by the individual university for a particular subject or as per the required locally in their state

2-Name of activity: it can include any session, activity done or group discussion

3. Date of activity

4. Assessment- done by Supervised faculty. They give their respective views on the skill of an individual:

• First only (IF)
• Repeat (R)
• Remedial (Re)

5. Rating: rating is also given by faculty on individual performance either in criteria or numerical score

·         (B)-Below Expectation

·         (M)-Meets expectation

·         (E)- Exceeds expectation

6. Initials & Decision of Faculty

·         C-activity completed, closed & can be certified

·         R-activity needs to be repeated without further investigation

·         Re-Activity needs remedial action (Usually done after repetition did not had satisfactory completion)

7. Initials of a student after receiving feedback

Example of a Skill in logbook

1. AETCOM (Attitude, Ethics & Communication Manual) Competency

1. Competency

It includes various skills that are mentioned in AETCOM manual 1.4

2. Name of Activity: (Group session (Large & small); self-directed learning; Closure of discussion)-Total 5 hours

·   Improvement Activity components (Introduction (checking communication); learning that is self-directed & effective communication; another small discussion to improve the communication-in the form of plays or videos; Closure session with emphasis on improvement points)

3. Faculty Criteria to decide activity completion e.g., Active participant or not

4. Assessment by mentors

5. Numerical Scoring: NA

6. Activity documentation

7. Recommendation by Faculty to improve in other sessions

8-Feedback

2. Documentation of field or clinic visit

1. Competency: It’s given in PE6.11 (Adolescent Clinic)

2. Activity name: Adolescent clinic visit (Students in small group visits clinic; the session is provided by the supervisor; students learned about required work or service provided; then students write brief summary)

3. Activity Criteria: Observation recorded in a logbook

4. Scoring: NA

6. Summary of observations (Learnings)

7. Recommendation by Faculty to improve in other sessions: NA

8. Any other feedback by faculty

Evaluation of Logbook

•   The university assess all the skills of a candidate with a number of procedures to enable him to conduct that in actual practice
•   After evaluation by the concerned department, department head submits marks statement to university head within one week after evaluation completion
•    If any students fail in any of the respective subject training, he/she has to repeat that respective training for a period of 30% of the  total number of days allotted to that subject
•  Head of Medical college issues Internship certificate after all the evaluation is done