Dnb-General Surgery: Competency Based Training Programme
Dnb-General Surgery: Competency Based Training Programme
Dnb-General Surgery: Competency Based Training Programme
for
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CONTENTS
I. INTRODUCTION
V. SYLLABUS
VI. COMPETENCIES
X. EXAMINATION –
a) FORMATIVE ASSESSMENT
b) FINAL THEORY & PRACTICAL
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INTRODUCTION
Preamble
After qualifying in the final examination of the NBE, the candidate should be able
to function as a specialist in General Surgery. This requires a thorough
knowledge of the fundamentals. He/She should be reasonably acquainted with
the recent advances and be able to perform essential elective and emergency
operative procedures independently. He/She should be able to make decisions
regarding patient management and adopt favorable attitudes. During this period,
the candidate will also acquire skills of experience in research methodology by
writing a dissertation / thesis.
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PROGRAMME GOAL
PROGRAMME OBJECTIVES
Objectives
The aim of the courses is to develop human recourses and personnel in the field
of surgery who shall:
1. Provide the health care to the patients needing surgical care with
principles and ethics.
2. Teach and train future undergraduates and postgraduates medical
students and junior doctors in General Surgery in Hospitals and other
Institutions.
3. Carry out and guide research to improve the practice of the art and
science of surgery
4. Have management capabilities to manage personnel and budgets to make
health care more cost-effective
5. Organize health teams to provide care during natural or man-made
calamities.
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6. Develop further in the areas of their interest and/or specialize to practice
existing or new specialties allied to surgery through further training
programs as required
At the end of the course, the Diplomate of National Board in Surgery shall be
able to:
1. Practice the art and science of surgery in his/her field of practice and seek
and provide consultation as required. He/She will be able to provide
comprehensive and good quality surgical care in general surgery including
pre-operative and postoperative care
2. Conduct research and communicate the findings, result and conclusion to
his fraternity
3. Acquire necessary skills of teaching and training his junior colleagues and
medical students and Para-medical personnel
4. Keep abreast with the latest developments by self learning and/or
participating in continuing medical education programs
5. Organize and manage administrative responsibilities in the routine day to
day work as well as new situations including natural and/or man-made
accidents/ calamities
6. Manage situations calling for emergency interventions in the sphere of
surgical specialties and also routine problems in their areas within the
ambit of the general surgeon
7. Exhibit awareness of the importance of surgical audit and the need for
considering cost affectivity in patient management
8. Be aware of one’s professional and infrastructural limitations and be able
to refer to appropriate centers at the optimum time, when required
9. Exhibit awareness of the need for accurate documentation in medical
records including medico-legal cases.
10. Adopt ethical procedures in the field of doctor-patient relationship
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11. Exhibit proper attitude in dealing with patients and relatives and be able to
communicate with them effectively
12. To develop the skill of innovation and improvisation in times of need.
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ELIGIBILITY CRITERIA FOR ADMISSIONS TO THE PROGRAMME
(A) DNB General Surgery Course:
1. Any medical graduate with MBBS qualification , who has qualified the
Entrance Examination conducted by NBE and fulfill the eligibility criteria
for admission to DNB Broad Specialty courses at various NBE accredited
Medical Colleges/ institutions/Hospitals in India is eligible to participate in
the Centralized counseling for allocation of DNB General Surgery seats
purely on merit cum choice basis.
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TEACHING AND TRAINING ACTIVITIES
The rounds should include bedside sessions, file rounds & documentation of case
history and examination, progress notes, round discussions, investigations and
management plan) interesting and difficult case unit discussions.
The training program would focus on knowledge, skills and attitudes (behavior), all
essential components of education. It is being divided into theoretical, clinical and
practical in all aspects of the delivery of the rehabilitative care, including methodology of
research and teaching.
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Clinical: The trainee would be attached to a faculty member to be able to pick up
methods of history taking, examination, prescription writing and management in
rehabilitation practice.
Bedside: The trainee would work up cases, learn management of cases by discussion
with faculty of the department.
Journal Clubs: This would be a weekly academic exercise. A list of suggested Journals
is given towards the end of this document. The candidate would summarize and discuss
the scientific article critically. A faculty member will suggest the article and moderate the
discussion, with participation by other faculty members and resident doctors. The
contributions made by the article in furtherance of the scientific knowledge and
limitations, if any, will be highlighted.
Research: The student would carry out the research project and write a thesis/
dissertation in accordance with NBE guidelines. He/ she would also be given exposure
to partake in the research projects going on in the departments to learn their planning,
methodology and execution so as to learn various aspects of research.
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SYLLABUS
History of Surgery
Molecular and Cell Biology
Mediators of Inflammatory Response
Regenerative Medicine
Fluids and Electrolyte balance/ Acid – Base metabolism
Wound Healing and Wound Management
Pathophysiology and Management of Shock
Principles of Operative Surgery: Asepsis, Sterilization and Antiseptics
Surgical Infections and Antibiotics
Nutrition and Metabolism
Principles of Burn Management
Principles of Oncology
Principles of Laparoscopy, Endoscopy and Robotics
Hemostasis, Blood Transfusion
Trauma: Assessment of polytrauma, triage, basic and advanced trauma
Basic Principles of Anesthesia
Informed Consent and Medico legal Issues
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Pediatric Surgery
Organ Transplantation
Molecular Biology and Genetics
Hernias: Types of hernias, repair techniques
Breast Diseases: Benign breast disorders, investigations, screening, genetics,
Breast Cancer
Thyroid Disorders: Solitary nodule, investigations, multinodular goiter, Graves
disease malignancies
GIT Diseases
Urogenital disease
Cardio thoracic disease
Hepatobilary disease
Surgery in CNS disorder
Diabetes and Renal failure in Surgery
HIV AIDS in Surgery (Universal Safety precautions)
PRE-OPERATIVE MANAGEMENT
Pre-operative Management
Infection
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Investigative and Operative Procedures
Anesthesia
Principles of anesthesia.
Pre-medication and sedation.
Local and regional anesthesia.
Care and monitoring of the anaesthetized patient.
Theatre Problems
PRE-OPERATIVE MANAGEMENT
Fluid Balance
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Techniques of venous access.
Nutritional support - indications, techniques, total parenteral nutrition.
Blood
Post-operative Complications
Post-operative Sequelae
Pain control
Immune response to trauma, infections and tissue transplantation.
Pathophysiology of the body’s response to trauma.
Surgery in the immuno-compromised patient.
TRAUMA
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disorders particularly those caused by cranial or spinal trauma; and
interpretation of special investigations.
Intracranial hemorrhage.
Head injuries, general principles of management.
Surgical aspects of meningitis.
Spinal cord injury and compression.
Paraplegia and quadriplegia - principles of management.
Special Problems
Pre-hospital care.
Triage.
Trauma scoring systems.
Traumatic wounds - principles of management.
Gunshot and blast wounds.
Skin loss - grafts and flaps.
Burns.
Facial and orbital injuries.
INTENSIVE CARE
Cardiovascular
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Respiratory
The surgical anatomy of the airways, chest wall, diaphragm and thoracic
viscera.
The mechanics and control of respiration.
The interpretation of special investigations; lung function tests, arterial
blood gases, radiology.
The understanding of disorders of respiratory function caused by trauma,
acute surgical illness and surgical intervention.
Respiratory failure.
Complications of thoracic operations.
Adult respiratory distress syndrome.
Endotracheal intubation, laryngotomy, tracheostomy.
Artificial ventilation.
Multisystem Failure
Multisystem failure.
Renal failure - diagnosis of renal failure, complications of renal failure.
GI tract and hepatic failure.
Nutrition.
Principles of ICU
Principles of Oncology
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Pathology, clinical features, diagnosis and principles of management of
common cancers in each of the surgical specialties.
Principles of cancer treatment by surgery, radiotherapy, chemotherapy,
immunotherapy and hormone therapy.
The principles of carcinogenesis and the pathogenesis of cancer relevant
to the clinical features, special investigations, staging and the principles of
treatment of the common cancers.
Principles of molecular biology of cancer, carcinogenesis; genetic factors;
mechanisms of metastasis.
Tumor Biology and Tumor Markers
Techniques of Management
Outcome of Surgery
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LOCOMOTOR SYSTEM
VASCULAR
The surgical anatomy and applied physiology of blood vessels relevant to clinical
examination, the interpretation of special investigations and the understanding of
the role of surgery in the management of cardiovascular disease
Arterial Diseases
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Limb ischaemia: acute and chronic; clinical features; gangrene;
amputations for vascular disease.
Principles of reconstructive arterial surgery.
Atherosclerosis
Principles of Angioplasty/stenting
Thrombolysis
Reno-vascular disease
Raynaud’s/vasospastic disorders
Lymphoedema
Cerebrovascular disease
Vasculitis
Mesenteric ischaemia
Graft prosthetics
Graft surveillance
Autonomic dysfunction
Reperfusion injury
Ischaemic limb Arterial trauma
Hyper/hypo coagulable state
Arteriography
Continuous wave doppler
Duplex ultrasound
Venous Diseases
Thromboembolic disease.
Spleen; role of splenectomy; hypersplenism.
Lymph nodes; lymphoedema.
Surgical aspects of auto-immune disease.
The anatomy and physiology of the haemopoeitic and lymphoreticular
systems.
Surgical aspects of disordered haemopoiesis.
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HEAD, NECK and ENDOCRINE
The surgical anatomy and applied physiology of the head and neck relevant to
clinical examination, the interpretation of special investigations, the
understanding of disorders of function, and the treatment of disease and injury
involving the head and neck.
The Head
The surgical anatomy and applied physiology of the endocrine glands relevant to
clinical examination, the interpretation of special investigations, the
understanding of disordered function and the principles of the surgical treatment
of common disorders of the endocrine glands.
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Skin in Surgical Disorders
ABDOMEN
The surgical anatomy of the abdomen and its viscera and the applied physiology
of the alimentary system relevant to clinical examination, the interpretation of
common special investigations, the understanding of disorders of function, and
the treatment of abdominal disease and injury.
Abdominal Wall
• Anatomy of the groin, groin and other ventral hernias, acute and elective;
clinical features of hernias; complications of hernias.
• Anterior abdominal wall, anatomy, incisions, laparoscopic access.
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Acute Abdominal Conditions
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Pancreatic debridement
Median sternotomy
Reconstructive Surgery
Myocutaneous flaps
Tissue expanders
Breast reduction
Colorectal
Splenectomy
Oesophageal dilatation
Operations for upper GI bleeding
Exploration of common bile duct
Biliary bypass
Formation of Roux-en-Y loop
Oesophagectomy/total gastrectomy
Pancreatectomy
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Liver resection
Oesophagectomy
Total and subtotal gastrectomy
Heller’s myotomy
Long oesophageal myotomy
Pharyngeal pouch
Repair of biliary stricture
Whipple’s procedure
Pancreatectomy (distal and total)
Drainage of infected pancreatitis
Drainage of pancreatic pseudo-cyst
Liver injuries
Hydatid disease
Porto-systemic shunt
Vascular suture/anastomosis
Control of venous bleeding
Balloon thrombo-embolectomy
Fasciotomy
Artenal injuries
Vascular access for dialysis
Abdominal injury
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Haemorrhoids
Anal fissure
Rectal prolapse
Acute appendicitis/RIF pain
Intestinal obstruction
Intestinal pseudo-obstruction
Intestinal ischaemia
Peritonitis
Large bowel and rectal injuries
Anal tumours
Pelvic autonomic nerves
Screening for colorectal cancer
Genetics of colorectal cancer
Place of radiotherapy and chemotherapy in treatment
Anorectal physiology
Anorectal ultrasound
Faecal incontinence
Chronic constipation
Intestinal fistulae
Colonic bleeding
Radiation enterocolitis
Other small bowel conditions
Colonic obstruction
Colonic perforation
The use of staplers
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Theory and pracice of choledocho-scopy
Theory of different forms of diathermy
Laparoscopic ultrasound
Advanced instrumentation and equipment
Endoscopic suturing devices
Theory, uses and dangers of lasers and other energy sources e.g.
harmonic scalpel
Creation and maintenance of new endoscopic spaces
Use of assistance robots and robotic instruments
HEPATOPANCREATOBILIARY SURGERY
UPPER GI TRACT
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Management of perforations of the upper GI tract
Management of intestinal obstruction
Management of GI bleeding
Oesophageal motility disorders
Oesophageal Strictures
Gastro-oesophageal reflux and its complications
Peptic ulceration and its complications
Radiation enteritis
Abdominal trauma
Principles of screening for cancer
The use and limitations of multimodality treatment for upper GI cancer
Oesophageal motility disorders
Other small bowel conditions
Principles of Small bowel resection
Sutured and stapled anastomoses
Genito Urinary Tract
Urinary tract infection.
Urinary Tract Obstruction
Haematuria.
Trauma to the urinary tract.
Urinary calculi.
Retention of urine.
Urinary tract Neoplasm
Disorders of prostate.
Pain and swelling in the scrotum.
Other Scrotal Lesions
Testicular Neoplasm
NEUROSURGERY
Myocardial revascularization
Valvular Disorders
Peripheral vascular disease
Reno vascular disease
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Secondary Hypertension
Inflammatory Lung Disease
Chest Wall lesions
Thoracic Neoplastic Disease
Chest Trauma
Pleural Diseases
ORTHOPEDICS
OTHER AREAS
CLINICAL POSTINGS
The postgraduate student rotates through all the clinical units in the department. In
addition, following special rotations are also undertaken:
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Mandatory Postings (minimum 15 Days in each)
The rest of the postings in other specialties should be as per the choice of the
candidates or as per interim arrangement and if no other areas of posting is
being undertaken by the candidate the above mentioned mandatory postings
should be increased to a period of minimum one month each.
Radiology (2 weeks)
Anaesthesia (2 weeks)
Gynae & Obs. (2 weeks)
Emergency (2 weeks)
Urology (6 weeks)
Pediatric Surgery (6 weeks)
ICU (6 weeks)
Bariatric Surgery (6 weeks)
Minimally Invasive Surgery (6 weeks)
If the institution does not have these departments, they should have a local tie up with a
suitable hospital for imparting this training.
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Competencies
Objectives
Surgical Skills:
Essential
Scrubbing(surgical hand wash and donning of gowns and gloves) & Patient part
preparation and draping
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Working knowledge of sterilization of OT instruments including Laparoscopic Set
Knowledge of Surgical Material, sutures and Instruments
Electro Surgical Units
Shifting of OT patients
WHO Safety check list implementation
Acquisition of basic surgical skills to perform minor/medium surgeries
independently Suprapubic cystostomy
Cystolithotomy
Varicocele
Orchidectomy
Excision of Cyst & I&D
Excision of Breast Lump
Surgery of Hydrocele
Appendectomy
Herniotomy
Hernia repair (ventral & groin) and management
Umblical hernia
Exploratory laparotomy in different conditions
Haemorrhoidectomy
Fistulectomy
Fissurectomy
Circumcision
Skin grafting
Stoma Formation
Desirable
Urethral Dilatation
Ureterolithotomy
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Basic Ward Procedures
Essential
Insertion of intravenous cannula, Nasogastric tube, urinary catheters
Removal of Tubes and Drains
Abdominal Paracentesis, Pleural Tap
Venous Cutdown
Wound dressings
Desirable
Taking blood samples
ICU Procedures
Essential
Insertion of CVP line, arterial lines, endotracheal intubation
Intercostal Drainage
Tracheostomy
Knowledge of Ventilators and Monitors
Prescribing TPN
Taking an ABG Sample and its Interpretation -E
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Emergency Room Procedures
Essential
Peritoneal lavage
Suturing of lacerations
Drainage of abscesses
Wound Debridement
Reduction and Plaster application of Common simple fractures and
dislocations
Use of external fixators in compound fractures
Skeletal traction
Anal Dilatation and Sphincterotomy
Preoperative Workup and Postoperative Care
Desirable
Focussed Abdominal Sonography for Trauma
Routine
Essential
Cholecystectomy
Groin Hernia Repair
Mastectomy
Breast Lump Excision
Suprapubic cystostomy
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Bowel Resection
Feeding Gastrostomy and feeding jejunostomy
Emergency Nephrectomy
Orchidopexy
Desirable
Microdochectomy
Radical Duct Excision
Hemithyroidectomy
Cystogastrostomy
Bowel Anastamosis
Cysts and Sinuses of the Neck
Pyelolithotomy
Ureterolithotomy
Varicose vein surgery and Vein harvesting
Emergency:
Essential
Appendectomy
Laparotomy for intestinal Obstruction
Trauma Laparotomy
Splenectomy
Closure of Peptic Ulcer Perforation
Enteric Perforation
Amputations
Tracheostomy
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B) Assist/Observe
The below mentioned skills and procedures are desirable for a DNB General
Surgery resident:
Vascular
Reconstructive arterial surgery.
Aneurysm Surgery
The Head
Parotidectomy, submandibular gland excision
Paediatric Disorders
Common paediatric surgical disorders: cleft lip and palate; pyloric stenosis;
intussusception; hernia; maldescent of testis; torsion; and diseases of the
foreskin.
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THESIS PROTOCOL & THESIS
The candidates are required to submit a thesis at the end of three years of
training as per the rules and regulations of NBE.
The protocol for a research proposal (including thesis) is a study plan, designed
to describe the background, research question, aim and objectives, and detailed
methodology of the study. In other words, the protocol is the ‘operating manual’
to refer to while conducting a particular study.
The candidate should refer to the NBE Guidelines for preparation and
submission of Thesis Protocol before the writing phase commences. The
minimum writing requirements are that the language should be clear, concise,
precise and consistent without excessive adjectives or adverbs and long
sentences. There should not be any redundancy in the presentation.
The development or preparation of the Thesis Protocol by the candidate will help
her/him in understanding the ongoing activities in the proposed area of research.
Further it helps in creating practical exposure to research and hence it bridges
the connectivity between clinical practice and biomedical research. Such
research exposure will be helpful in improving problem solving capacity, getting
updated with ongoing research and implementing these findings in clinical
practice.
Research Ethics: Ethical conduct during the conduct and publication of research
is an essential requirement for all candidates and guides, with the primary
responsibility of ensuring such conduct being on the thesis guide. Issues like
Plagiarism, not maintaining the confidentiality of data, or any other distortion of
the research process will be viewed seriously. The readers may refer to standard
documents for the purpose.
The NBE reserves the right to check the submitted protocol for plagiarism, and
will reject those having substantial duplication with published literature.
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PROTOCOL REQUIREMENTS
1. All of the following will have to be entered in the online template. The
thesis protocol should be restricted to the following word limits.
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3. Since most of the difficulties faced by the residents relate to the work in
clinical subject or clinically-oriented laboratory subjects, the following
steps are suggested:
a. The number of cases should be such that adequate material,
judged from the hospital attendance/records, will be available and
the candidate will be able to collect case material within the period
of data collection, i.e., around 6-12 months so that he/she is in a
position to complete the work within the stipulated time.
b. The aim and objectives of the study should be well defined.
c. As far as possible, only clinical/laboratory data of investigations of
patients or such other material easily accessible in the existing
facilities should be used for the study.
d. Technical assistance, wherever necessary, may be provided by the
department concerned. The resident of one specialty taking up
some problem related to some other specialty should have some
basic knowledge about the subject and he/she should be able to
perform the investigations independently, wherever some
specialized laboratory investigations are required a co-guide may
be co-opted from the concerned investigative department, the
quantum of laboratory work to be carried out by the candidate
should be decided by the guide & co-guide by mutual consultation.
Title- A good title should be brief, clear, and focus on the central theme of
the topic; it should avoid abbreviations. The Title should effectively
summarize the proposed research and should contain the PICO elements.
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Introduction- It should be focused on the research question and should
be directly relevant to the objectives of your study.
Aim and Objectives - The ‘Aim’ refers to what would be broadly achieved
by this study or how this study would address a bigger question / issue.
The ‘Objectives’ of the research stem from the research question
formulated and should at least include participants, intervention,
evaluation, design.
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Thesis Protocol Submission to NBE
1. DNB candidates are required to submit their thesis protocol within 90 days
of their joining DNB training.
1. As per NBE norms, writing a thesis is essential for all DNB candidates
towards partial fulfillment of eligibility for award of DNB degree.
2. DNB candidates are required to submit the thesis before the cut-off date
which shall be 30th June of the same year for candidates appearing for
their scheduled December final theory examination. Similarly, candidates
who are appearing in their scheduled June DNB final examination shall be
required to submit their thesis by 31st December of preceding year.
3. Candidates who fail to submit their thesis by the prescribed cutoff date
shall NOT be allowed to appear in DNB final examination.
4. Fee to be submitted for assessment (In INR): 3500/-
5. Fee can be deposited ONLY through pay-in-slip/challan at any of the
Indian bank branch across India. The challan can be downloaded from
NBE website www.natboard.edu.in
6. Thesis should be bound and the front cover page should be printed in the
standard format. A bound thesis should be accompanied with:
a. A Synopsis of thesis.
b. Form for submission of thesis, duly completed
c. NBE copy of challan (in original) towards payment of fee as may be
applicable.
d. Soft copy of thesis in a CD duly labeled.
e. Copy of letter of registration with NBE.
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LOG BOOK
This log book shall be made available to the board of examiners for their perusal
at the time of the final examination.
The log book should show evidence that the before mentioned subjects were
covered (with dates and the name of teacher(s) The candidate will maintain the
record of all academic activities undertaken by him/her in log book .
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Leave Rules
1. DNB Trainees are entitled to leave during the course of DNB training as per the
Leave Rules prescribed by NBE.
2. A DNB candidate can avail a maximum of 20 days of leave in a year excluding
regular duty off/ Gazetted holidays as per hospital/institute calendar/policy.
3. MATERNITYLEAVE:
a. Afemale candidate is permitted a maternity leave of 90 days once during
the entire duration of DNB course.
b. The expected date of delivery (EDD) should fall within the duration of
maternity leave.
c. Extension of maternity leave is permissible only for genuine medical
reasons and after prior approval of NBE. The supporting medical
documents have to be certified by the Head of the Institute/hospital where
the candidate is undergoing DNB training. NBE reserves its rights to take
a final decision in such matters.
d. The training of the candidate shall be extended accordingly in case of any
extension of maternity leave being granted to the candidate.
e. Candidate shall be paid stipend during the period of maternity leave. No
stipend shall be paid for the period of extension of leave.
4. Male DNB candidates are entitled for paternity leave of maximum of one week
during the entire period of DNB training.
5. No kind of study leave is permissible to DNB candidates. However, candidates
may be allowed an academic leave as under across the entire duration of training
program to attend the conferences/CMEs/Academic programs/Examination
purposes.
DNB COURSE NO. OF ACADEMIC LEAVE
DNB 3 years Course (Broad & Super Specialty) 14 Days
DNB 2 years Course (Post Diploma) 10 Days
DNB Direct 6 years Course 28 days
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6. Under normal circumstances leave of one year should not be carried
forward to the next year. However, in exceptional cases such as
prolonged illness the leave across the DNB training program may be
clubbed together with prior approval of NBE.
7. Any other leave which is beyond the above stated leave is not permissible
and shall lead to extension/cancellation of DNB course.
8. Any extension of DNB training for more than 2 months beyond the
scheduled completion date of training is permissible only under extra-
ordinary circumstances with prior approval of NBE. Such extension is
neither automatic nor shall be granted as a matter of routine. NBE shall
consider such requests on merit provided the seat is not carried over and
compromise with training of existing trainees in the Department.
9. Unauthorized absence from DNB training for more than 7 days may lead
to cancellation of registration and discontinuation of the DNB training and
rejoining shall not be permitted.
10. Medical Leave
a. Leave on medical grounds is permissible only for genuine medical
reasons and NBE should be informed by the concerned
institute/hospital about the same immediately after the candidate
proceeds on leave on medical grounds.
b. The supporting medical documents have to be certified by the Head
of the Institute/hospital where the candidate is undergoing DNB
training and have to be sent to NBE.
c. The medical treatment should be taken from the institute/ hospital
where the candidate is undergoing DNB training. Any deviation
from this shall be supported with valid grounds and documentation.
d. In case of medical treatment being sought from some other
institute/hospital, the medical documents have to be certified by the
Head of the institute/hospital where the candidate is undergoing
DNB training.
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e. NBE reserves its rights to verify the authenticity of the documents
furnished by the candidate and the institute/hospital regarding
Medical illness of the candidate and to take a final decision in such
matters.
11.
a. Total leave period which can be availed by DNB candidates is
120+28 = 148 days for 6 years course, 60+14=74 days for 3 years
course and 40+10 = 50 days for 2 years course. This includes all
kinds of eligible leave including academic leave. Maternity /
Paternity leave can be availed separately by eligible candidates.
Any kind of leave including medical leave exceeding the
aforementioned limit shall lead to extension of DNB training. It is
clarified that prior approval of NBE is necessary for availing any
such leave.
b. The eligibility for DNB Final Examination shall be determined strictly
in accordance with the criteria prescribed in the respective
information bulletin.
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EXAMINATION
FORMATIVE ASSESSMENT
The performance of the resident during the training period should be monitored
throughout the course and duly recorded in the log books as evidence of the
ability and daily work of the student
1. Personal attributes:
Behavior and Emotional Stability: Dependable, disciplined, dedicated,
stable in emergency situations, shows positive approach.
Motivation and Initiative: Takes on responsibility, innovative,
enterprising, does not shirk duties or leave any work pending.
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Honesty and Integrity: Truthful, admits mistakes, does not cook up
information, has ethical conduct, exhibits good moral values, loyal to the
institution.
Interpersonal Skills and Leadership Quality: Has compassionate
attitude towards patients and attendants, gets on well with colleagues and
paramedical staff, is respectful to seniors, has good communication skills.
2. Clinical Work:
FINAL EXAMINATION
The summative assessment of competence will be done in the form of DNB Final
Examination leading to the award of the degree of Diplomate of National Board in
General Surgery. The DNB final is a two-stage examination comprising the
theory and practical part. An eligible candidate who has qualified the theory exam
is permitted to appear in the practical examination.
Theory Examination
1. The theory examination comprises of Four papers, maximum marks 100
each.
2. There are 10 short notes of 10 marks each, in each of the papers. The
number of short notes and their respective marks weightage may vary in
some subjects/some papers.
3. Maximum time permitted is 3 hours.
4. Candidate must score at least 50% in the aggregate of Four papers to
qualify the theory examination.
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5. Candidates who have qualified the theory examination are permitted to
take up the practical examination.
6. The paper wise distribution of the Theory Examination shall be as follows:
PAPER 1:
PAPER 2:
Elective Orthopedics
Skin and Subcutaneous Tissue / soft tissue
Head and Neck
Breast and Endocrine
PAPER 3:
Vascular
Abdominal
PAPER 4:
a) Practical Examination:
1. Maximum Marks: 300.
2. Comprises of Clinical Examination and Viva.
3. Candidate must obtain a minimum of 50% marks in the Clinical
Examination (including Viva) to qualify for the Practical Examination.
4. There are a maximum of three attempts that can be availed by a
candidate for Practical Examination.
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5. First attempt is the practical examination following immediately after the
declaration of theory results.
6. Second and Third attempt in practical examination shall be permitted out
of the next three sessions of practical examinations placed alongwith the
next three successive theory examination sessions; after payment of full
examination fees as may be prescribed by NBE.
7. Absentation from Practical Examination is counted as an attempt.
8. Appearance in first practical examination is compulsory;
9. Requests for Change in center of examination are not entertained, as the
same is not permissible.
10. Candidates are required not to canvass with NBE for above.
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RECOMMENDED TEXT BOOKS AND JOURNALS
Essential
Preferable
Journals
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3. JACS
4. American Journal of Surgery
5. SCNA
6. Annals of Surgery
7. JAMA-Archives of Surgery
8. Diseases of Colon and Rectum
9. Journal of Trauma
10. Journal of Minimal Access Surgery
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