LOG BOOK edited APRIL 2021

LOGBOOK

UROGYNAECOLOGY SUBSPECIALITY TRAINING PROGRAMME

MINISTRY OF HEALTH
MALAYSIA

Passport Size
Photograph
(coloured)

NAME …………………………………….....
IDENTITY CARD NO. ……………………………………….
DATE OF BIRTH ……………………………………….
BASIC MEDICAL QUALIFICATION (YEAR) ……………………………………….
POSTGRADUATE QUALIFICATION (YEAR) ……………………………………….
NAME OF HOSPITAL ……………………………………….
UNIT/ DEPARTMENT ……………………………………….
PERIOD OF TRAINING ……………………………………….
SUPERVISING CONSULTANT ……………………………………….

Urogynae Subspeciality Training
Obstetrical and Gynaecological Service
Ministry of Health, Malaysia

1

CONTENTS OF LOGBOOK

1. INTRODUCTION
2. OBJECTIVES
3. GENERAL INSTRUCTIONS TO THE TRAINEE AND CONSULTANT
4. RECORD OF TRAINING/ ATTACHMENT
5. PROCEDURES LIST AND REQUIREMENT
6. RECORD OF PROCEDURE/ SURGERY

6A. UROGYNAECOLOGY CORE SECTION
6B. UROLOGY SECTION
6C. COLORECTAL SECTION
7. ATTENDED CONFERENCE/ CLINICAL MEETING/ WORKSHOP/ WEBINAR/ ONLINE COURSE/ CME
8. PRESENTATIONS, RESEARCH AND PUBLICATIONS
9. PROGRESS ASSESSMENT REPORT & TESTIMONY
10. EXIT REQUIREMENT & ELIGIBILITY
11. ACKNOWLEDGEMENT

Urogynae Subspeciality Training
Obstetrical and Gynaecological Service
Ministry of Health, Malaysia

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1. INTRODUCTION

1.1 This logbook record is designed to guide both the trainee and supervising consultant in coordinating activities that are regarded as
essential experience during the Urogynaecological Subspeciality Training at an accredited local and/or overseas training centre.

1.2 The supervisor will be required to assess the trainee at the 1st 6 months of training and to provide a report to Subspecialty
Training Committee, Ministry Of Health. This report should specifically address the suitability of the candidate to continue
with the chosen subspecialty training.

1.3 Subsequent to this, a yearly progress assessment reports should be submitted to the Subspeciality Training Committee in terms of
attitude, clinical skills, progress with research project, organisation and leadership skills, etc.

2. OBJECTIVES OF UROGYNAECOLOGY SUBSPECIALITY TRAINING

2.1 To acquire advance knowledge on anatomy and embryology, physiology, pharmacology and pathophysiology related to the
female pelvic organs.

2.2 To acquire a high degree of clinical competence, understand the indications for urodynamic studies, the technique and the
interpretation of the results.

2.3 To acquire a clinical competence and urogynaecology skills in making a clinical diagnosis, planning appropriate treatment,
management options.

2.4 To acquire skills and improve technique in urogynaecology surgery

2.5 To acquire adequate skills and expertise in epidemiology, research, statistics and audit pertaining to urogynae..

2.6 To demonstrate full participation in the unit’s postgraduate programme and ability to undertake administrative responsibility in
the organization.

Urogynae Subspeciality Training
Obstetrical and Gynaecological Service
Ministry of Health, Malaysia

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3. GENERAL INSTRUCTIONS TO THE TRAINEE AND CONSULTANTS

3.1 This logbook must be filled up completely. The trainee may have performed many procedure/surgery and attended many
specialised clinics but only the related urogynaecological procedure is to be recorded in the logbook. The minimum number of
the required procedure listed is a guide and is to be achieved as much as possible.

3.2 The trainee must/either:
• Perform the procedure under the supervision of a consultant,
• Assist the consultant in performing the procedure or,
• Observe the procedure performed by another doctor.
• Attend a 3 months Urology and 3 months Colorectal attachment with an assessment report for each
• Publication of at least 2 research papers and/or case report in an indexed journal of urogynaecology
• An oversea fellowship training with recognized & accredited Consultant’s Urogynaecologist. This training is subject to
the availability of training scholarships by the Ministry of health.
• Attend a minimum of one international and two national Urogynaecology conferences/workshop/clinical meeting
• In Malaysians context, urogyane trainees are expected to do 70 % urogynae work and 30 % general O & G work,
including obstetric calls.

3.3 The supervising consultant is required to complete the record by filling up the following:
• Endorse the completion of the procedure or task by entering his/her name and signature in the column provided
• Provide a yearly progress assessment reports and/or upon completing each 3 monthly subspecialty attachment.

4

4. UROGYNAECOLOGY TRAINING/ ATTACHMENT RECORD

YEAR HOSPITAL/ DATE DATE DURATION CONSULTANT
UNIT COMMENCED COMPLETED IN-CHARGE
1

2

3

Urogynae Subspeciality Training
Obstetrical and Gynaecological Service
Ministry of Health, Malaysia

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5. PROCEDURES LIST AND REQUIREMENT

PROCEDURES/ SURGERY REQUIREMENT

PROLAPSE SURGERY 50
• VAGINAL HYSTERECTOMY 50
• ANTERIOR COLPORRHAPHY 30
• POSTERIOR COLPORRHAPHY 20
• MCCALL CULDOPLASTY 10
• PARAVAGINAL DEFECT REPAIR 10
• PERINEORRHAPHY 10
• TRANSVAGINAL ENTEROCELE REDUCTION 10
• MANCHESTER - FOTHERGILL - STURMDORF PROCEDURE 10
• COLPOCLEISIS (Le Fort, Total Colpocleisis) 10
• SACROSPINOUS VAGINAL VAULT SUSPENSION 10
• TRANSVAGINAL UTEROSACRAL COLPOSUSPENSION 10
• ABDOMINAL SACROCOLPOPEXY 10
• MESH AND GRAFTS (Vaginal/ Abdominal) 5
• LAPAROSCOPIC SACROCOLPOPEXY 5
• LAPAROSCOPIC UTEROSACRAL COLPOSUSPENSION 5
• LAPAROSCOPIC PARAVAGINAL DEFECT REPAIR
10
OBSTETRICS ANAL SPHINCTER INJURY REPAIR
20
VAGINAL PESSARY 20
• INSERTION 10
• REMOVAL
• IMPACTED PESSARY RELEASE

6

URODYNAMIC STUDY 50
• UROFLOWMETRY 50
• CYSTOMETRY 10
• URETHRAL PRESSURE PROFILE (UPP) 5
• ELECTROMYOGRAPHY (EMG) – if applicable 5
• VIDEO CYSTOMETRY – if applicable
20
CONTINENCE SURGERY 5
• MID-URETHRAL SLING (transobturator/retropubic) 2
• BURCH COLPOSUSPENSION 2
• LAPAROSCOPIC BURCH COLPOSUSPENSION 2
• INJECTION OF BULKING AGENT 2
• BOTOX INJECTION
• FASCIAL SLING – if applicable 2
2
FISTULA REPAIR 2
• URETHRO-VAGINAL/ VESICO-VAGINAL (vaginal approach)
• VESICO-VAGINAL (abdominal approach) 20
• RECTO-VAGINAL 15
15
ULTRASONOGRAPHY
• BLADDER SCAN (2D/ portable scan) 10
• TRANSPERINEAL/ PELVIC FLOOR SCAN 10
• ENDOANAL ULTRASOUND 5

7

PELVIC FLOOR REHABILITATION (Physiotherapy Unit Attachment - if any) 2
• KEGEL EXERCISE
• BIOFEEDBACK 50
• VAGINAL ELECTRICAL STIMULATION 5
• SACRAL NEUROMODULATION/ PTNS 5
5
UROLOGY 5
• CYSTOSCOPY/URETHROSCOPY 5
• BLADDER REPAIR 2
• URETERIC STENTING (observe/assist) 2
• INJECTION OF BULKING AGENT/ BOTOX/ STEROID etc. 2
• FISTULA REPAIR
• CISC/SPC 5
• REPAIR OF URETERIC INJURY – if applicable 5
• NEPHROSTOMY (observe/assist) 5
• SUPRAPUBIC CATHETERIZATION 5
2
COLORECTAL PROCEDURES / SURGERY 5
• ANAL MANOMETRY
• ENDOANAL ULTRASOUND (EUS)
• FISTULOTOMY/ FISTULECTOMY / LIFT
• OVERLAPPING/ END TO END ANAL SPHINCTEROPLASTY
• REPAIR OF RECTAL PROLAPSE (Ripstein, Altemier or Delorme Procedure)
• COLONOSCOPY

Urogynae Subspeciality Training
Obstetrical and Gynaecological Service
Ministry of Health, Malaysia

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6. RECORD OF
PROCEDURES AND

SURGERY

6A. UROGYNAECOLOGY CORE SECTION

Urogynae Subspeciality Training
Obstetrical and Gynaecological Service
Ministry of Health, Malaysia

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6A.1. VAGINAL OPERATIVE PROCEDURE

Vaginal hysterectomy

NO DATE PATIENT’S NAME RN DIAGNOSIS PROCEDURE OUTCOME CONSULTANT’S

SIGNATURE

Urogynae Subspeciality Training
Obstetrical and Gynaecological Service
Ministry of Health, Malaysia

10

Vaginal hysterectomy

NO DATE PATIENT’S NAME RN DIAGNOSIS PROCEDURE OUTCOME CONSULTANT’S

SIGNATURE

Urogynae Subspeciality Training
Obstetrical and Gynaecological Service
Ministry of Health, Malaysia

11

Anterior Colporrhaphy/ Paravaginal Repair/ Mc Call Culdoplasty

NO DATE PATIENT’S NAME RN DIAGNOSIS PROCEDURE OUTCOME CONSULTANT’S

SIGNATURE

Urogynae Subspeciality Training
Obstetrical and Gynaecological Service
Ministry of Health, Malaysia

12

Posterior Colporrhaphy/ Vaginal Enterocele Repair/ Perineal Body Reconstruction

NO DATE PATIENT’S NAME RN DIAGNOSIS PROCEDURE OUTCOME CONSULTANT’S

SIGNATURE

Urogynae Subspeciality Training
Obstetrical and Gynaecological Service
Ministry of Health, Malaysia

13

Cervical Amputation/ Manchester/ Fothergill/ Sturmdorf Procedure

NO DATE PATIENT’S NAME RN DIAGNOSIS PROCEDURE OUTCOME CONSULTANT’S

SIGNATURE

Urogynae Subspeciality Training
Obstetrical and Gynaecological Service
Ministry of Health, Malaysia

14

Vaginal Closure Surgery - Colpocleisis (Le Fort/Total)

NO DATE PATIENT’S NAME RN DIAGNOSIS PROCEDURE OUTCOME CONSULTANT’S

SIGNATURE

Urogynae Subspeciality Training
Obstetrical and Gynaecological Service
Ministry of Health, Malaysia

15

Sacrospinous Vaginal Vault Suspension/ Transvaginal Utero-Sacrocolpopexy

NO DATE PATIENT’S NAME RN DIAGNOSIS PROCEDURE OUTCOME CONSULTANT’S

SIGNATURE

Urogynae Subspeciality Training
Obstetrical and Gynaecological Service
Ministry of Health, Malaysia

16

Mid-urethral/Sub-urethral Slings (MUS/SUS):
 Transobturator approach

NO DATE PATIENT’S NAME RN DIAGNOSIS PROCEDURE OUTCOME CONSULTANT’S

SIGNATURE

Urogynae Subspeciality Training,
Obstetrical and Gynaecological Services
Ministry of Health, Malaysia

17

Mid-urethral/Sub-urethral Slings (MUS/SUS):
 Retropubic approach

NO DATE PATIENT’S NAME RN DIAGNOSIS PROCEDURE OUTCOME CONSULTANT’S

SIGNATURE

Urogynae Subspeciality Training,
Obstetrical and Gynaecological Services
Ministry of Health, Malaysia

18

Peri-urethral/Suburethral/Gartner’s cyst - Cystectomy/Marsupialization

NO DATE PATIENT’S NAME RN DIAGNOSIS PROCEDURE OUTCOME CONSULTANT’S

SIGNATURE

Vaginal mesh and grafts (tension-free vaginal mesh, mesh overlay)

NO DATE PATIENT’S NAME RN DIAGNOSIS PROCEDURE OUTCOME CONSULTANT’S
SIGNATURE

Urogynae Subspeciality Training,
Obstetrical and Gynaecological Services
Ministry of Health, Malaysia

19

Fistula Repair (vesico-vaginal/urethro-vaginal/recto-vaginal)

NO DATE PATIENT’S NAME RN DIAGNOSIS PROCEDURE OUTCOME CONSULTANT’S

SIGNATURE

Other related procedures (injection of bulking agent/steroid injection/botox injection/ bladder biopsy, etc)

NO DATE PATIENT’S NAME RN DIAGNOSIS PROCEDURE OUTCOME CONSULTANT’S

SIGNATURE

Urogynae Subspeciality Training,
Obstetrical and Gynaecological Services
Ministry of Health, Malaysia

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6A.2. ABDOMINAL OPERATIVE PROCEDURE

Sacrocolpopexy (abdominal/laparoscopic approach)

NO DATE PATIENT’S NAME RN DIAGNOSIS PROCEDURE OUTCOME CONSULTANT’S

SIGNATURE

Urogynae Subspeciality Training,
Obstetrical and Gynaecological Services
Ministry of Health, Malaysia

21

Burch Colposuspension (abdominal/laparoscopic approach)

NO DATE PATIENT’S NAME RN DIAGNOSIS PROCEDURE OUTCOME CONSULTANT’S

SIGNATURE

Other Abdominal approach Urogynae surgery (mesh & grafts, fistula repair, etc)

NO DATE PATIENT’S NAME RN DIAGNOSIS PROCEDURE OUTCOME CONSULTANT’S

SIGNATURE

Urogynae Subspeciality Training,
Obstetrical and Gynaecological Services
Ministry of Health, Malaysia

22

6A.3. OBSTETRICS ANAL SPHINCTER INJURY (OASIS) REPAIR

3rd Degree (3A, 3B, 3C)/ 4th Degree Perineal Tear

NO DATE PATIENT’S NAME RN DIAGNOSIS PROCEDURE OUTCOME CONSULTANT’S

SIGNATURE

Urogynae Subspeciality Training,
Obstetrical and Gynaecological Services
Ministry of Health, Malaysia

23

6A.4. URODYNAMIC STUDY

Uroflowmetry/ CMG/ Video cystometry/ UPP/ EMG

NO DATE PATIENT’S NAME RN DIAGNOSIS PROCEDURE OUTCOME CONSULTANT’S

SIGNATURE

Urogynae Subspeciality Training,
Obstetrical and Gynaecological Services
Ministry of Health, Malaysia

24

Uroflowmetry/ Cystometry/ Video cystometry/ Urethral Pressure Profile (UPP)/ Electromyography (EMG)

NO DATE PATIENT’S NAME RN DIAGNOSIS PROCEDURE OUTCOME CONSULTANT’S

SIGNATURE

Urogynae Subspeciality Training,
Obstetrical and Gynaecological Services
Ministry of Health, Malaysia

25

6A.5. VAGINAL PESSARY

Insertion/Removal/Impacted pessary release (conventional ring/ Gellhorn/ etc)

NO DATE PATIENT’S NAME RN DIAGNOSIS PROCEDURE OUTCOME CONSULTANT’S

SIGNATURE

Urogynae Subspeciality Training,
Obstetrical and Gynaecological Services
Ministry of Health, Malaysia

26

Insertion/Removal/Impacted pessary release (conventional ring/ Gellhorn/ etc)

NO DATE PATIENT’S NAME RN DIAGNOSIS PROCEDURE OUTCOME CONSULTANT’S

SIGNATURE

Urogynae Subspeciality Training,
Obstetrical and Gynaecological Services
Ministry of Health, Malaysia

27

6A.6. ULTRASONOGRAPHY

Perineal scan (translabial, transvaginal/ pelvic floor/ endo-anal)

NO DATE PATIENT’S NAME RN DIAGNOSIS PROCEDURE OUTCOME CONSULTANT’S

SIGNATURE

Urogynae Subspeciality Training,
Obstetrical and Gynaecological Services
Ministry of Health, Malaysia

28

Bladder scan (2D/ portable scan)

NO DATE PATIENT’S NAME RN DIAGNOSIS PROCEDURE OUTCOME CONSULTANT’S

SIGNATURE

Urogynae Subspeciality Training,
Obstetrical and Gynaecological Services
Ministry of Health, Malaysia

29

6A.7. PELVIC FLOOR REHABILITATION

Kegel exercise (with/without cone)/ Bladder retraining/ Bio feedback/ Vaginal electrical stimulation/ Sacral neuromodulation

NO DATE PATIENT’ NAME RN DIAGNOSIS PROCEDURE OUTCOME CONSULTANT’S

SIGNATURE

Urogynae Subspeciality Training,
Obstetrical and Gynaecological Services
Ministry of Health, Malaysia

30

6B. UROLOGY SECTION

CYSTOSCOPY/URETHROSCOPY

NO DATE PATIENT’ NAME RN DIAGNOSIS PROCEDURE OUTCOME CONSULTANT’S

SIGNATURE

Urogynae Subspeciality Training
Obstetrical and Gynaecological Service
Ministry of Health, Malaysia

31

CYSTOSCOPY/URETHROSCOPY

NO DATE PATIENT’ NAME RN DIAGNOSIS PROCEDURE OUTCOME CONSULTANT’S

SIGNATURE

Urogynae Subspeciality Training
Obstetrical and Gynaecological Service
Ministry of Health, Malaysia

32

BLADDER REPAIR

NO DATE PATIENT’S NAME RN DIAGNOSIS PROCEDURE OUTCOME CONSULTANT’S

SIGNATURE

URETERIC STENTING

NO DATE PATIENT’S NAME RN DIAGNOSIS PROCEDURE OUTCOME CONSULTANT’S

SIGNATURE

Urogynae Subspeciality Training
Obstetrical and Gynaecological Service
Ministry of Health, Malaysia

33

INJECTION OF BULKING AGENT/ BOTOX/ STEROID etc

NO DATE PATIENT’S NAME RN DIAGNOSIS PROCEDURE OUTCOME CONSULTANT’S

SIGNATURE

FISTULA REPAIR

NO DATE PATIENT’S NAME RN DIAGNOSIS PROCEDURE OUTCOME CONSULTANT’S

SIGNATURE

Urogynae Subspeciality Training
Obstetrical and Gynaecological Service
Ministry of Health, Malaysia

34

URETERIC INJURY REPAIR

NO DATE PATIENT’S NAME RN DIAGNOSIS PROCEDURE OUTCOME CONSULTANT’S

SIGNATURE

NEPHROSTOMY

NO DATE PATIENT’S NAME RN DIAGNOSIS PROCEDURE OUTCOME CONSULTANT’S

SIGNATURE

Urogynae Subspeciality Training
Obstetrical and Gynaecological Service
Ministry of Health, Malaysia

35

CLEAN INTERMITTENT SELF-CATHETERIZATION (CISC)

NO DATE PATIENT’S NAME RN DIAGNOSIS PROCEDURE OUTCOME CONSULTANT’S

SIGNATURE

SUPRAPUBIC CATHETERIZATION

NO DATE PATIENT’S NAME RN DIAGNOSIS PROCEDURE OUTCOME CONSULTANT’S

SIGNATURE

Urogynae Subspeciality Training
Obstetrical and Gynaecological Service
Ministry of Health, Malaysia

36

OTHER RELATED PROCEDURES

NO DATE PATIENT’S NAME RN DIAGNOSIS PROCEDURE OUTCOME CONSULTANT’S

SIGNATURE

Urogynae Subspeciality Training
Obstetrical and Gynaecological Service
Ministry of Health, Malaysia

37

6C. COLORECTAL SECTION

ANAL MANOMETRY

NO DATE PATIENT’S NAME RN DIAGNOSIS PROCEDURE OUTCOME CONSULTANT’S

SIGNATURE

Urogynae Subspeciality Training
Obstetrical and Gynaecological Service
Ministry of Health, Malaysia

38

ENDO-ANAL ULTRASOUND (EUS)

NO DATE PATIENT’S NAME RN DIAGNOSIS PROCEDURE OUTCOME CONSULTANT’S

SIGNATURE

Urogynae Subspeciality Training
Obstetrical and Gynaecological Service
Ministry of Health, Malaysia

39

FISTULOTOMY/ FISTULECTOMY/ LIFT

NO DATE PATIENT’S NAME RN DIAGNOSIS PROCEDURE OUTCOME CONSULTANT’S

SIGNATURE

ANAL SPHINCTER INJURY REPAIR (OVERLAPPING/ END-TO-END ANAL SPHINCTEROPLASTY)

NO DATE PATIENT’S NAME RN DIAGNOSIS PROCEDURE OUTCOME CONSULTANT’S

SIGNATURE

Urogynae Subspeciality Training
Obstetrical and Gynaecological Service
Ministry of Health, Malaysia

40

REPAIR OF RECTAL PROLAPSE

NO DATE PATIENT’S NAME RN DIAGNOSIS PROCEDURE OUTCOME CONSULTANT’S

SIGNATURE

COLONOSCOPY

NO DATE PATIENT’S NAME RN DIAGNOSIS PROCEDURE OUTCOME CONSULTANT’S

SIGNATURE

Urogynae Subspeciality Training
Obstetrical and Gynaecological Service
Ministry of Health, Malaysia

41

OTHER RELATED PROCEDURES

NO DATE PATIENT’S NAME RN DIAGNOSIS PROCEDURE OUTCOME CONSULTANT’S

SIGNATURE

Urogynae Subspeciality Training
Obstetrical and Gynaecological Service
Ministry of Health, Malaysia

42

7. CONFERENCE/ CLINICAL MEETING/ WORKSHOP/ ONLINE COURSE/
WEBINAR/ CME

7.1 INTERNATIONAL/ LOCAL CONFERENCES

No Conference Venue Date Consultant’s
Signature

7.2 OTHERS Venue Date Consultant’s
No Course/ Webinar/ CME Signature

Urogynae Subspeciality Training
Obstetrical and Gynaecological Service
Ministry of Health, Malaysia

43

8.0 PRESENTATIONS/ RESEARCH/ PUBLICATIONS

8.1 Presentations/ Lecture/ Talks at Clinical Meeting DATE CONSULTANT’S
No TITLE OF PAPER PRESENTATION NAME OF MEETING SIGNATURE

8.2 Research Publications/ Case Reports STATUS DATE DATE CONSULTANT’S
No TITLE STARTED

COMPLETED SIGNATURE

Urogynae Subspeciality Training
Obstetrical and Gynaecological Service
Ministry of Health, Malaysia

44

9.0 ASSESSMENT AND TESTIMONY

9.1 SUITABILITY ASSESSMENT (To be completed by Supervising Consultant in the first 6 month of training)

TRAINEE’S NAME :
YEAR OF TRAINING : 1st Year (first six month)
HOSPITAL :
DATE (duration) :

AREA OF CONCERN EXCELLENT GOOD FAIR POOR CONSULTANT’S
SIGNATURE

Clinical skills: ______________ __________ __________ ___________
 History taking _____________ ______________ __________ __________ ___________
 Examination _____________
 Investigations

Knowledge

Academic Activity

Attitude

Brief description of the trainee’s strengths and weakness:
............................................................................................................................................................................................................................
............................................................................................................................................................................................................................
......................................................................................................................................................................................................................…
….

CONCLUSION Email & submit to: [email protected]
SUITABLE TO CONTINUE [email protected]
UNSUITABLE TO CONTINUE
Urusetia, Program Latihan Subkepakaran KKM,
Date: Cawangan Pembangunan Profesion Perubatan,
Bahagian Perkembangan Perubatan,
Urogynae Subspeciality Training Kementerian Kesihatan Malaysia,
Obstetrical and Gynaecological Service Aras 6, Blok E1, Kompleks E, Presint 1,
Ministry of Health, Malaysia 62590 PUTRAJAYA

45

9.2 1st YEAR PROGRESS ASSESSMENT REPORT

TRAINEE’S NAME:
DATE (duration) :
PLACEMENT :

AREA EXCELLENT GOOD FAIR POOR CONSULTANT’S
SIGNATURE
ATTITUDE
CLINICAL SKILLS
PROGRESS WITH
RESEARCH PROJECT
ORGANIZATION AND
LEADERSHIPS SKILLS

Consultant’s Comment:
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________

Consultant’s Signature:

___________________

Date:

Urogynae Subspeciality Training
Obstetrical and Gynaecological Service
Ministry of Health, Malaysia

46

9.3 2nd YEAR PROGRESS ASSESSMENT REPORT

TRAINEE’S NAME:
DATE (duration) :
PLACEMENT :

AREA EXCELLENT GOOD FAIR POOR CONSULTANT’S
SIGNATURE
ATTITUDE
CLINICAL SKILLS
PROGRESS WITH
RESEARCH PROJECT
ORGANIZATION AND
LEADERSHIPS SKILLS

Consultant’s Comment:
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________

Consultant’s Signature:

___________________

Date:

Urogynae Subspeciality Training
Obstetrical and Gynaecological Service
Ministry of Health, Malaysia

47

9.4 3rd YEAR PROGRESS ASSESSMENT REPORT

TRAINEE’S NAME:
DATE (duration) :
PLACEMENT :

AREA EXCELLENT GOOD FAIR POOR CONSULTANT’S
SIGNATURE
ATTITUDE
CLINICAL SKILLS
PROGRESS WITH
RESEARCH PROJECT
ORGANIZATION AND
LEADERSHIPS SKILLS

Consultant’s Comment:
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________

Consultant’s Signature:

___________________

Date:

Urogynae Subspeciality Training
Obstetrical and Gynaecological Service
Ministry of Health, Malaysia

48

9.5 UROLOGY ATTACHMENT REPORT

TRAINEE’S NAME:
DATE (duration) :
PLACEMENT :

AREA EXCELLENT GOOD FAIR POOR CONSULTANT’S
SIGNATURE
ATTENDANCE
COMMITMENT (discipline & dedicated)
INTEGRITY (performed task with
intellectual honesty)
ORGANIZATION AND LEADERSHIPS
SKILLS

Consultant’s Comment:
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________

Consultant’s Signature:

___________________

Date:

Urogynae Subspeciality Training
Obstetrical and Gynaecological Service
Ministry of Health, Malaysia

49