Mci Form Ortho
Mci Form Ortho
1. Please read the Standard Assessment Form (SAF) carefully before filling. You will NOT be
allowedtomakeany changes in the Dataafter it hasbeensubmitted.
2. Do NOT leave any section of the SAF or part thereof unanswered. Incompletely filled up forms
shallbesummarily rejected without any intimationto thecollege/institution.
3. Do NOT edit or modify any part of the SAF. Tampering with the format of these forms will
renderyoursubmissioninvalid.
4. Do NOT attach Annexures or enclosures. All the information furnished should be in the
appropriatesectionsofthe SAF. AnnexuresandEnclosures willNOT beconsidered.
6. In case of faculty/residents with DNB qualification, full Name of the hospital/institution where
DNBtraining was obtained and year of passing should clearly be mentioned failing which they shall
NOTbeconsidered.Merely mentioning NationalBoard of Examinations,NewDelhi, shall notsuffice.
8. Ifpromotionsareafterthecut-offdates(21/07/2013forProfessors;21/07/2014forAssociateProfessors) and
benefit of publications has been given in promotion before the cut-off dates, list thepublications
immediately below the name of faculty in the format: Title of Paper, Authors, Citation ofJournal,
details of Indexingin the faculty table. Photocopies of published articles should be attachedwith the
Faculty declaration forms failing which they will not be considered. Please provide details
offull/originalarticlesONLY. Casereports,reviewarticlesandabstractsshallNOTbeconsidered.
9. DoNOTuseabbreviations fornamesofMedicalCollegesintheSAFandDeclarationForms.
INSTRUCTIONS FORASSESSORS:
10. Please follow all instructions carefully. Instructions marked NOTE: are repeated in various
sectionsoftheSAFto ensurecomplianceforthe sakeofconsistency and uniformity.
11. Only Faculty members and Resident doctors who sign the attendance sheet by 11:00 A.M.,
presentthemselvesforsubsequentverificationandarefoundeligiblemustbeconsidered.Inaddition,allthose
who are on NMC permitted leave, or on NMC/Court duties are to be considered.Please ensure
thatsignaturesof faculty membersand resident doctorsareobtained in theFaculty table.
13. DataforRadiodiagnosisinvestigations,CentralClinicalLaboratories,BloodBanketc.,enteredintheSA
Fmust beverifiedwithphysical records/registers.
14. Information regarding Births and Deaths to be verified from Birth/Death registration forms sent
byhospitalto theRegistrar ofBirths/Deaths.
15. Assessorsmaywriteconfidentialremarksnotshownintheassessmentreportonthepagemarked“Remarksof
Assessor”.DoNOTsend/attach separate confidential letter/s.
SignatureofDean SignatureofAssessor
STANDARD ASSESSMENT FORM FOR POSTGRADUATE COURSES
ORTHOPEDICS
1. Nameof Institution: MADURAI MEDICAL COLLEGE, MADURAI -20
NMCReferenceNo.:
2. ParticularsoftheAssessor: DateofAssessment __/__/_ _ _ _.
3. InstitutionalInformation:
A. ParticularsoftheInstitution/College
B. ParticularsofAffiliatingUniversity
Department HeadofDepartment
inspected
Name Dr.R.Arivasan.M.S.Ortho.,
3 (b) UG – 15/10/2019 PG
Date of last Purpose: Increase of Purpose: Conversion
assessmentfor
MBBS seats of D.Ortho to M.S.
(Ortho) - 1 seat
Result:Recognzied Result: Recognzied
4. TotalTeachersavailableintheDepartment:
Designation Number Name Total Benefit of
Teaching Publications in
experience promotion
Professor Prof.R.Arivasan.M.S.Ortho. 21y/4m/10d NO
3 Prof.V.R.Ganesan.M.S,DNB,D.Ortho., 21y/6m/28d NO
Prof.B.Sivakumar, M.S.Ortho., 19y/16d NO
9 Dr.V.A.Prabhu.M.S.Ortho 10y/9m/2d NO
Dr.Singaravel.M.S.Ortho 3y/8m/5d NO
Dr.B.Saravanan.M.S.Ortho 4y/7m/1d NO
Dr.S.Anbarasan.M.S.Ortho,D.Ortho., 6y/10m/15d NO
Dr.S.Karthikeyan.M.S.Ortho., 5y/10m/10d NO
5 Dr.R.Balaji.M.S.Ortho 5y/10d NO
Dr.S.R.Venkateswaran,M.S.Ortho., 3y/2m/3d NO
Dr.M.Manoj Deepak.M.S.Ortho., 6m/21d NO
Note:Onlythosewhoarephysicallypresentto beconsidered.
5. NumberofUnitswith beds in each unit:
6. ClinicalworkloadoftheInstitutionandDepartmentofOrthopedics:
EntireHospital DepartmentofOrthopedics
Particulars On Day of On Day of Avg of 3
Assessment Assessment DaysRandom
OPDattendanceup to 2:00 P.M. 5700
Totalnumber ofnewadmissions 434
TotalBedsoccupied at10:00A.M. 2482
Totalno.ofRequiredBeds 1000
BedOccupancyat10:00A.M.(%) 98
No.ofMajorOperations 88
No.ofMinorOperations 27
No.ofDay CareOperations 14
Totalno.ofDeliveries 25
Totalno.ofCaesareanSections 18
Totalno.ofDeaths 10
Casualtyattendance 69
Note:
i. OPDattendancetobeconsideredonlyupto2:00 P.M.andBedoccupancytill10:00A.M.
ii. Verify datafromBirth/DeathregistrationformssentbyhospitaltotheRegistrarofBirths/Deaths.
iii. Datatobeverifiedwithphysicalrecords/registersforRadiodiagnosis,CentralClinicalLaboratoryandBloodBank
7. InvestigativeWorkload ofentirehospitalandDepartmentofOrthopedics.
EntireHospital DepartmentofOrthopedics
Particulars On day On day Avg of
ofassessment ofassessment 3randomdays
Radio-diagnosis MRI 10
CT 172
USG 137
PlainX-rays 205
IVP/Bariumetc. 2
Mammography -
DSA 10
CTguidedFNAC 1
USGguidedFNAC 3
Anyother
Pathology Histopathology 68
Cytopathology 17
Hematology 12
Others NIL
Biochemistry 1250
Microbiology 1676
Unitsofbloodconsumed 58
8. Year-wiseavailableclinicalmaterialofthedepartmentofOrthopedics (past3calendaryears).
Licensevalid Yes
Bloodcomponentfacilityavailable Yes
Numberofunits storedon thedayof Assessment
Averagenumberofunits consumed daily(entirehospital) 65
15. Library:
16. Emergency/Casualty:NumberofBeds:25
17. Availableequipment:Adequate
18. Commonfacilities:
1. Centralsupply ofOxygen /Suction: Available
2. CentralSterileSupplyDepartment Adequate
3. Laundryservices: Available
4. Dietaryservices Available
5. Bio-MedicalWastedisposal Outsourced
6. Generatorfacility Available
7. MedicalRecordSection: Noncomputerized
8. ICDXclassification Notused
19. NumberofOPD,IPDcases&DeathsintheInstitutionanddepartmentofOrthopedics(pastyear).
Intheentirehospital InthedepartmentofOrthopedics.
OPD 1602140 OPD 57036
UG PG Interns
Detail
Boys Girls Boys Girls Boys Girls
NumberofStudents 312 157 130 70 47 42
Recognized Date
Permittedseats Dateof permission
seats ofrecognition
Degree
M.S.
(Orthopaedics) 9
23. Year wise PG students admitted (in the department inspected) during the preceding 5
yearsandavailablenumberof PG teachers
Year NumberofPGsadmitted NumberandNamesof PGTeachersavailable
2020 9
2019 9
2018 9
2017
2016
Namesoffacultymembers
Designation Number
Appointed Relieved
Professor
AssociateProf. 1 Dr. Ravichandran Dr. M.N.Karthi
AssistantProf. 2 Dr. Manoj Deepak
Dr. S.R. Venkateshwaran Dr. T.C.Premkumar
SR/Tutor/Demons. 2 Dr. Balaji
Dr.Gopi Manohar
Others
1. PleaseDONOTrepeat informationalreadyprovidedelsewhereinthisform.
2. PleaseDONOTmakeanyrecommendationregardinggrantof permission/recognition
3. Please PROVIDE DETAILS of irregularities that you have noticed/ come across, during the assessment,
likefake/dummyfaculty,fake/ dummypatients,fabrication/falsificationof dataofclinical materialetc.ifany.
PART– I
(INSTITUTIONALINFORMATION)
1. ParticularsofDirector / Dean/Principal:
(WhosoeveristheHeadoftheInstitution)
TeachingExperience
2. CentralLibrary
a) TotalnumberofBooksinlibrary: 43214
b) BookspertainingtoOrthopedics: 142
c) Purchaseof latesteditions ofbooks in last3 years:Total:1090Orthopedicsbooks:25
d) Journals:
Totalnumber Orthopedics.
Indian 200 2
Foreign 88 3
e) Year/MonthuptowhichlatestIndianJournalsavailable: 2020
f) Year/Monthuptowhich latestForeignJournalsavailable:2020
g) Internet: Available
h) Libraryopening times: 9:00 a.m. to 6.00 p.m.
i) Readingfacilityoutofroutinelibraryhours:Available
(Obtainalistofbooks &journalsrelatedtoOrthopedicsdulysignedby Dean)
3. Casualty/EmergencyDepartment
Particulars Numbers/relevantdetails
NumberofBeds 30
EmergencyLabinCasualty(roundtheclock): Available
EmergencyOTand DressingRoom Available
Staff(Medical/Paramedical) MEDICAL OFFICER 6
STAFF NURSE 6
WARD BOY 6
SWEEPER 2
STRETCHER BEARER 6
Equipmentavailable Suction,Oxygen Cylinder
Ambu bag Ventilator,Pulse Oxymetre
Pipeline gas system,
Oxygen Concentrator
Ventilators, Defibrillator.
4. BloodBank
(vii)Average number of units utilized daily and on the day of the assessment in the
entirehospital(various specialty wisedistribution)
4. CentralsupplyofOxygen/Suction: Available
5. CentralSterileSupply Department Adequate
6. Bio-MedicalWasteDisposal Outsourced
7. Generatorfacility: Available
8. MedicalRecordSection: Noncomputerized
ICDXclassification Notused
9. NumberofOPD,IPDcases&Deathsin theInstitutionanddepartmentofOrthopedics.(pastyear).
Intheentirehospital InthedepartmentofOrthopedics.
OPD 1602140 OPD 57036
12. Hostelaccommodation:
UG PG Interns
Detail
Boys Girls Boys Girls Boys Girls
NumberofStudents 375 432 131 66 67 83
14. EthicsCommittee(Constitution):
Sl. Role/DesignationinEt
NameofMember Qualification
No. hicsCommittee
1 Dr.VNagaraajan MBBS(MD.,DM.-Neurology) ChairPerson
2 Dr.KRaadhika MBBS(MD-Pharmacology) MemberSecretary
3 Dr.VDhanalakshmi MBBS(MD-Microbiology) BasicMedicalScientist
4 Dr.CDharmaraj MBBS(MD-GeneralMedicine) Clinician
5 Dr.MNatarajan MBBS(MD-GeneralMedicine) Clinician
6 Dr.AMSyedImrahim MBBS(MS-Generalsurgery) Clinician
7 Dr.VBagiyalakshmi MBBS(MD-Pathology) BasicMedicalScientist
B.Sc.-Psychology(MSc.,M.Phil.,Ph.D-ClinicalPsychology)
8 Dr.RSelviKumari SocialScientist
9 Mr.SRamesh B.Sc.(BL) LegalExpert
10 Mr.PKMChelliah HSC,SSC(BA) LayPerson
11 Dr.SGBalamurugan MBBS(MS-Generalsurgery,M.Ch-SurgicalOncology) Clinician
12 Dr.KSampathkumar MBBS(MD-GeneralMedicine,DNB,DM) Clinician
15.MedicalEducationUnit(Constitution)
(Specifynumberofmeetingsheldannually&minutesthereof)
-12meetingsperyear
CHAIRMAN:Dr.J.Sangumani,M.D,Dean,MaduraiMedicalCollege,Madurai
.
CO-CHAIRMAN:Dr.Dhanalakshmi,M.D.(Micro),VicePrincipal,MaduraiMedicalCollege,Madurai.
Coordinator:Dr.K.MuraliKrishnan,M.D(Physio),Director&Professor,InstituteofPhysiology,Madurai
MedicalCollege,Madurai.
Coordinator:Dr.Sarojini,M.D.[Pharm],ProfessorofPharmacology,MaduraiMedicalcollege,Madurai
CurriculumCommitteeMembers:
LISTOFPROGRAMSCONDUCTEDINGOVT.MADURAIMEDICALCOLLEGE,MADURAI-20
Dr.G.Geetharani.M.D Professor&HOD,DeptofDermatology
Dr.Vijayashanmugam,M.S(Opthal) Prof&HODofOpthalmology
Dr.Dhamayanthi.M.D AssociateProfessorofPathology
Dr.ShobanaMS AssociateProfessorofAnatomy
Members
Dr.V.Dhanalakshmi.M.D ProfessorofMicrobiology
Dr.G.Jeyanthi.M.D AssociateProfessorofPathology
Dr.S.Malliga.M.D AssociateProfessorofPathology
Dr.G.MeenakumariM.D ProfessorofPathology
Dr.P.MohankumareshM.D Professor&HODofBiochemistry
Dr.V.RajagopalM.D AsstProfessorofBiochemistry
Dr.R.UmamaheshwariM.D AsstProfessorofBiochemistry
Dr.M.ShanthiM.D ProfessorofPharmacology
Dr.K.RadhikaM.D AssociateProfessorofPharmacology
Dr.N.S.SunithaM.S AssisstantProfessorofAnatomy
Dr.RajakohilaJ,M.S AssisstantProfessorofAnatomy
Dr.C.AnithaMohanM.D AssociateprofessorofPhysiology
Dr.S.SudhaM.D AssistantprofessorofPhysiology
Dr.S.PriyaM.D AssociateProfessorofCommunitymedicine
DrG.ArunKumarYogarajM.D AssisstantProfessorofCommunitymedicine
DrC.DharmarajM.D ProfessorofGeneralmedicine
DrV.N.AlagavenkatesanM.D ProfessorofGeneralmedicine
DrT.KumananM.D ProfessorandHODofPsychiatricMed
Dr.S.BalasankarM.D ProfessorandHODofPaediatrics
DrN.K.MahalakshmiM.D ProfessorofObsteriticsandGynaecology
DrV..SelvarajM.S AssociateProfessorofGeneralsurgery
Dr.MangalaAdiseshM.D DirectorandProfessorofMicrobiology
Dr.S.MaheshprabhuM.D AssisstantProfessorofMicrobiology
Dr.S.RadhakumariM.D ProfessorofMicrobiology
DrJ..AlaguvadivelM.D AssociateProfessorofENT
LISTOFPROGRAMSCONDUCTEDINGOVT.MADURAIMEDICALCOLLEGE,MADURAI- 20
Date Program
1-31-Aug-2019 FoundationcourseforIstMBBS
10-10-2019 CurriculumCommitteeMeeting
12-11-2019 CurriculumCommitteeMeeting
16-11-2019 CurriculumCommitteeMeeting
06-01-2020 ATCOMRevision
15-02-2020 GoodTeacher
16-03-2020 Handwashteaching
9&10–july-2020 OnlineCISPTraining-CMC-Vellore
PART– II
(DEPARTMENTALINFORMATION)
1. Departmentinspected: ORTHOPEDICS
2. ParticularsofHOD
TeachingExperience
3. PurposeofPresentAssessment: Increaseofseats
DateoflastMCI/NMCAssessmentofthedepartment: 29/04/2019
(WriteNotApplicableforfirstNMCAssessment)
4. Purposeof LastAssessment: Conversion of Diploma to M.S.(Ortho) 1 seat
5. ResultoflastAssessment: Recognized
6. Modeofselection(actual/proposed) ofPGstudents: NEET PG
7. If course has already started, year-wise number of PG students admitted, and number
withnamesofavailable PGteachersin thedepartmentduring the last5 years:
No.ofPGstudentsadmitted
Year Degree Diploma NumberandNamesof PGTeachersavailable
Prof.R.Arivasan.M.S.Ortho.
Prof.V.R.Ganesan.M.S,DNB,D.Ortho.,
Prof.B.Sivakumar, M.S.Ortho.,
2020 9 --
Prof.N.ThanappanM.S.Ortho.,
Prof.P.V.Thirumalaimurugan M.S,DNB,D.Ortho.,
Prof.K.Ravichandran. M.S,DNB,D.Ortho.,
Prof.R.Arivasan.M.S.Ortho.
Prof.V.R.Ganesan.M.S,DNB,D.Ortho.,
Prof.B.Sivakumar, M.S.Ortho.,
2019 9 --
Prof.N.ThanappanM.S.Ortho.,
Prof.D.Pathiarasa Kumar,M.S.Ortho.,
Prof.M.N.Karthi.,M.S.(Ortho).,
Prof.P.V.Pugalenthi.D.Ortho,M.S.(Ortho)
Prof.R.Arivasan.M.S.Ortho.
Prof.R.Sivakumar, M.S,DNB,D.Ortho.,
2018 8 1 Prof.V.R.Ganesan.M.S,DNB,D.Ortho.,
Prof.B.Sivakumar, M.S.Ortho.,
Prof.N.ThanappanM.S.Ortho.,
Prof.P.V.Pugalenthi.D.Ortho,M.S.(Ortho)
Prof.R.Arivasan.M.S.Ortho.
Prof.R.Sivakumar, M.S,DNB,D.Ortho.,
2017 8 1
Prof.V.R.Ganesan.M.S,DNB,D.Ortho.,
Prof.B.Sivakumar, M.S.Ortho.,
Prof.N.ThanappanM.S.Ortho.,
Prof.P.V.Pugalenthi.D.Ortho,M.S.(Ortho)
Prof.R.Arivasan.M.S.Ortho.
Prof.R.Sivakumar, M.S,DNB,D.Ortho.,
2016 8 1 Prof.V.R.Ganesan.M.S,DNB,D.Ortho.,
Prof.B.Sivakumar, M.S.Ortho.,
Prof.N.ThanappanM.S.Ortho.,
8. DepartmentalGeneralfacilities:
TotalnumberofBeds: 285
Totalnumber ofUnits: 6
time/parttime/
PANNo./T
Name & Experience Signatures
DS PGQualification
DateofBirth Datewiseteachingexperiencewithdesignation&Institution (Faculty)
Designation
Full
deducted
Subject/ Institution University Institution From To TotalPeri * Whether
Mentionings
Designation
S.No
Year od benefit
ubject
ofpassi ofpublications
ng givenYes/No–
Honorary
Listpapers
Jr.Resident MMC,Madurai 00/09/94 00/09/97 3 yrs
Asst.Prof. MMC,Madurai 01/00/99 30/09/02 3y
Sr.Asst.Pro MMC,Madurai 01/10/02 30/09/04 2y
f
TTN M.G.R.
Dr. R. Arivasan M.S.Ortho
MMC,
1. Professor Full time ABRPA4061B Medical Asso.Prof. MMC,Madurai 01/00/04 03/12/08 4y/2m/2d NO
09/07/1966 1998
Madurai
university
MMC,Madurai 04/12/08 30/09/09 9m/26d
TMC, 01/10/09 26/09/11 2y/25d
Prof. Thirunelveli
GTMC, Theni 27/09/11 19/08/14 2y/10m/23d
MMC,Madurai 20/08/14 Till Date 6y/5m/15d
Dr.J.Maheswaran Asst.Prof. TMC, Theni 10/06/10 07/06/11 1y
TTN M.G.R.
30/05/1969 M.S.Ortho TMC, Sr.Asst.Pro
2. Asst.Prof Full time AHOPM3552A Medical
2010 Thirunelveli f MMC,Madurai 07/06/11 Till Date 9y
university
TTN M.G.R. Jr.Resident MMC,Madras 2011 2014 3y
Dr.S.Karthikeyan M.S.Ortho MMC,
3 Asst.Prof Full time BMLPK8820Q Medical Sr.Resident TMC,Theni 2016 2017 1y
29/07/1982 2011 Madras
university Asst.Prof. MMC,Madurai 2017 Till Date 3y
Jr.Resident SMC,Chennai 30/06/14 29/06/17 3y
TTN M.G.R. Sr.Resident GTMC,Thooth 08/12/17 07/12/18 1y
Dr.S.R.Venkateswaran M.S.Ortho SMC, ukudi
Sr.Resident Full time AUTPV2118F Medical
18/09/1989 2017 Chennai GTMC,Thooth
4. university Asst.Prof. 08/12/18 10/06/20 1y/6m/2d
ukudi
Sr.Resident MMC,Madurai 12/06/20 Till Date 7m
Note:
i. UnitwiseTeaching/Residentstaffshouldbeshownseparatelyforeachunit intheproforma.
ii. FILLALLCOLOUMNS. DoNOTmodify anypartoftheabove table.Tampering withtheformat ofthetablewillrenderyoursubmission invalid.
iii. IfBENEFITOFPUBLICATIONHASBEENGIVEN,list onlyoriginal articlesinindexedJournalspublishedduringtheperiodofassessmentforpromotionhere.AnnexurewillNOTbeconsidered.
iv. IncaseofpersonswithDNBqualifications,thenameofthehospital/institutionwhereDNBtrainingwasobtainedandtheyearofpassingshouldclearlybementionedfailingwhichshe/heshallNOTbeconsidered.Merelymen
SignatureofDean SignatureofAssessor
tioning NationalBoardof Examinations,New Delhishallnotsuffice.
v. ExperienceofDefenseservicespersonnelmustbe supportedbycertificate/sfromthecompetentauthoritiesoftheofficeoftheDGAFMS,tobeattachedwiththeFacultydeclarationformsfailingwhichitshallnot beconsidered. I
have verified the eligibility of all faculty members for the posts they are holding based on experience certificates issued by competent authorities of their place of working. The details
oftheirworking and teaching experiencewhile holdingdifferent Designations isfurnished in the tableabove.
InstitutionalTANNo: MRIG00154A
9. UnitwiseTeachingandResidentStaff
Full time/parttime/
PANNo./TD
Name & Experience Signatures
S PGQualification
DateofBirth Datewiseteachingexperiencewithdesignation&Institution (Faculty)
deducted
Designation
Mentionings
Designation
S.No
ubject
ofpassi givenYes/No–
Honorary
ng Listpapers
SignatureofDean SignatureofAssessor
Thoothukudi
MMC,Madurai 06/12/19 Till Date 1y/2m
4. Sr.Resident Dr.M.Manoj Deepak Full Time BUTPM3755N M.S.Ortho Sree Balaji Bharath Jr.Resident SBMC&H 01/05/12 31/04/15 3y
2012 Medical University Sr.Resident
College
Hospital, GTMC,Theni 08/01/16 31/10/19 3y/10m
GTMC, Theni 01/11/19 20/07/20 8m/20d
MMC,Madurai 21/07/20 Till Date
Note:
vi. UnitwiseTeaching/Residentstaffshouldbeshownseparatelyforeachunit intheproforma.
vii. FILLALLCOLOUMNS. DoNOTmodify anypartoftheabove table.Tampering withtheformat ofthetablewillrenderyoursubmission invalid.
viii. IfBENEFITOFPUBLICATIONHASBEENGIVEN,list onlyoriginal articlesinindexedJournalspublishedduringtheperiodofassessmentforpromotionhere.AnnexurewillNOTbeconsidered.
ix. IncaseofpersonswithDNBqualifications,thenameofthehospital/institutionwhereDNBtrainingwasobtainedandtheyearofpassingshouldclearlybementionedfailingwhichshe/heshallNOTbeconsidered.Merelymen
tioning NationalBoardof Examinations,New Delhishallnotsuffice.
x. ExperienceofDefenseservicespersonnelmustbe supportedbycertificate/sfromthecompetentauthoritiesoftheofficeoftheDGAFMS,tobeattachedwiththeFacultydeclarationformsfailingwhichitshallnot
beconsidered.
I have verified the eligibility of all faculty members for the posts they are holding based on experience certificates issued by competent authorities of their place of working. The details
oftheirworking and teaching experiencewhile holdingdifferent Designations isfurnished in the tableabove.
InstitutionalTANNo:
SignatureofDean SignatureofAssessor
MMC,
Jr.Resident 08/03/94 26/03/97 3y
Madurai
MMC,
Sr.Resident 26/01/02 25/01/03 1y
Madurai
Note:
xi. UnitwiseTeaching/Residentstaffshouldbeshownseparatelyforeachunit intheproforma.
xii. FILLALLCOLOUMNS. DoNOTmodify anypartoftheabove table.Tampering withtheformat ofthetablewillrenderyoursubmission invalid.
xiii. IfBENEFITOFPUBLICATIONHASBEENGIVEN,list onlyoriginal articlesinindexedJournalspublishedduringtheperiodofassessmentforpromotionhere.AnnexurewillNOTbeconsidered.
xiv. IncaseofpersonswithDNBqualifications,thenameofthehospital/institutionwhereDNBtrainingwasobtainedandtheyearofpassingshouldclearlybementionedfailingwhichshe/heshallNOTbeconsidered.Merelymen
tioning NationalBoardof Examinations,New Delhishallnotsuffice.
xv. ExperienceofDefenseservicespersonnelmustbe supportedbycertificate/sfromthecompetentauthoritiesoftheofficeoftheDGAFMS,tobeattachedwiththeFacultydeclarationformsfailingwhichitshallnot
beconsidered.
SignatureofDean SignatureofAssessor
I have verified the eligibility of all faculty members for the posts they are holding based on experience certificates issued by competent authorities of their place of working. The details
oftheirworking and teaching experiencewhile holdingdifferent Designations isfurnished in the tableabove.
InstitutionalTANNo:
SignatureofDean SignatureofAssessor
Full Experience Signatures
time/pa PANNo./T PGQualification Datewiseteachingexperiencewithdesignation&Institution (Faculty)
11. Name &
DateofBirt rttime/ DS Subject/ Design * Whether benefit
No. Designation
h Honorar deducted Year ationMenti Total ofpublications
Institution University Institution From To
y ofpassi oningsubje Period givenYes/No–
ng ct Listpapers
MMC,
Jr.Resident 1998 2001 3y
Madurai
MMC,
Sr.Resident 17/06/06 17/06/07 1y
Madurai
MMC,
Asst.Prof 17/06/07 30/11/12 5y/6m
TN.MGR. Madurai
Medical KMC,
M. Thanappan M. S.Ortho MMC,
1. Asso.Professor Full time ADKPT2879F University Asso.Prof. Kanyakumar 05/12/12 31/10/13 YES
12/09/1973 2001 Madurai
i
TMC,
08/11/13 31/08/14
Thirunelveli
7y/10m
SMC,
08/09/14 21/03/15
Sivagangai
MMC,Madu
25/03/15 Till Date
rai
CMC,
Jr.Resident 09/05/07 08/05/10 3y
Coimbator
TN.MGR.
M.S.Ortho
V.A.Prabhu CMC, Medical TMC,
2. Asst.Professor Full time APXPP1158G 2010 Sr.Resident 09/05/10 17/02/11 1y
21/01/1980 Coimbatore University Thirunelveli
MMC,
Tutor 18/02/11 09/05/11 3m
Madurai
MMC,
Asst.Prof 10/05/11 Till Date 10y
Madurai
TMC,
Jr.Resident 2007 2009 2y
Thanjavur
TMC,
Sr.Resident 2010 2012 2y
Thanjavur
TN.MGR.
R. Anbarasan M.S.Ortho TMC, Medical VMC,
3. Asst.Professor Full time APPPA9790R Tutor 27/03/14 30/03/15 1y/3d
SignatureofDean 27/04/1980 SignatureofAssessor
2012 Thanjavur University Viluppuram
SMC,
Asst.Prof 01/04/15 30/06/17 2y/3m
Sivagangai
UnitwiseTeachingandResidentStaff:
Note:
xvi. UnitwiseTeaching/Residentstaffshouldbeshownseparatelyforeachunit intheproforma.
xvii. FILLALLCOLOUMNS. DoNOTmodify anypartoftheabove table.Tampering withtheformat ofthetablewillrenderyoursubmission invalid.
xviii. IfBENEFITOFPUBLICATIONHASBEENGIVEN,list onlyoriginal articlesinindexedJournalspublishedduringtheperiodofassessmentforpromotionhere.AnnexurewillNOTbeconsidered.
xix. IncaseofpersonswithDNBqualifications,thenameofthehospital/institutionwhereDNBtrainingwasobtainedandtheyearofpassingshouldclearlybementionedfailingwhichshe/heshallNOTbeconsidered.Merelymen
tioning NationalBoardof Examinations,New Delhishallnotsuffice.
xx. ExperienceofDefenseservicespersonnelmustbe supportedbycertificate/sfromthecompetentauthoritiesoftheofficeoftheDGAFMS,tobeattachedwiththeFacultydeclarationformsfailingwhichitshallnot
beconsidered.
I have verified the eligibility of all faculty members for the posts they are holding based on experience certificates issued by competent authorities of their place of working. The details
oftheirworking and teaching experiencewhile holdingdifferent Designations isfurnished in the tableabove.
InstitutionalTANNo:
GTMC,
02/02/17 06/02/19
Theni
Asso.Prof. 5y
MMC,
11/02/19 Till Date
Madurai
INHSASW
Jr.Resident Jan 2003 Jan 2006 3y
INI
GTMC,
M.S.Ortho University 21/07/08 19/03/10
S. Saravanamuthu INHSAS Theni 1y/8m
2. Asst.Professor Full time ABPPT5048P 2006 of
17/07/1970 WINI
Mumbai Asst.Prof
MMC, 10y/5m/
19/03/10 Till Date
Madurai 20d
SMC,Siva 3y/8m/7
R.Balaji Ramachan 01/02/16 17/11/19
M.S.Ortho gangai d
3. Sr.Resident 27/07/1987 Full time BBOPB4249Q SRMC dra Sr.Resident
2015 MMC,Mad
University 18/11/19 Till Date
urai
Note:
xxi.UnitwiseTeaching/Residentstaffshouldbeshownseparatelyforeachunit intheproforma.
xxii.FILLALLCOLOUMNS. DoNOTmodify anypartoftheabove table.Tampering withtheformat ofthetablewillrenderyoursubmission invalid.
xxiii.IfBENEFITOFPUBLICATIONHASBEENGIVEN,list onlyoriginal articlesinindexedJournalspublishedduringtheperiodofassessmentforpromotionhere.AnnexurewillNOTbeconsidered.
xxiv. IncaseofpersonswithDNBqualifications,thenameofthehospital/institutionwhereDNBtrainingwasobtainedandtheyearofpassingshouldclearlybementionedfailingwhichshe/heshallNOTbeconsidered.Merelymen
tioning NationalBoardof Examinations,New Delhishallnotsuffice.
xxv. ExperienceofDefenseservicespersonnelmustbe supportedbycertificate/sfromthecompetentauthoritiesoftheofficeoftheDGAFMS,tobeattachedwiththeFacultydeclarationformsfailingwhichitshallnot
beconsidered.
I have verified the eligibility of all faculty members for the posts they are holding based on experience certificates issued by competent authorities of their place of working. The details
oftheirworking and teaching experiencewhile holdingdifferent Designations isfurnished in the tableabove.
InstitutionalTANNo:
SignatureofDean SignatureofAssessor
FORM-NMC-2-PG (ORTHOPEDICS) - V_2020 13
13. UnitwiseTeachingandResidentStaff:
TN.MGR.
M.S.Ortho MMC,Madr Medical Asst.Prof MMC,Madurai 14.02.98 05/02/17 18y
YES
1997 as University
Asso.Prof SMC,Sivagang 06/02/17 17/11/19 2y/9m
ai
2. Asst.Professor K.Singaravel Full time BFDPS0873L M.S.Ortho MMC, TN.MGR. Jr.Resident MMC, 16/05/11 15/05/14 3y
17/08/1978 2015 Madurai Medical Madurai
University
Sr.Resident SMC,Sivagang 06/06/14 24/04/15 10m/18
ai d
3. Asst.Professor B.Saravanan Full time ALNPB9311P M.S.Ortho MMC, TN.MGR. Sr.Resident GTMC,Theni 10/07/16 25/06/18 1y/11m/
21/01/1977 2016 Madras Medical 15d
SignatureofDean SignatureofAssessor
University Asst.Prof MMC, 01/07/18 Till Date 2y/7m
Madurai
Note:
xxvi.UnitwiseTeaching/Residentstaffshouldbeshownseparatelyforeachunit intheproforma.
xxvii. FILLALLCOLOUMNS. DoNOTmodify anypartoftheabove table.Tampering withtheformat ofthetablewillrenderyoursubmission invalid.
xxviii. IfBENEFITOFPUBLICATIONHASBEENGIVEN,list onlyoriginal articlesinindexedJournalspublishedduringtheperiodofassessmentforpromotionhere.AnnexurewillNOTbeconsidered.
xxix. IncaseofpersonswithDNBqualifications,thenameofthehospital/institutionwhereDNBtrainingwasobtainedandtheyearofpassingshouldclearlybementionedfailingwhichshe/heshallNOTbeconsidered.Merelymen
tioning NationalBoardof Examinations,New Delhishallnotsuffice.
xxx. ExperienceofDefenseservicespersonnelmustbe supportedbycertificate/sfromthecompetentauthoritiesoftheofficeoftheDGAFMS,tobeattachedwiththeFacultydeclarationformsfailingwhichitshallnot
beconsidered.
I have verified the eligibility of all faculty members for the posts they are holding based on experience certificates issued by competent authorities of their place of working. The details
oftheirworking and teaching experiencewhile holdingdifferent Designations isfurnished in the tableabove.
InstitutionalTANNo:
SignatureofDean SignatureofAssessor
FORM-NMC-2-PG(ORTHOPEDICS)-V_2020
14
14. Have any of these faculty members been considered in PG/UG Assessment at any other
collegesorforanyothersubject inthis college orothercollegesinthelast2years?If yes,givedetails.
Namesoffacultymembers
Designation Number Appointed Relieved
1.Professor
2.AssociateProf. 1 Dr.M.N.Karthi
3.AssistantProf. 1 Dr.T.C.Premkumar
4.SR/Tutor/Demons. Dr.S.R.Venkateswaran
Dr.M.Manoj Deepak
5.Others
16. ListofNon-teachingStaffinthedepartment:
3 Mrs.T.Vijaya Steno-typist
4 Mrs.N.Malathy Assistant
5 Mr.Venugopal
6 Mrs.Keerthana
7 Mr.Ananthakumar
8 Mrs.P.Vidhya
17. AvailableClinicalMaterialofthedepartmentofOrthopedics.
DailyadmissionsthroughOPD 6
DailyadmissionsthroughEmergency/casualty 20
Totaldaily admissions 26
BedoccupancyintheDepartment 97%
NumberofOperationsintheDepartment 20
NumberofMajoroperations 14
NumberofMinor operations 6
NumberofDay careoperations 10
NumberofDeaths 2
SignatureofDean SignatureofAssessor
18. Clinicalworkload /materialofthedepartment(past3years):
A.IntensiveCareUnit(ICU)
1.Numberof Beds 8
2.Bedsoccupiedon assessmentday
3.Averagebed occupancy 6
4.Availableequipment Suction,Oxygen Cylinder
Ambu bag Ventilator,Pulse Oxymetre
Pipeline gas system,
Oxygen Concentrator
Ventilators, Defibrillator.
B.Anyotherintensive careserviceprovided:
(List in thespaceprovidedbelow)
Number Name of
Nameof theClinic Weekday/s Timings
ofcases( ClinicIn-
Avg) charge
1)Fractureclinic All days 7:30 am to 12.00 Chief of corresponding
p.m. unit
2)CTEVclinic Thursdays 10 a.m. to 12.00 p.m Prof.Dr.N.Thanappan
3)Spine Clinic Wednesdays 10 a.m. to 12.00 p.m Prof Dr.B.Sivakumar
4)Hand and foot Clinic Saturday 10 a.m. to 12.00 p.m Prof Dr.K.Ravichandran
5)ArthroplastyClinic Tuesdays 10 a.m. to 12.00 p.m Prof.Dr.V.R.Ganesan
6)ArthroscopyClinic Mondays 10 a.m. to 12.00 p.m Prof.Dr.R.Arivasan
7)Tumorclinic Fridays 10 a.m. to 12.00 p.m Prof Dr.P.V.Thirumalai
Murugan
Purchaseoflatesteditionsin past3years 25
NumberofJournals 5 (Five)
23. DepartmentalResearchLab.
Space
Equipment
ResearchprojectsutilizingResearchlab NIL
24. DepartmentalMuseum(Whereverapplicable).
Space 19*19 Sq
ft
Numberofspecimens 10
25. Space
26. OfficeSpace/Accommodation:
*Strikeoutwhicheverarenot applicable
22. Clinico-PathologicalConferences (CPCs)participation: No
(Ifyes, providenumberswith dates)
Equipment Numbers/functionalstatus/comments
1.Arthroscope 2 sets
2.Image Intensifier 3 (Three) C- Arm
3.HipArthoplastyset 1 Set
4.KneeArthoplasty set 1 Set
5.FractureFixationset 10 Set
6.Spinesurgeryset 3 Set
7.DHSset 2 Set
8.Interlockingnailset 8 Set
9.Anyotherequipment PFN Set, Ilizarov Set, LRS Set, Locking Plate set - 4
Monthly tests
Case presentations
Ward rounds
Quiz programmes
28. Academicactivities(outcomebased):
b)Datesandsubject Available&Verified
c)NameandDesignationoftheTeacher Available&Verified
d)Attendancesheet Available&Verified
d)Tutorialsheld inthepast12months
a)Numbers NIL
b)Datesandsubject Available&Verified
c)NameandDesignationoftheTeacher Available&Verified
d)Attendancesheet Available&Verified
e)Group discussionsheldin thepast12 months
a)Numbers 50
b)Datesandsubject Available&Verified
c)NameandDesignationoftheTeacher Available&Verified
d)Attendancesheet Available&Verified
f) Guestlecturesorganized in thepast 12months
a)Numbers NIL
b)Datesandsubject Available&Verified
c)NameandDesignationoftheTeacher Available&Verified
d)Attendancesheet Available&Verified
29. Anyotherinformation.
PARTIII
(POSTGRADUATEEXAMINATION)
(OnlyatthetimeofrecognitionAssessment)
1. Minimumprescribedperiodoftraining:
Dateofadmission ofthe RegularBatchappearinginexamination:16.05.2021
2. Minimumprescribedessentialattendance: 80%
6. Whetherthecandidatesappearing intheexaminationhave:
a) presentedoneposter Yes/No
b) presentedaresearchpaperata National/Stateconference Yes/No
c) published/ receivedacceptanceforapaperduringtheirPGstudyperiod Yes /No
d) communicatedapaperforpublication. Yes /No
7. Providedetailsofexaminers appointedbyExaminingUniversitybelow(NoAnnexures):
Whetherappointment,eligibilityofexaminersandconductofexaminationisasperprescribedNMC/MCI
norms: Yes / No
Ifnot, providedetails:
9. StandardofTheorypapersandthatofClinical/PracticalExamination:
10. Year of passing out of the 1stbatch of PG students (mention name of previous/existing
Madurai-20.
Note:
i. Retired/Superannuated/re-employedfacultymembersshouldnotbeappointedas ExternalExaminer.
ii. Thereshould betwointernal and twoexternalexaminers.
iii. Threeexternalexaminersshouldbeappointediftwointernalexaminersarenot availableinthedepartment.