OFFICE COPY - e-Log Book - College of Physicians and Surgeons ...

OFFICE COPY

THIS IS AN EVOLVING DOCUMENT.
The College of Physicians and Surgeons Pakistan
would appreciate any criticism, suggestions,
advice from the readers and users of this document.
Comments may be sent in writing or by
e-mail to the CPSP at:
National Directorate Residency Program (NDRP)
College of Physicians and Surgeons Pakistan (CPSP)
7th Central Street, Defence Housing Authority, Karachi-75500.
ndrp@cpsp.edu.pk

Contact Details:
College of Physicians and Surgeons, Pakistan.
7th Central Street, Phase II, D.H.A. Karachi - 75500.
Phone: 99207100-10, UAN 111-606-606
Facsimile: 99266450
Website: www.cpsp.edu.pk
CONTENTS
1
6
The College
General Information
10
12
13
35
37
Supervisor’s Role and Responsibilities
Trainee’s Roles and Responsibilities
Training Program
Frequently asked questions (FAQ’s)
Useful Addresses and telephone numbers

Composed by:
Syed Faisal Babar
Department of Medical Education
Published: March, 2010
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7th Central Street, Defence Housing Authority, Karachi-75500.
Phone No. 99207100-10. UAN: 111-606-606. Fax No. 99266432

THE COLLEGE
The College was established in 1962 through an ordinance of the
Federal Government. The objectives/functions of the College include
promoting specialist practice of Medicine, Obstetrics & Gynaecology,
Surgery, Dentistry, and other specialties by securing improvement of
teaching and training, arranging postgraduate medical, surgical and
other specialists training, providing opportunities for research, holding
and conducting examinations for awarding College diplomas and
admission to the Fellowship of the College.
Since its inception, the College has taken great strides in improving
postgraduate medical and dental education in Pakistan. Competencybased
structured Residency Programs have now been developed, along
with criteria for accreditation of training institutions, and for the
appointment of supervisors and examiners. The format of examinations
has evolved over the years to achieve greater objectivity and reliability
in methods of assessment. The recognition of the standards of College
qualifications nationally and internationally, particularly of its Fellowship,
has enormously increased the number of trainees, and consequently the
number of training institutions and the supervisors. The rapid increase in
knowledge base of medical sciences and consequent emergence of
new subspecialties have gradually increased the number of CPSP
fellowship disciplines to fifty three.
After completing two years of training during IMM, the trainees are
allowed to proceed to the advanced phase of FCPS training in the
specific specialty of choice for 2-3 years. However, it is mandatory to
qualify IMM examinations before taking the FCPS-II exit examinations.
The prospectii of Post IMM phase of each discipline have been
extensively revised and structured so as to delineate well defined
competencies to be achieved along with the level of participation.
CPSP Obstetrics and Gynaecology 2010
1

These prospectuses have been complemented by color coded
Structured Visual Curriculum Display (SVCD) charts to be placed at a
prominent place in each training Unit. They help remind at a glance the
trainees and the supervisors about the competencies and their levels
to be achieved at a given time period along with the minimum number
of cases. They also describe the rotations to be performed along with
their duration and objectives, mandatory workshops to be attended,
and the requirements and deadlines for submitting research synopsis
and dissertation (or two research articles in lieu of the dissertation as
per CPSP rules).
The work performed by the trainee is also to be recorded in the
e-logbook. The purpose of the e-logbook is to ensure entries are made
on a regular basis and to avoid belated and fabricated entries. It will
hence promote accuracy, authenticity and vigilance on the part of
trainees and the supervisors. The College expects to enforce e-
logbook system from July 2010. However, the manual logbook will also
continue.
CPSP Obstetrics and Gynaecology 2010
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The average number of candidates taking CPSP examinations is over
13,000 every year. The College conducts examinations for FCPS I (11
disciplines), IMM, FCPS II (53 disciplines), MCPS (18 disciplines) and
DCPS (2 non-clinical disciplines). A large number of Fellows and
senior medical teachers from within the country and overseas are
involved at various levels of examinations of the College.
The College, in its endeavor to decrease inter-rater variability and
increase fairness and transparency, is using TOACS (Task Oriented
Assessment of Clinical Skills) in IMM and FCPS-II Clinical
examinations. Inclusion of foreign examiners adds to the credibility of
its qualifications at an international level.

It is important to note that in the overall scenario of health delivery over
15,000 of the total functioning and registered health care specialists of
the country have been provided by the CPSP. To coordinate training
and examination, and provide assistance to the candidates stationed
in cities other than Karachi, the College has established 12 Regional
Centers (including five Provincial Headquarter Centres) in the country.
The five Provincial Headquarter Centers, in addition to organizing the
capacity building workshops/short courses also have facilities of
libraries, I.T, and evaluation of synopses and dissertations along with
providing guidance to the candidates in conducting their research work.
The training towards Fellowship can be undertaken in more than 130
accredited medical institutions throughout the country and 70 plus
accredited institutions abroad. The total number of departments
recognized in these institutions is over 1200 and the number of
Supervisors engaged in the training has crossed the figure of 2000.
These continuous efforts of the College have contributed well over
90% of specialist medical manpower of Pakistan and even more
importantly has developed a credible system of postgraduate medical
education for the country. The College strives to make its courses and
training programs ‘evidence’ and need ‘based’ so as to meet
international standards as well as to cater to the specialist healthcare
needs not only for this country but also for the entire region.
CPSP Obstetrics and Gynaecology 2010
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Training and Examinations Summary
The College lays down the training programs and holds examination for
the award of Fellowship in the following disciplines:
CPSP Obstetrics and Gynaecology 2010
Disciplines for 1st Fellowship
1. Anaesthesia
24. Obstetrics and Gynaecology
2. Anatomy
25. Operative Dentistry
3. Biochemistry
26. Ophthalmology
4. Cardiac Surgery
27. Oral Surgery
5. Cardiology
28. Orthodontics
6. Chemical Pathology
29. Otorhinolaryngology (ENT)
7. Community Medicine
30. Orthopedic Surgery
8. Dermatology
9. Diagnostic Radiology
31. Paediatrics
10. Family Medicine
32. Paediatric Surgery
11. Forensic Medicine
33. Periodontology
12. Gastroenterology
34. Pharmacology
13. General Surgery
35. Physiology
14. Haematology
15. Histopathology
36. Physical Medicine & Rehabilitation
37. Plastic Surgery
16. Immunology
38. Prosthodontics
17. Medical Oncology
39. Psychiatry
18. General Medicine
40. Pulmonology
19. Microbiology
20. Nephrology
41. Radiotherapy
21. Neurology
42. Thoracic Surgery
22. Neurosurgery
23. Nuclear Medicine
43. Urology
44. Virology
Disciplines for 2nd Fellowship
1. Cardiothoracic Anaesthesiology 6. Paediatric Cardiology
2. Critical Care Medicine
7. Paediatric Ophthalmology
3. Endocrinology
4. Infectious Diseases
8. Rheumatology
5. Neonatal Paediatrics
9. Vitreo Retinal Ophthalmology
4

Fellowship of the College of Physicians and Surgeons Pakistan is
awarded to those applicants who are declared successful in
examinations carried out by the Examination Department of the
CPSP, and elected by the College Council and have:
● a recognized medical degree
● completed a one year house job in a recognized institution
● passed the relevant FCPS Part I Examination
● registered with the RTMC
● qualified in IMM exams
● undergone specified years of supervised accredited training
It is important to note that all applicants must undergo a
formal examination before being offered fellowship of the
relevant specialty, except in case of fellowship without
examination and honorary fellowship.
TRAINING ENQUIRIES AND
REGISTRATION
All trainees should notify the College in writing of any change of
address and proposed changes in training (such as change of
Supervisor, change of department, break in training etc) as soon as
possible.
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GENERAL REGULATIONS
GENERAL
INFORMATION
The following regulations apply to all the candidates taking the
FCPS-II Examination.
Candidate will be admitted to the examination in the name (surname
and other names) as given in the MBBS degree. CPSP will not
entertain any application for change of name on the basis of
marriage / divorce /deed.
Eligibility requirements for entering the FCPS Part II Training
program in Obstetrics and Gynaecology
- Passed FCPS Part I in Obstetrics & Gynaecology/allowed
exemption
- Completed two years RTMC registered training as per
Intermediate Module Curriculum
EXEMPTION FROM FCPS PART-I
An application for exemption from FCPS Part-I must be submitted to
the College with all the relevant documents and a bank draft for the
prescribed fee.
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After due verification, the College may grant exemption from FCPS
Part-I to those applicants who have acquired any of the following
qualifications in Obstetrics & Gynaecology:
- Diplomate American Board of Specialties
- FCPS Part-I, Bangladesh.
In all other cases, after proper scrutiny and processing, the College
shall decide acceptance or rejection of the request for exemption
from FCPS-I on case to case basis.
All applicants who are allowed exemption will be issued an
EXEMPTION CERTIFICATE on payment of exemption fee. The date
of issue of the exemption certificate will be considered as the date of
passing FCPS I examination. A copy of this certificate will have to be
attached with the application to the Research & Training Monitoring
Cell (RTMC) of the CPSP, for registration as FCPS-II trainee and later
with the application for appearing in FCPS Part-II examination.

APPROVED TRAINING CENTRES
Training must be undertaken in units/departments/institutions
approved by the College. A current list of approved locations is
available from the College and its regional offices, as well as on the
College website: www.cpsp.edu.pk.
REGISTRATION AND SUPERVISION
All training must be supervised and Trainees are required to notify the
RTMC in case of any change of supervisor. Any training undertaken
without RTMC registration is not accepted as valid by the CPSP.
The supervisor will normally be a Fellow of the College. However
another supervisor may be accepted if there is no Fellow available to
offer appropriate supervision. Non-Fellows must be approved by the
College as supervisor.
Normally, only one supervisor is nominated, and if the Trainee spends
significant periods working in an area where the supervisor has no
personal involvement, the supervisor must certify that suitable
supervision is being provided. The nomination of more than one
supervisor is needed only if the Trainee divides the year between two
or more unrelated units, departments or institutions.
DURATION OF TRAINING IN OBSTETRICS & GYNAECOLOGY:
● Total duration of the training is 4 years divided into two phases
(IMM and advanced specialty training), all of which is to be
undertaken after passing FCPS I, and after registration with
RTMC and with an approved Supervisor at a CPSP accredited
unit/institution.
● The first two years of training, inclusive of rotations, will constitute
the Intermediate Module (IMM), at the end of which the trainee
enters the advanced phase of training in the specialty in the years
3 & 4.
● Upon completion of IMM training, trainee is expected to appear in
the Intermediate Module examinaton in Obstetrics and Gynaecology.
But passing of IMM examination is one of the eligibility
requirements before appearing in FCPS-II examination.
● All training inclusive of rotations is to be completed one month
before the date of theory examination for FCPS-II.
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ROTATION
One rotation of three months has to be carried out from the list given
below during 3rd or 4th year of FCPS-II training, excluding the one
done earlier in 1st and 2nd year of training in IMM:
1. Medicine
2. Neonatology
3. Diagnostic Imaging
COMPONENTS OF TRAINING
Mandatory Workshops
All mandatory workshops should be attended during the first two years
of training. Therefore no workshop is mandatory during the 3rd & 4th
year of training. However the trainee will be required to take any
workshop as may be introduced by the CPSP.
CPSP Obstetrics and Gynaecology 2010
Research (Dissertation / Two Papers)
One of the training requirements for fellowship trainees is a
dissertation or two research papers on a topic related to the field
of specialization. Synopsis of the dissertation or research papers
must be approved from the Research & Evaluation Unit (REU) of
CPSP before starting the research work. The dissertation or
research paper must be submitted for approval to the REU before
or during first six months of fourth year of training program.
Logbook
Trainees are required to maintain a logbook in which entries of all
academic / professional work done during the period of training should
be made on a daily basis and should be signed by the supervisor.
Completed and duly certified logbook will form a part of the application
for appearing in FCPS II Medicine examination.
8

E-logbook
The CPSP council has decided to introduce E-logbook system for all
trainees in FCPS from January 2009. Upon registration with RTMC
each trainee is allotted a registration number and a password to log
on to the e-logbook on the CPSP website. The trainee is required
to enter all work performed and the academic activities undertaken
in the logbook on daily basis. The concerned supervisor is required
to verify the entries made by the trainee. This system ensures timely
entries by the trainee and prompt verification by the supervisor. It
also helps in monitoring the progress of trainees and vigilance of
supervisors.
GENERAL REQUIREMENTS
Training should incorporate the principle of gradually increasing
responsibility, and provide each trainee with a sufficient scope,
volume and variety of experience in a range of settings that include
inpatients, outpatients, emergency and intensive care.
Instructional Methodology
Teaching occurs using several methods that range from formal
lectures to planned clinical experiences. Aspects covered will
include knowledge, skills and practices relevant to the discipline
in order to achieve specific learning outcomes and
competencies.
The theoretical part of the curriculum presents the current body of
knowledge necessary for practice. This can be imparted using
lectures, grand teaching rounds, clinico-pathological meetings,
morbidity/mortality review meetings, literature reviews and
presentations, journal clubs, conferences and seminars along with
self directed learning.
Clinical learning is organized to provide appropriate expertise
and competence necessary to evaluate and manage common
clinical problems. Demonstration in outpatient clinics and wards
and procedural skill training on simulators, mannequins and
patients are all practical training modalities.
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SUPERVISOR’S
ROLE AND RESPONSIBILITIES
Training held under the aegis of CPSP is compulsorily supervised. A
supervisor is a CPSP fellow or a specialist with relevant postgraduate
qualifications recognized by CPSP and registered as Supervisor with
RTMC.
Supervision is a multifaceted task and essential for the comprehensive
grooming of a trainee. The task is arbitrarily divided into the following
components for the sake of convenience. This division is by no means
exhaustive or rigid. It is merely meant to give semblance of order to
this comprehensive yet abstract and versatile role of the supervisor.
CPSP Obstetrics and Gynaecology 2010
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EXPERT TRAINER
●
●
●
●
●
●
This is the most fundamental role of a supervisor. He has to not
only ensure and monitor adequate training but also provide
continuous helpful feedback (formative) regarding the progress of
the training.
This would entail observing the trainee’s performance and rapport
with all the people within his work environment.
He / she should teach the trainee and help him / her overcome the
hurdles during the learning process.
It is the job of the supervisor to make the trainee develop the ability
to interpret findings in his patients and act suitably in response.
The supervisor must be adept at providing guidance in writing
synopsis and dissertation / research articles which are essential
components of training.
Every supervisor is required to participate in Supervisors’
workshops, conducted regularly by CPSP, and do his/her best to
implement the newly acquired information/ skills in the training. It is
his basic duty to keep abreast of the innovations in his field of
expertise and ensure that this information percolates to trainees of
all years under him/ her.

LIAISON WITH CPSP
● The supervisor must maintain regular contact with the College
regarding training and the conduct of various mandatory
workshops and courses.
● It is expected that the supervisor will establish direct contact with
relevant quarters of CPSP if any problem arises during the
training process, including the suitability of trainee.
● They must be able to coordinate with the administration of their
institutions/ organizations in order to ensure that their trainees do
not have administrative problems hampering their training.
PROFICIENT ADMINISTRATOR
● He/ she must ensure that the trainees have completed the
logbooks and authenticate them on a regular basis.
● They are expected to provide assessment reports to the College
at the end of each year or training period. These reports are used
to evaluate a trainee's performance. It should indicate if training
has been followed satisfactorily. The report must also contain
positive and deficient aspects of the trainee's performance and
any extra academic endeavors made by the trainees. Prolonged
absences must also be mentioned in sufficient detail. It is
essential that each report be discussed and signed both by the
trainer and the trainee before it is sent to the College.
● The supervisors might be required to submit confidential reports
on trainee's progress to the College.
● The supervisor should notify the College of any change in the
proposed approved training program.
● In case the supervisor plans to be away for more than two
months, he/ she must arrange satisfactory alternate supervision
during the period.
CPSP Obstetrics and Gynaecology 2010
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TRAINEE’S
ROLE AND RESPONSIBILITIES
Given the provision of adequate resources by the institution, Trainees
should accept responsibility for their own learning and ensure that it is
in accord with the relevant requirements. The trainee should:
1. investigate sources of information about the program and
potential Supervisor and play an informed role in the selection of
the Supervisor.
2. seek reasonable infrastructure support from their institution and
Supervisor, and use this support effectively.
3. ensure that they undertake training diligently.
4. accept responsibility for the dissertation, and plan and execute
the research within the time limits defined (six months before the
final exams).
5. be responsible for arranging regular meetings with the supervisor
to discuss any hindrance to progress and documenting the
progress. If the supervisor is not able/willing to meet the student
on a regular basis, the student should notify the College.
6. provide the supervisor with word-processed dated synopsis and
dissertation drafts that have been checked for spelling, grammar
and typographical errors, prior to submission.
CPSP Obstetrics and Gynaecology 2010
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7. ensure that the supervisor has all the relevant raw data prior to
submission of dissertation.
8. ensure that no intellectual property rights have been violated at
any time (i.e. plagiarisms is to be absolutely avoided).
9. submit the completed Dissertation or publish two research papers
in the CPSP approved journal six months before final exams.
10. follow the College complaint procedures if serious problems arise
11. complete all requirements for taking an examination.
12. feedback regarding the training post should be sent to the
College on the prescribed Confidential form.

CURRICULUM
TRAINING
PROGRAM
No academically sound institution would bank on a static curriculum. A
curriculum should be documented, objective, evolving and sustainable
(DOES). CPSP also endeavors to use a format which has scope for
transition and yet is relevant to the needs of the time. The curriculum
documented below is not rigid and all embracing. It is intended to give
a holistic view of the requirements of the discipline in general. The
Fellowship training program focuses on a few key pegs of viable
training: knowledge, skills and attitudes. CPSP is inclined to follow an
outcome based curricular format, which is a blend of behavioral and
cognitive philosophies of curriculum development.
Following is a global and extensive, yet not total, list of learning
outcomes recommended by the College.
Learning outcomes relating to:
KNOWLEDGE
1. Discuss etiology, pathogenesis, epidemiology, and management of
disorders in Obstetrics & Gynecology, as given in the section on
Specific Learning Outcomes(SLO).
2. Show initiative to become life long self directed learners tapping on
resources including clinical material, faculty, library, internet and
on-line learning programs.
3. Have understanding of and discuss Biostatistics and Epidemiology
of health and disease in Pakistan.
4. Advise policy makers & stakeholders in Pakistan on aspects of
Obstetrical & Gynecological disease in urban & rural settings,
exhibiting detailed knowledge of such problems in the community.
CPSP Obstetrics and Gynaecology 2010
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SKILLS
1. Manage skillfully pregnant women from conception to postnatal
period by:
- obtaining pertinent history.
- counseling individuals in the preconception period.
- examining the pregnant women at appropriate intervals.
- detecting pre-existing problems in pregnant women.
- detecting and treating any complications occurring during the
course of pregnancy which may be hazardous to the health of
the mother or child.
- dealing with the problem of mother and child occurring in the
post-natal period.
- advising methods regarding child spacing and family limitation.
2. Undertake research and publish findings.
3. Acquire new information, assess its utility and make appropriate
applications.
4. Recognize the role of team work and function as an effective
member/leader of the team.
5. Advise the community on matters related to promoting health and
preventing diseases.
6. Provide EMOC services in the community as define by the CPSP.
7. Train para professionals and other junior members of the team.
CPSP Obstetrics and Gynaecology 2010
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ATTITUDES
Towards Patients
The trainee will be able to:
1. establish a positive relationship with all patients in order to ease
illness and suffering.
2. facilitate the transfer of information important to the management
and prevention of disease.
3. demonstrate awareness of bio-psycho-social factors in the
assessment and management of a patient.

4. demonstrate sensitivity in performing any examination. All such
encounters should be chaperoned. It is important to explain to the
patient why an intimate examination is necessary and what the
examination will involve. The patient's permission must be
obtained and, where possible, the patient should be invited to bring
a relative or friend. The patient should have privacy to dress and
undress. The discussion should be kept relevant and avoid
unnecessary personal comments. Questions and feedback should
be encouraged throughout and at the end of the session.
5. consistently show consideration of the interests of the patient & the
community as paramount, and these interests should never be
subservient to one's own personal or professional interest.
Towards Self Development
The trainee will be able to:
1. demonstrate, consistently, respect for every human being
irrespective of ethnic background, culture, socioeconomic status or
religion.
2. deal with patients in a non-discriminatory and prejudice-free
manner.
3. deal with patients honestly and with compassion.
4. demonstrate flexibility and willingness to adjust appropriately to
changing circumstances.
5. foster the habit and principle of self-education and reflection in
order to constantly update and refresh knowledge and skills and as
a commitment to continuing education.
6. recognize stress in one self and others.
7. deal with stress and support medical colleagues and allied health
workers.
8. handle complaints including self-criticism or criticism by colleagues
or patients.
9. understand the importance of obtaining and valuing a second
opinion.
CPSP Obstetrics and Gynaecology 2010
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Towards Society
The trainee will be able to:
1. understand the social and governmental aspects of health care
provision.
2. offer professional services while keeping the cost effectiveness of
individual forms of care in mind.
3. apply an understanding of hospital and community-based
resources available for patients and care givers in rural areas.
4. demonstrate an understanding of health service management
and health economics in rural areas.
5. understand the use of 'telemedicine' in practicing health.
CLINICAL COMPETENCIES
The clinical competencies, a specialist must have, are varied and
complex. A list of the core procedural competencies including those
required during training in the Department of Obstetrics and
Gynaecology and the departments during rotations is given below.
The level of competencies to be achieved each year is specified
according to the key, as follows:
CPSP Obstetrics and Gynaecology 2010
LEVELS OF COMPETENCE
Level 1 Observes Observes the clinical activity
performed by a Colleague
Level 2 Assists Assists a colleague perform the
clinical activity
Level 3 Direct Supervision Performs the entire activity under
direct supervision of a senior
Level 4 Indirect Supervision Performs the entire activity with
indirect supervision of a senior
Level 5 Independent Performs the entire activity without
need of supervision
Note: Levels 4 and 5 for practical purposes are almost synonymous
16

COMPETENCIES
3 Months 6 Months
Level Cases Level Cases
Third Year
9 Months 12 Months
Level Cases Level Cases
Total Cases
3rd Year
OBSTETRICS
Eliciting Pertinent history 5 30 5 30 5 30 5 30 120
Performing physical examination 5 30 5 30 5 30 5 30 120
Requesting appropriate investigations 5 30 5 30 5 30 5 30 120
Interpreting the results of investigations 5 30 5 30 5 30 5 30 120
Deciding and implementing appropriate treatment 5 30 5 30 5 30 5 30 120
Managing immediate complications 5 30 5 30 5 30 5 30 120
Maintaining follow-up 5 30 5 30 5 30 5 30 120
Using ultrasound (basic) 5 7 5 7 5 7 5 7 28
Fetal monitoring (including CTG) 5 60 5 60 5 60 5 60 240
Amniocentesis for polyhydramnios 2 1 2 1 3 1 3 1 4
Management of medical disorders in pregnancy 5 20 5 20 5 20 5 20 80
CPSP Obstetrics and Gynaecology 2010
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CPSP Obstetrics and Gynaecology 2010
COMPETENCIES
3 Months 6 Months
Level Cases Level Cases
Third Year
9 Months 12 Months
Level Cases Level Cases
Total Cases
3rd Year
OBSTETRICS (Labour Room)
Assessment on admission 5 30 5 30 5 30 5 30 120
Medical induction of labour 5 10 5 10 5 10 5 10 40
Surgical induction of labour 5 15 5 15 5 10 5 10 50
Management of normal labour 5 15 5 15 5 15 5 15 60
SVD with and without episiotomy 5 15 5 15 5 15 5 15 60
Repair of vaginal & perineal tears 5 4 5 4 5 4 5 4 16
(excluding third degree tears)
Correction of inverted uterus (acute) 4 1 4 1 4 1 4 1 4
Repair of cervical tears 5 2 5 3 5 2 5 3 10
Immediate management of 5 5 5 5 5 5 5 5 20
post-partum haemorrhage
Outlet forceps delivery 5 5 5 5 5 5 5 5 20
Vacuum extraction 5 5 5 5 5 10 5 10 30
Breech, twin delivery, destructive operations, 5 - 5 - 5 - 5 - 15
craniotomy etc.
18

COMPETENCIES
3 Months 6 Months
Level Cases Level Cases
Third Year
9 Months 12 Months
Level Cases Level Cases
Total Cases
3rd Year
OBSTETRICS (Operative Skills)
Repair of ruptured uterus 4 2 4 2 4 3 4 3 10
Obstetric hysterectomy 4 1 4 1 4 1 4 1 4
Repair of third degree tears 4 1 4 1 4 1 4 1 4
Caesarean section 4 - 4 - 5 - 5 - 50
OBSTETRICS (Postnatal)
Resuscitation of neonate 5 20 5 10 5 10 5 10 50
Contraception counseling / advice 5 50 5 50 5 50 5 50 200
CPSP Obstetrics and Gynaecology 2010
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CPSP Obstetrics and Gynaecology 2010
COMPETENCIES
3 Months 6 Months
Level Cases Level Cases
Third Year
9 Months 12 Months
Level Cases Level Cases
Total Cases
4rd Year
GYNAECOLOGY (OPD / WARD)
Eliciting Pertinent history 5 40 5 40 5 40 5 40 160
Performing physical examination 5 40 5 40 5 40 5 40 160
Requesting appropriate investigations 4 40 4 40 5 40 5 40 160
Interpreting the results of investigations 4 40 4 40 5 40 5 40 160
Deciding and implementing appropriate treatment 3 40 3 40 4 40 4 40 160
Managing immediate complications 3 20 3 20 4 20 4 20 80
Maintaining follow-up 5 40 5 40 5 40 5 40 160
Taking Pap smears 4 5 4 5 4 5 4 5 20
Arranging assessment by an anesthetist 4 15 4 15 4 15 4 15 60
Colposcopy 3 3 3 3 3 2 3 2 10
Hystero-salpingography (injection of dye) 4 1 4 1 4 1 4 1 4
Cauterization of cervix /cryosurgery 3 2 3 2 4 3 4 3 10
Pipelle Sampling 3 5 3 5 3 5 4 5 20
Insertion of IUCD 4 3 4 3 4 4 4 5 15
GYNAECOLOGY - Operative Skills (General Skills) B 1
Scrubbing 5 15 5 15 5 15 5 15 60
Opening & Closing abdomen 5 10 5 10 5 15 5 15 50
20

COMPETENCIES
3 Months 6 Months
Level Cases Level Cases
Third Year
9 Months 12 Months
Level Cases Level Cases
Total Cases
3rd Year
GYNAECOLOGY - Operative Skills (Operations Skills) B 2
Evacuation of Retained products of conception 4 3 4 3 4 4 4 4 14
Dilatation & Curettage 4 3 4 3 4 4 4 4 14
Cervical Biopsy/LLETZ 4 1 4 1 4 1 4 1 4
Polypectomy 4 1 4 1 4 1 4 - 3
Marsupilization of Bartholin’s Cyst 4 1 4 1 4 1 4 - 3
Minilaparotomy (for tubal ligation) 4 2 4 2 4 2 4 - 6
Drainage of abscess (Pelvic) 4 1 4 1 4 1 4 1 4
Post-partum tubal ligation 4 1 4 1 4 1 4 - 3
Diagnostic laparascopy 3 3 3 3 3 2 4 2 10
Hysteroscopy 3 5 3 5 3 5 4 5 20
Ovarian cystectomy 3 1 3 1 3 1 4 1 4
Laparotomy for ectopic pregnancy 3 2 3 2 3 2 4 2 8
Myomectomy 2 1 2 - 2 - 2 - 1
Abdominal hysterectomy 3 1 3 2 4 3 4 4 10
Vaginal hysterectomy 3 1 3 2 3 2 4 2 7
Repair of prolapse 3 1 3 2 3 2 4 1 6
Tuboplasty 1 1 1 - 2 1 2 - 2
Repair of V V F 1 - 1 - 1 1 1 1 2
Repair of Rectovaginal Fistula 1 - 1 - 1 - 1 1 1
Vaginoplasty 1 - 1 - 1 - 1 1 1
Wertheim's operation 1 - 1 - 1 - 1 1 1
Vulvectomy 1 - 1 - 1 - 1 1 1
Radical Vulvectomy 1 - 1 - 1 - 1 1 1
Cervical Cerclage 3 1 3 1 3 1 3 1 4
CPSP Obstetrics and Gynaecology 2010
21

CPSP Obstetrics and Gynaecology 2010
COMPETENCIES
15 Months
Level Cases
Fourth Year
18 Months 21 Months
Level Cases Level Cases
Total Cases
4th Year
OBSTETRICS
Eliciting Pertinent history 5 30 5 30 5 20 80
Performing physical examination 5 30 5 30 5 20 80
Requesting appropriate investigations 5 30 5 30 5 20 80
Interpreting the results of investigations 5 30 5 30 5 20 80
Deciding and implementing appropriate treatment 5 30 5 30 5 20 80
Managing immediate complications 5 30 5 30 5 20 80
Maintaining follow-up 5 30 5 30 5 20 80
Using ultrasound (basic) 5 7 5 7 5 8 22
Fetal monitoring (including CTG) 5 60 5 60 5 60 180
Amniocentesis for polyhydramnios 3 1 3 1 3 1 3
Management of medical disorders in pregnancy 5 20 5 20 5 20 60
22

COMPETENCIES
15 Months
Level Cases
Fourth Year
18 Months 21 Months
Level Cases Level Cases
Total Cases
4th Year
OBSTETRICS (Labour Room)
Assessment on admission 5 30 5 30 5 20 80
Medical induction of labour 5 20 5 20 5 20 60
Surgical induction of labour 5 10 5 10 5 10 30
Management of normal labour 5 15 5 15 5 10 60
SVD with and without episiotomy 5 15 5 15 5 10 40
Repair of vaginal & perineal tears (excluding third degree tears) 5 4 5 4 5 4 12
Correction of inverted uterus (acute) 4 1 4 1 4 1 3
Repair of cervical tears 5 2 5 2 5 1 5
Immediate management of post-partum haemorrhage 5 5 5 5 5 5 15
Outlet forceps delivery 5 6 5 6 5 8 20
Vacuum extraction 5 6 5 6 5 8 20
Breech, twin delivery, destructive operations, craniotomy etc. 5 5 5 5 5 5 15
CPSP Obstetrics and Gynaecology 2010
23

CPSP Obstetrics and Gynaecology 2010
COMPETENCIES
15 Months
Level Cases
Fourth Year
18 Months 21 Months
Level Cases Level Cases
Total Cases
4th Year
OBSTETRICS (Operative Skills)
Repair of ruptured uterus 4 1 4 1 4 - 2
Obstetric hysterectomy 4 1 4 1 4 - 2
Repair of third degree tears 4 1 4 1 4 - 2
Caesarean section 5 10 5 15 5 25 50
OBSTETRICS (Postnatal)
Resuscitation of neonate 5 10 5 10 5 10 30
Contraception counseling / advice 5 50 5 50 5 50 150
24

COMPETENCIES
15 Months
Level Cases
Fourth Year
18 Months 21 Months
Level Cases Level Cases
Total Cases
4th Year
GYNAECOLOGY (OPD / WARD)
Eliciting Pertinent history 5 35 5 35 5 35 105
Performing physical examination 5 35 5 35 5 35 105
Requesting appropriate investigations 5 35 5 35 5 35 105
Interpreting the results of investigations 5 35 5 35 5 35 105
Deciding and implementing appropriate treatment 4 25 5 25 5 25 75
Managing immediate complications 5 25 5 25 5 25 75
Maintaining follow-up 5 35 5 35 5 35 105
Taking Pap smears 5 10 5 10 5 10 30
Arranging assessment by an anesthetist 5 20 5 20 5 20 60
Colposcopy 3 5 3 5 3 5 15
Hystero-salpingography (injection of dye) 5 2 5 2 5 2 6
Cauterization of cervix /cryosurgery 5 2 5 2 5 1 5
Pipelle Sampling 4 5 5 5 5 5 15
Insertion of IUCD 5 5 5 5 5 5 15
GYNAECOLOGY - Operative Skills (General Skills) B 1
Scrubbing 5 20 5 20 5 20 60
Opening & Closing abdomen 5 15 5 15 5 20 50
CPSP Obstetrics and Gynaecology 2010
25

CPSP Obstetrics and Gynaecology 2010
COMPETENCIES
15 Months
Level Cases
Fourth Year
18 Months 21 Months
Level Cases Level Cases
Total Cases
4th Year
GYNAECOLOGY - Operative Skills (Operations Skills) B 2
Evacuation of Retained products of conception 5 5 5 5 5 6 16
Dilatation & Curettage 5 5 5 5 5 6 16
Cervical Biopsy/LLETZ 5 2 5 2 5 2 6
Polypectomy 5 1 5 1 5 - 2
Marsupilization of Bartholin’s Cyst 5 1 5 1 5 - 2
Minilaparotomy (for tubal ligation) 4 2 4 2 4 2 6
Drainage of abscess (Pelvic) 4 1 4 1 5 1 3
Post-partum tubal ligation 4 1 4 1 4 - 2
Diagnostic laparascopy 4 2 4 2 4 2 6
Hysteroscopy 4 5 5 5 5 5 15
Ovarian cystectomy 4 1 4 1 4 1 3
Laparotomy for ectopic pregnancy 4 2 4 2 5 2 6
Myomectomy 3 1 3 - 3 - 1
Abdominal hysterectomy 4 3 4 4 4 3 10
Vaginal hysterectomy 4 2 4 2 5 2 6
Repair of prolapse 4 2 4 2 5 2 6
Tuboplasty 2 1 2 - 2 - 1
Repair of V V F 2 1 2 1 2 - 2
Repair of Rectovaginal Fistula 2 1 2 - 3 - 1
Vaginoplasty 2 1 2 - 2 - 1
Wertheim's operation 2 1 2 - 2 - 1
Vulvectomy 2 1 2 - 2 - 1
Radical Vulvectomy 2 1 2 - 2 - 1
Cervical Cerclage 3 1 4 1 4 - 2
26

ROTATIONAL TRAINING
Three Months Rotations
ROTATIONS
Level Cases
NEONATOLOGY
Neonatal Examination 1,2,3,4 10 each
Neonatal Resuscitation 1,2,3,4 10 each
Emergency drug dosage and side effects 1,2,3,4 5 each
I / V fluids in first seven days 1,2,3,4 5 each
Management of LBW 1,2,3,4 5 each
Recognition of Sepsis & emergency care 1,2,3,4 5 each
IMCI (Integrated management of Childhood illness) 1,2,3,4 5 each
Vaccination 1,2,3,4 5 each
Recognition & emergency management of danger signs like.
i. Jaundice 1,2,3,4 10 each
ii. Respiratory distress 1,2,3,4 10 each
iii. Convulsions 1,2,3,4 10 each
iv. CCT 1,2,3,4 10 each
v. Anaemia 1,2,3,4 10 each
vi. Peripheral Circulatory Failure 1,2,3,4 10 each
CPSP Obstetrics and Gynaecology 2010
27

CPSP Obstetrics and Gynaecology 2010
ROTATIONS
Three Months Rotations
Level Cases
MEDICINE
Medical problems relevant to OBG / GYN like
Diabetes Mellitus 1,2,3,4,5 10 each
Hypertension 1,2,3,4,5 10 each
Liver Disease 1,2,3,4,5 10 each
Anaemia 1,2,3,4 10 each
Renal Diseases 1,2,3,4 10 each
Thyroid Diseases 1,2,3,4 10 each
Epilepsy 1,2,3,4 10 each
Viral Diseases 1,2,3,4,5 10 each
Preventive Management 1,2,3,4,5 10 each
History, examination, Appropriate investigation and treatment of
Paracentesis 1,2,3 5 each
Aspiration 1,2,3 5 each
Liver Biopsy 1 5
Case Presentation/ Journal Club 5 3
28

ROTATIONS
Three Months Rotations
Level Cases
DIAGNOSTIC IMAGING
Basics of Ultra Sound Scan 1,2,3,4 10 each
Diagnosis of IU Pregnancy 1,2,3,4 10 each
Fetal Biometry 1,2,3 10 each
Placental Localisation 1,2,3 10 each
BPP 1,2,3 10 each
Diagnosis of Ectopic pregnancy 1,2 10 each
Identification of normal ovary & Uterus 1,2 10 each
Ovarian Follicle 1,2,3 10 each
Ovarian Cyst alongwith its characteristics 1,2,3 10 each
Interpertation of X-Ray Chest 1,2,3,4 15 each
Interpertation of HSG 1,2,3,4 10 each
Interpertation of CT 1,2 5 each
Interpertation of MRI 1,2 5 each
CPSP Obstetrics and Gynaecology 2010
29

ASSESSMENT
ELIGIBILITY REQUIREMENTS FOR FCPS-II IN OBSTETRICS AND
GYNAECOLOGY EXAMINATION:
The eligibility requirements for candidates appearing in
FCPS-II examination in Obstetrics and Gynaecology are:
1. To have passed FCPS Part-I in Obstetrics and Gynaecology and
allied, or been granted official exemption.
2. To have undertaken four years of the specified training in
Obstetrics and Gynaecology, all of which should be after passing
FCPS Part-I (a certificate testifying attendance is obligatory for
admittance to examination) in an institution recognized by the
CPSP
3. To provide a certificate of attendance of mandatory workshops.
4. To submit a completed and duly attested logbook.
5. To provide a certificate of having passed the Intermediate Module
in Obstetrics and Gynaecology.
6. To provide a certificate of approval of dissertation or acceptance of
two research papers for publication in CPSP approved journals,
synopsis of which were earlier approved by the RTMC.
CPSP Obstetrics and Gynaecology 2010
30
FORMAT OF EXAMINATIONS
Theory Examination
The written examination will comprise of two theory papers of 3 hours
duration each:
Paper I 10 Short Essay Question - SEQs
Paper II 75 One Best type of MCQs
25 Extended Matching type - EMQs
Clinical Examination
Only those candidates who pass the theory examination will be eligible
to appear in the clinical examination. Detailed instructions will be sent
out to all candidates who pass the theory exam regarding the date and
particulars of the clinical exam.

The clinical examination consists of:
1. TOACS (Task Oriented Assessment of Clinical Skills) - 15 to 20
stations
2. Long case - One
3. Short cases - Four
Short Essay questions
Rationale: Short essay questions are meant to increase the
appropriateness of the examination by increasing the number of topics
being tested. In this sense they are better than long essay questions
that candidates might be used to. Further, short essay questions are
more focused than long essay ones because they are meant to clearly
specify what candidates are expected to write. These types of
questions assess higher order thinking, for example critical analysis of
a given situation. It is hoped that these questions will encourage
originality and creativity in answers. It is also hoped that these
questions will discourage bluffing, rambling and undue advantage
gained by proficiency in English language without the required level of
clinical knowledge.
FORMAT OF TOACS
Tasks-Oriented Assessment of Clinical Skills (TOACS) has been
introduced as of Novmeber, 2001 in FCPS II examinations.
TOACS will comprise of 15-20 stations of 5-8 minutes each with a
change time of one minute for the candidate to move from one station
to the other. Structured clinical tasks will be set at each station. The
examiners using a global rating scale will assess the performance of
each candidate. On stations where no examiner is present the
candidates will have to submit written responses to short answer
questions on a response sheet.
There will be two types of stations: static and interactive. On static
stations the candidate will be presented with patient data, a clinical
problem or a research study and will be asked to give written
responses to questions asked. In the interactive stations the candidate
will have to perform a procedure, for example, taking history,
performing clinical examination, counseling, assembling an instrument
etc. One examiner will be present at each interactive station and will
either rate the performance of the candidate or ask questions testing
reasoning and problem-solving skills.
CPSP Obstetrics and Gynaecology 2010
31

FORMAT OF LONG CASE
Each candidate will be allotted two long cases (one of Obstetrics and
the other of Gynaecology). They will be allowed 30 minutes for history
taking and clinical examination for each case. Candidates should take
a careful history from the patient (or relative) and after a thorough
physical examination identify the problems which the patient presents
with. During this period a pair of examiners will observe the candidate.
Each examiner is provided separate assessment form for recording the
performance of the candidate on the long case on a 5-point rating scale
(excellent, good, adequate, inadequate and poor).
In this section the candidates will be assessed on the following
areas:
Interviewing skills
1. Introduces one self. Listens patiently and is polite with the
patient.
2. Is able to extract relevant information.
Clinical examination skills
1. Takes informed consent
2. Uses correct clinical methods systematically (including
appropriate exposure and re-draping).
CPSP Obstetrics and Gynaecology 2010
32
Case presentation/ discussion.
1. Presents skillfully
2. Gives correct findings
3. Gives logical interpretations of findings and discusses
differential diagnosis.
4. Enumerates and justifies relevant investigations.
5. Outlines and justifies treatment plan (including rehabilitation).
6. Discusses prevention and prognosis.
7. Has knowledge of recent advances relevant to the case.
8. During case discussion the candidate may ask the examiners
for laboratory investigations which shall be provided, if available.
Even if they are not available and are relevant, candidates will
receive credit for the suggestion.
Note: The candidate is required to fill a self explanatory ‘feedback
proforma’ at the end of the examination. This will help the College in
improving the future examinations and making them more candidate
friendly.

THE COLLEGE RESERVES THE RIGHT TO ALTER/AMEND ANY
RULES/REGULATIONS.
Any decision taken by the College on the interpretation of these
regulations will be binding on the candidate.
EXAMINATION SCHEDULE
1. The Fellowship theory examination in Medicine will be held
twice a year.*
2. Theory examinations are held in various cities of the country
usually at Abbottabad, Bahawalpur, Faisalabad, Hyderabad,
Islamabad, Karachi, Lahore, Larkana, Nawabshah, Multan,
Peshawar and Quetta centres. The College shall decide where to
hold clinical examination depending on the number of candidates
in a city and shall inform the candidates accordingly.*
3. English shall be the medium of examination for the theory and
clinical examinations.
4. The College will notify of any change in the centres, the dates and
format of the examination.
5. A competent authority appointed by the College has the power to
debar any candidate from any examination if it is satisfied that such
a candidate is not a fit person to take the College examination
because of using unfair means in the examination, misconduct or
other disciplinary reasons.
6. Each successful candidate in the Fellowship examination shall be
entitled to the award of a College Diploma after being elected by
the College Council and payment of registration fee & other dues.
EXAMINATION FEES
1. Fees deposited for a particular examination shall not be carried
over to the next examination in case of withdrawal/ absence/
exclusion/ any other reason under normal circumstances.
2. Applications along with the prescribed examination fees and
required documents must be submitted by the last date notified for
this purpose before each examination.
3. The details of examination fee and fees for change of centre,
subject, etc. shall be notified before each examination.
*The CPSP reserves the right to alter dates, postpone examinations or change venue
in the interest of safety and well being of its staff, invigilators and / or candidates.
CPSP Obstetrics and Gynaecology 2010
33

REFUND OF FEES
1. If, after submitting an application for examination, a
candidate decides not to appear, a written request for a
refund must be submitted before the last date for withdrawl with
the receipt of applications. In such cases a refund is admissible
to the extent of 75% of fee only. No request for refund will be
accepted after the closing date for receipt of applications.
3. Fee deposited for a particular examination shall not be carried
over to the next examination in case of withdrawal /
absence/exclusion.
4. If an application is rejected by the CPSP, 75% of the
examination fee will be refunded, the remaining 25%
being retained as a processing charge. No refund will be made
for fee paid for any other reason, e.g. late fee, change of
centre/subject fee, etc.
Note: The candidate is required to fill a self explanatory 'feedback
proforma' at the end of the clinical examination. This will help the
College in making future examination more candidate friendly.
CPSP Obstetrics and Gynaecology 2010
34

FREQUENTLY
ASKED
QUESTIONS
Q. Can you tell me what opportunities are available for a
medical graduate to pursue postgraduate studies in
Pakistan
Students can opt for joining fellowship and membership programs
offered by CPSP or join the programs offered by various universities
such as M.S., M.D. and other diplomas.
Q. Who can sit the FCPS Part I examination
●
●
Medical and Dental School Graduates - All applicants must
have graduated from a dental/ medical college recognised by
the PMDC.
One (1) year of house job - All applicants, for FCPS I must
complete a postgraduate clinical year in an approved institution.
Q. How do I apply for FCPS I examination
The application forms are available with the examination
department at the CPSP - Karachi as well as all the regional
centres of the College
Q. What are the requirements for appearing in FCPS I
examintion
Requirements for a physician to enter into postgraduate fellowship
training include:
●
●
Medical School Graduates - All applicants must have
graduated from a dental/ medical college recognised by the
PMDC.
One (1) year of house job - All applicants, for FCPS I must
complete a postgraduate clinical year in an approved hospital.
CPSP Obstetrics and Gynaecology 2010
35

Q. What are the requirements to be completed before
appearing in FCPS II examination
1. Three (3) to five (5) years in a residency program -
2. In addition to a house job, all applicants must satisfactorily
complete a residency training program including specified
rotations accredited by the College of Physicians & Surgeons
Pakistan.
3. Attendance of mandatory workshops
4. Submission of a completed logbook
5. Submission of approved dissertation
After successfully completing these requirements, a candidate
may sit for the FCPS Part II examination.
Q. Where can I get more information about specific
postgraduate programs offered by the CPSP
All information pertaining to the training program is outlined in the
relevant subject Prospectus. This is available at all regional
centres of the College on payment of the prescribed fee.
CPSP Obstetrics and Gynaecology 2010
36
Q. I hold a foreign qualification. Do I need an equivalence
certificate and from whom
A. If you hold a recognised specialist certificate confirming your
specialist training in another country you should apply directly to
the Pakistan Medical and Dental Council (PMDC) for an
equivalence certificate. However, if your qualification is not
recognised by the PMDC you could apply to be assessed as an
overseas trained specialist.

USEFUL
ADDRESSES AND
TELEPHONE
NUMBERS
1. Regional Offices of the CPSP
MUZAFFARABAD
CMH Muzaffarabad
Azad Kashmir
TEL: 058810 - 43307
FAX: 058810 - 43902
Email: ssgr-brehman@cpsp.edu.pk
ABBOTTABAD
Ayub Hospital Complex
Abbottabad
TEL: 0992-383330
Email: rc_abbottabad@cpsp.edu.pk
PESHAWAR
Hayatabad Medical Complex
Phase IV, Hayatabad,
Peshawar
UAN: 091-111-666-666
TEL: 091-9217011, 091-9217320-1
FAX: 091-9217062
Email: rc_peshawar@cpsp.edu.pk
ISLAMABAD
P.I.M.S, Ravi Road, Sector G- 8/ 3
Islamabad.
UAN: 051-111-666-666
TEL: 051-9262590-1,
FAX: 051-9262592
Email: rc_islamabad@cpsp.edu.pk
FAISALABAD
Punjab Medical College
Faisalabad
UAN: 041-111-666-666
TEL: 041-9210131, 9210366-8
FAX: 041-9210224
il:rc_faisalabad@cpsp.edu.pk
LAHORE
Next to INMOL, Hospital
New Muslim Town, Block-D
Lahore.
UAN: 042-111-666-666
TEL: 042- 9231320-8
FAX: 042- 9231327
Email: rc_lahore@cpsp.edu.pk
MULTAN
Nishtar Medical College,
Distt. Jail Road, Opp Circuit House,
Multan.
UAN: 061-111-666-666
TEL: 061-9200946, 9200952
Email: rc_multan@cpsp.edu.pk
BAHAWALPUR
Quaid-e-Azam Medical College
Bahawalpur
TEL: 062- 9250461
Email: rc_bahawalpur@cpsp.edu.pk
NAWABSHAH
Peoples Medical College for Girls
Nawabshah
TEL: 0244-9370271, 9370479
FAX: 0244-9370478
Email: rc_nawabshah@cpsp.edu.pk
LARKANA
Chandka Medical College
Larkana
TEL: 074 – 9410726
Email: rc_larkana@cpsp.edu.pk
CPSP Obstetrics and Gynaecology 2010
37

HYDERABAD
Liaquat University Hospital, Jamshoro
Hyderabad
TEL: 022-3877393
Email: rc_hyderabad@cpsp.edu.pk
QUETTA
CPSP Bolan Medical College
Sandeman Civil Hospital
TEL: 081- 9202424
Email: rc_quetta@cpsp.edu.pk
2.
KARACHI
Departments of CPSP Karachi
OVERSEAS CPSP CENTRES
UAN – 021-111-606-606
● Examination (FCPS Part I)
9207100 -10 Ext: 311
●
●
Examination (FCPS Part II)
9207100 -10 Ext: 215
Department of Medical
Education
9207100 -10 Ext: 305
● Registration, Training &
Monitoring Cell
9207100 -10 Ext: 320
For further Information visit the
College website at:
www.cpsp.edu.pk
3. Saudi Arabia
RIYADH
Saudi Commission for Health
Specialities,
Diplomatic Quarter, P.O. Box 94656
Riyadh -11614, KSA.
TEL: 966-1-4822415 Ext: 156/141
966-2-6401000 Ext: 25843
Email: medexam5@scfhs.org
4. Nepal
KATHMANDU
T.U. Institute of Medicine
Maharajganj, Kathmandu, Nepal
TEL: 977-1- 416224
Email: cpsp@iomdit.org.np
CPSP Obstetrics and Gynaecology 2010
38

ADDENDUM FCPS II PROSPECTUS
OBSTETRICS AND GYNECOLOGY
This Addendum is to be read after Page 29 of the prospectus
SPECIFIC LEARNING OUTCOMES (SLOS)
SLOs are guidelines for adopting modes of information transfer for
training as part of overall Instructional Strategy in the training program.
These SLOs are the minimum desirable level to be achieved at the end
of supervised training and will also serve as components of tools for
assessment in the Part II FCPS Examination. It is emphasized that
these SLOs are not meant to be comprehensive or all encompassing
and clinical spectrum of experience may require greater exposure to
other topics.
SLOS IN OBSTETRICS
Antenatal
Antenatal Care
● Book patients for confinement
● Identify and manage high risk pregnancy
● Involve inter-disciplinary referral where indicated
● Plan frequency of antenatal visits
● Perform Obstetric ultrasound
● Identify and manage patients with drug and substance abuse
● Understand principles of safe medication in pregnancy
Screening
● Carry out 1st and 2nd trimester screening for fetal abnormalities
● Counsel and manage abnormal result on a screening or diagnostic
test for fetal abnormality
Monitoring
● Critical evaluation of fetal growth and well being
● Diagnosis and management of fetal abnormality
● Manage pregnancies with fetal congenital anomalies appropriately
● Diagnose and manage IUGR
CPSP Obstetrics and Gynaecology 2010
A

Preterm labor / PROM
●
Diagnose and manage preterm labor and PROM
Antepartum Hemorrhage
●
●
Diagnose types of APH
Manage all severities of APH and subsequent complications
Intra Uterine Death (IUD)
●
●
●
Confirm etiology as much as possible
Manage IUD pregnancy
Perform appropriate follow up / subsequent advice
Multiple Pregnancy
●
●
●
Monitor multiple pregnancy and offer effective antenatal care
Conduct appropriate labor
Manage complications of multiple pregnancy
Prolonged pregnancy
●
●
Manage and monitor prolonged pregnancy
Induce labor effectively and appropriately
Hydramnios
●
Investigate and manage pregnancy with Hydramnios
CPSP Obstetrics and Gynaecology 2010
B
Rh Incompatibility
●
●
Understand and implement principles of prevention
Manage and appropriately make in-utero or ex-utero transfer
Medical Disorders with Pregnancy
specially Hypertension, Diabetes, Anemia and hematological
disorders, Cardiac Disease, Asthma, Epilepsy, Tuberculosis, Renal
disease, Hepatitis and Jaundice, thrombo embolism, thyroid disorder
● Diagnosis of disease and its risk factors
● Manage and deliver pregnancies thus affected
● Appropriate liaison with physicians

INTRAPARTUM
Normal labor and delivery
●
●
●
●
●
●
Care for first stage of labor
Offer labor analgesia
Monitor labor effectively, identifying and managing clinical problems
including emergencies, as and when they arise
Evaluate CTG and take appropriate action
Conduct normal vaginal delivery with and without episiotomy
Manage third stage of labor
Operative Delivery
● Manage outlet forceps delivery
● Manage ventouse delivery
● Manage assisted breech delivery
● Manage malpresentations
● Carry emergency and elective Cesarean Section skillfully for
medical and ethical indications
● Diagnose and manage complications of operative delivery
EmOC
● Have knowledge of principles of Emergency Obstetric care
● Advise policy makers and health organizations about EmOC
POST-DELIVERY
Puerperium
●
●
●
●
●
Manage Postpartum hemorrhage
Guide breast feeding and identify problems in relation to it
Investigate and mange puerperal fever
Detect, diagnose “postpartum blues” and depression
Detect and refer complicated Psychiatric issues.
Neonatal Care
●
●
Manage basic resuscitation of newborn
Undertake routine care of newborn
CPSP Obstetrics and Gynaecology 2010
C

SLOS IN GYNECOLOGY
Reproductive Endocrinology
Adolescent and Pediatric Gynecology
●
●
●
Manage Intersex disorders
Manage Primary amenorrhea
Manage disorders of Puberty
Miscarriage, Ectopic and TOP
●
●
●
●
●
Manage various types of miscarriage
Evaluate and manage Recurrent Early Pregnancy loss
Diagnose and manage Ectopic pregnancy
Evaluate, select and mange TOP
Manage Septic abortion
Infertility and Assisted Reproduction
●
●
●
Investigate the infertile couple
Select appropriate management strategies for Infertility
Be aware of principles of Assisted Reproductive techniques
Hirsutism and PCO
●
●
●
Investigate and manage Hirsutism
Diagnose and manage PCO
Liaise with Dermatologist when indicated
CPSP Obstetrics and Gynaecology 2010
D
Menopause
●
●
Diagnose problems in relation to Menopause
Understand current concepts regarding feasibility of Hormone
Replacement Therapy (HRT)
Menstrual disorders
●
●
●
Investigate and manage menorrhagia in reproductive age group
Manage Oligomenorrhea and Secondary amenorrhea
Diagnose and manage Premenstrual Syndrome (PMS)

Psychosexual Medicine
●
Understand and manage common psychosexual problems
Endometriosis
●
●
Diagnose endometriosis
Manage Endometriosis medically and surgically
Lieomyomata
●
Diagnose and manage uterine fibroids
Contraception and Family Planning
●
●
●
●
●
Offer appropriate contraceptive method
Carry out all contraceptive procedures
Have understanding of current contraceptive methods
Manage side effects and complications of different contraceptive
methods
Detailed knowledge of Health statistics of Pakistan
GYNECOLOGIC ONCOLOGY
●
●
●
●
●
●
Have basic knowledge and concepts about Epidemiology,
Genetics and Molecular Biology of Gynecologic cancer
Understand principles of Radiotherapy and Chemotherapy
Manage specially Ovarian, Endometrial, Cervical, Vulval cancers
and Gestational Trophoblastic Disease
Manage pre-invasive disease of Vulva and Cervix
Manage adnexal cysts
Provide supportive, terminal and palliative care to Cancer patients
CPSP Obstetrics and Gynaecology 2010
E

WOMEN'S REPRODUCTIVE HEALTH
Reproductive Health (RH)
●
●
●
Apply concepts and components of RH according to local
circumstances
Have detailed knowledge of factors in Maternal morbidity & mortality
Undertake counseling and informational care in all situations
demanding Psychosocial management, e.g., bereavement,
breaking bad news, surgical complications.
Women's Rights to Sexual and Reproductive Health (WRSRH)
● Discuss the concepts of WRSRH
● Effectively counsel, protect, promote, and advance Women's Rights
to SRH
● Understand principles of management of Violence against women
Pelvic Pain and PID
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Diagnose and manage all types of Vaginal discharge
Diagnose and manage acute and chronic PID
Understand principles of management of HIV
CPSP Obstetrics and Gynaecology 2010
F
UROGYNECOLOGY
Urinary Incontinence
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Evaluate and interpret varied urinary symptoms
Order and interpret relevant Urodynamic investigations
Manage Genuine Stress Incontinence and Detrusor Instability
Understand principles of VVF repair
Utero vaginal prolapse
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Understand principles of prevention
Evaluate types of UV prolapse
Manage prolapse conservatively and surgically
Understand principles of management of Vault prolapse
Urinary tract infections
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Evaluate UTI
Manage and follow-up UTI