This document contains an assessment form for a medical houseman. It evaluates the houseman's knowledge and competency in various medical topics like cardiology, infection, endocrine, neurology, electrolyte imbalance, respiratory, abdomen, skin, and connective tissue diseases. It also assesses procedural and clinical skills, teamwork, participation in continuing professional development programs, handling of hazards, and infectious control. The form rates the houseman's performance in various areas as poor, acceptable or excellent and includes space for comments. It is used to provide an overall assessment of whether the houseman passed or failed.

1. Medical topics
Essential for end posting

2. MedicalHousemanAssessmentForm
Name: I.C:
TypeofAssessment:(offtag/cont.assessment/E
OP/2ndEOP)
A.Knowledge/Competency

3. Cardiology
1.ECG
2.ACSandMI+Management
3.HypertensionanditsEmergency
4.HeartFailure
5.Managementofarrhythmias
(AF/SVT)
6.VT/VFandasystole
7.DVTandPulm.Embolism
Infection
1.Denguefever
2.Malaria/Leptospirosis
3.Typhoid

4. Endocrine
1.DM/Hypoglycemia/DKA/HHS
2.Hyper/Hypothyroidism
3.Cushingsynd.
4.Adrenalinsuff.
NeurologyandManagement
1.Stroke
2.Bell’spalsy
3.Epilepsy
4.Meningoencephalitis

5. Electrolyteimbalance
1.Ca/K/Na/Mganditscauseandmx
Respiratory
1.BA/COPD
2.Pneumonia
3.TBandANTI-TB
4.Pneumothorax
5.Pleuraleffusion
6.Empyema
AbdomenandHBS
1.Chronicliverdisease
2.HepB/C
3.AKI
4.NephroticSyndrome
5.CKD/ESRF
6.Inflammatoryboweldisease

6. Skin
1.SIS
2.TEN
ConnectiveTissueDisease
1.SLE
2.RA
Misc
1.Paraquate/OPpoisoning
2.PCMoverdose
3.Salicylatepoisoning
4.Antidepressant/antipsyoverdose
5.Snakebites
Others
1.Caseclerking
2.Accuracyofdiagnosis
3.Presentation
4.Mxofpatient

7. D/Dx
1.Chestpain
2.SOB
3.Legswelling
4.Epigastricpain
5.Headache

8. Poor Acceptable Excellent
Punctuality
Communicationskills
Relationshipwithpatientsanddoctors
Basicproceduralskills
Teamwork
Initiativeness
Leadershipquality
ParticipationinCPDprogram
Participationindepartmentalactivities
Safehandlingofhazards
Infectiouscontrol
Assessor1:
Dateofassessment:
Assessor2:
Overallassessment:PASSED / FAILED
B.DisciplineandAttitude
Comment: