STUDENT NAME: MATRIC NO: SUPERVISOR: YEAR / GROUP:
ASSESSMENT OF SURGICAL CASE WRITE-UP:
History Mental state & Physical Examination Biological & Psychological Diagnosis/Differential Diagnosis Identify problems, management and progress of patient Preventive + community health Prognosis & Outcome Discharge Summary Referral letter Prescription References
Total Score MARKS FOR CORE CLINICAL COMPONENT
/ 10
PROFESSIONALISM Part 1 : Issues on Professionalism Part 2 : Reflection & Life Long Learning /10 /10 Total Score MARKS FOR PROFESSIONALISM COMPONENT