Guidelines

for

Competency Based Training Programme

in

FNB-
Pediatric Gastroenterology

NATIONAL BOARD OF EXAMINATIONS

Medical Enclave, Ansari Nagar, New Delhi-110029, INDIA
Email: mail@natboard.edu.in Phone: 011 45593000

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 CONTENTS

I. INTRODUCTION

II. OBJECTIVES OF THE PROGRAMME

a) Programme goal
b) Programme objective

III. ELIGIBILITY CRITERIA FOR ADMISSION

IV. TEACHING AND TRAINING ACTIVITIES

V. SYLLABUS

VI. COMPETENCIES

VII. LOG BOOK

VIII. NBE LEAVE GUIDELINES

IX. EXAMINATION

a) FORMATIVE ASSESSMENT
b) FINAL THEORY & PRACTICAL

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INTRODUCTION

The specialty of Pediatric Gastroenterology developed as a Sub-Specialization of

Pediatrics and is predominantly concerned with the care of pediatric patients with
gastrointestinal problems. It is a branch of Pediatrics concerned with prevention,
investigation and therapy of and research into diseases involving gastrointestinal
disorders.

PROGRAMME GOAL

1. To prepare pediatric gastroenterologists who would be able to meet and

respond to the changing healthcare needs and expectations of the society.
2. To develop pediatric gastroenterologists who posses knowledge, skills
and attitudes that will ensure that they are competent to practice
gastroenterology safely and effectively.
3. To ensure that they have appropriate foundation for lifelong learning and
further training in their specialty.
4. To help them develop to be critical thinkers and problem solvers when
managing health problems in the community they serve.

PROGRAMME OBJECTIVES

The educational and training process aims to produce Pediatric

gastroenterologists who:

Can address all aspects of healthcare needs of patients and their families.
Maintain highest standards appropriate in their professional field.
Are aware of current thinking about ethical and legal issues.

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 Are Able to acts as safe independent practitioners whilst recognizing the
limitation of their own expertise and are able to recognize their obligation
to seek assistance of colleagues where appropriate.
Are aware of the procedures and able to take appropriate action, when
things go wrong, both in their own practice and in that of others.
Will be honest and objective when assessing the performance of those
they have supervised and trained.
Can take advantage of information technology to enhance all aspects of
patient care.
Can develop management plans for the whole patient and maintain
knowledge in other areas of medicine which impinge on the specialty of
Pediatric Gastroenterology.
Understand that effective communication between them and their patients
can lead to more effective treatment and care.
Apply appropriate knowledge and skill in the diagnosis and management
of patients.
Establish a differential diagnosis for patients presenting with medical
problems by the appropriate use of the clinical history, examination and
investigations.
Are competent to perform the core investigations and procedures required
in their specialties.
Develop clinical practice which is based on an analysis of relevant clinical
trials and have an understanding of their research methodologies.
Are able to apply the knowledge of biological and behavioral sciences in
clinical practice.
Are able to identify and take responsibility for their own educational needs
and attainment of these needs.
Have developed the skills of an effective teacher.

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ELIGIBILITY CRITERIA FOR ADMISSIONS TO THE PROGRAMME

(A) FNB Pediatric Gastroenterology Course:

1. Any medical graduate with DNB/ MD Pediatrics qualification , who has

qualified the Entrance Examination conducted by NBE and fulfill the
eligibility criteria for admission to FNB Pediatric Gastroenterology courses
at various NBE accredited Medical Colleges/ institutions/Hospitals in India
is eligible to participate in the Centralized counseling for allocation of FNB
Pediatric Gastroenterology seats purely on merit cum choice basis.

2. Admission to 2 years FNB Pediatric Gastroenterology course is only

through Entrance Examination conducted by NBE and Centralized Merit
Based Counseling conducted by National Board of Examination as per
prescribed guidelines.

Duration of Course: 2 Years

Every candidate admitted to the training programme shall pursue a regular

course of study (on whole time basis) in the concerned recognized institution
under the guidance of recognized post graduate teacher for assigned period of
the course.

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TEACHING AND TRAINING ACTIVITIES

The fundamental components of the teaching programme should include:

1. Case presentations & discussion- once a week
2. Seminar Once a week
3. Journal club- Once a week
4. Grand round presentation (by rotation departments and subspecialties)-
once a week
5. Faculty lecture teaching- once a month
6. Clinical Audit-Once a Month
7. A poster and have one oral presentation at least once during their training
period in a recognized conference.

The rounds should include bedside sessions, file rounds & documentation of case
history and examination, progress notes, round discussions, investigations and
management plan) interesting and difficult case unit discussions.

The training program would focus on knowledge, skills and attitudes (behavior), all
essential components of education. It is being divided into theoretical, clinical and
practical in all aspects of the delivery of the rehabilitative care, including methodology of
research and teaching.

Theoretical: The theoretical knowledge would be imparted to the candidates through

discussions, journal clubs, symposia and seminars. The students are exposed to recent
advances through discussions in journal clubs. These are considered necessary in view
of an inadequate exposure to the subject in the undergraduate curriculum.

Symposia: Trainees would be required to present a minimum of 12 topics based on the

curriculum in a period of two years to the combined class of teachers and students. A
free discussion would be encouraged in these symposia. The topics of the symposia
would be given to the trainees with the dates for presentation.

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Clinical: The trainee would be attached to a faculty member to be able to pick up
methods of history taking, examination, prescription writing and management in
rehabilitation practice.

Bedside: The trainee would work up cases, learn management of cases by discussion
with faculty of the department.

Journal Clubs: This would be a weekly academic exercise. A list of suggested Journals
is given towards the end of this document. The candidate would summarize and discuss
the scientific article critically. A faculty member will suggest the article and moderate the
discussion, with participation by other faculty members and resident doctors. The
contributions made by the article in furtherance of the scientific knowledge and
limitations, if any, will be highlighted.

Research: The student would carry out the research project and write a thesis/
dissertation in accordance with NBE guidelines. He/ she would also be given exposure
to partake in the research projects going on in the departments to learn their planning,
methodology and execution so as to learn various aspects of research.

Training Rotations:
Specialty training shall comprise of rotations in:
Inpatients
Outpatients
Pediatric surgery
Other relevant departments as deemed fit (eg. Adult Gastroenterology and
endoscopy/ Radiology/ Liver Transplant these are not a must and can be
modified depending upon the available local expertise)

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SYLLABUS

OVERVIEW

The training is designed to develop both the generic and specialty- specific
attributes necessary to practice independently as a consultant pediatric
gastroenterologist. The aim is to train individuals to provide the highest standard
of service to patients with gastrointestinal disorders. This includes the
development of positive attributes towards lifelong learning and the ability to
adapt to future technological advances and the changing expectations of society.

The educational process in pediatric gastroenterology aims to provide basic

knowledge, intellectual, clinical and transferable skills to produce competent
gastroenterology specialist. These specialists will be capable of providing
specialized care of the highest order to pediatric patients with gastrointestinal
disorders in the community as well as clinical tertiary centers. They shall
recognize the health needs to the community and carry out professional
obligations ethically and keeping their standards by engaging in continuing
medical education.

Scientific basis of Pediatric Gastroenterology

Basic principles in Gastroenterology

Explain anatomy and physiology of alimentary system.
Explain gastrointestinal biochemistry
Apply clinical skills to diagnose and mange gastrointestinal and
hepatobiliary disorders.

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Diseases and presentations

Acute and chronic diarrhea

Know the causes and symptoms of acute and chronic diarrhoea
Be familiar with local isolation policies
Know about oral and intravenous fluid therapy
Understand the scientific principles for oral and intravenous fluid therapy
Recognize features in the presentation which suggest serious pathology,
e.g. haemolytic uraemic syndrome, pelvic appendicitis, intestinal
obstruction
Know work-up and management of acute diarrhea
Know the causes of chronic diarrhea and relevant work-up/ management
both enteral and total parenteral nutrition
Know to recognize and manage CMPA/ IBD/ celiac disease and intestinal
lymphangiectasia
Be able to evaluate complex case of malabsorption

Approach to vomiting
Know causes of vomiting/ appropriate evaluation and management
Recognize features in the presentation which suggest serious pathology,
e.g. appendicitis, intestinal obstruction, malrotation, ICSOL,

Congenital abnormalities and the newborn

Know the presenting features of congenital abnormalities including

trachea-oesophageal fistula. Malrotation, bowel atresias, Hirschsprungs
disease, abdominal wall defects, diaphragmatic hernia
Be familiar with potential associated abnormalities.
Know when the antenatal transfer to a neonatal Surgical centre should be
considered
Institute appropriate emergency treatment

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 Recognize the need to liaise with surgeons
Institute appropriate emergency treatment and be able to assess the
fitness of the baby and the need to transfer to a specialist centre.
Recognize when the bowel might be compromised
Recognize the need to liaise with surgeons and when this urgent
Know the full range of presenting features of congenital abnormalities of
the intestinal tract.
Be able to diagnose and manage care for the child with shorter bowel
syndrome.

Inflammatory bowel disease

Be familiar with uncommon and unusual manifestations of inflammatory

bowel disease
Know and recognize the macroscopic and microscopic features of Crohns
disease, ulcerative colitis and intermediate colitis
Be able to recognize common extra-intestinal manifestation of IBD
Be able to manage all forms of IBD but especially severe cases including
fistulas
Anticipate and manage the complications of IBD, including malnutrition,
osteoporosis and dysplasia/ cancer.
Know the indications of surgery in IBD
Be familiar with anti-inflammatory drugs and immune suppression used to
manage IBD
Be familiar with novel agent for treating IBD and possess an open attitude
to their use in research protocols

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Celiac disease

Know and recognize the histopathological changes in celiac disease.

Know the precise level of risk, short and long-term complications of celiac
disease.
Be able to conduct a gluten challenge safely and measure adherence to a
gluten free diet by endoscopy if necessary.

Upper and lower Gastrointestinal bleeding

Know the cause of upper and lower gastrointestinal bleeding

Understand the potentially life threatening nature of this condition
Assess the severity of this condition
Institute appropriate emergency treatment
Recognize features in presentation which suggest serious pathology
Be able to investigate and manage upper and lower GI bleeding
Recognize and be able to resuscitate a child with a significant GI bleeding

Motility problems including gastro-oesophageal reflux and oesophagitis

Know the range of presentations of gastro-oesophageal reflux and

oesophagitis in otherwise well infants children and also in disabled
children.
Recognize the range of signs and symptoms associated with gastro-
oesophageal reflux and oesophagitis
Manage mild and moderate gastro-oesophageal reflux and recognize
when to refer.
Be able to manage severe gastro-oesophageal reflux disease.
Be able to manage severe dysphagia
Be able to diagnose and treat H. Pylori infection in young children and
recurrent episodes in adolescents.

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 Be able to perform and interpret intestinal transit studies
Know the indications for the surgical treatment of gastro-oesophageal
reflux disease and how to manage complications of surgery
Pseudo Obstruction

Chronic or recurrent abdominal pain

Know the possible biological, psychological and social contributing factors

in chronic or recurrent abdominal pain.
Know which features suggest that reassurance rather than investigation is
needed.
Recognize features in the presentation that suggest the importance of
different etiologies
Be able to refer appropriately to psychology when required
Consider when there might be child protection issues
Be aware of different management strategies for irritable bowel syndrome
(IBS)
Be able to manage patients with IBS

Pancreatic diseases

Know about exocrine pancreatic dysfunction including cystic fibrosis and

Shwachman-diamond syndrome
Know the cause of acute and chronic pancreatitis
Know the management of chronic pancreatitis and its complications
Indications for ERCP/ surgery/ celiac plexus block
Be able to prescribe Enzyme supplements

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Infantile Cholestasis

Know the cause of intra and extra hepatic cholestasis

Understand the clinical manifestations of cholestasis
Know the potential diagnosis and jaundice, particularly the differential
between biliary atresia and other forms of infantile cholestasis.
Understand the various genetic basis of cholesystatic syndromes
Know the reasons behind nutritional deficiencies in cholestasis and
chronic liver disease.
Understand the clinical manifestations of nutritional deficiencies
Understand the clinical manifestations of nutritional deficiencies
particularly found in liver disease
Know the special nutritional formulae and supplements and the indications
for their use.
Be able to identify infantile cholestasis and initiate appropriate medical
treatment and investigations
Be able to interpret blood, ultrasound and biopsy results and understand
their importance and limitations in reaching diagnosis.
Be able to interpret blood, ultrasound and biopsy results and understand
their importance and limitations in reaching diagnosis
Be able to identify treatable causes of infantile cholestasis such as
metabolic and infectious conditions
Be able to counsel parents about the cause of cholestasis and give a
realistic prognosis
Be able to recognize and assess nutritional deficiencies and manage
appropriate medical treatment and investigations

Hepatosplenomegaly

Know the causes of cirrhosis

Understand the pathophysiology of portal hypertension

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 Know other causes of ascites
Know the causes of hepatic and extra-hepatic masses
Know about storage disorders
Know about haematological malignancies
Know about peripheral stigmata of liver cell failure
Be able to identify hepatosplenomegaly and other abdominal masses and
manage appropriate treatment investigation
Be able to make a diagnosis of cirrhosis, hepatic malignancies and
metabolic conditions presenting in older children
Be able to manage appropriately ascites and SBP
Be able to manage refractory ascites and SBP
Be able to recognize stigmata of liver cell failure

Viral hepatitis and immune disorders

Understand the serology, molecular diagnostics and their prognostic value

in hepatotropic viruses
Understand the screening tests used to detect hepatotropic viruses
Understand the immune basis of some liver disorders
Be able to identify viral and immune liver disorders and initiate appropriate
medical treatment and investigations
Be able to interpret immunological profiles related to auto-immune liver
disorders
Be able to interpret immunological profiles related to auto-immune liver
disorders especially atypical patterns

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Metabolic liver disease

Know the pathophysiology of metabolic conditions

Know the pathophysiology of metabolic conditions affecting the liver and
recent advance in treatment
Understand the management of these conditions
Be able to discuss metabolic problems with consultants in metabolic
medicine

Acute liver failure

Be familiar with causes of acute liver failure

Be familiar with the complications of acute liver failure
Know the management of paracetamol poisoning
Know the causes of acute liver failure
Recognize the need to discuss the case with the liver unit early
Be able to assess the severity and complications of this condition
Be able to initiate appropriate resuscitation and liaise early with the
pediatric liver unit
Be able to identify acute liver failure and manage appropriate medical
treatment and investigations
Be able to identify acute liver failure and initiate first line treatment whilst
arranging referral to Pediatric liver transplant unit
Be able to recognize the progression of acute liver failure and the need for
transplantation
Be able to recognize the progression of acute liver failure and when liver
transplantation is indicated and contra-indicated
Know the causes of acute hepatic failure
Understand the clinical manifestations of acute hepatic failure

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 Know the pathophysiology of complications including cerebral oedema
and heapto-renal syndrome
Understand the indications for liver transplantation
Understand the indications for liver transplantation and know the
importance of timely involvement of transplant team
Know about liver assist devices, dialysis and intracranial pressure
monitoring

Hepatic Tumor

Know about benign and malignant liver tumors

Understand the investigations in liver tumor
Be able to assess a child with hepatic tumor
Be able to initiate specialist investigations and interpret their results

Nutrition

Be able to take detailed dietary history

Know the physiology of nutrient digestion, absorption, metabolism and
elimination
Know about the nutrition of the newborn, infancy, childhood and
adolescent
Know about child growth and development
Be able to assess anthropometry
Be able to assess WHO growth standard
Know about nutritional status of children: Global and National
Know about Breastfeeding: Anatomy, Physiology & Biochemistry
Know about Breastfeeding problems & their management
Know about Breastfeeding: Recent advances

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 Know about Breastfeeding management, counseling and lactation
management center
Know about the importance of breastfeeding
Know about IYCF: Complimentary feeding
Know about Nutritional disorders: Chronic energy deficiency disorders,
micronutrient deficiency disorders & different kind of nutrients
Know about PEM
Be able to manage SAM
Be able to assess FTT
Know about food based dietary guidelines: Food classification, food
groups demonstration, including prepared home based menus
Know about healthy food habits
Know the epidemiology, etiology and clinical features of childhood obesity
Know how to recognize, investigate and manage a case of short stature
Know the indications and contraindications for commencing enteral and
patrenteral nutritional supports
Know the composition of different enteral feeds and patrenteral nutritional
supports
Understand the role of different members of the nutritional support team in
the establishment and maintenance of patients receiving enteral and
patrenteral nutritional supports
Know the causes and effects of specific nutrient deficiencies including
iron, zinc, copper, selenium, folate, vitamins and essential fatty acids

Abdominal distension

Know the causes of abdominal distension

Initiate investigation and seek surgical opinion when required

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Constipation with or without soiling

Be familiar with local and national guidelines for management

Know about the predisposing conditions, e.g. hypothyroidism,
neurodisability, psychosocial problems
Understand the relevance of predisposing conditions, e.g. hypothyroidism,
neurodisability, psychosocial problems
Manage simple constipation with and without soiling
Recognize when to liaise with more senior pediatricians or with specialist
nurses, psychologist or psychiatrists

Dysphagia

Know the causes of dysphagia

Be able to distinguish between organic and functional dysphagia
Be able to evaluate dysphagia recognize achalasia cardia/ stricture
esophagus/ esophageal stenosis and eosinophilic esophagitis

Malabsorption

Know the causes of malabsorption including celiac disease

Understand the principles of treatment of different types of malabsorption
Recognize the role of the dietician and liaise appropriately
Be able to explain and initiate investigations, nutritional assessment,
dietary principles and liaise appropriately with the dietician

Malnutrition

Know the causes of malnutrition including organic and inorganic causes

Be familiar with the consequences of malnutrition
Know the principles of entreal and parentreal nutrition support

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 Be able assess nutritional status
Be able to initiate investigations to establish the diagnosis and to detect
nutritional deficiencies

Iron deficiency anaemia

Know the causes of iron deficiency anaemia including poor diet, bleeding
and malabsorption
Understand factors which predisposes to dietary iron deficiency anaemia
Be aware to the consequences of this condition
Be able to manage iron deficiency anaemia
Be able to counsel parents about dietary iron deficiency

Other areas in which knowledge is to be acquired:

Biostatistics, Research Methodology and Clinical Epidemiology

Ethics
Medico legal aspects relevant to the discipline
Health Policy issues as may be applicable to the discipline

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Competencies

Residents of this training program will be equipped to function effectively within

the current and emerging professional, medical and social contexts. At the
completion of the training program in Pediatric Gastroenterology, as defined by
this curriculum, it is expected that the pediatric gastroenterologist will have
developed the clinical skills and have acquired the theoretical knowledge for
competent pediatric gastroenterology practice.

It is expected that the pediatric gastroenterologist will be able to:

Utilize effective communication with patients and their families and with
professional colleagues
Be devoted to lifelong learning
Be equipped to manage both accurate and chronic gastrointestinal
disorders
Identify the pathophysiology and manifestations of gastrointestinal
disorders, and modern therapeutics, which can be applied to patient
diagnosis and management.
Apply appropriate skills to perform necessary diagnostic and therapeutic
decisions.
Demonstrate a capacity to rationally analyze clinical date and published
work.
Demonstrate an understanding of and commitment to the role of research
in advancing medical care of gastrointestinal diseases.
Develop a commitment to compassionate, ethical and professional
behavior.
Identify gastrointestinal health issue of importance to the community and
contribute constructively to debate about those issues.
Apply primary and secondary prevention strategies in gastrointestinal and
heaptobiliary diseases.

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LOG BOOK

A candidate shall maintain a log book of operations (assisted / performed) during

the training period, certified by the concerned post graduate teacher / Head of
the department / senior consultant.

This log book shall be made available to the board of examiners for their perusal
at the time of the final examination.

The log book should show evidence that the before mentioned subjects were
covered (with dates and the name of teacher(s) The candidate will maintain the
record of all academic activities undertaken by him/her in log book .

1. Personal profile of the candidate

2. Educational qualification/Professional data
3. Record of case histories
4. Procedures learnt
5. Record of case Demonstration/Presentations
6. Every candidate, at the time of practical examination, will be required to
produce performance record (log book) containing details of the work done by
him/her during the entire period of training as per requirements of the log
book. It should be duly certified by the supervisor as work done by the
candidate and countersigned by the administrative Head of the Institution.
7. In the absence of production of log book, the result will not be declared.

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Leave Rules

1. FNB Trainees are entitled to leave during the course of FNB training as per the
Leave Rules prescribed by NBE.
2. FNB candidate can avail a maximum of 20 days of leave in a year excluding
regular duty off/ Gazetted holidays as per Hospital/Institute calendar/policy.
3. MATERNITY / PATERNITY LEAVE:
a. There is no provision of maternity or paternity leave during the FNB
tenure. However, if a FNB trainee avails maternity (90 days) or paternity
(7 days) leave during the FNB tenure, her or his tenure will be extended
by an equal number of days.
b. FNB trainees are required to complete their training by a prescribed cut
off date (as per information bulletin of Exit exam) for being eligible to FNB
Exit examination. Trainees whose FNB tenure is extended beyond this
cut off date only due to the maternity/paternity leave availed by them shall
be permitted to take exit examination, if otherwise eligible, with other
registered candidates of same session.
4. No kind of study leave is permissible to FNB candidates. However, candidates
may be allowed an academic leave of 10 days across the entire duration of
training program to attend the conferences/CMEs/Academic
programs/Examination purposes.
5. Under normal circumstances, leave of one year should not be carry forward to
next year, however, in exceptional cases like prolonged illness or any meritorious
ground the leave across the training program may be clubbed together with prior
approval of NBE.
6. Any other leave which is beyond the above stated leave is not permissible and
shall lead to extension/cancellation of FNB course.
7. Any extension of FNB training for more than 2 months beyond scheduled
completion date of training is permissible only under extra-ordinary
circumstances with prior approval of NBE. Such extension is neither automatic
nor shall be granted as a matter of routine.

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8. Unauthorized absence from FNB training for more than 7 days may lead
to cancellation of registration and discontinuation of the FNB training and
rejoining shall not be permitted.
9. MEDICAL LEAVE
a. Leave on medical grounds is permissible only for genuine medical
reasons and NBE should be informed by the concerned
Institute/hospital about the same immediately after the candidate
proceeds on leave on medical grounds.
b. The supporting medical documents have to be certified by the Head
of the Institute/hospital where the candidate is undergoing FNB
training and have to be sent to NBE.
c. The medical treatment should be taken from the Institute/hospital
where the candidate is undergoing FNB training. Any deviation from
this shall be supported with valid grounds and documentation.
d. In case of medical treatment being sought from some other
Institute/hospital, the medical documents have to be certified by the
Head of the Institute/hospital where the candidate is undergoing
FNB training.
e. NBE reserves its rights to verify the authenticity of the documents
furnished by the candidate and the Institute/hospital regarding
Medical illness of the candidate and to take a final decision in such
matters.
10. (i) Total leave period which can be availed by FNB candidates is 40+10 =
50 days. This includes all kinds of eligible leave including academic leave.
Any kind of leave including medical leave exceeding the aforementioned
limit shall lead to extension of FNB training. It is clarified that prior
approval of NBE is necessary for availing any such leave.
(ii) The eligibility for Fellowship Exit Examination shall be determined
strictly in accordance with the criteria prescribed in the respective
information bulletin.

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EXAMINATION

FORMATIVE ASSESSMENT

Formative assessment includes various formal and informal assessment

procedures by which evaluation of students learning, comprehension, and
academic progress is done by the teachers/ faculty to improve student
attainment. Formative assessment test (FAT) is called as Formative as it
informs the in process teaching and learning modifications. FAT is an integral
part of the effective teaching .The goal of the FAT is to collect information which
can be used to improve the student learning process.

Formative assessment is essentially positive in intent, directed towards

promoting learning; it is therefore part of teaching. Validity and usefulness are
paramount in formative assessment and should take precedence over concerns
for reliability. The assessment scheme consists of Three Parts which has to be
essentially completed by the candidates.

The scheme includes:-

Part I:- Conduction of theory examination

Part-II :- Feedback session on the theory performance
Part-III :- Work place based clinical assessment

Scheme of Formative assessment

Candidate has to appear for
CONDUCT OF THEORY
PART I Theory Exam and it will be
EXAMINATION
held for One day.
FEEDBACK SESSION ON Candidate has to appear for
PART II THE THEORY his/her Theory Exam
PERFORMANCE Assessment Workshop.
After Theory Examination,
WORK PLACE BASED
PART III Candidate has to appear for
CLINICAL ASSESSMENT
Clinical Assessment.

The performance of the resident during the training period should be monitored
throughout the course and duly recorded in the log books as evidence of the
ability and daily work of the student

1. Personal attributes:
Behavior and Emotional Stability: Dependable, disciplined, dedicated,
stable in emergency situations, shows positive approach.
Motivation and Initiative: Takes on responsibility, innovative,
enterprising, does not shirk duties or leave any work pending.

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 Honesty and Integrity: Truthful, admits mistakes, does not cook up
information, has ethical conduct, exhibits good moral values, loyal to the
institution.
Interpersonal Skills and Leadership Quality: Has compassionate
attitude towards patients and attendants, gets on well with colleagues and
paramedical staff, is respectful to seniors, has good communication skills.

2. Clinical Work:

Availability: Punctual, available continuously on duty, responds promptly

on calls and takes proper permission for leave.
Diligence: Dedicated, hardworking, does not shirk duties, leaves any
work pending, and does not sit idle, competent in clinical case work up
and management.
Academic ability: Intelligent, shows sound knowledge and skills,
participates adequately in academic activities, and performs well in oral
presentation and departmental tests.
Clinical Performance: Proficient in clinical presentations and case
discussion during rounds and OPD work up. Preparing Documents of the
case history/examination and progress notes in the file (daily notes, round
discussion, investigations and management) Skill of performing bed side
procedures and handling emergencies.

3. Academic Activity: Performance during presentation at Journal club/

Seminar/ Case discussion/Stat meeting and other academic sessions.
Proficiency in skills as mentioned in job responsibilities.

FINAL EXAMINATION

The summative assessment of competence will be done in the form of Fellowship

Exit Examination leading to the award of the degree of Fellow of National Board
in Pediatric Gastroenterology. The Fellowship Exit Examination is a two-stage
examination comprising the theory and practical part.

Theory Examination:

1. The Theory examination comprises of one paper with maximum marks of

100.
2. There are 10 short notes of 10 marks each in the Theory paper
3. Maximum time permitted is 3 hours.

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Practical Examination:

1. Maximum marks : 300

2. Comprises of Clinical Examination and viva

The candidate has to score a minimum of 50% marks in aggregate i.e.

200 out of total 400 marks (Theory & Practical) with at least 50% marks in
theory examination to qualify in the Fellowship Exit Exam.

The Theory and Practical of Fellowship Exit Examination shall be

conducted at the same examination centre of the concerned specialty.

Declaration of Fellowship Exit Results

1. Fellowship Exit Examination is a qualifying examination.

2. Results of Fellowship Exit Examination (theory & practical) are declared as
PASS/FAIL.
3. FNB degree is awarded to a FNB trainee in the convocation of NBE.

******

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