Guidelines

For

Competency Based Training Programme

In

FNB- Reproductive Medicine

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. OBJECTIVES OF THE PROGRAMME

II. ELIGIBILITY CRITERIA FOR ADMISSION

III. TEACHING AND TRAINING ACTIVITIES

IV. SYLLABUS

V. COMPETENCIES

VI. LOG BOOK

VII. NBE LEAVE GUIDELINES

VIII. EXAMINATION –

a) FORMATIVE ASSESSMENT
b) FELLOWSHIP EXIT THEORY & PRACTICAL

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PROGRAMME OBJECTIVES
The practice of reproductive medicine involves the following major sub group of patients

A. Infertile couple with female factor

 Anovulation ( WHO type 1, 2, 3, 4)

 Tubal factor: tubal obstruction, peri-tubal adhesions and hydrosalpinx.
 Uterine cavity abnormality both congenital and acquired (fibroid, adenomyoma,
polyps, synechia, septum and other uterine malformations).
 Endometriosis.
 Endocrine abnormality (hyperprolactinemia, hyperandrogenism, thyroid
dysfunction, congenital adrenal hyperplasia etc)

B. Infertile couple with male factor

 Erectile & Ejaculatory dysfunction.

 Obstructive azoospermia.
 Non- obstructive Azoospermia.
 Other sperm Abnormality (OATs).
 Endocrine abnormalities (hypogonadotrophic hypogonadism).

C. Couple with decreased gamete reserves to be offered donor gamete or donor

embryo program

D. Third Party Reproduction and its ethical and legal issues (ICMR guidelines)
 Oocyte donation
 Embryo donation
 Sperm donation
 Surrogacy

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ELIGIBILITY CRITERIA FOR ADMISSIONS TO THE PROGRAMME

(A) FNB Reproductive Medicine Course:

1. Any medical graduate with DNB/MS in Obstetrics and Gynecology Degree

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

2. Admission to 2 years Fellowship 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.

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.

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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.

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 an original
research paper/article. 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.

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SYLLABUS
BASIC SCIENCES

1. Anatomy: Comprehensive knowledge of the regional anatomy of the pelvis which

includes female and male reproductive organs. Detailed knowledge of gross
anatomy of hypothalamus, pituitary and adrenal glands. Comprehensive
knowledge of the histology of the genital tract and endocrine glands related to
reproduction. Detailed knowledge of cell structure in relation to function.
2. Physiology: Comprehensive knowledge of human physiology with particular
reference to the female and male reproductive system.
3. Genetics and molecular biology: Detailed knowledge of sexual differentiation and
common inherited disorders. Knowledge of the principles of inheritance of
chromosomal and genetic disorders. Detailed knowledge of chromosomal
abnormalities involve in reproduction.
4. Embryology: Comprehensive knowledge of gametogenesis, fertilization and early
embryo development. Comprehensive knowledge of development of the
reproductive organs and abnormalities associated with it. Knowledge of common
fetal malformations.
5. Pathology: Detailed knowledge of the cytopathology and histology of the female
and male reproductive tract.
6. Biochemistry: Knowledge of the metabolism and function of neurotransmitters,
receptors, autocrine and paracrine factors.
7. Biophysics: Knowledge of the physical principles and biological effects on
reproductive organs of heat, sound and electromagnetic radiation, understanding
of the principles of laser, isotopes, X rays, ultrasound and magnetic resonance
imaging.
8. Immunology: Detailed Knowledge of immune mechanisms and of the principles
of reproductive immunology.
9. Pharmacology: Comprehensive knowledge of the properties,
pharmacodynamics, actions, interactions and hazards of pharmacological agents
which are used in reproductive medicine and particularly the compounds which
could have a deleterious effect on the reproductive tract and adverse epigenetic
influence.

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CLINICAL SCIENCES

1. Infertility: Comprehensive knowledge of epidemiology, causes, investigations

and management of female and male infertility.
2. Endocrinology: Comprehensive knowledge of gynaecological and
andrological endocrinology including its applications in reproductive medicine.
3. Reproductive Genetics: Detailed knowledge of genetic disorders related to
female and male reproduction (infertility, recurrent abortions, etc).
4. Pediatric and adolescence: Detailed knowledge of normal and abnormal
sexual development and of specific disorders affecting young females and
males and adolescents
5. Disorders of menstruation: Comprehensive knowledge of normal
menstruation and of the pathophysiology of menstrual disorders, their
investigations and management
6. Andrology: Comprehensive knowledge of normal and abnormal
spermatogenesis, as well as of testicular, epididymal and accessory sex
glands patho-physiology. Comprehensive knowledge of erection and
ejaculation, as well as their physiopathology. Detailed knowledge of
endocrine changes in spermatogenesis, seminogram and sperm function
tests.
7. Andrology laboratory: Semen analysis, processing of semen for various
procedures – intrauterine insemination ,IVF/ICSI, processing samples of
testicular / epidydymal sperms for ICSI.
8. Assisted reproductive technology: Evolution of different technologies in ART.
Controlled ovarian stimulation, oocyte retrieval and embryo transfer
techniques. Comprehensive knowledge of endocrine therapy, especially
ovarian stimulation and its complications. Comprehensive knowledge of the
ART: insemination, IVF, ICSI. Comprehensive knowledge of gamete and
embryo donation. Comprehensive knowledge of pre-implantation genetic
diagnostic techniques
9. Embryology laboratory: Culture media, oocyte identification, insemination,
fertilization and cleavage check, blastocyst culture, embryo hatching,
techniques of intra-cytoplasmic sperm injection, cryopreservation and its

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 principles. Semen freezing /embryo freezing/oocyte freezing with slow freeze
techniques or vitrification.
10. Comprehensive knowledge of reproductive surgery and competence in
common fertility enhancing endoscopic and open surgeries.
11. Ultrasound: Detailed knowledge and competence in ultrasound in all
aspects:-

a) Pelvic ultrasound in women and ability to diagnose pathological conditions of

female genital tract

b) Scrotal ultrasound

c) Follicle monitoring

d) Ultrasound guided invasive procedures.

12. Statistics and epidemiology: Detailed knowledge of statistical analysis.

Collection of data in reproductive medicine as well as the knowledge of calculating
effectiveness of infertility treatments. Detailed knowledge of setting up and
interpreting clinical trials. Knowledge of evidence based medicine pertaining to
human reproduction as well as the knowledge of meta-analysis or guidelines on
diagnosis or management of various conditions given by important medical bodies
such as RCOG, ASRM, ESHREE or Cochrane

8. Psychosomatic: Knowledge of psychosexual and stress related disorders.

Detailed knowledge of the psychopathology and management of psychosexual
disorders, and the influence of stress conditions such as ejaculation disorders,
impotence and vaginismus.

9. Ethics and law: Detailed knowledge of ethical and national legal issues involved
in reproductive medicine and ART and the resources required in providing adequate
health care in hospital and wider community.

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DETAILED SYLLABUS

A. Basic & Applied Sciences:

 Basic Anatomy and physiology of male and female reproductive system

 Applied Pharmacology, Biochemistry and Pathology of the male and female
reproductive system
 Physiology : Menstrual cycle / ovulation
 Endocrinology: Relevant to human reproduction – hypothalamic-pituitary-ovarian
hormones.
 Ovarian Hormones: Structure, Biosynthesis, Function, Mechanism of Action, and
Laboratory Diagnosis. Knowledge of autocrine and paracrine hormones.
 Endocrine disturbances affecting reproduction such as thyroid and adrenal
function. Physiologic and Pathophysiologic Alterations of the Neuroendocrine
Components of the Reproductive Axis
 Normal puberty and pubertal disorders.
 Polycystic ovary syndrome and other hyperandrogenic states
 Abnormal Uterine Bleeding
 Disorders of Sex Development
 Reproductive Immunology and Its Disorders
 Ultra-sonography in reproductive medicine
 Endoscopic surgery, both Hysteroscopy and Laparoscopy
 Diagnosis of male and female infertility
 Ovulation Induction
 Monitoring of Ovulation
 Intrauterine insemination
 Controlled Ovarian Stimulation
 Embryology :Gametogenesis and fertilization
 Genetics : Nomenclature / Basic principle / Pre-implantation genetic diagnosis
 Laboratory equipment – handling and maintenance, record keeping, quality
control and quality assurance
 Andrology: Spermatogenesis.
 Andrology laboratory: Semen analysis and sperm function tests

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 Infertility: Broad outlines of causes of male and female infertility. Workup of male
and female partner.
 Assisted reproductive technology: Evolution and different technologies
 Processing sperm for various procedures –for intrauterine insemination, IVF,
ICSI
 Processing samples of testicular / Epididymal sperms
 Embryology laboratory
 Culture media
 Egg identification
 Insemination
 Normal/abnormal Fertilization and cleavage check.
 Blastocyst culture
 Embryo hatching
 Techniques of intra-cytoplasmic sperm injection
 Cryopreservation
 Principles of cryopreservation
 Semen freezing / oocyte freezing/ embryo freezing
 Slow freeze techniques / vitrification
 Ovum pick up and embryo transfer
 Safety issue in ART including OHSS and multiple pregnancies
 Embryology lab quality control and maintenance
 Exposure to laboratory techniques in ART
 Storage and use of gametes
 Basics of reproductive genetics

B. Genetic history and counseling

C. Pre-implantation genetic diagnosis

D. Pre-implantation genetic screening

E. Endometrial Receptivity assay

F. Ethical principles in ART

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After completion of the course, the reproductive medicine specialist will
be proficient in the following areas of learning:

1. Operative gynecological open surgery, minimally invasive surgery and

microsurgery for pelvic resurrection.
o Proficient in the practice of microsurgical principles as applied to the
treatment of tubal disease especially with regard to distal tubal
obstruction, proximal tubal recanalization and mid tubal obstruction by
end to end anastomosis.
o Proficient in principles and practice of diagnostic and operative
laparoscopy for conditions like ovarian cystectomy/ resection and
desiccation of endometriosis /myomectomy and repair of tubal blocks and
adhesiolysis etc.
o Proficient in the principles and practice of diagnostic and operative
hysteroscopy for conditions causing infertility like removal of foreign body,
polyps, IUCD, biopsy, septum resection, adhesiolysis, cannulation of
tubal ostium and myomectomy for sub-mucous fibroid.
o A clear understanding of the principles of reconstructive surgery as
applied to Mulllerian duct abnormalities – vaginoplasty for vaginal
agenesis, or unification of bicornuate uterus.
2. Reproductive endocrinology and its management.
3. Proficient in the etiology, pathophysiology, diagnosis and management of
common gynecological problems related to infertility like – fibroids /
endometriosis / pelvic infections /ectopic pregnancy and management of high
order pregnancy.
4. Expertise in the use of ovulation inducing agents and hormonal control of the
menstrual cycle and controlled ovarian stimulation.
5. Follicular recruitment and oocyte retrieval procedure.
6. Understand and be able to manage OHSS.
7. Trans Vaginal Ultrasonography with particular reference to follicular monitoring
and early pregnancy scanning.
8. Andrology: Semen analysis and semen preparation

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 9. Laboratory Technology: Familiarity with ART laboratory equipment, maintenance
and trouble shooting.
10. Oocyte identification and grading, embryo grading, micromanipulation, cell
culture, freezing techniques etc
11. Medico legal and ethical aspect
A. Third Party Reproduction
a. Oocyte donation
b. Embryo donation
c. Sperm donation
d. Surrogacy
B. Ethical & medico-legal aspects of infertility management- ICMR guidelines
12. Miscellaneous

 Biostatics & Data management.

 Fertility preservation – Social & Onco- fertility.
 Monitoring & treatment of early pregnancy after ART treatment
 Research Methodology
 Medical statistics
 Writing and presenting a paper

Suggested minimal requirements:

 Assist 10 Proximal cornual block

 Perform 05 Tubal re-canalization procedures
 Minimally Invasive Assist 20 diagnostic laparoscopies
 Assist 20 operative laparoscopies
 Perform 10 diagnostic laparoscopies
 Perform 10 operative laparoscopies
 Andrology Assist 20 PESA, TESA, TESE of testis
 Perform 5 PESA, TESA, TESE testis
 IVF Assist 25 Oocyte retrieval
 Perform 10 Oocyte retrieval
 Laboratory Observe 20 semen analysis & 20 sperm preparation
 Perform 10 semen analysis & 10 sperm wash procedures
 Follow up 5 cases of IVF & 5 ICSI retrieval to embryo transfer (written records)

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Counseling sessions

Observed 10 sessions & Performed 25 sessions

1. Reproductive anatomy and physiology of the male and the female.

2. Reproductive endocrinology.
3. Gametogenesis.
4. Fertilization in vivo.
5. Implantation and early embryogenesis.
6. Pathology of infertility - Causes of infertility namely the ovarian, tubal, uterine,
male factors, pathology that reduces fertility namely endometriosis, fibroid,
adenomyosis uterine anomaly, etc.
7. Approach to investigate and diagnose sub-fertility.
8. Clinical decision making and choice of treatment.
9. Pharmacology - Pharmacological effects of the various drugs including the
pharmacokinetics and pharmacodyanamics of the commonly used drugs.
Prostaglandins and Other Lipid Mediators in Reproductive Medicine
10. Clinical Embryology.
 Principles and practice of semen analysis and cryopreservation of semen.
 Cytology of mammalian and human oocyte to identify stages of oocyte
maturation accurately.
 All aspects of embryology including developmental.
 Cell biological techniques used in cell and tissue culture.
 Molecular biology and genetics of human reproduction.
 Micromanipulation of sperm and oocytes for carrying out ICSI and single-cell
biopsies of embryos for preimplantation genetic diagnosis.
 Principles and functioning of all the equipment used in the laboratory.
 In vitro fertilization of oocytes after processing the gametes.
 Principles and practice of embryo freezing.
11. Anesthesia during the ART procedure.
12. Complication of ART procedure.
13. Ovulation induction during IUI and IVF procedures.
14. Ultrasound and other imaging modalities in infertility.
15. Fundamental of the surgical procedures namely laparoscopy, hysteroscopy etc.
16. Pre-conception evaluation and counseling.

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 17. Administration setting up the ART unit, quality control and assurance, creating
protocol for management and organizing and coordinating of clinical meetings.
18. Research and audit.
19. Counseling of the infertile couple Implicative, therapeutic, ethical and social.
20. Teaching.
21. Clinical andrology.

Topics to be included in all subjects:

 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
1. Ovulation induction protocols. The trainees work in the hospital out-patient unit where
they share the responsibility with the consultant in the evaluation of the infertile couple,
Participate in the decision marking depending on the couple’s need; formulate a plan of
action, pre-procedure assessment, counseling, protocol selection, monitoring the patient
for response and early detection of side- effect, etc. The trainee receives instruction and
is guided by the consultant in acquiring the cognitive and technical skills for the various
diagnostic and therapeutic procedures.

2. Ultrasound and other imaging. The trainee acquires special competence in ultrasound
imaging both in the pre-procedure evaluation and in the monitoring of the infertile
women.

3. Clinical Embryology. Each trainee is required to spend a minimum required time in the
IVF laboratory.

4. Surgical training. The trainee is required to participate in the pre-procedure

assessment; surgical procedure and the post operative follow up the patients who
undergo laparoscopy, hysteroscopy and laparotomy.

5. Research and Audit. The research project should be approved and should
demonstrate the basic principles of the research. The trainee is required to participate in
the audit of the ART procedure and should obtain knowledge in quality control and
assurance.

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OSATSOSATS (Objective Structured Assessment of Technical Skill)

You have to be competent in the below

 Caesarean section
 Diagnostic hysteroscopy
 Diagnostic laparoscopy
 Hysteroscopic surgery
 Laparoscopic adhesiolysis
 Laparoscopic treatment of endometriosis
 Laparoscopic ovarian cystectomy
 Laparoscopic salpingectomy
 Laparoscopic salpingostomy
 Myomectomy

The academic activities of the programme in the hospital should include:

 Regular academic sessions - 2 sessions per week

 Case discussions - One per week
 Seminars - One per month
 Paper presentation. - one per year
 Audit - 2 per year
 Projects - One in 2 years
 Research - as co-Author - one in 2 years
 Thesis
 Conferences - 2 per year
 CMEs - 4 per year minimum CME's to be attended – 6, maximum – 8
 Workshops. - one per year (2 works shop)

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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. 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.

2. 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.

3. 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.

4. 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.

5. Any other leave which is beyond the above stated leave is not permissible
and shall lead to extension/cancellation of FNB course.

6. 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.

7. 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.

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MEDICAL LEAVE

1. 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.

2. 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.

3. 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.

4. 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.

5. 5. 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.

6. 6. 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.

7. The eligibility for FNB Exitl Examination shall be determined strictly in

accordance with the criteria prescribed in the respective information
bulletin.

8. Extension of training due to maternity leave shall not be affected while

deciding the cutoff date of FNB training

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EXAMINATION

FORMATIVE ASSESSMENT

Formative assessment includes various formal and informal assessment procedures by

which evaluation of student’s 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.
 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.

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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 no work
pending, 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.

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Fellowship Exit 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
Reproductive Medicine. The FNB final 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.

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 FNB 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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