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Department of Ophthalmology
JUINIOR INTERNSHIP GRADING SHEET
1stfundoscop 2ndfundoscopy
y
Index finger on dialing knob (1 pt)
Proper hand and eye positioning
(3pts)
Checks for ROR and compares
bilaterally (3pts)
Reports description of fundus findings
(3 pts)
Discussion (5pts)
_______________________
CONSULTANTs
SIGNATURE
II. FUNDOSCOPY
UST: A002-17-FO01
1stfundoscop 2ndfundoscopy
y
Index finger on dialing knob (1 pt)
Proper hand and eye positioning
(3pts)
Checks for ROR and compares
bilaterally (3pts)
Reports description of fundus findings
(3 pts)
Discussion (5pts)
_______________________
CONSULTANTs
SIGNATURE
II. FUNDOSCOPY
I. MINI REVALIDA
History Taking (5pts)
Mini Revalida (20%)
Fundoscopy (20%)
Ophtha Emergencies
(20%)
Quiz (20%)
Attendance (10%)
Eye Exam (5pts)
Participation (10%)
TOTAL
(100%)
Discussion (5pts)
_______________________
CONSULTANTs
SIGNATURE
II. FUNDOSCOPY
Accuracy- Made a concise and accurate (2pts)
history
III. Completeness- Asked all pertinent (2pts) EMERGENCIES
questions
Completeness- Did pertinent
Presentation- Presented tests
organized (2pts)
(1pt)
Accuracy- __________________
thoughts, Made accurate observations (3pt)
proper language
Arrived and form
at a reasonable diagnosis and (2pts)
IV. OPERATING ROOM
differentials ROTATION
Discussed case with sufficient (3pt)
background knowledge __________________
1stfundoscop 2ndfundoscopy
y
Index finger on dialing knob (1 pt)
Proper hand and eye positioning
(3pts)
Checks for ROR and compares
Mini Revalida (20%)bilaterally (3pts)
Reports (20%)
Fundoscopy description of fundus findings UST:
Ophtha Emergencies(3 pts) A002-
(20%) 17-
Quiz (20%) FO01
Attendance (10%)
UST Faculty of Medicine and Surgery
Participation (10%)
TOTAL Department of Ophthalmology
(100%) JUINIOR INTERNSHIP GRADING SHEET
I. MINI REVALIDA
History Taking (5pts)
Discussion (5pts)
IV. OPERA
1stfundoscop 2ndfundoscopy TING
y ROOM
Index finger on dialing knob (1 pt)
Proper hand and eye positioning
(3pts)
Checks for ROR and compares
Mini Revalida (20%)bilaterally (3pts)
Reports (20%)
Fundoscopy description of fundus findings
Ophtha Emergencies(3 pts)
(20%) ROTATION
Quiz (20%) __________________
Attendance (10%)
Participation (10%)
TOTAL
(100%)
UST: A002-17-FO01
UST Faculty of Medicine and Surgery
Department of Ophthalmology
JUINIOR INTERNSHIP GRADING SHEET
I. MINI REVALIDA
History Taking (5pts)
Eye Exam (5pts)
Discussion (5pts)
1stfundoscop 2ndfundoscopy
y
Index finger on dialing knob (1 pt)
Proper hand and eye positioning
(3pts)
Checks for ROR and compares
Mini Revalida (20%)bilaterally (3pts)
Reports (20%)
Fundoscopy description of fundus findings
Ophtha Emergencies(3 pts)
(20%) CONSULTANTs
Quiz (20%) SIGNATURE
Attendance (10%)
Participation (10%)
TOTAL
(100%)
II. FUNDOSCOPY
UST: A002-17-FO01
UST Faculty of Medicine and Surgery
Department of Ophthalmology
JUINIOR INTERNSHIP GRADING SHEET
1stfundoscop 2ndfundoscopy
y
Index finger on dialing knob (1 pt)
Proper hand and eye positioning
(3pts)
Checks for ROR and compares
bilaterally (3pts)
Reports description of fundus findings
(3 pts)
Discussion (5pts)
_______________________
CONSULTANTs
SIGNATURE
II. FUNDOSCOPY
I. MINI REVALIDA
History Taking (5pts)
Mini Revalida (20%)
Fundoscopy (20%)
Ophtha Emergencies
(20%)
Quiz (20%)
Attendance (10%)
Eye Exam (5pts)
Participation (10%)
TOTAL
(100%)
Discussion (5pts)
_______________________
CONSULTANTs
SIGNATURE
II. FUNDOSCOPY
Accuracy- Made a concise and accurate (2pts)
history
III. Completeness- Asked all pertinent (2pts) EMERGENCIES
questions
Completeness- Did pertinent
Presentation- Presented tests
organized (2pts)
(1pt)
Accuracy- __________________
thoughts, Made accurate observations (3pt)
proper language
Arrived and form
at a reasonable diagnosis and (2pts)
IV. OPERATING ROOM
differentials ROTATION
Discussed case with sufficient (3pt)
background knowledge __________________
1stfundoscop 2ndfundoscopy
y
Index finger on dialing knob (1 pt)
Proper hand and eye positioning
(3pts)
Checks for ROR and compares
Mini Revalida (20%)bilaterally (3pts)
Reports (20%)
Fundoscopy description of fundus findings UST:
Ophtha Emergencies(3 pts) A002-
(20%) 17-
Quiz (20%) FO01
Attendance (10%)
UST Faculty of Medicine and Surgery
Participation (10%)
TOTAL Department of Ophthalmology
(100%) JUINIOR INTERNSHIP GRADING SHEET
I. MINI REVALIDA
History Taking (5pts)
Discussion (5pts)
IV. OPERA
1stfundoscop 2ndfundoscopy TING
y ROOM
Index finger on dialing knob (1 pt)
Proper hand and eye positioning
(3pts)
Checks for ROR and compares
Mini Revalida (20%)bilaterally (3pts)
Reports (20%)
Fundoscopy description of fundus findings
Ophtha Emergencies(3 pts)
(20%) ROTATION
Quiz (20%) __________________
Attendance (10%)
Participation (10%)
TOTAL
(100%)
UST: A002-17-FO01
UST Faculty of Medicine and Surgery
Department of Ophthalmology
JUINIOR INTERNSHIP GRADING SHEET
I. MINI REVALIDA
History Taking (5pts)
Eye Exam (5pts)
Discussion (5pts)
1stfundoscop 2ndfundoscopy
y
Index finger on dialing knob (1 pt)
Proper hand and eye positioning
(3pts)
Checks for ROR and compares
Mini Revalida (20%)bilaterally (3pts)
Reports (20%)
Fundoscopy description of fundus findings
Ophtha Emergencies(3 pts)
(20%) CONSULTANTs
Quiz (20%) SIGNATURE
Attendance (10%)
Participation (10%)
TOTAL
(100%)
II. FUNDOSCOPY
UST: A002-17-FO01
UST Faculty of Medicine and Surgery
Department of Ophthalmology
JUINIOR INTERNSHIP GRADING SHEET
1stfundoscop 2ndfundoscopy
y
Index finger on dialing knob (1 pt)
Proper hand and eye positioning
(3pts)
Checks for ROR and compares
bilaterally (3pts)
Reports description of fundus findings
(3 pts)
Discussion (5pts)
_______________________
CONSULTANTs
SIGNATURE
II. FUNDOSCOPY
I. MINI REVALIDA
History Taking (5pts)
Mini Revalida (20%)
Fundoscopy (20%)
Ophtha Emergencies
(20%)
Quiz (20%)
Attendance (10%)
Eye Exam (5pts)
Participation (10%)
TOTAL
(100%)
Discussion (5pts)
_______________________
CONSULTANTs
SIGNATURE
II. FUNDOSCOPY
Accuracy- Made a concise and accurate (2pts)
history
III. Completeness- Asked all pertinent (2pts) EMERGENCIES
questions
Completeness- Did pertinent
Presentation- Presented tests
organized (2pts)
(1pt)
Accuracy- __________________
thoughts, Made accurate observations (3pt)
proper language
Arrived and form
at a reasonable diagnosis and (2pts)
IV. OPERATING ROOM
differentials ROTATION
Discussed case with sufficient (3pt)
background knowledge __________________
1stfundoscop 2ndfundoscopy
y
Index finger on dialing knob (1 pt)
Proper hand and eye positioning
(3pts)
Checks for ROR and compares
Mini Revalida (20%)bilaterally (3pts)
Reports (20%)
Fundoscopy description of fundus findings UST:
Ophtha Emergencies(3 pts) A002-
(20%) 17-
Quiz (20%) FO01
Attendance (10%)
UST Faculty of Medicine and Surgery
Participation (10%)
TOTAL Department of Ophthalmology
(100%) JUINIOR INTERNSHIP GRADING SHEET
I. MINI REVALIDA
History Taking (5pts)
Discussion (5pts)
II. FUNDOSCOPY
1stfundoscop 2ndfundoscopy
y
Index finger on dialing knob (1 pt)
Proper hand and eye positioning
(3pts)
Checks for ROR and compares
Mini Revalida (20%)bilaterally (3pts)
Reports (20%)
Fundoscopy description of fundus findings
Ophtha Emergencies(3 pts) UST:
(20%) A002-
Quiz (20%) 17-FO01
Attendance (10%)
Participation (10%)
TOTAL
(100%)