SAF General Medicine 17-03-2020

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FORM-MCI-13(ANAESTHESIOLOGY)- R-2016
STANDARD ASSESSMENT FORMFOR PGCOURSES YEAR 2019-20

(Report in this SAF prescribed for the year 2019-20 will only be accepted)
SUBJECT –GENERAL MEDICINE
INSTRUCTIONS TO DEANS & ASSESSORS
1. Please read the SAF carefully before filling it up. Retrospective changes in Data will not be
allowed.
2. Do not use Annexures. All information should be provided in SAF at appropriate place
earmarked. No Annexures will be considered.
3. Experience details should be supported by experience certificate from competent authority (from
the place of work) without which it will not be considered.
4. Don’t add, alter or delete any column of SAF.
5. In case of DNB qualification name of the hospital/institution from where DNB training was done
and year of passing must be provided. Simply saying National Board of Examination, New Delhi
is not enough. Without these details DNB qualification holder will be summarily rejected.
6. Experience of defence service must be supported by certificate from the competent authority of
the office of DGAFMS without which it will not be considered.
7. Dean will be responsible for filling all columns and signing at appropriate places.
8. If promotion is after cut-off date (i.e. after 21/07/2013 for Professor & 21/07/2014 for Associate
Professor) or benefit of publications is given in promotion before cut-off date, give the list of
publications immediately below the name of faculty in this format: Title of Paper, Authors,
Citation of Journal, details of Indexing. Photocopies of published articles should also be
submitted without which they will not be considered. Give details of only original research
articles; Case reports, Review articles and Abstracts will not be considered and should not be
included.
9. No abbreviations of the name of Medical College in the Faculty List and Declaration Forms are
acceptable
INSTRUCTIONS TO ASSESSORS: Please ensure that only original research papers

published in indexed print journals are included in the list. Remaining entries, if included, should
be struck off.
10. Assessor may give any relevant remarks not shown in the assessment report on the page marked
“Remarks of Assessor”. No separate confidential letter should be sent.
11. Count only those faculty & Residents who have signed in attendance sheet before 11:00 a.m. and
are present for subsequent verification and are found eligible on verification and also those who
are on MCI permitted leave and MCI or Court duty. Do not forget to obtain signature of faculty
and residents/senior residents in faculty table in appropriate columnn.
nature of Dean Signature of Assessor

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STANDARD ASSESSMENT FORM FOR POSTGRADUATE COURSES

(GENERAL MEDICINE)
1. Name of Institution:_____GAJRA RAJA MEDICAL COLLEGE, GWALIOR, M.P.

MCI Reference No.: 268670______________________________________________________
2. Particulars of the Assessor:- Assessment Date_________________
Name …Dr.Diwakar.T.N. Residential Address (with Pin Code)
Designation Professor Malar Primrose apts, Rajaji Nagar Main

Road, Lawspet, Puducherry. 605008.
Specialty. General Medicine
Phone .(Off) 0413-2272543…(Resi.) 0413-
Name & Address of Institute/College 2250012
Bangalore Medical College And Research (Fax)…………………………………………...
Institute Fort, K. R. Road
Mobile No. …9443056973 E-mail: ……
Bangalore-560002 ijoerajesh@gmail.com
3. (Institutional Information)
A). Particulars of college
Item College Chairman/ Director/ Medical Superintendent
Health Secretary Dean/ Principal
Name Gajra Raja Medical Commissioner Dr Saroj Kothari Dr Ashok Mishra
College, Gwalior Gwalior Division
Addres Veer Savarkar Divisional JAH Campus Gwalior J A H Campus
s
Marg, Gwalior Commisioner Gwalior
office Moti
Mahal, Gwalior
State Madhya Pradesh Madhya Pradesh Madhya Pradesh Madhya Pradesh
Pin 474009 474002 474009 474009
Code
Phone 0751-2403400 0751-2446252 0751-2403400 0751-2403400
(Off)
(Res) 0751-2403403 0751-2340100 0751-2492929
(Fax)
Fax 0751-2403403
Mobile 7987664612 7697820196
No.
E.mail: grmc1946@yahoo.co commgwa@mp.nic. sudha_shriniwas@hotmail.c drashokgrmc@yahoo.co
.in in om .in
B). Particulars of Affiliated University

Item University Vice Chancellor Registrar
Name Madhya Pradesh Medical Science Dr. T. N. Dubey Dr. Sanjay K. Totade
University, Jabalpur
Address Medical college campus, Jabalpur Medical college Campus, Medical college Campus,
Jabalpur Jabalpur
State Madhya Pradesh Madhya Pradesh Madhya Pradesh
Pin Code 482003 482003 482003
Phone 0761-2670340 0761-2670340 0761-2670332

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(Off)
(Res)
(Fax)
Mobile No.
E.mail: mpmsuregistrar@gmail.com Vcmpmsu108@gmail.com registrarmpmsu@mp.gov.in

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SUMMARY
Date of Assessment: Name of Assessor:__
1. Name of Institution Director / Dean / Principal

(Private / Government) (Who so ever is Head of Institution)
Gajra Raja Medical College, Name Dr. Saroj Kothari
Gwalior Age & Date of Birth
Teaching experience
PG Degree MD Pharmacology
(Recognized/Non-R) Recognized
Subject Pharmacology
2. Department inspected Head of Department

Medicine Name Dr. O. P. Jatav
Age & Date of Birth 21-10- 1964 & 55 YEARS
Teaching experience 26 years
PG Degree Recognized
(Recognized/Non-R)
3. (a). Number of UG Recognised- 150 Permitted- First LOP date

seats (Year: 2019 ) (Year: ) when MBBS
course was first
permitted
(b). Date of last UG 13-7-2019 PG-11-12-19 No.U.12012/127/2016

inspection for -ME-I,
[fts no.3084749]
Government of India,
Ministry of Health and
Family Welfare. New
Delhi, Dated
31.5.2017
Purpose:compliance Purpose: renewal
of recognition
Result:Recognized Result: recognized

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4. Total Teachers available in the Department:
Designation Number Name Total Teaching Benefit of

Experience Publications
in
Promotion
Professor 4 Dr. O. P. Jatav 25Yrs
Dr. SushmaTrikha 32Yrs
Dr. A. Gupta 22 yrs
Dr. SanjayDhawle 19 yrs 8 mon

Addl./Assoc Prof. 7 Dr. ArchanaKansal 21Yrs. 8 mon
Dr. Ajay Pal Singh 19yrs
Dr. S. Sahai 16Yrs. 2 mon
Dr. R. Gaharwar 14Yrs08mon
Dr. P. Prajapati 18yrs 5 mon
Dr. D. Tiwari 16Yrs3 mon
Dr. N. Singh 19Yrs. 9mon

Asstt. Professor 4 Dr. M.Sharma 04Yrs6mon
Dr. J.S.Namdhari 3 yrs
Dr. V. Garg 3 yrs
Dr. S. Kannaujia 4 yrs

SENIOR 8 Dr. Sutakshee Sonwani 3 yrs
RESIDENT
Dr. Jagat Pal 1 yr
Dr. Mukesh singh Tomar 1 yr
Dr. Vinod Singh Dhakad 11 months
Dr. Rohit Pratap Tomar 6 months
Dr. Sylvester Justin 6 months

Note: Count only those who are physically present
5.Number of Units with beds in each unit:

Total no. of units 06
Unit I - 40 beds,
Unit II – 30 beds,
Unit III- 30 beds,
Unit IV – 30 beds,
Unit V – 30 beds,
nature of Dean
Unit VI – 30 beds, Signature of Assessor
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6. Clinical workload of the Institution and Department concerned :

Parameter Entire Hospital Department of Medicine
On the Day of On the Day of Average of 3 Days

Assessment Assessment Random
OPD attendance upto 2 p.m. 297
New admissions 76
Total Beds occupied at 10 a.m. 264
Total Required Beds NIL
Bed Occupancy at 10 a.m. (%) 90%-95%
Major Operations NA NA NA
Minor Operations NA NA NA
Day Care Operations NA NA NA
Total Number of Deliveries NA NA NA
Total Caesarean Sections NA NA NA
Total Deaths 3
Casualty attendance 60
Put N.A. whichever is not applicable to the Department.

Note:
 OPD attendance is to be considered only upto 2 p.m. Bed occupancy is to be considered at 10 a.m. only.
 Investigative Data to be verified with Physical Registers in Radiodiagnosis& Central Clinical Laboratory.
 Data to be verified with Physical Registers in Blood Bank..
7. Investigative Workload of entire hospital and Department Concerned.
Parameter Entire Hospital

On the Day of Assessment
Radio-diagnosis MRI 4
CT 21
USG 129
Plain X-rays 217
IVP/Barium etc 02
Mammography NIL
DSA nil
CT guided FNAC NIL
USG guided FNAC 06
Any other NIL
Pathology Histopath 24
FNAC 10
Hematology 236
Others 124
Bio-Chemistry 317
Microbiology 56
Blood Units Consumed 42

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8. Publications from the department during last 3 years:

(Give only full articles published in indexed journals. No case reports or review articles be given)
1. To study the correlation of peripheral vascular disease and coronary artery disease
(Myocardial infarction). Gupta A, Rajkumar B., Parihar A. Raj V., Sebastian S., .(IOSR-
Journal of Dental and Medical Science (JDMS) Volume 16, Issue 6, Ver. VI (June 2017),
PP 117-121
2. Study of glycemic control (HbA1c) and its correlation with nephropathy in diabetes
mellitus type 2 patients. Gupta A. ,Sisodia R., Nambiar A.(IOSR- Journal of Dental and
Medical Science (JDMS) Volume 16, Issue 8, Ver. 12 (August 2017).
3. Study of Lipid profile in patients of hypothyroidism and correlation with incidence of
gallstone., Gupta A., Agrawal N, Soundya S.(IOSR- Journal of Dental and Medical
Science (JDMS) Volume 16, Issue 6, Ver. X (June 2017), PP 42-47
4. Echocardiographic study of left ventricular diastolic dysfunction in normotensive
asymptomatic type 2 diabetes mellitus. Gupta A. , Gupta H, Jain H. (IOSR- Journal of
Dental and Medical Science (JDMS) (Article ID K540007) Volume 14, Issue 7 (July
2015), PP 39-43
5. Correlation of microalbuminuria in hypertensive patients of a tertiary care teaching
hospital of Central India. Gupta A, Kumar D., Yadav M. International Journal of
Research in Medical Sciences 2016 Aug; 4(8): 3402-3406
6. Acute myorcardial infraction with bundle branch block (RBBB or LBBB) – Clinical
Characteristics, Complications and prognostic significance – A hospital based study.
Gupta A, Shelke . IOSR Journal of Dental &medical sciences.Vol. 16 Issue 1, Ver. 11
Jan’ 2017
7. The sudy of dyslipidemia and its correlation with nephropathy in diabetes mellitus type
2 patients.Sisodia R., Gupta A, Singh N. International journal of Advances in Medicine
September to October 2017 /Vol 4 / Issue 5 page 1-5
8. QT Dispersion – An Ignored screening Tool for cardiovascular disease in Diabetics.
Wahane M., Gupta A., Tyagi P, Singhal P, Mohammed A., Shah N. IOSR Journal of
Dental and Medical Sciences (IOSR-JDMS) Volume 16, Issue 3 Ver. VI(March.2017), PP
11-13
9. A study of clinicetiological profile of patients with pleural effusion. Shashikant A.,
Gupta A., (IOSR - JDMS) (Article ID L71242). Vol. 16, issue 1, ver. 12 January 2017
10. To study the endothelial dysfunction by brachial artery flow mediated dilatation
in coronary artery disease patients.Chauhan M. International Journal of Advances in
Medicine. 2017 Aug;4(4):1158-1164ISSN No. 2349-3925, 2349-3933
11. To study the carotid intima media thickness in patients of fatty liver disease.
Chauhan M. International Journal of Advances in Medicine. 2017 Oct;4(5):1282-
1287.ISSN No. 2349-3925, 2349-3933
12. Study of anemia in diabetes and its association with diabetic retinopathy.
Chauhan M. International Journal of Advances in Medicine 2017 Oct;4(5):1437-
1440.ISSN No. 2349-3925, 2349-3933
13. Study of dermatological manifestation in internal malignancies. Jayant S.,
Dhawale S. Journal of Evidence Based Medicine and Healthcare. 07 Dec
2015;2(54):8792-8795. eISSN No. - 2349-2502pISSN No. - 2449-2570
14. Clinical profile, morbidity and mortality among swine flu (H1N1) infected
patients 2015, Gwalior, Madhya Pradesh Pandemic. Jayant S., Dhawale S. International
Journal of Advances in Medicine. 2016 May;3(2):324-327eISSN No. - 2249-3933pISSN
No. - 2349-3925\
15. Serum fibrinogen level in type 2 diabetes mellitus patients. Jayant S., Dhawale
S. , Gupta A. International Journal of Advances in Medicine. 2016;3(1):83-87.eISSN No.
- 2249-3933 pISSN No. - 2349-3925
16. Study of Clinical Profile of Patients of Non Alcoholic Fatty Liver Disease and its
Association with Metabolic Syndrome. Gaharwar R. Journal of Association of Physicians
of India. Vol. 63, Jan. 2015, Page no. 12-16.ISSN No. 0004-5772

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17. Association of electrocardiogram abnormalities in human immunodeficiency virus

infected patients with special reference to QTc interval.Gaharwar R. International
Journal of Advances in Medicine. vol. 2(4), Page no. 379-382, Nov. 2015ISSN No. 2349-
3933
18. Role of cerebrospinal fluid adenosine deaminase in diagnosis of tubercular
meningitis in adults. Gaharwar R. Journal of Evidence Based Medicine and Healthcare.
Nov. 2015, Vol. 2, Issue 51, Page No. 8634-8636.ISSN No. 2349-2570
19. Study of Cardiovascular Manifestations in Patients of Hypothyroidism with
Special Reference to TMT.Gaharwar R. Journal of Multidisciplinary Research and
Development. Vol. 2, Issue 8, Page no. 515-523, Aug. 2015.ISSN No. 2349-4182.
20. Study of Hyponatermia and its prognostic implications in hospitalized patients
with cirrhosis of liver. Trikha S. International Journal of Public Health Research and
Development. Jan-Mar 2017;8(1): 13-17P-ISSN No. 0976-0245. E-ISSN No. 0976-5506
21. Prevalence of obesity in Chambal region and predictors of risk factors. Trikha S.
International Journal of Advances in Medicine.Aug 2016;3(3):230-234.P-ISSN No.
2349-3925E-ISSN No. 2349-3933
22. Study of Clinical Profile of patients of Non Alcoholic Fatty Liver Disease and its
association with metabolic syndrome. TrikhaS.Journal of Association of Physicians of
India. Jan 2015;63(1):12-16.ISSN No. 0004-5772
23. Upper gastrointestinal endoscopic findings in premenopausal anemic patients.
TrikhaS.International Journal of Multidisciplinary Research and Development. Sept
2015;2(9):68-71.P-ISSN No. 2349-4182.E-ISSN No. 2349-5979
24. Prospective study of etiology, clinical profile and outcome in patients with fever,
jaundice and acute kidney injury. TrikhaS.Journal of Evidence Based Medicine and
Healthcare. Sept. 2015;2(39:6269- 6273.P-ISSN No. 2349-2562. E-ISSN No. 2349-2570
25. Comparative analysis of biochemical parameters to differentiate transudative and
exudative pleural fluid. Trikha S. IOSR-Journal of dental and medical sciences
pISSn:22, ver79-08661,volume 17,issue 2,ver.13 February(2018 P13-18)
26. Serum fibrinogen level in type 2 diabetes mellitus patients. Dhawale S. Jayant S.
International Journal of Advances in Medicine. 2016;3(1):83-87.eISSN No. - 2249-
3933pISSN No. - 2349-3925
27. Clinical profile, morbidity and mortality among swine flu (H1N1) infected
patients 2015, Gwalior, Madhya Pradesh Pandemic. Dhawale S. Jayant S. International
Journal of Advances in Medicine. 2016 May;3(2):324-327eISSN No. - 2249-3933,pISSN
No. - 2349-3925
28. Role of cerebrospinal fluid adenosine deaminase in diagnosis of tubercular
meningitis in adults. Gaharwar R., Dhawale S. Journal of Evidence Based Medicine and
Healthcare. Nov. 26;2015:2(51):8634-8636 doi:10.18410.jebml/2015/1195 eISSN No. -
2349-2502 pISSN No. - 2449-2570
29. Hepatic dysfunction in falciparum malaria. Chandra S., Dhawale S., Chauhan A.
Journal of Evolution of Medical and Dental Sciences. Jan. 2015;4(2):184-189. ISSN No.
2278-4802.
30. A prospective study of pulmonary function test in obese patients. Prajapati P.,
Singh N, Prajapati R. Singh J. International Journal of Advances in Medicine. Feb.
2016, Vol. 3, Issue 1, Page 73-76. ISSN No. e2349-3933, ISSN No. p. 2349-3925
31. Prospective study of etiology, clinical profile and outcome in patients with fever,
jaundice and acute kidney injury. Prajapti P., Trikha S., Jatav O. P., Wahane M., Gupta
H. Prajapati R., Journal of Evidence Based Medicine & Healthcare. Vol. 2, No. 39, Sept.
28, 2015, Page 6269-6273 ISSN No. 2349-2570
32. Acute Malarial Nephropathy - A complicated Less Recognized. Trikha S.,
Prajapati P., Singh N. Journal of Medical Science & Research July 14, 2015 ISSN No.
e2321-5798 ISSN No. p. 0976-5948
33. To Study severity and risk prediction of mortality in malaria by the malaria
severity score. Ahirawar S., Kansal A, Jatav O. P., Trikha S, Malviya K., Journal of
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Evolution of Medical and Dental Science. Vol. 3, No. 07, Feb., 2014 Page 1796-1810.
ISSN No. 2278-4748
34. To study the carotid intima-media thickness in patients of fatty liver disease.
Ahirwar S., Indian Journal of Clinical Practice. Vol. 26, No. 4, Sept. 2015, Page 337-
344.ISSN No. 0971-0876
35. Hyperuricaemia as a predictor of complication in cases of type II diabetes
mellitus. Kansal A., Ahirwar S., Trikha S., Dhawale S., Vishandasani J., Wahane M.,
Journal of Evolution of Medical and Dental Science. Vol. 4, No. 68, August 2015, Page
11882-11887.ISSN No. 2278-4748
36. Diagnostic utility of serum ascites albumin gradient against ascitic fluid total
protein for detection of liver disease in patients of ascites – A comparative study.
Kansal A, Ahirwar S., Trikha S., Sharma A., Sahai S. International Journal of Medical
Research and Review. Vol. 3, No. 8, Sept. 2015, Page 861-865.ISSN No. 2321-127X. A
study of CSF C-reactive protein levels in patients of meningitis. Ahirwar S., Trikha S.,
Kansal A., Verma K., Jatav O. P. Journal of Indian Academy of Clinical Medicine 2016;
Volume 17, No. 2, Page 105-110. ISSN No. 0972-3560
37. A study on prevalence of spontaneous bacterial peritonitis in chronic liver
disease. Ahirwar S., Kansal A., Shaikh R.G., Journal of Evolution of Research in General
Medicine. July-Dec. 2015; Vol. 1, Issue 1, Page 1-5ISSN No. 2455-8214.
38. A study of lipid profile in chronic kidney disease in non-diabetic patients. Ahirwar
S., Lahariya D., Journal of Evolution of Research in General Medicine Jul-Dec. 2015,
Vol. 1, Issue 1, Page 16-20.ISSN No. 2455-8214
39. Study of clinical and etiopathological profile of liver abscess. Tiwari D., Jatav O.
P. Jain M., Kumar S., J of Evidence Based Medcare& Healthcare, Oct 5,
2015;2(40):6705-6712.
40. Prospective study of clinical profile in hair dye poisoning (PPD) with special
reference to electrocadiographic manifestations. Tiwari D., Jatav O. P., Dudani M.
International Journal of Medical Science and Public Health, 2016;Vol. 5/issue 07
41. Study of carotid intima media thickness in patients of chronic kidney disease.
Tiwari D., Jatav O. P., Gupta M., Saraf S. National Journal of Integrated Research in
Medicine (NJIRM), Vol.6(6),Nov.-Dec 2015,11-14.
42. Comparison between Platelet Count, Spleen Diameter and Their Ratio with
Esophageal Varices in Patients with Liver Cirrhosis. Tiwari D., Kumar S., Lahariya D.,
Jacob J., American Journal of Medicine and Medical Sciences, 2016,6(1):29-33.
43. Lipid Profile and carotid artery intima media thickness in diabetic and non
diabeticischaemic stroke, Pillai P., Tiwari D., Jatav O. P., Rai H. International Journal of
Advance in Medicine. March – April 2017 –Vol-4 Issue 2 471-475
44. Study of toxic effect of aluminum phosphide poisoning on Myocardium in thirty
patients treated in care hospital. Singh N, Nigam R. Indian journal of Forensic
Medicine & Toxicology. Vol.110, No. 2 July – Dec. Page No. 78-82
45. A study of Microbiology Evaluation of Chronic Suppurative Otitis Media, Nigam
R., Singh N., Kumara A. , Jain A. K., Gupta R. “Indian Journal of Public Health
Research & Development Vol 7 No.3 , July – September 2016, Page No. -1-6
46. Prevalence of Obesity in Chambal region and predictors of risk factors. Trikha S.,
Singh N. International Journal of advances in medicine – 2016, Aug ; 3(3) : 467-70.
47. Study of pulmonary function test in asymptomatic smokers and non-smokers
between 30-50 years of age in a tertiary care hospital. International journal of
advances in medicine 2017 4(4) 959-963.
48. To study the clinico-pathological profile and radiological characteristics in
patients with liver abscess. Arya D., Singh N. Jatav O. P., Trikha S., Shah N., Singhal
P., IOSR-JDMS. eISSN-2279-0853, pISSN2279-0861, Vol 17 , Issue 2, Ver 12, Feb
2018.
49. The predictive and prognostic value of low serum albumin in the critically ill
patient. Rai H., Sahai S. , Pillai P., Balachandra S., International Journal of
10
Contemporary Medicine ISSN – 2320-9623 July – September 2017, Vol 5, No. 2 page
36-41
50. Risk of developing diabetes in the Indian youth: An evaluation using Indian
diabetes risk score (IRDS). Sahai S., InternationalJournal of Medical and Health
Research Vol 3, Issue 5 May 2017 , pg no 17-19 ISSN: 2454-9142
51. Prevalence of Impaired Fasting Glucose in an urban Population of Central
India.Tyagi P., Sahai S., Shah N. International Journal of Medical Science and Public
Health ISSN-2320-4664, 2277-338X Accepted December 15,2017, vol 6 issue 5
52. A study of Brachial Artery Flow Mediated Dilatation and Carotid Artery Intimal
Media Thickness in Subject Having Risk Factors for Coronary Artery Disease. Sahai S.,
Sinha S. International Journal of Advances in Medicine ISSN-2349-3925 March – April
2017, Vol 4 issue 2, page 437-441
53. The Role of AFTP in the Diagnosis of Tubercular Ascites., Sahai S. Parpipex
National Journal of Research ISSN 2250-1991 Dec. 2016 Vol 5, issue 12, pg 55-57
54. Acute Liver failure in Pregnancy : Causes and Prognosis Factors. Sahai S., Kiran
R. Saudi Journal of Gastroenterology, ISSN 1319-3767 Jan-Feb 2015, Vol 21,p 30-34
55. Viral hepatitis in Pregnancy- its effect on Fetal and Maternal Outcome. Sahai S.,
Mishra V., Ganga D., Jatav O. P. JAPI, Jan 2015 Vol63, no.1 p-26-31 ISSN-0004-5772
56. Study of anemia in diabetes and its association with diabetic retinopathy. Kansal
A., Varghese J. International Journal of Advances in Medicine 2017 Oct;4(5):1437-1440
ISSN No.2349-3925,2349-39
57.

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9 Blood Bank License valid Yes
Blood component facility available Yes
Number of blood units stored on the inspection day 379
Average units consumed daily (entire hospital) 37
10. Specialized services provided by the department: 1.Pain Clinic
2. Intensive care Unit
3.Dialysis
11. Specialized Intensive care services provided by the Dept: Adequate
12. Specialized equipment available in the department: Adequate
13. Space (OPD, IPD, Offices, Teaching areas) Adequate
14 Library Central Departmental
Number of Books pertaining to General Medicine 23487 198
Number of Journals 102 267
Latest journals available upto Dec 2019 Dec 2019
15. Casualty Number of Beds_25 Available equipment ____ Adequate
16. Common Facilities
 Central supply of Oxygen / Suction: Available

 Central Sterilization Department Adequate
 Laundry: Outsourced
 Kitchen Gas
 Incinerator: Capacity: 100KG/HOUR
 Bio-waste disposal Outsourced
 Generator facility Available
 Medical Record Section: Registration Computerized MDR manual
 ICD10 classification Partially done.
17. Total number of OPD, IPD and Deaths in the Institution and department concerned during the last one year:
In the entire hospital In the department of Medicine

OPD 622963 OPD 98731
IPD (Total Number of 87680 IPD 35260

Patients admitted)
Deaths 3949 Deaths 1097

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18. Number of Births in the Hospital during the last one year:
Note : 1) The data be verified by checking the death/birth registration forms sent by the college/hospital to
the Registrar, Deaths & Births (Photocopy of all such forms be provided.)
2) Year means calendar year (1st January to 31stDecember )
19. Accommodation for staff Available

20 Hostel Accommodation UG PG Interns
No. Boys Girls Boys Girls Boys Girls
No. of Students 153 123 52 40 44 14
No. of Rooms 310 205 104 80 88 14
Status of Cleanliness Good Good Good Good Good Good
21 Total number of PG seats in Recognized Date of Permitted Seats Date of

the concerned subject seats recognition permission
(Medicine) Degree 14 24.02.2007 14 annual
intake
yearly since
last 25
years
22. Year wise PG students admitted (in the department inspected) during the last 5 years and available PG teachers
Year No. of PG students admitted No. of PG Teachers available in the dept.
Degree Diploma (give names)
2019 14 11
Dr. O.P. Jatav, Dr. SushmaTrikha, Dr. Archana Gupta, Dr.

Sanjay Dhawale, Dr. ArchanaKansal ,Dr. Ajay Pal Singh, Dr.
PradeepPrajapati, , Dr. DharmendraTiwari, Dr. S. Sahai,
Dr.R.Gaharwar, Dr.NeelimaSingh
2018 14 12

ArchanaKansal,
Dr. Sanjay Dhawale, Dr. Ajay Pal Singh, Dr. PradeepPrajapati,
Dr. DharmendraTiwari, Dr. S. Sahai,
Dr.R.Gaharwar, Dr.N Singh, Dr.SJayant
2017 14 14

ArchanaKansal,
Dr. ArvindChauhan, Dr. SandeepAharwar, Dr.
DharmendraTiwari, Dr. S. Sahai,
Dr.R.Gaharwar, Dr.NeelimaSingh, Dr.SJayant
2016 14 14.

13
ArchanaKansal,
2015 14 15.
Dr. O.P. Jatav, Dr. DeveshDutta Dr. SushmaTrikha, Dr.

Archana Gupta, Dr. ArchanaKansal,
23 Other PG courses run by Course Name No. of seats Department

the institution DNB Nil NA
M.Sc. Nil NA
Others Nil NA
24. Whether other medical superspecialty department exits in the institution …………… Yes
(If yes give details)
Name of department Beds/Units When LOP for DM seats granted Available faculty
& Number of seats (Names & Designation)
CARDIOLOGY 30/I NIL Professor &HOD:-
Dr.PuneetRastogi (DM)
Associate Professor :-
Dr.RamRawat (DM)
Assistant Professor:-
Dr Gaurav Kavi(DM)
NEUROLOGY 30/I NIL Professor &HOD:-
Dr.DineshUdaeniya (DM)
Assistant Professor:-
DrArvind Gupta(DM)
I have physically verified the beds, faculty and patients of above Super specialty departments and they have not been counted
in anesthesia department inspection.
25. Stipend paid to the PG students, year-wise:
Year Stipend paid in Govt. colleges by State Govt. Stipend paid by the Institution
Ist Year 55000 55000
IInd Year 57000 57000
IIIrd Year 59000 59000
26. List of Departmental Faculty joining and leaving after last inspection:
Designations Number Names

14
Joining faculty Leaving faculty

Professor Nil
Associate Prof. Nil
Assistant Prof. Nil
SR/Tutor/Demons. 1. Sylvester justin 1.Dr. Saurabh S. Rajput
2. Dr. Devendra Arya
3. Dr. Anvesh Parmar
Others Nil
27. Faculty deficiency, if any
Designation Faculty available Faculty required Deficiency, if any
(number only)
Professor 4 3 Nil
Assoc Professor 7 4 Nil

Asstt. Professor 4 Nil
Sr. Residents 6 5 Nil

Jr. Residents 42 42 nil
Tutor/ Demonstrator NA
Any Other NA
28. Remarks of Assessor

1. please do not repeat information already provided
2. please do not make any recommendation regarding granting permission/recognition
3. if you have noticed or come across any irregularity during your assessment like fake or dummy faculty, fake or
dummy patients, fudging of data of clinical material etc., please mention them here)

15
PART – I
(Institutional Information)
1 Particulars of Director / Dean / Principal:

(Who so ever is Head of Institution)
Name: _Dr. Saroj Kothari Age: __ Years (Date of Birth)___
PG Degree Subject Year Institution University

Recognized Pathology 1982 Gajra Raja Medical College, Jiwaji University,
Gwalior Gwalior, MP
Teaching Experience
Designation Institution From To Total
Experience
Assistant Professor Gajra Raja Medical College, Gwalior 21.1.1984 16.4.1994 15Years
02 Months
Associate GMC Bhopal 16.04.1999 21.6.2000 01 Year 2 mth

Professor/Reader
Gajra Raja Medical College, Gwalior 22.6.2000 14.4.2005 04 Year 9 mth
Professor 1.Gajra Raja Medical College, Gwalior 14.4.2005 09.02.2010 4 years 9 mth
2.SSMC Rewa 10.02.2010 29.03.2010 1 mth 20 days
3.GRMC Gwalior 30.03.2010 17.12.2015 5 yrs 8 mths
4.BMC Sagar 18.12.2015 01.06.2017 1 yr 5 mnths
5.GRMC Gwalior 02.06.2017 04.12.2018 1 yr 06 mths
As Dean in GRMC Gwalior 05.12.2018 Till Date
Any other Grand Total 35 Years 4

months
2. Central Library
 Total number of Books in library: 25180
 Books pertaining to General Medicine: 894
 Purchase of latest editions of books in last 3 years: Total: 499 Medicine books 42
 Journals:
Journals Total Medicine
Indian 73 15
Foreign 45 5
 Year / Month up to which latest Indian Journals available: Dec. 2019
 Year / Month up to which latest Foreign Journals available: Dec. 2019
 Internet / Med pub / Photocopy facility: Available
 Library opening times: 8am to 11pm
 Reading facility out of routine library hours: Available
(obtain list of books & journals duly signed by Dean)
3. Casualty:/ Emergency Department

Space Adequate (6000 sqft)
Number of Beds 20
No. of cases (Average daily OPD and Admissions): OPD- 116, Admission- 35
Emergency Lab in Casualty (round the clock): Available

Emergency OT and Dressing Room Available
Staff (Medical/Paramedical) 08 Doctors Permanent

16
06 Nurses
01 Compounder
03 class IV
Equipment available Crash trolly-2

ECG Machine -2 (12 channel)
High Tech Cot-4
High tech stretcher trolly-5
Pulse Oximeter-6
Oxygen Points-2
Multipara Monitors -4
Central Oxygen Line – Available
Oxygen cylinders-3
Suction central wall mounted- 14
Nebulizer machine ( extra)-2
Ventilator-2 (one for transfer)
100 MA X-ray machine Portable-1
Defibrillator-1
Spare hot water sterilizer-1
Vaccum pump-1
Ambu bag-2
Glucometer -2
4 Blood Bank
(i) Valid License(copy of certificate be annexed) Yes(Enclosed)
(ii) Blood component facility available Yes
(iii) All Blood Units tested for Hepatitis C,B, HIV Yes
(iv) Nature of Blood Storage facilities (as per specifications) Yes
(v) Number of Blood Units available on inspection day 379

(vi) Average blood units consumed daily and on inspection day in the Average daily On Inspection
entire Hospital day
( give distribution in various specialties)
46 37
5. Central Research Lab:

 Whether it exists? Yes
 Administrative control: Professor and Head, Pathology Department
 Staff: Medical ( faculty-5 and Residents from pathology) / paramedical ( lab technician and
lab attendants from pathology
 Equipment: Adequate
 Workload:Adequate
6. Central Laboratory:
 Controlling Department: Pathology, Biochemistry, Microbiology.
 Working Hours: 24hours
 Investigative workload: 765/day
(Approximate number of investigations done daily)

17
Radiotherapy (Optional)
Radiotherapy Available (456 patients in last year)
Teletherapy N.A
Brachy therapy N.A
8. Central supply of Oxygen / Suction: Available

9. Central Sterilization Department Adequate
10. Laundry: Outsourced
11. Kitchen Gas
12. Incinerator: Functional Capacity: 100kg/hour Outsourced
13. Bio-waste disposal Outsourced
14. Generator facility Available
15. Medical Record Section: Registration Computerized MDR manual
 ICD10 classification Used
 16. Total number of OPD, IPD and Deaths in the Institution and concerned department during the last one
year:
In the entire hospital In the department of Medicine

OPD 622963 OPD 98731
IPD (Total Number of 87680 IPD (Total Number of 35260

Patients admitted) Patients admitted)
Deaths 3949 Deaths 1097
17. Total Number of Births in the Hospital during the last one year: 9990
Note: (1) The data be verified by checking the death/birth registration forms sent by the college/hospital to
the Registrar, Deaths & Births (Photocopy of all such forms be provided.)
18. Recreational facilities: Available
Play grounds
1. Tennis Court Flood Lighted- Two(one clay court, one synthetic) Available
2. Badminton court- one
3. Basketball court- one (cemented)
4. One big ground for all other games like Cricket, hockey
5. Table Tennis table in each hostel
6. Chess and carom in all hostels
7. Badminton court in Pt.Ravishankar Hostel and senior boy's Hostel
8. Volley ball court in PanditRavishankar Hostel
Gymnasium
Two fully equipped Gyms available one for Boys and one for Girls students
19 Hostel Accommodation UG PG Interns

Boys Girls Boys Girls Boys Girls
No. of Rooms 153 123 52 40 44 14
18
No. of Students 310 205 104 80 88 14
Status of Cleanliness Good Good Good Good Good Good
20. Residential accommodation for Staff / Paramedical staff Adequate
21. Ethical Committee (Constitution):
Chairperson Dr.(Mrs.) Veena Agrawal-Ex-Dean-GRMC,Gwalior
Member secretary Dr. Dilip Kothari, Professor, Anesthesiology
Member Dr. Smt. Saroj Kothari, Professor,Pharmacology
Dr.K.K.Magnani, Professor, Pediatrics
Dr.Ajay Gaur, Professor,, Pediatrics
Mrs. Nidhi Patankar (Legal Advisor)
Dr. Avinash Tiwari, Professor, Jiwaji University
Dr. B.R.Shrivastava, Professor, Gen. Surgery
Mr. Anil Sarode( Eminent lay person)
22. Medical Education Unit (Constitution)

(Specify number of meetings held annually & minutes thereof)
One Chair person( Prof. Dr.Saroj Kothari )
One Coordinator ( Prof. Dr.Ajay Gaur) (Adv. Course)
Hon. Faculty
1. Dr. Archana Maurya, Professor, Obst. And Gynecology
2. Dr. Ranjana Tiwari, Professor, Community Medicine
3. Dr. SudhaIyengar, Professor, Pathology
4. Dr. Ajit Singh Rajpoot, Professor, Physiology
5. Dr. VaibhavMisra, Professor, Microbiology
6. Dr. SudhirSaxena , Assoc. Professor, Anatomy
7. Dr. SonalKulshrestha, Professor, Obst. & Gynecology
8. Dr. Ajay Pal Singh, Professor, General Medicine
PART – II
(DEPARTMENTAL INFORMATION)

19
1 Department inspected: GENERAL MEDICINE

2 Particulars of HOD
Name: Dr. O.P. Jatav______Age: 55 yrs. 05 months(Date of Birth) 21-10-1964
PG Degree Year Institution University
Recognised 1991 MGM Medical College, Indore Devi Ahilya University, Indore (M.P.)
Teaching Experience
Designation Institution From TO Total

experience
Asstt Professor S.S. Medical College Rewa 05-11-93 23-05-01 7 yrs 6 mon
Assoc Professor/Reader S.S. Medical College Rewa 24-05-01 21-01-07 5 yrs 7 mon
Professor G.R. Medical College Gwalior 22-01-07 Till date 13 yrs 2

months
Any Other Grand Total 25 yrs6mon
a) Purpose of Present inspection:

Grant of Permission/ Recognition/ Increase of seats /Renewal of recognition/Compliance Verification
b) Date of last MCI inspection of the department: 11-12-2019 (PG)

(Write Not Applicable for first MCI inspection) 13-07-2019 (UG)
c) Purpose of Last Inspection: Recognition renual of Seats
d)Result of last Inspection: Recognized (14 seats)
3 Mode of selection (actual/proposed) of PG students. NEET PG

4 If course already started, yearwise number of PG students admitted and available PG teachers during the last 5
years:
Year No. of PG students admitted No. of PG Teachers available in the dept.

(give names)
Degree Diploma

20
2019 14 11
Dr. O.P. Jatav, Dr. SushmaTrikha, Dr. Archana

Gupta, Dr. Sanjay Dhawale, Dr. ArchanaKansal ,Dr.
Ajay Pal Singh, Dr. PradeepPrajapati, , Dr.
Dr.R.Gaharwar, Dr.NeelimaSingh
2018 14 12

Gupta, Dr. ArchanaKansal,
Dr. Sanjay Dhawale, Dr. Ajay Pal Singh, Dr.
PradeepPrajapati, Dr. DharmendraTiwari, Dr. S.
Sahai,
2017 14 14

PradeepPrajapati, Dr. ArvindChauhan, Dr.
SandeepAharwar, Dr. DharmendraTiwari, Dr. S.
Sahai,
Dr.R.Gaharwar, Dr.NeelimaSingh, Dr.SJayant
2016 14 14.

Sahai,
2015 14 15.
Dr. O.P. Jatav, Dr. DeveshDutta Dr. SushmaTrikha,

Dr. Archana Gupta, Dr. ArchanaKansal,
Sahai,

21
Unit wise Teaching and Resident Staff

Unit _I____ Bed strength __40_______ :
S. Designation Name with Date of Birth Nature of PAN Number PG QUALIFICATION Experience Signat
No. employme ure of
nt TDS deducted Date wise teaching experience with designation & Institution Faculty
Memb
Full er
time/part
time/Hon.
Subject with Institution University Designation Institution From To Total * Benefit of

Year of Period publications
passing given in
promotion
Yes/No, if yes
List
publications
1 Professor Dr. O. P. Jatav, Full time ACIPJ 44256 MD Medicine MGM Devi Ahilya Assistant SS Medical 5-11-93 23-05- 7 yrs NO
1991 Medical University Professor College Rewa 2001
21-10-1964 Rs. 232660 College 6 mths
Indore MP Indore
Associate SS Medical
Professor College Rewa
21-01-
24-05- 2007 5 yrs
2001
7 mths
Professor GRMC 22-01- Till date

Gwalior 2007
13yrs
2mths

22
2 Associate Dr. RakeshGaharwar Full time AIHPG9191K MD MGM Devi Ahilya Assistant GRMC 10-09- 12-3- 10yrs08 NO
Professor Medical Professor Gwalior 2007 2018 months
11.-06-1978 Medicine College University
2006 Indore Indore

GRMC 2 yr
Associate
Gwalior
13-3- Till Date
Professor
2018
3 Assistant Dr. J.S.Namdhari Full time AAWPN0351P MD G.R.M.C Jiwaji Assistant G.R.M.C 10-05- Till Date 3 Year NO
Professor 2016 11
02-08-1959 Medicine Gwalior University Professor Gwalior months
1988
4 Senior Dr. Sylvester Justin Full time AVEPR3357G MD G.R.M.C MPMSU

Resident Medicine Jabalpur
2018 Gwalior
5 Junior Dr.Narendra Nagar

Resident
6 Junior Dr.Ashutosh
Resident
7 Junior Dr. Pranshu

Resident
8 Junior Dr.Sanjay
Resident
9. Junior
Resident
Note: Unit wise teaching / Resident staff should be shown separately for each Unit in the proforma.
Use only the Format provided. DO NOT devise your own format otherwise the information will not be considered. Fill up all columns
*Publications : Give only full articles in indexed Journals published during the period of promotion

23
I have verified the eligibility of all faculty members for the post they are holding (based on experience certificates issued by competent authority of the place of working). Their
experience details in different Designations and unitwise distribution is given the faculty table above.
Signature of Assessor Signature of Dean

24
Unit wise Teaching and Resident Staff:

Unit _II____ Bed strength _____30____ :
S. Designation Name with Date of Nature of PAN Number PG QUALIFICATION Experience Signature
No Birth employment of Faculty
. TDS deducted Date wise teaching experience with designation & Institution Member
Full
time/part Subject Institution University Designation Institution From To Total * Benefit of
time/Hon. with Period publications
Year of given in
promotion
passing
Yes/No, if yes
List
publications
1 Professor Prof Dr. Sushma Full time ACFPT3886J MD GRMC Jiwaji Echocardiologist Delhi 1986 1987 1 yr NO
Trikha Rs. 138014 Medicine Gwalior University Medical
25-08-1959 1986 Centre
S.R./Registrar GRMC
Gwalior
Neurology 25-08- 31-8- 5 yrs
deptt 1990 1995
Medicine 31-08- 23- 2 yrs
Deptt 1995 04- 8 mths
1998
Assistant GRMC 24-04- 4-07- 7 yrs
Professor Gwalior 1998 2005 2mths
Associate GRMC 04-07- 06-1- 11 years

Professor Gwalior 2005 2017 07
T.S. PROFESSOR month
Professor GRMC 7-1- 12-3- 1 Year &
Gwalior 2017 2018 3 Months
13-3- Till
GRMC 2018 date
Gwalior

25
2. Associate Dr. Dharmendra Full time ACVPT0923C MD GRMC Jiwaji Assistant GRMC 28-02- 12-3- 12 years NO
Professor Tiwari Medicine Gwalior University Gwalior 2006 2018
2005 Professor
07-08-1976
GRMC
Associate Gwalior
Professor 13-3- Till 1 yr3
2018 Date Months
3. Assistant Dr. Neelima Singh

Professor
3. Senior Dr. Sutkshee

Resident Sonwani
4 Junior Dr. Mayank

Resident Maheswari
5 Junior Dr. Sanchit

Resident
6 Junior Dr. Raghav

Resident
7 Junior Dr. Pankaj

Resident
I have verified the eligibility of all faculty members for the post they are holding (based on experience certificates issued by competent authority of the place of working). Their experience details in different Designations and
unitwise distribution is given the faculty table above.

26

Unit _III____ Bed strength ___30______ :
S. Designation Name with Nature of PAN PG QUALIFICATION Experience Signatur
No Date of Birth employmen Number e of
. t Date wise teaching experience with designation & Institution Faculty
TDS Member
Full deducted
time/part Subject Instituti University Designati Institution From To Total * Benefit of
time/Hon. with on on Period publications
Year of given in
passing promotion
Yes/No, if yes
List
publications
1 Professor Dr. Archana Full time AFGPG2078D MD Pt. Ravi Assistant GRMC 04-7- 12-3- 12 years NO
Gupta Medicin JLNM Shankar Professor Gwalior 2005 2018 9
e 1991 Medical University months
11-05-1965 College
Raipur
Associate GRMC 13-3- Till date
Professor Gwalior 2018 1 yr3
Months

27
2. Associate Dr. Full time ALIPP5121E MD GRMC Jiwaji S.R./ G.B. Pant 21-08- 15-10- 2 mths NO
Professor PradeepPrajapati Medicine Gwalior University Registrar New Delhi 2004 2004
25-06-1976 2004
Assistant GRMC 18-10- 12-3- 13yrs 05
Professor Gwalior 2004 2018 months
Associate GRMC
Professor Gwalior 13-3- Till date 1 yr3
2018 Months
3. Assistant Dr. Vijay Garg Full Time ARNPG5460 MD GRMC Jiwaji SR GRMC 8/7/15 11/9/17 2 year
Professor A Medicine Gwalior University Assistant Gwalior 20/9/18 Till date 10
2015 Professor GRMC months
Gwalior
3 Senior Dr. Rohit Tomar
Resident
5 Junior Dr. Balwant
Resident
6 Junior Dr Aman Yadav
Resident
7 Junior Dr. FarazAdil
Resident
8 Junior Dr. Bharat Batham
Resident
I have verified the eligibility of all faculty members for the post they are holding (based on experience certificates issued by competent authority of the place of working). Their experience details in
different Designations and unitwise distribution is given the faculty table above.

28

Unit _IV____ Bed strength __30_______ :
S. Designation Name with Nature of PAN Number PG QUALIFICATION Experience Signat
No. Date of Birth employment TDS Date wise teaching experience with designation & Institution ure of
Full deducted Faculty
time/part Memb
time/Hon. er
Subject Institution University Designatio Institutio From To Total * Benefit
with n n Period of
Year of publication
passing s given in
promotion
Yes/No, if
yes
List
publication
s
1 Professor Dr. Sanjay Full time AHQPD5358P MD GMC Bhopal Barkatullah Assistant SSMC 02-01- 04-07- 6 mths NO
Dhawale Rs. 118499 Medicine University Professor Rewa 2003 2003
14-07-1972 2002 GRMC 08-07- 09-07- 5 yrs
Gwalior 2003 2008
Associate GRMC 10-07-
Professor Gwalior 2008 12-3- 9 years&
2018 8
Professor GRMC, Months
Gwalior 13-3-
2018 Till Date
1 yr3
Months
2. Associate Dr. N. Singh Full Time AGGPS1620J MD G.R.M.C Jiwaji Associate GRMC 13-3- Till date 1 yr3 NO
professor 15-08-1961 Medicine Gwalior University Professor Gwalior 2018 Months
1999
3 Assistant Dr. S. Full Time 455441518399 MD NSCB Rani Assistant Baba 27-9-15 22-9-18 3 yrs
Professor Kannaujia Medicine Jabalpur Durgawati Professor SahebAm
2010 University bedkar,
Rohini 24-9-18 Till date 10
GRMC months
Gwalior

29
3 Senior Dr. Jagat Pal Full time AXKPG4235G MD GRMC Jiwaji Senior GRMC 31-12-18 Till date 6 months
Resident 20.06.1985 Medicine Gwalior University Resident Gwalior
2015
4 Junior Dr.
Resident AnkitaKashya
p
5 Junior Dr. Arun V.
Resident
6 Junior Dr. Anupam
Resident Raj
7 Junior Dr.
Resident UmeshPrajapa
ti

30

Unit _V____ Bed strength _____30____ :
S. Designation Name with Date Nature of PAN PG QUALIFICATION Experience Signatur
No. of Birth employmen Number e of
t Date wise teaching experience with designation & Institution Faculty
TDS Member
Full deducted
time/part
time/Hon.
Subject Instituti Universit Designati Institution From To Total * Benefit of

with on y on Period publications
Year of given in
passing promotion
Yes/No, if yes
List
publications

31
1 Professor Dr. ArchanaKansal Full time AJHPK6315J MD GRMC Jiwaji S.R./Registr GRMC 23-09- 22-09- 2 years NO
Medicine Gwalior University ar Gwalior 1995 1997
16-07-1967 1994
Assistant GRMC
Professor Gwalior
29-12- 01-01-
2002 2008 5 yrs
Associate
Professor
02-01- 12-3-
2008 2018
10yrs
GRMC 3mths
Professor Gwalior 13-3-
2018
Till date
1 yr3
months
2 Associate Dr. ShwetaSahai Full time AJJPS1621B MD Govt. Nagpur Assistant MPCD March April 1 year 1 NO
Professor Medical Professor 2005 2006 month
08-07-1967 Medicine College University Gwalior
Nagpur
1992
April 06-5- 12 years
GRMC 2006 2018
Gwalior
Associate GRMC
professor Gwalior 07-05-
2018 1 yr2
Till date Months

32
3. Senior Dr. Full time DLQPS8 MD GRMC Jiwaji Senior GRMC

Resident SutaksheeSonwani 314R Medicine Gwalior University Resident Gwalior
2018
28.10.1990
4. Junior Dr. BalwantPatle

Resident
5. Junior DrVikas Yadav

Resident
6. Junior Dr. Raghav Mittal

Resident
7. Junior Dr. Pankaj

Resident

33

Unit _VI____ Bed strength __30_____ :
S. Designation Name with Date of Birth Nature of PAN Number PG QUALIFICATION Experience Signat
No. employme ure of
nt TDS deducted Date wise teaching experience with designation & Institution Faculty
Memb
Full er
time/part
time/Hon.
Subject with Institution University Designation Institution From To Total * Benefit of

Year of Period publications
passing given in
promotion
Yes/No, if yes
List
publications
2 Professor Dr. Ajay Pal Singh Full time AZHPS1223R MD GRMC Jiwaji Assistant GRMC 19-10- 19-10- 5yrs NO
Gwalior University Professor Gwalior 2004 2009

01-07-1976 Rs. 152088 Medicine
Associate GRMC 20-10- 11-3-
2004 9 yrs
Professor Gwalior 2009 2018
04
months
Professor Grmc 12-3- Till Date
Gwalior 2018
1 yr3
Month
s

34
4 Assistant Dr. M. Sharma(MD) Full time CRKPS9579 MD G.R.M.C Jiwaji Assistant G.R.M.C 09-11- Till Date 3 Year 7 NO
Professor M 2015 month
02-08-1959 Medicine Gwalior University Professor Gwalior
2013
5 Senior Dr. RohitPratapTomar Full time 763870773603 MD TMMCR Teertha Senior GRMC 8-7-2019 Till date
Medicine C nkarMa Resident Gwalior
Resident 17-07-1991 2019 Morada haveer
bad Universi
ty
6 Junior Dr.SanchitChouksey
Resident
7 Junior Dr.
Resident MayankMaheshwari
8 Junior Dr Aditya Chouhan

Resident
Junior Dr. Sanjay Rawat

Resident

35
Note: 1. Unit wise teaching / Resident staff should be shown separately for each Unit in the Proforma.
2. Use only the Format provided. DO NOT devise your own format otherwise the information will not be considered. Fill up all columns
3. *Publications: Give only full articles in indexed Journals published during the period of promotion and list them here only. No Annexure will be seen.
4. Incase of DNB qualification name of the institution/hospital from where DNB training was done and year of passing must be provided. Simply saying National
Board of Examinations, New Delhi is not enough. Without these details DNB qualification holder will be summarily rejected.
5. Experience of Defence services must be supported by certificate from competent authority of the office of DGAFM without which it will not be considered.
I have verified the eligibility of all faculty members for the post they are holding (based on experience certificates issued by competent authority of the
place of working). Their experience details in different Designations and unitwise distribution is given the faculty table above.
Signature of Dean Signature of Assessor

FORM-MCI-13(ANE) 36
6. Has any of these faculty members been considered in PG/UG inspection at any other college or any other
subject in this college after 01.03.2015. If yes, give details.-NO
Date of Inspection Subject Institution
7 List of Faculty joining and leaving after last inspection:

Designations Number Names
Joining faculty Leaving faculty
Professor Nil
Associate Prof. Nil
Assistant Prof. Nil
SR/Tutor/Demons. 1. Dr. 1.Dr. Pankaj Jain
MukeshsinghTomar
2. Dr. Vinod Singh
Dhakad
3. Dr. RohitPratap
Singh Tomar
Others Nil
27. Faculty deficiency, if any

Designation Faculty available Faculty required Deficiency, if any
(number only)
Professor 4 3 Nil
Assoc Professor 7 4 Nil

Asstt. Professor 4 Nil
Sr. Residents 8 5 Nil

Jr. Residents 42 42 nil
Tutor/ Demonstrator NA
Any Other NA
8 List of Non-teaching Staff in the department: -

Department Name of Name of Name of Others
Name Technicians Assistants Attendants
1. Mr.AtulDubey(UD
C)
Department 1. Mr. P.K. Jain
2. Mr.
of Medicine 2. Mr.PawanKa
Homsingh(Peon)
ushal
1. Mr.Hebran Nil 3. Mr.Kadar
3. Mr.PankajVer
Singh Gohar Khan(Sweeper)
ma
4. Mr.ParmoleMajhi(
4. Miss.Asha
Mali)
Sharma
5. Mr.Ramji
Das(Khlassi)
9 Available Clinical Material: (Give the data only for the department of General Medicine)
Parameter On the Day of Average of 3 Days Random

FORM-MCI-13(ANE) 37
Assessment
OPD attendance upto 2 p.m. 297
New admissions 76
Total Beds occupied at 10 a.m. 264
Total Required Beds NIL
Bed Occupancy at 10 a.m. (%) 90%-95%
Major Operations NA NA
Minor Operations NA NA
Day Care Operations NA NA
Normal Deliveries NA NA
Caesarean Sections NA NA
Deaths 3
Note: Put N.A. for those columns not applicable
10 Year-wise available clinical materials (during previous 3 years) for department of General Medicine
S.No. Parameters Year 1 Year 2 Year 3
(Last Year )
1 Total number of patients in OPD 81609 80731 98731
2 Total number of patients admitted (IPD) 16229 15260 35260
3 Total Number of Major Operations NA NA NA
4 Total Number of Minor Operations NA NA NA
5 Total Number of Day Care Operations NA NA NA
6 Total Number of Normal Deliveries NA NA NA
7 Total Number of Operative Deliveries NA NA NA
8 Total Number of Caesarians NA NA NA
Note : Put N.A. for those columns not applicable
11 Intensive Care facilities
I. ICU
 No. of beds: 16
 Beds occupied on inspection day: …………………
 Average bed occupancy 14-16
 Available equipment
Defibrillator,
Holter
Ventillator,
Cardiac Monitor,
ECG Machine
Nebulizer
FORM-MCI-13(ANE) 38
Larngoscope,
Ambubag
BP Apparatus
Glucometer,
Pulse Oxymeter
Needle Cutter,
X Ray View Box
Oxygen Cylinder
Infusion pump
Suction machine
II. ICCU
 No. of beds: 12 (CARDIOLOGY DEPT.)

 Beds occupied on inspection day: …………………
 Average bed occupancy 10-11
Defibrillator,
Ventillator,
Cardiac Monitor,
ECG Machine
Nebulizer
Larngoscope,
Ambubag
BP Apparatus
Glucometer,
Pulse Oxymeter
Needle Cutter,
X Ray View Box
Oxygen Cylinder
III. Dialysis Section
No. of Beds 08
No. of Dialysis machines 07 (4 Working , 3 Non Working)
Beds occupied on inspection day …………………
Occupancy 6-8

FORM-MCI-13(ANE) 39
IV. Any other intensive care service provided: …………………..
12 Specialty clinics being run by the department and number of patients in each
S.No. Name of the Clinic Days on which held Timings Average Name of Clinic In-charge
No. of
cases
attended
1 Cardiovascular Daily 8.30 am Dr.P.Rastogi
-1.30 pm
Dr.R.Rawat
2 Nephrology Tuesday 10 am Dr.S.Dhawle
-1.30 pm
3 Endocrine Friday 10 am Dr.S.Trikha
-1.30 pm
4 Gastroeneterology Monday 10 am Dr.A.Kansal
-1.30 pm
5 Neurology Daily 8.30 am – Dr.D.Udaeniya
1.30 pm
Dr. arvindgupta
6 Any other Wednesday/Saturday 10 am Dr.A.P.Singh/Dr.A.Gupta
(Geriatric/Obesity) -1.30 pm
13. Services provided by the Department.
(a) Cardiology services (ICCU) – ECG, TMT, Echo including color Doppler, Holter
(b) Endoscopy 
(c) Dialysis 
(d) Bronchoscopy 
(e) Physiotherapy Section.
(f) Investigative facilities like Nerve conduction, EMG etc.
(g) Other special diagnostic facilities being provided by the department.
(These facilities are an integral part of Medicine Department and should be available
in the department even if super specialty departments exist in the institution)

FORM-MCI-13(ANE) 40
14 Departmental Library:
 Total No. of Books. 156

 Purchase of latest editions in last 13 years.
 No. of Journals 255

15 Departmental Research Lab. – PG Lab cum side LAB
 Space 600 sq.ft.

 Equipment : Semi –auto analyzer
ABG Analyzer
Electrolyte Analyzer
 Research projects utilizing Deptt research lab.
16 Departmental Museum (Wherever applicable).
 Space
 No. of specimens
 Charts / Diagrams
17 Space:
OPD IPD
Numbers of Rooms in 6 12
 Patient Exam. arrangement: Examination Table with curtain available
 Equipments : B.P. Instruments, ECG machine, Nebulizer, Glucometer

etc.
 Teaching Space : Available room no. 48 (Area 11 ft. 8’ x 15 ft 11’)
(MMW-I, MMW-II, KRH, ACADEMIC HALL)
 Waiting area for patients. : Available
18 Departmental Office Office Space for Teaching Faculty
 Space (Adequate) Yes/No HOD : 5.3x6.58 sq. m.

 Staff (Steno /Clerk). Yes/No Professors : : 5.3x6.58 sq. m.
 Computer/ Typewriter: Yes/No Assoc. Prof : 5 rooms of

FORM-MCI-13(ANE) 41
5.2 x 4.55 sq. m. each
Asstt Prof. 2 rooms of
4.4 x2.90 sq. m each.
Residents 2 rooms of
4.4 x2.90 sq. m each.
19. Clinico- Pathological conference Yes
20. Death Review Meetings Yes
21. Submission of data to national authorities if any - Yes
22 Equipments:List of important equipments available and their functional status
. (List here only – NO annexure to be attached)
Defibrillator 16 Pulse Oxymeters 16 Multipara Monitors 9
Upper GI endoscope 3 Colonoscope Available in Bronchoscope Available in

surgery ENT
dept.
Dialysis machines 7 ECG 12 TMT 2

4 (W) Shiftedto
Cardiology
3(NW)
Echo – color Doppler 1 Holter 1 Syringe pump 4
Resuscitation kit 6 Crash cart 4 Invasive Ventilators 12
Laryngoscope 12 Computerized PFT 1 (W)

equipment
24. Academic outcome based parameters
(a) Theory classes taken in the last 12 months – Number - 96
(Dates, Subjects, Name & Designation Available & Verified/
of teachers, Attendance sheet) Not available
(b) Clinical Seminars in last 12 months Number - 77

FORM-MCI-13(ANE) 42
Final Part II Final Part I 2nd Prof.

Theory ( per week) 4+1 (Dermatology) 1 1
Practical (per year) 60 30 45
(c) Journal Clubs held in last 12 months Number - 14
(d) Case presentations held in last 12 months Number - 126
(e) Group discussions held in last 12 months Number - 203
(f) Guest lectures held in last 12 months Number - 0
25. Any other information.

FORM-MCI-13(ANE) 43
PART III
POSTGRADUATE EXAMINATION
(Only at the time of recognition inspection)
1. Minimum prescribed period of training.3 yrs

(Date of admission of the Regular Batch appearing in examination)
2. Minimum prescribed essential attendance.80%
3. Periodic performance appraisal done or not?yes
4. Whether the candidates appearing in the examination have submitted their thesis six months before appearing
in examination as per PG Regulations.2000?yes
5. Whether the thesis submitted by the candidates appearing in the examination been accepted or not?yes
6. Whether the candidates appearing in the examination have (i) presented one poster (ii) read one paper at
National/State conference and presented one research paper which has been published/accepted for
publication/sent for publication during period of their postgraduate study period. yes
7. Details of examiners appointed by Examining University (Give details here, No Annexures).
8. Whether appointment of examiners, their eligibility & conduct of examination is as per prescribed MCI norms
or not ?yes
9. Standard of Theory papers and that of Clinical / Practical Examination: As per MPMSU, Jabalpur, M.P.
10. Year of 1st batch pass out (mention name of previous/existing University)
Degree Course MD – 1973/ MPMSU
Note: (i) Please do not appoint retired faculty as External Examiner
(ii) There should be two internal and two external examiners. If there are no two internal examiners
available in the department then only appoint three external examiners.

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1

STANDARD ASSESSMENT FORMFOR PGCOURSES YEAR 2019-20

4. Don’t add, alter or delete any column of SAF.

INSTRUCTIONS TO ASSESSORS: Please ensure that only original research papers

nature of Dean Signature of Assessor

STANDARD ASSESSMENT FORM FOR POSTGRADUATE COURSES

1. Name of Institution:_____GAJRA RAJA MEDICAL COLLEGE, GWALIOR, M.P.

Name …Dr.Diwakar.T.N. Residential Address (with Pin Code)

Designation Professor Malar Primrose apts, Rajaji Nagar Main

B). Particulars of Affiliated University

State Madhya Pradesh Madhya Pradesh Madhya Pradesh

Pin Code 482003 482003 482003

Phone 0761-2670340 0761-2670340 0761-2670332

E.mail: mpmsuregistrar@gmail.com Vcmpmsu108@gmail.com registrarmpmsu@mp.gov.in

nature of Dean Signature of Assessor

Date of Assessment: Name of Assessor:__

1. Name of Institution Director / Dean / Principal

2. Department inspected Head of Department

3. (a). Number of UG Recognised- 150 Permitted- First LOP date

(b). Date of last UG 13-7-2019 PG-11-12-19 No.U.12012/127/2016

nature of Dean Signature of Assessor

4. Total Teachers available in the Department:

Designation Number Name Total Teaching Benefit of

Dr. SushmaTrikha 32Yrs

Dr. A. Gupta 22 yrs

Dr. SanjayDhawle 19 yrs 8 mon

Dr. Ajay Pal Singh 19yrs

Dr. S. Sahai 16Yrs. 2 mon

Dr. R. Gaharwar 14Yrs08mon

Dr. P. Prajapati 18yrs 5 mon

Dr. D. Tiwari 16Yrs3 mon

Dr. N. Singh 19Yrs. 9mon

Dr. J.S.Namdhari 3 yrs

Dr. V. Garg 3 yrs

Dr. S. Kannaujia 4 yrs

Dr. Mukesh singh Tomar 1 yr

Dr. Vinod Singh Dhakad 11 months

Dr. Rohit Pratap Tomar 6 months

Dr. Sylvester Justin 6 months

5.Number of Units with beds in each unit:

Unit III- 30 beds,

6. Clinical workload of the Institution and Department concerned :

On the Day of On the Day of Average of 3 Days

OPD attendance upto 2 p.m. 297

Total Beds occupied at 10 a.m. 264

Total Required Beds NIL

Bed Occupancy at 10 a.m. (%) 90%-95%

Day Care Operations NA NA NA

Total Number of Deliveries NA NA NA

Total Caesarean Sections NA NA NA

Put N.A. whichever is not applicable to the Department.

7. Investigative Workload of entire hospital and Department Concerned.

Parameter Entire Hospital

nature of Dean Signature of Assessor

8. Publications from the department during last 3 years:

nature of Dean Signature of Assessor

17. Association of electrocardiogram abnormalities in human immunodeficiency virus

nature of Dean Signature of Assessor

9 Blood Bank License valid Yes

Blood component facility available Yes

Number of blood units stored on the inspection day 379

Average units consumed daily (entire hospital) 37

Name: _Dr. Saroj Kothari Age: Years (Date of Birth)_