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NATIONAL BOARD OF EXAMINATIONS

(Ministry of Health & Family Welfare. Govt of India)

Mahatma Gandhi Marg (Ring Road)

Ansari Nagar, New Delhi – 110029

Phone : 26589119, 26589517,

Fax : 26589786, 26589781

Website : www.natboard.nic.in

No : ACC/Policy dated 29th June, 2005

To : Directors / DNB Coordinators,

Accredited Hospitals/ Institutions

Sub : Policy decisions – DNB training

Sir,

I am directed to convey to you the following decisions taken by the Governing Body of the National Board with regard to the admission and conduct of DNB courses in your hospital/institution:-

1. Validity of Primary / CET: The restriction on the validity period of Primary pass candidates has been removed forthwith. The restriction on the validity of the CET has also been removed.

2. No marks for CET : Effective from June, 2005, the Central Entrance Test (CET) shall be of qualifying nature only. Therefore, Marks / Merit list shall not be applicable and should not be insisted upon while enrolling candidate(s).

3. Admission Ratio : In super session to the Board’s letter dated 21^st January, 2004, the admission ratio of 75 : 25 between Primary and CET passed candidates has been dispensed with. All accredited institutions are hereby allowed to enroll either Primary pass or CET pass candidate against their allotted seat(s).

4. Selection process : Accredited hospitals are NOT to conduct any written examination for selecting candidates as this defeats the very objective of the Board’s conduct of the CET. Selection of DNB trainees is to be done only through an Interview and Objective assessment of the candidate’s aptitude, communication and technical skills. Details of the method adopted for selection, along with marks obtained and rank of each candidate is to be sent to the Board immediately on declaration of results.

5. Time frame/Schedule for enrolment : Specialties whose period of Accreditation ends in December or June are to enroll DNB trainees each year only for the academic sessions beginning in January or July respectively. The following admission schedule is to be adhered to during the admission process.

· Date of Centralised Entrance Test : 2^nd Sunday of June & December each year.

· Tentative date of Results : On or before 30^th June & 31^st December each year.

· Publication of Advertisement : Within one week of announcement of results.

· Last date for candidates to apply : Within 15 days of publication of results for admission : i.e.15^th July or 15^th January each year.

· List of selected candidate to be : Within 7 days of holding aptitude test displayed by accredited institute i.e. 22^nd July or 22^nd January each year.

· Candidates to join the institution by : Three weeks after the display of results by institution

i.e. 15^th August or15^th February each year.

Contd….2

-2-

6. Stipend / Remuneration: Accredited hospitals should pay each trainee (both Post MBBS & Post Diploma) a minimum monthly stipend not less than the following rates. It is also desirable that the Hospital provides accommodation to their trainees in addition to their stipend. NBE has no objection to the payment of a sum exceeding the amount stipulated, according to the stature of the institution and work load of the trainees:-

Programme	First year	Second year	Third year
Broad Specialities	Rs. 8,000/-	Rs. 9,000/-	Rs.10,000/-
Super Specialities	Rs.10,000/-	Rs.11,000/-	Rs.12,000/-

7. Leave for DNB trainees : Leave to DNB trainee(s) as and when required may be granted by the Accredited institutions as per their respective leave policy.

8. Assesment of Trainees : All Accredited institutions shall hereafter conduct Six monthly assessment tests of their DNB trainees. The assessment would cover theoretical knowledge, clinical skills procedural skills, communication skills, knowledge of health care system, ethical & legal issues. Semester-wise (6 monthly) assessment of the knowledge of DNB trainees by formal Structured short essay type (10) questions. The exams will be conducted by institutions under supervision of Local Appraisers.

A panel of Local Appraisers, specialty wise (with Post graduate teaching background from local institutions) should be sent to the Board’s Training Monitoring Cell by the Accredited institutions. The cell will select one appraiser from the panel for appraisal of the training in the Accredited Institutions.

Respective Appraisers will study the log book entries of all trainees of his specialty and also assess the progress of thesis work. He/she will then send a report to the NBE Training Monitoring Cell.

9. Assesment of Accredited Institutions: All Accredited institutions will be closely monitored till two batches of students have completed their training. If it is satisfactory the period of accreditation can be extended upto 5 years. If the training is not satisfactory, the concerned institution/ hospital will be given six months for correction of deficiencies. If at the end of this period the institution is not in a position to fulfill the requirements, the accreditation granted to the institutions will be reviewed.

The parameters for institutional assessment will be as follows. The Board’s appraisers in his report will comment upon:

· The objectives of the Accredited institutions, expected outcome of DNB training; adequacy of learning resources (library, clinical materials, lab services etc.);

· Number of inter-departmental conferences held in the past six months (with list of topics discussed);

· Research publications;

· Records of cases presented by DNB trainees;

· Continuing Medical Education programmes; full time / part time staff in the hospitals / institutions;

· Rotational training programme in basic sciences;

· Information on status of implementation of curriculum etc.

10. Library facilities : The minimal learning resources in the Accredited / institutions / hospitals should be as follows:-

· Standard latest editions of post-graduate text books in the subject.

· Internet access to trainees with institutional subscription to e-libraries and journals (like DELNET etc).

· Journals in the subject (at least one international and one national)

Contd….3

-3-

Accreditation fees : All Accredited Corporate hospitals and other profit making institutions shall continue to pay the Accreditation fees of Rs. 40,000 per specialty. However, the Board has decided to consider exemption of the following categories of Accredited institutions from payment of inspection fees, if requested for, on a case to case basis, provided, they bear the travel & accommodation expenses of the inspectors:-

a) Government & Defence Services Hospitals

b) Charitable / Trust hospitals who are Non profit oriented

12. Training Charges: With a view to provide relief to the training hospitals, to maintain uniformity and also to inculcate seriousness into the candidate towards their training, the Board has decided to increase the annual training charges. Accredited hospitals are hereby allowed to collect a sum not exceeding Rs. 50,000/- from their DNB trainee(s) each year under the following heads:-

a) Tuition fees - Rs. 15,000

b) Library fees - Rs. 5,000

c) Internet fees - Rs. 10,000

d) Guest Lectures, Seminar/Conference fees - Rs. 10,000

e) Six monthly Theory & Practical Exam fees - Rs. 10,000

13. Capitation Fees/Security deposit: Accredited hospitals should NOT demand / levy any other charges like capitation fees / security deposit, etc from its DNB trainees.

Each of the above decisions are for implementation with immediate effect. This letter supersedes all letters issued in the past.

Yours faithfully,

(Dr. A. K. Sood)

Executive Director

National Board of Examinations

(Ministry of Health & Family Welfare, Govt. of India)

Ansari Nagar, Ring Road, New Delhi-110029.

Phone : 011 26589119, 26589517

Revised Minimum Criteria for Accreditation for DNB Courses

1. Minimum Criteria of Patient care in each speciality (for ONE seat **)

** For training of two candidates the minimum number of beds and General beds should be 1.5 times the number of required for intake of one Candidate as mentioned above

Hospital Total Beds : 100

Broad Specialties	Indoor Beds in the specialty	*General beds in the specialty**	Outpatient attendance per year	*General OPD**	Inpatient occupancy per year	*General bed occupancy**
General Medicine, General Surgery, Obstetrics & Gynaec., Paediatrics, Respiratory Diseases	35	30%	5,000	30%	1000	30%
DVD	10	30%	5,000	30%	200	30%
ENT, Ophthalmology, Orthopaedics, Psychiatry Radio-therapy	25	30%	5,000	30%	1000	30%
Anesthesiology, Microbiology Pathology, Radio-Diagnosis	The minimum word load in respect of the procedures carried out in each specialty may be furnished in the application form, for the Board to determine the potential of DNB training available in respective specialties.

Super Specialties

Indoor Beds in the specialty

General beds * in the specialty

Outpatient attendance per year

General * OPD

Inpatient occupancy per year

General bed * occupancy

C. T. Surgery,

G. I. Surgery,

Neuro Surgery,

Paediatrics Surgery,

Plastic Surgery,

Surgical Oncology,

Genito-Urinary Surgery

30%

3500

30%

1000

30%

Cardiology,

Endocrinology, Gastroenterology,

Medical Oncology

Nephrology,

Neurology

30%

3500

30%

1000

30%

* General ward beds are those ‘earmarked’ beds / cases whose patients are to be looked after by DNB trainees under the supervision of Consultants and charged `at cost’ only, with no special fees or profit.

Contd…2

-2-

2. Staff : -(Common for all specialties)

S. No.	Particulars	For One Candidate	For Two Candidates
a.	Senior Consultant with 8 years experience after MD/MS/DNB/MCh/DM in the speciality applied for	1	2
b.	Junior Consultants with 5 years experience after MD/MS/DNB/MCh/DM in the specialty applied for	1	2
b.	Note: Out of the Two consultants (one Senior and one Junior), atleast one should be a recognized Post Graduate Teacher while atleast One should be employed on Full Time salaried basis in the speciality.
c.	Whole time registrar/Sr. residents with postgraduate qualification in the speciality applied for.	2	2
d.	Whole time Resident with or without postgraduation qualification	--	1

3. Emergency Medicine/Critical Care:

Should have 24 hours emergency services having adequate number of beds with supportive facilities for resuscitation and good medical cover.

4. For Surgical Specialties:

- Adequate number of operation theatres

- Adequate equipments as required for the concerned speciality

- Anaesthesiologists both for the service and training of candidates

- Other para medical staff to help in the operation theatre

- Intensive care unit for surgical emergencies

- Post operative ward

5. Supportive Services:-

Radiology and other essential contrast studies

- Clinical Haematology

- Clinical Mircrobiology

- Clinical Pathology/Histopathology and Cytology

- Any special investigative procedures required for the concerned specialty.

Department of Dietetics with trained dietician.

Contd…3

-3-

6. Physical Facilities :-

a) Out patient department :-

The hospital should possess adequate space for

- Registration of patients’ along with facilities for record keeping.

- Adequate number of rooms for examining the patients in privacy.

- Case conference room (OPD) teaching room.

- One or more side rooms for OPD procedures such as pleural aspirations dressings, plaster application, minor operation room etc.

- Site laboratory to provide immediate facilities for routine investigative procedures.

b) Inpatient Department :-

The hospital should possess adequate space for doctor’s duty room with attached toilet, adequate space for each bed and in between for side laboratory, for clinical investigations and separate room for clinical conference (ward teaching).

7. Training in Basic Sciences:-

The earlier practice of producing a letter from a Medical College to train DNB trainees in Basic Medical Sciences has been discontinued. The training/teaching in Basic Sciences concerning the specialties will be insisted upon in future.

The hospital seeking accreditation should arrange appropriate number of lectures / demonstrations / group discussions / seminars in Basic sciences as related to the specialty concerned.

Accredited hospitals should also give each of their DNB trainees a mandatory One month rotation training each year, (in addition to the routine duties) in their Hospital’s Laboratory so as to enable them to gain knowledge in Laboratory procedures in subjects like Pathology, Histapathology, Biochemistry, Microbiology, Genetics etc. The institution may also arrange for training in all Basic Sciences as per the Syllabus. An undertaking to this effect is to submitted to NBE while applying for Accreditation.

8. Training Schedule :-

The hospital must arrange for didactic lectures, special clinics as related to concerned specialty, clinical meetings / group discussions / seminars / workshops / Inter unit departmental meetings / journal clubs etc.

The hospital applying for accreditation must have a good Library with adequate number of Standard text books of latest edition, all the Indian journals in the specialty in which the accreditation is sought / subscribed for and preferably Two foreign journals. Facilities for students to study and consult the textbooks and journals with trained librarian to cater to the needs of the students. The library should be open even on Sundays and holidays.

9. Remuneration / Stipend:-

Accredited hospitals should pay each trainee (both Post MBBS & Post Diploma) a minimum monthly stipend not less than the following rates. It is also desirable that the Hospital provides accommodation to their trainees in addition to their stipend. NBE has no objection to the payment of a sum exceeding the amount stipulated, according to the stature of the institution and work load of the trainees:-

Programme	First year	Second year	Third year
Broad Specialities	Rs. 8,000/-	Rs. 9,000/-	Rs.10,000/-
Super Specialities	Rs.10,000/-	Rs.11,000/-	Rs.12,000/-

An undertaking to pay all DNB trainees at the above mentioned rates should be submitted to NBE while applying for accreditation. Contd…4

-4-

10. Training Charges:-

With a view to provide relief to the training hospitals, to maintain uniformity and also to inculcate seriousness into the candidate towards their training, the Board has decided to increase the annual training charges. Accredited hospitals are hereby allowed to collect a sum not exceeding Rs. 50,000/- from their DNB trainee(s) each year under the following heads:-

a) Tuition fees - Rs. 15,000

b) Library fees - Rs. 5,000

c) Internet fees - Rs. 10,000

d) Guest Lectures, Seminar/Conference fees - Rs. 10,000

e) Six monthly Theory & Practical Exam fees - Rs. 10,000

11. Capitation Fees/Security deposit: Accredited hospitals should NOT demand / levy any other charges like capitation fees / security deposit, etc from its DNB trainees.

12. Library facilities :

The minimal learning resources in the Accredited/institutions/hospitals should be as follows:-

· Standard latest editions of post-graduate text books in the subject.

· Internet access to trainees with institutional subscription to e-libraries and journals (like DELNET etc).

· Journals in the subject (at least one international and one national)

13. Record Keeping:-

Good record department with follow up record.

______________

a) Tuition fees - Rs. 15,000

Ansari Nagar, Ring Road, New Delhi-110029.

1. Minimum Criteria of Patient care in each speciality (for ONE seat **)

Hospital Total Beds : 100

Broad Specialties

Super Specialties

5. Supportive Services:-

a) Out patient department :-

b) Inpatient Department :-

9. Remuneration / Stipend:-

10. Training Charges:-

a) Tuition fees - Rs. 15,000