First name, middle name, last name and age of the patient

The clinical diagnosis:

The basic _______________________________________________

Complications____________________________________________

Accompanying diseases____________________________________

Student _____________________________ year, medical faculty

Group_______________________________

Place of taking practice:

Country______________________________

City (town) ____________________________

Hospital______________________________

Department ___________________________

Beginning of supervision_____________ (date)

Ending of supervision _______________ (date)

Appendix 5

Registartion of the title page of the educational-research work of the students (erw)

Tver State Medical Academy

EDUCATIONAL-RESEARCH WORK OF THE STUDENT

SUMMARY PAPER

THEME: ____________________________________________________

_____________________________________________________________

ERW has been fulfilled by:

Student _______________________________year

__________________faculty _________group

Date of the summary paper finishing___________

Appendix 6

DIGITAL REPORT

(Summer) industrial practice in therapy from (date) __________ till _______

Student ________________________ the medical faculty _________group

Country _________________ city (town) ___________________________

Hospital _________________Department __________________________

Name of the work	What the student has seen	Where the student took part	What the student has executed independently
Quantity amount
Supervised patients in a hospital
Receiving patients:
at a polyclinic
at a reception ward
participation in the head doctor daily rounds
visiting patients at their homes
with the doctor
independently
night watching
discharging patients with the official registration of papers
filling in system for drop-by-drop introduction of medicinal substances
Performing
drop-by-drop introduction of medicines
intravenous jet injections
hypodermic injections
intramuscular injections
gastric lavage
gastric sounding
duodenal sounding
pleural punctures
ascetic liquid removal
bloodletting
arterial pressure measurement
electrocardiogram records
X-ray examination of the stomach
X-ray of the chest
carrying out physiotherapeutic procedures to the patients
Attendance at:
clinical-path anatomical conference
scientific-practical conference
conversations with the patients
taking part in release of a bulletin with the theme:
Assistance at the urgent conditions. To list diseases/cases:
1.
2.
3.
4.
ERW with the theme:

Seal of the medical establishment. Student ____________________(signature)

Head of the training of the base medical establishment ____________ (signature)

Head of the training from the Academy ________________________ (signature)