Implementation of Elective Plan:

A mandatory 4 weeks’ Electives Rotation schedule has been programmed to be replaced by

Clinical rotation in SMDC planner of 4th year, batch wise. These students will only be attending
their elective rotation during this period. Therefore, at any given time only a limited number of
students will go for electives rotation.

Students on Clinical/Electives rotations are not just observers, but are active participants in patient
care, learning, and team function. The student’s active roles* will include:
1. Independently gathering data- patient history, physical examination, review of electronic
medical records.
2. Synthesis of information from history, examination, and data review
3. Formulation of assessment and prioritized problem list
4. Suggestions on next steps in evaluation and management
5. Self-directed learning, targeted to answer questions that advance patient’s care
6. Documentation of History and Physical examination for new patient evaluations or
consultations; progress notes on subsequent hospital days
Structure and Organization:

 For the mandatory electives rotation in 4 th year; SMDC will specify the dates during which an
elective will be undertaken by students.
 Electives will be entirely self-arranged by students, with the student organizing travel,
accommodation, the placement itself, and other aspects like travel insurance.
 Students will need to cover travel and living costs by themselves.

Where the students will go for Electives Rotation?

The students can go nationally or out of country to other institutions and may even select the
electives rotation in their own institution. However, it is encouraged that students seek electives
outside their own institution for diversity of experience. However, in each of the case students will
arrange themselves for placement of their own electives rotation.

 Students should conform to general guideline of Electives rotations*.

 The elective office will ask the student to provide a copy of acceptance of Electives rotation.
 At the end of the rotation, the student shall get the Electives Form signed by the supervisor
for onward submission to electives office.
Elective evaluation form

 At the conclusion of the elective, concerned faculty/preceptor will evaluate students. This
formative evaluation must be submitted within one week of completion of the rotation.
 Students will be required to submit a comprehensive report on the training/research
undertaken, to the Elective Office which will also include reflection.
 Failure to hand over the evaluation form will result in zero attendance for this rotation
 The Grading will be done as Satisfactory/Unsatisfactory
(Example of elective evaluation form and attendance forms attached)
 SHALAMAR MEDICAL AND DENTAL COLLEGE
UNDERTAKING BY THE STUDENT PROCEEDING ON ACADEMIC LEAVE TO UNDERTAKE AN
ELECTIVES ROTATION
I the undersigned hereby state that I am proceeding on academic leave to undertake Electives
rotation in ______________________ at_______________________________
From _____________________________ to _______________________________
I solemnly affirm the following:

1. I have carefully read the ‘SHALAMAR MEDICAL AND DENTAL COLLEGE ADMINISTRATIVE
GUIDELINES FOR GRANT OF ‘ACADEMIC LEAVE’ TO STUDENTS UNDERTAKING ELECTIVES’
and will follow these guidelines in letter and spirit.

2. I and my parent / guardian hereby agree that we will not hold the administration of
Shalamar Medical and Dental College Lahore responsible for any untoward incident like
theft, loss of valuables, illness, disability, death, legal or medico legal issues during the
period of academic leave granted for the abovementioned elective rotation.

3. I fully understand that I will be granted waiver for attendance and any assessments /
evaluations / internal examinations scheduled during the period of my academic leave up
to a maximum of four weeks in an academic year.

Name: _____________________________ S/O, D/O: _____________________________

Roll No: ____________________Class:____________ CNIC No: ________________________

Address: _____________________________________________________________________

Signature: ____________________________Date: ____________________________________

COUNTER SIGNATURE BY PARENT / GUARDIAN:

Name of Father/Mother/Guardian: _________________________CNIC No:_______________

Address: ____________________________________________________________________

Signature: ___________________________Date: __________________________________

(Please submit the form to the Office of Student Affairs-SMDC before proceeding for Electives)
 ELECTIVE EVALUATION FORM
(To be filled by the Supervisor of Electives)

Thank you for accommodating our student for an elective experience under supervision.
Since Electives are a curriculum requirement, we require official documentation about the
satisfactory completion of the students’ elective.

You are requested to kindly complete this form, please sign and stamp the form and handover
this completed form to the student in a sealed envelope.

Name of student: ___________________ Department : ___________________

Name of Supervisor: ___________________ Institution : ___________________
Electives Start Date: ___________________ Electives End Date: ___________________

Please rate each Category

Outstanding Above Average Below Unsatisfactory Not
Average Average Applicable
Demonstrate Factual Knowledge
Data Gathering Skills
Problem Solving Skills
Initiative & Productivity
Attendance & Reliability
Judgment & Maturity
Interpersonal Relationship
Social Sensitivity
Clarity in Student Objectives
Degree of Achievement of Objectives

Outstanding : Exceptional, superior, far exceeds reasonable expectations, only occasionally observed
among student.
Above Average : Unusually strong, often exceeds reasonable expectations
Average : Equal to majority of students at this level of training occasionally exceeds reasonable
expectations.
Below Average : Often falls short of reasonable expectations, but acceptable
Unsatisfactory : Not acceptable for student at this level of training, required define recommendation for
remedial work:

Attendance Grading (tick ( ) one):

(>90%) Outstanding (75& to 90%) Below Average <75%) Unsatisfactory

Overall Performance (tick ( ) one)

Outstanding Above average Average Below Average

Constructive Feedback to the student

(Comments which may be included in student’s letter of recommendation
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________

Has this final assessment been discussed with the student? Yes No
How do you consider this student’s service and achievement during his/ her electives?
 Satisfactory Unsatisfactory

Additional Comments: _________________________________________________________________

___________________________________________________________________________________
___________________________________________________________________________________

Supervisor’s Signature: _____________________ Name: _________________________

Date: _____________________ Title: __________________________

Stamp:_________________________

Please complete and return this form to:

Electives Office,
Shalamar Medical & Dental College,
Shalimar Link Road, Mughalpura, Lahore
042-36835555 ext#212-14 & 311

Thank you for your help and support

 Shalamar Medical & Dental College
Acceptance of Electives Student
To be filled by student:

Name of Student:____________________________________________________________________

Roll No:_______________________________________Class:_________________________________

Electives Site: ______________________________________________________________________

Department: ________________________________ Specialty: _____________________________

Supervisor: _______________________________________________________________________

Start Date:_____________________________________ End Date:______________________________

(Please submit the form to the Office of Student Affairs-SMDC before proceeding for Electives)
 FEEDBACK FORM

To be filled by student at the end of electives/research rotation

Name Institution

Department Date of Elective/

Research Rotation:
Please give us your views by placing a tick in appropriate column of each of the rows

Strongly Agree=SA Agree=A Disagree=D Strongly Uncertain=U

Disagree=SD
1. Elective/Research Rotation Content and Organization SA A D SD U

1.1 The learning objectives were clear and shared at the o o o o o

beginning of elective rotation
1.2 The elective rotation was well organized (e.g. o o o o o
Administrative matters, Notification of changes etc.)
1.3 I had the opportunity to discuss clinical cases with o o o o o
supervisor
1.4 I have seen 10/more than 10 cases during my rotation o o o o o

1.5 I had the opportunity to utilize skills lab and simulation for o o o o o
clinical cases
2. Student Contribution SA A D SD U

2.1 I participated actively in the learning o o o o o

2.2 I think I have made progress in this elective/research o o o o o

rotation
2.3 I had the opportunity to communicate with patients o o o o o

3. Supervisors SA A D SD U

3.1 My supervisors have good communication skills o o o o o

3.2 The supervisors are committed to teaching o o o o o

3.3 The way my supervisors dealing with elective trainees is o o o o o

satisfactory
3.4 I have been respected by my supervisor o o o o o

4. Quality of Delivery SA A D SD U
4.1 The pace of rotation was appropriate o o o o o

4.2 Ideas and concepts were presented clearly o o o o o

4.3 The instructor communicates the subject matter effectively o o o o o

4.4 The instructor gives individual attention o o o o o

4.5 The Instructor arrives on time o o o o o

4.6 The instructor gives enough time for practice of skills o o o o o

Suggestions for Improvements:-

Date:-

Signature:-

(Please submit the form to the Office of Student Affairs-SMDC after completion of Electives)