COLLEGE OF PHYSICIANS & SURGEONS PAKISTAN

ACCREDITATION FORM
FCPS MCPS
(Tick only one)
DISCIPLINE: Department of Plastic & Reconstructive Surgery

(Separate form to be filled for each discipline to be accredited)

I. INSTITUTION:

1. Name: PNS Shifa Hospital

Head of Institution: SURG.CDRE. MALIK WAQAR AWAN TI (M)

Designation: Commandant

Mailing Address: PNS Shifa Hospital, DHA II, Karachi

Office No: (with extension if available) 021-48506528 Fax No:

Cell No: 03334343040 E-mail: Irfanilahi63@gmail.com

Focal person (if any):

Cell No: 03334343040 Office No. 021-48506528 E-mail: irfanilafi63@gmail.com

2. Disclosure: (please Specify)

a). Public Sector Private Sector Armed Forces

Any other like Autonomous, Semi Autonomous

3. Owns Hospital:

a) Single Hospital

b) Multiple sites

4. Has the following Undergraduate programmes:

a) M.B.B.S

b) B.D.S

c) Nursing School

d) Para Medical / Medical Technical School

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5. Other CPSP approved Residency Programmes in the Institution:

S. No. Name of Residency Programme

1 FCPS Surgery 9. FCPS Ophthalmology

2 FCPS Medicine 10. FCPS Gynaecology
3 FCPS Nephrology 11. FCPS Paediatrics
4 MCPS Radiology
5 FCPS Psychiatry
6 FCPS Microbiology
7 FCPS Chemical Pathology
8 FCPS Haematology

6. Other ongoing University postgraduate programmes in the Institution, for example, MS, MD etc:

S. No. Name of other ongoing training programme

NIL

7. Relevant Hospital Certification, for example, Standards of Punjab Health Care Commission or
other relevant authority:

Yes No ISO-9001

8. Approved by PM&DC for House job & Internships:

Yes No

9. Institution Vision and a Mission Statement (if yes please mention below):

PNS Shifa Hospital provides total health care to its patients with the highest level of skills,

professionalism and ethical practice leading to their effective care and treatment. PNS

Shifa is committed to continued quality improvement.

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II. OTHER SERVICES AVAILABLE IN THE INSTITUTION:
1. Pathology Services:

a) Histopathology Yes No

b) Chemical Pathology Yes No

c) Haematology Yes No

d) Microbiology Yes No

e) Virology Yes No

f) Immunology Yes No

g) Others (specify) Yes No

h) Post-mortem facilities available in the hospital Yes No

Online Reports (preferred) Yes No

In charge Pathology Services:

Name: Surg. Cdre Raza Jafar

Qualification (with dates):

FCPS Chemical Pathology, 1998

2. Transfusion Services: Yes No

3. Pharmacy Services Institutional (preferred): Yes No

Incharge Pharmacist:

Name: Lt PN Kamran BSc

Qualification (with dates): B Pharmacy, 2010

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 4. Radiology/ Imaging:
Make &
Facilities available in the institution type of Machine

X-rays Yes No Canon CX-D1 /2012/Japan

Ultrasonography Yes No Toshiba -Nemio 20/ 2005/ Japan

Yes No
CT Scan Aqulion-16/2008/ Japan

MRI Yes No 1.5 Tesla, Excelart Vantage/ 2008/ France

Mammogram Yes No Medtronic/ 2004/ Italy

Others (specify) DEXA Scan MEDIX DR/ 2016/France

Colour Doppler Ultrasound APLIO-500 Platinum/Japan/ 2016
_______________________________________________________________________________________

5. Medical Records:

Manual Computerized Mixed

MIS

Central Record Keeping of the Institution Yes No

III. DEPARTMENT:
Unit (Seeking Accreditation): Department of Plastic & Reconstructive Surgery
1. _____________________________________________

Name of Head of Department: Surg. Cdre Muhammad Irfan Ilahi TI(M)

Designation: Classified Specialist and Associate Professor

Mailing Address: Department of Plastic and Reconstructive Surgery PNS Shifa Hospital,DHA Phase 2 Karachi

Office No: (with extension if available) 021-48506528 Fax No:

Cell No: 03334343040 E-mail : irfanilafi63@gmail.com

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 Name of the Head of Unit (if different from above): Same as above

Designation:

Mailing Address:

Office No: (with extension if available) Fax No:

Cell No: E-mail:

2. Specialty Specific Equipment’s:

S. No. Equipment(s) Name Number Model

1 Electric Dermatome 01 2015

2 Bipolar diathermy 01

3 Skin Graft Mashers 02 2017

4 Burn Shower Trolley with Panel 01 2003

5 Hand Held Doppler 01 2015

6 Plastic Surgery Instruments 02 2014

7 Micro Surgery Instruments 02 2014

8 Micro Clamps 04 2012

9 Varioscope 01 2010

10 Magnification Loupes 01 2010

11 Operating Microscope 01

12 Cardiac Monitors 08 Under procurement

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13 Anaesthesia Machine

14 Infusion Pump 02 2012

15 OT Lights Fixed/portable 02 2012

16 OT Table (old) 01 2013

17 Suction Machine 04 2016

(Attach a separate sheet if required)

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3. Bed Strength of the Unit:

Total number of beds: 15

Male: 10 Female: 05

No. of ICU Beds Nil

No. of High Dependency Beds Nil

Other Beds Paediatric Beds: 05

Private Rooms: NIL Semi Private Rooms: 02

4. Average inpatients stay in the Ward during the last 03years:_____4-7 days_______________________________

5. Bed Occupancy Rate in last 06 months: _________________50%____________________________________

5. Work Load:

a) List of 20 important conditions seen in unit in the last six months in order of decreasing frequency.

1. Major Burn Injuries _______________________________________________________________________

2. Minor Burn Injuries________________________________________________________________________

3. Compound Fracture Of Lower Limb___________________________________________________________

4. Hand Injury______________________________________________________________________________

5. Peripheral Nerve Injury____________________________________________________________________

6. Post Burn Contracture_____________________________________________________________________

7. Crush Injuries of Hand_____________________________________________________________________

8. Diabetic Foot____________________________________________________________________________

9. Cleft Lip & Palate ________________________________________________________________________

10. Hypospadiasis___________________________________________________________________________

11. Flexor Tendon Injury______________________________________________________________________

12. Vascular Malformation ____________________________________________________________________

13. Facial Injuries___________________________________________________________________________

14. Soft Tissue Tumor________________________________________________________________________

15. Carpel tunnel Syndrome___________________________________________________________________

16. Congenital Hand anomilies_________________________________________________________________

17. Congenital Foot Anomilies__________________________________________________________________

18. Malignant Tumour of head and neck__________________________________________________________

19. Pressure Sore___________________________________________________________________________

20. Soft Tissue Tumor_______________________________________________________________________

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 b) List the procedures performed in the unit in last six months in order of decreasing frequency:
1. Wound excisions and Debridement___________________________________________________

2. Skin Grafting’s________________________________________________

3. Congenital Hand Anomalies__________________________________________________________

4. Soft Tissue Injuries of Hand____________________________________________

5. Soft tissue injuries of Face_____________________________________________

6. Crush Injuries of Lower Limbs____________________________________________________

7. Limb Salvage Surgeries_________________________________________

8. _Fascio cutaneous Flaps__________________________________________

9. _Sural Artery Flaps_____________________________

10. Free Flaps_________________________________________

c) Total number of deaths in the unit in the previous 06 months: Nil

6. Seminar / Conference Room:

Seminar Room near the Ward: Yes No

Audio Visual Aids Resources:

Multimedia: Yes No

Flip Charts / white board etc: Yes No

Photo Copier: Yes No

Scanner: Yes No

Photographer available: Yes No

Others (specify):

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IV. FACULTY:
1. (Please enclose letter of appointment of the faculty members and provide pertinent Curriculum
Vitae of each faculty member listed):
Supervisor
Status with
Designation & Qualification
S. their
Name Date of joining with year /
No. Registered
the present post Institution
Supervisor
Number

01 Surg Cdre Irfan Illahi TI(M) Classified specialist MBBS 1987 Formalities
Associate Professor FCPS Surgery 1999 completed
FCPS PLAST 2004

2. Able to devote sufficient time to fulfil their supervisory and teaching responsibilities:
(Please attach proposed / existing weekly schedule of the whole
faculty) (Evidence of Faculty Evaluation and Feedback to Supervisors)
___________________________________________________________________
___________________________________________________________________

3. Is the unit complete with Professor, Associate Professor, Assistant Professor and / or Senior
Registrar?

Yes No

4. Designation of the posts yet to be filled:

Professor and Senior
registrar__________________________________________________

____________________________________________________________________
_________________________________________________________________
___________________________________________________________________

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 5. Faculty Related Policies:
Faculty will be encouraged to attend CPSP sponsored and other related educational workshops.

Faculty will be affiliated with Bahria University of Medical and Dental College for teaching experience.
Faculty will be encouraged to engage in research and writing
Whenever possible faculty members will have protected time for research and writing, once a week

6. Faculty Research & Publications: (Add additional sheet if

required) Annex -A

____________________________________________________________________
_________________________________________________________________
___________________________________________________________________

V. ACADEMIC PROGRAMME:

1. Please provide details of the existing teaching programme:

This would include lectures, demonstrations, small group discussions, clinical-pathological conferences,
ward rounds, OPD work, casualty and emergency work, rotation duties in various sub-specialties,
morbidity and mortality meetings, self-learning and others, as applicable.

Annex -B (for the planned teaching program)

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2. Where and how each competency is acquired (attach separate sheets): Annex -C
a) Patient Care.

b) Knowledge & Critical Thinking.

c) Technical Competence.

d) Communication Skills.

e) Team Work.

f) Self-Education and Teaching Skills.

g) Research.

h) Are the following workshops arranged for the trainees?

i. Advocacy: Yes No

ii. Professionalism: Yes No

iii. Leadership:
Yes No

3. Quantum of Supervision & Independence for the trainees:

(Technical / procedural / academic)

All residency programmes require:

• A minimum of 40 duty hours per week for clinical specialties excluding emergency duties and the
number of Sundays on call per month depending on the number of trainees available in the unit.

________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________

4. Academic Time (Please attach Residents weekly schedule):

i. Minimum of 04 hours per week of protected time should be allocated to academic (educational &
Research activities & responsibilities). YES
OR
ii. You are in favour of a day reserved for study.

Yes No

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VI. INFORMATION REGARDING PROPOSED RESIDENCY PROGRAMME:
1. Selection criteria:

Fellowship Part-
Medical Degree House Job / Internship I
MBBS / BDS One year Passed within last 3 years

2. Describe the selection process:

a. Advertisement Yes No

b. Written test & entrance interview Yes No

c. Only interview Yes No

d. Open merit for candidates Yes No

3. No. of residents to be admitted in Jan/ July sessions each year:

4. Electives and / or Resident Exchange Programmes:

a. Are all your required rotations inter departmental in CPSP approved Units / Departments:

Yes No

b. Electives: Yes No

c. External Rotations where CPSP approved disciplines are not available in the Institutions:

Yes No

External Rotations of Residents (attach document/s of agreement from relevant institutions–Signed MoU’s):
Year of
Specialties Name of Institute Duration
training

d. Resident Exchange Programs (attach MoU): Yes No

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VII. EDUCATION RESOURCES.

1. Department of Medical Education in the Institution: Yes No

a) Assistance and guidance in the Curriculum. Yes No

b) Capacity building for Faculty.

− Mandatory Yes No

− Optional and available

Yes No
2. Library:

a) Central Library of Institution. Yes No

b) Ward collection of specialty books & specialty journals. Yes No

c) Computer access & internet facilities available close to workplace. Yes No

i. Basic Textbooks of specialty available in the Unit / ward:

List of Books Editions No. Yes / No

Grabb and Smith plastic surgery 7th Edition Yes

Mathes Plastic Surgery textbook 2nd Edition Yes
Microsurgical reconstruction of head and neck
Yes
Rhinoplasty A practical Guide To Nose
Surgery 3rd Edition Yes
Plastic Surgery Indication ,Operation and Outcome 5th Edition Yes

i
i
. List Of Journals In The Specialty Received Regularly:
Subscribed since (month,
S.No Name of the Journals
year)

Journal Of College of Physicians and Surgeons Pakistan 2014

Journal of Bahria University Medical and Dental College 2006

Rehab in Review 2010

Pakistan Journal Of Neurological Sciences 2015

3. Skills Lab. Yes No

4. Patient Bank.
a
)Real Patients. Yes No
b
)Simulated Patients. Yes No
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 UNDERTAKING
We have read and understand the Rules and Regulation of Accreditation of Units / Institution as envisaged in
the “Guide to formal accreditation of training posts” and do hereby undertake to abide by them. We also
promise to supply / provide any further information regarding training programme as and when required by
CPSP.
We further agree to comply with the following conditions:-
• To inform CPSP immediately, if the Supervisor is transferred or not available.
• Not to charge tuition or any other fee (in respect of training) from the trainees.
• Every trainee must be paid stipend for training as per decision of Federal / Provincial
Government. Honorary training is not registered.
• No other training programme will be introduced without the prior knowledge of CPSP. (i.e.
dilution of training is not to occur).
• To apprise CPSP regarding any change in the existing faculty, equipment and facilities as and
when they occur.
• No trainee will be inducted simultaneously in CPSP program along with another Program.
• The Institute shall also be bound to allow / permit and facilitate its teachers, fellows / supervisors
to take part in academic activities of CPSP including teaching, training, workshops, courses,
examinations etc when and where needed inside and outside the country. They shall be entitled
for TA/DA as per institution rules and regulations.
We also understand that failing to abide by any of the above-mentioned requirements on the part of our Unit /
Institution, may result in suspension of any accreditation granted.
Name of Institution: PNS Shifa Hospital

Name of Department: Department of Plastic & Reconstructive Surgery

Name of Unit: Department of Plastic & Reconstructive Surgery

Name of Unit Head (in block letters): Surg Cdre MUHAMMAD IRFAN ILAHI TI(M)

Designation: Classified Specialist and Associate Professor

Address: Department of Plastic & Reconstructive Srgery, PNS Shifa Hospital, DHA II, Karachi

Tel: 021-48506605 Fax: E mail irfanilahi63@gmail.com

___________________________________________
Signature of the head of Unit (with stamp / seal)
Name (in block letters): SURG.CDRE. MALIK WAQAR AWAN TI (M)

Designation: Commandant

Address: PNS Shifa Hospital, DHA II, Karachi

Tel: Fax: E mail

____________________________________________________
Counter-signature of the head of Institution (with stamp / seal)
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 CHECK LIST

For submission of Accreditation request

1. Letter of Intent from institution to the Registrar, CPSP.

2. Accreditation Form duly completed, in triplicate, separately for accreditation of each unit.

3. Detailed CV’s of teaching faculty indicating their PG qualification with date of acquisition.

4. Photocopies of participation in mandatory workshops by prospective/ respective supervisor/s. RTMC

Registered Supervisor/s may send copy of their Registration Certificate/s only.

5. Identity of Proposed Fellowship/ Membership Programme.

6. Any other additional information may be included, if considered relevant.

ACCREDITATION FEE:

After completing the documentation; the Accreditation Fee shall be charged as per following breakup.

PUBLIC & ARMED FORCES INSTITUTIONS:

1. Initial Processing Fee @ Rs. 5,000/= per unit

2. Basic Fee to visit institute Rs.70,000/=
3. Unit Fee @ Rs.30,000/= per unit

For Accreditation of one discipline; you may remit a Bank Draft of Rs.105,000/- only in favour of CPSP; add Rs.
35,000/- for each additional discipline seeking accreditation.

PRIVATE INSTITUTIONS:

1. Initial Processing Fee @ Rs. 5,000/= per unit

2. Basic Fee to visit institute Rs.80,000/=
3. Unit Fee @ Rs.40,000/= per unit

For Accreditation of one discipline; you may remit a Bank Draft of Rs.125,000/- only in favour of CPSP; add
Rs.45,000/- for each additional discipline seeking Accreditation.

___________________________________

www.cpsp.edu.pk

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