Surgical Logbook Template For Dha Jun 2026

Use a unique hospital registration number or medical record number (MRN). Never include patient names to maintain strict HIPAA and data confidentiality compliance. 2. Clinical Context

You must include your full name, the date range of the record, and the total number of procedures performed. Essential Data Fields for the Template

When submitting this to the DHA (via the Sheryan portal or DataFlow), presentation matters.

Clear medical terminology detailing the clinical indication and the structural findings. 3. Procedure Details surgical logbook template for dha

Option 2: The Individual Case Card Layout (Recommended for Word/PDF)

A logbook without a Medical Director's stamp is the most common reason for rejection.

| Procedure Category | Procedure Name | Number of Cases (Lead Surgeon) | Number of Cases (Assistant) | Total Cases | |---|---|---|---|---| | General Surgery | Laparoscopic Cholecystectomy | 45 | 8 | 53 | | General Surgery | Open Appendectomy | 32 | 5 | 37 | | Orthopedic Surgery | Total Knee Replacement | 28 | 10 | 38 | | Orthopedic Surgery | Arthroscopic ACL Repair | 41 | 9 | 50 | | ... | ... | ... | ... | ... | | | | XXX | XXX | XXX | Use a unique hospital registration number or medical

You performed the surgery under direct supervision.

Failing to specify whether you were the primary surgeon or the assistant. Marking "Surgeon" ambiguously is a frequent cause of file return.

: Always verify the latest DHA logbook policy directly with DHA’s Licensing Department (Tel: +971-4-219-1111) or via the Sheryan system (DHA’s licensing portal), as requirements may be updated periodically. Clinical Context You must include your full name,

If you'd like to share , I can give you more specific advice on what procedures to highlight.

| Column # | Field Name | Description & DHA Requirement | | :--- | :--- | :--- | | 1 | | Enter the exact date (DD/MM/YYYY). Mandatory . | | 2 | Patient MR Number | A unique identifier for the patient, such as the medical record number. Required for heart/lung transplant logs and recommended for all. | | 3 | Procedure Name & CPT Code | Full name of the surgery. DHA also requires "the name of the surgery/procedure". Including a CPT code is best practice for clarity. | | 4 | Surgeon's Role | Your role (e.g., Lead Surgeon, First Assistant, Supervisor). Mandatory . | | 5 | Surgical Complexity | Categorize the case (e.g., Major/Minor/Intermediate). Helps demonstrate case-mix variety. | | 6 | Complications & Outcomes | Note any intraoperative or postoperative complications and the outcome. Recommended to demonstrate competency . | | 7 | Co-surgeons/Assistants | Names of other surgical team members. Provides a complete picture of the surgical episode. | | 8 | Facility Name | The specific hospital or surgical center where the procedure was performed. Essential for verification. | | 9 | Medical Director's Signature | A dedicated column for the Medical Director's signature. Mandatory for every page . | | 10 | Facility Stamp | A dedicated column or space for the official facility stamp. Mandatory for every page . |

Only typed logbooks are accepted; handwritten versions will be rejected.

Example Summary Table: -------------------------------------------- Total Laparoscopic Appendectomies (As Primary): 120 Total Laparoscopic Cholecystectomies (As Primary): 85 Total Hernia Repairs (As Assistant): 45 -------------------------------------------- GRAND TOTAL CASES: 250 ⚠️ Strict Verification and Attestation Rules

In practice, the DHA evaluates applications through a . Missing signatures, inconsistent case logs, or incomplete records are among the most common reasons for application delays or outright rejections, even for highly qualified surgeons. Therefore, preparing a meticulous logbook is not optional—it is essential.