Surgical Logbook Template For Dha Verified (2026 Release)

The DHA utilizes the surgical logbook during the credentialing and Dataflow verification phases to assess your clinical competency. The logbook serves three primary purposes:

| | Procedure Name | Procedure Date | Patient ID / MRN | Facility Name | Your Role | | :--- | :--- | :--- | :--- | :--- | :--- | | # | | | | | | | Details | - Full, specific name of the surgery (e.g., "Laparoscopic Cholecystectomy", "CABG x 3 Vessels"). | - Exact date of surgery (DD/MM/YYYY). | - A unique, anonymized patient identifier (e.g., Medical Record Number). | - Official name of the hospital or surgical center where the procedure was performed. | - Primary Surgeon (only operator) or First/Second Assistant . | | Entry | Patient Age/Gender | Indication for Surgery | Complexity | Outcome / Complications | Verified By | | :--- | :--- | :--- | :--- | :--- | :--- | | # | | | | | | | Details | - Patient's age and gender (e.g., "45/F", "60/M"). | - Brief, clinical reason the surgery was necessary (e.g., "Symptomatic gallstones", "3-vessel CAD"). | - Routine, Emergency, or High-Risk. | - Discharge status. Note any intra-op or post-op complications (e.g., "Uneventful", "Wound infection, resolved with antibiotics"). | - Signature and official stamp of the Medical Director or HOD. |

I confirm that the above _____ cases were performed by the above-named practitioner under my supervision / within the stated privileges, and the record is accurate.

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 surgical logbook template for dha

A compliant logbook is not just a list; it must include a at the beginning. DHA reviewers will scan this first. The summary must present:

"I hereby certify that the above-listed surgical procedures were performed by the applicant during the specified tenure at this facility, and the roles indicated are accurate to the best of my clinical knowledge."

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Master Your Surgical Logbook: The Ultimate Guide and Template for DHA Compliance

The logbook must be signed and stamped by the Head of Department or Medical Director of the facility where the procedures were performed. Essential Data Fields for the Template

I, [Name of Medical Director], as the Medical Director of [Hospital Name], hereby confirm that the surgical cases listed in this logbook (pages X to Y) accurately reflect the procedures performed by Dr. [Applicant Name] during the period from [Start Date] to [End Date]. The logbook has been reviewed against hospital records and is complete and correct to the best of my knowledge. | - A unique, anonymized patient identifier (e

By utilizing this structured approach and keeping your data clean, transparent, and verified, you will significantly streamline your DHA credentialing process and move one step closer to practicing medicine in Dubai.

The DHA uses your surgical logbook to verify your practical experience. It serves three primary functions: