IMS BHU ADMISSION NOTICE FOR DM / MCh – 3 years Course August 2012

IMS BHU ADMISSION NOTICE FOR DM / MCh – 3 years Course August 2012

Institute of Medical Sciences, Banaras Hindu University – Varanasi-221105

ADMISSION NOTICE FOR DM / MCh – 3 years Course August 2012

The Banaras Hindu University will conduct Admission Test on All India Basis at

B.H.U. Varanasi on Sunday the1st July, 2012 at 9.00 A.M. for the following subjects:

The sale of application form and information leaflets will start from 19.03.2012. The same can be purchased in person from Institute’s counter or by post after submitting a MICR Demand Draft of Rs. 100/- (Rupees One Hundred) along with a self addressed envelope of 25x 16 cm and a request letter addressed to The Director, IMS, BHU, Varanasi – 221 005 mentioning the appropriate course and full address with contact telephone number. The envelope must be superscribed as “REQUEST FOR APPLICATION FORM for DM/MCh AUGUST 2012.” The same can also be downloaded from BHU website www.bhu.ac.in. & www.imsbhu.nic.in

The completed Application Form with all enclosures must reach the office of the Director, IMS, BHU on or before 07.05.12. The MICR D/D drawn in favour of “Director, IMS, BHU” payable at Varanasi of Rs.2000/- (Two Thousand only) for DM/MCh Course (Residency/Sponsored) must accompany the Application form.

* Only ONE seat available (under Residency scheme)

DIRECTOR

.

1
Grams : MEDINSTUTE Fax & ℡℡℡ : 0542-2367568
INSTITUTE OF MEDICAL SCIENCES
BANARAS HINDU UNIVERSITY
VARANASI – 221005
INFORMATION LEAFLET FOR REGISTRATION TO
D.M./M.Ch. 3 YEARS COURSE – AUGUST 2012
1. ELIGIBILITY:
D.M. : Medical graduates holding the degree of M.D. (Medicine) or M.D. (Paediatrics) or DNB in
respective subjects or equivalent degree recognized by the Medical Council of India.
For the DM (Endocrinology) MD/DNB in Biochemistry candidates are also eligible.
M.Ch. : M.S./DNB (Surgery) or equivalent degree recognized by the Medical Council of India.
For the Surgical Oncology, the candidates having MS/DNB in ENT, Orthopedics and
Obst. & Gynaecology are also eligible.
For both the above courses the candidates must have passed the MD/MS/DNB Examination
before 31
st
May 2012.
2. DURATION AND RECOGNITION OF THE COURSE:
a) Duration of DM/MCh course is 3 years
b) The degrees of M.Ch. (Paediatric Surgery, Plastic Surgery, Neurosurgery, Urology) and DM (Endocrinology,
Gastroenterology, Nephrology) are recognized by the Medical Council of India. The recognition of other
degrees is under process.
3. SUBJECT AND NUMBER OF SEATS:
*Note: Only one seat of residency is available in Cardiology and Surgical Oncology which will be filled up
on the basis of the merit of candidates in DM/MCh entrance examination.
The list of subjects and seats cited above are provisional, and subject to change without assigning
any reason there for or any prior notice.
DM (Subject) Number of seats Total number
Residency Sponsored of seats
*Cardiology 1 — 1
Endocrinology 1 1 2
Gastroenterology 1 1 2
Nephrology 1 1 2
Neurology 1 1 2
M.Ch. (Subject) Number of seats Total number
Residency Sponsored of seats
Paediatric Surgery 1 1 2
Plastic Surgery 1 1 2
Neurosurgery 1 1 2
*Surgical Oncology 1 — 1
Urology 1 1 2 2
Sponsored Category:

i) For sponsored category seats, only those candidates who are in permanent service of any Government or
statutory body are eligible.
ii) They must apply with a sponsorship certificate on the format given in the application form (duly signed by the
Employer with date, designation and seal) that he/she is being sponsored for undergoing the course applied for
and that he/she will get leave for the full duration of three years of the course of study, with full pay or half pay,
and the assurance that after completion of the course he/she will be taken back in service by the employer
concerned.
iii) The selection of the candidates will be on the index (out of 100) calculated on the basis of their aggregate marks
in the MBBS, and PG examination (number of attempts) and merit in interview.
Sponsored candidates will not have to appear in the Entrance examination.
5. AVAILABILITY OF APPLICATION FORMS:
a) It can be downloaded from BHU Web. Site www.bhu.ac.in. & www.imsbhu.ac.in
b) It can also be obtained from the office of the Director, Institute of Medical sciences, BHU, Varanasi on
submission of a MICR D/D of Rs. 100/- in favour of the “Director, Institute of Medical Sciences, BHU”,
payable at Varanasi along with self addressed envelop (25 x 16 cm) by post till 30
th
April, 2012 and in person
till 1st May 2012.
6. SUBMISSION OF APPLICATION FORMS:
i) The eligible candidates may apply by filling up all the six pages of application form enclosed herewith in
his/her own clean handwriting and all the entries in the form should be filled by the same writing material.
ii) A candidate can apply and appear for one subject only for the regular residency seat. The same is
applicable for the sponsored candidates as well.
iii) The application must be accompanied with attested copies of all the mark sheets / certificates / degrees /
registration number certificate and other documents (from High School to MD/MS/DNB)
iv) The completed application form in all respects along with all necessary enclosures should reach the office of
Director, IMS – BHU on or before Monday, 7th May 2012, 5.00 PM. The envelope containing the application
should be superscribed “APPLICATION FOR D.M./M.Ch. COURSE AUGUST 2012”. Applications sent by
Fax, E-Mail, Photocopies or any other form will not be entertained. Only the original Application form and
form downloaded through BHU website will be accepted.
v) Duly completed application must be accompanied by a MICR Demand Draft drawn on a nationalized bank
and payable at Varanasi in favour of DIRECTOR, IMS, BHU of Rs. 2000/- (Rupees Two Thousand only).
Demand Draft submitted with this form includes examination fees and is not refundable in any case.
vi) Candidates who are in service of Government/Semi-Government/Statutory Body must apply through proper
channel with endorsement certificate of the Employer on the proforma as provided in the application form.
vii) Incomplete applications in any respect will be summarily rejected and no correspondence in this regard will
be entertained. Applications received after the last date will not be entertained on any ground including
postal delay.
viii) All passport size photographs must be self attested, identical, snapped with front profile, showing full head,
face, shoulder and with both ears and taken without wearing any Cap/Hat/Sun glasses. Polaroid photos are
not accepted. Photograph must be taken on or after 31
st
December 2011 with a placard indicating the date,
and name of candidate.
ix) Provisional Admit Card shall be sent by Registered Post to the candidates. If an eligible candidate does not
receive the admit card, he/she may contact the office of the Director, Institute of Medical Sciences, BHU,
Varanasi on 30
th
June 2012 between 10.00 AM to 5.00 PM along with 2 copies of self attested passport
size photographs identical to those pasted in Original application form.
Duplicate admit card will NOT be issued on the day of the examination. i.e. 01
st
July 2012. 3
7. EVALUATION:
i) The test paper will consist of 100 objective type questions and the Examination will be of 100 minutes duration.
ii) Four marks will be awarded for each correct answer. There will be negative marking for incorrect answer, and
One mark will be deducted for every incorrect answer.
iii) The qualifying marks are 50 percent of the aggregate.
iv) No scrutiny/revaluation of the answer sheet of the Admission test shall be allowed on any ground.
8. SELECTION:
Subject wise merit list will be declared & posted on the BHU web site www.bhu.ac.in
i) The candidates will be selected for registration/ admission strictly based on merit in the written test. In case
of equal marks in the test the inter-se-ranking of the candidates shall be determined in the following order:-
(a) In case of candidates having equal marks in the test, the merit shall be decided on the basis of number
of failures at the MD/MS/DNB examination. One mark will be deducted, out of the total marks obtained
by the candidates in the written test, for each failure.
(b) In case of candidates having equal marks vice (a) above, the merit shall be decided on the basis of
percentage of aggregate or marks obtained by the candidates in MBBS (Final Examination).
(c) In case of candidates having equal percentage of aggregate marks at the MBBS (Final) Examination
vice (b) above, the merit shall be decided on the basis of percentage of marks obtained by the
candidates, in subject of Medicine (for selection to D.M. course) and Surgery (for selection to M.Ch.
course), in the MBBS examination.
(d) If the marks at the above vice (c) happen to be the same, the date of birth would be the basis i.e. the
candidate senior in the age would rank higher.
9. GENERAL:
i) The sponsored/deputed applicants will be treated as supernumerary candidates and in case of their
selection and registration/admission and joining for the course, they will not get any payment from the
Institute/University.
ii) No private practice of any kind shall be permitted during the entire duration of the DM / MCh course.
iii) The decision of the Director, Institute of Medical Sciences, B.H.U., shall be final and binding on the
candidates in respect of the Admission test.
iv) The selected candidates will have to appear before the admission committee for counseling and also
required to sign a bond on non-judicial stamp paper of Rs. 100/- (to be purchased from Varanasi or
any district of State of Uttar Pradesh) on the format to be supplied by the Directorate before he/she is
permitted to join the DM / MCh course.
v) The admission and continuance of Registration/Residency of the candidate shall be subject to the
BHU Act, Statutes, Ordinance, Rules and Regulations and orders as may be applicable from time to
time and the aforesaid bond. The registration/ admission may be cancelled without any notice if the
supervisor of the Department is not satisfied with the work and/or conduct of the candidate.
vi) The decision of the Postgraduate Medical Board / Faculty of Medicine, Institute of Medical Sciences –
BHU in all the matters of admission/registration shall be final and binding on the candidate.
vii) Mere submission of application and appearing and qualifying in the Admission test will not entitle the
candidates to claim admission in any of the above course. The candidates must note that if it is found
that he/she is not eligible for the Admission test, the Directorate will not issue the Admit Card and will
not take any responsibility in this regard.
viii) No TA/DA will be admissible for appearing in the Admission test, and for joining the course.
ix) Candidate will have to submit documentary proof at the time of admission / registration that their
medical degrees are recognized by MCI. 4
NOTE:
• CANDIDATES ARE ADVISED TO DOWNLOAD EACH PAGE OF THE APPLICATION FORM ON ONE SIDE OF THE
PAPER ONLY.
• PLEASE ATTACH A SELF ADDRESSED ENVELOP OF 25 CM X 16 CM SIZE FOR SENDING THE ADMIT CARD. THE
ADDRESS SHOULD BE CLEARLY AND NEATLY WRITTEN BY THE CANDIDATE.

IMPORTANT DATES
LAST DATE for obtaining application form and information leaflet by
post
Monday, 30
th
April 2012
LAST DATE for obtaining application form and information leaflet
from IMS
Tuesday, 1
st
May 2012
LAST DATE for receipt of completed Application Form in the office of
the Director, IMS – BHU, Varanasi
Monday, 7
th
May 2012
DATE of written examination Sunday, 01
st
July 2012
(Time: 9.00 AM)
Place of Examination BHU, Varanasi
Duration of the Examination 100 minutes5
Roll No………………….
INSTITUTE OF MEDICAL SCIENCES
BANARAS HINDU UNIVERSTY
VARANASI- 221005
APPLICATION FORM FOR APPEARING IN ADMISSION TEST FOR
THREE YEAR D.M./M.Ch. COURSES – AUGUST 2012
Last date for accepting the application form in Office of Director, IMS, BHU: 7
th
May 2012

(For Office Use Only)
Course: D.M. / M.Ch. Date of Receipt ________________
Subject: ………………………… Receipt No. ___________________
Category : RESIDENCY / SPONSORED
Provisionally allowed / Not allowed Reasons (if not allowed) : ………………………………
(To be filled in by the CANDIDATE in his/her own handwriting)
DD No. Date Amount Rs. Issuing Bank
1. Course applied for : DM MCh
2. Subject : ……………………………………
3. Category : SPONSORED OR RESIDENCY
4. Name of the Candidate …………………………………………………………………….
(in BLOCK letters)

-A-

Paste photograph
self attested
5. a) Father’s Name : ………………………………………………………………….
b) Mother’s Name : ………………………………………………………………….
6. Date of birth : ………………………………………………………………….
7. Address for Communication : ……………………………………………………………………………………………………….
………………………………………………………………………………………………………………………………………………
……………………………………………………………………..E-mail …………………………………………………………….
Mobile No…………………………………… Tel. No………………………………………………..
8. Permanent address : ……………………………………………………………………………………………………………………..
………………………………………………………………………………………………………………………………………………
9. Nationality : 10. Religion :
11. State to which belongs : 12. Caste :
13. Marital Status : Married/Unmarried
If married, name of spouse : ………………………………………………………………………………………………………..
Candidates are advised to read this form and information leaflet carefully before filling up their application form 6
14. Details of the Examinations passed:
NOTE : Please attach attested copies of all the Mark sheets/Certificates/Degrees/Registration number certificate
and other documents (from High School to MD / MS / DNB)
15. Details of Internship: From ………………………….To ………………………. Institution ……………………………………………………
16. Permanent Registration No. : ……………………………………. Date: ……………………. State: …………………………..

17. Details of present employment, if any: …………………………………………………………………………………..

Name and full address of the Employer:…………………………………………………………………………………..
………………………………………………………………………………………
Post held w.e.f. : ……………………………………… Tenure of appointment: …………………………………………

_________________________________________________________________________________________
DECLARATION
I declare that I have read the information leaflet and that all the information furnished above by me are true. All
the attested/ certified copies of certificates/mark sheets are attached. In case any information furnished by me
above is found wrong at any time, my candidature for the examination/selection to the course may be cancelled
outright and I may be debarred permanently from the test and disciplinary action may be taken against me. I
declare that I am an Indian National and have not taken part in any activity subversive of law and no disciplinary
action has been taken against me by the University. I have never been debarred by the University for appearing in
examination or for seeking admission to any courses of studies.
Date:

(Signature of the Candidate)
Place:
Name of the
examination
University / Board Year Subjects Marks obtained /
Maximum marks
% of
Marks
No. of
Attempt
High School/ or
equivalent

I.Sc. or equivalent
of +2 level
1st Prof. MBBS
2nd Prof. MBBS
3rd Prof. MBBS
MD / MS / DNB
or equivalent
7
CERTIFICATE TO BE GIVEN BY THE CANDIDATE SEEKING ADMISSION
UNDER SPONSORED CATEGORY
SPONSORSHIP CERTIFICATE*
This is to certify that Dr. . . . . . . . . . . . . . . . . . . . . . . . . . . . . …….. ………..………….is a permanent employee of .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . …… . . . . . . . holding the post of . . . . . . . . . . . . . . . . . . . . . . . . . . . . since
. . . . . . . . . . . . . . .. He/She is hereby sponsored for undergoing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . course at
Institute of Medical Sciences, Banaras Hindu University.
In the event of selection he/she will be sanctioned leave for three years on Full Pay/Half Pay to undergo the
above course. This is also further certified that he/she will be taken back into the services after completing the above
course.
Name of the Employer:……………………………………………….
Name of the Institute:……………………………………………….… Signature of the Employer
…………………………………………………. (SEAL)
Date:…………………………….

*This certificate should be issued / signed only by the EMPLOYER of the candidate, clearly mentioning the salary
payment status during the course, otherwise sponsorship and candidature will not be considered
___________________________________________________________________________________________
NO OBJECTION CERTIFICATE
(FOR CANDIDATES APPLYING UNDER RESIDENCY CATEGORY AND IN EMPLOYMENT)
Endorsement by the employer under whom the candidate is presently working
Dr. . . . . . . . . . . . . . . . . . …………………………………………………………. is working as . . . . . . . . . . . . . . . . ……. . . .
with effect from. . . . . …………….. . . He/She is a permanent / temporary employee of the . . . . . . . .
………………………………………………………………………………………………………………….. . . . . . . . . . . . . . . .
The information furnished by the candidate in his application form is correct. I have no objection in his/her seeking
admission to the D.M./M.Ch. course at the Institute of Medical Sciences, B.H.U.
If he/she is admitted he/she will be relieved for three years for undergoing the course.
Name of the Employer:……………………………………………….
Name of the Institute:……………………………………………….… Signature of the Employer
…………………………………………………. (SEAL)
Date:……………………………. 8
CHECK LIST
(Please arrange enclosures in the following order)
I) Self attested copies of Certificates Enclosed Attested Encl. No.
1. MD/MS/DNB passing/appearing certificate Yes/No Yes/No ………..
2. Permanent medical registration certificate Yes/No Yes/No .………..
3. Internship completion certificate Yes/No Yes/No ….……..
4. MBBS Marks sheets Yes/No Yes/No ………..
5. High School or equivalent
with Date of Birth certificate Yes/No Yes/No ………..
6. I.Sc. or equivalent of + 2 level Yes/No Yes/No ……….
7. MBBS passing certificate Yes/No Yes/No ……….
8. Character certificate Yes/No Yes/No ……….
9. MICR Demand Draft of Rs. 2000/- Yes/No ………..
II) 1. Sponsorship certificate from Yes / No / Not required
employer (for sponsored category)
2. Forwarded by Employer/Head of Yes / No / Not required
organization (for Residency category)
III) THREE self attested photographs affixed Yes/No
at designated space marked A, B, C

(Signature of the Candidate)

NOTE:
1) Self attested copy of Certificates should be arranged in above order and an enclosure number should be given on
each and same should be listed above in the appropriate column.
.
2) If any of above answer is NO, the application will be rejected without making any correspondence. 9

Examination Centre:(To be filled by Office) ………………………………………………………………..
_______________________________________________________________________________
(To be filled in by the candidate)
Dr………………………………………………………………………………………………………………………..
(Write name in BLOCK LETTERS)
Address:
…………………………………………………………………………………………………………………………………..
…………………………………………………………………………………………………………………………………..
…………………………………………………………………………………………………………………………………..
Son/Daughter of Sri ……………………………………………………………………………………………………
-B-
Paste photograph
self attested
D.M./M.Ch. (Subject) …………………………………………………………………

Provisionally allowed to appear in the Admission Test on Sunday, 1
st
July 2012 at 9.00 AM, against Residency

Deputy Registrar
(Specimen signature of the candidate)

IMPORTANT INSTRUCTIONS FOR CANDIDATES
1. Candidate must bring original Admit Card with him/her to secure admission to the examination room.
2. Example for writing your ROLL Number (e.g. 10107 : Ten Thousand One Hundred Seven)
3. Mark your answers on the “Answer Sheet” by blackening the circles using Black Ball Pen.
4. Please bring your own writing material only
5. Envelop of admit card/ any other paper/ any resource material /calculators /slide rule/ mobile phone/pagers are not
allowed in the examination hall.
6. The examination rooms will be opened half an hour before the commencement of the examination
7. No candidate will be admitted to the examination room after Ten Minutes of start of the examination
8. No candidate will be allowed to leave the examination room till the examination is over.
9. Candidates should not leave the examination room without handing over his/her question booklet and answer sheet
to the Invigilator.
10. Candidates will be required to sign his/her attendance and thumb impression at designated place in the presence of
the invigilator when directed to do so by the Invigilators.
11. Candidates who fail to observe these regulations may be disqualified and debarred from appearing in the entrance
test and any subsequent examination held by the University.
Do Preserve your provisional admit card which has to be produced before
Admission Committee in case of your selection.
Roll No.
INSTITUTE OF MEDICAL SCIENCES
BANARAS HINDU UNIVERSITY
VARANASI – 221005
PROVISIONAL ADMIT CARD
D.M./M.Ch. ADMISSION TEST – 2012 (1
st
July: 9AM) 10

Roll No……………….

INSTITUTE OF MEDICAL SCIENCES
BANARAS HINDU UNIVERSITY
Varanasi-221005
D.M./M.Ch. ADMISSION TEST – 2012
Examination Centre: (to be filled by office) …………………………………………………………..
____________________________________________________________________________
(To be filled in by the candidate)
1. Full Name : …………………………………………………………………………………..
2. Father’s name : ……………………………………………………………………………………….
3. Mother’s name : ………………………………………………………………………
4. Date of birth : …………………………………………………………………………………………….
5. Subject:………………………………………………………………………………..
6. Address: ……………………………………………………………………………….
……………………………………………………………………………….
……………………………………………………………………………….
Mobile………………………………. Tel. No…………………………….
-C-
Paste photograph
self attested
7. Specimen signature of the candidate 8. To be filled in the examination hall
at the time of applying for the course in presence of Invigilator
Signature of the Candidate Signature of the Candidate
Thumb impression of the candidate* Thumb impression of the candidate*
* Left hand thumb impression for Male
candidates and Right hand thumb
impression for Female Candidates

Name and signature of the Invigilator
REGISTRATION CARD