SPECIALIZED REFRESHER MODULES IN CLINICAL NUTRITION AND DIETETICS Indian Dietetic Association is pleased to offer the third set of the Specialized Refresher Modules in Clinical Nutrition and Dietetics from April 2016. The course is through Distant Learning Mode. Chief coordinators: Ms Neelanjana Singh, President, IDA, Delhi Chapter Ms Anuja Agarwala, National Executive member, IDA Deputy Coordinator: Dr. Parmeet Kaur, Sr. Dietician, AIIMS Course Co-ordinators Ms Neelanjana Singh Dr. Namrata Singh Ms Ritika Samaddar Ms Anuja Agarwala - President, Indian Dietetic Association,Delhi Chapter - Member, RD Board, IDA - Executive Member, Delhi Chapter IDA - National Executive Member, IDA The four modules being offered are: 1. Assessment of Nutritional Status 2. Medical Nutrition Therapy in Diabetes mellitus 3. Weight Management 4. Pediatric Nutrition Some Aspects FACULTY Ms Rekha Sharma, M.Sc., RD; Director, Nutrition and Dietetics, Diabetes Foundation (India),Country representative and Director, International Confederation of Dietetic Associations, Former Chief Dietician, All India Institute of Medical Sciences, New Delhi Dr Veenu Seth, M.Sc., Ph. D. Nutrition, RD; Nutrition Consultant and Former Associate Professor, Nutrition, Lady Irwin College (Delhi University), New Delhi; Clinical Director (Health Promotion) Special Olympics International Ms Manju Mathur, M.Sc., RD; Clinical Nutritionist and Former Chief Dietician &Head, Department of Dietetics, Government Medical College & Hospital, Chandigarh Ms Anuja Agarwala, M.Sc., RD; Dietician, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi. Ms. Meenakshi Bajaj, B.Sc.,PGDND,M.Sc.,RD,CDE; Dietician, RGGGH & Coordinator, Academy of Clinical Nutrition, Madras Medical College, Chennai. Ms Madhu Sharma, M.Sc.; Independent Diet Consultant "Diet for life", Panchkula, Former Pediatric Dietitian, PGI, Chandigarh
Dr Priyanka Rohatgi, M.Sc., Ph.D. ADND, PGCCGM (XLRI); Chief Clinical Nutritionist, HOD, Department of Nutrition and Dietetics, Apollo Hospitals, Bangalore Ms Namrata Singh, M.Sc., RD; Dietician, Department of Human Nutrition and Gastroenterology, All India Institute of Medical Sciences, New Delhi Ms Ritika Sammadar, M.Sc, RD; Chief Dietician, Max Super speciality Hospital, Saket, New Delhi Eligibility Criteria Members of IDA with a post graduate degree/diploma in Food, Nutrition and Dietetics shall be eligible. The applicants may opt for one or more modules of their interest at one time. Candidates are required to fill a separate Application form for each module. Last date for receiving the completed application forms for the course commencing from April, 2016 is 15 th March, 2016. Total study duration = 10 weeks This shall be followed by a two three day contact programme for each module. Tentatively, contact programme for all the modules will commence from last week of June, extending till first week of July. Exact dates will be informed to the eligible candidates as soon as the admissions are confirmed. The contact programme shall be conducted in an education hub, presently at Delhi. Final evaluation of the candidates shall be done after the contact programme. Candidates securing a minimum of 70% marks shall be considered successful and shall be awarded a certificate by IDA. Fee Structure: Rs 5000/- per module. Contact programme will be conducted at AIIMS, New Delhi Contact mail ID for queries: idacourse@gmail.com.
Course Enrollment No. (For Official Use) INDIAN DIETETIC ASSOCIATION EDUCATION AND RESOURCE CENTRE Specialized Refresher Modules in Clinical Nutrition and Dietetics (Distant Learning Mode) APPLICATION FORM Submission of completed form by 15 th MARCH, 2016 Tick the module for which this application is being submitted 1. Nutritional Assessment 2. Diabetes 3. Obesity 4. Paediatric Nutrition (some aspects) A separate application is required for each module Affix a signed passport size photo here 1of 2 Please type or use block letters to write your full name. Female Male / / (Mr/ Mrs/ Ms/ Dr) (First name) (Family name) Date of Birth: / / ( Day) (Month) (Year) IDA life membership number National Number Present Address for Correspondence: State Pin Home telephone: Mobile number: Email address: Current position/job title (if applicable):
EDUCATIONAL QUALIFICATIONS S.No. Certificate / Diploma / Degree 1 School Leaving (class XI) Year of Passing Institution, City& Country Major Subjects / Area of Specialization 2 B.Sc. 3 PG Diploma 4 M.Sc. 5 Ph.D. 6 Any Other (specify) REFERENCES: One reference must be submitted in support of your application. Please list below the name of the referee you have selected. Name: Designation & Institution: Phone No.: Send the completed application form with necessary enclosures to the following address by 15 th March, 2016. Ms. ANUJA AGARWALA Dietitian, Department of Paediatrics Coordinator ERC R.No. 3058, 3 rd floor Academic Block AIIMS, Ansari Nagar, New Delhi - 110029 DETAILS OF THE BANK DEMAND DRAFT (Fees per module: Rs 5000 /= (Five thousand only) Demand Draft No. Dated Amount (Rs) Payable to: Payable at: INDIAN DIETETIC ASSOCIATION, DELHI CHAPTER STATE BANK OF INDIA ANSARI NAGAR BRANCH NEW DELHI-110029 Date: / / (Day) (Month) (Year) Place: Signature of the Applicant
Suggest other areas of interest in Clinical Nutrition & Dietetics in which you would like such courses: - Renal - GI tract & accessory organs - Paediatrics - Geriatrics - Women s health - Cancer - Critical care - Any other (specify) SPECIAL INSTRUCTIONS (1) You will receive your (a)enrolment No., (b) Contact Program Entry Slip and (c) Module, once your documentation is complete and payment is received. (2) You must carry your Contact Program Entry Slip when you come to attend the Contact Program (3) Kindly enclose: - Application form with complete information - Self attested photocopy of valid ID-card or IDA National Certificate (at least one year of life membership) - Self attested photocopies of mark sheets + degrees and/or diploma - Proof of present employment, if applicable - Course fee Demand Draft payable at SBI, Ansari Nagar Branch, New Delhi 110029 in favour of Indian Dietetic Association, Delhi Chapter - Two signed Passport size photographs one to be affixed in the application form and the other to be affixed on the detachable contact program form to be used as an entry card for the contact program. - 1 Reference Letter For Official Use Only Receipt No. Date Enclosures: Complete/ incomplete Admission: Yes/ No For Course 1/2/3/4 Course Enrolment No. Signature of the course co-ordinator CONTACT PROGRAM ENTRY SLIP Name of the candidate: Course Enrolment No. Module Name and Code Date of Contact Program Affix a signed passport size Photo here 2 of 2