Guidelines for Synopsis and Dissertation Writing for CPSP

1. Format of Synopsis
2. Components of a Research Article
3. Dissertation Writing
4. Format of Dissertation
 

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FORMAT OF SYNOPSIS

Before starting to work on Dissertation/Article, the FCPS trainee has to send a Synopsis to RTMC and get it approved. The synopsis is a brief out line (about four A-4 size pages or 1000 words is the maximum limit) of your future work.

A synopsis must have the following headings:

TITLE: Should reflect the objectives of the study. It must be written after the whole synopsis has been written so that it is a true representative of the plan (i.e. the synopsis).

INTRODUCTION: Should contain brief background of the selected topic. It must identify the importance of study, its relevance and applicability of results. It must clearly state the purpose of the study.

OBJECTIVES: Objectives are statements of mentions. They inform the reader clearly what the researcher plans to do in his/her work. The must identify the variables involved in research. Objective should start with an action verb and be sufficiently specific, measurable, achievable, relevant and time bound (SMART).

OPERATIONAL DEFINITION: May be required in some synopses. It is definition of a term specifically telling how it will be measured for e.g.:

1. Morbidity: this encompass a number of aspects viz. prolonged hospital stay, severe pain, immediate complications, long term sequelac. A research must define how a vague term will be measured.
2. Efficacy: These can by measured
   

i. Time taken in relieve of symptoms which may be pain, fever cough heartburn etc.
ii. Taking into account number of side effects.
iii. Time taken for complete recovery student is requirement to specify how he/she will measure efficacy.

HYPOTHESIS: A hypothesis is a statement showing expected relation b/w 2 variables. A hypothesis is needed in the following study designs:

i. All interventional studies
ii. Cohort
iii. Case control
iv. Comparative cross sectional.

MATERIAL AND METHODS:

STUDY DESIGN: Mention the name of the appropriate study design.

SETTING: Name and place where the research work is to be conducted.

DURATION OF STUDY: How long will the study take with dates.

SAMPLE SIZE: How many patients will be included. If there are groups how many per group?

SAMPLING TECHNIQUE: Type of sampling technique employed.

SAMPLE SELECTION:
Inclusion criteria: on what bases will patients be inducted in the study.
Exclusion criteria: On what bases will patients be excluded from the study.

DATA COLLECTION PROCEDURE: A detailed account of how the researcher will perform research; how s/he will measure the variable. It includes:

Identification of the study variables
Methods for collection of data
Data collection tools (proforma/questionnaire)

DATA ANALYSIS PROCEDURE: Relevant details naming software to be used, which descriptive statistics and which test of significance if and when required, specifying variables where it will be applied.

REFERENCES:
In Vancouver style (for detail refer to page 132).

DATA COLLECTION INSTRUMENT:
The researcher must attach, as an annex, the proforma or questionnaire with the help of which he/she intends to collect data. The proforma/ questionnaire must match the objectives and must not contain irrelevant sections like inclusion and exclusion criteria etc.

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COMPONENTS OF A RESEARCH ARTICLE

There are five essential components of an original/research article
1. Abstract/Summary
2. Introduction
3. Material & Method
4. Result
5. Discussion.

These can be remembered with the help of the acronym, IMRAD that stands for :
= I = Introduction,
= M = Material & Method
= R = Result,
= A = And
= D = Discussion.

Key words are included with structured abstract. Additional components are acknowledgement (which is optional) and the References. Hence the manuscript of all research articles should contain the following sections:-

Esssential Components

Title page: The complete title of the manuscript, the name of the authors with their highest qualifications, the department or institution to which they are attached, address for correspondence with telephone numbers and
fax number, if possible.

Abstract/Structured: All original articles should have a structured abstract. Usually the limit ranges from one hundred fifty to two hundred fifty words. The abstract should be in structured form and should have headings of objective, design ,settings, subjects, interventions (if applicable),main outcome measures results and conclusions.

Key Words: Below the abstract give few key words, which should not more than ten. These key words are used in cross-indexing the article and are usually published with abstract. Use terms from the Medical Subject Headings (MeSH) which are standard medical headings given in the list of index medicus, e.g Glomerulonephritis, Paraplegia, Infertility. If suitable
MeSH terms are not yet available for recently introduced terms, present term may be used.

Introduction: This should describe the purpose of the article and the Research Methodology, Biostatistics & Medical Writing Workshop rationale for the study. It should neither review the subject extensively nor should it have data or conclusions of the study.

Material: Material refers to the subjects and apparatus

= SUBJECTS: are patients or person on whom study was done their age, sex, mean age, and standard deviation, and other relevant characteristics should be given.
= APPARATUS: refers to the main device used to measure the observation, this may be a laboratory equipment, surgical procedure, questionnaire, or a clinical method e.g. a laboratory instrument for Hemoglobin estimation, a procedure to remove the stone from bile duct, a questionnaire developed to know the effect of poverty on nutritional status or clinical criteria to asses the severity of pain

Method: METHOD is the procedure of data collection. Mention the study design, place where study was conducted, procedure of data collection. Mention the name of statistical test and software program wherever
applied.

RESULTS must be presented in the form of text, tables and illustrations. The contents of the tables should not be repeated in the text. Instead, a reference to the table number must be given.

DISCUSSION should emphasize the present findings and comparison should be made of variations or similarities with other works done in the field .The detailed data should not be repeated in the discussion. It must be mentioned whether the hypothesis in the article is true, false or no conclusions can derived.

OPTIONAL COMPONENTS are added only whenever applied. These are as follow:

ACKNOWLEDGEMENT if desired, it should be included after the discussion and before references.

LETTER OF UNDERTAKING signed by the main author must accompany all manuscripts:

Sample Letter of Undertaking

This is to confirm that the original / review Article / case report titled submitted for publication in has not been published in any other journal and if accepted for publication, it will not be published in any other medical journal in Pakistan or overseas.
Name of author (In capital)	Signature

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DISSERTATION WRITING

General Information:
Dissertation is a detailed discourse on a subject especially submitted for a higher degree in a University (Oxford Dictionary). The CPSP dissertation is a document that contains relevant details of the research work conducted by the fellowship trainee relating to the problem selected. The objective of writing a dissertation is to develop skills in fellowship trainees for:

• collection and compilation of data,
• analyzing and reviewing relevant literature available on the subject (both national and international),
• developing medical writing habits as an art for writing scientific articles in medical journals.

The other advantages of writing a dissertation include:

• Cultivating an inquiring mind
• Encouraging in depth study of common problems afflicting our people
• Generation of scientific data locally
• Keeping abreast of new developments locally and abroad
• Understanding the fundamentals of research

Rules and Requirements
To prepare a dissertation acceptable to the CPSP, the rules and requirements prescribed below must be followed while writing.

Approval:

• The research work or study must be started after receiving the approval of synopsis / research protocol from RTMC, CPSP.
• The research work or study must be planned in such a way that the entire study, including dissertation writing, is completed during the training period.
• The topic and research methodology must be the same as laid down in the synopsis/research protocol approved by the RTMC, CPSP.
• Patients in the photograph(s), if included in the dissertation, must not be identifiable or the photographs must be accompanied with a written consent of the patients. Colored photographs are to be preferred.
• Photomicrographs, if included in the dissertation, must have internal scale markers and symbols, arrows or letters in contrast to the background.
• If tables, figures, diagrams, photographs, photomicrographs or any other type of illustrations are reproduced from published literature, they must be properly acknowledged in the dissertation.
• Only standards terms and abbreviations must be used if needed in the dissertation. When using for the first time, a full word or phrase, together with its abbreviation in bracket (except for standard measurement units), must be mentioned. A list of all abbreviations used in the text must also be attached in the dissertation.
• The information about patients such as names, initials or hospital numbers must be kept confidential, especially in illustrative material.

Contents:

• It is essential that a minimum of one third contents of the dissertation should be from the trainee’s own research work or study.
• The statistical tests mentioned in the dissertation must have proper references to enable an assessor or reader to verify the reported results. Statistical terms, abbreviations and symbols must be defined. Any computer program, if used, must also be specified.
• The illustrations in the dissertation must be accurately drawn, on separate pages and numbered serially. Each figure / diagram must have a legend. Free hand lettering is not accepted.
• Measurement, units of length, height, weight and volume mentioned in the dissertation must be in metric system i.e., meter, kilogram and liter.

Format:

• Each section of the dissertation must be started on a new page.
• The section in part 1, from "Dedication" upto the list of "Abbreviation", should be serially numbered in Roman number while the rest should be serially numbered in Arabic numerals.
• The Dissertation must contain 15,000 to 20,000 words i.e., about 80-100 A4 size pages, typed or computer-printed with double space, on one side of each page.
• It must have 4-cm margin, at all 4 sides of each page.
• All pages must have serial numbers at upper right hand corner.
• It must not contain any typographical errors or spelling mistakes.
• The font size should be 12.
• Font should be New Times Roman or Arial or Verdana.

Language:

• The writing of dissertation must be planned in such a way that continuity of the theme is maintained.
• It must be written in trainee’s own words and style. The language must be simple, direct and precise. Verbosity must be avoided.
• Direct quotations must be minimally used. If quoted, these must be given within inverted commas with full acknowledgment.
• The statements, other than trainee’s own, must be supported with reference citation.
• The trainee, who plagiarizes or copies someone else’s Dissertation, will Research Methodology, Biostatistics & Medical Writing Workshop be liable for a punitive action by CPSP, which may include debarring him/her from appearing in FCPS examination for lifetime.
• Each table must be typed or computer-printed with double space, on a separate page. It must be numbered consecutively, in order of citation and inserted at the appropriate place in the text. Symbols and abbreviations, if used, must be explained in the footnote of each table.

Special Cases:

• If the trainee wishes to change the supervisor, he must intimate the original supervisor in writing that he/she is applying for a change of supervisor and submit documentary evidence with full justification(s) to RTMC.
• The trainee must obtain approval in writing from RTMC, CPSP for changing the supervisor originally approved by the CPSP. The Supervisor must endorse the certificate annexed at "B", before the dissertation is submitted to RTMC, CPSP.
• In case the trainee, who has already acquired a Fellowship from CPSP, desires to appear for FCPS in any other specialty, he/she may submit a fresh Dissertation or his/her 2 published papers on the chosen specialty in JCPSP or journals listed in Index Medicus as the main author.

Submission:

• Certified copies of dissertation must be submitted to CPSP, through the Supervisor for assessment and approval, at least nine months before the date of examination in which the trainee desires to appear.
• The dissertation must be secured with spiral binding.
• The CPSP will get it bound permanently after acceptance.
• The dissertation must be submitted along with the paid bank challan or a bank draft / pay order issued in the name of CPSP, on account of Dissertation fee and binding charges.
• Once the dissertation is submitted to CPSP, it must not be submitted to any other institution for a postgraduate diploma or degree. Violation of this rule, will render the trainee liable to punitive action by CPSP, which may include cancellation of Fellowship.
• The trainee may write an article based on his/her approved dissertation and submit it to the Journal of CPSP. Such an article must have the name of trainee as the first author.

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FORMAT OF DISSERTATION

The different sections in the part I and II of the dissertation are formatted as per description given below.

1) Sections In Part I.

i. Title Page
It is the very first page of dissertation. The title is a concise statement identifying actual variables or theoretical issues under investigation and the relation between them. A title should be in minimum possible words that adequately describes the contents of research work/study all the words in the title are to be chosen with great care and the association with one another properly sequenced. This is also important for indexing the study. The title does not contain any abbreviation, chemical formulae, proprietary names and jargons etc.

The title should be written on the top in bold letters, followed by full name of trainee in the order of first, middle, initial and last name alongwith the highest academic degree. Then full name of Supervisor is mentioned under whom the entire research work/study has been completed together with his/her highest academic degree. At the bottom the name of department and institution is to be given, where research work/study has been conducted. The date of submitting Dissertation is given at the lowest end of the title page.

ii. Supervisor’s Certificate
It is placed after the acknowledgement and is numbered in the Roman numeral.

iii. Dediction
It is an optional section, in which trainees normally dedicate their Dissertation to their parents, brother, sister, teachers, friends, spouses and/or children. The dedication is written in the center of a separate page in one or two lines and numbered in Roman numerals.

iv. Acknowledgement
This section is designed to offer thanks or appreciation to the efforts of individuals or organizations for help, advice or financial and material assistance extended by them during the research work/study. The trainees should not forget to mention the names of there colleagues, statisticians, the computer operator and spouse, if applicable, as well as the supervisor. This is the best place to show gratitude and appreciation. Technical help and other contributions like financial and material support are acknowledged in a separate paragraph. This section is placed after the dedication on a separate page and numbered in Roman numerals.

v. Table of Contents
It is an important section of part I that contains the main headings of the text in the dissertation, annexes and page numbers in Arabic and Roman numerals. Sub-headings are also used where necessary. Table of contents is written on separate page(s) and numbered in Roman numerals.

vi. List of Tables
All the tables of dissertation are listed together with titles and page numbers in this section. It is written on separate page(s) and numbered in Roman numerals.

vii. List of Figures / Graphs / Illustrations
All the figures, graphs and illustrations drawn for the dissertation are listed with titles and page numbers in this section. It is written on a separate page and duly numbered in Roman numerals.

viii. List of Abbreviations
A list of all the abbreviations used in the dissertation along with full words is written on separate page(s) and numbered in Roman numerals. Only standard abbreviations are used in the dissertation.

2) Sections of Part II:

i. Structured Abstract
It is the first section of the dissertation. The abstract is a brief account of the dissertation, summarizing the information given in each major section. It is different from the conclusion and identifies the basic contents of the dissertation. It is written in past tense, emphasizing on important aspects of the dissertation. The abstract is around 250 pages words written under the following headings:

• introduction
• objectives
• main outcome measures,
• study design
• setting
• subjects
• methods
• results
• conclusions.

At the end of abstract, three to ten (3-10) key words are identified and written. Selected key words should be from the Medical Subject Headings (MeSH), List of Index

ii. Introduction
It is second section of the dissertation that presents the specific problem under study and reflects:

• The importance of the topic selected
• The rationale of the study and discusses the background.

Before writing introduction in the dissertation, the trainee should study relevant literature retrieved from published papers. Relevant articles are selected, which improve the understanding of the topic. Only pertinent references are cited but not extensively reviewed in this section. Rationale of the study should be mentioned at the end of introduction.

iii. Review of Literature
Review of the literature is essential. A comprehensive review of the current status of knowledge on the selected topic must be included. It should be a collective review and critique in the candidate's own words of various viewpoints supported by relevant data, and should not be copied from published work. The review should be properly referenced. References should preferably be of the last five years, including some published in the recent past. However, older references can be cited provided they are
relevant and historical. It is essential to also include a review of the local literature. A special effort should be made to collect and review all work done in Pakistan on the chosen topic. This should include work published in recognized journals and in publications of various societies and medical colleges, as well as abstracts of meetings, conferences or seminars held in Pakistan or abroad. Data collected by others, whether published or unpublished, must be acknowledged whenever included.

iv. Objectives
Objectives are statements of intentions. They inform the reader clearly what the researcher plans to do in his/her work. The must identify the variables involved in research. Objective should start with an action verb and be sufficiently specific, measurable, achievable, relevant and time bound (SMART).

v. Operational Definition:
May be required in some cases. It is definition of a term specifically telling how it will be measured for e.g.:

a. Morbidity: this encompass a number of aspects viz. prolonged hospital stay, severe pain, immediate complications, long term sequelac. A research must define how a vague term will be measured.
b. Efficacy: These can by measured

i. Time taken in relieve of symptoms which may be pain, fever cough heartburn etc.
ii. Taking into account number of side effects.
iii. Time taken for complete recovery student is requirement to specify how he/she will measure efficacy.

vi. Hypothesis:
A hypothesis is a statement showing expected relation between two variables. A hypothesis is needed in the following study designs:

i. All interventional studies
ii. Cohort
iii. Case control
iv. Comparative cross sectional.

vii. Material and Methods:

SETTING: Name and place where the research work has been conducted – community based or facility based (e.g. hospital, laboratory).
DURATION OF STUDY: How long did the study take.
SAMPLE SIZE: how many patients were included. If there were groups how many per group?
SAMPLING TECHNIQUE: Probability or Non probability.
SAMPLE SELECTION:
Inclusion criteria: on what bases were patients inducted in the study.
Exclusion criteria: on what bases were patients be excluded from the study.
STUDY DESIGN: Mention the name of the appropriate study design.
DATA COLLECTION PROCEDURE: a detailed explanation of how the researcher performed research; how s/he measured the variable. It includes:

Identification of the study variables
Methods for collection of data
Data collection tools (proforma/ questionnaire)

DATA ANALYSIS PLAN: A brief statement about what statistical procedures have been used. The exact name of the software and its version used must also be mentioned.
REFERENCES : in Vancouver style
PROFORMA(S): must be according to the objectives  

viii. Results
The results should be in logical sequence with the main results being stated first. The data should be reported in sufficient detail to justify the conclusions. The results section should include the:

• Number of subjects in the study at its inception.
• Statistics describing the study population, and the number of subjects who were excluded.
• Number of subjects dropped out, or lost at any point in the study.
• To illustrate the main effects, the data should be presented in appropriate tables and figures.
• Data in tables or figures should not be repeated in the text where only important observations should be summarized.
• When data is statistically analyzed, information should be included about the tests of significance (such as chi-square or t-test) used, obtained magnitude or value of the test, the degrees of freedom, the probability level. Results should be presented in terms of confidence intervals wherever possible.
• If one statistical test has been used throughout the manuscript, the test should be clearly stated in the methods section. If more than one statistical test have been used, the statistical tests performed should be discussed in the methods and the specific test used reported along with the results.

ix. Discussion
The writing skills of a trainee are best projected in this section of the dissertation. It is meant to fit the results of current research work into pre-existing pool of knowledge.

• If a hypothesis existed, whether the hypothesis was supported or refuted by the results should be addressed.
• The results of the study should be examined and interpreted, and implications described.
• The limitations of the study should be discussed, including possible sources of bias and how these problems might affect conclusions and generatizability.
• The implications for clinical practice, in any specific directions for future research may be offered.
• Similarities and differences between the findings of the study and those of others should be brought out and explained through a review of the literature.
• The study results should be placed in context with published literature.

x. Conclusion(s)
This is the last section of the text in which conclusions or inferences drawn on the basis of the results of study are described. The conclusions should be linked with the objectives of the study. Recommendations for further research may be included when appropriate e.g. if you find a statistically significant number of cases of anemia of severe degree in the school going girls of a particular area you can recommend further research to probe the cause of anemia in that area. It is important to be careful that
the conclusions should not go beyond data and should be based on the study results and population.

xi. References
CPSP follows the Vancouver reference style. References are serially numbered in the order in which these are mentioned in the text e.g., for the first cited reference the trainee may either put "1" at superscript or in parenthesis at the most relevant place in
the sentence. This reference will then be listed at serial number "1" in the References section of the Dissertation. The next reference will be marked as number "2" at superscript or in parenthesis and listed at number "2" in the References section and so on. References in the text, tables and legends are identified by Arabic numerals within parenthesis. Only reference of articles indexed/abstracted in Medline, Excerpta Medica, Extra-Med and those published in journals recognized by the Pakistan Medical & Dental Council may be listed. The trainee is expected to check all parts of each reference against the original publication, before the manuscript of the Dissertation is submitted to R.T.M.C.

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