UG Regulations Syllabus

REGULATION FOR THE DEGREE OF BACHELOR OF
MEDICINE AND BACHELOR OF SURGERY (MBBS) 2019

(New Competency Based Medical Education)
In exercise of the powers conferred by Bharath Institute of Higher Education and

Research – to be Deemed University, amended up to May 2019 of MCI
Regulations on Graduate Medical Education, 1997, the Academic Council hereby
makes the following revised Competency based Medical Education MBBS
regulations. These regulations framed are subject to modification as and when
amended by the Academic Council of BIHER from time to time.
Gazette Publication -------- BOARD OF GOVERNORS IN SUPER-

SESSION OF MEDICAL COUNCIL OF INDIA - AMENDMENT
NOTIFICATION, New Delhi, the 4th November, 2019
No. MCI-34(41)/2019-Med./161726.- In exercise of the powers

conferred by Section 33 of the Indian Medical Council Act, 196 (102 of
1956), the Board of Governors in super-session of Medical Council of
India with the previous sanction of the Central Government, hereby makes
the following Regulations to further amend the “Regulations on
Graduate Medical Education, 1997”, namely:-
1. (i) These Regulations may be called the “Regulation on Graduate Medical

Education (Amendment), 2019.
(ii) They shall come into force the date of their publication in the Official
Gazette.
2. The following shall be added as clause 1A to the Regulations on Graduate

Medical Education, 19997:-
1
(i) The regulations of Graduate Medical Education, 1997 from
clause 2 to 14 contained in Chapters I to V and the Appendices
and Schedules appended therein shall be included as Part I of
the Regulation. These provisions shall be the governing
Regulations with respect to batches admitted in MBBS course
until academic year 2018-19.
(ii) Part II containing the following Chapters shall be added the
Regulations on Graduate Medical Education, 1997 that shall be
the governing Regulations with respect to batches admitted in
MBBS course from academic year 2019-20 onwards.
3. Following shall be added as Part II of the Regulations on Graduate

Medical Education, 1997: -
Part II
For MBBS course starting from academic year 2019-20
onwards
THE REGULATIONS ON GRADUATE MEDICAL

EDUCATION, 1997
PART II
ARRANGEMENT OF CLAUSES
2
CHAPTER I
GENERAL CONSIDERATIONS AND TEACHING
APPROACH
1. Introduction
2. Objectives of the Indian Medical Graduate Training Programme
2.1National Goals
2.2Institutional Goals
2.3Goals and Roles for the Learner
3. Competency Based Training Programme of the Indian Medical
Graduate
4. Broad Outline on training format
CHAPTER II
ADMISSION TO INDIAN MEDICAL GRADUATE PROGRAMME:
NATIONAL ELIGIBILLITY-CUM-ENTRANCE TEST AND
COMMON COUNSELLING
5. Admission to the Indian Medical Graduate Programme
CHAPTER III
MIGRATION
6. Migration
3
CHAPTER IV
PHASE WISE TRAINING AMD TIME DISTRIBUTION FOR

PROFESSIONAL DEVELOPMENT
7. Training period and time distribution:

8. Phase distribution and timing of examination
9. New teaching / learning elements
9.1 Foundation Course
9.2 Early Clinical Exposure
9.3 Electives
9.4 Professional Development including Attitude, Ethics and
Communication Module (AETCOM)
9.5 Learner-doctor method of clinical training (Clinical Clerkship)
CHAPTER V
COMPETENCY BASED CURRICULUM OF THE INDIAN

MEDICAL GRADUATE PROGRAMME
10. Specific Competencies
10.1 Preamble
10.2 Integration
10.3 Pre-clinical Subjects
10.4 Second Professional (Para-Clinical)
4
10.5 Third Professional (Part I)
10.6 Third Professional (Part II)
CHAPTER VI
ASSESSMENT
11. Assessment
11.1 Eligibility to appear for Professional examinations
11.2 University Examinations
CHAPTER VII
INTERNSHIP
12. Internship
12.1 Goal
12.2 Objectives
12.3 Time Distribution
12.4 Other details
12.5 Assessment of Internship
12.6 Internship – discipline related
5
6
CONTENTS
S. No. Title Page no.

Chapter I: 1, 2.1 – 2.3, 3.1 – 3.5, 4.1-4.2
1 General considerations and teaching approach
9
1 . Introduction
2. Indian Medical Graduate Training
9-12
Programme
3. Competency Based Training Programme of the
12-16
Indian Medical Graduate
4. Broad Outline on training format 16-17
Chapter II: 5
2 18-23
Admission to the Indian Medical Graduate Programme
3 Chapter III: 6 - Migration 23-28
Chapter IV: 7 - 7.1 to 7.10 29-33
4
Training period and Time distribution
Chapter IV: 8 - 8.1 to 8.8
33-34
Phase distribution and timing of Examination
Table 1 : Time distribution of MBBS Programme &
35
Examination Schedule
Table 2 : Distribution of subjects by Provisional Phase 35-36
Table 3: Foundation Course (1 month) 37
Table 4: First Provisional Teaching hours 38
Table 5: Second Provisional Teaching hours 39
Table 6: Third Provisional Part I Teaching hours 40
Table 7: Third Provisional Part II Teaching hours 41
Table 8: Clinical Postings 42-43
Chapter IV: 9 – 9.1 to 9.5
New Teaching / Learning elements, Early Clinical Exposure, 43-49
Professional Development, Clinical Clerkship
Table 9: Learner - Doctor programme (Clinical Clerkship) 49
Chapter V: 10 – 10.1 to 10.6
5 Competency Based Curriculum of the Indian Medical 50-66
Graduate Programme– Specific Competencies
7
Chapter VI: 11 – 11.1 to 11.2
Assessment & University Examinations
67-79
6 Table 10: Marks distribution for various subjects
Re-totalling, Grace marks, Regulation for Re-Admission
Conduction of Supplementary Examination
Chapter VII: 12 – 12.1 to 12.6
7 80-105
Internship
Table 11: Certifiable Procedural Skills 105-107
8 Distribution of marks to various disciplines: 110-119
Syllabus for various subjects 119
8.1 Anatomy 123-136
8.2 Physiology 137-160
8.3 Biochemistry 161-173
8.4 Pathology 175-190
8.5 Microbiology 191-202
8.6 Pharmacology 203-211
8.7 Forensic Medicine and Toxicology 213-220
8.8 Oto-Rhino-laryngology 221-227
8.9 Ophthalmology 229-235
8.10 Community Medicine 237-264
8.11 Medicine & Allied Subjects 265-287
8.12 Surgery & Allied Subjects 289-312
8.13 Obstetrics and Gynaecology 313-328
8.14 Paediatrics 329-340
8
CHAPTER I
GENERAL CONSIDERATIONS AND TEACHING APPROACH
1. Introduction
The provisions contained in Part II of these Regulations shall apply to
the MBBS course starting from academic year 2019-20 onwards
2. Indian Medical Graduate Training Programme

The undergraduate medical education Programme is designed with a
goal to create an “Indian Medical Graduate” (IMG) possessing
requisite knowledge, skills, attitudes, values and responsiveness, so that
she or he may function appropriately and effectively as a physician of
first contact of the community while being globally relevant. To
achieve this, the following national and institutional goals for the
learner of the Indian Medical Graduate training programme are hereby
prescribed:-
2.1 National Goals
At the end of undergraduate programme, the Indian Medical
Graduate should be able to:
(a) Recognize “health for all” as a national goal and health right of
all citizens and by undergoing training for medical profession to
fulfill his/her social obligations towards realization of this goal.
(b) Learn every aspect of National policies on health and devote
her/him to its practical implementation.
(c) Achieve competence in practice of holistic medicine,
encompassing promotive, preventive, curative and rehabilitative
aspects of common diseases.
(d) Develop scientific temper, acquire educational experience for
proficiency in profession and promote healthy living.
(e) Become exemplary citizen by observance of medical ethics and
fulfilling social and professional obligations, so as to respond to
national aspirations.
9
2.2 Institutional Goals
(1) In consonance with the national goals each medical institution
should evolve institutional goals to define the kind of trained
manpower (or professionals) they intend to produce. The Indian
Medical Graduates coming out of a medical institute should:
(a) Be competent in diagnosis and management of common

health problems of the individual and he community,
commensurate with his/her position as a member of the health
team at the primary, secondary or tertiary levels, using his/her
clinical skills based on history, physical examination and
relevant investigations.
(b) Be competent to practice preventive, promotive, curative,
palliative and rehabilitative medicine in respect to the
commonly encountered health problems.
(c) Appreciate rationale for different therapeutic modalities; be
familiar with the administration of “essential medicine” and
their common adverse effects.
(d) Be able to appreciate the socio-psychological, cultural,
economic and environmental factors affecting health and
develop humane attitude towards the patients in discharging
one‟s professional responsibilities.
(e) Possess the attitude for continued self-learning and to seek
further expertise or to pursue research in any chosen area of
medicine, action research and documentations skills.
(f) Be familiar with the basic factors which are essential for the
implementation of the national Health Programmes including
practical aspects of the following:
(i) Family Welfare and Maternal and Child Health (MCH)
(ii) Sanitation and water supply
(iii) Prevention and control of communicable and non-
communicable diseases
(iv) Immunization
(v) Health Education
10
(vi) Indian Public Health Standards (IPHS), at various
levels of service delivery
(vii) Bio-medical waste disposal
(viii) Organizational and/or institutional arrangement.
(g) Acquire basic management skills in the area of human
resources, materials and resource management related to
health care delivery, hospital management, inventory skills
and counseling.
(h) Be able to identify community health problems and learn to
work to resolve these by designing, instituting corrective
steps and evaluating outcome of such measures.
(i) Be able to work as a leading partner in health care teams and
acquire proficiency in communication skills.
(j) Be competent to work in a variety of health care settings.
(k) Have personal characteristics and attitudes required for
professional life such as personal integrity, sense of
responsibility and dependability and ability to relate to or
show concern for other individuals.
(2) All efforts must be made to equip the medical graduate to acquire
the skills as detailed in Table11 Certifiable procedural skills – A
Comprehensive list of skills recommended as desirable for
Bachelor of Medicine and Bachelor of Surgery (MBBS) – Indian
Medical Graduate.
2.3 Goals and Roles for the Learner
In order to fulfill the goal of the IMG training programme, the
medical graduate must be able to function in the following roles
appropriately and effectively: -
2.3.1 Clinician who understands and provides preventive,
promotive, curative, palliative and holistic care with
compassion.
2.3.2 Leader and member of the health care team and system with
capabilities to collect analyze, synthesize and communicate
health data appropriately.
2.3.3 Communicator with patients, families, colleagues and
community.
11
2.3.4 Lifelong leaner committed to continuous improvement of
skills and knowledge.
2.3.5 Professional, who is committed to excellence, is ethical,
responsive and accountable to patients, community and
profession.
3. Competency Based Training Programme of the Indian
Medical Graduate
Competency based learning would include designing and implementing
medical education curriculum that focuses on the desired and
observable ability in real life situations. In order to effectively fulfill
the roles as listed in clause 2, the Indian Medical Graduate would have
obtained the following set of competencies at the time of graduation:
3.1 Clinician, who understands and provides preventive, promotive,
curative, palliative and holistic care with compassion
3.1.1 Demonstrate knowledge of normal human structure, function
and development from a molecular, cellular, biologic, clinical,
behavioural and social perspective.
3.1.2 Demonstrate knowledge of abnormal human structure,
function and development from a molecular, cellular,
biological, clinical, behavioural and social perspective.
3.1.3 Demonstrate knowledge of medico-legal, societal, ethical
and humanitarian principles that influence health care.
3.1.4 Demonstrate knowledge of national and regional health
care policies including the National Health Mission that
incorporates National Rural Health Mission (NRHM) and
National Urban Health Mission (NUHM), frameworks,
economics and systems that influence health promotion,
health care delivery, disease prevention, effectiveness,
responsiveness, quality and patient safety.
3.1.5 Demonstrate ability to elicit and record from the patient,
and other relevant sources including relatives and
caregivers, a history that is complete and relevant to
disease identification, disease prevention and health
promotion.
12
3.1.6 Demonstrate ability to elicit and record from the patient,
and other relevant sources including relatives and
caregivers, a history that is contextual to gender, age,
vulnerability, social and economic status, patient
preferences, beliefs and values.
3.1.7 Demonstrate ability to perform a physical examination that
is complete and relevant to disease identification, disease
prevention and health promotion.
3.1.8 Demonstrate ability to perform a physical examination that
is contextual to gender, social and economic status, patient
preferences and values.
3.1.9 Demonstrate effective clinical problem solving, judgment
and ability to interpret and integrate available data in order
to address patient problems, generate differential diagnoses
and develop individualized management plans that include
preventive, promotive and therapeutic goals.
3.1.10 Maintain accurate, clear and appropriate record of the
patient in conformation with legal and administrative
frame works.
3.1.11 Demonstrate ability to choose the appropriate diagnostic
tests and interpret these tests based on scientific validity,
cost effectiveness and clinical context.
3.1.12 Demonstrate ability to prescribe and safely administer
appropriate therapies including nutritional interventions,
pharmacotherapy and interventions based on the principles
of rational drug therapy, scientific validity, evidence and
cost that conform to established national and regional
health programmes and policies for the following:
(i) Disease prevention,
(ii) Health promotion and cure,
(iii) Pain and distress alleviation, and
(iv) Rehabilitation.
3.1.13 Demonstrate ability to provide a continuum of care at the
primary and/or secondary level that addresses chronicity,
mental and physical disability.
13
3.1.14 Demonstrate ability to appropriately identify and refer
patients who may require specialized or advanced tertiary
care.
3.1.15 Demonstrate familiarity with basic, clinical and
translational research as it applies to the care of the patient.
3.2 Leader and member of the health care team and system
3.2.1 Work effectively and appropriately with colleagues in an

inter-professional health care team respecting diversity of
roles, responsibilities and competencies of other
professionals.
3.2.2 Recognize and function effectively, responsibly and
appropriately as a health care team leader in primary and
secondary health care settings.
3.2.3 Educate and motivate other members of the team and work
in a collaborative and collegial fashion that will help
maximize the health care delivery potential of the team.
3.2.4 Access and utilize components of the health care system
and health delivery in a manner that is appropriate, cost
effective, fair and in compliance with the national health
care priorities and policies, as well as be able to collect,
analyze and utilize health data.
3.2.5 Participate appropriately and effectively in measures that
will advance quality of health care and patient safety
within the health care system.
3.2.6 Recognize and advocate health promotion, disease
prevention and health care quality improvement through
prevention and early recognition: in a) life style diseases
and b) cancers, in collaboration with other members of the
health care team.
14
3.3 Communicator with patients, families, colleagues and community
3.3.1 Demonstrate ability to communicate adequately,

sensitively, effectively and respectfully with patients in a
language that the patient understands and in a manner that
will improve patient satisfaction and health care outcomes.
3.3.2 Demonstrate ability to establish professional relationships
with patients and families that are positive, understanding,
humane, ethical, empathetic, and trustworthy.
3.3.3 Demonstrate ability to communicate with patients in a
manner respectful of patient‟s preferences, values, prior
experience, beliefs, confidentiality and privacy.
3.3.4 Demonstrate ability to communicate with patients,
colleagues and families in a manner that encourages
participation and shared decision-making.
3.4 Lifelong learner committed to continuous improvement of

skills and knowledge
3.4.1 Demonstrate ability to perform an objective self-

assessment of knowledge and skills, continue learning,
refine existing skills and acquire new skills.
3.4.2 Demonstrate ability to apply newly gained knowledge or
skills to the care of the patient.
3.4.3 Demonstrate ability to introspect and utilize experiences,
to enhance personal and professional growth and learning.
3.4.4 Demonstrate ability to search (including through

electronic means), and critically evaluate the medical
literature and apply the information in the care of the
patient.
3.4.5 Be able to identify and select an appropriate career

pathway that is professionally rewarding and personally
fulfilling.
15
3.5 Professional who is committed to excellence, is ethical, responsive
and accountable to patients, community and the profession
1.5.1 Practice selflessness, integrity, responsibility,

accountability and respect.
1.5.2 Respect and maintain professional boundaries between
patients, colleagues and society.
1.5.3 Demonstrate ability to recognize and manage ethical and
professional conflicts.
1.5.4 Abide by prescribed ethical and legal codes of conduct
and practice.
1.5.5 Demonstrate a commitment to the growth of the medical
profession as a whole.
4. Broad Outline on training format
4.1 In order to ensure that training is in alignment with the goals and
competencies listed in sub-clause 2 and 3 above:
4.1.1 There shall be a "Foundation Course" to orient
medical learners to MBBS programme, and provide

them with requisite knowledge, communication
(including electronic), technical and language skills.
4.1.2 The curricular contents shall be vertically and
horizontally aligned and integrated to the maximum
extent possible in order to enhance learner‟s interest and
eliminate redundancy and overlap.
4.1.3 Teaching-learning methods shall be learner centric and
shall predominantly include small group learning,

interactive teaching methods and case based learning.
4.1.4 Clinical training shall emphasize early clinical exposure,
skill acquisition, certification in essential skills;
16
community/primary/secondary care-based learning
experiences and emergencies.
4.1.5 Training shall primarily focus on preventive and
community based approaches to health and disease, with
specific emphasis on national health priorities such as
family welfare, communicable and noncommunicable
diseases including cancer, epidemics and disaster
management.
4.1.6 Acquisition and certification of skills shall be through
experiences in patient care, diagnostic and skill

laboratories.
4.1.7 The development of ethical values and overall

professional growth as integral part of curriculum shall
be emphasized through a structured longitudinal and
dedicated programme on professional development
including attitude, ethics and communication.
4.1.8 Progress of the medical learner shall be documented
through structured periodic assessment that includes

formative and summative assessments. Logs of skill-
based training shall be also maintained.
4.2 Appropriate Faculty Development Programmes shall be

conducted regularly by institutions to facilitate medical teachers
at all levels to continuously update their professional and
teaching skills, and align their teaching skills to curricular
objectives.
17
CHAPTER II
ADMISSION TO INDIAN MEDICAL GRADUATE PROGRAMME:
NATIONAL ELIGIBILITY-CUM- ENTRANCE TEST
AND COMMON COUNSELLING
5. Admission to the Indian Medical Graduate Programme

5.1. Admission to the Medical Course - Eligibility Criteria: No Candidate shall be
allowed to be admitted to the Medical Curriculum proper of first Bachelor of

Medicine and Bachelor of Surgery (MBBS) Course until:
a) He/she shall complete the age of 17 years on or before 31st December of the year of
admission to the MBBS Course.

b) He/She has obtained a minimum of marks in National Eligibility-cum-Entrance Test
as prescribed in Clause 5 of Chapter II.”

c) “In order to be eligible to take National Eligibility-cum-Entrance Test,” He/she has
passed qualifying examination as under:

The higher secondary examination or the Indian School Certificate Examination
which is equivalent to 10+2 Higher Secondary Examination after a period of 12
years study, the last two years of study comprising of Physics, Chemistry,
Biology/Biotechnology and Mathematics or any other elective subjects with
English at a level not less than core course of English as prescribed by the
National Council of Educational Research and Training after the introduction of
the 10+2+3 years educational structure as recommended by the National
Committee on education;
18
Note: Where the course content is not as prescribed for 10+2 education structure of the
National Committee, the candidates will have to undergo a period of one year pre-
professional training before admission to the Medical colleges;
Or
The intermediate examination in science of an Indian University/Board or other
recognized examining body with Physics, Chemistry and Biology/Bio-technology
which shall include a practical test in these subjects and also English as a compulsory
subject;
Or
The pre-professional/pre-medical examination with Physics, Chemistry and
Biology/Bio-technology, after passing either the higher secondary school examination,
or the pre-university or an equivalent Examination. The pre-professional/pre-medical
examination shall include a practical test in Physics, Chemistry and Biology/Bio-
technology and also English as a compulsory subject;
Or
The first year of the three years degree course of a recognized university, with
Physics, chemistry and Biology/Bio-technology including a practical test in three
subjects provided the examination is a "University Examination" and candidate has
passed 10+2 with English at a level not less than a core course;
Or
B.Sc. examination of an Indian University, provided that he/she has passed the B.Sc.
examination with not less than two of the following subjects Physics, Chemistry,
Biology (Botany, Zoology)/Bio-technology and further that he/she has passed the
earlier qualifying examination with the following subjects – Physics, Chemistry,
Biology and English.
Or
19
Any other examination which, in scope and standard is found to be equivalent to the
intermediate science examination of an Indian University/Board, taking Physics,
Chemistry and Biology/ Biotechnology including practical test in each of these
subjects and English.
Note:
The pre-medical course may be conducted either at Medical College, or a
science College.
Marks obtained in Mathematics are not to be considered for admission to
MBBS Course.
After the 10+2 course is introduced, the integrated courses should be abolished.
d) 3% seats of the annual sanctioned intake capacity shall be filled up by candidates
with locomotory disability of lower limbs between 50% to 70%.Provided that in

case any seat in this 3% quota remains unfilled on account of unavailability of
candidates with locomotory disability of Lower limbs between 50% to 70% then any
such unfilled seat in this 3% quota shall be filled up by persons with locomotory
disability of lower limbs between 40% to 50% - before they are included in the
annual sanctioned seats for General Category candidates. Provided further that this
entire exercise shall be completed by each medical college / institution as per the
statutory time schedule for admissions and in no case any admission will be made in
the MBBS course after 30th of September.
SELECTION OF STUDENTS: The selection of students to medical college shall be
based solely on merit of the candidate and for determination of merit, the following
criteria be adopted uniformly throughout the country:
20
5.2. Procedure for selection to MBBS course shall be as follows: -
a) There shall be a single eligibility cum entrance examination namely „National
Eligibility-cum-Entrance Test (NEET) for admission to MBBS course‟ in each
academic year. The overall superintendence, direction and control of National
Eligibility-cum-Entrance Test shall vest with Medical Council of India. However,
Medical Council of India with the previous approval of the Central Government
shall select organization/s to conduct „National Eligibility-cum-Entrance Test for
admission to MBBS course.
b) In order to be eligible for admission to MBBS Course for a particular academic year,
it shall be necessary for a candidate to obtain minimum of marks at 50th percentile
in „National Eligibility-cum-Entrance Test to MBBS course‟ held for the said
academic year. However, in respect of candidates belonging to Scheduled Castes,
Scheduled Tribes, Other Backward Classes, the minimum marks shall be at 40th
percentile. In respect of candidates with locomotory disability of lower limbs terms
of Clause 4(3) above, the minimum marks shall be at 45th percentile. The percentile
shall be determined on the basis of highest marks secured in the All-India common
merit list in „National Eligibility-cum-Entrance Test for admission to MBBS course‟.
Provided when sufficient number of candidates in the respective categories
fail to secure minimum marks as prescribed in National Eligibility-cum-Entrance
Test held for any academic year for admission to MBBS Course, the Central
Government in consultation with Medical Council of India may at its discretion
lower the minimum marks required for admission to MBBS Course for candidates
belonging to respective categories and marks so lowered by the Central Government
shall be applicable for the said academic year only.”
c) The reservation of seats in medical colleges for respective categories shall be as per
applicable laws prevailing in States/Union Territories. An all India merit list as well
as State-wise merit list of the eligible candidates shall be prepared on the basis of the
21
marks obtained in National Eligibility-cum-Entrance Test and candidates shall be
admitted to MBBS course from the said lists only.
d) No Candidate who has failed to obtain the minimum eligibility marks as prescribed
in Sub Clause (ii) above shall be admitted to MBBS Course in the said academic
year.
e) All admissions to MBBS course within the respective categories shall be based
solely on marks obtained in the National Eligibility-cum-Entrance Test.”
f) To be eligible for admission to MBBS course, a candidate must have passed in the
subjects of Physics, Chemistry, Biology/Biotechnology and English individually and
must have obtained a minimum of 50% marks taken together in Physics, Chemistry
and Biology/Bio-technology at the qualifying examination as mentioned in clause
(2) of Regulation 4 and in addition must have come in the merit list of “National
Eligibility-cum-Entrance Test” for admission to MBBS course. In respect of
candidates belonging to Scheduled Castes, Scheduled Tribes or other Backward
Classes the minimum marks obtained in Physics, Chemistry and Biology/Bio-
technology taken together in qualifying examination shall be 40% instead of 50%. In
respect of candidates with locomotory disability of lower limbs in terms of Clause
4(3) above, the minimum marks in qualifying examination in Physics, Chemistry
and Biology/Bio-technology taken together in qualifying examination shall be 45%
instead of 50%.
Provided that a candidate who has appeared in the qualifying examination the
result of which has not been declared, he/she may be provisionally permitted to take
up the National Eligibility-cum-Entrance Test and in case of selection for admission
to the MBBS course, he/she shall not be admitted to that course until he fulfills the
eligibility criteria under Regulation 4.
22
g) The Central Board of Secondary Education shall be the organization to conduct
National Eligibility-cum-Entrance Test for admission to MBBS course.”
5.3. COMMON COUNSELING

a) There shall be a common counseling for admission to MBBS course in all Medical
Educational Institutions on the basis of merit list of the National Eligibility Entrance
Test.
b) The Designated Authority for counseling for the 15% All India Quota seats of the
contributing States and all MBBS seats of Medical Educational Institutions of the
Central Government, Universities established by an Act of Parliament and the
Deemed Universities shall be the Directorate General of Health Services, Ministry of
Health and Family Welfare, Government of India.
c) The counseling for admission to MBBS course in a State/Union Territory, including,
Medical Educational Institutions established by the State Government, University
established by an Act of State/Union Territory Legislature, Trust, Society, Minority
Institutions, Municipal Bodies or a Company shall be conducted by the State/Union
Territory Government.
CHAPTER III
MIGRATION
6. Migration
a) Migration of students from one medical college to another medical college may be
granted on any genuine ground subject to the availability of vacancy in the college
where migration is sought and fulfilling the other requirements laid down in the
Regulations. Migration would be restricted to 5% of the sanctioned intake of the
23
College during the year. No migration will be permitted on any ground from one
medical college to another located within the same city.
b) Migration of students from one College to another is permissible only if both the
colleges are recognized by the Central Government under section 11(2) of the Indian
Medical Council Act, 1956 and further subject to the condition that it shall not result
in increase in the sanctioned intake capacity for the academic year concerned in
respect of the receiving medical college.
c) The applicant candidate shall be eligible to apply for migration only after qualifying
in the first professional MBBS examination. Migration during clinical course of
study shall not be allowed on any ground.
d) For the purpose of migration an applicant candidate shall first obtain “No Objection
Certificate” from the college where he is studying for the present and the university
to which that college is affiliated and also from the college to which the migration is
sought and the university to it that college is affiliated. He/She shall submit his
application for migration within a period of 1 month of passing (Declaration of result
of the 1st Professional MBBS examination) along with the above cited four “No
Objection Certificates” to: (a) the Director of Medical Education of the State, if
migration is sought from one college to another within the same State or (b) the
Medical Council of India, if the migration is sought from one college to another
located outside the State.
24
e) A student who has joined another college on migration shall be eligible to appear in
the IInd professional MBBS examination only after attaining the minimum
attendance in that college in the subjects, lectures, seminars etc. required for
appearing in the examination prescribed under Regulation 12(1)
Note-1: The State Governments/Universities/Institutions may frame appropriate

guidelines for grant of No Objection Certificate for migration, as the case may be, to the
students subject to provisions of these regulations.
Note-2: Any request for migration not covered under the provisions of these Regulations
shall be referred to the Medical Council of India for consideration on individual merits by
the Director (Medical Education) of the State or the Head of Central Government
Institution concerned. The decision taken by the Council on such requests shall be final.
Note-3: The College/Institutions shall send intimation to the Medical Council of India
about the number of students admitted by them on migration within one month of their
joining. It shall be open to the Council to undertake verification of the compliance of the
provisions of the regulations governing migration by the Colleges at any point of time.
The above clause 6 has been substituted in terms of notification published on

20.10.2008 in Gazette of India and the same is as under:-
(1) Migration of students form one medical college to another medical college
in India shall be granted only in exceptional Cases to the most deserving
among the applicants for good and sufficient reasons and not on routine
grounds. The number of students migrating to/from any one medical
college shall be kept to the minimum which shall in any case not exceed the
limit of 5% of its sanctioned intake in one academic year. There shall be no
migration on any ground from one medical college to another located in
the same city.
25
(2) Migration of students from one College to another is permissible only if
both the colleges are recognized by the Central Government under section
11(2) of the Indian Medical Council Act, 1956 and further subject to the
condition that it shall not result in increase in the sanctioned intake
capacity for the academic year concerned in respect of the receiving
medical college.
(3) The applicant candidate shall be eligible to apply for migration only after
qualifying in the first professional MBBS examination. Migration during
clinical course of study shall not be allowed on any ground.
(4) For the purpose of migration, an applicant candidate shall first obtain „No
Objection Certificates‟ from the college where he is studying for the
present, the University to which it is affiliated to, the college to which
migration is sought and the University to which that college is affiliated to.
He shall submit his application for migration within a period of one month
of passing (declaration of results) of the first professional MBBS
examination along with the said „No Objection Certificates‟ to the
Director, Medical Education of the State where the College/Institutions
including Deemed Universities to which migration is sought is situated or
to the Head of the Institution in case migration is sought to a Central
Government institution. The Director, Medical Education of the State
concerned or the Head of the Central Government institution, as the case
may be, shall take a final decision in the matter as to whether or not to
allow migration in accordance with the provisions of these Regulations and
communicate the same to the date of receipt of the request for migration.
26
(5) A student who has joined another college on migration shall be eligible to
appear in the IInd Professional MBBS examination only after attaining the
minimum attendance in that college in the subjects, lectures, seminars etc.
required for appearing in the examination prescribed under Regulation
12(1).
Note-1: The State Governments/Universities/Institutions may frame appropriate
guidelines for grant of No Objection Certificate or migration, as the case
may be, to the students subject to provisions of these regulations.
Note-2: Any request for migration not covered under the provisions of these
Regulations shall be referred to the Medical Council of India for
consideration on individual merits by the Director (Medical Education)
of the State or the Head of Central Government Institution concerned.
The decision taken by the Council on such requests shall be final.
Note-3: The College/Institutions shall send intimation to the Medical Council of
India about the number of students admitted by them on migration
within one month of their joining. It shall be open to the Council to
undertake verification of the compliance of the provisions of the
regulations governing migration by the Colleges at any point of time.
The above clause 6(1) and 6(4) have been further substituted in terms of notification
published on 22.12.2008 in Gazette of India and the same is as under:-
6(1) Migration of students from one medical college to another medical college
may be granted on any genuine ground subject to the availability of vacancy
in the college where migration is sought and fulfilling the other requirements
laid down in the Regulations. Migration would be restricted to 5% of the
sanctioned intake of the college during the year. No migration will be
permitted on any ground from one medical college to another located within
the same city.
27
6(4) for the purpose of migration an applicant candidate shall first obtain “No
Objection Certificate” from the college where he is studying for the present
and the university to which that college is affiliated and also from the college
to which the migration is sought and the university to it that college is
Affiliated. He/She shall submit his application for migration within a period of
1 month of passing (Declaration of result of the 1st Professional MBBS
examination) along with the above cited four “No Objection Certificates” to:
(a) The Director of Medical Education of the State, if migration is
sought from one college to another within the same State
Or
(b) The Medical Council of India, if the migration is sought from one
college to another located outside the State.
CHAPTER IV
PHASE WISE TRAINING AND TIME DISTRIBUTION FOR
PROFESSIONAL DEVELOPMENT
The Competency based Undergraduate Curriculum and Attitude,

Ethics and Communication (AETCOM) course, as published by the
Medical Council of India and also made available on the Council‟s
website, shall be the curriculum for the batches admitted in MBBS from
the academic year 2019-20 onwards.
Provided that in respect of batches admitted prior to the academic

year 2019-20, the governing provisions shall remain as contained in the
Part I of these Regulations.
28
7. Training period and time distribution:
7.1 Every learner shall undergo a period of certified study
extending over 4 ½ academic years, divided into nine

semesters from the date of commencement of course to the
date of completion of examination which shall be followed
by one year of compulsory rotating internship.
7.2 Each academic year will have at least 240 teaching days with
a minimum of eight hours of working on each day including

one hour as lunch break.
7.3 Teaching and learning shall be aligned and integrated across
specialties both vertically and horizontally for better learner

comprehension. Learner centered learning methods should
include problem oriented learning, case studies, community
oriented learning, self- directed and experiential learning.
7.4 The period of 4 ½ years is divided as follows:
7.4.1 Pre-Clinical Phase [(Phase I) - First Professional phase
of 13 months preceded by Foundation Course of one

month]: will consist of preclinical subjects – Human
Anatomy, Physiology, Biochemistry, Introduction to
Community Medicine, Humanities, Professional
development including Attitude, Ethics &
Communication (AETCOM) module and early clinical
exposure, ensuring both horizontal and vertical
integration.
29
7.4.2 Para-clinical phase [(Phase II) - Second Professional
(12 months)]: will consist of Para-clinical subjects

namely Pathology, Pharmacology, Microbiology,
Community Medicine, Forensic Medicine and
Toxicology, Professional development including
Attitude, Ethics & Communication (AETCOM)
module and introduction to clinical subjects ensuring
both horizontal and vertical integration. The clinical
exposure to learners will be in the form of learner-
doctor method of clinical training in all phases. The
emphasis will be on primary, preventive and
comprehensive health care. A part of training during
clinical postings should take place at the primary level
of health care. It is desirable to provide learning
experiences in secondary health care, wherever
possible. This will involve:
(a) Experience in recognizing and managing common problems
seen in outpatient, inpatient and emergency settings,
(b) Involvement in patient care as a team member,
(c) Involvement in patient management and performance of

basic procedures.
7.4.3 Clinical Phase – [(Phase III) Third Professional (28

months)]
(a) Part I (13 months) - The clinical subjects include

General Medicine, General Surgery, Obstetrics &
30
Gynaecology, Pediatrics, Orthopaedics, Dermatology,
Oto-rhino-laryngology, Ophthalmology, Community
Medicine, Forensic Medicine and Toxicology,
Psychiatry, Respiratory Medicine, Radiodiagnosis &
Radiotherapy and Anaesthesiology & Professional
development including AETCOM module.
(b) Electives (2 months) - To provide learners

with opportunity for diverse learning
experiences, to do research/community
projects that will stimulate enquiry, self
directed experimental learning and lateral
thinking [9.3].
(c) Part II (13 months) - Clinical subjects

include:
(i) Medicine and allied specialties
(General Medicine, Psychiatry,
Dermatology Venereology and
Leprosy (DVL), Respiratory Medicine
including Tuberculosis)
(ii) Surgery and allied specialties (General
Surgery, Orthopedics [including
trauma]), Dentistry, Physical Medicine
and rehabilitation, Anesthesiology and
Radiodiagnosis)
(iii) Obstetrics and Gynecology (including
Family Welfare)
(iv) Pediatrics
(v) AETCOM module
31
7.5 Didactic lectures shall not exceed one third of the schedule;
two third of the schedule shall include interactive sessions,

practical‟s, clinical or/and group discussions. The learning
process should include clinical experiences, problem oriented
approach, case studies and community health care activities.
The admission shall be made strictly in accordance with the
statutory notified time schedule towards the same.
7.6 Universities shall organize admission timing and admission
process in such a way that teaching in the first Professional

year commences with induction through the Foundation
Course by the 1st of August of each year.
(i) Supplementary examinations shall not be conducted later

than 90 days from the date of declaration of the results of
the main examination, so that the learners who pass can
join the main batch for progression and the remainder
would appear for the examination in the subsequent year.
(ii) A learner shall not be entitled to graduate later than ten

(10) years of her/his joining the first MBBS course.
7.7 No more than four attempts shall be allowed for a candidate

to pass the first Professional examination. The total period
for successful completion of first Professional course shall
not exceed four (4) years. Partial attendance of examination
in any subject shall be counted as an attempt.
32
7.8 A learner, who fails in the second Professional examination,
shall not be allowed to appear in third Professional Part I
examination unless she/he passes all subjects of second
Professional examination.
7.9 Passing in third Professional (Part I) examination is not
compulsory before starting part II training; however, passing

of third Professional (Part I) is compulsory for being eligible
for third Professional (Part II) examination.
7.10 During para-clinical and clinical phases, including prescribed
2 months of electives, clinical postings of three hours

duration daily as specified in Tables 5, 6, 7 and 8 would
apply for various departments.
8. Phase distribution and timing of examination

8.1 Time distribution of the MBBS programme is given in Table 1.
8.2 Distribution of subjects by Professional Phase-wise is given in
Table 2.
8.3 Minimum teaching hours prescribed in various disciplines are

as under Tables 3-7.
8.4 Distribution of clinical postings is given in Table 8.
8.5 Duration of clinical postings will be:
8.5.1 Second Professional : 36 weeks of clinical posting (Three

hours per day - five days per week : Total 540 hours)
33
8.5.2 Third Professional part I: 42 weeks of clinical posting
(Three hours per day - six days per week : Total 756
hours)
8.5.3 Third Professional part II: 44 weeks of clinical posting

(Three hours per day - six days per week : Total 792
hours)
8.6 Time allotted excludes time reserved for internal / University

examinations, and vacation.
8.7 Second professional clinical postings shall commence before /

after declaration of results of the first professional phase
examinations, as decided by the institution/ University. Third
Professional parts I and part II clinical postings shall start no
later than two weeks after the completion of the previous
professional examination.
8.8 25% of allotted time of third Professional shall be utilized for

integrated learning with pre- and para- clinical subjects. This
will be included in the assessment of clinical subjects.
34
Table 1: Time distribution of MBBS Programme & Examination Schedule
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
Foundation I MBBS
Course
I MBBS Exam I II MBBS
MBBS
II MBBS Exam II III MBBS

MBBS
Exam III
MBBS Electives
III MBBS Part I & Skills
Part I
III MBBS Part II
Exam III
MBBS Part Internship
II
Internship
 One month is provided at the end of every professional year for

completion of examination and declaration of results.
Table 2: Distribution of subjects by Professional Phase
Phase & year of University

Subjects & New Teaching Elements Duration#
MBBS training Examination
 Foundation Course (1 month)
 Human Anatomy, Physiology &
Biochemistry, introduction to
First Community Medicine, Humanities 1 + 13 I
Professional  Early Clinical Exposure months Professional
MBBS  Attitude, Ethics and
Communication Module
(AETCOM)
35
 Pathology, Microbiology,
Pharmacology, Forensic Medicine
Second and Toxicology,
Professional  Introduction to clinical subjects
12 months II Professional
including Community Medicine
MBBS
 Clinical postings
 Attitude, Ethics & Communication
Module (AETCOM)
 General Medicine, General Surgery,

Obstetrics & Gynecology,
Pediatrics, Orthopedics,
Dermatology, Psychiatry,
Third Otorhinolaryngology, III
Ophthalmology, Community Professional
Professional Medicine, Forensic Medicine and 13 months
Toxicology, Respiratory medicine, (Part I)
MBBS Part I
Radiodiagnosis & Radiotherapy,
Anesthesiology
 Clinical subjects /postings
Module (AETCOM)
Electives  Electives, Skills and assessment* 2 months
 General Medicine, Pediatrics,

General Surgery, Orthopedics,
Third Obstetrics and Gynecology III
Professional including Family welfare and allied Professional

specialties 13 months
(Part II)
MBBS Part II
 Clinical postings/subjects
Module (AETCOM)
*Assessment of electives shall be included in Internal Assessment.
36
Table 3: Foundation Course (one month)
Teaching Self Directed Total

Subjects/ Contents hours Learning hours
(hours)
1. Orientation 1 30 0 30
2. Skills Module 2 35 0 35
3. Field visit to Community Health 8 0 8

Center
4. Introduction to Professional - - 40
Development & AETCOM module
5. Sports and extracurricular activities 22 0 22
6. Enhancement of language/ computer 40 0 40

skills3
- - 175
1. Orientation course will be completed as single block in the first week and will
contain elements outlined in 9.1.
2. Skills modules will contain elements outlined in 9.1.
3. Based on perceived need of learners, one may choose language enhancement
(English or local spoken or both) and computer skills. This should be provided
longitudinally through the duration of the Foundation Course.
Teaching of Foundation Course will be organized by pre-clinical departments.
37
Table 4: First Professional teaching hours
Small Group Self Total

Subjects Lectures Teaching/Tutorials/ directed (hours)
(hours) Integrated learning/ learning
Practical (hours) (hours)
Human Anatomy 220 415 40 675
Physiology* 160 310 25 495
Biochemistry 80 150 20 250
Early Clinical Exposure** 90 - 0 90
Community Medicine 20 27 5 52
Attitude, Ethics &

Communication Module - 26 8 34
(AETCOM) ***
Sports and extracurricular

- - - 60
activities
Formative assessment and

- - - 80
Term examinations
Total - - - 1736
* including Molecular Biology.

** Early clinical exposure hours to be divided equally in all three subjects.
*** AETCOM module shall be a longitudinal programme.
38
Table 5: Second Professional teaching hours
Small group learning Self -

Clinical Directed Total
(Tutorials / Seminars)
Subjects Lectures Postings Learning (hours)
/Integrated learning
(hours) (hours) * (hours)
(hours)
Pathology 80 138 - 12 230
Pharmacology 80 138 - 12 230
Microbiology 70 110 - 10 190
Community Medicine 20 30 - 10 60
Forensic Medicine and 15 30 - 5 50

Toxicology
Clinical Subjects 75** - 540*** 615
Attitude, Ethics & 29 - 8 37

Communication
Module (AETCOM)
Sports and - - - 28 28
extracurricular
activities
Total - - - - 1440
* At least 3 hours of clinical instruction each week must be allotted to training in

clinical and procedural skill laboratories. Hours may be distributed weekly or as a
block in each posting based on institutional logistics.
** 25 hours each for Medicine, Surgery and Gynecology & Obstetrics.
*** The clinical postings in the second professional shall be 15 hours per week (3 hrs
per day from Monday to Friday).
39
Table 6: Third Professional Part I teaching hours
Teaching Tutorials/ Self- Total

Subjects Hours Seminars/Integrated Directed (hours)
Teaching (hours) Learning
(hours)
General Medicine 25 35 5 65
General Surgery 25 35 5 65
Obstetrics and
25 35 5 65
Gynecology
Pediatrics 20 30 5 55
Orthopaedics 15 20 5 40
Forensic Medicine and

25 45 5 75
Toxicology
Community Medicine 40 60 5 105
Dermatology 20 5 5 30
Psychiatry 25 10 5 40
Respiratory Medicine 10 8 2 20
Otorhinolaryngology 25 40 5 70
Ophthalmology 30 60 10 100
Radio diagnosis and

10 8 2 20
Radiotherapy
Anesthesiology 8 10 2 20
Clinical Postings* - - - 756
Attitude, Ethics &

Communication Module 19 06 25
(AETCOM)
Total 303 401 66 1551
* The clinical postings in the third professional part I shall be 18 hours per week
(3 hrs per day from Monday to Saturday).
40
Table 7: Third Professional Part II teaching hours
Tutorials/Seminars Self - Total*

Subjects / Integrated Directed (hours)
Teaching Hours Teaching (hours) Learning
(hours)
70 125 15 210
General Medicine
70 125 15 210
General Surgery
Obstetrics and 70 125 15 210

Gynecology
20 35 10 65
Pediatrics
20 25 5 50
Orthopaedics
792
Clinical Postings**
Attitude, Ethics &
28 16 43
Communication Module
(AETCOM)***
200
Electives
250 435 60 1780
Total
* 25% of allotted time of third professional shall be utilized for integrated

learning with pre- and para- clinical subjects and shall be assessed during the
clinical subject‟s examination. This allotted time will be utilized as integrated
teaching by para-clinical subjects with clinical subjects (as Clinical Pathology,
Clinical Pharmacology and Clinical Microbiology).
** The clinical postings in the third professional part II shall be 18 hours per week
(3 hrs per day from Monday to Saturday).
*** Hours from clinical postings can also be used for AETCOM modules.
41
Table 8: Clinical postings
Period of training in weeks

II MBBS III MBBS III MBBS Total
Subjects
Part I Part II weeks
- - 8* (4 regular 4
Electives clinical posting)
General Medicine1 4 4 8+4 20
General Surgery 4 4 8+4 20
Obstetrics &Gynaecology2 4 4 8 +4 20
Pediatrics 2 4 4 10
Community Medicine 4 6 - 10
Orthopedics - including 2 4 2 8
Trauma3
Otorhinolaryngology 4 4 - 8
Ophthalmology 4 4 - 8
Respiratory Medicine 2 - - 2
Psychiatry 2 2 - 4
Radiodiagnosis4 2 - - 2
Dermatology, Venereology & 2 2 2 6

Leprosy
Dentistry & Anesthesia - 2 - 2
Casualty - 2 - 2
36 42 48 126
42
* In four of the eight weeks of electives, regular clinical postings shall be
accommodated. Clinical postings may be adjusted within the time
framework.
1. This posting includes Laboratory Medicine (Para-clinical) & Infectious

Diseases (Phase III Part I).
2. This includes maternity training and family welfare (including Family
Planning).
3. This posting includes Physical Medicine and Rehabilitation.
4. This posting includes Radiotherapy, wherever available.
9. New teaching / learning elements
9.1. Foundation Course

9.1.1 Goal: The goal of the Foundation Course is to prepare a learner to
study medicine effectively. It will be of one month duration after
admission.
9.1.2 Objectives: The objectives are to:
(a) Orient the learner to:
(i) The medical profession and the physician‟s role in society
(ii) The MBBS programme
(iii) Alternate health systems in the country and history of
medicine
(iv) Medical ethics, attitudes and professionalism
(v) Health care system and its delivery
(vi) National health programmes and policies
(vii) Universal precautions and vaccinations
(viii) Patient safety and biohazard safety
(ix) Principles of primary care (general and community based
care)
(x) The academic ambience
(b) Enable the learner to acquire enhanced skills in:
(i) Language
(ii) Interpersonal relationships
43
(iii) Communication
(iv) Learning including self-directed learning
(v) Time management
(vi) Stress management
(vii) Use of information technology
(c) Train the learner to provide:

(i) First-aid
(ii) Basic life support
9.1.3 In addition to the above, learners may be enrolled in one of the
following programmes which will be run concurrently:
(a) Local language programme
(b) English language programme
(c) Computer skills
(d) These may be done in the last two hours of the day for the
duration of the Foundation Course.
9.1.4 These sessions must be as interactive as possible.
9.1.5 Sports (to be used through the Foundation Course as protected 04
hours / week).
9.1.6 Leisure and extracurricular activity (to be used through the
Foundation Course as protected 02 hours per week).
9.1.7 Institutions shall develop learning modules and identify the
appropriate resource persons for their delivery.
9.1.8 The time committed for the Foundation Course may not be used
for any other curricular activity.
9.1.9 The Foundation Course will have compulsory 75% attendance.
This will be certified by the Dean of the college.
9.1.10 The Foundation Course will be organized by the Coordinator
appointed by the Dean of the college and will be under
supervision of the heads of the preclinical departments.
9.1.11 Every college must arrange for a meeting with parents and their
wards.
44
9.2. Early Clinical Exposure
9.2.1 Objectives: The objectives of early clinical exposure of the first-
year medical learners are to enable the learner to:
(a) Recognize the relevance of basic sciences in diagnosis, patient
care and treatment,
(b) Provide a context that will enhance basic science learning,
(c) Relate to experience of patients as a motivation to learn,
(d) Recognize attitude, ethics and professionalism as integral to the
doctor-patient relationship,
(e) Understand the socio-cultural context of disease through the
study of humanities.
9.2.2 Elements
(a) Basic science correlation: i.e. apply and correlate principles of
basic sciences as they relate to the care of the patient (this will
be part of integrated modules).
(b) Clinical skills: to include basic skills in interviewing patients,
doctor-patient communication, ethics and professionalism,
critical thinking and analysis and self-learning (this training
will be imparted in the time allotted for early clinical
exposure).
(c) Humanities: To introduce learners to a broader understanding
of the socio-economic framework and cultural context within
which health is delivered through the study of humanities and
social sciences.
9.3. Electives
9.3.1 Objectives: To provide the learner with opportunities:
(a) For diverse learning experiences,
(b) To do research/community projects that will stimulate enquiry,
self-directed, experiential learning and lateral thinking.
9.3.2 Two months are designated for elective rotations after completion
of the examination at end of the third MBBS Part I and before
commencement of third MBBS Part II.
9.3.3 It is mandatory for learners to do an elective. The elective time
should not be used to make up for missed clinical postings,
shortage of attendance or other purposes.
9.3.4 Structure
45
(a) The learner shall rotate through two elective blocks of 04
weeks each.
(b) Block 1 shall be done in a pre-selected preclinical or para-
clinical or other basic sciences laboratory OR under a
researcher in an ongoing research project.
During the electives regular clinical postings shall continue.
(c) Block 2 shall be done in a clinical department (including
specialties, super-specialties, ICUs, blood bank and casualty)
from a list of electives developed and available in the
institution.
OR
as a supervised learning experience at a rural or urban
community clinic.
(d) Institutions will pre-determine the number and nature of
electives, names of the supervisors, and the number of learners
in each elective based on the local conditions, available
resources and faculty.
9.3.5 Each institution will develop its own mechanism for allocation of
electives.
9.3.6 It is preferable that elective choices are made available to the
learners in the beginning of the academic year.
9.3.7 The learner must submit a learning log book based on both blocks
of the elective.
9.3.8 75% attendance in the electives and submission of log book
maintained during elective is required for eligibility to appear in
the final MBBS examination.
9.3.9 Institutions may use part of this time for strengthening basic skill
certification.
9.4. Professional Development including Attitude, Ethics and
Communication Module (AETCOM)
9.4.1 Objectives of the programme: At the end of the programme, the
learner must demonstrate ability to:
(a) understand and apply principles of bioethics and law as they
apply to medical practice and research
(b) understand and apply the principles of clinical reasoning as
they apply to the care of the patients,
(c) understand and apply the principles of system based care as
46
they relate to the care of the patient,
(d) understand and apply empathy and other human values to the
care of the patient,
(e) communicate effectively with patients, families, colleagues and
other health care professionals,
(f) understand the strengths and limitations of alternative systems
of medicine,
(g) respond to events and issues in a professional, considerate and
humane fashion,
(h) translate learning from the humanities in order to further his /
her professional and personal growth.
9.4.2 Learning experiences:
(a) This will be a longitudinal programme spread across the
continuum of the MBBS programme including internship,
(b) Learning experiences may include – small group discussions,
patient care scenarios, workshop, seminars, role plays, lectures
etc.
(c) Attitude, Ethics &Communication Module (AETCOM
module) developed by Medical Council of India should be used
longitudinally for purposes of instruction.
9.4.3 75% attendance in Professional Development Programme
(AETCOM Module) is required for eligibility to appear for final
examination in each professional year.
9.4.4 Internal Assessment will include:
(a) Written tests comprising of short notes and creative writing
experiences,
(b) OSCE based clinical scenarios / viva voce.
9.4.5 At least one question in each paper of the clinical specialties in
the University examination should test knowledge competencies
acquired during the professional development programme.
9.4.6 Skill competencies acquired during the Professional
Development Programme must be tested during the clinical,
practical and viva voce.
47
9.5. Learner-doctor method of clinical training (Clinical Clerkship)
9.5.1 Goal: To provide learners with experience in:
(a) Longitudinal patient care,
(b) Being part of the health care team,
(c) Hands-on care of patients in outpatient and inpatient setting.
9.5.2 Structure:
(a) The first clinical posting in second professional shall orient
learners to the patient, their roles and the specialty.
(b) The learner-doctor programme will progress as outlined in
Table 9.
(c) The learner will function as a part of the health care team with
the following responsibilities:
(i) Be part of the unit‟s outpatient services on admission days,
(ii) Remain with the admission unit until 6 PM except during
designated class hours,
(iii) Be assigned patients admitted during each admission day
for whom he/she will undertake responsibility, under the
supervision of a senior resident or faculty member,
(iv) Participate in the unit rounds on its admission day and will
present the assigned patients to the supervising physician,
(v) Follow the patient‟s progress throughout the hospital stay
until discharge,
(vi) Participate, under supervision, in procedures, surgeries,
deliveries etc. of assigned patients (according to
responsibilities outlined in table 9),
(vii) Participate in unit rounds on at least one other day of the
week excluding the admission day,
(viii) Discuss ethical and other humanitarian issues during unit
rounds,
(ix) Attend all scheduled classes and educational activities,
(x) Document his/her observations in a prescribed log book /
case record.
48
(d) No learner will be given independent charge of the patient
(e) The supervising physician will be responsible for all patient
care decisions
9.5.3 Assessment:
(a) A designated faculty member in each unit will coordinate and
facilitate the activities of the learner, monitor progress, provide
feedback and review the log book/ case record.
(b) The log book/ case record must include the written case record
prepared by the learner including relevant investigations,
treatment and its rationale, hospital course, family and patient
discussions, discharge summary etc.
(c) The log book should also include records of outpatients
assigned. Submission of the log book/ case record to the
department is required for eligibility to appear for the final
examination of the subject.
Table 9: Learner - Doctor programme (Clinical Clerkship)

Year of Focus of Learner - Doctor programme
Curriculum
Year 1 Introduction to hospital environment, early clinical exposure,
understanding perspectives of illness
Year 2 History taking, physical examination, assessment of change in

clinical status, communication and patient education
Year 3 All of the above and choice of investigations, basic procedures

and continuity of care
Year 4 All of the above and decision making, management and

outcomes
49
CHAPTER V
COMPETENCY BASED CURRICULUM OF THE INDIAN MEDICAL
GRADUATE PROGRAMME
10. Specific Competencies
10.1. Preamble: The salient feature of the revision of the medical

curriculum in 2019 is the emphasis on learning which is
competency-based, integrated and learner-centered acquisition of
skills and ethical & humanistic values.
Each of the competencies described below must be read in

conjunction with the goals of the medical education as listed in
items 2 to 3.5.5
It is recommended that didactic teaching be restricted to less than

one third of the total time allotted for that discipline. Greater
emphasis is to be laid on hands-on training, symposia, seminars,
small group discussions, problem-oriented and problem-based
discussions and self-directed learning. Learners must be encouraged
to take active part in and shared responsibility for their learning.
The global competencies to be achieved by the learner are outlined

above in Chapter 1- section 3. Since the MBBS programme
assessment will continue to be subject based, subject specific
competencies have been outlined. These have to be acquired by the
learner in the corresponding professional year. These competencies
must be interpreted in the larger context outlined in section 3 and
may be considered as “sub competencies” of the global
competencies.
50
10.2. Integration must be horizontal (i.e. across disciplines in a given
phase of the course) and vertical (across different phases of the

course). As far as possible, it is desirable that teaching/learning
occurs in each phase through study of organ systems or disease
blocks in order to align the learning process. Clinical cases must be
used to integrate and link learning across disciplines.
10.3. Pre-clinical Subjects
10.3.1. Human Anatomy

(a) Competencies: The undergraduate must demonstrate:
1. Understanding of the gross and microscopic structure and
development of human body,

2. Comprehension of the normal regulation and integration of
the functions of the organs and systems on basis of the

structure and genetic pattern,
3. Understanding of the clinical correlation of the organs and
structures involved and interpret the anatomical basis of the

disease presentations.
(b) Integration: The teaching should be aligned and integrated
horizontally and vertically in organ systems with clinical

correlation that will provide a context for the learner to
understand the relationship between structure and function and
interpret the anatomical basis of various clinical conditions and
procedures.
10.3.2. Physiology
(a) Competencies: The undergraduates must demonstrate:
1. Understanding of the normal functioning of the organs and
organ systems of the body,
51
2. Comprehension of the normal structure and organization of
the organs and systems on basis of the functions,

3. Understanding of age-related physiological changes in the
organ functions that reflect normal growth and development,

4. Understand the physiological basis of diseases.
horizontally and vertically in organ systems in order to provide

a context in which normal function can be correlated both with
structure and with the biological basis, its clinical features,
diagnosis and therapy.
10.3.3. Biochemistry
The course will comprise Molecular and Cellular Biochemistry.
(a) Competencies: The learner must demonstrate an understanding of:
1. Biochemical and molecular processes involved in health and
disease,
2. Importance of nutrition in health and disease,
3. Biochemical basis and rationale of clinical laboratory tests,
and demonstrate ability to interpret these in the clinical context.

(b) Integration: The teaching/learning programme should be
integrated horizontally and vertically, as much as possible, to

enable learners to make clinical correlations and to acquire an
understanding of the cellular and molecular basis of health and
disease.
10.3.4. Introduction to Community Medicine
1. Understanding of the concept of health and disease,
2. Understanding of demography, population dynamics and
disease burden in National and global context,
52
3. Comprehension of principles of health economics and
hospital management,
4. Understanding of interventions to promote health and
prevent diseases as envisioned in National and State Health

Programmes.
10.4. Second Professional (Para-Clinical)
10.4.1. Pathology
1. Comprehension of the causes, evolution and mechanisms of
diseases,
2. Knowledge of alterations in gross and cellular morphology
of organs in disease states,

3. Ability to correlate the natural history, structural and
functional changes with the clinical manifestations of

diseases, their diagnosis and therapy,
horizontally and vertically in organ systems recognizing
deviations from normal structure and function and clinically
correlated so as to provide an overall understanding of the
etiology, mechanisms, laboratory diagnosis, and management
of diseases.
10.4.2. Microbiology
(a) Competencies: The undergraduate learner demonstrate:
1. Understanding of role of microbial agents in health and
disease,
2. Understanding of the immunological mechanisms in health
and disease,
3. Ability to correlate the natural history, mechanisms and
clinical manifestations of infectious diseases as they relate to
the properties of microbial agents,
53
4. Knowledge of the principles and application of infection
control measures,
5. An understanding of the basis of choice of laboratory
diagnostic tests and their interpretation, antimicrobial
therapy, control and prevention of infectious diseases.
horizontally and vertically in organ systems with emphasis on

host-microbe-environment interactions and their alterations in
disease and clinical correlations so as to provide an overall
understanding of the etiological agents, their laboratory
diagnosis and prevention.
10.4.3. Pharmacology
1. Knowledge about essential and commonly used drugs and an
understanding of the pharmacologic basis of therapeutics,

2. Ability to select and prescribe medicines based on clinical
condition and the pharmacologic properties, efficacy, safety,

suitability and cost of medicines for common clinical
conditions of national importance,
3. Knowledge of pharmacovigilance, essential medicine
concept and sources of drug information and industry-doctor
relationship,
4. Ability to counsel patients regarding appropriate use of
prescribed drug and drug delivery systems.

horizontally and vertically in organ systems recognizing the
interaction between drug, host and disease in order to provide
an overall understanding of the context of therapy.
54
10.4.4. Forensic Medicine and Toxicology
(a) Competencies: The learner must demonstrate:
1. Understanding of medico-legal responsibilities of physicians
in primary and secondary care settings,

2. Understanding of the rational approach to the investigation
of crime, based on scientific and legal principles,

3. Ability to manage medical and legal issues in cases of
poisoning / overdose,
4. Understanding the medico-legal framework of medical
practice and medical negligence,

5. Understanding of codes of conduct and medical ethics.

horizontally and vertically recognizing the importance of
medico-legal, ethical and toxicological issues as they relate to
the practice of medicine.
10.4.5. Community Medicine – as per 10.3.4
10.5. Third Professional (Part I)
10.5.1. General Medicine

(a) Competencies: The student must demonstrate ability to do the
following in relation to common medical problems of the adult

in the community:
1. Demonstrate understanding of the patho-physiologic basis,
epidemiological profile, signs and symptoms of disease and
their investigation and management,
2. Competently interview and examine an adult patient and
make a clinical diagnosis,
3. Appropriately order and interpret laboratory tests,
55
4. Initiate appropriate cost-effective treatment based on an
understanding of the rational drug prescriptions, medical
interventions required and preventive measures,
5. Follow up of patients with medical problems and refer
whenever required,
6. Communicate effectively, educate and counsel the patient
and family,
7. Manage common medical emergencies and refer when
required,
8. Independently perform common medical procedures safely
and understand patient safety issues.
horizontally and vertically in order to provide sound biologic

basis and incorporating the principles of general medicine into a
holistic and comprehensive approach to the care of the patient.
10.5.2. General Surgery
(a) Competencies: The student must demonstrate:
1. Understanding of the structural and functional basis,

principles of diagnosis and management of common surgical
problems in adults and children,
2. Ability to choose, calculate and administer appropriately
intravenous fluids, electrolytes, blood and blood products
based on the clinical condition,
3. Ability to apply the principles of asepsis, sterilization,
disinfection, rational use of prophylaxis, therapeutic utilities
of antibiotics and universal precautions in surgical practice,
4. Knowledge of common malignancies in India and their
prevention, early detection and therapy,
56
5. Ability to perform common diagnostic and surgical
procedures at the primary care level,
6. Ability to recognize, resuscitate, stabilize and provide Basic
& Advanced Life Support to patients following trauma,
7. Ability to administer informed consent and counsel patient
prior to surgical procedures,
8. Commitment to advancement of quality and patient safety in
surgical practice.
horizontally and vertically in order to provide a sound biologic

basis and a holistic approach to the care of the surgical patient.
10.5.3. Obstetrics and Gynaecology
(a) Competencies in Obstetrics: The student must demonstrate
ability to:
1. Provide peri-conceptional counseling and antenatal care,
2. Identify high-risk pregnancies and refer appropriately,
3. Conduct normal deliveries, using safe delivery practices in
the primary and secondary care settings,
4. Prescribe drugs safely and appropriately in pregnancy and
lactation,
5. Diagnose complications of labor, institute primary care and
refer in a timely manner,
6. Perform early neonatal resuscitation,
7. Provide postnatal care, including education in breast-feeding,
8. Counsel and support couples in the correct choice of
contraception,
9. Interpret test results of laboratory and radiological
investigations as they apply to the care of the obstetric
patient,
57
10. Apply medico-legal principles as they apply to tubectomy,
Medical Termination of Pregnancy (MTP), Pre-conception
and Prenatal Diagnostic Techniques (PC PNDT Act) and
other related Acts.
(a) Competencies in Gynecology: The student must demonstrate
ability to:
1. Elicit a gynecologic history, perform appropriate physical

and pelvic examinations and PAP smear in the primary care
setting,
2. Recognize, diagnose and manage common reproductive tract
infections in the primary care setting,
3. Recognize and diagnose common genital cancers and refer
them appropriately.
horizontally and vertically in order to provide comprehensive

care for women in their reproductive years and beyond, based
on a sound knowledge of structure, functions and disease and
their clinical, social, emotional, psychological correlates in the
context of national health priorities.
10.5.4. Pediatrics
1. Ability to assess and promote optimal growth, development
and nutrition of children and adolescents and identify
deviations from normal,
2. Ability to recognize and provide emergency and routine
ambulatory and First Level Referral Unit care for neonates,
infants, children and adolescents and refer as may be
appropriate,
3. Ability to perform procedures as indicated for children of all
ages in the primary care setting,
4. Ability to recognize children with special needs and refer
appropriately,
58
5. Ability to promote health and prevent diseases in children,
6. Ability to participate in National Programmes related to
child health and in conformation with the Integrated
Management of Neonatal and Childhood Illnesses (IMNCI)
Strategy,
7. Ability to communicate appropriately and effectively.
horizontally and vertically in order to provide comprehensive

care for neonates, infants, children and adolescents based on a
sound knowledge of growth, development, disease and their
clinical, social, emotional, psychological correlates in the
context of national health priorities.
10.5.5. Orthopaedics (including Trauma)
1. Ability to recognize and assess bone injuries, dislocation and
poly-trauma and provide first contact care prior to
appropriate referral,
2. Knowledge of the medico-legal aspects of trauma,
3. Ability to recognize and manage common infections of bone
and joints in the primary care setting,
4. Recognize common congenital, metabolic, neoplastic,
degenerative and inflammatory bone diseases and refer
appropriately,
5. Ability to perform simple orthopaedic techniques as
applicable to a primary care setting,
6. Ability to recommend rehabilitative services for common
orthopaedic problems across all ages.
59
horizontally and vertically in order to allow the student to

understand the structural basis of orthopaedic problems, their
management and correlation with function, rehabilitation and
quality of life.
10.5.6. Forensic Medicine and Toxicology – as per 10.4.4
10.5.7. Community medicine
1. Understanding of physical, social, psychological, economic

and environmental determinants of health and disease,
2. Ability to recognize and manage common health problems
including physical, emotional and social aspects at
individual family and community level in the context of
National Health Programmes,
3. Ability to Implement and monitor National Health
Programmes in the primary care setting,
4. Knowledge of maternal and child wellness as they apply to
national health care priorities and programmes,
5. Ability to recognize, investigate, report, plan and manage
community health problems including malnutrition and
emergencies.
horizontally and vertically in order to allow the learner to

understand the impact of environment, society and national
health priorities as they relate to the promotion of health and
prevention and cure of disease.
60
10.5.8. Dermatology, Venereology & Leprosy
(a) Competencies: The undergraduate student must demonstrate:
1. Understanding of the principles of diagnosis of diseases of

the skin, hair, nail and mucosa,
2. Ability to recognize, diagnose, order appropriate
investigations and treat common diseases of the skin
including leprosy in the primary care setting and refer as
appropriate,
3. A syndromic approach to the recognition, diagnosis,
prevention, counseling, testing and management of common
sexually transmitted diseases including HIV based on
national health priorities,
4. Ability to recognize and treat emergencies including drug
reactions and refer as appropriate.
horizontally and vertically in order to emphasize the biologic

basis of diseases of the skin, sexually transmitted diseases and
leprosy and to provide an understanding that skin diseases may
be a manifestation of systemic disease.
10.5.9. Psychiatry
1. Ability to promote mental health and mental hygiene,

2. Knowledge of etiology (bio-psycho-social-environmental
interactions), clinical features, diagnosis and management of
common psychiatric disorders across all ages,
3. Ability to recognize and manage common psychological and
psychiatric disorders in a primary care setting, institute
preliminary treatment in disorders difficult to manage, and
refer appropriately,
61
4. Ability to recognize alcohol/ substance abuse disorders and
refer them to appropriate centers,
5. Ability to assess risk for suicide and refer appropriately,
6. Ability to recognize temperamental difficulties and
personality disorders,
7. Assess mental disability and rehabilitate appropriately,
8. Understanding of National and State programmes that
address mental health and welfare of patients and
community.

understand bio-psycho-social-environmental interactions that
lead to diseases/ disorders for preventive, promotive, curative,
rehabilitative services and medico-legal implications in the care
of patients both in family and community.
10.5.10Respiratory Medicine
1. Knowledge of common chest diseases, their clinical

manifestations, diagnosis and management,
2. Ability to recognize, diagnose and manage pulmonary
tuberculosis as contemplated in National Tuberculosis
Control programme,
3. Ability to manage common respiratory emergencies in
primary care setting and refer appropriately.

recognize diagnose and treat TB in the context of the society,
national health priorities, drug resistance and co-morbid
conditions like HIV.
62
10.5.11 Otorhinolaryngology
1. Knowledge of the common Oto-rhino-laryngological (ENT)

emergencies and problems,
2. Ability to recognize, diagnose and manage common ENT
emergencies and problems in primary care setting,
3. Ability to perform simple ENT procedures as applicable in a
primary care setting,
4. Ability to recognize hearing impairment and refer to the
appropriate hearing impairment rehabilitation programme.
horizontally and vertically in order to allow the learner to

understand the structural basis of ENT problems, their
management and correlation with function, rehabilitation and
quality of life.
10.5.12 Ophthalmology
1. Knowledge of common eye problems in the community

2. Recognize, diagnose and manage common eye problems and
identify indications for referral,
3. Ability to recognize visual impairment and blindness in the
community and implement National programmes as
applicable in the primary care setting.
63

understand the structural basis of ophthalmologic problems,
their management and correlation with function, rehabilitation
and quality of life.
10.5.13 a Radiodiagnosis
1. Understanding of indications for various radiological

investigations in common clinical practice,
2. Awareness of the ill effects of radiation and various radiation
protective measures to be employed,
3. Ability to identify abnormalities in common radiological
investigations.
(b) Integration: Horizontal and vertical integration to understand
the fundamental principles of radiologic imaging, anatomic

correlation and their application in diagnosis and therapy.
10.5.13 b Radiotherapy
(a) Competencies: The student must demonstrate understanding of:
1. Clinical presentations of various cancers,
2. Appropriate treatment modalities for various types of
malignancies,
3. Principles of radiotherapy and techniques.
(b) Integration: Horizontal and vertical integration to enable basic

understanding of fundamental principles of radio-therapeutic
procedures.
64
10.5.14 Anaesthesiology
(a) Competencies in Anaesthesiology: The student must
demonstrate ability to:
1. Describe and discuss the pre-operative evaluation,
assessing fitness for surgery and the modifications

in medications in relation to anaesthesia / surgery,
2. Describe and discuss the roles of Anaesthesiologist
as a peri-operative physician including pre-

medication, endotracheal intubation, general
anaesthesia and recovery (including variations in
recovery from anaesthesia and anaesthetic
complications),
3. Describe and discuss the management of acute and
chronic pain, including labour analgesia,

4. Demonstrate awareness about the maintenance of
airway in children and adults in various situations,

5. Demonstrate the awareness about the indications,
selection of cases and execution of cardio-

pulmonary resuscitation in emergencies and in the
intensive care and high dependency units,
6. Choose cases for local / regional anaesthesia and
demonstrate the ability to administer the same,

7. Discuss the implications and obtain informed
consent for various procedures and to maintain the
documents.
65
(b) Integration: The teaching should be aligned and
integrated horizontally and vertically in order to
provide comprehensive care for patients undergoing
various surgeries, in patients with pain, in intensive
care and in cardio respiratory emergencies. Integration
with the preclinical department of Anatomy, para-
clinical department of Pharmacology and horizontal
integration with any/all surgical specialities is
proposed.
10.6. Third Professional (Part II)
10.6.1. General Medicine – as per 10.5.1
10.6.2. General Surgery – as per 10.5.2
10.6.3. Obstetrics & Gynaecology – as per 10.5.3
10.6.4. Pediatrics – as per 10.5.4
10.6.5. Orthopaedics – as per 10.5.5
66
CHAPTER VI
ASSESSMENT
11. Assessment
11.1. Eligibility to appear for Professional examinations
11.1.1. The performance in essential components of training are to

be assessed, based on:
(a) Attendance
1. Attendance requirements are 75% in theory and 80%
in practical /clinical for eligibility to appear for the

examinations in that subject. In subjects that are taught
in more than one phase – the learner must have 75%
attendance in theory and 80% in practical in each
phase of instruction in that subject.
2. If an examination comprises more than one subject
(for e.g., General Surgery and allied branches), the

candidate must have 75% attendance in each subject
and 80% attendance in each clinical posting.
3. Learners who do not have at least 75% attendance in
the electives will not be eligible for the Third

Professional - Part II examination.
(b) Internal Assessment: Internal assessment shall be

based on day-to-day assessment. It shall relate to different
ways in which learners participate in learning process
including assignments, preparation for seminar,
67
clinical case presentation, preparation of clinical case for
discussion, clinical case study/problem solving exercise,
participation in project for health care in the community,
proficiency in carrying out a practical or a skill in small
research project, a written test etc.
1. Regular periodic examinations shall be conducted

throughout the course. There shall be no less than three
internal assessment examinations in each Preclinical /
Para-clinical subject and no less than two examinations in
each clinical subject in a professional year. An end of
posting clinical assessment shall be conducted for each
clinical posting in each professional year.
2. When subjects are taught in more than one phase, the

internal assessment must be done in each phase and must
contribute proportionately to final assessment. For
example, General Medicine must be assessed in second
Professional, third Professional Part I and third
Professional Part II, independently.
3. Day to day records and log book (including required skill

certifications) should be given importance in internal
assessment. Internal assessment should be based on
competencies and skills.
4. The final internal assessment in a broad clinical specialty

(e.g., Surgery and allied specialties etc.) shall comprise of
marks from all the constituent specialties. The proportion
of the marks for each constituent specialty shall be
determined by the time of instruction allotted to each.
68
5. Learners must secure at least 50% marks of the total
marks (combined in theory and practical / clinical; not
less than 40 % marks in theory and practical separately)
assigned for internal assessment in a particular subject in
order to be eligible for appearing at the final University
examination of that subject. Internal assessment marks
will reflect as separate head of passing at the summative
examination.
6. The results of internal assessment should be displayed on

the notice board within a 1-2 weeks of the test.
Universities shall guide the colleges regarding
formulating policies for remedial measures for students
who are either not able to score qualifying marks or have
missed on some assessments due to any reason.
7. Learners must have completed the required certifiable

competencies for that phase of training and completed the
log book appropriate for that phase of training to be
eligible for appearing at the final university examination
of that subject.
University Examinations
11.2.1 University examinations are to be designed with a view to

ascertain whether the candidate has acquired the necessary
knowledge, minimal level of skills, ethical and professional
values with clear concepts of the fundamentals which are
necessary for him/her to function effectively and
appropriately as a physician of first contact. Assessment
shall be carried out on an objective basis to the extent
possible.
69
11.2.2 Nature of questions will include different types such as
structured essays (Long Answer Questions - LAQ), Short
Answers Questions (SAQ) and objective type questions (e.g.
Multiple-Choice Questions - MCQ). Marks for each part
should be indicated separately. MCQs shall be accorded a
weightage of not more than 20% of the total theory marks.
In subjects that have two papers, the learner must secure at
least 40% marks in each of the papers with minimum 50%
of marks in aggregate (both papers together) to pass.
11.2.3 Practical/clinical examinations will be conducted in the

laboratories and /or hospital wards. The objective will be to
assess proficiency and skills to conduct experiments,
interpret data and form logical conclusion. Clinical cases
kept in the examination must be common conditions that the
learner may encounter as a physician of first contact in the
community. Selection of rare syndromes and disorders as
examination cases is to be discouraged. Emphasis should be
on candidate‟s capability to elicit history, demonstrate
physical signs, write a case record, analyze the case and
develop a management plan.
11.2.4 Viva/oral examination should assess approach to patient

management, emergencies, attitudinal, ethical and
professional values. Candidate‟s skill in interpretation of
common investigative data, X-rays, identification of
specimens, ECG, etc. is to be also assessed.
70
11.2.5 There shall be one main examination in an academic year
and a supplementary to be held not later than 90 days after
the declaration of the results of the main examination.
11.2.6 A learner shall not be entitled to graduate after 10 years of

his/her joining of the first part of the MBBS course.
11.2.7 University Examinations shall be held as under:
(a) First Professional
1. The first Professional examination shall be held at the

end of first Professional training (1+12 months), in the
subjects of Human Anatomy, Physiology and
Biochemistry.
2. A maximum number of four permissible attempts

would be available to clear the first Professional
University examination, whereby the first Professional
course will have to be cleared within 4 years of
admission to the said course. Partial attendance at any
University examination shall be counted as an availed
attempt.
(b) Second Professional
1. The second Professional examination shall be held at

the end of second professional training (11 months), in
the subjects of Pathology, Microbiology, and
Pharmacology.
71
(c) Third Professional
1. Third Professional Part I shall be held at end of third

Professional part 1 of training (12 months) in the
subjects of Ophthalmology, Otorhinolaryngology,
Community Medicine and Forensic Medicine and
Toxicology
2. Third Professional Part II - (Final Professional)

examination shall be at the end of training (14 months
including 2 months of electives) in the subjects of
General Medicine, General Surgery, Obstetrics &
Gynecology and Pediatrics. The discipline of
Orthopedics, Anesthesiology, Dentistry and
Radiodiagnosis will constitute 25% of the total theory
marks incorporated as a separate section in paper II of
General Surgery.
3. The discipline of Psychiatry and Dermatology,

Venereology and Leprosy (DVL), Respiratory
Medicine including Tuberculosis will constitute 25%
of the total theory marks in General Medicine
incorporated as a separate section in paper II of
General Medicine.
(d) Examination schedule is in Table 1.
(e) Marks distribution is in Table 10.
72
Table 10 : Marks distribution for various subjects
Written- Practicals/ Orals/
Theory – Clinicals
Phase of Course Total Pass Criteria
First Professional
Human Anatomy - 2 papers 200 100
Physiology - 2 papers 200 100
Biochemistry - 2 papers 200 100

Internal
Second Professional Assessment:
Pharmacology - 2 Papers 200 100 50% combined in

theory and
Pathology - 2 papers 200 100 practical (not less
than 40% in each)
Microbiology - 2 papers 200 100 for eligibility for
Third Professional Part – I appearing for
University
Forensic Medicine & Examinations
100 100
Toxicology - 1 paper
University
Ophthalmology – 1 paper 100 100 Examination
Otorhinolaryngology – 1 paper 100 100 Mandatory 50%

marks separately
Community Medicine - 2 papers 200 100 in theory and
practical
Third Professional Part – II (practical =
practical/ clinical
General Medicine - 2 papers 200 200 + viva)
General Surgery - 2 papers 200 200
Pediatrics – 1 paper 100 100
Obstetrics & Gynaecology - 2 200 200

papers
Note: At least one question in each paper of the clinical specialties should test
knowledge - competencies acquired during the professional development
programme (AETCOM module); Skills competencies acquired during the
Professional Development programme (AETCOM module) must be tested
during clinical, practical and viva.
73
In subjects that have two papers, the learner must secure at least 40%
marks in each of the papers with minimum 50% of marks in aggregate (both
papers together) to pass in the said subject.
11.2.8 Criteria for passing in a subject: A candidate shall obtain

50% marks in University conducted examination separately in
Theory and Practical (practical includes: practical/ clinical and
viva voce) in order to be declared as passed in that subject.
11.2.9 Appointment of Examiners

(a) Person appointed as an examiner in the particular subject
must have at least four years of total teaching experience as
assistant professor after obtaining postgraduate degree in the
subject in a college affiliated to a recognized / approved /
permitted medical college.
(b) For the Practical/ Clinical examinations, there shall be at
least four examiners for 100 learners, out of whom not less
than 50% must be external examiners. Of the four
examiners, the senior-most internal examiner will act as the
Chairman and coordinator of the whole examination
programme so that uniformity in the matter of assessment of
candidates is maintained. Where candidates appearing are
more than 100, two additional examiners (one external &
one internal) for every additional 50 or part there of
candidates appearing, be appointed.
(c) In case of non-availability of medical teachers, approved
teachers without a medical degree (engaged in the teaching
of MBBS students as whole-time teachers in a recognized
medical college), may be appointed examiners in their
concerned subjects provided they possess requisite doctorate
qualifications and four years teaching experience (as
assistant professors) of MBBS students. Provided further that
the 50% of the examiners (Internal & External) are from the
medical qualification stream.
74
(d) External examiners may not be from the same University.
(e) The internal examiner in a subject shall not accept external
examinership for a college from which external examiner is
appointed in his/her subject.
(f) A University having more than one college shall have
separate sets of examiners for each college, with internal
examiners from the concerned college.
(g) External examiners shall rotate at an interval of 2 years.
(h) There shall be a Chairman of the Board of paper-setters who
shall be an internal examiner and shall moderate the
questions.
(i) All eligible examiners with requisite qualifications and
experience can be appointed internal examiners by rotation
in their subjects.
(j) All theory paper assessment should be done as central
assessment program (CAP) of concerned university.
(k) Internal examiners should be appointed from same
institution for unitary examination in same institution. For
pooled examinations at one centre approved internal
examiners from same university may be appointed.
(l) The grace marks up to a maximum of five marks may be
awarded at the discretion of the University to a learner for
clearing the examination as a whole but not for clearing a
subject resulting in exemption.
11.3. CONDUCTION OF SUPPLEMENTARY EXAMS
Conduction of the supplementary examination for 1st year MBBS failed

students within 45 days of the announcement of results of the main examination
in order to re-join the odd batch of 1st year MBBS students.
The archetype for conducting such supplementary examinations shall be as

follows.
75
 The supplementary examination for 1st year MBBS failed students shall be
conducted within two months from the date of announcement
of results of the main examination and it is effective from 2019-20 admitted
batches of students.
 The unsuccessful students in the main (Regular) examination may appear for
supplementary examination by paying examination fees only if otherwise
eligible.
 Successful students in the supplementary examination shall be allowed to take
admission to the 2nd phase of MBBS and be allowed to attend
classes/clinical/practical‟s along with regularly admitted students.
 Such successful students taking admission to 2nd phase of MBBS shall be
allowed to appear for the 2nd phase examinations subject to full filling the
criteria as specified in the BIHER - UG curriculum and MCI – Graduate
Medical Education Regulations 2019- Gazette - (as updated from time to time)
 Unsuccessful candidates in the such supplementary examination have to appear
for the next regular (main) examination along with the (junior) fresh batch of
students if otherwise eligible.
 There shall be no another examination in the end of the term i.e. at or around
December for such unsuccessful students in the supplementary examination for
1st MBBS students with effect from 2019 – 20 admitted batches onwards.
 Supplementary will not be conducted for batches enrolled prior to 2019-20 batch
as per BIHER University regulation.
 Students who have filled the application forms (paid the fee) but were unable to
attend the regular examination are also eligible to write this supplementary
examination, provided they have the eligibility with respect to attendance and
Internal Assessment and for such students it shall be considered as second
attempt.
76
 No extra term fees be collected from the students appearing for the
supplementary examination. However the students appearing for the
supplementary examination need to pay mandatory examination fee prescribed
by the university.
 Those students who have not taken the regular examinations due to lack of
eligibility, can be allowed to appear for supplementary examinations provided
they fulfill the eligibility criteria as per the BIHER guidelines and MCI
guidelines. With effect to this the concerned Head of the Institution shall certify.
(Classes conducted, IA conducted etc.,) that such students have fulfilled the
eligibility criteria after the regular examinations were conducted.
11.4. RE-TOTALING
Re-totaling of theory paper shall be done if a candidate fails in any subject/subjects.
11.5. GRACE MARKS

The grace marks up to a maximum of five marks may be awarded at the discretion
of the University to a student who has failed only in one subject but has passed in all
other subjects.
11.6 REGULATIONS FOR RE-ADMISSION AFTER BREAK OF STUDY

“Break of study” means any absence for more than three months during the course
of study. Three months for this purpose is a period of 90 days (Ninety days), to be
recorded from the date one of absence irrespective of the number of days in one
calendar month.
For all practical purposes only two types of break of study is allowed.
a) Less than three months of break
b) More than three months of break but less than eighteen months of study
of a particular study
77
PROCEDURE FOR REJOINING
a) The Principal / Dean of the college concerned shall permit any candidate who is
absent for less than three months during the course of study to rejoin the course
under intimation to the university. It is the responsibility of the Dean / Principal
of the college concerned to ensure that a copy of the order of permission granted
by them, as stated above, to rejoin the course of study shall reach the Academic
Officer and Controller of Examination of the university. It is also the
responsibility of the student concerned to intimate the date of rejoining the course
to the University through the Dean / Principal concerned. The candidate may be
permitted by the Principal / Dean to rejoin in the year of study in which he/she
discontinued the course and shall be admitted to the examination after fulfillment
of the regulations of the university to the course concerned. The candidate shall
be exempted in the subject he/she has already passed.
b) The candidate having a break of study for more than three months but less than
eighteen months of the course, shall apply for rejoining the course remitting the
stipulated fee for condonation of Break of Study to the Academic Officer of the
University through the concerned Dean/Principal of the college for issue of
necessary permission to rejoin the course.
c) The Dean/Principal of the college concerned shall not permit any candidate if the
Break of study is more than 3 months (90 days) to rejoin the course without
obtaining the prior permission from the university.
d) If the candidate after acquiring more than 50% of attendance in an academic year
goes on break, he/she will be permitted to continue the balance period of study
after obtaining the condonation order from the university.
e) If the candidate enters into the break of study with less than 50% of attendance in
an academic year, he/she has to undergo the course from the beginning of the year
of study in which the candidate has entered on break after obtaining the
condonation orders from the university.
78
f) The period of break of study of the candidate for rejoining the course shall be
calculated from the date of first discontinuance of the course.
g) The Vice-Chancellor has the power to condone any break of study as defined in
Regulation and to issue orders for permitting the candidates to continue the
course of study if such absence is more than three (3) months but less than
eighteen months. The Dean Principal of the college shall not permit the
candidates to rejoin the course till specific order are issued by the university.
h) Only two spells of break of study will be allowed for the entire duration of the
course for U.G. course.
i) Any break of study beyond eighteen months of course is considered as
discontinuance of study. This is applicable for all the years of study of the under
Graduate degree.
j) If the candidate is on Break of Study for more than three months on medical
grounds, the candidate has to give advance intimation to the Dean / Principal of
the concerned college. The Dean / Principal of the concerned college has to
inform the same to the University.
79
CHAPTER VII
12. INTERNSHIP
Internship is a phase of training wherein a graduate will acquire the

skills and competencies for practice of medical and health care under
supervision so that he/she can be certified for independent medical
practice as an Indian Medical Graduate. In order to make trained work
force available, it may be considered as a phase of training wherein the
graduate is expected to conduct actual practice under the supervision
of a trained doctor. The learning methods and modalities have to be
done during the MBBS course itself with larger number of hands on
session and practice on simulators.
12.1. Goal:
The goal of the internship programme is to train medical students to

fulfill their roles as doctors of first contact in the community.
12.2 . Objectives: At the end of the internship period, the medical graduate
will possess all competencies required of an Indian Medical Graduate,
namely:
12.2.1 Independently provide preventive, promotive, curative and
palliative care with compassion,
12.2.2 Function as leader and member of the health care team and
health system,
12.2.3 Communicate effectively with patients, families, colleagues and
the community,
12.2.4 Be certified in diagnostic and therapeutic skills in different
disciplines of medicine taught in the undergraduate programme,
12.2.5 Be a lifelong learner committed to continuous improvement of
skills and knowledge,
12.2.6 Be a professional committed to excellence and is ethical,
responsive and accountable to patients, community and
profession.
80
12.3 Time Distribution
Community Medicine (Residential posting) 2 months
General Medicine including 15 days of Psychiatry 2months
General Surgery including 15 days Anaesthesia 2months

Obstetrics & Gynaecology including
Family Welfare Planning 2 months
Pediatrics 1 month
Orthopaedics including PM & R 1 month
Otorhinolaryngology 15 days
Ophthalmology 15 days
Casualty 15 days
Elective posting (1x15 days) 15 days
Subjects for Elective posting will be as follows:

1. Dermatology, Venereology & Leprosy
2. Respiratory Medicine
3. Radio diagnosis
4. Forensic Medicine & Toxicology
5. Blood Bank
6. Psychiatry
Note: Structure internship with assessment at the end in the college.
81
12.4 Other details:
12.4.1 The core rotations of the internship shall be done in primary and
secondary/ tertiary care institutions in India. In case of any
difficulties, the matter may be referred to the Medical Council
of India to be considered on individual merit.
12.4.2 Every candidate will be required after passing the final MBBS
examination to undergo compulsory rotational internship to the
satisfaction of the College authorities and University concerned
for a period of 12 months so as to be eligible for the award of
the degree of Bachelor of Medicine and Bachelor of Surgery
(MBBS) and full registration.
12.4.3 The University shall issue a provisional MBBS pass certificate

on passing the final examination.
12.4.4 The State Medical Council will grant provisional registration to

the candidate upon production of the provisional MBBS pass
certificate. The provisional registration will be for a period of
one year. In the event of the shortage or unsatisfactory work,
the period of provisional registration and the compulsory
rotating internship shall be suitably extended by the appropriate
authorities.
12.4.5 The intern shall be entrusted with clinical responsibilities under

direct supervision of a designated supervising physician. They
shall not work independently.
12.4.6 Interns will not issue medical certificate or death certificate or

other medico-legal document under their signature.
82
12.4.7 Each medical college must ensure that the student gets learning
experience in primary/secondary and urban/rural centers in
order to provide a diverse learning experience and facilitate the
implementation of national health programmes/ priorities.
These shall include community and outreach activities,
collaboration with rural and urban community health centers,
participation in government health missions etc.
12.4.8 One year‟s approved service in the Armed Forces Medical

Services, after passing the final MBBS examination shall be
considered as equivalent to the pre-registration training detailed
above; such training shall, as far as possible, be at the
Base/General Hospital. The training in Community Medicine
should fulfill the norms of the MCI as proposed above.
12.4.9 In recognition of the importance of hands-on experience, full

responsibility for patient care and skill acquisition, internship
should be increasingly scheduled to utilize clinical facilities
available in District Hospital, Taluka Hospital, Community
Health Centre and Primary Health Centre, in addition to
Teaching Hospital. A critical element of internship will be the
acquisition of specific experiences and skill as listed in major
areas: provided that where an intern is posted to District/Sub
Divisional Hospital for training, there shall be a committee
consisting of representatives of the college/University, the State
Government and the District administration, who shall regulate
the training of such trainee. Provided further that, for such
trainee a certificate of satisfactory completion of training shall
be obtained from the relevant administrative authorities which
shall be countersigned by the Principal/Dean of College.
83
12.5 Assessment of Internship:
12.5.1 The intern shall maintain a record of work in a log book, which
is to be verified and certified by the medical officer under
whom he/she works. Apart from scrutiny of the record of work,
assessment and evaluation of training shall be undertaken by an
objective approach using situation tests in knowledge, skills and
attitude during and at the end of the training.
12.5.2 Based on the record of work and objective assessment at the

end of each posting, the Dean/Principal shall issue cumulative
certificate of satisfactory completion of training at the end of
internship, following which the University shall award the
MBBS degree or declare him eligible for it.
12.5.3 Full registration shall only be given by the State Medical

Council/Medical Council of India on the award of the MBBS
degree by the University or its declaration that the candidate is
eligible for it.
12.5.4 Some guidelines for the implementation of the training

programme are given below.
12.6 INTERNSHIP – DISCIPLINE RELATED:
12.6.1 COMMUNITY MEDICINE GOAL:
The aim of teaching the undergraduate student in Community

Medicine is to impart such knowledge and skills that may enable him to
diagnose and treat common medical illnesses and recognize the
importance of community involvement. He/she shall acquire competence
to deal effectively with an individual and the community in the context of
primary health care. This is to be achieved by hands-on experience in the
District Hospital and Primary Health Centre. The details are as under: -
84
I) District Hospital /Community Health Centre/Attachment to
General Practitioner:
A. An intern must be able to do without assistance:
1. An intern must:
a) Be able to diagnose common ailments and advise primary

care;
b) Demonstrate knowledge on „Essential drugs‟ and their usage;
c) Recognize medical emergencies, resuscitate and institute
initial treatment and refer to a suitable institution.
2. An intern must be familiar with all National Health Programmes
(e.g. RCH, UIP, CDD, ARI, FP, ANC, Tuberculosis, Leprosy
and others), as recommended by the Ministry of Health and
Family Welfare.
3. An intern must:
a) Gain full expertise in immunization against infectious

disease;
b) Participate in programmes related to prevention and control

of locally prevalent endemic diseases including nutritional
disorders;
c) Learn skills in family welfare planning procedures;
4. An intern must:
a) Conduct programmes on health education,
b) Gain capabilities to use Audiovisual aids,
c) Acquire capability of utilization of scientific information for

promotion of community health
85
B. An intern must have observed or preferably assisted at the
following:
1. An intern should be capable of establishing linkages with other

agencies as water supply, food distribution and other
environmental/social agencies.
2. An intern should acquire managerial skills including delegation

of duties to and monitoring the activities of paramedical staff
and other health professionals.
II) Taluka Hospital/ First Referral Unit
1. An intern shall provide health education to an individual/

community on:
a) tuberculosis,
b) small family, spacing, use of appropriate contraceptives,
c) applied nutrition and care of mothers and children,
d) immunization.
B. An intern must be able to do with supervision:

An intern shall attend at least one school health programme with the
medical officer.
III) Primary Health Centre / Urban Health Centre
A. An intern must be able to do without assistance the following:
a) Participate in family composite health care (birth to death),

inventory of events.
b) Participate in use of the modules on field practice for

community health e.g. safe motherhood, nutrition
surveillance and rehabilitation, diarrheal disorders etc.
86
c) Participate in and maintain documents related to
immunization and cold chain.
d) Acquire competence in diagnosis and management of

common ailments e.g. malaria, tuberculosis, enteric fever,
congestive heart failure, hepatitis, meningitis acute renal
failure etc.
B. An intern must be able to do under supervision the following:
a) Acquire proficiency in Family Welfare Programmes

(antenatal care, normal delivery, contraception etc.).
b) Undergo village attachment of at least one week duration to

understand issues of community health along with exposure
to village health centers, ASHA Sub Centers.
c) Participate in Infectious Diseases Surveillance and Epidemic

Management activities along with the medical officer.
12.6.2 GENERAL MEDICINE GOAL:
The aim of teaching the undergraduate student in General

diagnose and treat common medical illnesses. He/she shall acquire
competence in clinical diagnosis based on history, physical examination
and relevant laboratory investigations and institute appropriate line of
management; this would include diseases common in tropics (parasitic,
bacterial or viral infections, nutritional disorders, including dehydration
and electrolyte disturbances) and various system illnesses.
87
A. An intern must be able to do without assistance and interpret the
results of:
i. the following laboratory investigations:
a) Blood: (Routine haematology smear and blood groups),
b) Urine: (Routine chemical and microscopic examination),
c) Stool: (for ova/cyst and occult blood),
d) Sputum and throat swab for gram stain or acid-fast stain, and
e) Cerebrospinal Fluid (CSF) for smear,
f) Electrocardiogram (ECG),
g) Glucometer recording of blood sugar,
h) routine radiographs of chest, abdomen, skull etc.
ii. Perform independently the following:
a) diagnostic procedures
Proctoscopy,
Ophthalmoscopy/Otoscopy,
Indirect laryngoscopy.
b) Therapeutic procedures;
Urethral catheterization,
Insertion of Ryle‟s Tube,
Pleural, Ascitic fluid aspiration,
Cerebrospinal Fluid (CSF) aspiration,
Air way tube installation,
Oxygen administration etc.
88
following operations/ procedures:
a) Biopsy Procedures: Liver, Kidney, Skin, Nerve, Lymph
node, and muscle biopsy, Bone marrow aspiration, Biopsy
of Malignant lesions on surface, nasal/nerve/skin smear for
leprosy under supervision.
C. Skills that an intern should be able to perform under

supervision:
a) An intern should be familiar with lifesaving procedures,
including use of aspirator, respirator and defibrillator,
cardiac monitor, blood gas analyzer.
b) An intern should be able to advise about management and
prognosis of acute & chronic illnesses like viral fever,
gastroenteritis, hepatitis, pneumonias, myocardial
infarction and angina, TIA and stroke, seizures, diabetes
mellitus, hypertension renal and hepatic failure, thyroid
disorders and hematological disorders. He should
participate in counseling sessions for patients with non-
communicable diseases and tuberculosis, HIV patients etc.
c) Intern should be able to confirm death and demonstrate
understanding of World Health Organization cause of
death reporting and data quality requirements.
d) Intern should be able to demonstrate understanding of the
coordination with local and national epidemic management
plans.
e) Intern shall be able to demonstrate prescribing skills and
demonstrate awareness of pharmacovigilance, antibiotics
policy, prescription audit and concept of essential
medicines list.
89
12.6.3 : PAEDIATRICS:
GOAL:
The aim of teaching the undergraduate student in Pediatrics is to

impart such knowledge and skills that may enable him to diagnose and
treat common childhood illnesses including neonatal disorders. He/she
shall acquire competence for clinical diagnosis based on history,
physical examination and relevant laboratory investigations and
institute appropriate line of management; this would include diseases
common in tropics (parasitic, bacterial or viral infections, nutritional
disorders, including dehydration and electrolyte disturbances) and
various system illnesses.
An intern shall be able to diagnose and manage common

childhood disorders including neonatal disorders and acute
emergencies, examining sick child making a record of
information.
An intern shall perform:

a) Diagnostic techniques: blood collection (including from
femoral vein and umbilical cord), drainage of abscess,
collection of cerebrospinal, pleural and peritoneal fluids,
suprapubic aspiration of urine.
b) Techniques related to patient care: immunization,
perfusion techniques, nasogastric tube insertion, feeding

procedures, tuberculin testing & breast-feeding counseling.
c) Use of equipment‟s: vital monitoring, temperature
monitoring, resuscitation at birth and care of children
receiving intensive care.
90
d) Institute early management of common childhood disorders
with special reference to pediatric dosage and oral
rehydration therapy.

a) screening of newborn babies and those with risk factors for
any anomalies and steps for prevention in future; detect
congenital abnormalities;
b) recognize growth abnormalities; recognize anomalies of

psychomotor development;
c) assess nutritional and dietary status of infants and children
and organize prevention, detection and follow up of
deficiency disorders both at individual and community
levels, such as:
 protein-energy malnutrition
 deficiencies of vitamins especially A, B, C and D;
 Iron deficiency
C. Skills that an intern should be able to perform under
supervision:
a) An intern should be familiar with life-saving procedures,
including use of aspirator, respirator, cardiac monitor,
blood gas analyzer.
b) An intern should be able to advise about management and

prognosis of acute & chronic illnesses like viral fever,
gastroenteritis, hepatitis, pneumonias, congenital heart
diseases, seizures, renal and hepatic diseases, thyroid disorders
and hematological disorders. She/he should participate in
counseling sessions with parents including HIV counseling.
91
12.6.4 : GENERAL SURGERY GOAL:
The aim of teaching the undergraduate student in General Surgery is

to impart such knowledge and skills that may enable him to diagnose and
treat common surgical ailments. He/she shall have ability to diagnose and
suspect with reasonable accuracy all acute and chronic surgical illnesses.
(A) THERAPEUTIC- An intern must perform or assist in:

a) venesection or venous access
b) tracheostomy and endotracheal intubation
c) catheterization of patients with acute retention or trocar
cystostomy
d) drainage of superficial abscesses
e) basic suturing of wound and wound management (including
bandaging)
f) biopsy of surface tumors
g) perform vasectomy
(B) Skill that an intern should be able to perform under supervision:
a) Advise about prognosis of acute & chronic surgical illnesses,

head injury, trauma, burns and cancer. Counsel patients
regarding the same.
b) Advise about rehabilitation of patients after surgery and assist

them for early recovery.
c) Intern should be able to demonstrate understanding of World

Health Organization cause of death reporting and data quality
requirements.
d) Intern should be able to demonstrate understanding of the use

of national and sub-national cause of death statistics.
92
(C) An intern must have observed or preferably assisted at the
following operations/procedures:
a) Resuscitation of critical patients
b) Basic surgical procedures for major and minor surgical
illnesses
c) Wound dressings and application of splints
d) Laparoscopic/ Minimally Invasive surgery
e) Lymph node biopsy
12.6.5 : CASUALTY:
GOAL:
The aim of teaching the undergraduate student in casualty is to
impart such knowledge and skills that may enable him/her to diagnose
and treat common acute surgical /medical ailments. He/she shall have
ability to diagnose and suspect, with reasonable accuracy, acute surgical
illnesses including emergencies, resuscitate critically injured patient and a
severely burned patient, control surface bleeding and manage open
wounds and monitor and institute first-line management of patients of
head, spine, chest, abdominal and pelvic injury as well as acute abdomen.
a) Identification of acute emergencies in various disciplines of
medical practice,
b) Management of acute anaphylactic shock,
c) Management of peripheral-vascular failure and shock,
d) Management of acute pulmonary edema and Left Ventricular
Failure (LVF),
e) Emergency management of drowning, poisoning and seizure,
f) Emergency management of bronchial asthma and status
asthmaticus,
g) Emergency management of hyperpyrexia,
93
h) Emergency management of comatose patients regarding
airways, positioning, prevention of aspiration and injuries,
i) Assessment and administering emergency management of

burns,
j) Assessing and implementing emergency management of

various trauma victims,
k) Identification of medico-legal cases and learn filling up of

forms as well as complete other medico-legal formalities in
cases of injury, poisoning, sexual offenses, intoxication and
other unnatural conditions.
a) Advise about prognosis of acute surgical illnesses, head injury,

trauma and burns. Counsel patients regarding the same.

a) Resuscitation of critical patients
b) documentation medico legal cases
c) management of bleeding and application of splints;
12.6.6 : OBSTETRICS AND GYNAECOLOGY GOAL:
The aim of teaching the undergraduate student in Obstetrics &

Gynaecology is to impart such knowledge and skills that may enable him
to diagnose and manage antenatal and post natal follow up; manage labor
and detect intrapartum emergencies; diagnose and treat common
gynaecologic ailments.
94
a) Diagnosis of early pregnancy and provision of ante-natal care;
antenatal pelvic assessment and detection of cephalopelvic
disproportion,
b) Diagnosis of pathology of pregnancy related to:
 abortion
 ectopic pregnancy
 tumors complicating pregnancy
 acute abdomen in early pregnancy
 hyperemesis gravidarum,
c) Detection of high risk pregnancy cases and give suitable advice

e.g. PIH, hydramnios, antepartum haemorrhage, multiple
pregnancies, abnormal presentations and intra-uterine growth
retardation,
d) Induction of labor and amniotomy under supervision,
e) Induction of labor and amniotomy under supervision,
f) Management of normal labor, detection of abnormalities, post-
partum hemorrhage and repair of perennial tears,
g) Assist in forceps delivery,
h) Detection and management of abnormalities of lactation,
i) Evaluation and prescription oral contraceptives with
counseling,
j) Per speculum, per vaginum and per rectal examination for
detection of common congenital, inflammatory, neoplastic and
traumatic conditions of vulva, vagina, uterus and ovaries,
k) Medico-legal examination in Gynecology and Obstetrics.
(B) Skills that an intern should be able to perform under

supervision:
a) Dilatation and curettage and fractional curettage,
b) Endometrial biopsy,
c) Endometrial aspiration,
d) Pap smear collection,
e) Intra Uterine Contraceptive Device (IUCD) insertion,
f) Minilap ligation,
95
g) Urethral catheterization,
h) Suture removal in postoperative cases,
i) Cervical punch biopsy.

a) Major abdominal and vaginal surgery cases,
b) Second trimester Medical Termination of Pregnancy (MTP)
procedures
e.g. Emcredyl Prostaglandin instillations, Caesarean section.
12.6.7 OTORHINOLARYNGOLOGY (ENT) GOAL:
The aim of teaching the undergraduate student in ophthalmology is

treat common otorhinolaryngological conditions such as ear pain, foreign
bodies and acquire ability for a comprehensive diagnosis of common Ear,
Nose and Throat (ENT) diseases including emergencies and malignant
neoplasms of the head and neck.
a) Ear syringing, antrum puncture and packing of the nose for

epistaxis,
b) Nasal douching and packing of the external canal,
c) Removing foreign bodies from nose and ear,
d) Observing or assisting in various endoscopic procedures and
tracheostomy.
(B) Skill that an intern should be able to perform under

supervision:
a) Intern shall have participated as a team member in the
diagnosis of various ENT- related diseases and be aware of
National programme on prevention of deafness,
b) Intern shall acquire knowledge of various ENT related
rehabilitative programmes.
96
a) Intern shall acquire skills in the use of head mirror, otoscope
and indirect laryngoscopy and first line of management of
common Ear Nose and Throat (ENT) problems.
12.6.8 OPHTHALMOLOGY GOAL:

The aim of teaching the undergraduate student in ophthalmology is
treat common ophthalmological conditions such as Trauma, Acute
conjunctivitis, allergic conjunctivitis, xerosis, entropion, corneal ulcer,
iridocyclitis, myopia, hypermetropia, cataract, glaucoma, ocular injury and
sudden loss of vision.
a) Sub conjunctival injection

b) Ocular bandaging
c) Removal of concretions
d) Epilation and electrolysis
e) Corneal foreign body removal
f) Cauterization of corneal ulcers
g) Chalazion removal
h) Entropion correction
i) Suturing conjunctival tears
j) Lids repair
k) Glaucoma surgery (assisted)
l) Enucleation of eye in cadaver.
97
supervision:
(a) 4 Advise regarding methods for rehabilitation of the blind.

a) Assessment of refractive errors and advise its correction,
b) Diagnose ocular changes in common systemic disorders,
c) Perform investigative procedures such as tonometry, syringing,
direct ophthalmoscopy, subjective refraction and fluorescin
staining of cornea.
12.6.9 ORTHOPAEDICS GOAL:

The aim of teaching the undergraduate student in Orthopaedics and
Physical Medicine and Rehabilitation is to impart such knowledge and
skills that may enable him to diagnose and treat common ailments. He/she
shall have ability to diagnose and suspect presence of fracture,
dislocation, actual osteomyelitis, acute poliomyelitis and common
congenital deformities such as congenital talipes equino varus (CTEV)
and dislocation of hip (CDH).
(A) THERAPEUTIC- An intern must assist in:

a) Splinting (plaster slab) for the purpose of emergency
splintage, definitive splintage and postoperative splintage
and application of Thomas splint,
b) Manual reduction of common fractures – phalangeal,
metacarpal, metatarsal and Collis‟ fracture,
c) Manual reduction of common dislocations – interphalangeal,
metacarpophalangeal, elbow and shoulder dislocations,
d) Plaster cast application for undisplaced fractures of arm, fore
arm, leg and ankle,
e) Emergency care of a multiple injury patient,
f) Transport and bed care of spinal cord injury patients.
98
supervision:
a) Advise about prognosis of poliomyelitis, cerebral palsy, CTEV
and CDH,
b)Advise about rehabilitation of amputees and mutilating
traumatic and leprosy deformities of hand.
following operations:
a) Drainage for acute osteomyelitis,
b) Sequestrectomy in chronic osteomyelitis,
c) Application of external fixation,
d) Internal fixation of fractures of long bones.
12.6.10 DERMATOLOGY VENEREOLOGY & LEPROSY GOAL:
The aim of teaching the undergraduate student in Dermatology
Venereology & Leprosy is to impart such knowledge and skills that may
enable him to diagnose and treat common dermatological infections and
leprosy. He/she shall acquire competence for clinical diagnosis based on
history, physical examination and relevant laboratory investigations and
institute appropriate line of management; this would include diseases
common in tropics (parasitic, bacterial or viral infections, and cutaneous
manifestations of systemic illnesses.
A. THERAPEUTIC- At the end of internship an intern must be
able to:
a) Conduct proper clinical examination; elicit and interpret
physical findings, and diagnose common disorders and
emergencies,
b) Perform simple, routine investigative procedures for making
bedside diagnosis, specially the examination of scraping for
fungus, preparation of slit smears and staining for AFB for
leprosy patient and for STD cases,
99
c) Manage common diseases recognizing the need for referral for
specialized care in case of inappropriateness of therapeutic
response.
a) Skin biopsy for diagnostic purpose
12.6.11 PSYCHIATRY GOAL:
The aim of teaching the undergraduate student in Psychiatry is to

impart such knowledge and skills that may enable him to diagnose and
treat common psychiatric illnesses. He/she shall acquire competence for
clinical diagnosis based on history, physical examination and relevant
laboratory investigations and institute appropriate line of management.
He/she should also be able to recognize the behavioral manifestations of
systemic illnesses.
A. THERAPEUTIC- An intern must perform or assist in:
a) Diagnose and manage common psychiatric disorders,
b) Identify and manage psychological reactions,
c) Diagnose and manage behavioral disorders in medical and

surgical patients.

a) ECT administration,
b) Therapeutic counseling and follow-up.
100
12.6.12 RESPIRATORY MEDICINE GOAL:
The aim of teaching the undergraduate student in Respiratory

diagnose and treat common respiratory illnesses. He/she shall acquire
competence for clinical diagnosis based on history, physical examination
management.
A. THERAPEUTIC - An intern must perform or assist in:
a) diagnosing and managing common respiratory disorders and

emergencies,
b) simple, routine investigative procedures required for making

bed side diagnosis, especially sputum collection, examination
for etiological organism like AFB, interpretation of chest X-
rays and respiratory function tests,
c) interpreting and managing various blood gases and pH

abnormalities in various illnesses.

a) Laryngoscopy,
b) Pleural aspiration, respiratory physiotherapy, laryngeal

intubation and pneumo-thoracic drainage aspiration,
c) Therapeutic counseling and follow up.
101
12.6.13 ANAESTHESIOLOGY GOAL:
The aim of teaching the undergraduate student in anaesthesia is to

impart such knowledge and skills that may enable him to understand
principles of anaesthesia and recognize risk and complications of
anaesthesia. At the end of internship, graduate should be able to perform
cardio-pulmonary resuscitation correctly, including recognition of cardiac
arrest.

a) Pre-anaesthetic checkup and prescribe pre-anaesthetic
medications,
b) Venepuncture and set up intravenous drip,
c) Laryngoscopy and endotracheal intubation,
d) Lumbar puncture, spinal anaesthesia and simple nerve blocks,
e) Simple general anaesthetic procedures under supervision,
f) Monitor patients during anaesthesia and in the post-operative
period,
g) Maintain anaesthetic records,
h) Perform cardio-pulmonary resuscitation correctly, including
recognition of cardiac arrest.
a) Counseling and advice regarding various methods of
anaesthesia,
b) Recognize and manage problems associated with emergency
anaesthesia,
c) Recognise and treat complications in the post-operative
period.
102
a) Anaesthesia for major and minor surgical and other
procedures;
12.6.14 RADIODIAGNOSIS GOAL:
The aim of teaching the undergraduate student in radio diagnosis is
to impart such knowledge and skills that may enable him to understand
principles of imageology and recognize risk and complications of
radiologic procedures and the need for protective techniques. At the end
of internship, graduate should be able to counsel and prepare patients for
various radiologic procedures.
An intern must acquire competency in:

a) Identifying and diagnosing acute abdominal conditions clinically
and choose appropriate imaging modality for diagnosis,
b) Identifying and diagnosing acute traumatic conditions in bones
and skull using X rays / CT Scans with emphasis on fractures and
head injuries,
c) Recognizing basic hazards and precautions in radio-diagnostic
practices specially related to pregnancy,
d) Demonstrating awareness of the various laws like PC PNDT Act.
12.6.15 PHYSICAL MEDICINE AND REHABILITATION GOAL:
The aim of teaching the undergraduate student in Physical Medicine
& Rehabilitation is to impart such knowledge and skills that may enable
him to diagnose and treat common rheumatologic, orthopedic and
neurologic illnesses requiring physical treatment. He/she shall acquire
competence for clinical diagnosis based on history, physical examination
management.
103
A. THERAPEUTIC- An intern must perform or assist in:
a) Diagnosing and managing with competence clinical diagnosis

and management based on detailed history and assessment of
common disabling conditions like poliomyelitis, cerebral
palsy, hemiplegia, paraplegia, amputations etc.
b) Participation as a team member in total rehabilitation
including appropriate follow up of common disabling
conditions,
c) Procedures of fabrication and repair of artificial limbs and
appliances.

a) use of self-help devices and splints and mobility aids
b) accessibility problems and home making for disabled
c) simple exercise therapy in common conditions like prevention
of deformity in polio, stump exercise in an amputee etc.
d) Therapeutic counseling and follow up
12.6.16 FORENSIC MEDICINE AND TOXICOLOGY GOAL:
The aim of teaching the undergraduate student in Forensic Medicine

is to impart such knowledge and skills that may enable him to manage
common medico-legal problems in day to day practice. He/she shall
acquire competence for post mortem diagnosis based on history, physical
examination and relevant observations during autopsy.
A. An intern must perform or assist in:
a) Identifying and documenting medico-legal problems in a

hospital and general practice,
b) Identifying the medico-legal responsibilities of a medical man

in various hospital situations,
104
c) Diagnosing and managing with competence basic poisoning
conditions in the community,
d) Diagnosing and managing with competence and

documentation in cases of sexual assault,
e) Preparing medico-legal reports in various medico legal

situations.

following operations/ procedures, as given in Table 11:
a) Various medico legal / post-mortem procedures and formalities

during their performance by police.
Table 11: Certifiable Procedural Skills:
A Comprehensive list of skills recommended as desirable for Bachelor of Medicine

and Bachelor of Surgery (MBBS) – Indian Medical Graduate
Specialty Procedure
 Venipuncture (I)
 Intramuscular injection(I)
 Intradermal injection (D)
 Subcutaneous injection(I)
General Medicine  Intra Venous (IV) injection (I)
 Setting up IV infusion and calculating drip rate (I)
 Blood transfusion (O)
 Urinary catheterization (D)
 Basic life support (D)
 Oxygen therapy (I)
 Aerosol therapy / nebulization (I)
 Ryle‟s tube insertion (D)
 Lumbar puncture (O)
 Pleural and ascitic aspiration (O)
105
 Cardiac resuscitation (D)
 Peripheral blood smear interpretation (I)
 Bedside urine analysis (D)
 Basic suturing (I)
 Basic wound care (I)
General Surgery
 Basic bandaging (I)
 Incision and drainage of superficial abscess (I)
 Early management of trauma (I) and trauma life
support (D)
 Application of basic splints and slings (I)
 Basic fracture and dislocation management (O)
Orthopedics
 Compression bandage (I)
 Per Speculum (PS) and Per Vaginal (PV)

examination (I)
 Visual Inspection of Cervix with Acetic Acid (VIA)
(O)
Gynecology  Pap Smear sample collection & interpretation (I)
 Intra- Uterine Contraceptive Device (IUCD)
insertion & removal (I)
 Obstetric examination (I)
 Episiotomy (I)
Obstetrics
 Normal labor and delivery (including partogram) (I)
 Neonatal resuscitation (D)

 Setting up Pediatric IV infusion and calculating drip
Pediatrics
rate (I)
 Setting up Pediatric Intraosseous line (O)
 Documentation and certification of trauma (I)

 Diagnosis and certification of death (D)
Forensic Medicine
 Legal documentation related to emergency cases (D)
 Certification of medical-legal cases e.g. Age
estimation, sexual assault etc. (D)
106
 Establishing communication in medico-legal cases
with police, public health authorities, other
concerned departments, etc (D)
Otorhinolaryngology  Anterior nasal packing (D)
 Otoscopy (I)
 Visual acuity testing (I)

 Digital tonometry (D)
 Indirect ophthalmoscopy (O)
Ophthalmology  Epilation (O)
 Eye irrigation (I)
 Instillation of eye medication (I)
 Ocular bandaging (I)
 Slit skin smear for leprosy (O)

 Skin biopsy (O)
 Gram‟s stained smear interpretation(I)
Dermatology  KOH examination of scrapings for fungus (D)
 Dark ground illumination (O)
 Tissue smear (O)
 Cautery - Chemical and electrical (O)
107
I- Independently performed on patients, O- Observed in patients or on
simulations,
D- Demonstration on patients or simulations and performance under

supervision in patients
Certification of Skills: Any faculty member of concerned

department can certify skills. For common procedures, the
certifying faculty may be decided locally.
[ADVT.-III/4/Exty./277/19]
Foot Note: The Principal Regulations namely, “Graduate Medical Education

Regulations, 1997”were published in Part – III, Section (4)of the Gazette of India vide
Medical Council of India notification dated 4th March, 1997, and amended vide MCI
notifications dated 29/05/1999, 02/07/2002, 30/09/2003, 16/10/2003, 01/03/2004,
20/10/2008, 15/12/2008, 22/12/2008, 25/03/2009, 19/04/2010, 07/10/2010, 21/12/2010,
15/02/2012, 29/12/2015, 05/08/2016, 21/09/2016,10/03/2017, 04/07/2017, 23/01/2018,
06/02/2018, 21/05/2018, 05/02/2019 & 14/05/2019.
108
Part-I
Anatomy, Physiology, Biochemistry and Pharmacology
There shall be close integration in the teaching of these subjects. It is
suggested that during the early para-clinical years, two to three weeks may
be set apart for instruction in Family Welfare Planning relating to these
subjects; so that the student gets an overall understanding of the principles
and practice of ―Family Planning‖ within the limited time available for
covering all the subjects of the medical course. The method suggested
would save time and repetition of essential facts.
Part-II
This includes the later para-clinical and clinical courses. The practical
aspects of Family Welfare Planning methods should be emphasized. The
program of instruction shall be supervised by the Department of Obstetrics
and Gynecology. The department of Community Medicine Internal
Medicine, Psychiatry, Pediatrics and Surgery must be closely associated in
imparting instruction relating to the problems arising for want of family
welfare planning and the advantages to society and the individual which
will be gained by adopting the measures suggested.
Seminars:
The medical colleges shall organize occasional seminars in which staff
from all departments and the in-service trainees shall participate.
109
DISTRIBUTION OF MARKS TO VARIOUS DISCIPLINES:
FIRST PROFESSIONAL EXAMINATION:
(Pre-clinical Subjects): -
a) Anatomy:
Theory-Two papers of 100 marks each
Theory- Paper I & II 200 marks.
Practical 80 marks
Oral (Viva) 20 marks
Internal Assessment
(Theory-50; Practical-50) 100 marks
Total 300 marks
b) Physiology including Biophysics
Practical 80 marks
Internal Assessment
Total 300 marks
c) Biochemistry:
Practical 80 marks
Internal Assessment
Total 300 marks
Pass: In each of the subjects, a candidate must obtain 50% in aggregate
with a minimum of 50% in Theory and minimum of 50% in Practicals
including orals.
110
SECOND PROFESSIONAL EXAMINATION;
(Para-clinical subjects):
a) Pathology:
Practical 80 marks
Internal Assessment
Total 300 marks
b) Microbiology:
Practical 80 marks
Internal Assessment
Total 300 marks
c) Pharmacology
Practical 80 marks
Internal Assessment
Total 300 marks

including orals.
111
THEORY MARK DISTRIBUTION
1. Essay questions – 2 2 x15 = 30

(Each question will be of 15 marks)
Out of two structured essay questions, one will be Problem Based
Question)
The question should pose a clinical/practical problem to the
students and require them to apply knowledge and integrate
it with clinical disciplines
2. Short Notes questions – 10 questions
(Each carries 5 marks)
a) Out of 10 short note questions, 7 questions will be
Subject related questions 7 x 5 = 35
b) Two short note questions will be
Reasoning questions 2 x 5 = 10
(These provide excellent opportunities for testing integration,
clinical reasoning and analytic ability of the student)
c) One short note question will be on AETCOM Question only in one paper
(Applied aspects for Pre - & Para- Clinical subjects) 1x5=5
3. MCQs - 20 questions
(Each question will have 1 mark with 4 option answers
and all questions will be analytical type MCQs) 1 x 20 = 20
-------------------
Total = 100
-------------------
(ATCOM question will be for only Ist & IInd MBBS students)
112
THIRD PROFESSIONAL
PART 1
(Clinical subjects)
Part 1: To be conducted during end period of seventh semester.
a) Forensic Medicine & Toxicology

Theory- one paper 100 marks.
Practical 80 marks
Internal Assessment
Total 200 marks
b) Ophthalmology:
Theory : One paper 100 marks
(should contain one question
on pre-clinical and para-
clinical aspects, of 10 marks)
Practical 80 marks
Internal Assessment
Total 200 marks
113
c) Oto-Rhino-Laryngology :
Theory: One paper 100 marks
(should contain one question on pre-
clinical and para-clinical aspects, of 10
marks)
Practical 80 marks
Internal Assessment
Total 200 marks
d) Community Medicine:
Theory: Two papers of 100 marks each 200 marks
(includes problem solving, applied
aspects of management at primary level
including essential drugs, occupational
(agro based) diseases, rehabilitation and
social aspects of community).
Practical 80 marks
Internal Assessment
Total 300 marks

including orals.
114
PART-II
Each paper shall have two sections. Questions requiring essay type
answers may be avoided.
a) Medicine:
Theory- Two papers of 100 marks each 200 marks
Paper 1- General Medicine
Paper II- General Medicine (including
Psychiatry, Dermatology and S.T.D.)
(Shall contain one question on basic
sciences and allied subjects)
Clinical (Bed side) 160 marks
Oral (Viva) Interpretation of X-ray ECG, 40 marks
etc.
Internal assessment
Total 400 marks
b) Surgery:
Paper-1-General Surgery (Section 1)
Orthopaedics (Section 2)
PAPER II-General Surgery including
Anesthesiology, Dental diseases and
Radiology.
(shall contain one question on basic
sciences and allied subjects)
Clinical (Bed Side) 160 marks
Oral (Viva) Interpretation of Investigative 40 marks
data
Internal assessment
Total 400 marks
115
Paper 1 of Surgery shall have one section in Orthopedics. The
questions on Orthopedic Surgery be set and assessed by examiners who
are teachers in the Orthopedic surgery.
a) Obstetrics and Gynecology

Paper I- Obstetrics including social
obstetrics.
Paper II – Gynecology, Family Welfare and
Demography
(Shall contain one question on basic sciences
and allied subjects)
Clinical 160 marks
Oral (Viva) including record of delivery 40 marks
cases(20+10)
Internal assessment
Total 400 marks
b) Paediatrics : (Including Neonatology)
Theory : One paper 100 marks
(Shall contain one question on basic sciences
and allied subjects)
Clinical 80 marks
Internal assessment
Total 200 marks
Pass: In each of the subjects a candidate must obtain 50% in aggregate with
a minimum of 50% in Theory and minimum of 50% in Practical‘s/clinicals
including orals.
116
THEORY MARK DISTRIBUTION
III & IV YEAR
1. Essay questions – 2 2 x15 = 30
(Each question will be of 15 marks)

The question should pose a clinical/practical problem to the
students and require them to apply knowledge and integrate
it with clinical disciplines
2. Short Notes questions – 10 questions

(Each carries 5 marks) 10 x 5 = 50
3. MCQs - 20 questions
(Each question will have 1 mark with 4 option answers) 1 x 20 = 20
-------------------
Total = 100
-------------------
117
APPENDIX-E
TIME SCHEDULE FOR COMPLETION OF THE ADMISSION
PROCESS FOR FIRST MBBS COURSE
Sr.No. Schedule for Seats to be filled up by the Seats to be filled up by
Admission Central Government the State
through the All India Govt./Institution
Entrance Examination
1 Conduct of Entrance Between 1st to 7th
May May Between 10th to 17th
Examination May
2 Declaration of the By 1st June By 1st June
Result of the Qualifying
Exam/Entrance Exam.
3 Ist round of To be over by 25th June Between 6th July to 15th
counseling/admission July
th
4 Last date for joining the By 5 July By 22nd July
allotted college and the
course
5 2nd round of counseling Between 23rd July to 30th July Between 10th to 22nd
/ admission for August
vacancies
6 Last date of joining for By 9th August By 28th August
the 2nd round of
counseling /admission
7 Commencement of 1st of August 1st of August
academic session / term
8 Last date up to which - By 31st August
students can be
admitted/Joined against
vacancies arising due to
any reason.
118
Note:
1. All India Quota Seats remaining vacant after last date for joining, i.e.
9th August will be deemed to be converted into state quota.
2. Institute / college / courses permitted after 31st May will not be
considered for admission/allotment of seats for current academic year.
3. In any circumstances, last date for admission / joining will not be
extended after 31st August.
Note:
1. All India Quota Seats (15%) remaining vacant after last date for
joining, i.e. 16th August, 2017 will be deemed to be converted into
state quota.
2. Institute/college/courses permitted after 31st May will not be
considered for admission/allotment of seats for current academic year.
3. In any circumstances, last date for admission/joining will not be
extended after 31st August.
4. For the purpose of ensuring faithful obedience to the above time-
schedule, Saturday, Sunday or Holidays (except National Holiday on
account of Independence Day on Tuesday, 15th August) shall be
treated as working days.
119
120
SYLLABUS FOR
VARIOUS
SUBJECTS
121
122
ANATOMY
123
124
ANATOMY
Pre-clinical subjects
The teaching of Anatomy will be more oriented towards the basic
principles of the subject giving more emphasis on their applied aspects.
Goal:
The broad goal of the teaching of undergraduate students in Anatomy
aims at providing comprehensive knowledge of the human body in the
following branches in the subject.
1. Gross Anatomy
2. Microscopic Anatomy(Histology)
3. Developmental Anatomy
4. Anatomical basis for the clinical correlation and diseased conditions of
the body.
Objectives:
At the end of the course the student shall be able to:
1. To understand the normal position, clinically relevant relationships,
functional and cross sectional anatomy of various structures of the
body.
2. Identify the microscopic sections of various tissues and organs and
correlate the structure with functional aspects of the organs which is a
prerequisite for understanding the pathological state of the tissue in
diseased conditions.
3. In nervous system they shall understand the basic structure and
125
connections of each part and analyze the various functions and
connections of it and interpret the gross lesions in relation to its
structure.
4. In developmental anatomy(embryology), they should be able to
recognize basic principles of various normal and critical stages of
development, effects of common teratogens, genetic mutations and
environmental hazards and should appreciate the developmental and
congenital anomalies on the basis of development of each organ.
Skills:
At the end of the program the student should be able to:
1. Identify and locate all the structures of the body and mark the
topography of the living body.
2. Identify the organs and tissues under microscope.
3. Understand the principle of karyotyping.
4. Understand gross congenital anomalies.
5. Understand the principles of newer imaging techniques, interpret CT
scans, ultrasonograms, plain and contrast X—rays.
6. Understand the clinical basis of some common clinical procedures like
intramuscular injections, PV, PR, intravenous injections, lumbar
puncture, kidney biopsy, bronchoscopy, tracheostomy, urinary
catheterization, fundus examination using ophthalmoscope, otoscope
for viewing tympanic membrane.
Integration:
Integrated teaching of all basic sciences subjects should be done as
far as possible for certain systems and organs so that the student shall be
able to get a comprehensive idea and functions of the organs and systems of
the body and correlate them with anatomical basis.
126
Certain topics of clinical importance should be done in an integrated
method involving all basic sciences departments and relevant clinical
departments.
PAPER—1
Portions:—
1. General Anatomy
2. General embryology and embryology of the organs and tissues
3. General Histology and systemic histology
4. Upper limb
5. Lower limb
6. Abdomen Pelvis and Perineum
General Anatomy:
Introduction to all systems:
 Anatomical terms and positions , planes etc
 Skeletal system, joints
 Muscular system
 Cardiovascular system
 Nervous system
 Digestive system
 Respiratory system
 Urogenital system
 Endocrine system
127
Gross anatomy
 Dissection to be done by all staff and students
 Demonstration of important regions to be done using prosected
specimens.
 Detailed origin and insertion of muscles to be replaced by essential
attachments of important muscles and their nerve supply and action.
Upper Limb
Osteology :
 Clavicle, Scapula, Humerus, Radius, Ulna and Carpals
 Side identification and important muscular attachments
Regions:
 Pectoral region, axilla, mammary gland,
 Arm---flexor and extensor compartments
 Forearm--flexor and extensor compartments
 Palm and dorsum of hand
 Muscles and fasciae of these regions
Nerves: Brachial plexus, axillary, median, ulnar, radial and

musculocutaneous.
Arteries: Axillary brachial, ulnar, radial and palmar arches
Veins: Cephalic, basilic, median cubital and axillary
Joints: Shoulder, elbow, radioulnar, wrist and carpometacarpal joint of
thumb
Spaces: Quadrangular and triangular and fascial spaces of hand
Fossae: Cubital, anatomical snuff box
128
Retinacula: flexor and extensor
Lymphatics:
 Lymphatic drainage of upper limb, mammary gland
 Applied, surface and radiological anatomy
Lower Limb
Osteology:
 Hipbone, femur, tibia, fibula, calcaneum, talus, navicular and cuboid
Regions:
Thigh: 3 compartments - flexor, extensor and medial or adductor
Gluteal region
Leg: 3 compartments - extensor, flexor and lateral (peroneal).
Foot: dorsum and plantar (sole)
Muscles and fasciae of these regions
Nerves: Sciatic, femoral, obturator, tibial and common peroneal
Arteries: Femoral, obturator, popliteal, tibial, dorsalis pedis and
anastomoses: cruciate, trochanteric and knee.
Veins: Saphenous, femoral and popliteal,
Fossa and spaces: Femoral triangle, adductor canal and popliteal fossa
Sheath: Femoral and iliotibial tract
Retinacula: Flexor and extensor
Lymphatics:
 Lymphatic drainage of lower limb, inguinal and popliteal nodes
 Applied, surface and radiological anatomy of lower limb
129
Abdomen, Pelvis and Perineum
Osteology:
 lumbar vertebrae, articulated pelvis
 Planes and quadrants of anterior abdominal wall
 Testis, scrotum, spermatic cord and Penis
Peritoneum: lesser sac, lesser omentum, greater omentum, mesentery
Organs: Stomach, spleen, duodenum, pancreas, liver and extrahepatic
biliary apparatus, intestine(small and large) kidney and ureter,
Pelvis and perineum:
 Urinary bladder, rectum and anal canal
Urogenital region:
 Superficial and deep perineal pouches, perineal membrane
Male genital organs:, epididymis, , seminal vesicle, vas deferens, and

prostate.
Female genital organs: uterus, vagina, fallopian tube, ovary
Anal region: ischiorectal fossa
Posterior abdominal wall:
 lumbar plexus, muscles
 Thoraco abdominal diaphragm, Pelvic diaphragm
Arteries : abdominal aorta, celiac trunk, superior mesenteric and inferior

mesenteric arteries
Veins:
 inferior vena cava, portal vein
 Applied, surface and radiological anatomy
130
PAPER—2
Portions:
 Thorax
 Head and Neck
 Brain
 Histology and embryology of the organs concerned.
Thorax
Osteology:
 Sternum, ribs and thoracic vertebrae
Thoracic wall: intercostal spaces, muscles, nerves, arteries and veins
Mediastinum: definition, boundaries, subdivisions and contents
Pleura:
 reflection and recesses
 Lungs and bronchopulmonary segments
 Heart and pericardium, right atrium in detail, blood supply of heart
 Phrenic nerve, azygos veins, thoracic duct, trachea, arch of aorta and
oesophagus
 Thoracic sympathetic chain
 Applied, surface and radiological Anatomy
HEAD AND NECK

Osteology:
Skull: full, base and foramina, individual skull bones, mandible, cervical
vertebrae, Fetal skull.
Scalp and face: muscles, vessels and nerves and applied anatomy
131
Triangles of neck:
 anterior, posterior
 Midline structures in neck - superficial and deep - strap muscles and
thyroid gland
Cranial cavity: Dural folds and Dural venous sinuses
Orbit :
 Boundaries and contents
 Pituitary gland
Fossae: Temporal and infratemporal
Salivary gland: Parotid and submandibular
Joint:
 Temporomandibular
 Muscles of mastication
Arteries: Internal and external carotid, maxillary, subclavian, vertebral and

middle meningeal
Veins : Retromandibular, facial, internal jugular and external jugular
Nerves: All cranial nerves (12 pairs), cervical plexus, ansacervicalis
Lymph nodes: cervical and lymphatic drainage of all structures
132
Nose: external, cavity, lateral wall and nasal septum and paranasal air
sinuses
Pharynx:
 subdivisions, muscles
 Tongue, tonsil
 Larynx
Eyeball: muscles, vessels, layers, nerves etc
Ear:
 External, middle and Internal Ear
 BRAIN AND SPINAL CORD
 SPINAL CORD
Vertebral canal: contents
Meninges
Features: external and internal

Sections :
 levels
 Blood supply
133
BRAIN
Meninges
Brain stem: medulla oblongata, pons, midbrain - features, sections, blood

supply and lesions
Cerebellum and peduncles
Cerebrum: sulci and gyri, white mater, basal ganglia blood supply,
thalamus and hypothalamus
Ventricles of brain:
 lateral, third and fourth ventricle
 CSF circulation, subarachnoid cisterns
 Blood supply of Brain
 Applied and surface anatomy, CT and MRI.
Paper - 1
Portions:
1. General Anatomy,
2. General embryology and embryology of the organs and tissues
3. General Histology and systemic histology
4. Upper limb
5. Lower limb
6. Abdomen, Pelvis and Perineum
134
Paper - 2
Portions:
1. Thorax
2. Head and Neck
3. Brain
4. Embryology --neural tube, tongue and face development and
Pharyngeal arches.
5. Histology of structures concerned
Family Welfare
1. Gross and microscopic anatomy of the male and female generative
organs.
2. The menstrual cycle.
3. Spermatogenesis and Oogenesis
4. Fertilization of the ovum.
5. Tissue and organ changes in the mother in pregnancy.
6. Embryology and Organogenesis.
7. Principles of Genetics.
8. Applied anatomy of mechanical methods of preventing conception.
a. In female-chemical contraceptive, pessaries, Intra-Uterine

Contraceptive Device (IUCD), tubectomy etc.
b. In male – condom, vasectomy etc.
135
UNIVERSITY EXAMINATION
PASS CRITERIA:
MAXIMUM MINIMUM
Theory (Paper I & II) 200 100
Practical 80 40
Viva 20 -
Practical + Viva 100 50
------------ ------------
GRAND TOTAL: 300 150
------------ ------------
Pass Criteria for Internal Assessment

50% combined in theory and practical (not less than 40% in each) for
eligibility for appearing for University Examinations
University Examination
Mandatory 50% marks separately in theory and practical (practical =
practical/ clinical + viva)
Note:
Internal Assessment marks are not to be added to marks of the

University Examinations and should be shown separately in the
grade card.
136
PHYSIOLOGY
137
138
PHYSIOLOGY
GOAL
The broad goal of the teaching of undergraduate students in Physiology
aims at providing the student comprehensive knowledge of the normal
functions of the organ systems of the body to facilitate an understanding of
the physiological basis of health and disease.
OBJECTIVES
1. KNOWLEDGE
At the end of the course the student will be able to:
a. Explain the normal functioning of all the organ systems and their
interactions for well-coordinated total body function.
b. Assess the relative contribution of each organ system to the
maintenance of the milieu interior.
c. Elucidate the physiological aspects of normal growth and
development.
d. Describe the physiological response and adaptations to environmental
stresses.
e. List the physiological principles underlying pathogenesis and treatment
of disease.
2. SKILLS
At the end of the course the student should be able to:
a. Conduct experiments designed for study of physiological phenomena.
b. Interpret experimental/investigative data.
c. Distinguish between normal and abnormal data derived as a result of
tests which he/she has performed and observed in the laboratory.
139
3. INTEGRATION
At the end of the integrated teaching the student should acquire an
integrated knowledge of organ structure and function and its regulatory
mechanisms.
GENERAL PHYSIOLOGY
Homeostasis - Concept of maintenance of internal environment.

Feed Back Mechanisms – Types examples.
Body fluids – Total body water. Body fluid compartments. Composition of
body fluids. Concept of electroneutrality: Anion gap. Osmolarity of
body fluids. Tonicity. Osmolarity of body fluids starling forces. Edema.
CELL – Structural & functional in brief. Cell Membrane transport –
Passive & active. Endocytosis & Exocytosis. Membrane potential
resting membrane Potential, Action Potential, NERNST EQUATION.
CELL SIGNALING – Cytoplasmic and nuclear receptors. Membrane
receptors – Ionotropic and metabotropic.
BLOOD
1. INTRODUCTION TO BLOOD:
 Composition and functions of blood.
 Plasma proteins.
 Blood volume & measurements of blood & plasma.
2. HEMOPOIESIS AND BONE MARROW:
3. RED BLOOD CELL:
 Physical characteristics, concentration and causes for physiological
140
variation, functions, sites of red blood cell production, general changes
that take place during erythropoiesis, regulation/factors affecting
erythropoiesis, Life span and destruction of RBCs, Hematocrit/PCV.
 Normal values for Indian population.
 Morphology & functions.
4. HEMOGLOBINS AND BLOOD INDICES:
 Components of Hb, types, normal levels (Indian population also).
 Role in gas transport.
 Oxygen-Hb dissociation curve (done under resp system).
 Oxygen carrying capacity of blood.
 Hemoglobin as a buffer.
 Reduced hemoglobin and cyanosis.
 Abnormal Hb.
 Breakdown, Hemolytic jaundice.
5. PATHOPHYSIOLOGY OF ANEMIA AND POLYCYTHEMIA:
 Anemia - Definition etiological classification, morphological
classification, effects, symptoms and signs.
 Reticulocyte count – normal value and causes for increased and
decreased reticulocyte count, reticulocyte response.
6. BLOOD GROUPS AND PHYSIOLOGICAL BASIS OF BLOOD
TRANSFUSION:
 Importance of blood groups.
 ABO system.
 Genetic determination.
 Agglutinins in plasma.
141
 Frequency of different blood groups in India.
 Rh incompatibility.
 Presence of other minor blood group systems.
 Blood grouping/typing.
 Cross match.
 Erythroblastosis Fetalis: prevention, treatment.
 Transfusion reactions.
7. WHITE BLOOD CELLS:
 Normal count.
 Types – granulocytes, agranulocytes.
 Morphology.
 Differential count.
 Conditions in which counts are increased and decreased.
 Functions of neutrophils, eosinophils, basophils, mast cells.
 Lymphocytes, monocytes.
 Monocyte macrophage system.
 Leucopoiesis.
 Gross changes during maturation.
8. PLATELETS AND THEIR ROLE IN HEMOSTASIS:
 Formation from megakaryocytes, normal count, Life span & removal.
 Functions.
 Thrombocytopenia – causes and effects.
9. HEMOSTASIS:
 Mechanisms involved in hemostasis:
– Clotting mechanism.
142
– Clotting factor.
– Clot & clot retraction.
 Anticlotting and fibrinolytic mechanism in the body.
 Anticoagulants used in laboratory.
 Abnormalities of coagulation – Tests of hemostasis platelet count, BT,
CT, PT, APPTT, factor assays.
10. LYMPH: Reticulo endothelial system.
MUSCLE
Structure of Skeletal Muscle – Morphology, Types, E.M. Structure.
Muscle Protein. SarcoTubular system. Electrical activity in the Muscle.
Muscle contraction & relaxation – Molecular Basis of excitation contraction
coupling, Type of Muscle contraction. Changes in the muscle during
muscle Contraction. Motor unit. Neuro muscular junction, Drugs acting on
neuro Muscular junction Muscle Twitch-2 Successive stimuli & fatigue.
E.M.G.
Smooth Muscle – Properties, Types & functions. cardiac muscle –
Structure. Comparison of 3 types of Muscles.
NERVE
1. Neuron – Structure, functional features (Erlanger & gassers
classification) functional classification. Neuroglia general feature,
types function. Myelination Nerve impulse Excitation & conduction.
Ionic Basis.Saltatory conduction.
2. Neural growth. Nerve injury. Wallerian degeration.
143
Autonomic Nervous System
1. Organization of the system.
2. Description of sympathetic & parasympathic Nervous system.
3. Chemical neurotransmission.
4. Effects of sympathetic & Parasympathic stimulaitaion.
GASTROINTESTINAL (GI) SYSTEM

1. Introduction to GI system (functional organization and principles of
regulation)
2. Gastrointestinal Hormones.
3. Principles of GI secretion; gastric function testes and pathophysiology
of peptic ulcer.
4. Pancreatic secretion and pancreatic function tests.
5. Functions of liver and pathophysiology of jaundice.
6. Biliary secretion.
7. Intestinal secretion.
8. Secretions of large intestine.
9. Introduction to gastrointestinal motility.
10. Chewing and deglutition.
11. Esophageal motility.
12. Gastric motility.
13. Small intestinal motility.
14. Motility of large intestine.
15. Principles of digestion and absorption.
144
THE RENAL SYSTEM
1. General introduction and functional anatomy of kidney.
2. Renal blood flow.
3. Glomerular filtration.
4. Tubular functions.
5. Mechanisms of urine concentration and dilution.
6. Water excretion, diuresis and diuretics.
7. Acidification of urine.
8. Kidney function tests.
9. Physiology of micturition and bladder dysfunctions.
10. Structure and functions of skin.
11. Regulation of body temperature and acclimatization to cold & hot
environments.
ENDOCRINE PHYSIOLOGY
1. Introduction to endocrinology.
2. Receptors and mechanisms of hormone action.
3. Hypothalamus and hypothalamo pituitary axis.
4. Pituitary gland:
 Introduction.
 Physiological anatomy of pituitary gland.
 Anterior pituitary hormones – physiology of growth – clinical
correlates TSH,ACTH, LH, FSH, PL hormones and functions.
 Intermediate lobe – propiomelanocortin.
 Posterior pituitary hormones synthesis, secretion, actions.
145
 Hypothalamus – hormones – functional anatomy.
 Interrelationship between hypothalamus, anterior & posterior
pituitary and target organs.
 Clinical correlation – hypo & hypersecretion.
5. The thyroid gland.
 Physiological anatomy, formation, secretion, transport and

metabolism of T3 & T4. Effects of thyroid hormone & regulation of
its secretion – hypo & hypersecretion – clinical correlation
calcitonin.
6. Parathyroid glands
 Ca. & phosphorous metabolism – bone physiology – Vit. D. &

calcitriol.
 Physiological anatomy, secretions, transport and functions of
parathormone.
 Effect of other hormones and hormonal agents on calcium
homeostasis. Hypo & hypersecretion – clinical correlation.
7. The endocrine pancreas
Pancreas:
 Introduction - islet structure – biosynthesis and secretion of insulin.
 Fate, effects, mechanism of action of insulin – clinical correlation –
hypo & hypersecretion – diabetes mellitus.
 Regulation of insulin secretion.
 Glucagon, other islet cell hormones and their effects.
146
Adrenal glands:
 Introduction
 Adrenal medulla – morphology – biosynthesis functions and
regulation of adrenal medullary hormones – pheochromocytoma.
 Adrenal cortex – structure – biosynthesis of adrenal cortical
hormones – transport, metabolism and excretion of adrenal cortical
hormones.
 Effects of adrenal androgens and estrogens.
 Glucocorticoids – physiological effects.
 Regulation of secretion.
 Mineralocorticoids – regulation of aldosterone secretion – role
played by in the regulation of salt balance.
 Adrenocortical hypo & hyperfunction in humans.
8. Minor endocrine glands:
 Kidney, pineal body, thymus, atrium of heart.

9. Local hormones:
 Bradykinin, substance P, prostaglandin, histamine, serotonin, etc.
REPRODUCTIVE SYSTEM
1. Introduction: sex differentiation and chromosomal sex in brief factors
influencing differentiation of genitalia.

2. Male gonads and genitalia – structure – gametogenesis – erection,
emission and ejaculation – semen composition endocrine function of

testis – biosynthesis, secretion and sanction and actions of hormones
147
control of testicular function – abnormalities.
3. Female gonads and genitalia – ovarian function – menstrual cycle,
hypothalamus, pituitary, ovary, uterus, vagina cyclic changes –

biosynthesis, secretion and actions of estrogens and progesterone.
4. Fertilization and conception –contraception – corpus luteum of
pregnancy – chorion and placenta – hormones – pregnancy tests –

physiology of pregnancy – labor – lactation physiology of
contraception.
THE RESPIRATORY SYSTEM
1. ORGANISATION OF RESPIRATORY SYSTEM:

 Overview of the respiratory tract mentioning the associated
structures.
 Functions of the nose in humidifying air, smell, trapping dust
particles.
 The functions of the para – nasal sinuses.
 The importance of the mucous layer overlying the respiratory
passage.
 A basic overview of the histology of the respiratory pathway.
 The structure of the bronchial tree.
o Conducting zone.
o Respiratory zones.
 Bronchial musculature. Influences of sympathetic and
parasympathetics.
 Overview of the pulmonary vasculature.
 Introduction to the lobar structure of the lungs.
148
2. VENTILATION:
2.1 MUSCLES OF RESPIRATION
 Muscles of inspiration and expiration.
 Accessory muscles of respiration.
 The normal respiratory rate.
 The importance of recognizing usage of the accessory muscles of
respiration.
2.2 RESPIRATORY PRESSURES
 Intra alveolar pressure.
 Intra pleural pressure. Emphasis on the importance of the negative
intra pleural pressure.
 Trans pulmonary pressure.
 Changes in alveolar and intra pleural pressure during respiration
 The negative intrapleural pressure as a cause for pnemothorax in
trauma, and iatrogenic cases.
2.3 AIRWAY RESISTANCE
 Site of air way resistance.
 Changes in airway resistance with inspiration and expiration.
 Role of the sympathetic and parasympathetics on bronchial tone.
2.4 COMPLIANCE
 Definition.
 Factors affecting compliance – elasticity of lung tissue and surface
tension of alveolar lining.
 Conditions of increased and decreased compliance.
2.5 SURFACE TENSION, SURFACTANT
 An introduction to surface tension in air liquid interface.
149
 Law of Laplace.
 Composition and secretion of surfactant, cells that secrete surfactant.
 Mechanism of action of surfactant.
 Functions of surfactant.
3. LUNG VOLUMES AND CAPACITIES:

 Spirogram.
 Lung volumes & capacities.
o Tidal volume.
o Inspiratory reserve volume.
o Expiratory reserve volume.
o Residual volume.
o Vital capacity.
o Functional residual capacity.
o Total lung capacity.
o Inspiratory capacity.
o Timed vital capacity and forced expiratory volumes.
 The physiological significance of the functional residual capacity.
 Changes in FEVI and FVC and the FEVI/FVC ratio in obstructive
and restrictive diseases.
4. DEAD SPACE:
 Anatomical dead space.
 Physiological dead space.
 Ventilation/perfusion ratio V/Q
 High V/Q contributing to the physiological dead space.
150
 Low V/Q effectively serving as a shunt.
5. GAS EXCHANGE:
 Fick‘s law of diffusion.
 Factors that affect rate of gas diffusion.
 Composition of atmospheric, tracheal and alveolar air.
6. TRANSPORT OF OXYGEN:
 The forms of transport of oxygen.
 The combination of oxygen with hemoglobin.
 Oxygen carrying capacity of the blood.
 Oxygen hemoglobin dissociation curve
 Sigmoid nature of the dissociation curve and the reason behind it.
 Bohr Effect.
 Hypoxia and the types of hypoxia.
 High altitude physiology.
 Cyanosis.
7. TRANSPORT OF CARBON DIOXIDE:

 Forms of transported carbon dioxide.
 Chloride shift.
 Haldane effect.
8. CONTROL OF RESPIRATION:
 Respiratory centers.
 Neural control of respiration.
151
 Chemical control of respiration.
 Central and peripheral chemoreceptors.
 Carbon dioxide as respiratory drive.
 Respiratory Alkalosis.
 Respiratory Acidosis.
9. PULMONARY CIRCULATION:
 Pressure within pulmonary blood vessels.
 Blood volume in lungs and its significances in posture.
 Hypoxic vasoconstriction.
10. EXERCISE:
 Effect of exercise on the respiratory system.
 Types of exercise – aerobic (endurance) and anaerobic (resistance)
exercises. And their benefits.
 Concept of VO2 maximum.
 The concept of oxygen debt.
11. COMMON RESPIRATORY PROBLEMS:

 An introduction to the common respiratory disease, Emphasis should
be laid on the structural and physiological changes that occur in these
diseases. A mention of major signs that are tests for in the respiratory
examination.
 Pleural effusion.
 Pneumothorax.
 Pneumonia and consolidation.
152
 COPD.
 Asthma.
 Restrictive lung diseases.
12. PULMONARY FUNCTION TESTS:

 Spirometry.
 Arterial blood gases.
13. MISCELLANEOUS:
 Definition of asphyxia and common causes.
 Physiological basis of artificial ventilation.
CARDIOVASCULAR SYSTEM
1. Functional organization of cardiovascular system.
2. Functional anatomy and innervations of heart.
3. Properties of cardiac muscle – action potential.
4. Electrophysiology of heart – origin and spread of cardiac impulse..
5. The electrocardiogram.
6. Cardiac cycle.
7. Cardiac output.
8. Heart rate and arterial pulse.
9. Principles of hemodynamics.
10. The arterial system.
11. The venous system.
12. Capillary and lymphatic circulations.
13. Blood pressure and its regulation.
153
14. Integrated regulation of cardiovascular system.
15. The regional circulations – pulmonary, cerebral, coronary, splanchnic,
cutaneous & foetal circulations.

16. Applied and clinical aspects of cardiovascular system - hypertension,
hypotension and heart failure.
CENTRAL NERVOUS SYSTEM – NEUROPHYSIOLOGY

I. FUNCTIONAL ORGANISATION OF NERVOUS SYSTEM
1. Neuron – structure, types – neuroglia – nerve degeneration,
regeneration – denervation hypersensitivity.
2. Sensory receptors – classification and function. Electrical and lonic
events in receptors – receptor potential.

3. Synapse and junctional transmission – properties. Neuro transmitters
synaptic plastically and learning.

4. Reflexes – introduction – mono and poly synapatic reflexes –
properties.
5. Spinal cord – structure – transverse section – anterior nerve root
posterior nerve root – ascending tracts, posterior column &

anterolateral system. spinocerebellar tracts.
6. Pain – types – pathway – referred pain – pain inhibiting pathways.
7. Descending tracts – pyramidal and extra pyramidal tracts – complete
section, hemisection of spinal cord.
II. SPECIAL NEUROPHYSIOLOGY:

1. Cerebral cortex – layers, lobes, methods of study, function of each
lobe.
154
2. Thalamus – thalamic nuclei, connections, functions thalamic
syndrome.
3. Basal ganglia – nuclei, connections, circuits, functions – lesions – of
basal ganglia.
4. Hypothalamus – nuclei, connections, functions - lesions –
experimental of clinical syndromes.
5. Reticular formation – ascending and descending pathways, ARAS.
6. Sleep – theories – physiological changes during sleep. REM & NREM
disorders of sleep.
7. Cerebellum – lobes – cortex, circuitry – deep nuclei, connections.
Cerebellar disorders – cerebellar function tests.

8. Vestibular apparatus – semicircular canal, otolith organs – mechanism
of equilibrium.
9. Maintenance of posture, tone, equilibrium – muscle spindle types.
10. Autonomic nervous system – functional organization.
 Sympathetic system.
 Parasympathetic system.
 Control of autonomic function.
 Autonomic dysfunction.
 Autonomic function tests.
11. Limbic system – parts, circuits, functions.
12. Higher functions – mechanism of speech – mechanism of learning –
mechanism of memory, types – conditioned reflexes.

13. C.S.F. formation, circulation, absorption, function, lumbar puncture.
155
SPECIAL SENSES
Introduction:
1. Vision – functional anatomy – aqueous humor – glaucoma. Image
forming mechanism. Refractory error. Layers of retina photoreceptors

– photochemistry of vision – light and dark adaptation. Electrical
responses, electro retinogram, visual pathway, lesions – colour vision –
movements.
2. Hearing – functional anatomy – middle ear function – cochlea –
auditory pathway – hearing defects – tests for hearing defects – tests

for hearing, audiogram.
3. Smell – receptor organ pathway.
4. Physiology of olfaction – abnormalities.
5. Taste – receptor organ and pathway
6. Physiology of taste – abnormalities.
INTEGRATED GENERAL TOPICS

1. Basic principles of acid – base homeostasis.
2. Regulation of volume, composition and osmolality of body fluid
compartments.
3. Physiology of growth and development.
4. Physiology of aging; oxidative stress; prevention of aging; and
physiology of yoga.
5. Physiology of exercise.
156
PRACTICAL PHYSIOLOGY
I. MAJOR EXPERIMENTS:
1. Erythrocyte count.
2. Leucocyte count.
3. Leucocyte differential count.
4. Eosinophil count.
5. Clinical examination of cardio vascular system.
6. Clinical examination of respiratory system.
7. Clinical examination of sensory system.
8. Clinical examination of motor system.
9. Clinical examination of 1 – 6 cranial nerves.
10. Clinical examination of 7 – 12 cranial nerves.
11. Clinical examination of superficial and deep reflexes.
12. Effect of posture / exercise on blood pressure.
II. MINOR EXPERIMENTS:

1. Estimation of hemoglobin.
2. Erythrocyte sedimentation rate.
3. Blood groups – Rh factor, ABO system.
4. Bleeding time and clotting time.
5. Respiratory efficiency test / peak flow meter.
6. Recording of respiratory movements using stethograph.
7. Cerebellar function tests.
8. Clinical examination of any one or more cranial nerves.
9. Clinical examination of superficial reflexes.
10. Clinical examination of any one or more deep reflexes.
11. Demonstration the tests for hearing.
12. Demonstrate pupillary reflexes.
157
III. CHARTS:
1. Discussion of comments – problem oriented.
2. Discussion of calculations.
Family Welfare
1. Physiology of reproduction.
2. Endocrines and regulations of reproduction in the female
3. Endocrines and physiology of reproduction in the male.
4. Physiology and Endocrinology of pregnancy, parturition and lactation.
5. Nutritional needs of mother and child during pregnancy and lactation.
6. The safe period-rhythm method of contraceptions.
7. Principles of use of oral contraceptive.
158
THEORY:
Physiology including Biophysics
PAPER – I
1. Muscle & tissue.
2. Blood.
3. Gastrointestinal physiology.
4. Excretion & body fluids.
5. Endocrinology.
6. Reproduction.
Paper – II
1. Respiration.
2. CVS.
3. Special senses.
4. CNS.
159
PASS CRITERIA:
MAXIMUM MINIMUM
Practical 80 40
Viva 20 -
------------ ------------
------------ ------------

Note:

grade card.
160
BIOCHEMISTRY
161
162
BIOCHEMISTRY
GOAL:
The broad goal of the teaching of undergraduate students in
biochemistry is to make them understand the scientific basis of the life
processes at the molecular level and to orient them towards the
application of the knowledge acquired in solving clinical problems.
OBJECTIVES:
a) KNOWLEDGE:
At the end of the course, the student should be able to:
a. Describe the molecular and functional organization of a cell and list
its subcellular components;
b. Delineate structure, function and inter-relationships of biomolecules
and consequences of deviation from normal;
c. Summarize the fundamental aspects of enzymology and clinical
application wherein regulation of enzymatic activity is altered;
d. Describe digestion and assimilation of nutrients and consequences of
malnutrition;
e. Integrate the various aspects of metabolism and their regulatory
pathways;
f. Explain the biochemical basis of inherited disorders with their
associated sequelae;
g. Describe mechanisms involved in maintenance of body fluid and pH
homeostasis;
163
h. Outline the molecular mechanisms of gene expression and regulation,
the principles of genetic engineering and their application in
medicine;
i. Summarize the molecular concepts of body defense and their
application in medicine;
j. Outline the biochemical basis of environmental health hazards,
biochemical basis of cancer and carcinogenesis;
k. Familiarize with the principles of various conventional and
specialized laboratory investigations and instrumentation analysis
and interpretation of a given data;
l. Suggest experiments to support theoretical concepts and clinical
diagnosis.
b) SKILLS:
a. Make use of conventional techniques/instruments to perform
biochemical analysis relevant to clinical screening and diagnosis;
b. Analyze and interpret investigative data;
c. Demonstrate the skills of solving scientific and clinical problems and
decision making;
c) INTEGRATION:
The knowledge acquired in biochemistry shall help the students to integrate
molecular events with structure and function of the human body in health
and disease.
164
BIOCHEMISTRY – SYLLABUS
I. CELL:
a. Sub cellular Components - Molecular and functional organization.
b. Plasma membrane, cytoplasm, nucleus and sub cellular components,
like mitochondria, endoplasmic reticulum, lysosomes, peroxisomes,
cytoskeleton, golgi apparatus etc.
II. BIOMOLECULES:
INTRODUCTION
a. Chemistry of Carbohydrates – Monosaccharides, disaccharides –
homo and hetero polysaccharides.
b. Chemistry of Lipids – Classification, fatty acids, eicosanoids and
derivatives triglycerides, phospholipids, cholesterol, and lipoprotein.
c. Nucleic acids: nucleotides – DNA & RNA structure, nucleic acid
analogues of medical importance.
d. Structure of Hemoglobin, myoglobin – structure relationship with the
function.
e. Abnormal hemoglobin, myoglobin – structural relationship with the
function.
f. Abnormal hemoglobin – congenital and acquired.
g. Vitamins and minerals – (in brief details in nutrition).
III. ENZYMES:
a. Fundamental aspects of enzymology – definition, classification,
mechanism of action, factors affecting enzyme activity – Enzyme
regulation – Coenzymes – Isozymes – enzymes of clinical
importance.
165
IV. NUTRITION:
Digestion and assimilation of nutrients:-
 Carbohydrates, proteins, lipids, vitamins and minerals.
 Nutritional requirements – RDA, SDA balanced diet and limiting
amino acid.
 Vegetarianism.
 Consequences of malnutrition Marasmus, Kwashiorkor, over
nutrition.
V. METABOLOSM AND REGULATORY PATHWAY:

1. Introduction to metabolism:
a. Emphasize the purpose of metabolism like energy production,
interconversion and synthesis of important bio molecules etc.

b. High energy compounds.
c. Biological oxidation – enzymes involved – oxidative

phosphorylation – theories – shuttles.
2. Metabolic pathway, regulation and metabolic errors:
a. CARBOHYDARATE:
 Glycolysis - HMP pathway – gluconeogenesis – uric acid pathway
– glycogen metabolism – fructose and galactose metabolism –
fructose and galactose metabolism and TCA cycle. Regulation of
blood glucose – Diabetes mellitus – Hypoglycemia – Hyper
glycaemia. Inborn errors of carbohydrate metabolism.
 Clinical important investigations pertaining to carbohydrates
metabolism – reduction test of urine, differential diagnosis for
glycosuria including chromatography. Blood sugar values, GTT,
glycosylated hemoglobin, fructosamine.
166
b. LIPID METABOLISM:
 Synthesis of fatty acid – Fatty acid oxidation – energetic of
oxidation, ketone bodies, metabolism of unsaturated fatty acids –
prostaglandin – prostacyclin – thromboxane‘s – triglycerides –
phospholipids – sphingolipids – cholesterol and its derivatives
apoproteins – fatty liver lipotropic factors.
 Clinically important investigation pertaining to lipids and
lipoproteins.
c. PROTEIN METABOLISM:
 Dynamic state of body proteins – interorgan transport of amino
acids – ammonia production – transport and body amino acid pool –
its disposal – urea cycle.
 Metabolism of individual amino acids
 Biologically important compounds obtained from amino acids
including gamma aminobutyric acid and polyamines.
 Clinically important investigations pertaining to protein metabolism
- total protein – albumin – globulin – A G ratio – serum protein
electrophoresis – blood urea – BUR – serum creatinine – urea and
creatinine clearances – amino acid chromatography for screening
inborn errors.
d. INTEGRATION OF METABOLISM:
 Main control sites of metabolic pathways and key enzymes.

 Metabolic adaptation during fed state and starvation.
 Metabolism in principal organs like liver RBC, adipose tissue,
muscle, kidney, heart and brain.
167
e. NUCLEIC ACID METABOLISM:
 Purine and pyrimidine synthesis and degradation – salvage
pathways – abnormalities of nucleic and metabolism.
f. METABOLISM OF HAEMOGLOBIN, PROPHYRIAS AND
BILIRUBINAEMIA:
 Porphyria‘s, abnormal hemoglobin and jaundice and investigations
pertaining to these disorders.
VI. GENE EXPRESSION AND REGULATION:

a. Principles of genetic engineering and their application in medicine.
Basics of genetics – chromosomal structure – arrangement of coding
sequence and genetic code.
Bio synthesis of proteins with posttranslational modification.
b. Cell cycle
DNA replication and its repair – RNA synthesis and processing
mutation.
c. Gene Expression and Regulation.
Operon concept, genetic switch – gene rearrangement – gene
amplification – gene protein interaction.
d. Genetic engineering techniques and their application in medicine.
Restriction enzymes, vectors genome library – DNA probes – Blot
transfer techniques.
Recombinant DNA technology, PCR polymerase chain reaction – clinical
application of genetic engineering.
168
VII. INBORN ERRORS:
Biochemical basis of inherited disorders with their associated sequelae.
Introduction to various types of inheritance and type of mutation defect in
relation to various inherited disorders.
a. Carbohydrates:
 Glycogen storage disease, galactosemia G6PD deficiency. Lactose
intolerance, fructose intolerance, fructosuria, pentosuria.
b. Lipids:
 Disorder of FA oxidation, Sphingolipidosis, dyslipoproteinaemias.
c. Proteins:
 Urea cycle disorder, inborn errors associated with each aminoacid.
d. Porphyria‘s, hyper bilirubinemia (congenital and acquired)
e. Hyperuricemia, gout, uretic aciduria, LESCH NYHAN syndrome.
f. Neonatal screening for and prenatal diagnosis of inborn errors.
VIII. HOMOEOSTASIS:
 Mechanism involved in the maintenance of constant composition body
fluids and normal ph.
 Metabolism of water and electrolytes homeostasis of pH – buffer
system, rote of kidney and lungs – acid base disorders.
 Blood gas analysis and its interpretation and correlation to acid base
disorders.
IX. IMMUNITY:
 Molecular concept of body defense and application in medicine.
 Immunoglobin structure, type, synthesis and function – antigen
169
binding – monoclonal anti bodies – hyper and hypo gamma
globulinaemia immunodeficiency and AIDS – biochemical methods of
assessing the immunoglobulin RIA, ELISA.
X. ENVIRONMENTAL HAZARDS AND CANCER:

a. Biochemical basis of environmental hazards – occupational hazards
(lead, organo phosphorus compounds etc). Hazards due to modern
industrialization (HS) and traffic pollution (CO) xenobiotics.
b. Biochemical basis of cancer and carcinogenesis – Tumor makers.
XI. LABORATORY INVESTIGATION:

 Principles of various conventional and specialized laboratory
investigations and instrumentation analysis and interpretation of data.
a. Principles of conventional and specialized lab investigation including
instrumentation analysis.
 Conventional:- manual colorimetric methods for biochemical
parameter (death within practical classes).
 Flame photometer.
 Spectroscopy.
 Specialized:- automated techniques semi and random auto analyser –
ELISA – RIA – fluorimeter – blood gas analyser.
 Interpretation of date:
 Normal ranges of biochemical parameters – causes for deviation
from normal.
170
XII. CLINICAL CHEMISTRY:-
Experiments to support theoretical concept and clinical diagnosis.
a. Biochemical tests to determine the functional ability of an organ – liver
function test – renal function test – pancreatic function test.
b. Investigations pertaining to hormones – mode of action of hormone
and its function - thyroid function tests - parathyroid function tests –
adrenal function tests.
c. Biochemical tests to confirm the clinical diagnosis of a diseases and
their interpretation.
d. Jaundice (hemolytic, hepatic and obstructive) cirrhosis liver – acute
renal failure, chronic renal failure, nephritic syndrome – myocardial
infarction – diabetes mellitus, (mild, moderate and severe) – renal
glycosuria – alimentary glycosuria – rickets – hypo and
hyperparathyroidism – hypo and hyperthyroidism – pancreatitis.
Metabolic acidosis }
Alkalosis} both uncompensated and compensated.
Respiratory acidosis }
Alkalosis }
171
PAPER – I
1. Molecular and functional organization of cell and its subcellular
components.
2. Chemistry, digestion, absorption and metabolism of carbohydrate and
metabolic errors.
3. Chemistry, digestion, absorption and metabolism of lipids and
metabolic errors.
4. Enzymes.
5. Vitamins.
6. Electron transport chain and biological oxidation.
7. TCA cycle and integration of metabolism.
8. Nutrition.
9. Porphyrins, Haemoglobin and bilirubin metabolism.
PAPER – II
1. Chemistry, digestion absorption and metabolism of protein and
inborn errors of metabolism.
2. Chemistry and metabolism of nucleic acids and errors of metabolism.
3. Molecular biology.
4. Water, electrolytes.
5. PH and its regulation.
6. Cancer Xenobiotics.
7. Minerals.
8. Hormones.
9. Laboratory instrumentation, investigation and interpretation.
172
PASS CRITERIA:
MAXIMUM MINIMUM
Practical 80 40
Viva 20 -
------------ ------------
------------ ------------


Note:

grade card.
173
174
PATHOLOGY
175
176
PATHOLOGY
GOAL:
The broad goal of the teaching of undergraduate student in Pathology is to
provide the students with a comprehensive knowledge of the mechanisms
and causes of disease, in order to enable him/her to achieve complete
understanding of the natural history and clinical manifestations of disease.
OBJECTIVES:
A. KNOWLEDGE:
At the end of the course, the student should be able to:-
a. Describe the structure and ultrastructure of a sick cell, mechanisms of
cell degeneration, cell death and repair and be able to correlate
structural and functional alterations.
b. Explain the pathophysiological processes which govern the
maintenance of homeostasis, mechanisms of their disturbance and the
morphological and clinical manifestations associated with it.
c. Describe the mechanisms and patterns to tissue response to injury such
that she/he can appreciate the pathophysiology of disease processes
and their clinical manifestations.
d. Correlate normal and altered morphology (gross and microscopic) of
different organ systems in common diseases to the extent needed for
understanding of disease processes and their clinical significance.
B. SKILLS:
At the end of the course, the student should be able to:-
a. Describe the rationale and principles of technical procedures of the
diagnostic laboratory tests and interpretation of the results;
177
b. Perform the simple bed-side tests on blood, urine and other biological
fluid samples;
c. Draw a rational scheme of investigations aimed at diagnosing and
managing the cases of common disorders;
d. Understand biochemical/physiological disturbances that occur as a
result of disease in collaboration with pre clinical departments.
C. INTEGRATION:
a. At the end of training he/she should be able to integrate the causes of
disease and relationship of different etiological factors (social,
economic and environmental) that contribute to the natural history of
diseases most prevalent in India.
PATHOLOGY
I. CELL INJURY AND CELLULAR ADAPTATIONS:
a. Definition, causes – Chemical agents.
Physical agents.
Radiation.
Immunology.
Infections.
Genetics.
Free radical injury.
b. REVERSIBLE AND IRREVERSIBLE CELL INJURY:
Adaptation to cell injury, atrophy, hypertrophy, hyperplasia,
metaplasia and dysplasia.
c. APOPTOSIS.
d. NECROSIS & GANGRENE.
e. INTRACELLULAR ACCUMULATION – LIPIDS, PROTEIN,
GLYCOGEN, PIGMENTS.
178
II. PATHOLOGICAL CLASIFICATION
A. INFLAMMATION:
Acute inflammation
a. Causes, signs of inflammation humoral and cellular events of
inflammation – margination chemotaxis phagocytosis, chemical
mediators.
b. Chronic inflammation.
c. Causes, macrophages in chronic inflammation – special forms,
granulomas.
B. REPAIR AND REGENERATION

a. Mechanism of repairing soft tissues, factors governing wound
healing, fracture healing.
C. CIRCULATORY DISTURBANCES
a. Hyperemia and congestion, edema, thrombosis, embolism, infarction,
shock.
D. GENETIC DISORDERS
a. Normal karyotype, mendelian disorders, autosomal recessive. X
linked disorder, cytogenetic disorders, techniques – PCR, fish.
E. IMMUNOPATHOLOGY
a. Cells of immune system – antigen, antibody, T-lymphocytes, B-
lymphocytes, T-cell receptors, primary and secondary lymphoid
organs, major histo compatibility antigen, cytokines.
b. Functional immune response – antibody production, cell mediated
immunity, non specific effector mechanism complement
macrophages.
179
F. IMMUNO DEFICIENCY DISEASE
a. Hypersensitivity reactions, auto immune diseases, amyloidosis,
principle of organ transplantation.
G. NEOPLASIA
a. Definition – nomenclature, difference between benign and malignant
neoplasm, anaplasia, rate of growth, local invasion, metastasis,
epidemiology – incidence geographic factors heredity.
b. Pre neoplastic disorders.
c. Molecular basis of cancer – oncogenes, cancer suppressor genes,
genes that regulate apoptosis, genes that regulate DNA repair.
d. Biology of tumor growth – tumor angiogenesis, tumor progress,
mechanism of invasion and metastasis vascular dissemination.
e. Carcinogenic agent – chemical carcinogenesis, physical radiation
carcinogenesis, viral and microbial carcinogenesis.
f. Tumour immunity.
g. Clinical features of tumours, effect of tumour on host, paraneoplastic
syndromes.
h. Grading and staging of tumour.
i. Lab diagnosis of cancer.
H. ENVIRONMENTAL AND NUTRITIONAL DISORDERS
a. Occupational disorders – tobacco, alcohol, drug abuse, radiation
injury vitamin deficiency, protein, calorie, malnutrition.
I. INFECTIOUS DISEASES
a. Bacterial disease – gram positive, gram negative infection, typhoid,
tuberculosis, leprosy, syphilis. Fungal infection.
b. Protozoal infection – amoeba, malaria.
c. Viral infection.
180
J. DISEASE OF INFANCY AND CHILDHOOD
a. Inborn errors of metabolism-phenyl ketonuria, galactosemia, cystic
fibrosis, childhood tumors – benign and malignant.
III. SYTEMIC PATHOLOGY

a. Blood vessels - Atherosclerosis
Arterio sclerosis
Aneurysms
Hypertensive heart disease
Valvualr heart disease
Infective endocarditis
Non bacterial endocarditis
Libman sack‘s endocarditis
Cardiomyopath/myocarditis
Pericarditis
Tumour of heart
b. LUNGS – ARDS, COPD – brochical asthma
Bronchictasis
Emphysema
c. Bacterial pneumonia – broncho pneumonia & lobar pneumonia.
Viral & mycoplasmal pneumonia lung
abscess.
d. Pulmonary tuberculosis – primary & secondary.
Interstinal pneumonia.
Pneumoconiosis.
Tumours of lung.
181
IV. GASTRO INTESTINAL TRACT
a. Barrett esophagitis.
b. Carcinoma esophagus.
c. Peptic ulcer.
d. Gastric carcinomas.
e. Malabsorption syndromes.
f. Idiopathic irritable bowel syndromes – crohns disease. Ulcerative
colitis.
g. Tumours of small & large intestine – benign and malignant.
V. LIVER, BILIARY TRACT & PANCREAS

a. Pathology of jaundice.
b. Viral hepatitis.
c. Cirrhosis.
d. Alcoholic liver disease.
e. Inborn errors of metabolism – hemochromatosis, Wilsons disease.
f. Chole cystitis.
g. Gall stones.
h. Acute pancreatitis.
i. KINNEY: acute glomerulo nephritis.
j. Nephritic syndrome.
chronic glomerulonephritis.
k. Glomerular lesions associated with systemic disease – SLE.
l. Diabetes mellitus.
m. Amyloid.
n. Diseases of tubules / interstitium – pyelonephritis.
o. Diseases of blood vessels – benign nephrosclerosis.
p. Malignant hyper tension.
182
q. Obstructive uropathy – calculi.
r. Tumours of kidney – renal calculi.
Male genital system - carcinoma penis.
Pre malignant lesions.
Tumours of testis.
Prostate tumours.
Female genital system - carcinoma cervix. CIN.
Endometrium endomemetriosis. PCO.
Tumours of body of uterus.
Ovarian tumours.
Trophoblastic disease.
Brest - tumours of breast benign and malignant.
Endocrine system - - thyroiditis, goiter, tumours, pheochromcytoma
/ Neuroblastoma, diabetes mellitus, mulitiple
endocrine neoplasia.
Skin - premalignant lesions & tumours.

Skeletal system - osteomyelitis
Bone tumours – osteoblastoma
Osteosarcoma.
Ewing‘s tumour.
Giant cell tumour.
CNS Meningitis.
Tumours – primary and
secondary.
Lymph nodes - specific and nonspecific lymphadenitis
lymphomas.
183
Spleen - causes of splenomegaly.
Postmortem - 10 autopsies.
demonstrations
VI. HEMATOLOGY
Normal development of blood cells.
RBC disorders – anaemias – classifications and lab investigations.
Iron definiency anaemia.
Sideroblastic anaemia.
Megalo blastic anaemia.
Hemolytic anaemia.
Aplastic anaemia.
Polycythemia.
WBC disorders - leucopenia.
Leukaemai/classification.
Agranulocytosis.
Leucocytosis.
Multiple myeloma.
VII. BLEEDING DISORDERS

a. Due to vessel wall abnormality.
b. Thrombocytopenia - ITP
c. Drug induced.
d. Micro angiopathy.
e. Hemolytic uremic syndrome.
f. Due to defective platelet function.
Due to abnormalities in clotting factors.
184
g. Factor VIII.
h. VON Willebrand disease.
i. Hemophilia A & B.
VIII. DISSEMINATED INTRA VASCULAR COAGULATION.
IX. PRACTICALS
Introduction to histopathology & cytopathology lab.
Introduction to museum.
Cloudy swelling kidney. Slide.
Fatty change liver specimen & slide.
Abscess liver or lung specimen & slide.
Acute appendicitis
Tuberculous granuloma
Foreign body granuloma
Granulation tissue
organizing thrombus
CVC – liver lung, spleen
Myocardial infarct
Gangrene foot
Gangrene intestine
Amyloidosis of liver spleen
kidney
Infection diseases
Inflectional diseases actinomycosis.
Madura mycosis.
TB lymph adenititis.
185
TB lung.
Amoebic abscess liver.
Ulcer intestine.
Vascular system atherosclerosis.
Artheriosclerosis.
Monkeberg‘s sclerosis.
Lung bronchiectasis – specimen & slide.
Lobar pneumonia – red
hepatization
Grey hepatisation.
Lung abscess.
Emphysema.
Pulmonary tuberculosis.
Secondary deposit - LN
Liver cirrhosis liver.
Hepatoma.
Gall bladder gall stones.
Salivary gland pleomorphic adenoma.
Gastro intestinal system gastric ulcer.
Typhoid ulcer intestine.
Amoebic ulcer.
Crohn‘s disease.
Carcinoma colon.
Benign tumours lipoma
Leiomyoma.
Capillary, cavernous angioma.
Schwannoma.
186
Cystic teratoma ovary.
Squamous papilloma.
Villous papillous.
Adenomatous polyp intestine.
Chondroma.
Malignant tumours squamous cell carcinoma.
Chondrosarcoma.
Metastatic melanoama.
Osteosarcoma.
Metastatic deposit lymph node.
Genito urinary tract cancer cervix.
Cancer endometrium.
Proliferative,secretory,
endometrium.
Ovarian tumours.
Seminoma.
Dysgerminoma.
Kidney hypernephroma.
Wilm‘s tumour.
Transitional cell carcinoma
baldder.
Breast fibroadenoma.
Infiltrating ductal carcinoma.
Endocrine colloid goiter.
Hashimotos thyroiditis.
Papillary carcinorma thyroid.
Follicular carcinoma thyroid.
187
Skin basal cell carcinoma.
Squamous cell carcinoma.
Malignant melanoma.
Bone osteomyelitis, osteosarcoma.
Giant cell tumours.
Ewing‘s tumours.
Cytology estrogenic phase.
Progestational phase.
Pregnancy smear.
CIN I, II, III.
Invasive carcinoma cervix.
Adenoma carcinoma.
FNAC positive slides.
PRACTICALS
CLINCAL PATHOLOGY CLASS SCHEDULE – 5 TH SEMESTERS.
1. Introduction to clinical pathology – sample collection,
anticoagulants.
2. Urine examination.
3. Total RBC count.
4. Total WBC count.
5. Hemoglobin estimation.
6. Packed cell volume - demonstration and discussion.
7. Different count.
8. Peripheral smear - iron deficiency anaemia.
Macrocytic anaemia.
Megalo blastic bone marrow.
188
Aplastic anaemia.
Neutrophilia.
Eosinophillia.
Lymphocytosis.
Sickle cell anemia.
Spherocytosis.
Leukemia – AML
ALL
CML
CLL
Blood parasites.
9. ESR – demonstration & discussion.

10.Blood grouping and blood banking.
11.Bleeding time, clotting time.
12.Reticulocyte – slide demonstration.
13.Osmotic fragility test – demonstration.
14.Coomb‘s test – demonstration.
15.Bone marrow biopsy – demonstration.
16.CSF examination.
17.Sputum examination.
18.Semen analysis.
19.Exfoliative cytology.
20.Instrument demonstration.
189
PASS CRITERIA:
MAXIMUM MINIMUM
Practical 80 40
Viva 20 -
------------ ------------
------------ ------------


Note:

grade card.
190
MICROBIOLOGY
191
192
MICROBIOLOGY
GOAL:
The broad goal of teaching and training the medical graduates of
modern scientific medicine in medical Microbiology/clinical microbiology
is to provide an understating of the evolution of infectious diseases in order
to deal with the etiology, pathogenesis, laboratory diagnosis, treatment and
prevention of infections in the community.
OBJECTIVES:
A. KNOWLEDGE:
At the end of the course in medical Microbiology the student will be
able to
1. List the various micro-organism, causing infections in human body
(bacteria, viruses, fungi, parasites) describe about the pathogenesis of
the diseases produced by micro-organism; and the human body‘s
reactions to such infections.
2. State the sources of infections, modes of transmission of pathogenic
microorganisms including the role of vectors in transmission of
infections.
3. Describe about the various mechanisms of immunity to infections.
4. Acquire knowledge on choosing appropriate antimicrobial agents for
treatment of infections.
5. Acquire knowledge about immunoprophylaxis and the availability of
different vaccines for prevention of diseases.
6. Apply methods of sterilisation and use of disinfectants to prevent and
control infections.
7. Recommend laboratory investigations regarding various clinical
specimens.
193
8. Acquire knowledge about the availability of rapid and molecular
techniques for diagnosis of infectious diseases.
B. SKILLS:
At the end of the course the student will be able to
 Use aseptic and sterile techniques while performing simple invasive
producers such as venepuncture.
 Choose the correct method of collection, storage and transport of
clinical material for microbiological investigations.
 Operate and use the light compound microscope
 Perform common laboratory tests for direct demonstration of
microorganisms from clinical samples and interpret their findings.
 Prepare a smear and perform gram stain
 Prepare a smear and perform Ziehl-Neelsen stain for mycobacteria
 KOH preparation for identification of fungal elements.
 Wet mount preparations for demonstration of trophozoite, ova or cysts
in fecal samples.
 Prepare and stain peripheral blood for screening microfilaria and
malarial parasites.
 Wet preparation for Trichomonas vaginalis.
 Interpret the results of microbiological tests and to correlate the
clinical manifestaitons with the etiological agents.
 Perform simple standard rapid tests for diagnosis of infectious
diseases.
C) INTEGRATION
The student will be integrated with the knowledge of infectious
diseases of national importance in relations to the clinical, epidemiological,
therapeutic and preventive aspects.
194
I. GENERAL MICROBIOLOGY
S.NO TOPICS
1. Introduction and History of Microbiology
2. Morphology of Bacteria – I
3. Morphology of Bacteria – II
4. Physiology of Bacteria
5. Sterilisation
6. Disinfection
7. Culture Media
8. Culture Methods
9. Identification of Bacteria
10. Bacterial Genetics – I
11. Bacterial Genetics – II
12. Microbial Pathogenicity (infection)
MICROBIOLOGY SYLLABUS
I. IMMUNOLOGY:
S.NO TOPICS
1. Structure and functions of immune system
2. Immunity – I
3. Immunity – II
4. Antigen
5. Antibodies – immunoglobulins
6. Antigen antibody reactions –I
7. Antigen antibody reactions – II
8. Complement system
9. Immune response
10. Hypersensitivity –I
11. Hypersensitivity – II
12. Autoimmunity
13. Immunodeficiency diseases
14. Transplantation and tumor immunity
15. Immunohaemetology
195
II. PARASITOLOGY
S.NO TOPICS
Introduction to parasitology& Entamoebia
1.
histolytica
2. Nonpathogenic and opportunistic amoebae
3. Intestinal,oral and genital flagellates
4. Trypanosomes
5. Leishmania
6. Plasmodium –I
7. Plasmodium – II
8. Toxoplasma gondii & Cryptosporidium
9. Balantidium coil
Introduction to helmints, Taenia saginata and
10.
Taenia solium
11. Hymenolepsis nana and diphylobothrium latum
12. Echinococcus granulosus
13. Schistosomes
14. Fasciola buski
15. Clonorchis sinensis & paragonimus westermani
196
III. SYSTEMATIC BACTERIOLOGY
S.NO TOPICS
1. Staphylococcus
2. Streptococcus
3. Pneumococcus
4. Neisseria
5. Corynebacterium
6. Bacillus
7. Clostridium – I
8. Clostridium – II
9. Nonsporing anaerobes
10. Enterobacteriaecae- E.coli.Klebsiella
11. Proteus and pseudomonas
12. Salmonella –I
13. Salmonella – II
14. Shigella
15. Vibrio
16. Yersinia,Pasturella
17. Haemophilus
18. Bordetella
19. Brucella
20. Mycobacterium tuberculosis - I
21. Mycobacterium tuberculosis - II
22. Mycobacterium leprae
23. Atypical mycobacteria
24. Spirochetes – I (Treponema)
25. Spirochetes – II (Borrelia & leptospira)
26. Mycoplasma, Actinomycetes
27. Miscellaneous bacteria –I
28. Miscellaneous bacteria –II
29. Rickettsiaceae
30. Chlamydia
197
II. VIROLOGY
1. General properties of viruses – I
2. Gneral properties of viruses – II
3. Virus – host interactions
4. Bacteriophage
5. Poxviruses and Adenoviruses
6. Herpes viruses
7. Picornaviruses
8. Orthomyxoviruses
9. Paramyxoviruses
10. Arboviruses – I
11. Arboviruses – II
12. Rhabdoviruses
13. Hepatitis Viruses – I
14. Hepatitis Viruses – II
15. HIV – I
16. HIV – II
17. Oncogenic viruses
18. Miscellaneous viruses
II. NEMATODES
1. Introduction to nematodes and Trichinella spiralis
2. Trichuris trichiura and Enterobius vermicularis
3. Strongyloides stercoralis
4. Ancyclostoma duodenale
5. Ascaris lumbricoids
6. Filarial nematodes – I
7. Filarial nematodes – II
198
8. Dracunculus medinensis
9. Diagnostic procedures
10. Stool examination
11. Blood examination
III. MEDICAL MYCOLOGY

1. Introduction to mycology
2. Superficial mycoses
3. Superficial mycoses
4. Systemic mycoses
5. Opportunistic mycoses
IV. CLINICAL& APPLIED MICROBIOLOGY

1. Normal microbial flora of the human body
2. Sore throat & pneumonia
3. Urinary tract infections
4. Diarrhoel diseases
5. Meningitis
6. Bacteremia,Septicemia & infective endocarditis
7. Pyrexia of unknown origin (PUO)
8. Hospital acquired infection
9. Antimicrobial sensitivity testing
10. Bacteriology of water,milk and air
11. Hospital waste management
12. Emerging bacterial infections & drug resistance
13. Emerging viral infectious diseases
14. Recent advances in diagnostic techniques in clinical
microbiology.
199
PRACTICALS:
STAINING
 Grams stain
 Special stains – Acid fast staining
APPLIED EXERCISE
SYSTEMATIC - Identification of the pathogen from the given case

history, staining property, cultural characters, biochemical and serological
test.
 IMMUNOLOG – Interpretation of the given immunological test
 Agglutination – Slide & tube agglutination
 Latex agglutination test – RA, CRP, ASO
 Precipitation – RPR, Molecular methods
 MYCOLOGY – Identification of the given fungus by cultural
morphology LCB mount
 PARASITOLOGY – Stool examination for ova & cyst saline and
iodine preparation
 SPOTTERS – Identification and interpretation
BOOKS RECOMMENDED
 Textbook of microbilogy – Ananthanaryanan and Jayaaram panicker
 Textbook of microbiology – C.P Baveja
 Parasitology – (Protozoology, helminthology in relation to clinical
medicine) -
200
 K.D. Chatterjee
 Medical Parasitology – Rajesh karyakarte & Ajit Damle
 Medical Parasitology – D.R. Arora
 Medical Parasitology – Panicker
 Essential Immunology –Ivon M. Roitt
 Medical Parasitology – Pareja
Paper - I:
1. General Microbiology
2. Immunology
3. systematic bacteriology
Paper – II:
1. Virology
2. Mycology
3. Parasitiology
4. Applied Microbiology
201
PASS CRITERIA:
MAXIMUM MINIMUM
Practical 80 40
Viva 20 -
------------ ------------
------------ ------------

Note:

grade card.
202
PHARMACOLOGY
203
204
PHARMACOLOGY
GOAL:
The broad goal of the teaching of undergraduate students in Pharmacology
is to inculcate a rational and scientific basis of therapeutics.
OBJECTIVES:
A. KNOWLEDGE
1. Describe the pharmacokinetics and pharmaccodynamics of essential
and commonly used drugs.
2. List the indications, contraindications, interactions and adverse
reactions of commonly used drugs.
3. Indicate the use of appropriate drug in a particular disease with
consideration to its cost, efficacy and safety for.
i. Individual needs
ii. Mass therapy under national health program
4. Describe the pharmacokinetic basis, clinical presentation, diagnosis
and management of common poisonings.
5. List the drugs of addiction and recommend the management.
6. Classify enviornmental and occupational pollutants and state the
management issues.
7. Indicate causations in prescription of drugs in special medical
situations such as pregnancy, lactation, ingancy and old age.
8. Integrate the concept of rational drug therapy in clinical pharmacology
205
9. State the principles underlyiing the concept of ‗Essential Drugs‘
10.Evaluate the ethics and modalities involved in the development and
introduction of new drugs.
B. SKILLS:
At the end of the course, the student be able to
1. Prescribe drugs for common ailments
2. Recognise adverse reactions and interactions of commonly used drugs
3. Observe experiments designed for study of effects of drugs, bioassay
and interpretation of the experimental data.
4. Scan information on common pharmaceutical preparations and
critically evaluate drug formulations.
C. INTEGRATION:
Practical knowledge of use of drugs in clinical departments and pre
clinical departments.
PHARMACOLOGY – SYLLABUS
PAPER: I
1. General Pharmocological principles:
2. Introduction, Routes of drug administration
3. Pharmacokinetics: Membrane transport, absorption and distribution of
drugs
206
4. Pharmacokinetics, metabolism and excretion of drugs, kinetics of
elimination
5. Pharmacodynamics: mechanism of drug action, receptor pharmacology
6. Aspects of pharmacotherapy, clinical pharmacology and drug
development.
7. Adverse drug effects
I. Drugs acting on autonomic nervous system

Cholinergic system and drugs
1. Anticholinergic drugs and drugs acting on autonomic ganglia
2. Adrenergic system and drugs
3. Antiadrenergic drugs and drugs for glaucoma
II. Autocoids and related drugs:

1. Histamine and antihistamine
2. 5-Hydroxy tryptamine, its antagonists and drug therapy of migraine
3. Prostaglandins,Leukotrines (Eicosanoids) and Platelet activation factor
4. Non- steroidal anti- inflammatory drugs and antipyretics – analgesics
5. Anti-Rheumatoid and anti-Gout drugs
III. Respiratory system drugs:

1. Drugs for cough and bronchial asthma
IV. Drugs acting on peripheral nervous system

1. Skeletal muscle relaxant
2. Local anaesthetics
207
V. Drugs acting on central nervous system
1. General anesthetics
2. Ethyl and methyl alcohols
3. Sedative – Hypnotics
4. Antiepileptic drugs
5. Anti-Parkinsonian drugs
6. Drugs used in mental illness: Antipsychotics and antimanic drugs
7. Drugs used in mental illness: Antidepressant and antianxiety drugs
8. Opioid analgesics and antagonists
9. CNS stimulants and cognition enhancers
VI. Cardiovascular Drugs

1. Drugs affecting Renin angiotensin system and plasma kinins
2. Cardia Glycosides and drugs for heart failure
3. Anti arrhythmic drugs
4. Anti angina and other anti-ischemic drugs
5. Antihypertensive drugs
6. Pharmacology of shock: plasma expanders
VII. Drug acting on kidney

1. Diuretics
2. Antidiuretics
VIII. Drugs affecting blood and blood formation

1. Haematinics and Erythropoietin
2. Drugs affecting coagulation, bleeding and thrombosis
3. Hypolipidaemic drug
208
PAPER. II
I. Hormones and related drugs
1. Anterior pituitary hormones
2. Thyroid hormones and its inhibitors
3. Insulin, Oral hypoglycemic drugs and glucagon
4. Corticosteroids
5. Androgens and drugs for erectile dysfunction
6. Oxytocin and other drugs acting on uterus
7. Drugs affecting calcium balance
II. Gastrointestinal drugs

1. Drugs for peptic ulcer
2. Drugs for emesis, reflux and digestive disorders
3. Drugs for constipation and diarrhea
III. Chemotherapy
1. Sulfonamides, cotrimoxazole and Quinolones
2. Beta lactam antibiotics
3. Tetracyclines and Chloramphenicol
4. Aminoglycosides
5. Macrolides, Lincosamide, Glycopeptide and other antibacterial
antibiotics
6. Antitubercular drugs
7. Antileprotic drugs
8. Antifungal drugs
9. Antiviral drugs
10.Antimalarial drugs
209
11.Antiamoebic and antiprotozoal drugs
12.Antihelmintic drugs
IV. Chemotherapy of Neoplastic diseases

1. Anticancer drugs
V. Miscellaneous drugs
1. Immunosuppressants, Gene therapy
2. Drugs acting on skin and mucous membranes
3. Antiseptics, Disinfectants and Ectoparasitic ides
4. Chelating agents
5. Vitamins
6. Vaccines and Sera
7. Drug interaction
Family Welfare
1. Mode of action and administration of:
a. Chemical contraceptive
b. Oral contraceptive
2. Contraindication for administration of contraceptives.
3. Toxic effects of contraceptives.
210
PASS CRITERIA:
MAXIMUM MINIMUM
Practical 80 40
Viva 20 -
------------ ------------
------------ ------------


Note:

grade card.
211
212
FORENSIC
MEDICINE AND
TOXICOLOGY
213
214
FORENSIC MEDICINE AND TOXICOLOGY
1. GOAL:
The broad goal of the teaching of undergraduate students in Forensic
medicine is to produce a physician who is well informed about medicolegal
responsibilities in practice of medicine.He/she will also be capable of
making observations and inferring conclusions by logical deductions to set
enquiries on the right track in criminal matters and conneted medicolegal
prblems. He/she acquires knowledge of law in relation to medical practice,
medical negligence and respect for codes of medical ethics.
2. OBJECTIVES:
A. KNOWLEDGE
a) Identify the basic medicolegal aspects of hospital and general practice.
b) Define the medicolegal responsibilities of a general physician while
rendering community service either in a rural primary health centre or
an urban health centre.
c) Appreciate the physician‘s responsibilities in criminal matters and
respect for the codes of medical ethics.
d) Diagnose, manage and identify also legal aspects of common acute and
chronic poisonings.
e) Describe the medicolegal aspects and findings of post-mortem
examination in case of death due to common unnatural conditions &
poisionings.
215
f) Detect occupational and environmental poisioning. Prevention and
epidemiology of common poisioning and their legal aspects
particularly pertaining to Workmen‘s compensation Act.
g) Describe the general principles of analytical toxicology
3. SKILLS:

a) Make obsevations and logical inferences in order to initiate enquiries
in criminal matters and medicolegal problems.
b) Diagnose and treat common emergencies in poisoning and manage
chronic toxicity
c) Make observations and interpret findings at postmorterm examination.
d) Observe the principles of medical ethics in the practise of his
profession
4. INTEGRATION
Department shall provide an integrated approach towards allied
disciplines like Pathology, Radiology, Forensic Sciences, Hospital
administration etc.to impart training regarding medicolegal responsibilities
of physicians at all levels of health care. Integration with relevant discipline
will provide scientific basis of clinical toxicology e.g. medicine,
pharmacology etc.
216
FORENSIC MEDICINE &TOXICOLOGY – SYLLABUS
1. Medical jurisprudence:
Legal proceducres, inquests, Subpoena –conduct money procedure of
criminal trial, recording of evidence, types of evidence, types of witness
and various courts in India.
2. Medical law and ethics:
Indian medical council, State medical council, functions and powers,

duties of registered medical practitioners, infamous conduct,
professional negligence, professional secrecy, privileged
communication.
Doctrine of rea ispa loquitor, contributory negligence
Vicarious responsibility, consent, consumer protection act.
3. Identification:
To establish the identity in the dead and living: - Race, Religion, Sex,
Age, stature, complexion and features, external familarities,
anthropometry
4. Death and its medico legal aspects (Forensic Thanatology):

Pathophysiology of death, classification and medico legal apects.
Changes following death and their medico legal significance, Estimation
of postmortem interval. Sudden death, entomology of cadaver.
5. Asphyxial Deaths:
Classification, types, hanging, strangulation, throttling, gagging,
smothering, drowning, sexual asphyxia
217
6. Mechanical Injuries:
Classification, Mechanism of wound production, types-Abraion,
contusions, incised wounds, chop wounds, stab wounds, lacerations,
medico legal importance.
Injuries by firearms –classification of firearms, characteristics of firearm
injuries, Transportation and Bomb explosion injuries.
Regional injuries, Medico legal aspects of wounds
7. Death due to electricity:
Types of fatal electrocution, mechanism of death, autopsy findings, joule

burn, judicial electrocution, lightning and mechanism of injury by it.
8. Thermal Deaths:
Classification of burns, rule of nine, age of burn injury, autopsy

findings, antemortem and postmortem differentiation of burns, scalds
and their medical aspects, hypothermia.
a) Anaesthetic and operative deaths
b) Impotence and sterility:
Definition, causes, medico legal significance
Sterilization and artificial insemination – medico legal importance
c) Virginity, pregnancy, delivery:
Definition, diagnosis, medico – legal importance
Surrogate motherhood.
d) Sexual offences:
Rape – examination of victim and the accused
Unnatural sexual offences – types
Sexual perversion – types
218
9. Abortion:
Definition- classification, methods of procuring abortion, complications,
medical termination of pregnancy act.
10. Infanticide:
Definition – classification, methods of procuring abortion,

complications, medical termination of pregnancy act.
11. Examination of blood stains, blood grouping, medico legal aspects,
DNA profiling
12. Forensic psychiatry: -
classification of unsoundness of mind and medidco legal aspects.

Delusions, Hallucination, Illusions, Impulse, Obsession, Delirium,
Restraint of the insane, civil and criminal responsibility.
13. Medico- legal autopsy:
Procedure for external, internal examination, techniques, post mortem
record,examination of bones. Exhumation – procedure.
14. Toxicology:
Classification of poisons
Diagnosis of poisoning in the living and dead
Duties of medical practitioner in suspected cases of poisoning.
15. Treatment of poisoning:
Types of poisons –corrosives, metalic, insecticides, organic irritant

poisons, somniferous poisons, inebriants, deliriants,spinal poisons, food
poisoning, cardiac poisons, asphyxiants, tear gases, drug dependence
and addiction.
219
PASS CRITERIA:
MAXIMUM MINIMUM
Theory (One Paper) 100 50
Practical 80 40
Viva 20 -
------------ ------------
------------ ------------


Note:

grade card.
220
OTO-RHINO-
LARYNGOLOGY
221
222
OTO-RHINO-LARYNGOLOGY
GOAL:
The broad goal of the teaching of undergraduate students in oto-
rhino-laryngology is that the undergraduate student have acquired adequate
knowledge and skills for optimally dealing with common disorders and
emergencies and principles of rehabilitation of the impaired hearing.
OBJECTIVES
A. KNOWLEDGE
1. Describe the basic pathophysiology of common ENT diseases and
emergencies.
2. Adopt the rational use of commonly used drugs, keeping in mind their
adverse reactions.
3. Suggest common investigative procedures and their interpretation.
B. SKILLS
1. Examine and diagnose common ENT problems including the pre-
malignant and malignant disorders of the head and neck.
2. Manage ENT problems at the first level of care and be able to refer
whenever necessary.
3. Assist/carry out minor surgical procedures like ear syringing, ear
dressings, nasal packing etc.
4. Assist in certain procedures such as tracheostomy, endoscopies and
removal of foreign bodies.
223
C. INTEGRATION:
The undergraduate training in ENT will provide an integrated
approach towards other disciplines especially neurosciences,
ophthalmology and general surgery.
OTO-RHINO-LARYNCOLOGY:
EAR
1. Surgical anatomy of ear.
2. Physiology of hearing and vestibular function.
3. Symptomatology and clinical examination and management of ear
diseases.
4. Diseases of external ear:
 Perichondritis, external otitis, foreign bodies and pre-auricular
sinuses.
5. Diseases of middle ear.
 Acute and chronic otitis media, otosclerosis.
6. Diseases of inner ear:
 Menieres disease, BPPV, Acoustic Neuroma and Labyrinthitis.
7. Complications of middle ear diseases.
8. Deafness:
 Types and causes, Deaf mutism.
9. Principles of ear surgeries.
10.Facial nerve paralysis:
 Causes and management.
NOSE AND PARANASAL SINUSES

1. Surgical anatomy and physiology of Nose and PNS.
224
2. Symptomatology, clinical examination and management of nose
diseases.
3. Diseases of external nose:
 Rhinophyma, Deformities.
4. Diseases of nasal cavity:
 Acute and chronic Rhinitis, Foreign bodies, Rhinolith,
Granulomatous Disease of nose, Atrophic Rhinitis, CSF
Rhinorrhoea.
5. Diseases of nasal septum:
 Septal deviation, perforation, hematomas and abscess.
6. Epistaxis:
 Causes and management.
7. Allergic Rhinitis and vasomotor rhinitis.
8. Acute and chronic sinusitis.
9. Nasal polyposis.
10.Benign and malignant tumor of nose and PNS.
THROAT
1. Symptomatology, clinical features and management of throat diseases.
2. Pharynx:
 Nasopharynx – adenoids, juvenile nasopharyngeal angiofibroma.
 Oropharynx – acute and chronic tonsillitis, acute and chronic
pharyngitits, membranous lesions of tonsils.
 Hypopharynx – plummer Vinson syndrome.
 Dysphagia : causes and management.
 Benign and malignanat lesions of pharynx.
225
3. Larynx:
 Acute and chronic laryngitis, hoarseness of voice, stridor,
differential diagnosis of respiratory obstructions, vocal cord polyps
and nodule.
 Benign and malignant lesions of larynx.
4. Neck:
 Neck swelling, diseases of salivary glands.
 Tracheostomy – indications and complications.
 Diseases of oesophagus: strictures, malignancy and foreign bodies,
airway foreign bodies.
226
PASS CRITERIA:
MAXIMUM MINIMUM
Practical 80 40
Viva 20 -
------------ ------------
------------ ------------


Note:

grade card.
227
228
OPHTHALMOLOGY
229
230
OPHTHALMOLOGY
GOAL:
The broad goal of the teaching of students in ophthalmology is to
provide such knowledge and skills to the students that shall enable him to
practice as a clinical and as a primary eye care physician and also to
function effectively as a community health leader to assist in the
implementation of National Programme for the prevention of blindness and
rehabilitation of the visually impaired.
OBJECTIVES
A. KNOWLEDGE
At the end of the course, the student should have knowledge of:
a. Common problems affecting the eye:
b. Principles of management of major ophthalmic emergencies
c. Main systemic diseases affecting the eye
d. Effects of local and systemic diseases on patient's vision and the
necessary action required to minimize the sequalae of such diseases;
e. Adverse drug reactions with special reference to ophthalmic
manifestations;
f. Magnitude of blindness in India and its main causes;
g. National programme of control of blindness and its implementation at
various levels
h. Eye care education for prevention of eye problems
i. Role of primary health centre in organization of eye camps
j. Organization of primary health care and the functioning of the
ophthalmic assistant.
231
k. Integration of the national programme for control of blindness with the
other national health programmes;
l. Eye bank organization
B. SKILLS:
a. Elicit a history pertinent to general health and ocular status;
b. Assist in diagnostic procedures such as visual acuity testing,
examination of eye, Schiotz tonometry, Staining for Corneal
pathology, confrontation perimetry, Subjective refraction including
correction of presbyopia and aphakia, direct ophthalmoscopy and
conjunctival smear examination and Cover test.
c. Diagnose and treat common problems affecting the eye;
d. Interpret ophthalmic signs in relation to common systemic disorders;
e. Assist/observe therapeutic procedures such as subconjunctival
injection, Corneal/Conjunctival foreign body removal, Carbolic
cautery for corneal ulcers, Nasolacrimal duct syringing and
tarsorraphy;
f. Provide first aid in major ophthalmic emergencies;
g. Assist to organise community surveys for visual check up;
h. Assist to organise primary eye care service through primary health
centres;
i. Use effective means of communication with the public and individual
to motivate for surgery in cataract and for eye donation;
j. Establish rapport with his seniors, colleagues and paramedical
workers, so as to effectively function as a member of the eye care
team.
232
C. INTEGRATION
The undergraduate training in Ophthalmology will provide an integrated
approach towards other disciplines especially neurosciences, Otorhino-
laryngology, General Surgery and Medicine.
OPHTHALMOLOGY
SYLLABUS
1. Conjunctival infection, allergy, pterygium, xerophthalmia.
2. Aetiology, clinical features, complications and treatment of corneal
ulcers, keratomalacia and other sclera and corneal inflammations.
3. Eye donation, eye bank, cornea transplant.
4. Anatomy of eye lids and its disorders.
5. Anatomy of lacrimal passage and obstructive disorders.
6. Classification of cataract, investigation, management and complication
of cataract surgery.
7. Classification, aetiology, clinical features, complications and
management of various forms of uveitis.
8. Classification, aetiology, clinical features and management of various
glaucomas.
9. Differential diagnosis of red eye.
10.Optics and refractive errors.
11.Eye injuries.
12.Etiology, fundus picture, management of papilloedema and optic
neuritis.
13.Proptosis.
14.Retinal changes in HTN, DM, and AIDS.
15.Ocular manifestation of systemic diseases including diabetes,
hypertension, tuberculosis, leprosy, anaemia and pregnancy induced
hypertension.
233
16.Types of blindness and their causes.
17.Ocular side effects of systemic drugs.
18.Objective of national programmes of prevention and control of
blindness and trachoma control programme.
19.Retinal vascular occlusion, inflammation, detachmu and degeneration.
20.Aetiology, clinical features and principals of treatment of vitreous
diseases eg. Hemorrhage, degeneration, liquefaction, endophthalmitis.
21.Ocular manifestations of common neurological disorders.
22.Aetiology, symptoms, diagnosis and principles of treatment of
strabismus.
23.Recent advances in ophthalmology – types and scope of lasers and
imaging procedures, intraocular lens implantation.
234
PASS CRITERIA:
MAXIMUM MINIMUM
Practical 80 40
Viva 20 -
------------ ------------
------------ ------------

Note:

grade card.
235
236
COMMUNITY
MEDICINE
237
238
COMMUNITY MEDICINE
Teaching of Community Medicine is started in Phase – I –Pre-clinical
course (60hrs). The teaching will continue during Phase. II & III. The
detailed syllabus is outlined below.
I. GOAL:
The broad goal of the teaching of undergraduate students in Community
Medicine is to prepare them to function as community and first level
physicians in accordance with the institutional goals.
II. OBJECTIVES
1. KNOWLEDGE
At the end of the course, the student should be able to :-
 Describe the health care delivery system including rehabilitation of the
disabled in the country;
 Describe the National Health Programmes with particular emphasis on
 maternal and child health programmes, family welfare planning and
population control.
 List epidemiological methods and describe their application to
communicable and non-communicable diseases in the community or
hospital situation.
 Apply biostatistical methods and techniques;
 Outline the demographic pattern of the country and appreciate the roles
of the individual, family, community and socio-cultural milieu in
health and disease.
 Describe the health information systems.
239
 Enunciate the principles and components of primary health care and
the national health policies to achieve the goal of 'Health for All'.
 Identify the environmental and occupational hazards and their control.
 Describe the importance of water and sanitation in human health.
 To understand the principles of health economics, health
administration, health education in relation to community
III. SKILLS
At the end of the course, the student should be able to :-
1. Use epidemiology as a scientific tool to make rational decisions
relevant to community and individual patient intervention.
2. Collect, analyse, interpret and present simple community and hospital
based data.
3. Diagnose and manage common health problems and emergencies at
the individual, family and community levels keeping in mind the
existing health care resources and in the context of the prevailing
socio-cultural beliefs.
4. Diagnose and manage maternal and child health problems and advise a
couple and the community on the family planning methods available in
the context of the national priorities.
5. Diagnose and manage common nutritional problems at the individual
and community level.
6. Plan, implement and evaluate a health education programme with the
skill to use simple audio-visual aids.
7. Interact with other members of the health care team and participate in
the organisation of health care services and implementations of
national health programmes.
240
IV. INTEGRATION ;
Develop capabilities of synthesis between cause of illness in the
environment or community and individual health and respond with
leadership qualities to institute remedial measures for this.
COMMUNITY MEDICINE SYLLABUS

SYLLABUS – THEORY PAPER – I
CHAPTER I. EVOLUTION OF COMMUNITY MEDICINE & BASIC
CONCEPTS IN HEALTH AND DISEASE:
1. History background: hygiene, public health, preventive medicine,
social medicine & community medicine.
2. Definition of health; appreciation of health as a relative concept;
determinants of health, dimensions of health, ecology of health,
positive health.
3. Characteristics of agent, host and environmental factors in health and
disease and the multifactorial etiology of disease, spectrum of health
and disease.
4. Various levels of prevention with appropriate examples.
5. Indices used in measurement of health.
6. Difficulties in measurement of health.
CHAPTER II. DEMOGRAPHY:
1. Definition of demography.
2. Stages of the demographic cycle and their impact on the population.
3. Definition, calculation and interpretation of demographic indices like
birth rate, death rate, growth rate, and fertility rates.
4. Health situation in India: demography, mortality and morbidity profile
and the existing facilities in health services.
241
CHAPTER III. PRIMARY HEALTH CARE:
1. Salient features of the national health policy:
a) Provision of medical care;
b) Primary health and health for all.
c) Health manpower development.
d) Planned development of health care facilities;
e) Encouragement of indigenous system of medicine.
f) Recommendations of health committees.
2. Process of health care delivery in India.
3. The health system and health infrastructure at center, state and district
levels.
4. The inter relationship between community development block and
primary health center.
5. The organization, functions and staffing pattern of community health
centers, primary health centers and sub-centers.
6. The job descriptions of health supervisor (male and female) health
workers; village health guide, anganwadi workers, traditional birth
attendants.
7. The activities of the health team at the primary health center.
CHAPTER IV. SOCIAL AND COMMUNTIY HEALTH:
1. Conduct clinic-social evaluation of the individual in relation to social,
economic and cultural aspects; educational and residential background;
attitude towards health, diseases health services; the individual‘s
family and to the community.
2. Assessment of barriers to good health, to recovery from sickness and
to leading a socially and economically productive life.
3. Development of a good doctor – patient relationship.
242
4. Identification of social factors related to health and disease in the
context of urban and rural societies.
5. Impact of urbanization on health and disease.
6. Planning, collecting, analyzing and interpreting data to reach a
community diagnosis. Planning an intervention programmes with
community participation based on the community diagnosis.
CHAPTER V. HEALTH EDUCATION:
1. Effective communication with individuals, family and community
using tools and techniques of information, education and
communication.
2. Barriers to effective communication.
3. Principles, methods and evaluation of health education.
4. Methods of health education – their advantage and disadvantages.
5. Selection and use of appropriate media (simple audiovisual aids) for
affective health education.
6. Identification of missed opportunities for implementation of health
education activities for individual, family and the community.
CHAPTER VI. ENVIRONMENT & HEALTH:
1. Introduction to environment.
2. Sources of water pollution.
3. Water purification. Water quality, WHO – standers, surveillance of
drinking water quality. Horrock‘s Test. Water sampling.
4. Air pollution. Indicates of thermal comfort. Monitoring air pollution.
Control and prevention of air pollution.
5. Standards of ventilation & good lighting.
6. Noise pollution and control.
7. Radiation sources and control.
243
8. Air temperature measurement. Heat stress indices, effects and control,
cold stress. Humidity precipitation.
9. Housing standards.
10.Solid & liquid wastes disposal, modern sewage treatment.
CHAPTER VII. PUBLIC HEALTH ENTOMOLOGY:
1. Role of vectors in the causation of disease.
2. Indentifying features of and mode of transmission of vector borne
diseases.
3. Methods of vector control with advantages and limitations of each.
4. Mode of action, dose and application cycle of commonly used
insecticides.
5. Steps of management of a case of insecticide toxicity.
CHAPTER VIII. NUTRITION & HEALTH:
1. Common sources of various nutrients and special nutritional
requirement according to age, sex, activity & physiological condition.
2. Nutritional assessment of individual, family and the community by
selecting and using appropriate methods such as anthropometrics,
clinical , dietary, laboratory techniques.
3. Compare recommended daily allowances (RDA by ICMR) of
individuals and families with actual intake.
4. Plan and recommend a suitable diet for the individuals and families
bearing in mind local availability of foods, economic status etc.
5. Common nutritional disorders: protein energy malnutrition, vit. A
Deficiency, Anaemia, Iodine deficiency disease, flurosis, food toxins –
diseases and their control and management.
6. National programmes in nutrition.
244
CHAPTER IX. PRINCIPLES OF EPIDEMIOLOGY:
1. Aims of epidemiology.
2. Basic measurements in epidemiology.
3. Epidemiological methods.
4. Association and causation of disease.
5. Uses of epidemiology.
6. Investigation of epidemic.
7. Diseases prevention and control.
8. Epidemiology problems.
CHAPTER X. SCREENING FOR DISEASES:
1. Concept of screening.
2. Uses of screening.
3. Criteria for screening.
4. Accuracy and clinical value of diagnostic and screening test –
sensitivity, specificity, predictive value, problem of borderline values.
CHAPTER XI. MEDICAL STATISTICS:
1. Health information systems.
2. Elementary statistical methods.
3. Statistical averages.
4. Measures of dispersion.
5. Chi – square test.
6. Correlation and regression.
7. Statistical problems.
CHAPTER XII. FAMILY WELFARE:
1. Reasons for rapid population growth in India.
2. Need for population control measures and the national population
policy.
245
3. Different family planning methods and their advantages and
shortcoming. Recent advances in contraception.
4. Motivating a couple to select the appropriate family planning methods.
5. Medical termination of pregnancy act.
6. National family welfare programmes.
CHAPTER XIII. EPIDEMIOLOGY OF SPECIFIC DISEASES:
1. Epidemiology of communicable diseases:
Eruptive fevers – smallpox, chickenpox, measles, rubella, mumps,
influenza, diphtheria, whooping cough, meningococcal meningitis,
acute respiratory infections, SARS, tuberculosis, poliomyelitis, viral
hepatitis, cholera, acute diarrhoeal diseases, typhoid fever, food
poisoning, amoebiasis, ascariasis, hookworm infection, dracunculiosis,
dengue syndrome, malaria, filariasis, rabies, yellow fever, Japanese
encephalitis, KFD, brucellosis, leptospirosis, plague, human
salmonellosis, ricketsial zoonoses, scrub typhus, Q fever, taeniasis,
hydatid disease, leishmaniasis, trachoma, tetanus, leprosy, STD, yaws
and AIDS, I.B. epidemiology of chronic and noncommunicable
disease: cardiovascular disease, coronary heart disease, hypertension,
stroke, rheumatic heart disease, cancer, diabetes, obesity, blindness,
accidents and injuries.
2. Epidemiology of chronic and noncommunicable diseases:
cardiovascular diseases, coronary heart disease, hypertension, stroke,
rheumatic heart diseases, cancer diabetes, obesity, blindness, accidents
and injuries.
3. Epidemiology of emerging and reemerging diseases.
4. Extent of the problem, epidemiology and nature history of the disease.
246
5. Relative public health importance of particular diseases in a given area.
6. Influence of social, cultural and ecological factors on the epidemiology
of the disease.
7. Control of communicable and non-communicable disease.
a. Diagnosing and treating a case and in doing so demonstrate skills
in:
 Clinical methods.
 Use of essential laboratory techniques.
 Selection of appropriate treatment regimes.
 Follow – up of cases.
b. Principles of planning, implementing and evaluating control
measures for the diseases at the community level bearing in mind
the relative importance of the disease.
8. Institution of programmes for the education of individual and
communities.
9. Investigating a disease epidemic.
10.Principles of measures to control a disease epidemic.
11.Level of awareness of causation and prevention of disease amongst
individuals and communities.
CHAPTER XIV. MATERNAL AND CHILD HEALTH:
1. Need for specialized services for these groups.
2. Magnitude of morbidity and mortality in these groups in a given area.
3. Local customs and practices during pregnancy, childbirth and
lactation.
247
4. Concepts of ‗high risk‘ and ‗MCH packages‘ child survival and safe
motherhood, integrated child development scheme and other existing
regional programme.
5. Under – 5: morbidity, mortality, high risk and care.
6. Monitoring of growth and development and use of road to health chart.
7. Organization, implementation and evaluation of programmes for
mother and children as per national programme guidelines; supervising
health personnel; maintaining records; performing a nutritional
assessment; promoting breast feeding.
SYLLABUS – THEORY PAPER: II
CHAPTER XV. GENETICS AND COMMUNITY HEALTH:
1. Basic principles of genetics.
2. Chromosomal disorders.
3. Genetic predisposition in common disorders.
4. Advances in molecular genetics.
5. Preventive and social measures – eugenics & euthenics, genetic
counseling.
6. Early diagnosis, treatment and rehabilitation.
CHAPTER XVI. SCHOOL HEALTH AND ADOLECENT HEALTH:
1. Objectives of the school health programme.
2. Activities of the programme like carrying out periodic medical
examination of the children and the teachers.
3. Immunization of the children in the school.
4. Health education.
5. Mid day meals.
248
6. Participation of the teachers in the school health programme including
maintenance of records.
7. Defining healthful practices.
8. Early detection of abnormalities.
9. Care of the adolescent girl and boys.
CHAPTER XVII. COMMUNITY GERIATRICS:
1. Common diseases of the elderly.
2. Prevention of degenerative diseases – role of exercise, nutrition, life
style, etc.
3. Osteoporosis and arthrosis – effects of immobility – prevention of
contractures and bed sores.
4. Economic and psychosocial needs of the ages.
5. Care of elderly in organized and unorganized sectors.
6. Role of health visitor and social worker.
7. Social problems in the elderly – joint family; day care center and day
hospital; home for the aged – care given.
CHAPTER XVIII. MENTAL HEALTH:
1. Importance of mental health.
2. Types of mental illness and causes.
3. Preventive aspects.
4. Mental health services.
5. Alcoholism, drug dependence.
CHAPTER XIX. HEALTH PLANNING IN INDIA:
1. Health care system.
2. Levels of health care.
3. Primary health care in India.
4. PHC & community health care.
5. Health for all goals.
249
6. Health problems of India.
7. National health policy.
8. Health insurance.
9. Health planning in India.
CHAPTER XX. PUBLIC HEALTH ADMINISTRATION &
MANAGEMENT:
1. Explain the terms: public health, public health administration, and
regionalization, comprehensive medical care, delivery of health care,
planning, management, and evaluation.
2. Salient features of the national health policy.
a. Provisional of medical care.
b. Primary health care and health for all.
c. Health manpower development.
d. Planned development of health care facilities.
e. Encouragement of indigenous systems of medicine.
f. Recommendations of health committees.
3. Process of health care delivery in India.
4. Management techniques: define and explain principles of management.
Explain the three broad functions of management (planning,
implementation and evaluation) and how they relate to each other.
5. Appreciate the need for international health regulation and disease
surveillance.
6. Constitutional provisions for health in India: enumerate the three major
divisions of responsibilities and functions (concerning health) of the
union and the state governments.
250
CHAPTER XXI. OCCUPATIONAL HEALTH:
1. Relate the history of symptoms with the specific occupation including
agriculture.
2. Employees stat insurance scheme.
3. Identification of the physical, chemical and biological hazards to
which workers are exposed while working in a specific occupational
diseases.
4. Diagnostic criteria of various occupational diseases.
5. Preventive measures against these diseases including accident
prevention.
6. Various legislations in relation to occupational health.
CHAPTER XXII. URBAN HEALTH:
1. Common health problems (medical, social, environmental economic,
psychological) of urban dwellers – health problems due to urbanization
& industrialization.
2. Organization of health services for slum dwellers.
3. Organization of health services in urban areas.
CHAPTER XXIII. ESSENTIAL MEDICINE AND COUNTERFEIT
MEDICINES:
1. WHO model list of essential medicine.
2. Monitoring medicine safety and pharmacovigilance.
3. Counterfeit medicine, site.
4. Quality control in drug sector in India.
CHAPTER XXIV. INTERNALTIONAL HEALTH SYSTEMS:
1. Historical development of health organization.
2. Appreciate the role of national and international voluntary agencies in
health care delivery.
3. Health work of bilateral agencies.
251
4. Nongovernment & other voluntary agencies.
5. WHO & U.N. agencies.
6. International health regulations.
7. International classifications of diseases.
CHAPTER XXV. MEDICAL ETHICS & HEALTH LEGISLATION
SALIENT PROVISIONS OF OTHER ACTS ON HEALTH:
1. Hippocratic oath.
2. Physician‘s IMA oath.
3. Provisions of T.N. public health Act 1939.
4. The preconception & pre – Natal diagnostic techniques Act 2000.
5. The prevention of food adulteration Act 1954.
6. The Birth & Death registration Act 1969.
7. The ESI Act 1948.
8. The MTP Act 1971
9. The factories Act 1948.
CHAPTER XXVI. DISASTER MANAGEMENT:
1. Disaster Impact.
2. Disaster response.
3. Epidemiological surveillance and disease control.
4. Disaster preparedness.
5. Disaster mitigation.
CHAPTER XXVII. NATIONAL PROGRAMMES IN INDIA.
1. Epidemiological basis of national health programmes.
2. Policy guidelines of GOI under different National Heath Programmes.
3. Organizational set up under each programme.
4. Activities that are to be carried out under each programme.
5. Monitoring Indicators for each programme.
252
CHAPTER XXVIII. BIOMEDICAL WASTE MANAGEMENT:
1. Bio-medical waste (management and handling) rules 1998 of India.
2. Sources of health care waste.
3. Health hazards of health care waste.
4. Collection, storage & transportation of health care wastes.
5. Treatment & disposal technologies of health care wastes.
CHAPTER XXIX. HEALTH ECONOMICS:
1. Basic concepts.
2. Poverty line.
3. GDP & GNP.
4. Costs, CBA, CEA.
5. Budget.
6. Health Financing.
7. Cost of medical care.
8. Medical quality & medical audit.
253
SKILLS
ABLE TO ABLE TO
DO PERFORM
SKILLS ASSIST OBSERVE
INDEPEN UNDER
DENTLY GUIDANCE
GENERAL SKILLS:
THE STUDENT
SHOULD BE ABLE TO:
1. Elict clinic-social
history. Describe agent, 
host and environmental
factors determining
health and disease.
2. Indentify, prioritize and
manage common health 
problem of community.
3. Apply elementary
principles of
epidemiology in 
carrying out simple
epidemiological studies.
4. Work as a team member

in rendering health care.
5. Carry out health
promotion and

education effectively in
the community.
254
SKILLS IN RELATION
TO SPECIFIC TOPIC:
1. COMMUNICATION:
 Should be well versed

with the art of
interviewing techniques
to elicit the desired
information.
 The student should be
able to communicate
effectively with family

members at home,
patients at clinics or at
home; and community.
 Individuals, family or a
group for health
promotion and 
education, and also with
peers.
2. TEAM ACTIVITY:
 Work as an effective
member of the team; in
planning and carrying 
out field work like
school health, conduct
health camps etc.
255
3. ENVIRONMENTAL
SANITAION:
 Able to assess

environmental risk
factors and suggest
action plan.
 Able to collect water
and stool sample for

microbiological
analysis.
 Able to identify insects
of public health

importance, able to use
effective insecticides.
4. COMMUNICABLE
AND NON-
COMMUNICABLE
DISEASE: 
 Eliciting clinic-social
history and examination
the patient for diagnosis
and treatment.
 Assessing the severity
and /or classifying
dehydration in diarrhea,
upper respiratory tract
infection, dog bite, 
leprosy, classify
tuberculosis
(categorization) and
STD.
 Fixing, staining and 
256
examining peripheral
smear for malaria,
sputum for AFB,
hemoglobin estimation,
urine and stool
examination.
 Adequate and
appropriate treatment
and follow up of public

health diseases and of
locally endemic
diseases.
 Advice regarding
prevention and
prophylaxis against 
common and locally
endemic diseases.
 Use of proper screening
methods in early
diagnosis of certain 
diseases, applicable at
primary care level.
 Able to detect outbreak
in early, sport mapping,
investigation of 
outbreak, notification of
modifiable diseases.
 Surveillance skills

development,
257
calculating various
health indicators and
their interpretations.
5. REPRODUCTIVE
AND CHILD
HEALTH:
 Antenatal – examination 
of women, application
of at-risk approach in
antenatal care.
 Intranatal care –
conducting a normal

delivery, referral
indications.
 Postnatal – assessment
of newborn and mother,
promotion of Brest

feeding, advice on
weaning and on family
planning.
 Immunization – able to
immunize the eligible

using desired routes, for
providing vaccines.
 Contraception - able to
advice appropriate 
contraceptive methods.
258
 Able to insert any intra

uterine device (IUD)
6. STATISTICS:
 Able to draw sample

using simple sampling
techniques.
 Apply appropriate test

of significance.
 Calculation of various
health indicators and 
presentation of data.
7. NUTRITION:
 Conduct complete
nutritional assessment of

individual using clinical,
anthropometric and diet
survey tools.
 Ability to use and
interpret road to health 
card.
 Advice appropriate
balance diet and suggest

and dietary
modification.
 Nutritional promotion
and education to specific
group and related to
specific nutritional
diseases.
259
8. OCCUPATION
HEALTH:
 Screening of workers for 
any occupation related
health problem.
9. MANAGERIAL
SKILLS:
 Able to make 
community diagnosis
and take.
TOPICS FOR INTEGRATED TEACHING WITH DEPATMENT OF

COMMUNITY MEDICINE AS PARTICIPANT:
1. Nutrition.
2. Iron deficiency anemia.
3. Communicable diseases with national Health Programme like.
 HIV/AIDS.
 Tuberculosis.
 Malaria.
 Polio.
 Diarrhoeal diseases.
 Leprosy.
 Zoonotic diseases.
4. Lifestyle related diseases with preventive aspects lie.
 Diabetes.
 Hypertension.
 Stroke.
 Obesity.
 Cancers.
260
5. Jaundice.
6. Alcoholism.
7. Death and dying.
8. Geriatric medicine.
9. Adolescent health.
10.Rational drug use.
11.Contraception.
12.Industrial health.
13.Ethical issues.
LEARNING RESOURCES MATERIALS:

Test books, reference books, practical note books, internet resources, video
films etc.
RECOMMENDED BOOKS IN COMMUNITY MEDICINE:

1. Text book of preventive and social medicine by k park 19th edition.
2. Test book of preventive and social medicine by Gupta & Ghai.
3. Test book of preventive and social medicine by Gupta & Mahajan.
4. Essential of community medicine by Suresh Chandra.
5. Introduction to Biostatistics by Sathya Swaroop.
6. National Health Programme by Jugal Kishor.
7. National Health Programme by D K Taneja.
SUGESTED TOPICS FOR LEARNING THROUGH E – MODULES:

1. History of Medicine and public health.
2. Environmental health.
3. Nutrition (except public health nutritional program).
4. Epidemiological methods.
5. Screening.
261
6. Planning cycle.
7. Health management techniques.
8. Entomology.
9. Biostatistics.
10.Demography.
11.Disaster management.
12.Bio-medical waste management.
13.International health.
14.National health organizations.
FIELD VISITS FOR UNDERGRADUATE MEDICAL STUDENTS:

1. Sub center, primary health center and community health center/ district
hospital.
2. Anganwadi centre.
3. Water and sewage treatment plant.
4. Industrial visit.
5. Family health advisor services*.
6. Clinic-social case review*.
7. Infectious diseases hospital.
8. DOTS center.
9. Malaria clinic.
10.School health.
 Family and hospital visits are for development of various skills in
community and hospital setting.
METHOD OF ASSESSMENT:
Modified essay question, short answer questions, MCQs, problem solving
exercises, OSCE, OSPE, Epidemiological Exercise, Record review,
checklist. Research project reports and oral viva voce.
262
TEACHING LEARNING METHODS:
Structured interative sessions, small group discussion, focused group
discussion (FGD), participatory learning appraisal (PLA), family and
community visits, institutional visits, practical including demonstrations,
problem based exercises, video clips, written case scenario, self learning
tools, interactive learning and e- modules.
LEARNING RESOURSE MATERIALS:

Examination of community medicine should be at the end of 7 th semester
and formative and summative assessment during internship so that we have
a basic doctor competent to provide primary care.
Family Welfare
1. The need for family welfare Planning.
2. Organization of Family Welfare Planning service.
3. Health Education in relating to Family Welfare Planning.
4. Nutrition.
5. Psychological needs of the mother, the child and the family.
6. Demography and vital Statistics.
263
PASS CRITERIA:
MAXIMUM MINIMUM
Practical 80 40
Viva 20 -
------------ ------------
------------ ------------


Note:

grade card.
264
MEDICINE &
ALLIED SUBJECTS
265
266
GENERAL MEDICINE
GOAL :
The broad goal of the teaching of undergraduate students in Medicine
is to have the knowledge, skills and behavioral attributes to function
effectively as the first contact physician.
OBJECTIVES
A. KNOWLEDGE
1. diagnose common clinical disorders with special reference to
infectious diseases, nutritional disorders, tropical and environmental
diseases.
2. outline various modes of management including drug therapeutics
especially dosage, side effects, toxicity, interactions, indications and
contra-indications.
3. propose diagnostic and investigative procedures and ability to interpret
them.
4. provide first level management of acute emergencies promptly and
efficiently and decide the timing and level of referral, if required.
5. recognize geriatric disorders and their management.
B. SKILLS
1. develop clinical skills (history taking, clinical examination and other
instruments of examination) to diagnose various common medical
disorders and emergencies.
267
2. refer a patient to secondary and/or tertiary level of health care after
having instituted primary care.
3. perform simple routine investigations like haemogram, stool, urine,
sputum and biological fluid examinations.
4. assist the common bedside investigative procedures like pleural tap,
lumbar puncture, bone marrow aspiration/biopsy and liver biopsy.
C. INTEGRATION
1. with community medicine and physical medicine and rehabilitation to
have the knowledge and be able to manage important current national
health programs, also to be able to view the patient in his/her total
physical, social and economic milieu.
2. with other relevant academic inputs which provide scientific basis of
clinical medicine e.g. anatomy, physiology, biochemistry,
microbiology, pathology and pharmacology.
GENERAL MEDICINE – SYLLABUS
A. CLINICAL METHODS IN THE PRACTICE OF MEDICINE
1. clinical approach to the patient: the art of medicine , doctor – patient
relationship, communication skills and doctors responsibilities and

medicolegal aspects and litigation.
2. Clinical approach to disease and care of patient; Diagnostic
possibilities based on interpretation of history, physical findings and

laboratory investigations and principles of rational management.
268
B. COMMON SYMPTOMS OF DISEASE
1. Pain , Pathophysiology, clinical types, assessment and management
2. Fever: Pathophysiology of heat regulation, its disturbances, clinical
types, clinical assessment and management

3. Cough, expectoration and haemoptysis
4. Dyspnoea, tachypnoea,and cyanosis
5. Common Urinary symptoms including dysuria, oliguria nocturia
polyuria incontinence and enuresis

6. Oedema and anasarca
7. Shock and cardiovascular collapse
8. Palpitation and its causes
9. Anorexia, nausea and vomiting
10. Constipation and diarrhea
11. Haematemesis, malena and haematochezia
12. Jaundice and hepatomegaly splenomegaly
13. Abdominal distension and ascites
14. Weight loss and wight gain
15. Fainting, syncope and seizures; headache, dizziness and vertigo
16. Paralysis, movement disorders and disorders of gait and paraesthesia.
17. Coma and other disturbances of consciousness
18. Pallor and bleeding, various types of anaemia
19. Enlargement of lymp nodes and spleen
20. Joint pains and pain in the extremities and back
21. Importance of getting Rheumatic fever history
269
NUTRITION/EXPOSURE TO PHYSICAL AND CHEMICAL
AGENTS
Nutriton in clinical medicine and dietary management
1. Nutritional requirements
2. Protein calorie malnutrition in adults
3. Obesity
4. Vitmain deficiency and excess
5. Acute and chronic effects of alcohol and their management
6. Venoms, stings, insect bites: poisonous snakes, and scorpions
7. Disturbances of temperature: heat stroke, exhaustion and cold exposure
8. Drowning, electrocution and radiation hazards
TOXICOLOGY
1. Introduction and general measures of management of poisoning
2. Barbiturate poisoning
3. Organophosphorous poisoning
4. Aluminium phosphide poisoning
5. Lead poisoning, Arsenic poisoning
6. Carbon monoixide poisoning, MIC poisoning
7. Copper sulphate and yellow oleader poisoning
8. Chelating agents
9. Drug over dosage
270
INFECTIONS
Approach to infectious diseases – diagnostic and therapeutic
principles. General Principles of rational use of antibiotics and other
chemotherapy against the following:
1. Common gram positive infections
2. Common gram negative infection
3. Enteric fever
4. Cholera, gastroenteritis. Food poisoning and dysentery
5. Influenza and other common viral respiratory infections
6. Rabies
7. Tetanus
8. Herpes simplex and herpes zoster
9. Amoebiasis and worm infestations
10.Malaria, filariasis, leishmaniasis, dengue, leptospirosis, and chickun
gunya
11.Common exanthemata
12.HIV infection and infections in the immunocompromised conditions
13.Common sexually transmitted diseases
14.Common fungal infections
15.Viral encephalitis
16.Tuberculosis
17.Infectious mononucleosis
18.Brucellosis, plague, anthrax etc
271
HAEMATOLOGY
Definition, prevalence, aetilogical factors, Pathophysiology,
pathology recognition, investigations and principles of treatmentof:
A. Anaemia: iron deficiency, megaloblastic and common haemolytic
anaemias (thalassemia, sickle cell and acquired haemolytic)
B. Common bleeding disorders (thrombocytopenia haemophilia)
C. Agranulocytosis and aplastic anaemia
1. Leukaemias
2. Lymphomas
3. Blood group and tranfusion: Major blood group systems and
histocompatibility complex, concepts of tranfusion and component
therapy; indications of transfusion therapy, precautions to be taken
during blood tranfusion, hazards of transfusion and safe handling of
blood and blood products.
RESPIRATORY SYSTEM
1. Physiology and diagnostic methods: sputum examination, x-ray chest,
pulmonary function tests and bronchoscopy
2. Upper respiratory infections
3. Pneumonias
4. Bronchiectasis and lung abscess
5. Bronchial asthma and tropical eosinophilia
6. Chronic obstructive airway disease and corpulmonale
7. Acute and chronic respiratory failure
8. Diseases of pleura: pleural effusion, empyema,pneumothorax
9. Pulmonary tuberculosis
10.Neoplasms of lung
272
11.Common occupational lung diseases
12.A.R.D.S
CARDIOVASCULAR SYSTEM
1. ECG, X ray chest with reference to common cardiovascular diseases.
2. Coronary artery disease
3. Rheumatic fever and rheumatic heart disease
4. Infective endocarditis
5. Hypertension and hypertensive heart disease
6. Acute and chronic heart failure
7. Common congenital heart disease in adolescents and adults:
ASD,VSD,PDA,TOF and coarctation of aorta
8. Common cardiac arrhythmias
9. Acute and chronic pericarditis, pericardial effusion and cardiac
tamponade
10.Common aortic diseases; peripheral vascular disease: arterial and
venous
GASTROINTESTINAL TRACT
1. Stool examination, endoscopy and radiology in reference to common
gastrointestinal diseases
2. Acid peptic disease
3. Malabsorption syndrome
4. Inflammatory bowel disease and irritable bowel syndrome
5. Acute and chronic hepatitis
6. Cirrhosis of liver
7. Abdominal tuberculosis
273
8. Liver function tests
EMERGENCY MEDICINE
1. Cardiopulmonary resuscitation
2. Acute pulmonary oedema
3. Hypertensive emergencies
4. Diabetic ketoacidosis and hypoglycaemia
5. Status epilepticus
6. Acute severe bronchial asthma
7. Shock and anaphylaxis
8. Acute myocardial infection
9. Upper GI bleed and hepatic coma
10.Diagnosis and management of comatose patient
11.Management of unknown poisoning
12.Fluid and electrolyte balance; acidosis and alkalosis in particular
relevance to vomiting diarrhoea, uraemia and diabetic ketoacidosis
NERVOUS SYSTEM
1. Cerebrovascular diseases—Stroke.
2. Meningitis: Viral, bacterial and tuberculous
3. Peripheral neuropathy
4. Epilepsy
5. Extrapyramidal diseases, Parkinsons disease, chorea athetosis.
6. Common compressive and noncompressive spinal cord syndromes—
Paraplegia.
7. Motor system disease
8. Myasthenia gravis
274
9. Common myopathies in India
10.Degenerative, nutritional,and metabolic disease of the nervous system
11.Migraine and cluster headache
RENAL DISEASES
1. Acute renal failure
2. Chronic renal failure
3. Glomerulonephritis and nephrotic syndrome
4. Urinary tract infections/pyelonephritis
5. Tubulointerstitial diseases and toxic nephropathies
6. Renal function tests(Microalbuminuria)
CONNECTIVE TISSUE DISORDERS

1. Rheumatoid arthritis
2. Gout
3. S.L.E
4. Osteomalacia and Osteoporosis
5. Ankylosing spondylitis/Reiter‘s arthritis
6. Osteo arthritis and cervical spondylosis
ENDOCRINE DISORDERS
1. Diabetes mellitus
2. Hypo and hyperthyroidism; iodine deficiency disorders
3. Cushing‘s syndrome and Addisons‘s disease; Hyperaldosteronism
(Conn‘s syndrome)
275
4. Pituitary disorders; Gigantism, Acromegaly and Sheehan‘s syndrome
5. Calcium and phosporus metabolism: parathyroid and metabolic bone
disease
6. Phaeochromocytoma
GERIATRICS
1. Biology of aging; factors accelerating senescence
2. Age related changes in various organ systems
3. Presentation of disease in the elderly; identification of common
diseases
4. Diet for the aged; Management of Nutritional disorders
5. Acute medical problems – infection, dehydration, acute confusional
states
6. Osteoporosis; Degenerative joint disease; effects of immobility
prevention contracture and bed sores
7. Neurological disturbances – management & rehabilitation
8. Psychogeriatrics – sensory deprivation; personality charges, depressive
illness
9. Social problems in the elderly – joint family system; day care center
and day hospital; home for the aged.
10.Rehabilitation- Assessment of functional status – activities of daily
living Instrumental activities of daily living, role of physiotherapist
and social worker.
276
SUGGESTED BOOKS:
1. Hutchinson‘s clinical methods
2. Macleod‘s clinical examination
3. Chamberlain – symptoms and signs of clinical medicine
4. Alagappan – clinical method – practice of medicine
5. Davidsons principle and practice of medicine
6. Golwalla – Text book of medicine for students
7. Kumar and clark‘s – clinical medicine
8. Text book of medicine – Dr. K.U. Krishnadas
PSYCHIATRY
GOAL:
Aim of teaching psychiatry to undergraduate medical student is to
impart such knowledge and skills, so as to enable them to diagnose and
treat common psychiatric disorders, handle emergencies, to refer
complicated/unusual presentations.
A. OBJECTIVES:
At the end of the course, the student shall be able to
1. Comprehend nature of different aspects of normal behaviour like
learning, memory, personality, motivation, intelligence.
2. Recognize normal from abnormal behavior
3. Broadly classify psychiatry disorder
4. Recognize clinical manifestation of common disorders and plan their
management
5. Describe rational use of different modes to therapy in these disorders
277
B. SKILLS:
1. Interview patient understand communication in doctor patient
relationship Elicit detailed history
2. Conduct clinical examination for assessing mental status
3. Recognise psychopathological signs and symptoms
4. Diagnose common psychiatric disorders
5. Manage common psychiatric disorders
6. Identify and manage psychological reactions in special circumstances
and in patients suffering from other medical and surgical disorders
7. Diagnose, manage in community settings
LECTURE SCHEDULE
BASIC BEHAVIOURAL SCIENCES

Introduction of psychiatry
Concept of mind - Normality Vs Abnormality
Definition of mental health - Qualities of mental health Basic
Psychology
Learning - Types of learning, relevance in
normal behavior
Memory - Types of memory, mechanism,
neuroanatomical/
Physiological/Biochemical correlates
Motivation - Theories,neurophysiology, correlates
stress & theories
Emotion - Theories, neurophysiology,
correlates stress & theories
Intelligence - Normal levels, assessment methods

Personality - Different types, causation. Theories,
mental Mechanisms
278
NEUROBIOLOGY OF BEHAVIOURS
Functional Neuroanatomy
Prefrontal cortex
Basal Ganglia system
Limbic system
Reticular activating system
Neurotransmitters
Dopamine system
Serotonin system
Norepinephrine system
The cholinergic system
Amino-acid – GABA, glutamate
Genetics and Mental illness
PSYCHIATRIC CLASSIFICATION
Psychosis Vs Neurosis
Severe mental illness Vs Common mental disorders
TYPES OF PSYCHIATRIC DISORDERS

 Cognitive disorders
279
Difference between organic and functional disorders
Delirium - Etiology, features, management

Dementia - Etiology, Treatable causes, clinical
features, management
 Alcohol use disorders - Diagnosis, management, comorid
 Other substance use - Cannabis, opioid, solvent, nicotine, over
disorder counter drugs (OTC)
 Schizophrenia - Etiology, clinical features, management
 Mood disorders - Etiology, clinical features, management
 Neurotic and stress related disorder and somatoform disorders

- Definition of neurosis
- Anxiety (Neurotic) disorders –
GAD, Panic, Phobia, OCD,
PTSD
- Etiology, clinical features,
management
 Somatoform disorders - Somatization, Hypochondriasis,
Somatoform Pain disorders,
dissociative (Conversion)
disorders
 Personality disorders - Definition, different types –
cluster A,B,C Special emphasis
on Schizoid, Histrionic,
Antisocial personality disorders
 Eating disorders - Concept of eating disorders,
clinical features of Anorexia
nervosa (AN) Bulimia Nervosa
280
(BN)
 Sleep Disorders - Stages of normal sleep,
regulation, Classification,
Etiology of sleep disorders
 Sexual disorders - Various sexual dysfunction,
special Reference to Erectile and
ejaculation dysfunction,
Paraphilia and gender identity
disorders (GID)
 Psychiatric emergencies - Suicide, attempted suicide,
violence
 Special population - Children (Mental retardation,
learning disability, Autism, etc)
Adolesccent Woman Elderly.
 Psychiatry and physical illness - Psychiatric aspects of HIV,
diabetes Mellitus, Cardio vascular
disease Neurological disorders –
Parkinson‘s stroke
TREATMENT METHODS:
1. Biological therapies
a. Pharmacotherapy - Antipsychotics
Antidepressants
Mood stabilizers
Antianxiety drugs
Others
281
b. Somatic therapies ECT (Electro convulsive therapy)
Bio feedback
VNS ( Vagus Nerve Stimulation)
TMS
Psychosurgery
c. Psychological therapies - Basics of psychotherapy
Types – Reconstructive – family
therapy, Re educative – Behavioural
therapy, Supportive Psycho therapy
& counselling other therapies
DEPARTMENT OF DERMATOLOGY, VENEREOLOGY &

LEPROLOGY
GOAL:
The aim of teaching the undergraduate student in Dermatology, S.T.D. and
Leprology is to impart such knowledge and skills that may enable him to
diagnose and treat common ailments and to refer rare diseases or
complications/unusual manifestations of common diseases, to the specialist.
OBJECTIVES:
1. KNOWLEDGE:
At the end of the course of Dermato-S.T.D. and Leprology, the
student Shall be able to:
a. demonstrate sound knowledge of common diseases, their clinical
manifestations, including emergent situations and of investigative
procedures to confirm their diagnosis:
282
b. demonstrate comprehensive knowledge of various modes of therapy
used in treatment of respiratory diseases;
c. describe the mode of action of commonly used drugs, their doses, side
effects/toxicity, indications and contra-indications and interactions;
d. describe commonly used modes of management including the medical
and surgical procedures available for the treatment of various diseases
and to offer a comprehensive plan of management for a given disorder;
2. SKILLS:
The student should be able to:
a. Interview the patient, elicit relevant and correct information and
describe the history in a chronological order.
b. Conduct clinical examination, elicit and interpret physical findings and
diagnose common disorders and emergencies;
c. Perform simple, routine investigative and office procedures required
for making the bed-side diagnosis, especially the examination of
scrapings for fungus, preparation of slit smears and staining for AFB
for leprosy patients and for STD cases;
d. Take a skin biopsy for diagnostic purposes;
e. Manage common diseases recognizing the need for referral for
specialized care, in case of inappropriateness of therapeutic response;
f. Assist in the performance of common procedures, like laryngoscopic
examination, pleural aspiration, respiratory physiotherapy, laryngeal
intubation and pneumo-thoracic drainage/aspiration.
283
3. INTEGRATION:
The broad goal of effective teaching can be obtained through integration
with departments of Medicine, Surgery, Microbiology, Pathology,
Pharmacology and Preventive & Social Medicine.
TEACHING SCHEDULE FOR CLINICAL SUBJECTS:

THEORY CLASSES:
Skin and S.T.D. : 30 Hours.
CLINICAL POSTINGS:
Skin & STD

Two Weeks each in 4th 6th & 8th semester of MBBS. Totally 6 weeks.
a. Diseases caused by nutritional and environmental factors.
b. Infective disorders : Pyodermas, Common Viral and Fungal infections.
c. Infestations : Scabies, Pediculosis.
d. Allergic disorders: Urticaria, Atopic dermatitis, and contact dermatitis.
e. Common drug reactions and eruptions : Erythema multiforme, Toxic
epidermal necrolysis and Exfoliative dermatitis.

f. Dermatitis and Eczema.
g. Alopecia and Hirsutism.
h. Sebaceous glands : Structure and Function; Acne, Seborrhoeic
dermatitis, Other diseases; Pityriasis capitis.

i. Sweat glands : Structure, Function and Diseases; Miliaria,
Hyperhidrosis.
284
j. Leprosy : Classification, Pathology, Clinical features, Diagnosis,
Reactions, Management, Deformities and Control Programme.

k. Psoriasis.
l. Lichen Planus.
m. Sexually Transmitted Diseases : Genital ulcerative diseases, Genital
discharge diseases.
n. Dermatological therapy.
PREFERABLE TO BE TAUGHT ON:

Vesiculobullous Diseases : Pemphigus, Pemphigiod and Dermatitis
Herpetiforms, Melanocyte, Pigment metabolism and disorders of
pigmentation; Icthyosis.
SKILLS:
a. Perform skin scrapings and do a KOH preparation for fungus
infections.
b. Prepare slit skin and nasal smear for lepra bacilli.
c. Do staining for DTD cases.
d. More emphasis on HIV.
EXAMINATION:
THEORY: Paper II – General Medicine including Dermatology,
Venerology & leprology.
INTERNSHIP:
Elective Postings (1 X 15 days): 15 days.
285
An intern must be able to:-
a. Conduct proper clinical examination, elicit and interpret physical
findings and diagnose common disorders and emergencies.
b. Perform simple, routine investigative procedures for making bedside
diagnosis, specially the examination of scrapings for fungus,
preparation of slit smears and staining of AFB for leprosy patient and
for STD cases.
c. Take a skin biopsy for diagnostic purpose.
d. Manage common disease recognizing the need for referral for
specialized care in case of inappropriateness of therapeutic response.
286
Paper - I:
General medicine including therapeutics.
Paper – II:
1. General medicine (including Dermatology, S.T.D., Psychiatry).
PASS CRITERIA:
MAXIMUM MINIMUM
Practical 160 80
Viva 40 -
------------ ------------
------------ ------------

Note:

grade card.
287
288
SURGERY &
ALLIED SUBJECTS
289
290
GENERAL SURGERY
GOAL:
The broad goal of the teaching of undergraduate students in surgery
is to produce graduates capable of delivering efficient first contact surgical
care
OBJECTIVES:
A. KNOWLEDGE:
1. Describe aetiology, pathophysiology, principles of diagnosis and
management of common surgical problems including emergencies, in
adults and children
2. Define indications and methods for fluid and electrolyte replacement
therapy including blood transfusion
3. Define asepsis, disinfection and sterilization and recommended
judicious use of antibiotics
4. Describe common malignancies in the country and their management
including prevention
5. Enumerate different types of anaesthetic agents, their indications,
mode of administration, contraindications and side effects
B. SKILLS:
1. Diagnose common surgical conditions both acute and chronic, in adult
and children
2. Plan various laboratory tests for surgical conditions and interpret the
results
291
3. Identify and manage patients of hemorrhagic, septicaemic and other
types of shock
4. Be able to maintain patent air-way resusciatate
a) A critically injured patient
b) Patient with cardio-respiratory failure
c) A drowning case
1. Monitor patients of head, chest, spinal and abdominal injuries,
both in adults and children
2. Provide primary care for a patient of burns
3. Acquire principle of operative surgery, including pre-operative,
operative and post operative care and monitoring
4. Treat open wounds including preventive measures against
tetanus and gas gangrene
5. Diagnose neonatal and pediatric surgical emergencies and
provide sound primary care before referring the patient to
secondary/tertiary centers
6. Identify congenital anomalies and refer them for appropriate
management In addition to these he should have
observe/assisted/performed the following:
a) Incision and drainage of abscess
b) Debridement and suturing open wound
c) Venesection
d) Excision of simple cyst and tumours
e) Biopsy of surface malignancy
f) Catheterisation and nasogastric intubation
g) Circumcision
h) Meatotomy
292
i) Vasectomy
j) Peritoneal and pleural aspirations
k) Diagnostics proctoscopy
l) Hydrocele operation
m) Endotracheal intubation
n) Tracheostomy and cricothyreidotomy
o) Chest tube insertion
C. INTEGRATION:
The undergraduate teaching in surgery should be integrated at
various stages with different pre and para and other clinical departments
GENERAL SURGERY – SYLLABUS
I. GENERAL PRINCIPLES:
1. Introduction to principles and practice of surgery
2. History of surgery
3. Fluid, electrolyte and acid-base balance
4. Shock
5. Haemorrhage and blood transfusion
6. Surgical nutrition
7. Wounds, tissue repair and scars
8. Wound infection – classification and management
9. Tumours, ulcers, cyst, sinuses & fistulae
10.Specific infections
 Tetanus
 Gas-gangrene
293
 Koch-s
 Leprosy
 Syphilis
11.Parasitic infections:
 Protozoa – (eg.Amoebiasis)
 Helminth –(eg;SH)
 Nematodes – (eg: Ascariasis,Filariasis)
 Cestodes – (eg:Hydatid)
12.HIV & AIDS
13.Asepsis, Antisepsis, Sterilization
14.Diabetes mellitus – Surgical manifestations
15.Burns
16.Principles of plastic & reconstructive surgery
17.Principles of Oncology
18.Palliative care
19.Accident & Emergency surgery
20.Warfare injuries
21.Scalp, skull, brain, maxillo-facial and nerve injuries
22.Principles of Neuro-surgery
23.Organ Transplantation
24.Surgical audit and research
25.Ethics
26.Communication skills
294
II. SYSTEMIC SURGERY
1. Common skin & soft tissue conditions
a) Cyst, Benign, premalignant and malignant conditions of skin and soft
tissues
b) Pressure sores – prevention and management
2. Arterial Disorders
a) Acute arterial obstruction: diagnosis and initial management, types of
gangrene; diagnosis of chronic arterial insufficiency with emphasis
on Buerger‘s disease, atherosclerosis; investigation in case of arterial
obstruction, amputations, vascular injuries; basic principles of
management.
3. Venous Disorders
a) Varicose vein; diagnosis and management; deep vein thrombosis –
diagnosis, prevention, principles of therapy, thrombophlebitis
4. Lymphatics and Lymph nodes
a) Diagnosis and principles of management of lymphangitis,
lymphedema, acute and chronic lymphadenitis; cold abscess,
lymphomas; surgical manifestations of filariasis.
5. Oral cavity, jaw, salivary glands
a) Cleft lip and palate; Leukoplakia, retension cysts; ulcers of the
tongue
b) Features, diagnosis and basic principles of management of carcinoma
lip, buccal mucosa and tongue, prevention and staging of oral
carcinomas
c) Salivary glands: Acute sialadenitis, neoplasms, diagnosis and
principles of management
d) Epulis, cysts and tumors of jaw, salaivary fistulae
295
6. Neck
a) Branchial cyst, Cystic hygroma
b) Cervical lymphadenitis, non specific and specific tuberculosis of
lymphnodes, secondaries in neck
c) Thoracic outlet syndrome; diagnosis and management
7. Thyroid Gland
a) Throid : Surgical anatomy, Physiology investigations of thyroid
disorders; types, clinical features, diagnosis and principles of
management of goiter, thyrotoxicosis and malignancies, thyroglossal
cyst and fistula.
b) Thyroiditis, Hypothyroidism
8. Parathyroid and Adrenal glands
a) Clinical features and diagnosis of hyperparathyroidism, adrenal
hyperfunction/hypofunction
9. Breast
a) Surgical anatomy, nipple discharge, acute mastitis, breast abscess,
mammary dysplasia, gynaecomastia, fibroadenoma(Benign breast
disease)
b) Assessment and investigation of a breast lump
c) Cancer breast; Diagnosis, staging, principles of management
10.Throax
a) Recognition and treatment of pneumothorax, haemothorax,
pulmonary embolism, prevention/recognition and treatment, flail
chest, stove in chest. postoperative pulmonary complications
b) Principles of management of pyothorax, cancer lung
11.Heart and Pericardium
a) scope of cardiac surgery
296
12.Oesophagus
a) Benign conditions of oesophagus and GERD
b) Dysphagia, causes, investigation and principles of management
c) Cancer oesophagus, principles of management
13.Stomach and Duodenum
a) Anatomy, physiology, congenital hypertrophic pyloricstenosisl;
aetiopathogenesis, diagnosis and management of peptic ulcer,
cancer stomach, upper gastointestinal haemorrhage with special
reference to bleeding varices and duodenal ulcer
14.Liver
a) Clinical features, diagnosis and principles of management of
amoebic liver abscess, hydatid cyst and portal hypertension
b) Surgical anatomy, primary and secondary neoplasms of liver
c) Liver trauma
15.Spleen
a) Splenomegaly, causes, investigations and indications of
splenectomy; splenic injury
16.Gall Bladder and Bile Ducts
a) Anatomy, physiology and investigations of biliary tree, clinical
features, diagnosis, complications and principles of management of
cholelithiasis and cholecystitis; obstructive jaundice
b) Carcinoma gall bladder, choledochal cyst
17.Pancreas
a) Acute pancreatitis, clinical features, diagnosis, complications and
management
b) Chronic pancreatitis, cancer pancreas
297
18.Peritoneum, Omentum, Mesentery and Retroperitoneal space
a) Peritonitis, causes recognition and principles of management, inta-
peritoneal abscesses, mesentric cysts, retriperitonial cysts and
neoplasm
b) Laparaoscopy
19.Small and Large intestine
a) Diagnosis and principles of treatment of intestinal amoebiasis,
tuberculosis of intestine, carcinoma colon, lower gastrointestinal
haemorrhage
b) Ulcerative colitis, Crohns disease, premalignant conditions of large
bowel
c) Intestinal obstruction, types aeitiology, diagnosis and principles of
management, paralytic ileus
d) Acute abdomen, causes, approach, diagnosis and principles of
management
e) Appendix, diagnosis and management of acute appendicitis,
appendicular lump and abscess
20.Rectum
a) Surgical anatomy, clinical features of rectal disease and
investigations
b) Carcinoma of rectum, diagnosis, clinical features and principles of
management. Indications and management of colostomy
c) Prolapse of rectum
21.Anal Canal
a) Surgical anatomy, clinical features and management of fissure,
fistula in ano, perianal and ischiorectal abscess and haemorrhoids,
Diagnosis and referral of anorectal anomalies
298
b) Anal carcinoma
22.Hernias
a) Clinical features, diagnosis, complications and principles of
management of, umbilical, inguinal and femoral hernia
b) Epigastic hernia, omphalitis, umbilical fistulae, burst abdomen and
ventral hernia
23.Genito – Urinary system
a) Symptoms and investigations of the urinary tract
b) Investigations of renal mass, diagnosis and principles of
management of urolithiasis, hydronephrosis, pyonephrosis,
perinephric abscess and renal tumours, cyst.
c) Renal tuberculosis
d) Causes, diagnosis and principles of management of haematuria,
anuria and acute retention of urine & incontineuence of urine
e) Benign prostatic hyperplasia, diagnosis and management carcinoma
prostate
f) Diagnosis and principles of management of phimosis, paraphimosis
and carcinoma penis
g) Principles of management of urethral injuries, strictures.
h) Diagnosis and principles of treatment of undescended testis, torsion
testis, hydrocele, haematocele, pyocoele, Fourmiers gangrene,
epididymoorchitis and testicular tumours
i) Varicocele.
III. FUNDAMENTAL OF PAEDIATRIC SURGERY

1. Anatomy, physiology (difference between child and adult)
2. Principles of management of trauma in a child
299
3. Common paediatric surgical conditions
a) Congenital hernia (inguinal, umbulica)
b) Undescended testis
c) Hypospadias
d) Hypertrophic pyloric stenosis
e) Interssusception
f) Acute (abdominal pain-diagnosis & management)
g) Rectal prolapse
h) Congenital malformations of GI tract : Atresia, Hirschsprings
disease, anorectal malformation,urinary tract malformation –
polycystic kidney
i) Paediatric surgical oncology (Neuroblastoma, Wilms,
Rhabdomyosarcoma)
IV. SURGICAL ANATOMY AND PRINCIPLE OF OPERATIVE

SURGERY
1. The OR (Operating room) – Layout, Asepsis, Sterilisation etc
2. Investigations and Assessment of the patient for surgery
3. Preparing the patient for surgery ( including pre-operative counseling,
informed consent etc)
4. Principles of anaesthesia and pain management
5. Basic surgical skills and techniques (instruments, suture materials, IV
line, CVP line, venous cut down, Catheterisation, Enema, lumbar
puncture, Ascitic and pleural tap, emergency intubation, ICD)
6. Post-operative management and rehabilitation
300
7. Specific surgeries
a) Minor procedures – incision and drainage, sebaceous cyst excision,
ear lobe repair, wound dressing, circumcision (day care
surgery)Vasectomy
b) Hydrocele
c) Hernia
d) Tracheostomy
e) Appendix
f) Thyroid
g) Breast
h) Varicose Veins
i) Laparotomy- surface markings, incisions and drains
j) Stomach – T. Vagotomy and GJ, Perforation closure
k) Bowel Anastomosis
l) Universal precautions
m) Principles of laparoscopic surgery/endosurgery
301
ORTHOPAEDICS
1. KNOWLEDGE:
The student should be able to:
a. Explain the principles of recognition of bone injuries and dislocation.
b. Apply suitable methods to detect and manage common infections of
bones and joints.
c. Identify congenital, skeletal anomalies and their referral for
appropriate correction or rehabilitation.
d. recognize metabolic bone diseases as seen in this country.
e. explain etiogenesis, manifestations, diagnosis of neoplasm affecting
bones.
2. SKILLS
a. Detect sprains and deliver first aid measures for common fractures
and sprains and manage uncomplicated fractures of clavicle, Colles's,
forearm, phallanges etc.
b. Techniques of splinting, plaster, immobilization etc.
c. Management of common bone infections, learn indications for
sequestration, amputations and corrective measures for bone
deformities.
d. Aspects of rehabilitation for Polio, Cerebral Palsy and Amputation.
302
3. APPLICATION:
a. Be able to perform certain orthopedic skills, provide sound advise of
skeletal and related conditions at primary or secondary health care
level.
4. INTEGRATION:
a. Integration with anatomy, surgery, pathology, rediology and Forensic
Medicine be done.
5. OBJECTIVES:
1. Embryoloy, applied anatomy, physiology, pathology, clinical features,
diagnostic procedures and the principles of therapeutics including
preventive methods, (medical/surgical) pertaining to musculoskeletal
system.
2. Clinical decision making ability & management expertise: Diagnose
conditions from history taking, clinical evaluation and investigation
and should be able to distinguish the traumatic from infective and
neoplastic disorders.
3. Thrust areas.
a. Pediatric orthopaedics – the student should be exposed to common
congenital and developmental disorders such as CTEV (Club – Foot),
development dysplasia of hip, perthe‘s disease and infection, and also
should acquire adequate knowledge about the principles of
management of these disorders.
b. Orthopaedic oncology – the undergraduate is expected to be familiar
with the common tumours encountered in orthopaedic practice. The
student should be able to diagnose common bone.
303
c. Management of Trauma – Trauma in this country is one of the main
causes of morbidity and mortality in our demographic statics. The
student is expected to be fully conversant with trauma in its entirety
including basic life saving skills, control of hemorrhage, splintage of
musculoskeletal injuries and care of the injured spine.
d. Sports Medicine - The student should know about common
orthopaedic pathologies encountered in sportspersons and their
diagnostic and preventive aspects. 120 sy.
e. Physical medicine and rehabilitation – The student is expected to be
familiar with common orthotic and prosthetic devices and their
applications.
f. Orthopedic neurology – The student should be exposed to all kinds of
nerve injuries as regards their recognition & principles of
management, cerebral palsy and acquired neurologic conditions such
as post polio residual paralysis.
g. Disorders of spine – The student is expected to be familiar with
various kinds of spinal disorders such as scoliosis, kypho – scoliosis,
spinal trauma, prolapsed intervertebral disc and infections
(tuberculosis and pyogenic) as regards their clinical presentations and
principles of management.
h. Radiology – acquire knowledge about radiology/imaging and should
be able to interpret radiographs typical of common orthopaedic
radiographs typical of common orthopaedic pathologies.
304
ORTHOPAEDICS
I. TEACHING LEARNING ACTIVITIES:
Didactic lectures.
Under Graduate will attend didactic lectures on the following topics.
 Fracture: Definition, classification, principles of management.
 Fracture healing, delayed union.
 Classification & management of open fractures.
 Management of fracture calvicle, dislocation shoulder & fracture shaft
humerus.
 Classification of injuries around elbow & management of
supracondylar fracture & dislocation of elbow.
 Monteggia fracture dislocation & fracture both bones of forearm.
 Volkamann‘s ischaemic contracture.
 Fracture of lower end of radius fracture scaphoild and metacarpals.
 Fracture pelvis & dislocation of hip.
 Fracture neck of femur.
 Fracture shaft of femur & tibia.
 Internal Derangements of knee, injuries of ankle & foot amputations.
 Congenital Malformations: CTEN Torticollis.
 Congenital Malformation: CDH, Pseuodoarthrosis tibia etc.
 Disorders of the hip: coax vary, Perthes diseases.
 Deformities of the spine.
 Acute Pylogenic ostyemyelitis.
 Chronic pyogenic ostyemyelitis.
 Septic Arthritis.
 Other Arthritides (Rheumatoid/Ank. Spond).
305
 Osteo – articular tuberculosis:
 General consideration & Principles of management.
 Tuberculosis: Spine.
 Poliomyelitis.
 Bone Tumours: Benign tumors.
 Bone Tumours: malignant tumors.
 Integrated seminars – combined interdisciplinary seminars on subjects
like.
 Arthritis, tuberculosis, osteoporosis etc.
II. SPECIFIC ACTIVITIES IN DETAIL:

a. Case presentation in the ward and the afternoon special clinics (such as
scoliosis/Hand clinics). UG will present a clinical case for discussion
before a faculty in the ward every morning.
b. Case conference undergraduate will attend case conference on every
Monday afternoon where the residents are expected to work – up one
long case and three short cases and present the same to a faculty
member and discuss the management in its entirety.
c. X- Ray Classes – UG should attend x-ray classes held twice weekly in
morning in which the radiologic features of various problems are
discussed.
d. Surgicopathological conference: UG should attend period
surgicopathology conferences in which special emphasis is made on
the surgical pathology and the radiological aspect of the case in the
pathology department.
306
III. TEST BOOKS RECOMMENDED:
 Title of the book Author Publisher
 Outlines of Fractures Crawford Churchill Livingstone Adams.
 Closed Treatment of Fracutes H.John Churchill Livingstone Charnley.
 Outlines of Orthopaedics Crawford Churchill Livingstone Adams.
 Natrajan‘s textbook of Orthopaedics and Traumatology, 7/ed.
 Under Graduates fractures and orthopaedics : S. DAS
 Essential Orthopaedics Maheshwari.
307
COURSE CONTENTS
I. TRAUMA:
1. General principles in diagnosis, first aid and treatment methods of
closed fractures and open fractures, open reduction including
principles of internal fixation and external fixation, their
complications. Preservation of amputated parts before transfer.
2. General principles of diagnosis and management of non – unions and
delayed unions.
II. DIAGNOSIS, FIRST - AID AND REFERRAL OF:

1. Fracture clavicle.
2. Anterior dislocation of shoulder.
3. Fracture femur neck, trochanter and shaft.
4. Haemarthrosis, traumatic synovitis.
5. General principles of management of hand injuries.
6. Polytrauma.
7. Complications of fracture: fat embolism, ischaemic contracture,
myositis ossificans, osteodystrophy.
8. Fracture proximal end, shaft, supracondylar, and internal condylar
humerus.
9. Posterior dislocation of elbow.
10.Fracture shaft of radius and ulna.
11.Traumatic dislocation of hip.
12.Fracture patella.
13.Fracture shaft tibia and fibula.
14.Injury to muscles and ligaments (shoulder arc syndrome, tennis elbow,
ankle sprain).
15.Peripheral nerve injuries.
16.Spinal injuries.
17.Fracture of olecranon.
18.Monteggia fracture dislocation.
308
III. INFECTIONS OF BONES AND JOINTS:
Diagnosis and principles of management:-
1. Osteomyelitis: pyogenic, tubercular, fungal (mudurafoot), syphilitic
and parasitic infection of bone.
2. Arthritis: Septic and tubercular.
3. Tuberculosis of the spine.
4. Leprosy – Principles of corrective surgery.
IV. TUMOURS:
1. Benign lesions: multiple exostosis, enchondroma, osteoid osteoma,
simple bone cyst, osteochondroma.
2. Malignanat lesions: Osteochondroma, Ewing‘s sarcoma, giant cell
tumour, chondrosarcoma and secondary deposits.
V. DEGENERATIVE DISEASES:
1. Osteoarthritis.
2. Spondylosis.
3. Degenerative disc diseases.
VI. CONGENITAL ANOMALIES:

1. Congenital dislocation hip.
2. Congenital talipes equinovarus.
3. Pes planus.
309
VII. BONE DYSPLASIA:
1. Osteogenesis imperfect.
2. Achondroplasia.
VIII. NEURO – MUSCULAR DISORDERS:
1. Post – polio residual paralysis.
2. Cerebral palsy.
IX. OSTEOCHONDROSES:
1. Perthe‘s disease.
X. DEFORMITIES:
1. Scoliosis – diagnosis and referral.
2. Genu Varum and Valgum – diagnosis.
XI. PREVENTIVE ORTHOPAEDICS:
1. Osteoporosis.
2. Osteopenia.
3. Osteomalacia.
4. Scurvy.
5. Rickets.
XII. BASIC PRINCIPLES OF PHYSIOTHERAPY, OCCUPATIONAL
THERAPY AND ORTHOTICS/PROSTHETICS TO KNOW:
1. Physiatric evaluation of common neurological diseases.
2. Physiatric evaluation of common orthopaedic conditions.
3. Principles of cardiopulmonary rehabilitation.
4. Principles of exercise therapy, electrotherapy and occupational
therapy.
5. Principles of orthotics and prosthetics.
310
XIII. SKILLS:
1. Obtain a proper relevant history, and perform a humane and thorough
clinical examination in adults and children including neonates.
2. Arrive at a logical working diagnosis after examination.
3. Plan and institute a line of treatment which is need based, cost
effective and appropriate for common ailments.
4. Recognize situations which call for urgent or early treatment at
secondary and tertiary centres and make a prompt referral of such
patients after giving first aid or emergency treatment.
5. Be able to do surface marking of common superficial arteries, veins,
nerves and viscera.
6. Interpret skiagrams of common fractures and dislocations.
7. Apply skin traction.
8. Apply figure of 8 bandage for fracture clavicle.
9. Apply POP slabs/casts and splints.
10.Transport safely victims of accidents including those with spinal
injury.
11.Reduce colle‘s fracture.
12.Reduce shoulder dislocation.
13.Reduce tempero – mandibular joint dislocation.
14.Perform nerve blocks like infiltration, digital, pudendal, paracervical
and field block.
Family Welfare
1. Technique of Vasectomy.
311
Paper - I:
General Surgery including Orthopaedics.
Paper – II:
General Surgery including anaesthesiology, Dental Diseases and Radiology
.
Section A: General Surgery Section B: Orthopaedics
PASS CRITERIA:
MAXIMUM MINIMUM
Practical 160 80
Viva 40 -
------------ ------------
------------ ------------
Note:

grade card.
Paper 1 of Surgery shall have one section in Orthopaedics. The questions on
Orthopaedic Surgery be set and assessed by examiners who are teachers in
the Orthopaedic surgery.
312
OBSTETRICS AND
GYNAECOLOGY
313
314
OBSTETRICS AND GYNAECOLOGY
Obstetrics and Gynaecology to include family welfare and family planning.
GOAL:
The broad goal of the teaching of undergraduate students in Obstetrics and
Gynaecology is that he/she should acquire understanding of anatomy,
physiology and pathophysiology of the reproductive system and gain the
ability to optimally manage common conditions affecting it & also about
pregnancy & delivery & associated complications & to acquire knowledge
about new born investigations and common problems in early neonatal
period.
OBJECTIVES
A. KNOWLEDGE
1. Outline the anatomy, physiology and pathophysiology of the
reproductive system and the common conditions affecting it.
2. Detect normal pregnancy, labour puerperium and manage the problems
he/she is likely to encounter therein.
3. List the leading causes of maternal and perinatal morbidity and
mortality.
4. Understand the principles of contraception and various techniques
employed, methods of medical termination of pregnancy, sterilisation
and their complications.
5. identify the use, abuse and side effects of drugs in pregnancy,
premenopausal and post-menopausal periods.
315
6. describe the national programme of maternal and child health and
family welfare and their implementation at various levels.
7. Identify common gynaecological diseases and describe principles of
their management.
8. State the indications, techniques and complications of surgeries like
9. Caesarian section, laparotomy, abdominal and vaginal hysterectomy,
Fothergill's operation and vacuum aspiration for M.T.P. & sterlaisation
techniques and endoscopic procedures. (Basic knowledge)
B. SKILLS
1. examine a pregnant woman; recognise high risk pregnancies and make
2. appropriate referrals.
3. conduct a normal delivery, recognise complications and provide
postnatal care.
4. resuscitate the newborn and recognise congenital anomalies.
5. advise a couple on the use of various available contraceptive devices
and assist in insertion in and removal of intra-uterine contraceptive
devices.
6. perform pelvic examination, diagnose and manage common
gynaecological problems including early detection of genital
malignancies.
7. make a vaginal cytological smear, perform a post coital test and wet
vaginal smear examination for Trichomonas vaginalis, moniliasis and
gram stain for gonorrhoea. Colposcopy, endometrial sampliny.
8. interpretation of data of investigations like biochemical,
histopathological, radiological, ultrasound etc.
316
C. INTEGRATION:
The student should be able to integrate clinical skills with other
disciplines and bring about coordinations of family welfare programmes for
the national goal of population control.
OBSTETRICS
1. Anatomy (common)
2. Pelvis and fetal skull
3. Physiology of ovulation
4. Fertilization and development of embryo,
5. Placenta and fetal membrane
6. The fetus
 Fetal physiology
 Fetal circulation and changes at birth
7. Maternal changes in pregnancy
8. Diagnosis of pregnancy
9. Fetus in normal pregnancy
10.Prenatal care and pre conceptional counseling
11.Drugs in pregnancy
12.Antepartum fetal surveillance
13.Normal labour
14.Mechanism of labour
15.Conduct of labour
16.Intrapartum fetal surveillance
17.Normal puerperium
18.Breast and lactation
19.Early pregnancy complications
317
 Hyperemesis
 Abortion
 vesicular mole
 ectopic pregnancy
20.Medical disorders complicating pregnancy
 Anemia
 Hypertensive disorders
 DM
 CVS
 Renal Disorders
 Thyroid dysfunctions
 Epilepsy
 Liver disorders
21.Maternal infection
 Bacterial- TB, other infections.
 Viral
 Protozoal
 HIV in Pregnancy
22.Surgical conditions associated with pregnancy
 Appendicitis, pancreatitis, Cholelithiasis, acute pain abdomen.
 laparoscopy in pregnancy.
23.Gynecological conditions associated with pregnancy
 Abnormal vainal discharge
 Abnormal cervical cytology
 Retroverted uterus
 Fibroid, ovarian tumors, prolapsed uterus, carcinoma cervix
318
24.Preterm labour, PPROM, PROM
25.Intra uterine growth restriction
26.Prolonged pregnancy
27.IUFD (Intra Uterine Fetal death).
28.Multiple pregnancy
29.Antepartum haemorrhage
 Abruptio placenta
 Placenta previa
30.Abnormal labour
1. Abnormalities of the passenger
 Malpositions
 -occipitoposterior
2. Abnormal fetal presentation
 -Transverse lie
 -Oblique lie
 -Breech
 -Brow
 -Face
 -Compound
 -Cord Prolapse / Presentation
3. Abnormalities in the passage
 Contracted pelvis
 CPD
 Abnormal pelvis
4. Dystocia due to anomalies in expulsive power –
 Uterine inertia,
 Inco ordinate uterine action,
319
 Hypertonic uterine contractions
 Cervical dystocia
 Precipitate labour
 Management of dysfunctional labour and partograph
31. Prolonged labour
 Obstructed labour
 Dystocia due to fetal anamolies
 Threatened rupture and rupture uterus
32. Complications of 3rd stage of labour
 PPH
 Retained placenta and adherent placenta accrete
 Inversion of uterus
 Injuries to perineum
33. Abnormalities of puerperium
 Puerperal pyrexia, puerperal sepsis
 subinvolution
 urinary and breast complications
 venous thrombosis and pulmonary embolism
 psychiatric disorders
 puerperal emergencies
34. Special cases
 Labour following cesearean
 Rh isoimmunisation
 Bad obstetric history
 Teenage pregnancy
 Elderly primi
320
 Grand multipara
 Obesity
35. Induction of labour
36. Operative obstetrics
 Episiotomy
 Hysterotomy
 Cesearean section
 laparotomy,
 hysterectomy
 Operative vaginal deliveries
 Forceps
 Ventouse
 Version
 Destructive operations
37. Newborn
 Resusitation and examination of new born
 Feeding of newborn / immunization
 Term new born
 Low birth weight baby
 Preterm baby
 Growth restricted baby
 Macrosomic baby
 Post term baby
38. Diseases of the fetus and new born
 Asphyxia neonatorum
 Perinatal asphyxia
321
 Meconium aspirartion syndrome
 Jaundice
 Seizures
 Birth injuries
 Congenital malformations and pre natal diagnosis
 Down syndrome
 Non immune hydrops
39. Pharmacotherapeutics in obstetrics
 Oxytocics
 Tocolytics
 Anti hypertensives
 Diuretics
 Anti convulsants
 Anti coagulants
 Analgesia and anaesthesia in obstetrics
 Drugs in preganancy
40. Population dynamics and contraception
 Temporary methods
 Permanent methods-male and female
 Medical termination of preganancy-I ans 2nd trimester
41. Safe motherhood and epidemiology
 RCH and
 Safe motherhood programme
 CSSM
 Maternal mortality and morbidity
 Perinatal mortality and morbidity
322
42. Miscellaneous
 Shock in obstetrics
 Post partum collapse
 Blood coagulation disorders
 Immunology in obstetrics
43. Current topics
44. Audit in obstetrics
 Legal and ethical issues
 Antibiotic prophylaxis
 Day care obstetrics
 PNDT act
 Umbilical cord stem cell banking
45. Imaging in obstetrics
 Ultrasonogram
 Doppler
 MRI
 Radiology in obstetrics
 Amniocentesis
46. practical obstetrics
 Instruments
 Specimens
 Ultrasound pictures
 Drugs
 Doppler pictures
 Partogram pictures
 CTG tracings
323
Gynaecology
1. Anatomy of the female pelvic organs
2. Development of female genital tract and its abnormalities
3. Physiology of menstruation , ovulation and menopause
4. Sex and intersex
5. Gynaecological diagnosis
6. Reproductive tract infections
 STD/ PID
 Tuberculosis of genital tract
7. Disease of the vulva –
 benign conditions
 inflammations
 ulcers
 atrophy
 dystrophy
 cysts
8. Disease of the vagina
 Biology of vagina
 Vaginal infections
 Inflammation-vulvo vaginitis in children, senile vaginitis,
secondary vaginitis and rare form of vaginitis
 Ulcerations
 Cysts and benign neoplasm
9. Diseases of urinary system
10.Injuries of the female genital tract
11.Injuries to the intestinal tract
324
12.Genital fistulae and urinary incontinence
13.Pathology of conception
14.Birth control and MTP
15.Abnormal uterine bleeding-types and causes and management,DUB
16.Amenorrhoea
17.Hormonal therapy in gynaecology
18.Inflammation of uterus and cervix
19.Genital prolapsed
20.Other displacements of uterus
21.Benign lesions of uterus
22.Disorders of ovary and benign tumors
23.Endometriosis and adenomyosis
24.Diseases of parametrium
25.Premalignant lesions
 Vulva
 Vagina
 Cervix
 Endometrium
26.Genital malignancies
 Vulval carcinoma
 Vaginal carcinoma
 Cervical carcinoma
 Endometrial carcinoma
 Gestational trophoblastic neoplasia
 Sarcoma
 Ovarian carcinoma
 Fallopian tube
325
 Screening in genital tract malignancies-pap smear
27.Radiotherapy in gynaecology
28.Chemotherapy in gynaecology
29.Immunotherapy and gene therapy
30.Adolescent gynaecology
31.Special topics
 Abnormal vaginal discharge
 Pruritus vulva
 Pelvic pain
 Post menopausal bleeding
 Low back ache
 Breast in gynaecology
 Psychosexual problems
 Vaginismus
 Dyspareunia
 Abdomino pelvic lump
 Hirsutism
 Galactorrhoea
32.Operative gynaecology
 Pre operative preparations
 Day care surgery
 Post operative care
 Gynaecological operations
 Endometrial sampling
 Cervical biopsy
 Dilatation and curettage
326
 Hysterectomy
 Colposcopy
33.Endoscopic surgery in gynaecology
 Laparoscopy
 Hysteroscopy
34.Practical gynaecology
 Instruments
 Specimens
 Imaging studies-x ray, ultrasound, computed tomography, MRI
 Obstetrics and Gynaecology clinical examination
Family Welfare
1. Contraceptive methods in male/female
a. Mechanical
A. Pessaries, Intra Uterine Contraceptive Device (IUCD),
Condoms,
B. Tubectomy and vasectomy
b. Chemical
c. Oral
d. Rhythm Method
2. Demonstrations of use of Pessaries, IUCD, Condoms and technique of
tubectomy
3. Advice on family planning to be imparted to parents.
327
Paper - I:
Obstetrics including Social Obstetrics.
Paper – II:
Gynaecology, Family Welfare and Democraphy
PASS CRITERIA:
MAXIMUM MINIMUM
Practical 160 80
Viva 40 -
------------ ------------
------------ ------------

Note:

grade card.
328
PAEDIATRICS
329
330
PAEDIATRICS
Paediatrics including Neonatology

The course includes systematic instructions in growth and development,
nutritional needs of a child, immunization schedules and management of
common diseases of infancy and childhood, scope of Social Pediatrics and
counselling.
GOAL
The broad goal of the teaching of undergraduate students in Pediatrics is to
acquire adequate knowledge and appropriate skills for optimally dealing
with major health problems of children to ensure their optimal growth and
development.
OBJECTIVES
A. KNOWLEDGE
a. Describe the normal growth and development during foetal life,
neonatal period, childhood and adolescence and outline deviations
thereof.
b. Describe the common paediatric disorders and emergencies in terms of
epidemiology, etiopathogenesis, clinical manifestations, diagnosis,
rational therapy and rehabilitation.
c. State age related requirements of calories, nutrients, fluids, drugs etc.
in health and disease.
d. Describe preventive strategies for common infectious disorders,
malnutrition, genetic and metabolic disorders, poisonings, accidents
and child abuse.
331
e. Outline national programmes relating to child health including
immunization programmes.
B. SKILLS
a. Take a detailed pediatric history, conduct an appropriate physical
examination of children including neonates, make clinical diagnosis,
conduct common bedside investigative procedures, interpret common
laboratory investigation results and plan and institute therapy.
b. Take anthropometric measurements, resuscitate newborn infants at
birth, prepare oral rehydration solution, perform tuberculin test,
administer vaccines available under current national programs, perform
venesection, start an intravenous saline and provide nasogastric
feeding.
c. Conduct diagnostic procedures such as lumbar puncture, liver and
kidney biopsy, bone marrow aspiration, pleural tap and ascitic tap.
d. Distinguish between normal newborn babies and those requiring
special care and institute early care to all new born babies including
care of preterm and low birth weight babies, provide correct guidance
and counselling in breast feeding.
e. Provide ambulatory care to all sick children, identify indications for
specialized/inpatient care and ensure timely referral of those who
require hospitalization.
C. INTEGRATION
The training in pediatrics should prepare the student to deliver preventive,
promotive, curative and rehabilitative services for care of children both in
332
the community and at hospital as part of a team in an integrated form with
other disciplines, e.g. Anatomy, Physiology, Biochemistry, Microbiology,
Pathology, Pharmacology, Forensic Medicine, Community Medicine and
Physical Medicine and Rehabilitation.
PAEDIATRICS
SYLLABUS FOR MBBS COURSE
1. INTRODUCTION TO PAEDIATRICS:
2. GROWTH AND DEVELOPMENT:
a. Assessment of growth and development.
b. Growth curves and road to health chart.
c. Short stature.
d. Failure to thrive.
3. BEHAVIOURAL DISORDERS:
a. Pica.
b. Temper tantrums.
c. Thumb sucking.
d. Breath holding spells.
e. Enuresis.
f. Autism.
g. Phobia.
h. Eating disorders.
4. LEARNING DISORDERS:
5. CHILDREN WITH SPECIAL NEEDS:
a. Child adoption.
b. Child abuse.
6. NUTRITION:
a. Brest feeding, BFHI.
b. Normal requirements of nutrients.
333
c. Complementary feeding.
d. Nutritional deficiency disorders (protein energy malnutrition,
vitamin deficiencies, trace element deficiency).
e. Obesity.
7. COMMUNITY PAEDIATRICS:
a. Definition of mortality rates, causes of IMR and prevention.
b. IMNCI.
c. National programs.
d. (National anemia control program, RCH, ICDS, CEMONC,
national nutrition program).
8. IMMUNIZATION:
a. National immunization schedule.
b. Vaccine preservation and cold chain.
c. Individual vaccines.
9. NEONATOLOGY:
a. Resuscitation of newborn.
b. Examination of newborn.
c. Assessment of gestational age.
d. Thermoregulation and hypothermia.
e. Birth injury.
f. Common neonatal problems.
g. Low birth weight.
h. Preterm.
i. Congenital anomalies in newborn.
j. Birth asphyxia.
k. Neonatal jaundice.
l. Neonatal convulsion.
m. Neonatal sepsis.
334
n. Respiratory distress in newborn.
o. Haemorrhagic disease of newborn.
10.IMMUNOLOGY:
a. Immune system.
b. Allergic disorders.
c. Urticaria.
d. Allergic rhinitis.
e. Atopic eczema.
11.RHEUMATIC DISEASES OF CHILDHOOD:
a. Juvenile idiopathic arthritis.
b. Systemic lupus erythematosis.
c. Kawasaki disease.
d. Henoch schonlein purpura.
12.INFECTIOUS DISEASES:
a. Enteric fever.
b. Tuberculosis.
c. Leptospirosis.
d. Dengue fever.
e. Diphtheria, pertussis, tetanus, mumps.
f. Fever with rash (measles, rubella, varicella zoter).
g. Malaria.
h. HIV infection.
i. Poliomyelitis.
j. Helminthiasis.
k. Scrub typhus.
l. HINI virus.
m. Fungal infection.
n. Herpes simplex infection.
335
o. TORCH infection.
p. Rabies.
13.DIGESTIVE SYSTEM:
a. Diahorrea.
b. Dysentery.
c. Abdominal pain.
d. Hepatitis.
e. Hepatic failure.
f. Ascites.
g. Portal hypertension.
h. Liver transplantation.
14.RESPIRATORY SYSTEM:
a. Common cold.
b. Pharyngitis.
c. Laryngotracheobronchitis.
d. Laryngomalacia.
e. Stridor in children.
f. Bronchiolitis.
g. Pneumonia.
h. Bronchiectasis.
i. Pleural effusion.
j. Pneumothorax.
k. Pneumo mediastinum.
l. Asthma.
15.CARDIOVASULAR SYSTEM:
a. Congenital heart disease.
b. Rheumatic fever and rheumatic heart disease.
c. Infective endocarditis.
336
d. Congestive cardiac failure.
e. Hypertension.
16.CENTRAL NERVOUS SYSTEM:
a. Meningitis.
b. Encephalitis.
c. Convulsions.
d. Cerebral palsy.
e. Mental retardation.
f. Microcephaly.
g. Macrocephaly.
h. Hydrocephalous.
i. Movement disorders.
j. Neurocutaneous markers.
k. Pseudo tumor cerebri.
l. Facial nerve palsy.
17.HAEMATOLOGY:
a. Pancytopenias.
b. Anemias.
c. Bleeding disorders.
d. ITP.
e. Hemophilia.
f. DIC.
g. Blood components.
h. Hypersplenism.
18.ONCOLOGY:
a. Leukemia.
b. Lymphomas.
c. Brain tumor in children.
337
d. Wilm‘s tumor.
19.NEPHROLOGY:
a. Haematuria.
b. Acute glomerulo nephritis.
c. Nephritic syndrome.
d. Urinary tract infection.
e. Renal failure (acute renal failure, chronic kidney disease, end stage
renal disease).
20.ENDOCRINOLOGY:
a. Hypothyroidism.
b. Type 1 diabetes mellitus.
21.GENETIC DISORDERS AND COUNSELING:
a. Down‘s syndromes.
b. Genetic counseling.
22.EMERGENCY MEDICINE:
a. Fluid and electrolyte imbalance.
b. Shock.
c. Poisoning.
d. Snake bite.
e. Scorpion sting.
f. Submersion injury.
23.MICELLANEOUS:
a. Pyrexia of unknown origin.
b. Approach to jaundice.
c. Approach to hepatosplenomegaly.
d. Approach to lymphadenopathy.
e. Headache.
338
24.ADOLESCENT HEALTH:
a. General problems in adolescents.
25.PAEDIATRIC SURGERY:
a. Volvulus.
b. Malrotation of gut.
c. Appendicitis.
d. Intusussception.
e. Undescended testis.
f. Hernia.
g. Bleeding per rectum.
h. Infantile hypertrophic pyloric stenosis.
i. Anorectal malformations.
j. Hirchprung‘s disease.
k. Burns.
l. Accidents.
Family Welfare
1. Problems of child health in relation to large family.
a. Organization of pediatric services.
b. Nutritional problems of mother and child.
c. Childhood diseases due to overcrowding.
339
UNIVERSITY EXAMINATIONS
THEORY:
Pediatrics including Neonatology
PASS CRITERIA:
MAXIMUM MINIMUM
Practical 80 40
Viva 20 -
------------ ------------
------------ ------------

Note:

grade card.
340

UG Regulations Syllabus

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

UG Regulations Syllabus

Uploaded by

Copyright:

Available Formats

REGULATION FOR THE DEGREE OF BACHELOR OF

MEDICINE AND BACHELOR OF SURGERY (MBBS) 2019

In exercise of the powers conferred by Bharath Institute of Higher Education and

Gazette Publication -------- BOARD OF GOVERNORS IN SUPER-

No. MCI-34(41)/2019-Med./161726.- In exercise of the powers

1. (i) These Regulations may be called the “Regulation on Graduate Medical

2. The following shall be added as clause 1A to the Regulations on Graduate

3. Following shall be added as Part II of the Regulations on Graduate

THE REGULATIONS ON GRADUATE MEDICAL

5. Admission to the Indian Medical Graduate Programme

PHASE WISE TRAINING AMD TIME DISTRIBUTION FOR

7. Training period and time distribution:

COMPETENCY BASED CURRICULUM OF THE INDIAN

S. No. Title Page no.

GENERAL CONSIDERATIONS AND TEACHING APPROACH

2. Indian Medical Graduate Training Programme

(a) Be competent in diagnosis and management of common

3.2.1 Work effectively and appropriately with colleagues in an

3.3.1 Demonstrate ability to communicate adequately,

3.4 Lifelong learner committed to continuous improvement of

3.4.1 Demonstrate ability to perform an objective self-

3.4.4 Demonstrate ability to search (including through

3.4.5 Be able to identify and select an appropriate career

1.5.1 Practice selflessness, integrity, responsibility,

4. Broad Outline on training format

4.1.1 There shall be a "Foundation Course" to orient

medical learners to MBBS programme, and provide

shall predominantly include small group learning,

skill acquisition, certification in essential skills;

experiences in patient care, diagnostic and skill

4.1.7 The development of ethical values and overall

4.1.8 Progress of the medical learner shall be documented

through structured periodic assessment that includes

4.2 Appropriate Faculty Development Programmes shall be

5. Admission to the Indian Medical Graduate Programme

allowed to be admitted to the Medical Curriculum proper of first Bachelor of

admission to the MBBS Course.

as prescribed in Clause 5 of Chapter II.”

passed qualifying examination as under:

d) 3% seats of the annual sanctioned intake capacity shall be filled up by candidates

with locomotory disability of lower limbs between 50% to 70%.Provided that in

5.3. COMMON COUNSELING

Note-1: The State Governments/Universities/Institutions may frame appropriate

The above clause 6 has been substituted in terms of notification published on

The Competency based Undergraduate Curriculum and Attitude,

Provided that in respect of batches admitted prior to the academic

extending over 4 ½ academic years, divided into nine

a minimum of eight hours of working on each day including

specialties both vertically and horizontally for better learner

7.4.1 Pre-Clinical Phase [(Phase I) - First Professional phase

of 13 months preceded by Foundation Course of one

(12 months)]: will consist of Para-clinical subjects

(c) Involvement in patient management and performance of

7.4.3 Clinical Phase – [(Phase III) Third Professional (28

(a) Part I (13 months) - The clinical subjects include

(b) Electives (2 months) - To provide learners

(c) Part II (13 months) - Clinical subjects

(v) AETCOM module

two third of the schedule shall include interactive sessions,

7.6 Universities shall organize admission timing and admission

process in such a way that teaching in the first Professional

(i) Supplementary examinations shall not be conducted later

(ii) A learner shall not be entitled to graduate later than ten

7.7 No more than four attempts shall be allowed for a candidate

Clinical Subjects 75 - 540* 615