You are on page 1of 45

MEDICAL COUNCIL OF INDIA

REGULATIONS ON GRADUATE MEDICAL EDUCATION, 2012

MEDICAL COUNCIL OF INDIA SECTOR-8, POCKET-14, DWARKA, NEW DELHI-110077 Phone Nos. 011-25367033, 25367035, 25367036 Fax Nos. 011-25367024, 25367025

1. Theundergraduatemedicaleducationprogrammeisdesignedwithagoaltocreatean IndianMedicalGraduate(IMG)possessingrequisiteknowledge,skills,attitudes,valuesand responsiveness,sothatheorshemayfunctionappropriatelyandeffectivelyasaphysicianof firstcontactofthecommunitywhilebeinggloballyrelevant. 2. Inordertofulfilthisgoal,theIMGmustbeabletofunctioninthefollowingROLES appropriatelyandeffectively: 2.1. Clinicianwhounderstandsandprovidespreventive,promotive,curative,palliativeand holisticcarewithcompassion. 2.2. Leaderandmemberofthehealthcareteamandsystemwithcapabilitiestocollect analyze,synthesizeandcommunicatehealthdataappropriately. 2.3. Communicatorwithpatients,families,colleaguesandcommunity. 2.4. Lifelonglearnercommittedtocontinuousimprovementofskillsandknowledge. 2.5. Professional,whoiscommittedtoexcellence,isethical,responsiveandaccountableto patients,communityandprofession. 3. Competencies:Competencybasedlearningwouldincludedesigningandimplementing medicaleducationcurriculumthatfocusesonthedesiredandobservableabilityinreallife situations.Inordertoeffectivelyfulfiltherolesaslistedinitem1above,theIndianMedical Graduatewouldhaveobtainedthefollowingsetofcompetenciesatthetimeofgraduation: 3.1. Clinician,whounderstandsandprovidespreventive,promotive,curative,palliativeand holisticcarewithcompassion 3.1.1. Demonstrateknowledgeofnormalhumanstructure,functionanddevelopment fromamolecular,cellular,biologic,clinical,behavioralandsocialperspective. 3.1.2. Demonstrateknowledgeofabnormalhumanstructure,functionand developmentfromamolecular,cellular,biological,clinical,behaviouralandsocial perspective. 3.1.3. Demonstrateknowledgeofmedicolegal,societal,ethicalandhumanitarian principlesthatinfluencehealthcare. 3.1.4. Demonstrateknowledgeofnationalandregionalhealthcarepoliciesincluding theNationalRuralHealthMission(NRHM),frameworks,economicsandsystems 2

thatinfluencehealthpromotion,healthcaredelivery,diseaseprevention, effectiveness,responsiveness,qualityandpatientsafety. 3.1.5. Demonstrateabilitytoelicitandrecordfromthepatient,andotherrelevant sourcesincludingrelativesandcaregivers,ahistorythatiscompleteandrelevant todiseaseidentification,diseasepreventionandhealthpromotion. 3.1.6. Demonstrateabilitytoelicitandrecordfromthepatient,andotherrelevant sourcesincludingrelativesandcaregivers,ahistorythatiscontextualtogender, age,vulnerability,socialandeconomicstatus,patientpreferences,beliefsand values. 3.1.7. Demonstrateabilitytoperformaphysicalexaminationthatiscompleteand relevanttodiseaseidentification,diseasepreventionandhealthpromotion.

3.1.8. Demonstrateabilitytoperformaphysicalexaminationthatiscontextualto gender,socialandeconomicstatus,patientpreferencesandvalues.

3.1.9. Demonstrateeffectiveclinicalproblemsolving,judgmentandabilitytointerpret andintegrateavailabledatainordertoaddresspatientproblems,generate differentialdiagnosesanddevelopindividualizedmanagementplansthatinclude preventive,promotiveandtherapeuticgoals.

3.1.10. Maintainaccurateclearandappropriaterecordofthepatientinconformation withlegalandadministrativeframeworks.

3.1.11. Demonstrateabilitytochoosetheappropriatediagnostictestsandinterpret thesetestsbasedonscientificvalidity,costeffectivenessandclinicalcontext.

3.1.12. Demonstrateabilitytoprescribeandsafelyadministerappropriatetherapies includingnutritionalinterventions,pharmacotherapyandinterventionsbasedon theprinciplesofrationaldrugtherapy,scientificvalidity,evidenceandcost thatconformtoestablishednationalandregionalhealthprogrammesandpolicies forthefollowing: a. b. c. d. Diseaseprevention, Healthpromotionandcure, Painanddistressalleviation,and Rehabilitationandpalliation. 3

3.1.13 Demonstrateabilitytoprovideacontinuumofcareattheprimaryand/or secondarylevelthataddresseschronicity,mentalandphysicaldisability.

3.1.14 Demonstrateabilitytoappropriatelyidentifyandreferpatientswhomayrequire specializedoradvancedtertiarycare.

3.1.15 Demonstratefamiliaritywithbasic,clinicalandtranslationalresearchasitapplies 3.2. tothecareofthepatient.

Leaderandmemberofthehealthcareteamandsystem 3.2.1 3.2.2 3.2.3 3.2.4 3.2.5 3.2.6 Workeffectivelyandappropriatelywithcolleaguesinaninterprofessionalhealth careteamrespectingdiversityofroles,responsibilitiesandcompetenciesofother professionals. Recognizeandfunctioneffectively,responsiblyandappropriatelyasahealthcare teamleaderinprimaryandsecondaryhealthcaresettings. Educateandmotivateothermembersoftheteamandworkinacollaborativeand collegialfashionthatwillhelpmaximizethehealthcaredeliverypotentialofthe team. Accessandutilizecomponentsofthehealthcaresystemandhealthdeliveryina mannerthatisappropriate,costeffective,fairandincompliancewiththe nationalhealthcareprioritiesandpolicies,aswellasbeabletocollect,analyze andutilizehealthdata. Participateappropriatelyandeffectivelyinmeasuresthatwilladvancequalityof healthcareandpatientsafetywithinthehealthcaresystem. Recognizeandadvocatehealthpromotion,diseasepreventionandhealthcare qualityimprovementthroughpreventionandearlyrecognition:ina)lifestyle diseasesandb)cancer,incollaborationwithothermembersofthehealthcare team.

3.3.

Communicatorwithpatients,families,colleaguesandcommunity 3.3.1 Demonstrateabilitytocommunicateadequately,sensitively,effectivelyand respectfullywithpatientsinalanguagethatthepatientunderstandsandina mannerthatwillimprovepatientsatisfactionandhealthcareoutcomes.

3.3.2 3.3.3 3.3.4 3.4.

Demonstrateabilitytoestablishprofessionalrelationshipswithpatientsand familiesthatarepositive,understanding,humane,ethical,empathetic,and trustworthy. Demonstrateabilitytocommunicatewithpatientsinamannerrespectfulof patientspreferences,values,priorexperience,beliefs,confidentialityand privacy. Demonstrateabilitytocommunicatewithpatients,colleaguesandfamiliesina mannerthatencouragesparticipationandshareddecisionmaking.

Lifelonglearnercommittedtocontinuousimprovementofskillsandknowledge 3.4.1 3.4.2 3.4.3 3.4.4 3.4.5 Demonstrateabilitytoperformanobjectiveselfassessmentofknowledgeand skills,continuelearning,refineexistingskillsandacquirenewskills. Demonstrateabilitytoapplynewlygainedknowledgeorskillstothecareofthe patient. Demonstrateabilitytointrospectandutilizeexperiences,toenhancepersonal andprofessionalgrowthandlearning. Demonstrateabilitytosearch(includingthroughelectronicmeans),andcritically evaluatethemedicalliteratureandapplytheinformationinthecareofthe patient. Beabletoidentifyandselectanappropriatecareerpathwaythatisprofessionally rewardingandpersonallyfulfilling.

3.5.

Professionalwhoiscommittedtoexcellence,isethical,responsiveandaccountableto patientscommunityandtheprofession 3.5.1 3.5.2 3.5.3 3.5.4 3.5.5 Practiceselflessness,integrity,responsibility,accountabilityandrespect. Respectandmaintainprofessionalboundariesbetweenpatients,colleaguesand society. Demonstrateabilitytorecognizeandmanageethicalandprofessionalconflicts. Abidebyprescribedethicalandlegalcodesofconductandpractice. Demonstrateacommitmenttothegrowthofthemedicalprofessionasawhole.

4. Inordertoensurethattrainingisinalignmentwiththegoalsandcompetencieslistedin items,1and0above: 4.1. Thereshallbeabridgecoursetermedas"FoundationCourse"toorientmedical studentstoMBBSprogramme,andprovidethemwithrequisiteknowledge, communication(includingelectronic),technicalandlanguageskillsrequired. 4.2. Thecurricularcontentshallbeverticallyandhorizontallyalignedandintegratedtothe maximumextentpossibleinordertoenhancestudentinterestandeliminate redundancyandoverlap. 4.3. Teachinglearningmethodsshallbestudentcentricandshallpredominantlyinclude smallgrouplearning,interactiveteachingmethodsandcasebasedlearning. 4.4. Clinicaltrainingshallemphasizeearlyclinicalexposure,skillacquisition,certificationin essentialskills;community/primary/secondarycarebasedlearningexperiencesand emergencies. 4.5. Trainingshallprimarilyfocusonpreventiveandcommunitybasedapproachesto healthanddisease,withspecificemphasisonnationalhealthprioritiessuchasfamily welfare,communicablediseases,epidemicsanddisastermanagement. 4.6. Acquisitionandcertificationofskillsshallbethroughexperiencesinpatientcare, diagnosticandskilllaboratories. 4.7. Thedevelopmentofethicalvaluesandoverallprofessionalgrowthasintegralpartof curriculumshallbeemphasizedthroughastructuredlongitudinalanddedicated programmeonprofessionaldevelopmentandethics. 4.8. Progressofthemedicalstudentshallbedocumentedthroughstructuredperiodic assessmentthatincludesformativeassessment.Logsofskillbasedtrainingshallbe alsomaintained. 4.9. Appropriatefacultydevelopmentprogrammesshallbeconductedregularlyby institutionstofacilitatemedicalteachersatalllevelstocontinuouslyupdatetheir professionalandteachingskill;andaligntheirteachingskillstocurricularobjective. 5. AdmissiontotheMBBSprogramme 6. Migration:Migrationfromonemedicalcollegetootherisnotarightofastudentand normallyshallnotbeallowed.However,migrationfromonemedicalcollegetoanother 6

medicalcollegewithinIndiamaybeconsideredbytheMedicalCouncilofIndiaonlyin exceptionalcases,onextremecompassionategrounds,providedthefollowingcriteriaare fulfilled. 6.1 Bothcollegesi.e.,theoneatwhichthestudentisenrolledandonetowhichmigrationis sought,arerecognizedbytheMedicalCouncilofIndia. 6.2 TheapplicantcandidateshouldhavepassedfirstProfessionalMBBSexaminationinthe firstattempt. 6.3 Theapplicantshallsubmithisapplicationformigration,completeinallrespects,toall authoritiesconcernedwithinaperiodofonemonthofpassing(declarationofresult)the firstProfessionalBachelorofMedicineandBachelorofSurgery(MBBS)examination. 6.4 Theapplicantshallsubmitanaffidavitstatingthathe/shewillpursue14monthsof prescribedstudybeforeappearingatIIndProfessionalBachelorofMedicineandBachelor ofSurgery(MBBS)examinationatthetransfereemedicalcollege,whichshouldbeduly certifiedbytheRegistraroftheconcernedUniversityinwhichhe/sheisseekingtransfer. Thetransferwillbeapplicableonlyafterreceiptoftheaffidavit. 6.5 Migrationshallberestrictedto5%ofthesanctionedintakeofthecollegeduringthe year.Nomigrationwillbepermittedonanygroundfromonemedicalcollegetoanother locatedwithinthesamecity. 6.6 Thereshouldbeclearvacancythathasarisenduetononfillingofseats.Astudentwho wishestomigratemaybeaccommodatedonlyintheeventofvacancyinsanctioned seatsstrength.Failureofstudentsinexaminationwillnotcountasvacancyofsanctioned seatsstrength. 6.7 Migrationshallbeallowedonlyfortheregularbatch. 6.8 Migrationduringclinicalcourseofstudyshallnotbeallowedonanygrounds. 6.9 AllapplicationsformigrationshallbereferredtoMedicalCouncilofIndiabycollege authorities.Noinstitution/Universityshallallowmigrationsdirectlywithouttheapproval oftheCouncil. 6.10 Councilreservestheright,nottoentertainanyapplicationwhichisnotunderthe prescribedcompassionategroundsandalsototakeindependentdecisionwhere applicanthasbeenallowedtomigratewithoutreferringthesametotheCouncil.The 7

MedicalCouncilofIndiashallcommunicateitsdecisionwithin04weeksofreceiptof application. 6.11 Compassionategroundscriteria: 6.11.1 DeathofparentorsupportingguardianduringdurationoffirstProfessionalphase (FirstMBBS). 6.11.2 Illnessofcandidatecausingdisability. 6.11.3 DisturbedconditionsasdeclaredbyGovernmentintheareainwhichtheMedical Collegeislocated. 7 Trainingperiodandtimedistribution: 7.1. Everystudentshallundergoaperiodofcertifiedstudyextendingover4yearsfrom thedateofcommencementofstudyforthesubjectscomprisingthemedical curriculumtothedateofcompletionofexaminationwhichshallbefollowedbyone yearofcompulsoryrotatinginternship. 7.2. Eachacademicyearwillconsistofaminimumof240teachingdayswithaminimumof 08hourseachworkingdayincludingonehourforlunch. 7.3. Teachingandlearningshallbealignedandintegratedacrossspecialtiesbothvertically andhorizontallyforbetterstudentcomprehension.Studentcenteredlearning methodsshouldincludeproblemorientedlearning,casestudies,communityoriented learning,selfdirectedandexperientiallearning. 7.4. Theperiodof4yearsisdividedasfollows: 7.4.1 PreclinicalPhase(12monthsprecededbyfoundationcourseof2months):will consistofpreclinicalsubjectsHumanAnatomy,Physiology,Biochemistry, introductiontoCommunityMedicine,humanitiesandearlyclinicalexposure ensuringbothhorizontalandverticalintegration. 7.4.2 Phase2(12months):willconsistofParaclinical,namelyPathology, Pharmacology,Microbiology,CommunityMedicine,ForensicMedicineand Toxicology,andclinicalsubjectsasdetailedbelow(IIIMBBS)ensuringboth horizontalandverticalintegration.

a. Theclinicalexposuretostudentswillbeintheformofstudentdoctormethodof clinicaltraining.Theemphasiswillbeonprimary,preventiveandcomprehensive 8

healthcare.Apartoftrainingduringclinicalpostingsshouldtakeplaceatthe primarylevelofhealthcare.Itisdesirabletoprovidelearningexperiencesin secondaryhealthcare,whereverpossible.Thiswillinvolve: i) Experienceinrecognizingandmanagingcommonproblemsseenin outpatient,inpatientandemergencysettings. ii) iii) Involvementinpatientcareasateammember. Involvementinpatientmanagementandperformanceofbasic procedures. 7.4.3 Phase3(28months)

a. Part1(13months)TheclinicalsubjectsincludeOtorhinolaryngology, Ophthalmology,CommunityMedicineandForensicMedicineandToxicology. b. Elective(2months)Toprovidestudentswithopportunityfordiverselearning experiences,todoresearch/communityprojectsthatwillstimulateenquiry, selfdirected,experientallearningandlateralthinking[item9.3]. c. Part2(13months)Clinicalsubjectsinclude: i) Medicineandalliedspecialties(GeneralMedicine,Pediatrics, TuberculosisandChest,SkinandSexuallyTransmittedDiseases, Psychiatry,Radiodiagnosis,Infectiousdiseases). ii) Surgeryandalliedspecialties(GeneralSurgery,Orthopedicsincluding trauma,physiotherapyandrehabilitation,Anesthesia,Dentistry, Radiotherapy). iii) ObstetricsandGynecology(includingFamilyMedicineandFamily Welfare). iv) 7.5. Pediatrics.

Didacticlecturesshallnotexceedonethirdoftheschedule;twothirdoftheschedule shallincludeinteractive,practical,clinicalor/andgroupdiscussions.Thelearning processshouldincludelivingexperiences,problemorientedapproach,casestudiesand communityhealthcareactivities.Theteachingrostershouldbecarefullypreparedby eachinstitutionsoastogiveadequateandjustifiedtimeforstudentstolearnaswell aspreparefortheirassessments.

7.6.

Universitiesshallorganizeadmissiontimingandadmissionprocessinsuchawaythat teachinginthefirstProfessionalyearcommenceswithinductionthroughthe FoundationCoursebythe1stofAugusteachyear.

7.7.

Supplementaryexaminationsshallbeconductednotearlierthan60daysandnotlater than90daysafterthedeclarationofresults,sothatthestudentswhopasscanjointhe mainbatchandthestudentswhofail,willappearinthesubsequentyear.

7.8.

Astudentshallnotbeallowedtograduatelaterthan9yearsofjoiningfirstMBBS course.

7.9.

Passinginthe1stProfessionalexaminationsiscompulsorybeforeproceedingtoPhase IItraining.

7.10. Nomorethan04attemptsshallbeallowedforacandidatetopassthefirst Professionalexaminations.TotalperiodforsuccessfulcompletionoffirstProfessional shallnotexceed04years.Partialattendanceofexaminationinanysubjectshallbe countedasanattempt. 7.11. Astudent,whofailsintheIIndProfessionalexamination,shallnotbeallowedtoappear inIIIrdProfessionalPartIexaminationunlesshepassesallsubjectsofIIndProfessional examination. 7.12. PassinginIIIrdProfessional(PartI)examinationisnotcompulsorybeforestarting4th yeartraining,howeverpassingofIIIrdProfessional(PartI)iscompulsoryforbeing eligibleforIIIrdProfessional(PartII)examination. 7.13. DuringPhaseIIandPhaseIIIincludingprescribed04weeksofelectives,clinicalpostings ofthreehoursdurationdailyasspecifiedinTableissuggestedforvariousdepartments. 8. PhaseDistributionandTimingofexamination 8.1. 8.2. 8.3. 8.4. 8.5. TimedistributionoftheMBBSprogrammeisgivenintable1. Phasewisedistributionofsubjectsisgivenintable2. Minimumteachinghoursprescribedinvariousdisciplinesareasundertables37. Distributionofclinicalpostingsisgivenintable8. Totalweeksofclinicalpostingswillbe: 8.5.1 PhaseII:36weeks 10

8.5.2 8.5.3 8.6.

PhaseIIIpart1:42weeks PhaseIIIpart2:44weeks

Timeallottedexcludestimereservedforinternal/universityexaminations,and vacation

8.7.

Secondphaseclinicalpostingsshallcommenceafterdeclarationofresultsofthefirst professionalphaseexaminations.ThirdProfessionalphaseIandphaseIIclinical postingsshallstartnolaterthantwoweeksaftercompletionofthepreviousphase examination

8.8.

25%ofallottedtimeofPhase3shallbeutilizedforintegratedlearningwithpreand paraclinicalsubjects.Thiswillbeincludedintheassessmentofclinicalsubjects.

11


Table1:TimedistributionofMBBSprogramme

Jan

Feb

Mar

Apr

May

Jun

Jul

Aug

Sep

Oct

Nov

Dec

IMBBS

Foundation Iyr exam

IMBBS IIMBBS

IIMBBS

IIyr exam

IIIMBBSPart1

IIIMBBSPart1 IIIMBBSPart2 Part2 exam NEET Internship

Part1 exam

Electives andskills

NEETexaminationwillcompriseof6070%ofthecoursecontentfromPhaseIIIandrestwillbe fromphaseIandII.NEETwillbeheldinthelastweekofFebruary.

12


Table2:Phasewisedistributionofsubjects

Phase&yearof MBBStraining Phase1 IMBBS

Subjects&NewTeachingElements

Duration

University examination

FoundationCourse(2months) Anatomy,PhysiologyandBiochemistry EarlyClinicalExposure(12months) ProfessionalDevelopmentincluding Ethics

2+12 months

IstProfessional

Phase2 IIMBBS

Pathology,Microbiologyand Pharmacology,ForensicMedicineand Toxicology Introductiontoclinicalsubjects ProfessionalDevelopmentincluding Ethics

12months

IIndProfessional

Phase3 IIIMBBS PartI

Otorhinolaryngology,Ophthalmology, CommunityMedicineandForensic MedicineandToxicology Clinicalsubjects Professionaldevelopmentincluding ethics

13months

IIIrdProfessional (Part1)

Electives PhaseIII IIIMBBSPart2

Electives,Skillsandassessment* Medicine,Surgery,Obstetricsand GynecologyandPediatricsand specialties ProfessionalDevelopmentincluding Ethics

2months 13months

IIIrdProfessional (Part2)

*AssessmentofelectivesandskillswillbeincludedinInternalassessment.

13

Table3:FoundationCourse

Subjects/Contents

Teachinghours

SelfDirected Learning(hours)

Totalhours

Orientation1 SkillsModule2 CoreSubjectOrientation3 Fieldvisittocommunity healthcenter SportsandExtracurricular includingYoga Enhancementof language/computer skills4

30 35 120 8

0 0 15 0

30 35 135 8

32

32

80

80

320

1.Orientationcoursewillbecompletedassingleblockinfirstweekandwillcontainelementsoutlinedin9.1. 2.Skillsmoduleswillcontainelementsoutlinedin9.1 3.Coresubjectorientationincludesa)Integratedcellbiologymodule15hoursb)IntroductiontoAnatomy,Physiologyand Biochemistry. 4.Basedonperceivedneedstudents,maychooselanguageenhancement(Englishorlocalspokenorboth)andcomputerskills.This shouldbeprovidedlongitudinallythroughthedurationoftheFoundationCourseaftertheorientationblock.

14

Table4:PhaseIteachinghours

Subjects

Lectures (hours)

SmallGroup

Self

Total (hours)

Teaching/Tutorials/ directed Integratedlearning/ Practical(hours) learning (hours) 30 25 20 0 5 0

Anatomy Physiology Biochemistry EarlyClinicalExposure CommunityMedicine Professional developmentincluding ethics* Sportsandextracurricular includingYoga Total

200 170 90 80 20 35

350 235 115 27

580 430 225 80 52 35

38

1440

*Professionaldevelopmentshallbealongitudinalteachingprogram.

15

Table5:PhaseIIteachinghours

Subjects

Lectures (hours)

Smallgroup learning(Tutorials/ Seminars)/Integrated learning(hours)

Clinical Postings (hours)

Self Directed Learning (hours) 12

Total (hours)

Pathology Pharmacology Microbiology Community Medicine ForensicMedicine andToxicology ClinicalSubjects Professional development includingethics Sportsand extracurricular includingYoga Total

80 80 70 20

138 138 110 30

230 230 190 60

12 10 10

15

30

50

75 35

540

35

615 35

40

40

1440

Atleast3hoursofclinicalinstructioneachweekmustbeallottedtotraininginclinicalandproceduralskilllaboratories.The hoursmaybedistributedweeklyorasablockineachpostingbasedoninstitutionallogistics.

:Theclinicalpostingsinthesecondphaseshallbe15hoursperweek3hrsperdayonlyfromMondaytoFriday.Therest ofthetimeshallbeusedforparaclinicalsubjects

16

Table6:PhaseIIIPart1teachinghours

Subjects

Teaching Hours

Tutorials/ Seminars/Integrated Teaching (hours)

Self Directed Learning (hours) 35 35 35 5 5 5

Total (hours)

GeneralMedicine GeneralSurgery Obstetricsand Gynecology Pediatrics Orthopedics ForensicMedicineand Toxicology CommunityMedicine Dermatology Psychiatry PulmonaryMedicine Otorhinolaryngology Ophthalmology Radiologyand Radiotherapy Anesthesiology ClinicalPostings Professional developmentincluding Ethics Total

25 25 25

65 65 65

20 15 25

30 20 45

5 5 5

55 40 75

40 20 25 10 25 30 10

60 5 10 8 40 60 8

5 5 5 2 5 10 2

105 30 40 20 70 100 20

10

20 756 25

303

401

66

1680

17

Table7:PhaseIIIPart2teachinghours

Subjects

Teaching Hours

Tutorials/ Seminars/Integrated Teaching (hours)

Self Directed Learning (hours)

Total* (hours)

GeneralMedicine GeneralSurgery ObstetricsAnd Gynecology Pediatrics Orthopedics ClinicalPostings Professional Developmentincluding Ethics Electives Total

70 70 70

125 125 125

15 15 15

210 210 210

20 20

35 25

10 5

65 50 792 43

250

435*

60

200 1760

*25%ofallottedtimeofPhase3shallbeutilizedforintegratedlearningwithpreandparaclinicalsubjects.Thiswillbeincludedin theassessmentofclinicalsubjects.

18

Table8:Clinicalpostings

Subjects

Periodoftraininginweeks

Total weeks

II MBBS

IIIMBBS PartI

IIIMBBS PartII 8(4regular


clinicalposting)

Electives

GeneralMedicine1 GeneralSurgery2 OB/GYN3 Pediatrics CommunityMedicine3 Orthopedicsincluding Trauma4 Otorhinolaryngology Ophthalmology Tuberculosisand respiratorydiseases Psychiatry Radiology5 Dermatology,STDandHIV6 Dentistry Casualty

4 4 4 2 4 2

4 4 4 4 6 4

8+4 8+4 8+4 4 2

20 20 20 10 10 8

4 4 2

4 4

8 8 2

2 2 2

2 2 2 2

4 2 6 2 2

36

42

44

122

Infouroftheeightweeksofelectivesregularclinicalpostingsshallbeaccommodated. 19

Clinicalpostingsmaybeadjustedwithinthetimeframework
1 2 3 4 5 6

ThispostingincludesLaboratoryMedicineandInfectiousDiseases.

Thispostingincludes2weeksofDentistry,surgicaldressing,andAnesthesia. Thisincludesmaternitytrainingandfamilywelfare(includingfamilyplanning). ThispostingincludesTrauma,RehabilitationandPhysiotherapy. ThispostingincludesRadiotherapy,wherefeasible. IfHIVclinicisnotundertheDepartmentofDermatologythestudentmustbesenttotheappropriateclinicaldepartment.

9. Newteaching/learningelements 9.1. FoundationCourse 9.1.1 Goal:ThegoaloftheFoundationCourseistoprepareastudenttostudymedicine effectively.Itwillbeoftwomonthsdurationafteradmission. 9.1.2 Objectives:Theobjectivesareto: a. Orientthestudentto: i) ii) iii) iv) v) vi) vii) viii) ix) x) xi) Themedicalprofessionandthephysiciansroleinsociety, TheMBBSprogramme, Alternatehealthsystemsinthecountry, Medicalethics,attitudesandprofessionalism, Healthcaresystemanditsdelivery, Nationalhealthprioritiesandpolicies, Universalprecautionsandvaccinations, Patientsafetyandbiohazardsafety, Principlesoffamilypractice, IndianmedicalgraduatedocumentoftheMedicalCouncilofIndia, Themedicalcollegeandhospital,

b. Enablethestudenttoacquireenhancedskillsin: i) ii) Language, Interpersonalrelationships, 20

iii) iv) v) vi) vii)

Communication, Learningincludingselfdirectedlearning, Timemanagement, Stressmanagement, Useofinformationtechnology.

c. Trainthestudenttoprovide: i) ii) Firstaid, Basiclifesupport.

9.1.3 Elements:Theprogramwillinclude,inadditiontothemoduleslistedinthe objectivesabove: a. Traininginlanguageandcomputerskills, b. IntegratedCellBiologyModule, c. Foundationelementsofpreclinicalsciences. 9.1.4 Thesesessionsmustbeasinteractiveaspossible. 9.1.5 Sports(tobeusedthroughtheFoundationCourseasprotected04hoursper week). 9.1.6 Leisureandextracurricularactivity(tobeusedthroughtheFoundationCourseas protected02hoursperweek). 9.1.7 Studentsmaybeenrolledinoneofthefollowingprogrammeswhichwillberun concurrently: a. Locallanguageprogramme, b. Englishlanguageprogramme, c. Computerskills, d. Thesemaybedoneinthelasttwohoursofthedayforthedurationofthe FoundationCourse.

21

9.1.8 Subjectfoundationelements,inclusiveoftheintegratedcellbiologymodule,may startafterthefirsttwoweeks(Anatomy60hours;Physiology40hours; Biochemistry20hours). 9.1.9 ManyoftheseelementswillrequiretobecontinuedbeyondtheFoundation Course. 9.1.10 Institutionsshalldeveloplearningmodulesandidentifytheappropriateresource personsfortheirdelivery. 9.1.11 ThetimecommittedfortheFoundationCoursemaynotbeusedforanyother curricularactivity. 9.1.12 Fromthe2ndweekonwards,untiltheendoftheFoundationCourse,thelast02 hoursofeachdaywillremainprotectedforlanguageandcomputerskillclasses. 9.1.13 Everycollegemustarrangeforameetingwithparentsandtheirwards. 9.2. EarlyClinicalExposure 9.2.1 Objectives:Theobjectiveofearlyclinicalexposureofthefirstyearmedical studentsistoenablethestudentto: a. Recognizetherelevanceofbasicsciencesinpatientcare, b. Provideacontextthatwillenhancebasicsciencelearning,and c. Relatetoexperienceofpatientsasamotivationtolearn, d. Recognizeethicsandprofessionalismasintegraltothedoctorpatient relationship, e. Understandthesocioculturalcontextofdiseasethroughstudyofhumanities. 9.2.2 Elements a. Basicsciencecorrelation:i.e.applyandcorrelateprinciplesofbasicsciencesas theyrelatetothecareofthepatient(Thiswillbepartofintegratedmodules). b. Clinicalskills:toincludeBasicskillsininterviewingpatients,doctorpatient communication,ethicsandprofessionalism,criticalthinkingandanalysisandself learning(Thistrainingwillbeimpartedinthetimeallottedforearlyclinical exposure). 22

c.

Humanities:Tointroducestudentstoabroaderunderstandingofthesocio economicframeworkandculturalcontextwithinwhichhealthisdelivered throughthestudyofhumanitiesandsocialsciences.

9.3.

Electives 9.3.1 Objectives:Toprovidethestudentwithopportunities: a. Fordiverselearningexperiences, b. Todoresearch/communityprojectsthatwillstimulateenquiry,selfdirected, experientiallearningandlateralthinking. 9.3.2 Twomonthsaredesignatedforelectiverotationsaftercompletionoftheexamat endoftheIIIrdMBBSpart1andbeforecommencementofIIIrdMBBSpart2. 9.3.3 Itismandatoryforstudentstodoanelective.Theelectivetimemaynotbeused tomakeupformissedclinicalpostings,shortageofattendanceorotherpurposes. 9.3.4 Structure a. Thestudentshallrotatethroughtwoelectiveblocksof04weekseach, b. Block1shallbedoneinapreselectedpreclinicalorparaclinicalorotherbasic OR underaresearcheronanongoingresearchproject.Duringtheelectivesregular clinicalpostingsshallcontinue. c. Block2shallbedoneinaclinicaldepartment(includingspecialties,super OR asasupervisedlearningexperienceataruralorurbancommunityclinic. d. Institutionswillpredeterminethenumberandnatureofelectives,namesofthe supervisors,thenumberofstudentsineachelectivebasedonthelocal conditions,availableresourcesandfaculty. 9.3.5 Eachinstitutionwilldevelopitsownmechanismforallocationofelectives. specialties,ICUs,bloodbankandcasualty)fromalistofelectivesdevelopedand availableintheinstitution scienceslaboratory

23

9.3.6 Itispreferablethatelectivechoicesaremadeavailabletothestudentsinthe beginningoftheacademicyear. 9.3.7 Thestudentmustsubmitalearninglogbookbasedonbothblocksoftheelective. 9.3.8 75%attendanceintheelectiveandsubmissionoflogbookmaintainedduring electiveisrequiredforeligibilitytoappearinthefinalMBBSexamination. 9.3.9 Institutionsmayusepartofthistimeforstrengtheningbasicskillcertification. 9.3.10 AllelectivesarerequiredtobedoneinIndiaONLY. 9.4. ProfessionalDevelopmentincludingEthicsandMedicalHumanities 9.4.1 Objectivesoftheprogramme:Attheendoftheprogramme,thestudentmust demonstrateabilityto: a. understandandapplyprinciplesofbioethicsandlawastheyapplytomedical practiceandresearch, b. understandandapplytheprinciplesofclinicalreasoningastheyapplytothecare ofthepatients, c. understandandapplytheprinciplesofsystembasedcareastheyrelatetothe careofthepatient, d. understandandapplyempathyandotherhumanvaluestothecareofthe patient, e. communicateeffectivelywithpatients,families,colleaguesandotherhealthcare professionals, f. understandthestrengthsandlimitationsofalternativesystemsofmedicine,

g. respondtoeventsandissuesinaprofessional,considerateandhumanefashion h. translatelearningfromthehumanitiesinordertofurtherhis/herprofessional andpersonalgrowth 9.4.2 Learningexperiences: a. ThiswillbealongitudinalprogrammespreadacrossthecontinuumoftheMBBS programmeincludinginternship,

24

b. Learningexperiencesmayincludesmallgroupdiscussions,patientcare scenarios,workshop,seminars,roleplays,lecturesetc. 9.4.3 75%attendanceinprofessionaldevelopmentprogramisrequiredforeligibilityto appearforfinalexaminationineachprofessionalyear. 9.4.4 InternalAssessmentwillinclude: a. Writtentestscomprisingofshortnotesandcreativewritingexperiences, b. OSCEbasedclinicalscenarios/viva. 9.4.5 Atleastonequestionineachpaperoftheclinicalspecialtiesintheuniversity examinationshouldtestknowledgecompetenciesacquiredduringthe professionaldevelopmentprogram 9.4.6 Skillcompetenciesacquiredduringtheprofessionaldevelopmentprogrammust betestedduringtheclinical,practicalandviva. 9.5. StudentdoctorMethodofClinicalTraining 9.5.1 Goal:Toprovidestudentswithexperiencein: a. Longitudinalpatientcare, b. Beingpartofthehealthcareteam, c. Handsoncareofpatientsinoutpatientandinpatientsetting. 9.5.2 Structure: a. ThefirstclinicalpostinginphaseIIshallorientstudentstothepatient,theirroles andthespecialty, b. Thestudentdoctorprogrammewillprogressasoutlinedinthetable9, c. Thestudentwillfunctionasapartofthehealthcareteamwiththefollowing responsibilities: i) ii) Bepartoftheunitsoutpatientservicesonadmissiondays, Remainwiththeadmissionunituntil6PMexceptduringdesignatedclass hours,

25

iii)

Beassignednotmorethan2patientsadmittedduringeachadmissionday forwhomhe/shewillundertakeresponsibilityasoutlinedinthetable above,underthesupervisionofaseniorresidentorfacultymember,

iv)

Participateintheunitroundsonitsadmissiondayandwillpresentthe assignedpatientstothesupervisingphysician,

v) vi)

Followthepatientsprogressthroughoutthehospitalstayuntildischarge, Participate,undersupervision,inprocedures,surgeries,deliveriesetc.of theassignedpatients(accordingtoresponsibilitiesoutlinedinthetable above),

vii)

Participateinunitroundsonatleastoneotherdayoftheweekexcluding theadmissionday,

viii) ix) x)

Discussethicalandotherhumanitarianissuesduringunitrounds, Attendallscheduledclassesandeducationalactivities, Documenthis/herobservationsinaprescribedlogbook/caserecord.

d. Nostudentwillbegivenindependentchargeofthepatient. e. Thesupervisingphysicianwillberesponsibleforallpatientcaredecisions. 9.5.3 Assessment: a. Adesignatedfacultymemberineachunitwillcoordinateandfacilitatethe activitiesofthestudent,monitorprogress,providefeedbackandreviewthe logbook/caserecord. b. Thelogbook/caserecordmustincludethewrittencaserecordpreparedbythe studentincludingrelevantinvestigations,treatmentanditsrationale,hospital course,familyandpatientdiscussions,dischargesummaryetc., c. Thelogbookshouldalsoincluderecordsofoutpatientsassigned.Submissionof thelogbook/caserecordtothedepartmentisrequiredforeligibilitytoappear forthefinalexaminationofthesubject.

26

Table9:StudentDoctorprogram

YearofCurriculum Year2

FocusofStudentDoctorprogramme Historytaking,physicalexamination,assessmentof changeinclinicalstatus,communicationandpatient education

Year3

Alloftheaboveandchoiceofinvestigations,basic proceduresandcontinuityofcare

Year4

Alloftheaboveanddecisionmaking,managementand outcomes

10. Competencies 10.1. Preamble:Thesalientfeatureoftherevisionofthemedicalcurriculumin2012isthe emphasisonlearningwhichiscompetencybased,integratedandstudentcentered acquisitionofskillsandethicalandhumanisticvalues. Eachofthecompetenciesdescribedbelowmustbereadinconjunctionwiththegoals ofthemedicaleducationaslistedinitem2and3. 10.2. Integrationmustbehorizontal(i.e.acrossdisciplinesinagivenphaseofthecourse)and vertical(acrossdifferentphasesofthecourse).Asfaraspossible,itisdesirablethat teaching/learningoccursineachphasethroughstudyoforgansystemsordisease blocksinordertoalignthelearningprocess.Clinicalcasesmustbeusedtointegrate andlinklearningacrossdisciplines. 10.3. Forclinicalsubjects,itisrecommendedthatdidacticteachingberestrictedtolessthan 30%ofthetotaltimeallottedforthatdiscipline.Greateremphasisistobelaidon handsontraining,symposia,seminars,smallgroupdiscussions,problemorientedand problembaseddiscussionsandselfdirectedlearning.Studentsmustbeencouragedto takeactivepartinandsharedresponsibilityfortheirlearning. 10.4. PreclinicalSubjects 10.4.1. HumanAnatomy a. Competencies:Theundergraduatemustdemonstrate: 27

i.

Understandingofthegrossandmicroscopicstructureanddevelopmentof humanbody,

ii. Comprehensionofthenormalregulationandintegrationofthefunctionsof theorgansandsystemsonbasisofthestructure, iii. Understandingoftheclinicalcorrelationoftheorgansandstructuresinvolved andinterprettheanatomicalbasisofthediseasepresentations. b. Integration:Theteachingshouldbealignedandintegratedhorizontallyand verticallyinorgansystemswithclinicalcorrelationthatwillprovideacontextfor thestudenttounderstandtherelationshipbetweenstructureandfunctionand interprettheanatomicalbasisofvariousclinicalconditionsandprocedures. 10.4.2. Physiology a. Competencies: Theundergraduatesmustdemonstrate: i. Understandingofthenormalfunctioningoftheorgansandorgansystemsof thebody, ii. Comprehensionofthenormalstructureandorganizationoftheorgansand systemsonbasisofthefunctions, iii. Understandingofagerelatedphysiologicalchangesintheorganfunctions thatreflectnormalgrowthanddevelopment, iv. Understandthephysiologicalbasisofdisease. b. Integration:Theteachingshouldbealignedandintegratedhorizontallyand verticallyinorgansystemsinordertoprovideacontextinwhichnormalfunction canbecorrelatedbothwithstructureandwiththebiologicalbasis,itsclinical features,diagnosisandtherapy. 10.4.3. Biochemistry a. ThecoursewillcompriseCellularBiochemistryandMolecularBiology. b. Competencies:Thestudentmustdemonstrateanunderstandingof: i. biochemicalandmolecularprocessesinvolvedinhealthanddisease,

ii. importanceofnutritioninhealthanddisease, 28

iii. biochemicalbasisandrationaleofclinicallaboratorytestsandDemonstrate abilitytointerprettheseintheclinicalcontext. c. Integration:Theteaching/learningprogrammeshouldbeintegratedhorizontally andvertically,asmuchaspossible,toenablestudentstomakeclinical correlationsandtoacquireanunderstandingofthecellularandmolecularbasis ofhealthanddisease. 10.4.4. IntroductiontoCommunityMedicine a. Competencies:Theundergraduatemustdemonstrate: i. Understandingoftheconceptofhealthanddisease,

ii. Understandingofdemography,populationdynamicsanddiseaseburdenin Nationalandglobalcontext, iii. Comprehensionofprinciplesofhealtheconomicsandhospitalmanagement. 10.5. Phase2(ParaClinical) 10.5.1. Pathology a. Competencies:Theundergraduatemustdemonstrate: i. Comprehensionofthecauses,evolutionandmechanismsofdisease,

ii. Knowledgeofalterationsingrossandcellularmorphologyoforgansin diseasestates, iii. Abilitytocorrelatethenaturalhistoryandstructuralandfunctionalchanges withtheclinicalmanifestationsofdiseases,theirdiagnosisandtherapy. b. Integration:Theteachingshouldbealignedandintegratedhorizontallyand verticallyinorgansystemsrecognizingdeviationsfromnormalstructureand functionandclinicallycorrelatedsoastoprovideanoverallunderstandingofthe etiology,mechanisms,laboratorydiagnosisandtherapyofdisease. 10.5.2. Microbiology a. Competencies:Theundergraduatestudentdemonstrate: i. Understandingofroleofmicrobialagentsinhealthanddisease,

29

ii. Understandingoftheimmunologicalmechanismsinhealthanddisease, iii. Abilitytocorrelatethenaturalhistory,mechanismsandclinical manifestationsofinfectiousdiseasesastheyrelatetothepropertiesof microbialagents, iv. Knowledgeoftheprinciplesandtheapplicationofinfectioncontrol measures, v. Anunderstandingofthebasisofchoiceoflaboratorydiagnostictestsand theirinterpretation,antimicrobialtherapy,controlandpreventionof infectiousdiseases. b. Integration:Theteachingshouldbealignedandintegratedhorizontallyand verticallyinorgansystemswithemphasisonhostmicrobeenvironment interactionsandtheiralterationsindiseaseandclinicalcorrelationssoasto provideanoverallunderstandingoftheetiologicalagents,theirlaboratory diagnosisandprevention. 10.5.3. Pharmacology a. Competencies:Theundergraduatemustdemonstrate: i. Knowledgeaboutessentialandcommonlyuseddrugsandanunderstanding ofthepharmacologicbasisoftherapeutics, ii. Abilitytoselectandprescribemedicinesbasedonclinicalconditionandthe pharmacologicproperties,efficacy,safety,suitabilityandcostofmedicines forcommonclinicalconditionsofnationalimportance, iii. Knowledgeofpharmacovigilance,essentialdrugconceptandlist,sourcesof druginformationandindustrydoctorrelationships, iv. Abilitytocounselpatientsregardingappropriateuseofprescribeddrugand drugdeliverysystems b. Integration:Theteachingshouldbealignedandintegratedhorizontallyand verticallyinorgansystemsrecognizingtheinteractionbetweendrug,hostand diseaseinordertoprovideanoverallunderstandingofthecontextoftherapy.

30

10.6. PhaseIIIPart1 10.6.1. ForensicMedicineandToxicology a. Competencies:Thestudentmustdemonstrate: i. Understandingofmedicolegalresponsibilitiesofphysiciansinprimaryand secondarycaresettings, ii. Understandingoftherationalapproachtotheinvestigationofcrime,based onscientificandlegalprinciples, iii. Abilitytomanagemedicalandlegalissuesincasesofpoisoning/overdose, iv. Understandingthemedicolegalframeworkofmedicalpracticeandmedical negligence, v. Understandingofcodesofconductandmedicalethics. b. Integration:Theteachingshouldbealignedandintegratedhorizontallyand verticallyrecognizingtheimportanceofmedicolegal,ethicalandtoxicological issuesastheyrelatetothepracticeofmedicine 10.6.2. Communitymedicine a. Competencies:Thestudentmustdemonstrate: i. Understandingofphysical,social,psychological,economicandenvironmental determinantsofhealthanddisease, ii. Abilitytorecognizeandmanagecommonhealthproblemsincludingphysical, emotionalandsocialaspectsatindividualfamilyandcommunitylevelinthe contextofNationalHealthProgrammes, iii. AbilitytoImplementandmonitorNationalhealthprogrammesintheprimary caresetting, iv. Knowledgeofmaternalandchildwellnessastheyapplytonationalhealth careprioritiesandprogrammes, v. Abilitytorecognize,investigate,report,planandmanagecommunityhealth problemsandemergencies,

31

vi. Abilitytorecognize,investigate,reportandmanagecommunityhealth problemsandemergencies. b. Integration:Theteachingshouldbealignedandintegratedhorizontallyand verticallyinordertoallowthestudenttounderstandtheimpactofenvironment, societyandnationalhealthprioritiesastheyrelatetothepromotionofhealth andpreventionandcureofdisease. 10.6.3. OtoRhinolarngology a. Competencies:Thestudentmustdemonstrate: i. KnowledgeofthecommonOtorhinolaryngological(ENT)emergenciesand problems, ii. Abilitytorecognize,diagnoseandmanagecommonENTemergenciesand problemsinprimarycaresetting, iii. AbilitytoperformsimpleENTproceduresasapplicableinaprimarycare setting, iv. Abilitytorecognizehearingimpairmentandrefertotheappropriatehearing impairmentrehabilitationprogramme, b. Integration:Theteachingshouldbealignedandintegratedhorizontallyand verticallyinordertoallowthestudenttounderstandthestructuralbasisofENT problems,theirmanagementandcorrelationwithfunction,rehabilitationand qualityoflife. 10.6.4. Ophthalmology a. Competencies:Thestudentmustdemonstrate: i. Knowledgeofcommoneyeproblemsinthecommunity,

ii. Recognize,diagnoseandmanagecommoneyeproblemsandidentify indicationsforreferral, iii. Abilitytorecognizevisualimpairmentandblindnessinthecommunityand implementNationalprogrammeasapplicableintheprimarycaresetting. b. Integration:Theteachingshouldbealignedandintegratedhorizontallyand verticallyinordertoallowthestudenttounderstandthestructuralbasisof 32

ophthalmologicproblems,theirmanagementandcorrelationwithfunction, rehabilitationandqualityoflife. 10.7. PhaseIII(Part2) 10.7.1. Medicine a. Competencies: Mustdemonstrateabilitytodothefollowinginrelationto commonmedicalproblemsintheadultinthecommunity: i. Demonstrateunderstandingofthepathophysiologicbasis,epidemiological profile,signsandsymptoms,ofdiseaseandtheirinvestigationand management, ii. Competentlyinterviewandexamineanadultpatientandmakeaclinical diagnosis, iii. Appropriatelyorderandinterpretlaboratorytests, iv. Initiateappropriatecosteffectivetreatmentbasedonanunderstandingofthe rationaldrugprescriptions,medicalinterventionsrequiredandpreventive measures, v. Followuppatientswithmedicalproblemsandreferwheneverrequired, vi. Communicateeffectively,educateandcounselthepatientandfamily, vii. Managecommonmedicalemergenciesandreferwhenrequired, viii. Independentlyperformcommonmedicalproceduressafelyandunderstand patientsafetyissues, b. Integration:Theteachingshouldbealignedandintegratedhorizontallyand verticallyinordertoprovidesoundbiologicbasisandincorporatingtheprinciples ofinternalmedicineintoaholisticandcomprehensiveapproachtothecareof thepatient. 10.7.2. Pediatrics a. Competencies:Thestudentmustdemonstrate: i. Abilitytoassessandpromoteoptimalgrowth,developmentandnutritionof childrenandadolescentsandidentifydeviationsfromnormal, 33

ii. AbilitytorecognizeandprovideemergencyandroutineambulatoryandFirst LevelReferralUnitcareforneonates,infants,childrenandadolescentsand referasmaybeappropriate, iii. Abilitytoperformproceduresasindicatedforchildrenofallagesinthe primarycaresetting, iv. Abilitytorecognizechildrenwithspecialneedsandreferappropriately, v. Abilitytopromotehealthandpreventdiseasesinchildren, vi. AbilitytoparticipateinNationalProgrammesrelatedtochildhealthandin conformationwiththeIntegratedManagementofNeonatalandChildhood Illnesses(IMNCI)Strategy, vii. Abilitytocommunicateappropriatelyandeffectively. b. Integration:Theteachingshouldbealignedandintegratedhorizontallyand verticallyinordertoprovidecomprehensivecareforneonates,infants,children andadolescentsbasedonasoundknowledgeofgrowth,development,disease andtheirclinical,social,emotional,psychologicalcorrelatesinthecontextof nationalhealthpriorities. 10.7.3. Psychiatry a. Competencies:Thestudentmustdemonstrate: i. Abilitytopromotementalhealthandmentalhygiene,

ii. Knowledgeofetiology(biopsychosocialenvironmentalinteractions),clinical features,diagnosisandmanagementofcommonpsychiatricdisordersacross allages, iii. Abilitytorecognizeandmanagecommonpsychologicalandpsychiatric disordersinaprimarycaresetting,institutepreliminarytreatmentin disordersdifficulttomanage,andreferappropriately, iv. Abilitytorecognizealcohol/substanceabusedisordersandreferthemto appropriatecenters, v. Abilitytoassessriskforsuicideandreferappropriately, vi. Abilitytorecognizetemperamentaldifficultiesandpersonalitydisorders. 34

b. Integration:Theteachingshouldbealignedandintegratedhorizontallyand verticallyinordertoallowthestudenttounderstandbiopsychosocial environmentalinteractionsthatleadtodiseases/disordersforpreventive, promotive,curative,rehabilitativeservicesandmedicolegalimplicationsinthe careofpatientsbothinfamilyandcommunity. 10.7.4. Dermatology,sexuallytransmitteddiseasesandHIV a. Competencies:Theundergraduatestudentmustdemonstrate: i. Understandingoftheprinciplesofdiagnosisofdiseasesoftheskin,hair,nail andmucosa, ii. Abilitytorecognize,diagnose,orderappropriateinvestigationsandtreat commondiseasesoftheskinincludingleprosyintheprimarycaresettingand referasappropriate, iii. Asyndromicapproachtotherecognition,diagnosis,prevention,counseling, testingandmanagementofcommonsexuallytransmitteddiseasesincluding HIVbasedonnationalhealthpriorities, iv. Abilitytorecognizeandtreatemergenciesincludingdrugreactionsandrefer asappropriate. b. Integration:Theteachingshouldbealignedandintegratedhorizontallyand verticallyinordertoemphasizethebiologicbasisofdiseasesoftheskin,sexually transmitteddiseasesandleprosyandtoprovideanunderstandingthatskin diseasesmaybeamanifestationofsystemicdisease. 10.7.5. Tuberculosisandrespiratorydiseases a. Competencies:Thestudentmustdemonstrate: i. Knowledgeofcommonchestdiseases,theirclinicalmanifestations,diagnosis andmanagement, ii. Abilitytorecognize,diagnoseandmanagepulmonarytuberculosisas contemplatedinNationalTuberculosisControlprogramme, iii. Abilitytomanagecommonrespiratoryemergenciesinprimarycaresetting andreferappropriately.

35

b. Integration:Theteachingshouldbealignedandintegratedhorizontallyand verticallyinordertoallowthestudenttorecognizediagnoseandtreatTBinthe contextofthesociety,nationalhealthpriorities,drugresistanceandcomorbid conditionslikeHIV. 10.7.6. Surgery a. Competencies:Theundergraduatestudentmustdemonstrate: i. Understandingofthestructuralandfunctionalbasis,principlesofdiagnosis andmanagementofcommonsurgicalproblemsinadultsandchildren, ii. Abilitytochoose,calculateandadministerappropriatelyintravenousfluids, electrolytes,bloodandbloodproductsbasedontheclinicalcondition, iii. Abilitytoapplytheprinciplesofasepsis,sterilization,disinfection,rationaluse ofprophylaxis,therapeuticutilitiesofantibioticsanduniversalprecautionsin surgicalpractice, iv. KnowledgeofcommonmalignanciesinIndiaandtheirprevention,early detectionandtherapy, v. Abilitytoperformcommondiagnosticandsurgicalproceduresattheprimary carelevel, vi. Abilitytorecognize,resuscitate,stabilizeandprovideadvancedlifesupportto patientsfollowingtrauma, vii. Abilitytoadministerinformedconsentandcounselpatientpriortosurgical procedures, viii. Commitmenttoadvancementofqualityandpatientsafetyinsurgical practice. b. Integration:Theteachingshouldbealignedandintegratedhorizontallyand verticallyinordertoprovideasoundbiologicbasisandaholisticapproachtothe careofthesurgicalpatient. 10.7.7. Orthopaedics a. Competencies:Thestudentmustdemonstrate:

36

i.

Abilitytorecognizeandassessboneinjuries,dislocationandpolytraumaand providefirstcontactcarepriortoappropriatereferral,

ii. Knowledgeofthemedicolegalaspectsoftrauma, iii. Abilitytorecognizeandmanagecommoninfectionsofboneandjointsinthe primarycaresetting, iv. Recognizecommoncongenital,metabolic,neoplastic,degenerativeand inflammatorybonediseasesandreferappropriately, v. Abilitytoperformsimpleorthopedictechniquesasapplicabletoaprimary caresetting, vi. Abilitytorecommendrehabilitativeservicesforcommonorthopedic problemsacrossallages. b. Integration:Theteachingshouldbealignedandintegratedhorizontallyand verticallyinordertoallowthestudenttounderstandthestructuralbasisof orthopedicproblems,theirmanagementandcorrelationwithfunction, rehabilitationandqualityoflife. 10.7.8. RadioDiagnosis a. Competencies:Thestudentmustdemonstrate: i. Understandingofindicationsforvariousradiologicalinvestigationsin commonclinicalpractice, ii. Awarenessoftheilleffectsofradiationandvariousradiationprotective measurestobeemployed, iii. Abilitytoidentifyabnormalitiesincommonradiologicalinvestigations. b. Integration:Horizontalandverticalintegrationtounderstandthefundamental principlesofradiologicimaging,anatomiccorrelationandtheirapplication indiagnosisandtherapy. 10.7.9. Radiotherapy a. Competencies:Thestudentmustdemonstrateunderstandingof: i. Clinicalpresentationsofvariouscancers, 37

ii. Appropriatetreatmentmodalitiesforvarioustypesofmalignancies, iii. Principlesofradiotherapyandtechniques. b. Integration:Horizontalandverticalintegrationtoenablebasicunderstandingof fundamentalprinciplesofradiotherapeuticprocedures. 10.7.10. ObstetricsandGynaecology a. CompetencyinObstetrics:Thestudentmustdemonstrateabilityto: i. Providepericonceptionalcounselingandantenatalcare,

ii. Identifyhighriskpregnanciesandreferappropriately, iii. Conductnormaldeliveries,usingsafedeliverypracticesintheprimaryand secondarycaresettings, iv. Prescribedrugssafelyandappropriatelyinpregnancyandlactation, v. Diagnosecomplicationsoflabor,instituteprimarycareandreferinatimely manner, vi. Performearlyneonatalresuscitation, vii. Providepostnatalcare,includingeducationinbreastfeeding, viii. Counselandsupportcouplesinthecorrectchoiceofcontraception, ix. Interprettestresultsoflaboratoryandradiologicalinvestigationsasthey applytothecareoftheobstetricpatient, x. Applymedicolegalprinciplesastheyapplytotubectomy,Medical TerminationofPregnancy(MTP)andPreconceptionandPrenatalDiagnostic Techniques(PCPNDTAct). b. CompetencyinGynecology:Thestudentmustdemonstrateabilityto: i. Elicitagynecologichistoryperformappropriatephysical,pelvicexamination andPAPsmearintheprimarycaresetting, ii. Recognizediagnoseandmanagecommonreproductivetractinfectionsinthe primarycaresetting,

38

iii. Recognizeanddiagnosecommongenitalcancersandreferthem appropriately. c. Integration:Theteachingshouldbealignedandintegratedhorizontallyand verticallyinordertoprovidecomprehensivecareforwomenintheirreproductive yearsandbeyond,basedonasoundknowledgeofstructurefunctionanddisease andtheirclinical,social,emotional,psychologicalcorrelatesinthecontextof nationhealthpriorities. 11. Assessment 11.2. EligibilitytoappearforProfessionalexaminations 11.2.1. Theperformanceinessentialcomponentsoftrainingaretobeassessed,based on:

a. Attendance i. Attendancerequirementsare75%intheoryandpracticals/clinicalcombined foreligibilitytoappearfortheexaminationsinthatsubject, ii. Insubjectsthataretaughtinmorethanonephasethestudentmusthave 75%attendanceintheoryand75%inpracticalineachphaseofinstructionin thatsubject, iii. Whensubjectsaretaughtinmorethanonephasetheinternalassessment mustbedoneineachphaseandmustcontributeproportionallytofinal internalassessment, iv. Ifanexaminationcomprisesmorethanonesubject(fore.g.,Surgeryand alliedbranches),thecandidatemusthave75%attendanceineachsubject andclinicalposting, v. Thefinalinternalassessmentinabroadclinicalspecialty(e.g.,Surgeryand alliedetc.)shallcompriseofmarksfromalltheconstituentspecialties.The proportionofthemarksforeachconstituentspecialtyshallbedeterminedby thetimeofinstructionallottedtoeach, vi. Studentswhodonothaveatleast75%attendanceintheFoundationCourse willnotbeeligibleforthephaseIexamination,

39

vii. Studentswhodonothaveatleast75%attendanceintheelectiveswillnotbe eligibleforthephaseIIIpart2examination. b. InternalAssessment:Internalassessmentshallbebasedondaytoday assessment.Itshallrelatetodifferentwaysinwhichstudentsparticipatein learningprocessincludingassignments,preparationforseminar,clinicalcase presentation,preparationofclinicalcasefordiscussion,clinicalcase study/problemsolvingexercise,participationinprojectforhealthcareinthe community,proficiencyincarryingoutapracticaloraskillinsmallresearch project,awrittentestetc. i. Regularperiodicexaminationsshallbeconductedthroughoutthe course.Thereshallbenolessthantwointernalassessmentexaminationsin eachnonclinicalsubjectandnolessthanoneexaminationineachclinical subjectinaprofessionalyear.Anendofpostingclinicalassessmentshallbe conductedforeachclinicalpostingineachprofessionalyear. ii. Insubjectsthataretaughtatmorethanonephase,proportionateweightage mustbegivenforinternalassessmentforeachPhase.Forexample,Medicine mustbeassessedin3rd,4thand5thyearsindependently. iii. Daytodayrecordsshouldbegivenimportanceduringinternalassessment. iv. Studentsmustsecureatleast50%marksofthetotalmarks(separatelyin theoryandpracticals/clinicals)fixedforinternalassessmentinaparticular subjectinordertobeeligibletoappearinfinaluniversityexaminationofthat subject. v. Internalassessmentmarkswilldetermineeligibilityforappearingfor universityexamination.Internalassessmentmarkswillnotbeaddedtothe finalexaminationsmarkstodeterminepassorfail. 11.3. UniversityExaminations 11.3.1. Universityexaminationsaretobedesignedwithaviewtoascertainwhetherthe candidatehasacquiredthenecessaryknowledge,minimumskills,ethicaland professionalvalueswithclearconceptsofthefundamentalswhicharenecessary forhim/hertofunctioneffectivelyandappropriatelyasaphysicianoffirst contact.Assessmentshallbecarriedoutonanobjectivebasistotheextent possible. 40

11.3.2. Natureofquestionswillbestructuredessay,shortanswertype/objectivetype andmarksforeachpartindicatedseparately. 11.3.3. Practical/clinicalexaminationswillbeconductedinthelaboratoriesorhospital wards.Theobjectivewillbetoassessproficiencyandskilltoconduct experiments,interpretdataandformlogicalconclusion.Clinicalcaseskeptinthe examinationmustbecommonconditionsthatthestudentmayencounterasa physicianoffirstcontactinthecommunity.Raresyndromesanddisordersareto bediscouraged.Emphasisshouldbeoncandidatescapabilityinelicitahistory demonstratephysicalsignswriteacaserecord,analyzethecaseanddevelopa managementplan. 11.3.4. Viva/oralincludesassessmentofmanagementapproachandhandlingof emergencies,ethicalandprofessionalvalues.Candidatesskillininterpretationof commoninvestigativedata,xrays,identificationofspecimens,ECG,etc.alsoisto beassessed. 11.3.5. Thereshallbeonemainexaminationinayearandasupplementarytobeheld notearlierthan60daysandnolaterthan90daysafterthepublicationofits results.

11.3.6. Astudentshallnotbeallowedtograduatelaterthan09(nine)yearsofjoining firstMBBScourse.

11.3.7. UniversityExaminationsshallbeheldasunder: a. FirstProfessional i. ThefirstProfessionalexaminationshallbeheldattheendofPhase1training (2+12months),inthesubjectsofAnatomy,PhysiologyandBiochemistry. ii. MaximumnumberofattemptsallowedatthefirstProfessionalUniversity examinationswillbefour;thefirstProfessionalcoursemustbecompleted within4yearsofadmission.Partialattendanceinanexaminationinany subjectshallbecountedasanattempt. 41

b. SecondProfessional i. ThesecondProfessionalexaminationshallbeheldattheendofPhase2 training(12months),inthesubjectsofPathology,Microbiology,and Pharmacology. c. ThirdProfessional i. Part1shallbeheldatendofPhase3(Part1)oftraining(13months)inthe subjectsofOphthalmology,Otorhinolaryngology,CommunityMedicineand ForensicMedicineandToxicology ii. ThirdProfessionalPartII(FinalProfessional)shallbeattheendofPhase3of training(15monthsincluding2monthsofelectives)inthesubjectsof Medicine,Surgery,Obstetrics&GynecologyandPediatrics.Thedisciplineof Orthopedicswillconstitute25%ofthetotaltheorymarksinSurgery.The questionswillformaseparatesectioninSurgeryPaperII.Thestudentmust secureatleast40%marksintheOrthopedicsSectionwiththeprovisoto obtain50%ofmarksintotalaspasspercentage. The discipline of Psychiatry and Dermatology, Venereology and Leprology (DVL)willconstitute25%ofthetotaltheorymarksinMedicine.Thequestions willformaseparatesectioninMedicinePaperII.Thestudentmustsecureat least40%marksinthePsychiatryandDVLSectionwiththeprovisotoobtain 50%ofmarksintotalaspasspercentage. d. Examinationscheduleisintable1. e. Marksdistributionisintable10.

42

Table10:Markdistributionforvarioussubjects

PhaseofCourse

Written Theory 200Total

Practicals/Orals/Clinicals 100

PassCriteria

PhaseI Anatomy2 papers Physiology2 papers BioChemistry& MolecularBiology 2papers PhaseII Pharmacology2 Papers Pathology2 papers Microbiologyand Virology2papers PhaseIII PartI ForensicMedicine 1paper Ophthalmology1 paper Otorhino laryngology1 paper Community Medicine2 papers

200

100

Internal

200

100

Assessment: 50%

200

100

separatelyin theoryand practicalsfor

200

100

eligibilityto appearfor University

200

100

Exam

200

100 University Exam Mandatory

100

100

50%marksin theoryand

100

100

practical (practical=

100

100

practical/ clinical+viva)

200

100

43

PhaseIII PartII Medicine2 papers Surgery2papers Paediatrics1 paper Ob.&Gy.2 papers

200

200

200 100

200 100

200

200

Note:Atleastonequestionineachpaperoftheclinicalspecialtiesshouldtestknowledgecompetenciesacquired duringtheprofessionaldevelopmentprogram;Skillcompetenciesacquiredduringtheprofessionaldevelopment programmustbetestedduringtheclinical,practicalandviva.

11.3.8. CriteriaforPassinginaSubject:Acandidateshallobtain50%marksinUniversity conductedexaminationseparatelyinTheoryandPractical(practicalincludes: practical/clinicalandvivavoce)inordertobedeclaredaspassedinthatsubject.

11.3.9. AppointmentofExaminers a. Nopersonshallbeappointedasanexaminerinanyofthesubjectsofthe ProfessionalexaminationleadingtoandincludingthefinalProfessional examinationsfortheawardoftheMBBSdegreeunlesshe/shehastakenatleast eightyearspreviously,adoctoratedegreefromarecognizedUniversityoran equivalentqualificationintheparticularsubjectasperrecommendationofthe Councilonteacherseligibilityqualificationsandhashadatleasteightyearsof totalteachingexperienceinthesubjectconcernedinacollegeaffiliatedtoa recognizedUniversityatafacultyposition. b. Thereshallbeatleastfourexaminersfor100students,outofwhomnotlessthan 50%mustbeexternalexaminers.Ofthefourexaminers,theseniormostexternal examinerwillactastheChairmanandcoordinatorofthewholeexamination programmesothatuniformityinthematterofassessmentofcandidatesis maintained.Wherecandidatesappearingaremorethan100,twoadditional examinersforeveryadditional50orpartthereofcandidatesappearing,be appointed. 44

c. Nonmedicalscientistsengagedintheteachingofmedicalstudentsaswholetime teachers,maybeappointedexaminersintheirconcernedsubjectsprovidedthey possessrequisitedoctoratequalificationsandfiveyearteachingexperienceof medicalstudentsafterobtainingtheirpostgraduatequalifications.Provided furtherthatthe50%oftheexaminers(Internal&External)arefromthemedical qualificationstream. d. ExternalexaminersshallnotbefromthesameUniversityandmustbefrom outsidethestate. e. Theinternalexaminerinasubjectshallnotacceptexternalexaminershipfora collegefromwhichexternalexaminerisappointedinhis/hersubject.AUniversity havingmorethanonecollegeshallhaveseparatesetsofexaminersforeach college,withinternalexaminersfromtheconcernedcollege. f. Externalexaminersshallrotateatanintervalof2years.

g. ThereshallbeaChairmanoftheBoardofpapersetterswhoshallbeaninternal examinerandshallmoderatethequestions. h. ExceptHeadoftheDepartmentofsubjectconcernedinacollege/institution,all otherwiththerankofreaderorequivalentandabovewithrequisite qualificationsandexperienceshallbeappointedinternalexaminersbyrotationin theirsubjects;providedthatwheretherearenopostsofreaders,thenan AssistantProfessorof05years(total08yearsafterMD/MS)standingasAssistant Professormaybeconsideredforappointmentasexaminer. i. Thegracemarksuptoamaximumoffivemarksmaybeawardedatthediscretion oftheUniversitytoastudentwhohasfailedonlyinonesubjectbuthaspassedin allothersubjects.

45