BLDE University Courses

M.D. (General Medicine)

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Duration: 2 Years

Eligibility: Graduation

Course Syllabus

Objectives:

The following objectives are laid out to achieve the goals of the course. These objectives are to be achieved by the time the candidate completes the course. The objectives may be considered under the subheadings.

• Knowledge (Cognitive domain)
• Skills (Psycho motor domain)
• Human values, Ethical practice and Communication abilities.

Knowledge :

• Describe aetoiology, pathophysiolgy, principles of diagnosis and management of common problems including emergencies, in adults and children.
• Describe indications and methods for fluid and electrolyte replacement therapy including blood transfusion.
• Describe common malignancies in the country and their management including prevention.
• Demonstrate understanding of basic sciences relevant to this specialty.
• Identify social, economic, environmental and emotional determinants in a given case, and take them into account for planning therapeutic measures.
• Recognize conditions that may be outside the area of his specialty/competence and to refer them to the proper specialist.
• Advise regarding the operative or non-operative management of the case and to carry out this management effectively.
• Update oneself by self-study and by attending courses, conferences and seminars relevant to the specialty.
• Teach and guide his team, colleagues and other students.
• Undertake audit, use information technology tools and carry out research, both basic and clinical, with the aim of publishing his work and presenting his work at various scientific fora.

Skills

• Take a proper clinical history, examine the patient, perform essential diagnostic procedures and order relevant tests and interpret them to come to a reasonable diagnosis about the surgical condition.
• Perform common procedures relevant to the speciality.
• Provide basic and advanced life saving support services (BLS) in emergency situations.
• Undertake complete monitoring of the patient.
• Human values, Ethical practice and Communication abilities
• Adopt ethical principles in all aspects of his/her practice. Professional honesty and integrity are to be fostered. Care is to be delivered irrespective of the social status, caste, creed or religion of the patient.
• Develop communication skills, in particular the skill to explain various options available in management and to obtain a true informed consent from the patient.
• Provide leadership and get the best out of his team in a congenial working atmosphere.
• Apply high moral and ethical standards while carrying out human or animal research.
• Be humble and accept the limitations in his knowledge and skill and to ask for help from colleagues when needed.
• Respect patient’s rights and privileges including patient’s right to information and right to seek a second opinion.
• The goal is to provide learning opportunities for acquisition of knowledge, human values and skills that may enable to diagnose and treat relevant diseases and disorders as a specialist.

 

Course Contents

Theory:

Introduction To Clinical Medicine:

The practice of medicine – ethical; issues in clinical medicine – quantitative aspects of clinical reasoning – host and disease : influence of demographic and socioeconomic factors – influence of environmental and occupational hazards on disease – women’s health – medical disorders during  pregnancy – adolescent health problems – geriatric medicine – principles of disease prevention – cost awareness in medicine.

• Cardinal Manifestations and Presentations Of Diseses
• Pain – Pathophysiology and Management – chest discomfort and palpitation – abdominal pain –headache- back and neck pain
• Alterations In Body Temperature : fever and hyperthermia –fever and rash – hypothermia
• Nervous System Dysfunction : faintness, syncope, dizziness,and vertigo – weakness, abnormal movements, and imbalance – episodic muscle spasms, cramps and weakness –numbness, tingling and sensory loss – acute confusional states and coma – aphasia and other focal cerebral disorders – memory loss and dementia disorders of sleep and circadian rhythms.

Disorders Of The Eyes, Ears, Nose and Throat – disorders of the eye disorders of smell, taste and hearing – infections of the upper respiratory tract – oral manifestations of disease.

Alterations In Circulatory and Respiratory Functions – dyspnea and pulmonary edema – cough and hemoptysis – approach to the patient with a heart murmur – approach to the patient with hypertension – hypoxia, polycythemia and cyanosis – edema – shock – cardiovascular collapse, cardiac arrest, and sudden cardiac death. Alterations in Gastrointestinal Function – dysphagia, nausea, vomiting and indigestion– diarrhea and constipation – gain and loss in weight – gastrointestinal bleeding – jaundice – abdominal swelling,ascites.

Alterations In Urinary Function and Electrolytes – cardinal manifestations of renal disease – voiding dysfunction, incontinence, and bladder pain – fluid and electrolyte disturbances –acidosis and alkalosis.

Alterations In The Urogenital Tract – impotence – disturbances of menstruation and other common gyneocologic complaints in women – hirsutism and virilization.

Alteration In The Skin - approach to the patient with skin disorders –eczema, psoriasis, cutaneous infections, acne, and other common skin disorders – cutaneous drug reactions – skin manifestations of internal disease – photosensitivity and other reactions to light. Hematologiocal alterations – anemia – bleeding and thrombosis – enlargement of lymph nodes and spleen – disorders of granulocytes and monocytes.

Manifestations Of Cancer - presentations of the patient with cancer : solid tumours in adults – evaluation of breast masses in men and women.

Genetics and Disease – genetics and disease – cytogenetic aspects of human disease – treatment and prevention of genetic disease.

Clinical Pharmacology M - principles of drug therapy – adverse reactions to drugs –physiology and pharmacology of the autonomic nervous system – nitric oxide biologic and medical implications.

Nutrition – nutrition and nutritional requirements - assessment of nutritional status – protein and energy malnutrition – obesity – anorexia nervosa and bulimia nervosa – diet therapy – eternal and parenteral nutrition therapy – vitamin deficiency and excess- disturbances in trace elements.

Oncology And Hematology Neoplastic Disorder – approach to the patient with cancer – prevention and early detection of cancer – cell biology of cancer – cancer genetics – invasion and metastasis – principles of cancer therapy – infections in patients with cancer – melanoma and other skin cancers – head and neck cancer – neoplasms of the lung – breast cancer – gastrointestinal tract cancertumours of the liver and biliary tract – pancreatic cancer – endocrine tumours of the gastrointestinal tract and pancreas – bladder and renal cell cancer – hyperplasia and carcinoma of the prostate – testicular cancer – gyneocologic malignancies -= sarcomas of soft tissue and bone – metastatic cancer of unknown primary site – paraneoplastic syndromes – paraneoplastic neurologic syndromes – oncologic emergencies.

Disorders Of Hematopoiesis – hematopoiesis – iron deficiency and other hypoproliferative anemias disorders of hemoglobin – megaloblastic anemias – hemolytic anemias and acute blood loss – aplastic anemia and myelodyplasia- polycythehmia vera and other myloproliferative disease – acute and chronic myeloid leukemias – malignancies of lymphoid cells – plasma cell disorders transfusion biology and therapy – bone marrow transplantation

Disorders of Hemastasis- disorders of the platelet and vessel wall – disorders of coagulation and thrombosis – anticoagulant, fibrinolytic, and antiplatelet therapy.

Infectious Diseases – Basic Considerations In Infectious Diseases – Introduction to infectious diseases : host parasite interaction – laboratory diagnosis of infectious diseases – immunization principles and vaccine use – health risks to travelers 

Clinical Syndromes –Community Acquired – sepsis and septic shock – fever of unknown origin – infective endo carditis – intraabdominal infections and abscesses – acute infectious diarrhoeal diseases and bacterial food poisoning – sexually transmitted diseases : overview and clinical approach – pelvic  inflammatory disease– urinary tract infections and pyelonephritis – osteomyelitis – infections of the skin, muscle, and soft tissues – infections(excluding AIDs) in injection drug users – infections from bites scratches and burns

Clinical Syndromes –Nosomial Infections infections in transplant recipients – hospital –acqired and intravascular device- related infections – infection control in the hospital.

Bacterial Diseses : general considerations – molecular – mechanisms of bacterial pathogenesis – treatment and prophylaxis of bacterial infections

Diseases Caused By Gram-Positive Bacteria – pneumococcal infections – staphylococcal infections – streptococcal and enterococcal infections –diphtheria, other corynebacterial infections, and anthrax – infections caused by listeria monocytogenes –tetanus – botulism - gas gangrene, antibiotic – associated colitis, and other clostridial infections

Diseases Caused By Gram – Negative Bacteria – meningococcal infections – gonococcal infections – moraxella ( branchamella) catarrhalis other moraxella species and kinglla – infections due to heamophilus influenzae, other haemophilus species, the hacek group, and other gram – negative bacilli –leginella infection – pertussis diseases caused by gram – negative enteric bacilli – helicobacter infections– infections due to pseudomonas species and related organisms – salmonellosis – shigellosis – infections due to campylobacter and related species – cholera and other vibrios – rucellosis – tularemia – plague and other yersinia infections – bartonella infections, including cat – scratch disease – Donovanosis (ganuloma inguinale)

Miscellaneous Bacterial Infections – nocardiosis – actinomycosis – infections due to mixed anaerobic organisms

Mycobacterial Diseases – antimycobacterial agents – tuberculosis – leprocy (hansen’s disease) – infections due to nontuberculous myco bacteria

Spirochaetal Diseases syphilis –endemic – treponematoses – leptospirosis – relapsing fever – lyme borreliosis

Rickttsia, Mycoplasma And Chlamydia – rickttsial diseases- mycoplasma infections –chlamydial infections

Viral Diseases – medical virology – antiviral chemotherapy

DNA Viruses – herpes simplex viruses – varicella – zoster virus infections – epsteinbarr virus infections, including infections mononucleosis – cytomegalovirus and human herpesvirus types 6, 7 and 8 – smallpox, vaccinia and other poxviruses – parvovirus – human papillomavirus infections

 DNA And RNA Respiratory Viruses – common viral respiratory infections

 RNA Viruses – the human retroviuses – influenza – viral gastroenteritis – enteroviruses and reoviruses – measles ( rubeola) – rubella (german measles) – mumps – rabies virus and other rhabdoviruses- infections caused by arthopod and rodent – borne viruses – marburg and ebola viruses (filoviridae) *FUNGAL INFECTIONS – diagnosis and treatment of fungal infection – histoplasmosis – coccidioidomycosis – blastomycosis –cryptococcosis candidiasis – aspergillosis – mucormycosis – misclellaneous mycoses and prothotheca infection – pneumocystis carini infection

 Protozoal And Helminthic Infections: general considerations – approach to the patient with parasitic infections – laboratory diagnosis of parasitic infections – therapy for parasitic infection

Protozoal Infections – amoebiasis and infection with free – living amoebas – malaria and other diseases caused by red blood cell parasites leishmaniasis –trypanosomiasis – toxoplasma infection – protozoal intestinal infections and trichomoniasis

Helminthic Infections – trichinosios and infections with other tissue nematodes – intestinal nematodes – filariasis and related infections (loiasis, onchocericiasis, and dracunculaiasis) –schistosomiasis and other trematode infections – cestodes.

Disorders Of The Cardiovascular System – Diagnosis – approad to the patient with heart disease – physical examination of the cardio vascular system- electrocardiography – diagnostic cardiac catheterization and angiography

Disorders Of Ryhtm – the bradyarrhythmias: disorders of sinus node function and av conduction disturbances – the tachyarrhythmias

Disorders Of The Heart – normal and abnormal myocardial function – heart failure – cardiac transplantation congenital heart disease in the adult – rheumatic fever – valvular heart disease – corpulmonale – the cardiomypathies and myocarditis – pericardial disease – cardiac tumors, cardiac manifestations of systemic diseases, and traumatic cardiac injury

Vascular Disease – atherosclerosis – acute myocrdial infarction –ischemic heart disease – coronary angioplasty and other therapeutic applications of cardiac catheterization – hypertensive vascular disease – diseases of the aorta – vascular diseases of the extremities.

Disorders Of The Respiratory System –Diagnosis – approach to the patient with disease of the respiratory system – disturbances of respiratory system – disturbances of respiratory function – diagnostic procedures in respiratory disease

Disease Of The Respiratory System – asthma –hypersensivity pneumonitis and eosinophilic pneumonias – environmental lung diseases – pneumonia, including narcotizing pulmonary infections (lung abscess bronchiectasis – cystic fibrosis – chronic bronchitis, emphysema, and airway obstruction – interstitial lung disease – primary pulmonary hypertension pulmonary thromboembolism – disorders of the pleura, mediastinum and diaphragm –disorders of ventilation – sleep apnea – acute respiratory distress syndrome – mechanical ventilatory support Lung transplantation.

Disorders Of The Kidney and Urinary Tract- approach to the patient with diseases of the kidneys and urinary tract – disturbances of renal function – acute renal failure chronic renal failure – dialysis and transplantation in the treatment of renal failure – pathogenetic mechanisms of glomerular injury – the major glomerulopathies – glomerulopathies associated with multisystem diseases. Tubulointerstitial diseases of the kidney – vascular injury to the kidney – hereditary tubular disorders – nephrolithiasis – urinary tract obstruction.

Disorders Of The Gastrointestinal System – Disorders Of The Alimentary

Tract - approach to the patient with gastrointestinal disease – gastrointestinal endoscopy – diseases of the esophagus – peptic ulcer and related disorders – disorders of absorption – inflammatory bowel disease: ulcerative colitis and crohn’s disease – irritable bowel syndrome –diverticular, vascular, and other disorders of the intestine and peritoneum – acute intestinal obstruction – acute appendicitis

Liver And Biliary Tract Disease – approach to the patient with liver disease – evaluation of liver function – derangements of hepatic metabolism – bilirubin metabolism and hyperbilirubinemia – acute viral hepatitis – toxic and drug – induced complications of cirrhosis – infiltrative and metabolic diseases affecting the liver – liver transplantation diseases of the gallbladder and bile ducts

Disorders Of The Pancreas – approach to the patient with pancreativ disease – acute and chronic pancreatitis.

Disorders Of The Immune System, Connective Tissue, and Joints

Disorders Of The Immune System – Introduction to the immune system – the major histocompatibility gene complex – primary immune dificiency disease – human immunodeficiency virus (HIV) disease: aids and related disorders – amyloidosis

Disorders Of Immune – Mediated Injury – diseases of immediate type hypersensitivity – immunologically mediated skin diseases – systemic lupus erythematosus – rheumatoid arthritis – systemic sclerosis (seleroderma) dermatomyositis and poly myositis – Sjogren’s syndrome – ankylosing spondylitis, reactive arthritis and undifferentiated spondyloarthropathy – Behcet’s syndrome – the vasculitis syndromes – sarcoidosis.

Disorders Of The Joints – approach to articular and musculoskeletal disorders – osteoarthritis – arthritis due to deposition of calcium crystals – infectious arthritis – psoriatic arthritis and arthritis associated with gastrointestinal disease – relapsing polychondritis and other arthritides.

Encocrinology and Metabolism - Endocrinology – approach to the patient with endocrine and metabolic disorders – neuroendocrine regulation and diseases of the anterior pituitary and hypothalamus – disorders o growth – disorders of the neurohypophysis – diseases of the tyroid – diseases of the adrenal cortex – pheochromocytoma – diabetes mellitus – hypoglycemia – disorders of the tests – disorder of the ovary and femal reproductive tract – endocrine disorders of the breast - disorders of sexual differentiation – disorders affecting multiple endocrine systems

Disorders Of Intermediary Metabolism – disorders of lipopritein metabolism – hemochromatosis – the porphyries – gout and other disorders of Purina metabolism – Wilson’s disease – lysosomal storage diseases – glycogen storage diseases – inherited disorders of connective tissue – inherited disorders of amino acid metabolism and storage – inherited defects of membrane transport – galactosemia. galactokinase dificiency and other rare disorders of carbohydrate metabolism – the lipodystrophies and other rare disorders of adipose tissue

Disorders Of Bone and Mineral Metabolism – calcium, phosphorusm and bone metabolism: calcium – regulating hormones – diseases of the parathyroid glands and other hyper and hypolcalcemic disorders – metabolic bone disease – disorders of phosphorus metabolism – disorders of magnesium metabolism – Paget’s disease of bone. Hyperostosis, fibrous dysplasia, and other dysplasia of bone and cartilage.

Neurologic Disorders - Diagnosis Of Neurologic Disorders – approach to the patient with neurologic disease – electrophysiologic studies of the central and peripheral nervous systems – neuroimaging in neurologic disorders - molecular diagnosis of neurologic disorders

Diseases Of The Cntral Nervous System - migraine and the cluster headache syndrome – seizures and apilepsy – alzheimer’s disease and other primary dementias – parkinson;s disease and other extraphyramidal disorders – ataxic disorders – the motor neuron diseases – disorders of the autonomic nervous system – disorders of the cranial nerves – diseases of the spinal cord. Traumatic injuries of the head and spine tumors of the nervous system – multiples sclerosis and other demyelinating diseases – bacterial meningitis, brain abscess, and other suppurative intracranial infections – chronic and recurrent meaningitis – brain abscess, and other suppurative intracranial infections – chronic and recurrent meaningitis – aseptic meaningitis, viral encephalitis, and prion diseases – nutritional and metabolic diseases of the nerous system

Disorders Of The Nerve and Muscle – diseases of the peripheral nervous system – myasthenia gravis and other diseases of the neuromuscular junction –diseases of muscle

Chronic Fatigue Syndrome – chronic fatigue syndrome

Psychiatric Disorders– mental disorders

Alcoholism and Drug Dependency – alcohol and alcoholism – opioid drug abuse and dependence cocaine and other commonly abused drugs – nicotine addiction.

Environmental and Occupational Hazards – specific environmental and occupational hazards

Illnesses Due To Poisons, Drug Overdosage and Envenomation – poisoning and drug overdosage – disorders caused by reptile bites and marine animal envenomations –ectorparasite infestations and arthropid bites and stings

Specific Environmental and Occuptional Hazards- drowning and near. Drowning – electrical injuries – radiation injury –heavy metal poisoning.

Method of Training:

Emphasis is on hospital training with candidates given graded responsibility in the management and treatment of patients entrusted to them, while rotating in General medicine units and of subspecialty units. PG also attend respective units outpatient and inpatient activities and consultations.

Didactic lecture and demonstrations by basic and clinical departments to orient all new post graduate house staff to various departmental services and introduce basic concept of acute care management of medical / surgical emergencies. Involving Laboratory, Radiology, Blood bank services Also orientation to medical records and library facility. Lectures are organized over a peri8od of two months and serve as introduction to all new post graduates to promote the need for integrated approach between various disciplines. Preferably these should be organized between 8-9 AM /3-4 PM to minimize interferences with the working of parent departments.

Special orientation to bio statistics, research methodology, legal medicine and computer skills should be organized through lectures for all first year post graduate during first six months. Clinical seminar once a week involving participation of all staff of the department of Medicine to ensure combined staff moderated teaching. Bedside clinics once a week involving one individual senior Professor or Associate Professor or Specialist.

Hospital clinics once a in fortnight involving multidisciplinary approach. Case selection to bedone by senior faculty members to emphasize current diagnostic- therapeutic advances. Journal club once a week 3-4 Journals by P.G’s and Junior faculty under supervision of Senior faculty. Subject seminar once a week Topics to be selected carefully and should not be repeated unnecessarily within 2 years (Total period of PG training is 3 years).

Mortality – CPC once a month (instead of Journal Club). Two to three case will be discussed and moderated by senior faculty. Other consultants invited based on the need. Besides traditional OHP and 35 mm slide presentations, use of other forms of audio-visual aids may be encouraged.

Dissertation Work

Every candidate pursuing degree course is required to carry out work on a selected research project under the guidance of a recognised post graduate teacher. The results of such a work shall be submitted in the form of a dissertation.

The dissertation is aimed to train a post graduate student in research methods and techniques. It includes identification of a problem, formulation of a hypothesis, search and review of literature, getting acquainted with recent advances, designing of a research study, collection of data, critical analysis, comparison of results and drawing conclusions.

Every candidate shall submit to the Registrar (Academic), , in the prescribed proforma, a synopsis containing particulars of proposed dissertation work six months from the date of commencement of the course on or before the dates notified by the University. The synopsis shall be sent through the proper channel.

Such synopsis will be reviewed and the dissertation topic will be registered by the University. No change in the dissertation topic or guide shall be made without prior approval of the University.

The dissertation should be written under the following headings:

• Introduction
• Aims or Objectives of study
• Review of Literature
• Material and Methods
• Results
• Discussion
• Conclusion
• Summary
• References (Vancouver style)
• Tables
• Annexures

The written text of dissertation shall not less than 50 pages and shall not exceed 150 pages excluding references, tables, questionnaires and other annexures. It should be neatly typed in double line spacing on one side of paper (A4 size, 8.27” x 11.69”) and bound properly. Spiral binding should be avoided. The dissertation shall be certified by the guide, head of the department and head of the Institution.

Four copies of dissertation thus prepared shall be submitted to the Registrar (Evaluation), six months before final examination on or before the dates notified by the University.

The dissertation shall be valued by examiners appointed by the University. Approval of dissertation work is an essential precondition for a candidate to appear in the University examination.

For some more details regarding Guide etc., please see Chapter I and for books on research methodology, ethics, etc., see Chapter IV.

Rotation

Details of rotation including ancillary postings year wise as follows:

• PG  Ist  Year:
  • General Medicine – First four months in parent medical unit and next eight months in two or three other units. (PG will return to parent unit during III year of rotation for six months)
• PG IInd  Year:
  • Cardiology, Neurology – Two months each = 4 months
  • One months each in Pulmonary medicine, Immunology, Pharmacology Oncology, Hematology, Endocrinology, Nephrology, Gastroenterology, Dermatology & Psychiatry = 6 months
  • Special Elective rotation: 2 months
  • Special elective rotation should be encouraged like Cancer Institutes, Cardiology Institute, Neurology Institute and Multi-speciality centers of national & international repute. Candidate should make arrangement much in advance with approval of H.O.D. of medicine.
  • Medical departments with less number of specilalites, may rotate post sgraduates in general medicine department with postings in Medical intensive care unit. Coronary care unit and Emergency departments.
• PG IIIrd  Year:
  • General Medicine – Parent Medical Unit: 6 months
  • Two or three medical units: 6 months
  • During 3rd year rotation PG student works six months in parent unit and three months each in other two medical units. Postgraduate in III year training is expected to assume more responsibilities in managing patients and assist in first year residents and interns in wards, critical care unit and emergency rooms. Also should participate actively in teaching undergraduate medical students and prepare himself or herself for the role of General Medical Specialist.
  • The students are encouraged to attend local, state and national level conferences of API, CSI etc. as part of CME programme.

Log Book

The log book is a record of the important activities of the candidates during his training, Internal assessment should be based on the evaluation of the log book. Collectively, log books are a tool for the evaluation of the training programme of the institution by external agencies. The record includes academic activities as well as the preparations and procedures carried out by the candidate.

Format for the log book for the different activities is given in Tables 1,2 and 3 of Chapter IV. Copies may be made and used by the institutions.

Every student must maintain a record book ( diary/log book) and the work carried out by him and the training programme undergone by him during the training, including details of rotation, night calls, procedure and consultations done as M.D. candidates. Theses records books should be checked and assessed by faculty members imparting the training and certified by the head of the department. Postgraduate student diary should include following activities.

Format for PG Diary ( Log Book)

• cases seen on rounds – description of interesting cases and other miscellaneous topics discussed
• Outpatient cases seen and details of interesting cases with follow up.
• Procedures done on inpatients and outpatients and consultation done.
• Undergraduate teaching done during the day with details.
• PG training programmes attended – details of bedside clinics, basic sciences, subject and clinical seminars, Journal clubs, mortality meet and hospital conference.
• Night duties – details of patients managed and emergencies, consultation. Ward calls attended.
• Details of study with topics covered during off hours in library / home. Periodicals and Journals reviewed with notes on interesting articles.
• Medical meetings, Seminars, Local API / CSI meetings or other interesting CME, seminars attended.
• Diary should be reviewed on weekly basis by unit faculty and certified on monthly basis for P.G.’s benefit at the end of each Medical / specialty rotation. Faculty should comment regarding absences and irregularities ( Late arrivals early departure) and make appropriate comments and suggest remedial measures for problematic prodigies. Satisfactory progress and 80% attendance mandatory before student allowed to appear for University examination.
• Size of note book : 15 cm x 21 cm with 200 pages. All note books should have seal of college and H.O.D.s approval: Extra note books utilized as and when necessary. Diaries should be presented at the time of University clinical exam for review by examiners as per University regulations.

Internal evaluation of P.G. Students performance during three years

• I year of M.D. Students
  • Assessment of students with multiple choice questions multiple short note covering wide range of topics and practical examination attention to history taking symptomtology, clinical skills, relevant diagnostics and therapeutic plans ascertained Suggested time of evaluation after first six months and at the end of first year rotation.
• II Year of M.D. Students
  • Students should be evaluated at the end of cardiology and neurology posting with Theory and Practical Examinations by concerned specilities along with one faculty from General Medicine and make appropriate recommendation to meet minimal satisfactory guidelines expected of second year PG students. Other specilities with short rotations of one month, should be evaluated with MCQ format and Viva regarding candidates comprehension of the subject.
• III Year of M.D. Students
  • P.G’s should be evaluated at the beginning of his 3rd year training by panel of senior Postgraduate teachers. Suggested pattern of assessment with two essay type theory papers and multiple choice questions, clinical skills, diagnostic and therapeutic skills evaluated intermittently by unit faculties.
  • Mock examination suggested – 3 to 4 months prior to final university exam should consist of two question papers each 3 hours duration, one MCO with 200 questions and practical and viva voice similar to university examination under the supervision of senior faculty.
  • Results of all evaluations should be entered into P.G.’s diary and departmental file for documentation purposes. Main purpose of periodic examination and accountability is to ensure clinical  Expertise of students with practical and communication skills and balance broader concept of diagnostic and therapeutic challenges.

Procedures for defaulters : Every department should have a committee to review such situations. The defaulting candidate is counseled by the guide and head of the department. In extreme cases of default the departmental committee may recommend that defaulting candidate be withheld from appearing the examination, if she/he fails to fulfill the requirements in spite of being given adequate chances to set himself or herself right.