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Rules and Regulations
Graduate Medical Education Regulations, 1997 
MEDICAL COUNCIL OF INDIA
SALIENT FEATURES OF REGULATIONS ON GRADUATE MEDICAL EDUCATION, 1997
(PUBLISHED IN PART III, SECTION 4 OF THE GAZETTE OF INDIA DATED 17TH MAY 1997)
 
1. Short title and commencement : (1) These regulations may be called the "Regulations on Graduate Medical Education, 1997"
2. They shall come into force on the date of their publication in the Official Gazette.
 
CHAPTER 1 
 
2.    GENERAL CONSIDERATIONS AND TEACHING APPROACH 
 
(1)    Graduate  medical curriculum is  oriented  towards  training students  to  undertake the responsibilities of  a  physician  of  first  contact  who is capable of looking after  the  preventive, promotive, curative & rehabilitative aspect of medicine. 
(2)    With wide range of career opportunities available  today,  a graduate has a wide choice of career opportunities. The  training, though  broad  based  and  flexible  should  aim  to  provide  an educational experience of the essentials required for health care in our country. 
(3)    To undertake the responsibilities of service situations which is a changing condition and of various types, it is essential to provide adequate placement training tailored to the needs of such services as  to  enable  the  graduates  to   become effective instruments of implementation of those requirements. To avail of opportunities and be able to conduct  professional  requirements, the  graduate  shall endeavor to have acquired basic training  in  different aspects of medical care. 
(4)    The importance of the community aspects of health care and of rural health care services is to be recognized. This  aspect  of education & training of graduates should be adequately recognized in   the   prescribed  curriculum.  Its importance has been systematically upgraded over the past years and adequate exposure to such experiences should be available throughout all the three phases of education & training. This has to be further emphasized and intensified by providing exposure to field practice areas and training during the internship period. The aim of the period of rural training during internship is to enable the fresh graduates to function efficiently under such settings. 
(5)    The educational experience should emphasize health and community orientation instead of only disease  and  hospital orientation or being-concentrated - on-curative -aspects.  As such all the basic concepts of modern scientific medical education are to be adequately dealt with. 
(6)    There must be enough experiences to be provided for self-learning. The methods and techniques that would ensure this must become a part of teaching-learning process. 
(7)    The medical graduate of modern scientific medicine shall endeavor to become capable of functioning independently in both urban or rural environment. He/she shall endeavor to give emphasis on fundamental aspects of the subjects taught and on common problems of health and disease avoiding unnecessary details of specialization. 
(8)    The importance of social factors in relation to the problem of health and diseases should receive proper emphasis throughout the course and to achieve this purpose, the educational process should also be community based than only  hospital  based.  The importance of population control and family welfare planning should be emphasized throughout the period of training with the importance of health and development duly emphasized. 
(9)    Adequate emphasis is to be placed on cultivating logical and scientific habits of  thought, clarity of expression and independence of judgment, ability  to  collect  and   analyse information and to correlate them. 
(10)     The educational process should be placed in a historic background   as an evolving process and not merely as an acquisition of a large number of disjointed facts without a proper perspective. The history of Medicine with reference to the evolution of medical knowledge both in this country and the rest of the world should form a part of this process. 
(11)    Lectures alone are generally not adequate as a method of training and are a poor means of transferring/acquiring information and even less effective at skill development and in generating the appropriate attitudes. Every effort should be made to encourage the use of active methods related to demonstration and on first hand experience. Students will be encouraged to learn in small groups, through peer interactions so as to gain maximal experience through contacts with patients and the communities in which they live. While the curriculum objectives often refer to areas of knowledge or science, they are best taught in a setting of clinical relevance and hands on experience for students who assimilate and make this knowledge a part of their own working skills. 
(12)     The graduate medical education in clinical subjects should be based primarily on outpatient teaching, emergency departments and within the community including peripheral health care institutions. The outpatient departments should be suitably planned to provide training to graduates in small groups. 

(13)    Clinics should be organized in small groups of preferably not more than 10 students so that a teacher can give personal attention to each student with a view to improve his skill and competence in handling of the patients. 
(14)    Proper records of the work should be maintained which will form the basis for the students' internal assessment and should be available to the inspectors at the time of inspection of the college by the Medical Council of India. 
(15)    Maximal efforts have to be made to encourage integrated teaching between traditional subject areas using a problem based learning approach starting with clinical or community cases and exploring the relevance of various preclinical disciplines in both understanding and resolution of the problem. Every attempt be made to de-emphasize compartmentalisation of disciplines so as to achieve both horizontal and vertical integration in different phases. 
(16)    Every attempt is to be made to encourage students to participate in group discussions and seminars to enable them to develop personality, character, expression and other faculties which are necessary for a medical graduate to function either in solo practice or as a team leader when he begins his independent career. A discussion group should not have more than 20 students. 
(17)    Faculty member should avail of modern educational technology while teaching the students and to attain this objective, Medical Education Units/ Departments be established in all medical colleges for faculty development and providing learning resource material to teachers.
(18)    To derive maximum advantage out of this revised curriculum, the vacation period to students in one calendar year should not exceed one month, during the 4 ½ years Bachelor of Medicine and Bachelor of Surgery (MBBS) Course. 
(19)    In order to implement the revised curriculum in toto, State Govts. and Institution Bodies must ensure that adequate financial and technical inputs are provided. 

 

3.    OBJECTIVE OF MEDICAL GRADUATE TRAINING PROGRAMME: 

(1)    NATIONAL GOALS: At the end of undergraduate program, the medical student 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 fulfill his/her social obligations towards realization of this goal. 
(b)    learn every aspect of National policies on health and devote himself/herself 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 observation of medical ethics and fulfilling social and professional obligations, so as to respond to national aspirations. 
 

(2)  INSTITUTIONAL GOALS : (I) 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 undergraduate students coming out of a medical institute should: 
(a)    Be competent in diagnosis and management of common health problems of the individual and the 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 and   rehabilitative medicine in respect to the commonly encountered health problems. 
(c)    Appreciate rationale for different therapeutic modalities, be familiar with the administration of the "essential drugs" and their common side 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.
(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 Material and Child Health(MCH) 
(ii)    Sanitation and water supply 
(iii)    Prevention and control of communicable and non-communicable diseases 
(iv)    Immunization 
(v)    Health Education 
(g)    Acquire basic management skills in the area of human resources, materials and resource management related to health care delivery. 
(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. 
(j)    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. 
(II)    All efforts must be made to equip the medical graduate to acquire the skills as detailed in APPENDIX B.

CHAPTER II
 

ADMISSION, SELECTION, MIGRATION AND TRAINING: -

4.Admission to the Medical Course – Eligibility Criteria :
No Candidates shall be allowed to be admitted to the Medical Curriculum of first Bachelor of Medicine and Bachelor of Surgery (MBBS) Course until :

    He/She shall complete the age of 17 years on or before 31st December, of the year admission to the MBBS course. He/She has passed qualifying examination as under: - a) 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 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.

    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
    b) The intermediate examination in science of an Indian University/Board or other recognised examining body with Physics, Chemistry and Biology which shall include a practical test in these subjects and also English as a compulsory subject.

    Or
    c) The pre-professional/pre-medical examination with Physics, Chemistry and Biology, after passing either the higher secondary school examination, or the pre-university or an equivalent Examination. The pre0-professional/pre-medical examination shall include a practical test in Physics, Chemistry and Biology and also English as a compulsory subject.

    Or
    d) The first year of the three years degree course of a recognized university, with Physics, chemistry and Biology 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
    e) 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) and further that he/she has passed the earlier qualifying examination with the following subjects – Physics, Chemistry, Biology and English.

    Or
    f) 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 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.

Selection of Students:

The selection of students to medical college shall be based solely on merit of the candidate and for determination of the merit, the following criteria be adopted uniformly throughout the country:

    In states, having only one Medical College and one university board/examining body conducting the qualifying examination, the marks obtained at such qualifying examination may be taken into consideration; In states, having more than one university/board/examining body conducting the qualifying examination (or where there is more than one medical college under the administrative control of one authority) a competitive entrance examination should be held so as to achieve a uniform evaluation as there may be variation of standards at qualifying examinations conducted by different agencies; Where there are more than one college in a state and only one university/board conducting the qualifying examination, then a joint selection board be constituted for all the colleges; A competitive entrance examination is absolutely necessary in the cases of Institution of All India character.

    Procedure for selection to MBBS course shall be as follows:-

    In case of admission on the basis of qualifying examination under clause (1) based on merit, candidate for admission to MBBS course must have passed in the subjects of Physics, Chemistry, Biology & English individually and must have obtained a minimum of 50% marks taken together in Physics, Chemistry and Biology at the qualifying examination as mentioned in the clause (2) of regulation 4. In respect of candidates belonging to Scheduled Castes, Scheduled Tribes or Other Backward classes. The marks obtained in Physics, Chemistry and Biology taken together in qualifying examination be 40% instead of 50% as above. In case of admission of the basis of Competitive entrance examination under clause (2) to (4) of this regulation, a candidate must have passed in the subjects of Physics,. Chemistry, Biology and English individually and must have obtained a minimum of 50% of marks taken together in Physics Chemistry and Biology at the qualifying examination as mentioned in clause (2) of regulation 4 and in addition must have come in the merit list prepared as a result of such competitive entrance examination by securing not less then 50% marks in Physics, Chemistry and Biology competitive examination. In respect of candidates belonging to Schedule Caste, Schedule Tribes or other Backward Class the marks obtained in Physics, Chemistry, and Biology taken together in qualifying examination and competitive entrance examination be 40% instead of 50% as stated above. Provided that a candidate who has appeared in the qualifying examination the result of which has not been declared, he may be provisionally permitted to take up the competitive entrance examination and in case of selection for admission to the MBBS course, he shall not be admitted to that course until he fulfils the eligibility criteria under regulation 4.
 

Migration:

Migration from one medical college to other is not a right of a student. However, migration of students from one medical college to another medical college in India may be considered by the Medical Council of India only in exceptional cases on extreme compassionate grounds, provided following criteria are fulfilled. Routine migrations on other grounds shall not be allowed. Both the colleges, i.e. one at which the students is studying at present and one to which migration is sought, are recognised by the Medical Council of India. The applicant candidate should have passed first professional MBBS examination. The applicant candidate submits his application for migration, complete in all respects, to all authorities concerned within a period of one month of passing (declaration of result) the first professional Bachelor of Medicine and Bachelor of Surgery (MBBS) examination. The applicant candidate must submit an affidavit stating that he/she will pursue 18 months of prescribed study before appearing at IInd professional Bachelor of medicine and Bachelor of Surgery (MBBS) examination at the transferee medical college, which should be duly certified by the Registrar of the concerned University in which he/she is seeking transfer. The transfer will be applicable only after receipt of the affidavit.

Note:1:

Migration during clinical course of study shall not be allowed on any ground. All applications for migration shall be referred of Medical Council of India by college authorities. No institution/University shall allow migrations directly without the approval of the council. Council reserves the right, not to entertain any application which is not under the prescribed compassionate gourds and also to take independent decision where applicant has been allowed to migrate without referring the same to the Council.

Note 2: * Compassionate grounds criteria:

Death of a supporting guardian. Illness of the candidate causing disability. Disturbed conditions as declared by Government in the Medical College area.
 

Dear Web Surfer :- Please note

Complete application with all requisite documents to be made as per guidelines provided on the format which has been prepaid in view of regulations and policy decision in the matter
Migration of Mr./Miss ________________________________________ from __________________________________________Medical College, _______________________________to____________________________ Medical College ________________________________

 

1.

Date of admission in 1st MBBS course 

 

2.

Date of Passing 1st MBBS University Exam

 

3.

Date of application

 

4.

NOC from relieving college (enclosed)

Yes/No

5.

NOC from relieving Uni. (enclosed)

Yes/No

6.

NOC from receiving college (enclosed) 

Yes/No

7.

NOC from receiving Uni. (enclosed)

Yes/No

8.

Affidavit, duly Sworn before 1st Class Magistrate containing an undertaking that "I will study for full 18 months of IInd Phase of MBBS course in transfer medical college before appearing In the IInd Prof. University examination" (enclosed)

Yes/No

9.

Reasons for migration in brief (Please enclose copy as proof) 

Yes/No

10.

Bank Draft of Rs.500/- (non-refundable migration fee) in in favour of Secretary, Medical Council of India, New Delhi payable at New Delhi

 

11.

Permanent Address

______________________________
______________________________
______________________________
______________________________
______________________________

 

Training Period and Time Distribution

    Every student shall undergo a period of certified study extending over 4 ½ academic years divided into 9 semesters, (i.e. of 6 months each) from the date of commencement of his study for the subjects comprising the medical curriculum to the date of completion of examination and followed by one year compulsory rotating internship. Each semester will consist of approximately 120 teaching days of a hours each college working time, including one hour of lunch. The period of 4 1//2 years is divided into three phases as follows:-

    (a) Phase-1 (two semesters) – consisting of Pre-clinical subjects (Human Anatomy, Physiology including Bio-Physics, Biochemistry and introduction to Community Medicine including Humanities). Besides 60 hours for introduction to Community Medicine including Humanities, rest of the time shall be somewhat equally divided between Anatomy and Physiology plus Biochemistry combined (Physiology 2/3 and Biochemistry 1/3)
    (b) Phase-II (3 semesters) – consisting of para – clinical/clinical subjects.
    During this phase teaching of para-clinical and clinical subjects shall be done concurrently.
    The para-clinical subjects shall consist of Pathology, Pharmacology, Microbiology, Forensic Medicine including Toxicology and part of Community Medicine.
    The clinical subjects shall consist of all these detailed below in Phase III.

      Out of the time for Para-clinical teaching approximately equal time be allotted to Pathology, Pharmacology, Microbiology and Forensic Medicine and Community Medicine combined (1/3 Forensic Medicine and 2/3 Community Medicine).

    (c) Phase-III (continuation of study of clinical subjects for seven semesters after passing Phase-1)
    The clinical subjects to be taught during Phase II and III are Medicine and its allied specialties, Surgery and its allied specialties, Obstetrics and Gynaecology and Community Medicine.

    Besides clinical posting as per schedule mentioned herewith, rest of the teaching hours be divided for didactic lectures, demonstrations, seminars, group discussions, etc. in various subjects.
    The Medicine and its allied specialties training will include General Medicine, Pediatrics, Tuberculosis and Chest, Skin and Sexually Transmitted Diseases, Psychiatry, Radio-diagnosis, Infectious diseases etc. The Surgery and its allied specialties training will include General Surgery, Orthopedics Surgery including Physiotherapy and Rehabilitation, Ophthalmology, Otorhinolaryngology, Anesthesia, Dentistry, Radio-therapy etc. The Obstetrics & Gynecology training will include family medicine, family welfare planning etc.

    The first 2 semester (approximately 240 teaching days) shall be occupied in the Phase 1 (pre-clinical) subjects and introduction to a broader understanding of the perspectives of medical education leading to delivery of health care. No student shall be permitted to join the Phase II (Pare-clinical/clinical) group of subjects until he has passed in all the Phase 1 (Pre-clinical) subjects for which he will be permitted not more than four chances (actual examination), provided four chances are completed in three years from the date of enrollment. After passing pre-clinical subjects, 1 ½ year (3 semesters) shall be devoted to para-clinical subjects.

    Phase II will be devoted to para-clinical and clinical subjects, along with clinical posting. During clinical phase (Phase III) pre-clinical and para clinical teaching will be integrated into the teaching of clinical subjects where relevant. Didactic lectures should not exceed one third of the time schedule; two third schedule should include practical, clinical or/and group discussions. Learning process should include living experiences, problem oriented approach, case studies and community health care activities. Universities shall organize admission timings and admission process in such a way that teaching in first semester starts by 1st of August each year. Supplementary examination may be conducted within 6 months so that the students who pass can join the main batch and the failed students will have to appear in the subsequent year.
 
Phase Distribution and Timing of Examinations:-

6 MONTHS

6 MONTHS

6 MONTHS

 

1

2

 

1st professional Examination (during Second semester)

3

4

5

IInd Professional examination (during fifth semester)

6

7

 

IIIrd professional Part I (during 7th semester)

8

9

 

IIIrd professional Part II (Final professional during 9th semester)

Note :

    Passing in 1st Professional is compulsory before proceeding to Phase II training. A students who fails in the IInd professional examination, shall not be allowed to appear in IIIrd Professional Part I examination unless he passes all subjects of IInd Professional examination. Passing in IIIrd Professional (Part I) examination is not compulsory before entering for 8th and 9th semester training, however passing of IIIrd Professional (Part I) is compulsory for being eligible for IIIrd Professional (Part II) examination.

    During third to ninth semesters, clinical postings of three hours duration daily as specified in the Table is suggested for various departments, after Introductory Course in Clinical Methods in Medicine and Surgery of two weeks each for the whole class.

Subjects

3rd Semester (Wks)

4th Semester (Wks)

5th Semester (Wks)

6th Semester (Wks)

7th Semester (Wks)

8th Semester (Wks)

9th Semester (Wks)

Total (Wks)

General*** Medicine

6

-

4

-

4

6

6

26

Paediatrics

-

2

-

2

2

4

-

10

Tuberculosis And Chest Diseases

-

2

-

-

-

-

-

02

Skin & STD

-

2

-

2

-

2

 

06

Psychiatry

-

-

2

-

-

-

-

02

Radiology*

-

-

-

-

2

-

-

02

General ****  Surgery

6

-

4

-

4

6

6

26

Orthopaedics**

-

-

4

4

-

-

2

10

Ophthalmology

-

4

-

4

-

-

2

10

Ear Nose And Throat

-

4

-

4

 

 

 

08

Obstetrics and   Gynaecology***** including Family Welfare Planning 

 
2

 
4

 
4

 
-

 
4

 
4

 
6

 
24

Community Medicine

4

4

-

4

-

-

-

12

Casualty

-

-

-

2

-

-

-

02

Dentistry

-

-

-

-

2

-

-

02

Total (in Weeks)

18

22

18

22

18

22

22

142

-            Clinical methods in Medicine and Surgery for whole class will be for 2 weeks each respectively at the start of 3rd semester 
*           This posting includes training in Radiodiagnosis and Radiotherapy where existant. 

**         This posting includes exposure to Rehabilitation and Physiotherapy. 

***        This  posting includes exposure to laboratory medicine and infectious diseases. 

****      This posting includes exposure to dressing and Anesthesia. 

*****     This includes maternity training and Family medicine and the 3rd semester posting shall be in Family Welfare Planning.

CHAPTER III 

CURRICULUM (SUBJECT-WISE) 

9.   Pre-clinical subjects - Phase I  :  In the teaching of these subjects stress shall be laid on  basic principles of the subjects with more emphasis on  their  applied aspects. 

(1)            HUMAN ANATOMY 

(i)         Goal 

The broad goal of the teaching of undergraduate students in Anatomy  aims at providing comprehensive knowledge of the gross and microscopic structure and development of human body to provide  a  basis for understanding the clinical  correlation of organs or structures involved and the anatomical basis  for the disease presentations. 

ii)  Objectives  : 

A)  Knowledge :

     At the end of the course the student should be able to 

a.    comprehend the normal disposition, clinically relevant interrelationships, functional and cross sectional anatomy of the various structures in the body. 

b.    identify the microscopic structure and correlate elementary ultra-structure  of various organs and tissues and correlate the structure with the functions as a prerequisite for understanding the altered state in various disease processes. 

c.    comprehend the basic structure and connections of the central nervous system to analyse the integrative and regulative functions of the organs and systems. He/She should be able to locate the site of gross lesions according to  the deficits encountered. 

d.    demonstrate knowledge of the basic principles and sequential development  of the organs and systems, recognise the critical stages of development and the effects of common teratogens, genetic mutations and environmental hazards. He/She should be able to explain the developmental basis of the major variations and abnormalities.

 

(B)  Skills   : 

     At the end of the course the student should be able to: 

(a)    identify and locate all the structures of the body and mark the topography of the living anatomy. 

(b)     identify the organs and tissues under the microscope. 

(c)    understand the principles of karyotyping and identify the gross congenital anomalies. 

(d)    understand principles of newer imaging techniques and interpretation of Computerised Tomography (CT) Scan, Sonogram etc. 

(e)    understand  clinical  basis  of  some   common   clinical procedures  i.e., intramuscular & intravenous injection, lumbar puncture and kidney biopsy etc. 

(C)   Integration 

From the integrated teaching of other basic sciences, student should be able  to  comprehend  the  regulation and integration of the functions of the organs and systems in the body and thus interpret the anatomical basis of disease process. 

(2)            HUMAN PHYSIOLOGY INCLUDING BIO-PHYSICS 

(A)       PHYSIOLOGY   

i)  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. 

ii) OBJECTIVES 

a) KNOWLEDGE 

     At the end of the course the student will be able to : 

(1)       explain the normal functioning of all the organ systems and their interactions for well coordinated total body function. 

(2)       assess the relative contribution of each organ system to the maintenance of the milieu interior. 

(3)       elucidate  the physiological aspects of normal growth and development. 

(4)       describe  the  physiological response and adaptations to environmental stresses. 

(5)        list the physiological principles underlying pathogenesis and treatment of disease. 

b)   SKILLS 

     At the end of the course the student should be able to : 

(1)  conduct experiments designed for  study  of  physiological phenomena. 

(2)   interpret experimental/investigative data. 

(3)   distinguish between normal and abnormal data derived as a result  of tests which he/she has performed and observed in the laboratory. 

c)  INTEGRATION 

At  the  end of the integrated teaching the  student should acquire an integrated knowledge of organ structure and  function and its regulatory mechanisms. 

(B)  BIOPHYSICS 

(a)  GOAL & OBJECTIVES :     The  broad  goal  of teaching  Biophysics  to  undergraduate students is that they should understand basic physical principles   involved in the functioning of body organs in normal and diseased conditions. 

Total time for teaching Biophysics                                 = 5 hours

Out of which : 1. Didactic lectures                                = 3 hours 

                    2. Tutorial/group discussion                      = 1 hour 

                    3. Practical                                            = 1 hour 

(b) Topic distribution 

(1)   Lectures  : 

(i)  Physical principles of transport across cell memberanes and across capillary wall. 

ii)  Biopotentials. 

iii)   Physical principles governing  flow of blood in  heart and blood vessels.  Also  physical  principles  governing flow  of  air  in  air passages. 

2.   Tutorial/group discussion:      On the topic covered in didactic lectures. 

3.   Practicals: 

     Demonstration of :    

     a) Biopotential on oscilloscope   
     b) Electro Encephalogram (EEG)
     c) Electro Myelogram (EMG)
     d) Electro Cardiogram (ECG) 

(3)  BIOCHEMISTRY

 Biochemistry   including   medical  physics  and   Molecular Biology.

i)     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.

ii)    OBJECTIVES 

a)    KNOWLEDGE 

At the end of the course, the student should be able to : 

(1) describe the molecular and functional organization of a cell and list its subcellular  components; 

(2) delineate  structure, function and  inter-relationships of biomolecules and consequences of deviation from normal; 

(3)  summarize the fundamental aspects of enzymology and clinical application wherein regulation of enzymatic activity is altered; 

(4) describe  digestion  and  assimilation  of  nutrients and consequences of malnutrition; 

(5) integrate  the  various aspects of  metabolism  and  their regulatory pathways; 

(6) explain the biochemical basis of inherited  disorders  with their associated sequelae; 

(7) describe mechanisms involved in maintenance of  body  fluid and pH homeostasis; 

(8) outline  the molecular mechanisms of gene  expression  and regulation,  the  principles of genetic   engineering  and  their application in medicine; 

(9) summarize the molecular concepts of body defence and  their application in medicine; 

(10) outline  the  biochemical  basis  of  environmental  health hazards, biochemical basis of cancer and carcinogenesis; 

(11) familiarize with the principles of various conventional and specialized   laboratory   investigations   and   instrumentation analysis and interpretation  of a given data;    

(12) the  ability to suggest experiments to support  theoretical concepts and clinical diagnosis. 

 

b.   SKILLS: 

     At the end of the course, the student should be able to : 

(1) make use of conventional techniques/instruments to  perform biochemical analysis relevant to clinical screening and diagnosis; 

(2) analyze and interpret investigative data; 

(3) demonstrate the skills of solving scientific  and  clinical problems and decision making; 

c.   INTEGRATION 

The  knowledge  acquired  in biochemistry  should  help  the students  to  integrate  molecular  events  with  structure   and function of the human body in health and disease. 

(4)  INTRODUCTION TO HUMANITIES & COMMUNITY MEDICINE 

Including Introduction to the subjects of Demography, Health Economics,  Medical  Sociology, Hospital  Management,  Behavioral Sciences inclusive of Psychology. 

OBJECTIVES 

 

a)   KNOWLEDGE               

     The student shall be able to :                                                 

1.   explain the principles of sociology including demographic population dynamics; 

2.   identify  social factors related to  health,  disease and disability in the context of urban and rural societies; 

3.   appreciate the impact of urbanization on health and disease; 

4.   observe and interpret the dynamics of community behavior; 

5.    describe  the  elements of  normal  psychology  and  social psychology; 

6.    observe the principles of practice of medicine in  hospital and community setting; 

(b).   SKILLS 

     At the end of the course, the student should be able to make use of:

(1) Principles   of  practice  of  medicine  in  hospital and community  settings and familiarization with  elementary  nursing practices. 

(2) Art  of  communication with   patients  including  history taking and medico-social work. 

      Teaching of community medicine, should be both  theoretical as  well  as practical.  The practical aspects  of  the  training programme should include visits to the health establishments  and to  the  community where health intervention  programmes  are  in operation. 

      In  order  to inculcate in the minds of  the  students  the basic  concepts  of community medicine to be introduced  in  this phase  of training, it is suggested that the detailed  curriculum drawn   should   include  at  least  30   hours    of   lectures, demonstrations, seminars etc. together with atleast 15 visits  of two hours each. 

10.   PARA CLINICAL SUBJECTS OF PHASE II

9.1   PATHOLOGY

i)    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. 

ii)   OBJECTIVES 

a)    KNOWLEDGE      

      At the end of the course, the student should be able to :- 

(1)           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. 

(2)        explain the pathophysiological processes which govern the maintenance  of homeostasis, mechanisms of their disturbance  and the morphological and clinical manifestations associated with it. 

3.    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. 

4.   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:- 

1.    describe  the  rationale  and  principles  of   technical procedures of the diagnostic laboratory  tests and interpretation of the results;

2.    perform the simple bed-side tests on blood, urine and other biological fluid samples; 

3.    draw  a  rational  scheme  of  investigations  aimed  at diagnosing and managing the cases of common disorders; 

4.     understand  biochemical/physiological  disturbances   that occur  as a result of disease in collaboration with pre  clinical departments. 

 

c.    INTEGRATION 

     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. 

9.2   MICROBIOLOGY 

i)    GOAL 

      The broad goal of the teaching of undergraduate students in Microbiology  is  to  provide an  understanding  of  the  natural history of infectious disease in order to deal with the etiology, pathologenesis,  laboratory diagnosis, treatment and  control  of infections in the community. 

ii)    OBJECTIVES 

a.      KNOWLEDGE 

        At the end of the course, the student should be able to: 

1.    state the infective micro-organisms of the human  body  and describe the host parasite relationship. 

2.    list  pathogenic  micro-organisms   (bacteria,   viruses, parasites,  fungi) and describe the pathogenesis of the  diseases produced by them. 

3.     state or indicate the modes of transmission  of  pathogenic and  opportunistic organisms and their sources, including  insect vectors responsible for  transmission of infection. 

4.     describe the mechanisms of immunity to infections. 

5.     acquire  knowledge  on suitable  antimicrobial agents for treatment of infections and scope of immunotherapy and different vaccines available for prevention of communicable diseases. 

6.    apply methods of disinfection and sterilization to  control and prevent hospital and community acquired infections. 

7.     recommend    laboratory     investigations  regarding bacteriological examination of food, water, milk and air. 

(b).  SKILLS 

     At the end of the course, the student should be able to: 

1.    plan  and  interpret  laboratory  investigations  for   the diagnosis  of infectious diseases and to correlate  the  clinical manifestations with the etiological agent. 

2.    identify  the  common infectious agents with  the  help  of laboratory procedures and use antimicrobial sensitivity tests  to select suitable antimicrobial agents. 

3.    perform commonly employed bed-side tests for  detection  of infectious  agents such as blood film for malaria, filaria,  gram staining and AFB staining and stool sample for ova cyst. 

4.   Use the correct method of collection, storage and  transport of clinical material for microbiological investigations. 

c.   INTEGRATION 

     The student  should  understand  infectious  diseases  of national importance in relation to the clinical, therapeutic  and preventive aspects. 

(3)            PHARMACOLOGY 

i)          GOAL

     The broad goal of the teaching of undergraduate students  in Pharmacology  is to inculcate a rational and scientific basis  of therapeutics. 

ii) OBJECTIVES 

a.  KNOWLEDGE 

     At the end of the course, the student should be able to: 

1.     describe  the  pharmacokinetics  and  pharmacodynamics   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 environmental and occupational pollutants and state the management
          issues.

7.     indicate  causations in prescription of  drugs  in  special medical situations such as pregnancy, lactation, infancy and  old age. 

7.                    integrate the concept of rational drug therapy in  clinical pharmacology. 

9.    state the principles underlying 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 should 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  practice will  be  acquired  through  integrated  teaching  with  clinical departments and pre clinical departments. 

(4)            FORENSIC MEDICINE INCLUDING TOXICOLOGY 

i)    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 connected  medicolegal  problems. He/She acquires knowledge of law in relation to medical practice, medical negligence and respect for codes of medical ethics. 

ii)  OBJECTIVES 

a.  KNOWLEDGE 

     At the end of the course, the student should be able to: 

1.     identify  the  basic medicolegal aspects  of  hospital  and general practice. 

2.     define  the  medicolegal  responsibilities  of  a   general physician  while  rendering community service either in  a  rural primary health centre or an urban health centre. 

3.    appreciate  the physician's  responsibilities  in  criminal matters and respect for the codes of medical ethics. 

4.    diagnose, manage and identify also legal aspects of  common acute and chronic poisonings. 

5.   describe the medicolegal aspects and findings of post-mortem examination in case of death due to common unnatural conditions & poisonings. 

6.   detect occupational and environmental poisoning,  prevention and  epidemiology  of common poisoning and  their  legal  aspects particularly pertaining to Workmen's Compensation Act. 

7.   describe the general principles of analytical toxicology. 

b)   SKILLS 

     At the end of the course, the student should be able to :- 

1.    make  observations  and  logical  inferences  in  order  to initiate enquiries in criminal matters and medicolegal problems. 

2.    diagnose  and  treat common emergencies  in  poisoning  and manage chronic toxicity. 

3.    make  observations and interpret  findings  at  postmortem examination. 

4.   observe the principles of medical ethics in the practise  of his profession. 

(c)  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 disciplines will  provide scientific   basis   of  clinical   toxicology   e.g.   medicine, pharmacology etc. 

(5) COMMUNITY MEDICINE 

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     

a)   KNOWLEDGE 

     At the end of the course, the student should be able to :- 

(1)   describe  the  health  care  delivery   system   including rehabilitation of the disabled in the country; 

(2)  describe  the National Health  Programmes  with  particular emphasis on maternal and child health programmes, family  welfare planning and population control. 

(3)  list epidemiological methods and describe their  application to  communicable and non-communicable  diseases in the  community or hospital situation. 

(4)  apply biostatistical methods and techniques; 

(5)   outline  the  demographic  pattern  of  the  country   and appreciate  the  roles of the individual, family,  community  and socio-cultural milieu in health and disease. 

(6)   describe the health information systems. 

(7)    enunciate the principles and components of  primary  health care  and  the  national health policies to achieve  the  goal  of 'Health for All'. 

(8)    identify  the environmental and  occupational  hazards  and their control. 

(9)   describe  the importance of water and sanitation  in  human health. 

(10)  to  understand the principles of health  economics,  health administration,  health education in relation to community. 

b)   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. 

c).   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. 

11.    CLINICAL SUBJECTS OF PHASE II & PHASE III 

            The  teaching  and  training  in  clinical  subjects   will commence  at the beginning of Phase II and  continue  throughout 

      The  clinical subjects will be taught to prepare  the  MBBS graduates to understand and manage clinical problems at the level of a practitioner.  Exposure to subject matter will be limited to orientation and knowledge required of a general doctor.   Maximum attention to the diagnosis and management of the most common  and important  conditions encountered in general practice  should  be emphasised  in  all  clinical  subject  areas.   Instructions  in clinical  subjects  should be given both in out patient  and  in-patient during clinical posting. 

     Each  of the clinical departments shall  provide  integrated teaching  calling  on  pre-clinical, para-clinical  and  other clinical departments to join in exposing the students to the full range  of  disciplines relevant to each clinical area  of  study. Problem  approach  will  be  emphasised  based  on  basic  social sciences and a continuation of clinical and laboratory syllabi to optimally understand and manage each clinical condition. 

The course shall comprise of: 

(1)  MEDICINE & ITS ALLIED SPECIALITIES; 

(A)  MEDICINE

i)   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. 

ii)  OBJECTIVES 

(a)   KNOWLEDGE 

     At the end of the course, the student should be able to: 

(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

     At the end of the course, the student should be able to: 

(1)    develop   clinical  skills   (history   taking,   clinical examination  and  other instruments of examination)  to  diagnose various common medical disorders and emergencies. 

(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. 

(B)    PEDIATRICS 

     Pediatrics 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. 

i)   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.

ii)  OBJECTIVES 

a.   KNOWLEDGE 

     At the end of the course, the student should be able to: 

(1)   describe  the normal growth and development  during  foetal life,  neonatal  period, childhood and  adolescence  and  outline deviations thereof. 

(2)   describe the common paediatric disorders and emergencies  in terms of epidemiology, etiopathogenesis, clinical manifestations, diagnosis, rational therapy and rehabilitation. 

(3)   state  age  related requirements  of  calories,  nutrients, fluids, drugs etc. in health and disease. 

(4)    describe  preventive  strategies  for  common   infectious disorders,   malnutrition,   genetic  and   metabolic   disorders, poisonings, accidents and child abuse.  

(5)   outline national programmes relating to child health including immunisation programmes. 

b.   SKILLS 

     At the end of the course, the student should be able to: 

(1)  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. 

(2)   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. 

(3)   conduct  diagnostic  procedures  such  as   lumbar puncture,  liver  and  kidney  biopsy,  bone  marrow  aspiration, pleural tap and ascitic tap. 

(4)    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. 

(5).   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  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. 

(C)   PSYCHIATRY 

i)     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   disorders,   handle psychiatric   emergencies  and  to  refer   complications/unusual manifestations   of  common  disorders  and   rare  psychiatric disorders to the specialist. 

ii)    OBJECTIVES 

a.     KNOWLEDGE 

     At the end of the course, the student should be able to: 

(1)  comprehend nature and development of different  aspects  of normal  human  Behaviour  like  learning,  memory,   motivation, personality and intelligence; 

(2)  recognize differences between normal and abnormal behaviour; 

(3)  classify psychiatric disorders; 

(4).  recognize clinical manifestations of the  following  common syndromes  and  plan  their appropriate  management  of  organic psychosis,   functional  psychosis,   schizo-phrenia,   affective disorders,  neurotic  disorders, personality  disorders,  psycho-physiological disorders, drug and alcohol dependence, psychiatric disorders of childhood and adolescence; 

(5)  describe  rational  use of different modes  of  therapy  in psychiatric desorders.

 b.   SKILLS

      The student should be able to: 

(1)   interview the patient and understand different  methods  of communications in patient-doctor relationship; 

(2)  elicit  detailed  psychiatric  case  history  and   conduct clinical examination for assessment of mental status; 

(3)  define, elicit and interpret  psycho-pathological  symptoms and signs. 

(4)  diagnose and manage common psychiatric disorders; 

(5)  identify and manage psychological reactions and  psychiatric disorderes in medical and surgical patients in clinical  practice and in community setting. 

c.   INTEGRATION

     Training  in  Psychiatry  should  prepare  the  students  to deliver  preventive,  promotive,  curative  and   re-habilitative services  for  the  care  of patients  both  in  the  family  and community   and   to  refer  advance  cases  to   a   pecialised Psychiatry/Mental  Hospital. Training should be  integrated  with the  departments of Medicine, Neuro Anatomy, Behavioral  Sciences and Forensic medicine. 

 D  DERMATOLOGY AND SEXUALLY TRANSMITTED DISEASES 

I)   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. 

ii)  OBJECTIVES: 

a.  KNOWLEDGE: 

     At  the end of the course of Dermato-S.T.D. and  Leprology, the student Shall be able to: 

1.    demonstrate  sound  knowledge  of  common  diseases,  their clinical  manifestations,  including emergent situations  and  of investigative procedures to confirm their diagnosis: 

2.    demonstrate  comprehensive knowledge of  various  modes  of therapy used in treatment of respiratory diseases; 

3.    describe the mode of action of commonly used  drugs,  their doses, side-effects/toxicity, indications and  contra-indications and interactions; 

4.    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; 

b.   SKILLS: 

The student should be able to: 

1.     interview  the  patient,  elicit  relevant   and   correct information and describe the history in a chronological order. 

2.    conduct clinical examination, elicit and interpret  physical findings and diagnose common disorders and emergencies; 

3.     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; 

4.         take a skin biopsy for diagnostic purposes; 

5.     manage common diseases recognizing the need for referral for specialized  care,  in case of inappropriateness  of  therapeutic response; 
(E)                TUBERCULOSIS AND RESPIRATORY DISEASES : 
(I)      Goal: The aim of teaching the undergraduate student in Tuberculosis and Chest Diseases is to impart such knowledge and sills that may enable him/her to diagnose and manage common ailments affecting the chest with the special emphasis on management and prevention of Tuberculosis and especially National Tuberculosis control programme. 
(i)     OBJECTIVES: (a)

       Knowledge

At the end of the course of Tuberculosis and Chest-diseases, the student shall be able to :

(1)    demonstrate sound knowledge of common chest diseases, their clinical manifestations, including emergent situations and of investigative procedures to confirm their diagnosis.
(2)    Demonstrate comprehensive knowledge of various modes of therapy used in treatment of respiratory diseas;
(3)    Describe the mode of action of commonly used drugs, their doses, side-effects/toxicity, indications and contra-indications and interactions;
(4)    Describe commonly used odes of management including medical and surgical procedures available for treatment of various diseases and to offer a comprehensive plan of management inclusive of National Tuberculosis Control Programme. 
(b)    The student shall be able to :  (1)    interview the patient, elicit relevant and correct information and describe the history in chronological order; 
(2)    conduct clinical examination, elicit and interpret clinical findings and diagnose common respiratory disorders and emergencies; 
(3)    perform simple, routine investigative and office procedures required for making the bed side diagnosis, especially sputum collection and examination for etiologic organisms especially Acid Fast Bacilli (AFB), interpretation of the chest x-ray and respiratory function test; 
(4)    interpret and manage various blood gases and PH abnormalities in various respiratory diseases. 
(5)    Manage common diseases recognizing need for referral for specialized care, incase of inappropriateness of therapeutic response;  

6.     assist in the performance of common procedures, like laryngoscopic examination, pleural aspiration, respiratory physiotherapy, laryngeal intubation and pneumo-thoracic drainage/aspiration. 

c.    INTEGRATION: 

                The  broad  goal  of effective  teaching  can  be  obtained through  integration  with  departments  of  Medicine,   Surgery, Microbiology,  Pathology,  Pharmacology and Preventive  &  Social Medicine. 

(2)   SURGERY & ITS ALLIED SPECIALITIES 

(A)  SURGERY - including Paediatric Surgery: 

i)     GOAL: 

                The broad goal of the teaching of undergraduate students  in Surgery  is to produce graduates capable of delivering  efficient first contact surgical care. 

ii)    OBJECTIVES: 

a.    KNOWLEDGE: 

     At the end of the course, the student should be able to: 

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: 

     At the end of the course, the student should be able to: 

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. 

3.    identify and manage patients of hemorrhagic, septicaemic and other types of shock. 

4.           be  able to maintain patent air-way and resuscitate    i)                     a critically  injured patient ii)                  patient with  cardio-respiratory failure iii)               a drowning case 

5.    monitor  patients  of head,  chest,  spinal  and  abdominal injuries, both in adults and children. 

6.   provide primary care for a patient of burns. 

7.    acquire  principles of operative  surgery,  including  pre-operative, operative and post operative care and monitoring. 

8.    treat  open wounds including  preventive  measures  against tetanus and gas gangrene. 

9.    diagnose  neonatal and pediatric surgical  emergencies  and provide  sound  primary  care before  referring  the  patient  to secondary/tertiary centres. 

10.  identify congenital anomalies and refer them for appropriate management. 

     In  addition  to  these he  should  have  observed/assisted/ performed the following: 

1.   Incision and drainage of abscess

2.   Debridement and suturing open wound

3.   Venesection

4.   Excision of simple cyst and tumours

5.   Biopsy of surface malignancy

6.   Catheterisation and nasogastric intubation

7.   Circumcision

8.   Meatotomy

9.   Vasectomy

10.  Peritoneal and pleural aspirations

11.  Diagnostic proctoscopy

12.  Hydrocele operation

13.  Endotracheal intubation

14.  Tracheostomy and cricothyreidotomy

15.  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. 

B.    ORTHOPEDICS: 

a.   KNOWLEDGE: 

     The student should be able to: 

1.    explain the principles of recognition of bone injuries  and dislocation. 

2.   apply  suitable  methods  to  detect  and  manage   common infections of bones and joints. 

3.  identify congenital, skeletal anomalies and their  referral for appropriate correction or rehabilitation.

4.    recognize metabolic bone diseases as seen in this country. 

5.    explain etiogenesis, manifestations, diagnosis of  neoplasm affecting bones. 

b.   SKILLS 

     At the end of the course, the student should be able to: 

1.    Detect  sprains and deliver first aid  measures  for  common fractures  and  sprains  and manage  uncomplicated  fractures  of clavicle, Colles's, forearm, phallanges etc. 

2.    Techniques of splinting, plaster, immobilization etc. 

3.   Management of common bone infections, learn indications  for sequestration,  amputations  and  corrective  measures  for  bone deformities. 

4.    Aspects  of rehabilitation for Polio, Cerebral  Palsy  and Amputation.

 c.   APPLICATION: 

     Be able to perform certain orthopedic skills, provide  sound advise of skeletal and related conditions at primary or secondary health care level. 

d.   INTEGRATION: 

Integration with anatomy, surgery, pathology, rediology  and Forensic Medicine be done. 

C.   RADIO-DIAGNOSIS AND RADIOTHERAPY 

A     RADIODIAGNOSIS & IMAGING: 

i)     GOAL

     The  broad  goal  of  teaching  the  undergraduate   medical students  in  the  field of Radio-diagnosis should  be  aimed  at making  the  students realise the basic need  of  various  radio-diagnostic tools in medical practice. They should be aware of the techniques required to be undertaken in different situations  for the  diagnosis of various ailments as well as  during  prognostic estimations. 

ii)    OBJECTIVES 

a.   KNOWLEDGE

     The student should be able to:

1.   understand basics of X-ray production, its uses and hazards. 

2.    appreciate and diagnose changes in bones - like  fractures, infections, tumours and metabolic bone diseases. 

3.    identify  and  diagnose  various  radiological  changes  in disease  conditions  of chest and mediastinum,  skeletal  system, G.I. Tract, Hepatobiliary system and G.U. system. 

4.    learn about various imaging techniques, including  isotopes C.T., Ultrasound, M.R.I. and D.S.A. 

b.   SKILL 

     At the end of the course the student should be able to: 

1.    use  basic  protective techniques  during  various  imaging procedures. 

2.    Interpret  common  X-ray,  radio-diagnostic  techniques  in various community situations. 

3.    advise  appropriate diagnostic  procedures  in  specialized circumstances to appropriate specialists. 

B     RADIOTHERAPY 

i)   GOAL: 

    The  broad  goal  of  teaching  the  undergraduate   medical students  in  the field of Radiotherapy is to make  the  students understand the magnitude of the ever-increasing cancer problem in the country. The students must be made aware about steps required for the prevention and possible cure of this dreaded condition. 

ii)   OBJECTIVES 

a.   KNOWLEDGE: 

     The students should be able to: 

1.    identify  symptoms and signs of various cancers  and  their steps of  investigations and management. 

2.   explain the effect of radiation therapy on human beings  and the basic principles involved in it. 

3.     know  about  radio-active  isotopes  and  their   physical properies 

4.    be  aware of the advances made in  radiotherapy  in  cancer management  and knowledge of various radio therapeutic  equipment while treating a patient. 

b.   SKILL: 

     At  the  completion of the training programme,  the  student should be able to: 

1.      take a detailed clinical history of the case  suspected  of having a malignant disease. 

2.    assist various specialists in administration of  anticancer drugs  and  in application and use  of  various  radiotherapeutic equipment, while treating a patient. 

(3)     OTO-RHINO-LARYNGOLOGY 

i)     GOAL: 

     The broad goal of the teaching of undergraduate students  in  Otorhinolaryngology  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.

ii)   OBJECTIVES 

a.   KNOWLEDGE 

     At the end of the course, the student should be able to: 

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 

     At the end of the course, the student should be able to: 

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. 

c.   INTEGRATION: 

     The undergraduate training in ENT will provide an integrated approach  towards  other  disciplines  especially  neurosciences, ophthalmology and general surgery. 

4.   OPHTHALMOLOGY 

i)    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 

ii)   OBJECTIVES 

a.   KNOWLEDGE 

     At the end of the course, the student should have  knowledge of: 

1.   common problems affecting the eye: 

2.   principles of management of major ophthalmic emergencies 

3.   main systemic diseases affecting the eye 

4.    effects of local and systemic diseases on patient's  vision and  the  necessary action required to minimise the  sequalae  of such diseases; 

5.   adverse drug reactions with special reference to  ophthalmic manifestations; 

6.   magnitude of blindness in India and its main causes; 

7.     national  programme  of  control  of  blindness  and   its implementation at various levels 

8.   eye care education for prevention of eye problems 

9.   role of primary health centre in organization of eye camps 

10.   organization of primary health care and the functioning  of the ophthalmic assistant. 

11.   integration  of  the  national  programme  for  control  of blindness with the other national health programmes; 

12.  eye bank organization 

b.   SKILLS

     At the end of the course, the student should be able to: 

1.    elicit  a history pertinent to general  health  and  ocular status; 

2.    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. 

3.   diagnose and treat common problems affecting the eye; 

4.   interpret ophthalmic signs in relation to  common  systemic disorders; 

5.    assist/observe    therapeutic    procedures    such    as subconjunctival  injection,  Corneal/Conjunctival  foreign   body removal,  Carbolic cautery for corneal ulcers, Nasolacrimal  duct syringing and tarsorraphy; 

6.   provide first aid in major ophthalmic emergencies; 

7.   assist to organise community surveys for visual check up; 

8.   assist to organise primary eye care service through  primary health  centres; 

9.    use  effective means of communication with the  public  and individual  to  motivate  for surgery in  cataract  and  for  eye donation; 

10.    establish  rapport  with  his  seniors,  colleagues   and paramedical workers, so as to effectively function as a member of the eye care team. 

c.   INTEGRATION 

  The undergraduate training in Ophthalmology will provide  an integrated approach   towards  other   disciplines   especially neurosciences, Otorhino-laryngology, General   Surgery and Medicine. 

10.5.     OBSTETRICS AND GYNAECOLOGY

Obstetrics  and  Gynaecology to include family  welfare  and family planning. 

i)   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. 

ii)  OBJECTIVES 

a.   KNOWLEDGE 

     At the end of the course, the student should be able to: 

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, pre-menopausal and post-menopausal periods. 

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  Caesarian  section,  laparotomy,  abdominal  and vaginal   hysterectomy,   Fothergill's  operation   and   vacuum aspiration for M.T.P. 

b.   SKILLS 

     At the end of the course, the student should be able to: 

1.    examine a pregnant woman; recognise high  risk  pregnancies and make appropriate referrals. 

2.    conduct  a  normal delivery,  recognise  complications  and provide postnatal care.

3.   resuscitate the newborn and recognise congenital anomalies. 

4.     advise   a  couple  on  the  use  of   various   available contraceptive  devices and assist in insertion in and removal  of intra-uterine contraceptive devices. 

5.    perform  pelvic  examination,  diagnose  and  manage  common gynaecological  problems  including early  detection  of  genital malignancies. 

6.   make a vaginal cytological smear, perform a post coital test and  wet  vaginal smear examination  for  Trichomonas  vaginalis, moniliasis and gram stain for gonorrhoea. 

7.   interpretation of data of investigations like biochemical, histopathological, radiological, ultrasound etc. 

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. 

d.   GENERAL GUIDELINES FOR TRAINING: 

1.   attendance of a maternity hospital or the maternity wards of a  general  hospital  including  (i)  antenatal  care  (ii)   the management  of  the puerperium and (iii) a minimum  period  of  5 months  in-patient  and  out-patient  training  including  family planning. 

2.    of this period of clinical instruction, not less  than  one month shall be spent as a resident pupil in a maternity ward of a general hospital. 

3.    during this period, the student shall conduct at  least  10 cases of labour under adequate supervision and assist in 10 other cases. 

4.   a certificate showing the number of cases of labour attended by  the  student in the maternity hospital and/or  patient  homes respectively,  should be signed by a responsible medical  officer on the staff of the hospital and should state: 

(a)   that  the  student has been present during  the  course  of labour  and personally conducted each case, making the  necessary abdominal  and  other examinations under the supervision  of  the certifying officer who should describe his official position. 

(b)   that satisfactory written histories of the cases  conducted 5ncluding wherever possible antenatal and postnatal observations, were  presented by the student and initialed by  the  supervising officer.

5.   FAMILY PLANNING: 

Training in Family Planning should be emphasized in all  the three  phases and during internship as per guideline provided  in Appendix A. 

6.     COMMUNITY MEDICINE 

     The  teaching  and  training  of  community  medicine   will continue  during the first two semesters of phase  III  (clinical Phase).  The goals, objectives and skills to be acquired  by  the student has already been outlived  in Phase  II(Para Clinical Phase).

 

CHAPTER IV

12.              Examination Regulations 

Essentialities for qualifying to appear in professional examinations.

      The performance in essential components of training are to be assessed, based on:

 (1)    ATTENDANCE 

75%  of attendance in a subject for appearing in the examination is compulsory provided he/she has 80% attendance in non lecture teaching. i.e. seminars, group discussions, tutorials, demonstrations, practicals, Hospital  (Tertiary, Secondary, Primary) postings and bed side clinics, etc. 


(2)     Internal Assessment : 

(i)    It shall be based on day to day assessment ( see note), evaluation of student assignment, preparation for seminar, clinical case presentation etc.:
(ii)    Regular periodical examinations shall be conducted throughout the course.  The questions of number of examinations is left to the institution:
(iii)    Day to day records should be given importance during internal assessment :
(iv)    Weightage for the internal assessment shall be 20% of the total marks in each subject :
(v)    Student must secure at least 35% marks of the total marks fixed for internal assessment in a particular subject in order to be eligible to appear in final university examination of that subject.

Note Internal assessment shall relate to different ways in which students participation in learning participation in learning process during semesters in evaluated. Some examples are as follows: 

(i)    Preparation of subject for students seminar. (ii)    Preparation of a clinical case for discussion. (iii)    Clinical case study/problem solving exercise. (iv)    Participation in Project for health care in the community  (planning stage to evaluation). (v)    Proficiency in carrying out a practical or a skill in small research project. (vi)    Multiple choice questions (MCQ) test after completion of a system/teaching. 

Each item tested shall be objectively assessed and recorded.  Some of the items can be assigned as Home work/Vacation work. 

(3)    UNIVERSITY EXAMINATIONS : 

Theory papers will be prepared by the examiners as prescribed.  Nature of questions will be short answer type/objective type and marks for each part indicated separately. 

Practicals/clinicals will be conducted in the laboratories or hospital wards.  Objective will be assess proficiency in skills, conduct of experiment, interpretation of data and logical conclusion.  Clinical cases should preferably include common diseases not esoteric syndromes or rare disorders.   Emphasis should be on candidate’s capability in eliciting physical signs and their interpretation. 

Viva/oral includes evaluation of management approach and handling of emergencies.  Candidate’s skill in interpretation of common investigative data, x-rays, identification of specimens, ECG,etc. also is to be evaluated. 

The examinations are to be designed with a view to ascertainwhether the candidate has acquired the necessary for knowledge, minimum skills alongwith clear concepts of the fundamentals which are necessary for him to carry out his professional day to day work competently.  Evaluation will be carried out on an objective basis. 

Question papers should preferably be of short structure/objective type. 

Clinical cases/practicals shall take into account common diseases which the student is likely to come in contact in practice.  Rare cases/obscure syndromes, long cases of neurology shall not be put for final examination. 

During evaluation (both Internal and External) it shall be ascertained if the candidate has acquired the skills as detailed in Appendex-B. 

There shall be one main examination in a year and a supplementary to be held not later than 6 months after the publication of its results.  Universities Examinations shall beheld as under:- 

First Professional:- 

                In the second Semester of Phase 1 training, in the subjects of Anatomy, Physiology and Bio-Chemistry. 

Second Professional:- 

                In the Fifth Semester of Phase II training, in the subjects of Pathology, Microbiology, Pharmacy and Forensic Medicine. 

Third Profesional :- 

                Part 1- in the Seventh Semester of Phase III, in the subjects of Ophthamology, Oto-rhyno-laryngology and Community Medicine. 

Third Professional :- 

Part II-(Final Professional) – At the end of Phase III training in the subjects of Medicine, Surgery, Obstetrics & Gynecology and Pediatrics.

Note :  Results of all university examinations shall be declared before the start of teaching for next semester. 

(4)                 DISTRIBUTION OF MARKS TO VARIOUS DISCIPLINES :    (A)              First Professional examination:(Pre-clinical Subjects):-  (a)               Anatomy:

Theory-Two papers of 50 marks each

(One applied question of 10 marks in each paper) 100 marks. 

Oral(Viva)                                                                              20 marks

Practical                                                                                40 marks

Internal Assessment
(Theory-20; Practical-20)                                                          40 marks

            Total                                                                          200 marks 

(b)               Physiology including Biophysics

Theory-Two papers of 50 marks each

( One applied question of 10 marks in each paper) 100 marks

Oral (Viva)                                                                          20 marks

Practical                                                                             40 marks

Internal Assessment
(Theory-20; Practical-20)                                                       40 marks

            Total                                                                       200 marks

 (c)     Biochemistry :

Theory-Two papers of 50 marks each

( One applied question of 10 marks in each paper)                     100 marks 

Oral (Viva)                                                                          20 marks

Practical                                                                             40 marks

Internal Assessment
(Theory-20; Practical-20)                                                      40 marks

            Total                                                                      200 marks

Pass: In each of the subjects, a candidate must obtain 50% in aggregate with a minimum of 50% in Theory including orals and minimum of 50% in Practicals. 

(A)              SECOND PROFESSIONAL EXAMINATION; 

(Para-clinical subjects):

(a)               Pathology :

Theory-Two papers of 40 marks each

(One applied question of 10 marks in each paper)            80 marks

Oral (Viva)                                                               15 marks

Practical                                                                  25 marks

Internal assessment

(Theory-15; Practical-15)                                           30 marks

            Total                                                           150 marks

 (b)            Microbiology :

Thoery-Two papers of 40 marks each

(One applied question of 10 marks in each paper)            80 marks

Oral (Viva)                                                               15 marks

Practical

Internal assessment

(Theory-15; Practical-15)                                            30 marks

            Total                                                          150 marks

 

(c)               Pharmacology

Thoery-Two papers of 40 marks each

Containing one question on clinical therapeuics               80 marks

Oral (Viva)                                                               15 marks

Practical                                                                  25 marks

Internal assessment

(Theory-15; Practical-15)                                            30 marks

            Total                                                          150 marks

 

(d)       Forensic Medicine

            Theory-one papaers                                                 40 marks

            Oral (Viva)                                                              10 marks

            Practical/Clinicals                                                     30 marks

            Internal assessment

            (Theory-10; Practical-10)                                           20 marks

                        Total                                                         100 marks

           Pass: In each of the subjects, a candidate must obtain 50 % in aggregate with a minimum of 50% in Theory including oral and minimum of 50% in Practicals/clinicals. 

(d)              THIRD PROFESSIONAL 

(i)                 PART 1

(Clinical subjects)

Part 1: To be conducted during end period of seventh semester..

(a)               Ophthamology: 

Theory : One paper                                                                40 marks

(should contain one question on pre-clinical and 
           para-clinical aspects, of 10 marks)

            Oral (Viva)                                                                         10 marks

            Clinical                                                                              30 marks

            Internal assessment                                                             20 marks

(Theory-10; Practical-10)

            Total                                                                        100 marks 

(b)               Oto-Rhino-Laryngology : 

Theory:One paper                                                                 40 marks

(should contain one question on pre-clinical and
           para-clinical aspects, of 10 marks)

            Oral(Viva)                                                                          10 marks

            Clinical                                                                              30 marks

            Internal assessment                                                             20 marks

            (Theory –10 Practical-10)

                        Total                                                                     100 marks

(c)               Community Medicine including Humanities:

Theory : Two papers of 60 marks each                            120 marks

(includes problem solving, applied aspects of management at primary level including essential drugs, occupational (agro based) diseases, rehabilitation and social aspects of community).

            Oral (Viva)                                                                 10 marks

            Practical/Project evaluation                                           30 marks

            Internal assessment                                                     40 marks

            (Theory -20; Practical-20)

                        Total                                                            200 marks

Pass:  In each of the subjects a candidate must obtain 50% in aggregate with a minimum of 50% in Theory including orals and minimum of 50% in practicals/clinicals.

 PART-II 

            Each paper shall have two sections.  Questions requiring essay type answers may be avoided.

 (a)               Medicine :

Theory- Two papers of 60 marks each                            120 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)

Oral (Viva) Interpretation of X-ray ECG, etc. 20 marks

Clinical (Bed side)                                                         100 marks

Internal assessment                                                       60 marks

(Theory-30; Practical-30)

            Total                                                              300 marks 

(b)               Surgery:

Theory-Two papers of 60 marks each                            120 marks

Paper-1-General Surgery (Section 1)

Orthopaedics (Section 2) 

PAPER II-General Surgery including 

            Anaesthesiology, Dental diseases and Radiology.

            (shall contain one question on basic sciences and allied subjects)

            Oral (Viva) Interpretation of Investigative data                20 marks

            Clinical (Bed Side)                                                      100 marks

            Internal assessment                                                    60 marks

            (Theory-30; Practical-30)                                            60 marks

                        Total                                                          300 marks 

            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. 

(c)    Obstetrics and Gynaecology 

Theory Two papers of 40 marks each                                80 marks

Paper I- Obstetrics including social obstetrics.

Paper II – Gynaecology, Family Welfare and Demography

(Shall contain one question on basic sciences and allied subjects)

Oral (Viva) including record of delivery cases(20+10)            30 marks

Clinical                                                                         30 marks

Internal assessment                                                        60 marks

(Theory-30; Practical-30)

               Total                                                             200 marks 

(d)               Pediatrics : (Including Neonstology)

Theory : One paper              40 marks

           (Shall contain one question on basic sciences and allied subjects)

           Oral (Viva)                        10 marks

           Clinical                             30 marks

            Internal assessment           20 marks

            (Theory-10; Practical-10)

                          Total                100 marks 

             Pass :  In each of the subjects a candidate must obtain 50% in aggregate with a minimum of 50% in Theory including orals and minimum of 50% in Practicals/clinicals.

13         APPOINTMENT OF EXAMINERS: 

(1)    No person shall be appointed as an examiner in any of the subjects of the Professional examination leading to and including the final Professional examinations for the award of the MBBS degree unless he has taken atleast five years previously, a doctorate degree of a recognized university or an equivalent qualification in the particular subject as per recommendation of the Council on teachers’ eligibility qualifications and has had at least five years of total teaching experience in the subject concerned in a college affiliated to a recognized university at a faculty position. 

(2)    There shall be at least four examiners for 100 students, 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 co-ordinator of the whole examination programme so that uniformity in the matter of assessment of candidates is maintained.  Where candidates appearing are more than 100, one additional examiner, for every additional 50 or part thereof candidates appearing, be appointed. 

(3)    Non medical scientists engaged in the teaching of medical students as whole time teachers, may be appointed examiners in their concerned subjects provided they possess requisite doctorate qualifications and five year teaching experience of medical students after obtaining their postgraduate qualifications.  Provided further that the 50% of the examiners (Internal & External) are from the medical qualification stream.

(4)    External examiners shall not be from the same university and preferably be from outside the state. 

(5)    The internal examiner in a subject shall not accept external examinership for a college from which external examiner is appointed in his subject. 

(6)    A university having more than one college shall have separate sets of examiners for each college, with internal examiners from the concerned college. 

(7)    External examiners shall rotate at an interval of 2 years. 

(8)    There shall be a Chairman of the Board of paper-setters who shall be an internal examiner and shall moderate the questions. 

(9)    Except Head of the department of subject concerned in a college/institution, all other with the rank of reader or equivalent and above with requisite qualifications and experience shall be appointed internal examiners by rotation in their subjects; provided that where there are no posts of readers, then an Assistant Professor of 5 years standing as Assistant Professor may be considered for appointment as examiner..

(10)    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.  

CHAPTER - V 

14.   INTERNSHIP 

(1)     General 

Internship is a phase of training wherein a graduate is expected to conduct actual practice of medical and health care and acquire skills under supervision so that he/she may become capable of functioning independently. 

(2)    SPECIFICE OBJECTIVES 

At the end of the internship training, the student shall be able to: 

i.          diagnose clinical common disease conditions encountered in practice and make timely decision for referral to higher level; 

ii.       use discreetly the essential drugs, infusions, blood or its substitutes and laboratory services. 

iii.      Manage all type of emergencies-medical, surgical obstetric, neonatal and paediatric, by rendering first level care; 

iv.     Demonstrate skills in monitoring of the National Health Programme and schemes, oriented to provide preventive and promotive health care services to the community; 

v.       Develop leadership qualities to function effectively as a leader of the health team organised to deliver the health and family welfare service in existing socio-ecomic, political and cultural  environment; 

vi.     Render services to chronically sick and disabled (both physical and mental) and to communicate effectively with patient and the community. 

(3)    Time allocation to each discipline is approximate and shall be guided more specifically by the actual experience obtained. Thus a student serving in a district or taluk hospital emergency room may well accumulate skill in surgery, orthopaedics, medicine, obstetrics and Gynaecology and Paediatrics during even a single night on duty. Responsible authorities from the medical college shall adjust the intern experience to maximize intern’s opportunities to practice skills in patient care in rough approximation of the time allocation suggested. 
(4)   INTERNSHIP – TIME DISTRIBUTION   

Compulsory
Community Medicine 3 months
Medicine 2 months
Surgery including Orthopaedics 2 months
Obst./Gynae. Including Family 2 months
Welfare Planning 15 days
Paediatric 15 days
Ophthalmology 15 days
Otorhinolaryngology 15 days
Casualty 1 Month

 Elective Postings

Elective Subject :-

Elective posting will include Two of the following for 15 days in each subject.
    Dermatology and Sexually Transmitted Diseases. Psychiatry Tuberculosis and Respiratory Diseases Anesthesia Radio-diagnosis Physical Medicine and Rehabilitation Forensic Medicine and Toxicology Blood Bank and Transfusion Department.

    (5)    OTHER DETAILS: 

    i)         All parts of the internship shall be done as far as possible in institutions of India. In case of any difficulties, the matter may be referred to the Medical Council of India to be considered on individual merit. 

    ii)       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. 

    iii)     The University shall issue a provisional MBBS pass certificate on passing the final examination. 

    iv)    The State Medical Council will grant provisional registration to the candidate on 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 may be suitably extended by the appropriate authorities. 

    v)      The intern shall be entrusted with clinical responsibilities under direct supervision of senior medical officer. They shall not be working independently. 

    vi)     Interns will not issue a medical certificate or a death certificate or a medicolegal document under their signature. 

    vii)   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; 

    viii)   Adjustment to enable a candidate to obtain training in elective clinical subjects may be made. 

    ix)     Each medical college shall establish links with one entire district extending out-reach activities. Similarly, Re-orientation of Medical Education (ROME) scheme may be suitably modified to assure teaching activities at each level of District health system which will be coordinated by Dean of the medical college; 

    x)      Out of one year, 6 months shall be devoted to learning tertiary care being rendered in teaching hospital/district hospital suitably staffed with well qualified staff, 3 months of secondary care in a small District or Taluka Hospital/Community Health Centre and 3 months in Primary Health care out of which 2 months should be in Primary Health Programme at the Community level. One month of primary care training may be in the form of preceptorship with a practicing family physician or voluntary agency or other primary health care provider. 

    xi)     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. 

    (6) ASSESSMENT OF INTERNSHIP

    i)     The intern shall maintain a record of work which is to be verified and certified by the medical officer under whom he 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. Based on the record of work and date of evaluation, the Dean/Principal shall issue certificate of satisfactory comnpletion of training, following which the University shall award the MBBS degree or declare him eligible for it. 

    ii)    Satisfactory completion shall be determined on the basis of the following:- 

    (1)   Proficiency of knowledge required for each case

    SCORE 0-5

    (2)    The competency in skills expected to manage each case: 
    a)      Competency for performance of self performance,
    b)     of having assisted in procedures,
    c)      of having observed.

    SCORE 0-5

     (3)   Responsibility, punctuality, work up of case, involvement in treatment, follow-up reports.

    SCORE 0-5

     (4)   Capacity to work in a team (Behaviour with colleagues, nursing staff and relationship with paramedicals).

    SCORE 0-5

     (5)   Initiative, participation in discussions, research aptitude.

    SCORE 0-5

     poor

    Fair/

    Below Average/

    Average/

    Above Average/

    Excellent

    0

    1

    2

    3

    4

    5

    A Score of less than 3 in any of above items will represent unsatisfactory completion of internship. 

    (7)     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 it declaration that the candidate is eligible for it. 

    (8)    Some guidelines in the implementation of the training programme are given below. 

    (9)    INTERNSHIP – DISCIPLINE RELATED: 

    (i)    Community Medicine

    Interns shall acquire skills 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: - 

    (I)    Community Health Centre/District Hospital/Attachment to General Practitioner: 

    (1)      During this period of internship an intern must acquire 

    (a)    clinical competence for diagnosis of common ailments, use of bed side investigation and primary care techniques; 

    (b)   gain information on ‘Essential drugs’ and their usage; 

    (c)    recognise medical emergencies, resuscitate and institute initial treatment and refer to suitable institution. 

    (2)      Undergo specific Government of India/Ministry of Health and Family Welfare approved training using Government of India prescribed training manual for Medical Officers in all National Health Programmes (e.g. child survival and safe motherhood-EPI, CDD, ARI, FP, ANC, safe delivery, Tuberculosis, Leprosy and others as recommended by Ministry of Health and Family Welfare:- 

    (a)    gain full expertise in immunization against infectious disease;

    (b)   participate in programmes in prevention and control of locally prevalent endemic diseases including nutritional disorders;

    (c)    learn skills first hand in family welfare planning procedures;

    (d)   learn the management of National Health Programmes; 

    (3)      Be capable of conducting a survey and employ its findings as a measure towards arriving at a community diagnosis. 

    (4)      (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 

    (5) Be capable of establishing linkages with other agencies as water supply, food distribution and other environmental/social agencies. 

    (6) Acquire quality of being professional with dedication, resourcefulness and leadership. 

    (7) Acquire managerial skills, delegation of duties to paramedical staff and other health professionals. 

    (II)       TALUQA HOSPITAL 

    Besides clinical skill, in evaluation of patient in the environment and initiation of primary care, an Intern shall: - 

    (1)               effective participate with other members of the health team with qualities of leadership;

    (2)               make a community diagnosis in specific situations such as epidemics and institute relevant control measures for communicable diseases;

    (3)               develop capability for analysis of hospital based morbidity and mortality statistics.

    (4)               Use essential drugs in the community with the awareness of availability, cost and side effects;

    (5)               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;

    e)      participation in school health programme. 

    (III)                          PRIMARY HEALTH CENTRE 

    (1)   Initiate or participate in family composite health care (birth to death), Inventory of events;

    (2)   Participation in all of the modules on field practice for community health e.g. safe motherhood, nutrition surveillance and rehabilitation, diarrhea disorders etc.

    (3)   Acquire competence in diagnosis and management of common ailments e.g. malaria, tuberculosis, enteric fever, congestive heart failure, hepatitis, meningitis acute renal failure etc.;

    (4)   Acquire proficiency for Family Welfare Programmes (ante natal care, normal delivery, contraception care etc.) 

    (ii)         GENERAL MEDICINE  (I)                 Interns shall acquire following training during their term. 

    (1)   acquire competence for clinical diagnosis based on history physical examination and relevant laboratory investigation and institute appropriate line of management; 

    (2)   this would include diseases common in tropics (parasitic, bacterial or viral infections, nutritional disorders, including dehydration and electrolyte disturbances) and system illnesses. (II)       The intern shall have assisted as a care team in intensive care of cardiac, respirator, hepatic, neurological and metabolic emergencies. 

    (III)            The intern shall be able to conduct the following laboratory investigations: 

    (a)Blood: (Routine haematology smear and blood groups);

    (b)   Urine: (Routine chemical and microscopic);

    (c)Stool: (for ova/cyst and occult blood);

    (d)   Sputum and throat swab for gram stain or acid fast stain and

    (e)Cerebro Spinal Fluid (CSF) for smear. 

    (IV)              Conduct following diagnostic procedures: 

    (a)Urethral catheterisation;

    Proctoscopy;

    Ophthalmoscopy/Otoscopy;

    Indirect laryngoscopy; 

    (b)   therapeutic procedures;

    Insertion of Ryles Tube;

    Pleural, ascetic tap, Cerebro Spinal Fluid (CSF) tap, installing or air way tube, Oxygen administration etc. 

    (V)              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. 

    (VI)           (a) Familiarity with usage of life saving procedures:

    including use of aspirator, respirator and defibrillator,

    (b)   Competence in interpretation of different monitoring devices such as cardiac monitor, blood gas analysis etc. 
    (VII)         Participate as a team member in total health care of an individual including appropriate follow-up and social rehabilitation. 
    (VIII)      Other competencies as indicated in general objectives. 

    (iii)             PAEDIATRICS: 

    The details of the skills that an intern shall acquire during his/her tenure in the department of Paediatrics are as follows: 

    The intern shall be able to: 

    (1)     diagnose and manage common childhood disorders including neonatal disorders and acute emergencies( enquiry from parents of sick children), examining sick child making a  record of information; 
    (2)     carry out activities related to patient care such as laboratory work, investigative procedures and use of special equipments. The details are given as under:- 
    (a) diagnostic techniques: blood (including from femoral vein and umbilical cord), obscess, cerebrospinal fluid, urine, pleura and peritoneum and common tissue biopsy techniques;
    (b) techniques related to patient care: immunization, perfusion techniques, feeding procedures, tuberculin testing & breast feeding counselling;
    (c) use of  equipment: vital monitoring, temperature monitoring, resuscitation at birth and care of children receiving intensive care; 
    (3)       screening of newborn babies and those with objective risk factors for any anomalies and steps for prevention in future;
    (4)     plan in collaboration with parents and individual, collective surveillance of growth and development of new born babies, infants and children so that he/she is able to: 
    (a)    recognise growth abnormalities;
    (b)   recognise anomalies of psychomotor development; 
    (c)    detect congenital abnormalities; 
    (5)     assess nutritional and dietary status of infants and children and organise prevention, detection and follow up of deficiency disorders both at individual and community level such as: 
    (a)    protein-energy malnutrition
    (b)   deficiencies of vitamins especially A, B, C and D;
    (c)    Iron deficiency; 
    (6)     institute early management of common childhood disorders with special reference to Paediatrics dosage and oral rehydration therapy. 
    (7)     Participate actively in public health programme oriented towards children in the community. 

    (iv)             GENERAL SURGERY 

    An intern is expected to acquire following skills during his/her posting: 

    (A)       Diagnose with reasonable accuracy all surgical illnesses including emergencies  (B)        (a) resuscitate a critically injured patient and a severe burns patient;
    (b)                   control surface bleeding and manage open wound; 
    (C)       (a) monitor patients of head, spine, chest abdominal and pelvic injury;
    (b)   institute first-line management of acute abdomen; 

    (D)  (a) perform venesection;


    (b)perform tracheostomy and endotracheal intubation;


    (c)catheterise patients with acute retention or perform trocar cystostomy,
    (d)   drain superficial abscesses,
    (e)suturing of wound,
    (f)  perform circumcision,
    (g)biopsy of surface tumours,
    (h)Perform vasectomy

    (v)            CASUALTY: 

                The intern after training in Casualty must be able to: 

    (1)   identify acute emergencies in various disciplines of medical practice;
    (2)   manage acute anaphylatic shock;
    (3)   manage peripheral-vascular failure and shock;
    (4)   manage acute pulmonary oedema and Left Ventricular failure (LVF);
    (5)   undertake emergency management of drowning poisonings and seizures;
    (6)   undertake emergency management of bronchial asthma and status asthematicus;
    (7)   undertake emergency management of hyperpyrexia;
    (8)   undertake emergency management of comatose patients regarding airways positioning, prevention of aspiration and injuries;
    (9)   assess and administer emergency management of burns;
    (10)           assess and do emergency  management of various trauma victims;
    (11)           identify medicolegal cases and learn filling up forms as well as complete other medicolegal formalities in cases of injury, poisoning, sexual offenses, intoxication and other unnatural conditions. 

    (vi)             OBSTETRICS AND GYNAECOLOGY : 

    Technical skills that interns are expected to learn: 

    (1)   diagnosis of early pregnancy and provision of ante-natal care; 
    (2)   diagnosis of pathology of pregnancy related to 
(a)    abortions;
(b)   ectopic pregnancy;
(c)    tumours complicating pregnancy;
(d)   acute abdomen in early pregnancy;
(e)    hyperemesis gravidarum; 
(3)   detection of high risk pregnancy cases and suitable advise e.g. PIH, hydramanios, antepartum haemorrhage, multiple pregnancies, abnormal presentations and intra-uterine growth retardation; 
(4)   antenatal pelvic assessment and detection of cephalopelvic disproportion; 
(5)   induction of labour and amniotomy under supervision; 
(6)   management of normal labour, detection of abnormalities, post-partum hemorrhage and repair of perennial tears; 
(7)   assist in forceps delivery; 
(8)   assist in caesarean section and postoperative care thereof;  
(9)   detection and management of abnormalities of lactation; 
(10)           perform non-stress test during pregnancy; 
(11)           per speculum, per vaginum and per rectal examination for detection of common congenital, inflammatory, neoplastic and traumatic conditions of vulva, vagina, uterus and ovaries; 
(12)           medicolegal examination in Gynecology and obstetrics. 
(13)           To perform the following procedures:-
(a)    dilation 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;
(g)    Urethral catheterisation;
(h)    Suture removal in postoperative cases;
(i)      Cervical punch biopsy; 
(14)    to assist in major abdominal and vaginal surgery cases in Obstetrics and      Gynaecology. 
(15)    to assist in follow-up postoperative cases of obstetrics and gynaecology such as:(a)    Colposcopy;
(b)   Second trimester Medical Termination of Pregnancy (MTP) procedures e.g. Emcredyl Prostaglandin instillations; 
(16)           To evaluate and prescribe oral contraceptive. 

(vii)           OTO RHINO LARYNGOLOGY (ENT) 

(1)               Interns shall acquire ability for a comprehensive diagnosis of common Ear, Nose and Throat (ENT) diseases including the emergencies and malignant neoplasma of the head and neck;
(2)               he/she 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; 
(3)               he/she shall be able to carry out minor surgical procedures such as:
(a)    earsyringing antrum puncture and packing of the nose for epistaxis,
(b)   nosal douching and packing of the external canal,
(c)    Remove the foreign bodies from the nose and ear
(d)   Observed or assisted in various endoscopiec procedures and trachesotomy; 
(4)               an item shall have participated as a team member in the community diagnosis e.g. Chronic Suppurative Otitis Media (CSOM) and be aware of national programme on prevention of deafness,
(5)               he/she shall possess knowledge of various ENT rehabilitative programmes. 

(viii)         OPHTHALMOLOGY 

An intern shall acquire following skills: - 


(1)       he/she shall be able to diagnose and manage common ophthalmological conditions such as:-

Trauma, Acute conjunctivitis, allergic conjunctivitis, xerosis, entropion, corneal ulcer, iridocyclitis, myopia, hypermetropia, catarct, glaucoma, ocular injury and sudden loss of vision; 



(2)     he shall be able to carry out assessment of refractive errors and advise its correction;
(3)     he shall be able to diagnose ocular changes in common systemic disorders;
(4)     he/she shall be able to perform investigative procedures such as:-

Tonometry, syringing, direct ophthalmoscopy, subjective refraction and fluorescein staining of cornea.


(5)     he/she shall have carried out or assisted the following procedures:
(1) Subconjunctival injection;
(2) Ocular bandaging;
(3) Removal of concretions;
(4) Epilation and electroysis;
(5) Corneal foreign body removal;
(6) Cauterization of corneal ulcers;
(7) Chalazion removal;
(8) Entropion correction;
(9) Suturing conjunctival tears;

(10) Lids repair


(11)                      Glaucoma surgery (assisted);
(12)
                      Enucleation of eye in cadaver; 
(6)     he/she shall have full knowledge on available methods for rehabilitation of the blind. 

(ix)             ORTHOPAEDICS ; 

GOAL: 


The aim of teaching the undergraduate student in Orthopaedics and Rehabilitation is to impart such knowledge and shills that may enable him to diagnose and treat common ailments. He shall have ability to diagnose and suspect presence of fracture, dislocation, actual asteomyelitis, acute poliomyelitis and common congential deformities such as congentail talipes equinovarus (CTEV) and dislocation of hip (CDH). 



(A)         THERAPEUTIC- An intern must know: 
(a)    Splinting  (plaster slab) for the purpose of emergency splintage, definitive splintage and post operative splintage and application of Thomas splint;
(b)    Manual reduction of common fractures – phalangeal, metacarpal, metatarsal and Colles’s fracture;
(c)    Manual reduction of common dislocations – internphalangeal,
metacarpophalangeal, elbow an 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)      Precautions about transport and bed care of spinal cord injury patients. 

(B)         Skill that an intern should be able to perform under supervision: 

(1)   Advise about prognosis of poliomyelitis, cerebral palsy, CTEV and CDH;
(2)   Advise about rehabilitation of amputees and mutilating traumatic and leprosy deformities of hand; 
(C)         An intern must have observed or preferably assisted at the following operations: 
(1)   drainage for acute osteomyelitis;
(2)   sequestrectomy in chronic osteomyelitis;
(3)   application of external fixation;
(4)   internal fixation of fractures of long bones.

(x)               DERMATOLOGY AND SEXUALLY TRANSMITTED DISEASES 

An intern must be able to: - 


(1)   conduct proper clinical examination; elicit and interpret physical findings, and diagnose common disorders and emergencies.
(2)   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;
(3)   Take a skin biopsy for diagnostic purpose;
(4)   Manage common diseases recognizing the need for referral for specialized care in case of inappropriateness of therapeutic response. 

(xi)             PSYCHIATRY : 

An Intern must be able to: 


(1)   diagnose and manage common psychiatric disorders;
(2)   identify and manage psychological reaction and psychiatric disorders in medical and surgical patients in clinical practice and community setting. 

(xii)           TUBERCULOSIS AND RESPIRATORY DISEASES : 

An intern after training must be able to: - 


(1)   conducting proper clinical examination, elicit and interpret clinical findings and diagnose common respiratory disorders and emergencies;
(2)   perform simple, routine investigative procedures required for making bed side diagnosis, specially sputum collection, examination for etiological organism like AFB, interpretation of chest X-rays and respiratory function tests;
(3)   Interpret and manage various blood gases and pH abnormalities in various respiratory diseases;
(4)   Manage common diseases recognizing need for referral for specialized care in case of inappropriateness of therapeutic response;
(5)   Perform common procedures like laryngoscopy, pleural aspiration, respiratory physiotherapy, laryngeal intubation and pneumo-thoracic drainage aspiration. 

(xiii)         ANAESTHESIA : 

After the internship in the department of Anesthesiology an intern shall acquire knowledge, skill and attitude to: 


(1)   perform pre-anaesthetic check up and prescribe pre-anaesthetic medications;
(2)   perform venepuncture and set up intravenous drip;
(3)   perform laryngoscopy and endotracheal intubation;
(4)   perform lumbar puncture, spinal anaesthesia and simple nerve blocks;
(5)   conduct simple general asaesthetic procedures under supervision;
(6)   monitor patients during anaesthesia and post operative period;
(7)   recognise and manage problems associated with emergency anaesthesia;
(8)   maintain anaesthetic records;
(9)   recognise and treat complication in post operative period;
(10)           perform cardio-pulmonary brain resuscitation (C.P.B.R.) currectly, including recognition of cardiac arrest. 

(xiv)         RADIO-DIAGNOSIS: 

An intern after training must be able to identify and diagnose: 


(1)   all aspects of ‘Emergency Room’ Radiology like – 
(a)   all acute abdominal conditions;
(b)   all acute traumatic conditions with emphasis on head injuries;
(c)   differentiation between Medical and surgical radiological emergencies; 
(2)   Basic hazards and precautions in Radio-diagnostic practices. 

(xv)           PHYSICAL MEDICINE AND REHABILITATION: 

An intern is expected to acquire the following skills during his/her internship: - 


(1)   competence for clinical diagnosis based on details history an assessment of common disabling conditions like poliomyelitis, cerebral palsy, hemiplegia, paraplegia, amputations etc;
(2)   participation as a team member in total rehabilitation including appropriate follow up of common disabling conditions;
(3)   principles and procedures of fabrication and repair of artificial limbs and appliances;
(4)   various therapeutic modalities;
(5)   use of self help devices and splints and mobility aids;
(6)   familiarity with accessibility problems and home making for disabled;
(7)   ability to demonstrate simple exercise therapy in common conditions like prevention of deformity in polio, stump exercise in an amputee etc.; 

(xvi)         FORENSIC MEDICINE AND TOXICOLOGY 

The intern is to be posted in the casualty department of the hospital while attached under Forensic Medicine Department with the following objectives: 


(1)   to identify medicolegal problem in a hospital and general practice;
(2)   to identify and learn medicolegal responsibilities of a medical man in various hospital situations;
(3)   to be able to diagnose and learn management of basic poisoning conditions in the community;
(4)   to learn how to handle cases of sexual assault;
(5)   to be able to prepare medico-legal reports in various medicolegal situations;
(6)   to learn various medicolegal post-mortem procedures and formalities during its performance by police.

APPENDIX ‘A’ 

Curriculum in ‘Family Welfare’ for the Bachelor of Medicine and Bachelor of Surgery (MBBS) Course.

The Curriculum may be considered under various pre and para clinical heads and the following details  are worked out for each of the disciplines. 


1.    Anatomy

(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. 

2.    Physiology 

(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. 

3.    Pharmacology 

(1)    Mode of action and administration of: 
(a)    Chemical contraceptive
(b)    Oral contraceptive 
(2)    Contra indication for administration of contraceptives.
(3)    Toxic effects of contraceptives. 

4.    Community Medicine

(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. 


5.    Obstetrics & Gynaecology 

(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. 

6.    Paediatrics: 

(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. 
7.   

Surgery 

Technique of Vasectomy. 

I.    Compulsory Internship 

Placement of a student for in-service training in a family welfare planning clinic for a period of at least one month. 

II.    Examination 

It is necessary that questions on family welfare planning be introduced in the theory, practical and oral examination throughout the MBBS course. 

The curriculum content has been indicated subjectwise.  Hpwever, it would be more advantageous to the student for purpose of integrated learning and for understanding of the subject if family welfare planning instruction with the curriculum content indicated could be divided into two parts. 

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 Gynaecology.  The department of Community Medicine Internal Medicine, Psychiatry, Paediatics 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 organise occasional seminars in which staff from all departments and the in-service trainees shall participate.

APPENDIX-B

A comprehensive list of skills recommended as desirable for Bachelor of Medicine and Bachelor of Surgery (MBBS) Graduate: 

1.    Clinical Evaluation:

(a)    To be able to take a proper and detailed history.
(b)    To perform a complete and thorough physical examination and elicit clinical signs.
(c)    To be able to properly use the stethoscope, Blood Pressure, Apparatus Auroscope, Thermometer, Nasal Speculum, Tongue Depressor, Weighing Scales, Vaginal Speculum etc.:
(d)               To be able to perform internal examination-Per Rectum (PR), Per Vaginum (PV) etc.
(e)                To arrive at a proper provisional clinical diagnosis. 

II.    Bed side Diagnostic Tests: 

(a)    To do and interpret Haemoglobin(HB), Total Count (TC), Erythrocytic Sedimentation Rate (ESR), Blood smear for parasites, Urine examiantion /albumin /sugar /ketones /microscopic.:
(b)    Stool exam for ova and cysts;
(c)    Gram, staining and Siehl-Nielsen staining for AFB;
(d)    To do skin smear for lepra bacilli
(e)    To do and examine a wet film vaginal smear for Trichomonas
(f)    To do a skin scraping and Potassium Hydroxide (KOH) stain for fungus infections;
(g)   To perform and read Montoux Test. 

III.             Ability to Carry Out Procedures. 

(a)                 To conduct CPR (Cardiopulmonary resuscitation) and First aid in newborns, children and adults. (b)               To give Subcutaneous (SC) /Intramuscular (IM) /Intravenous
(IV) injections and start Intravenous (IV) infusions.
(c)                To pass a Nasogastric tube and give gastric leavage.
(d)               To administer oxygen-by masic/eatheter
(e)                To administer enema
(f)                 To pass a ruinary catheter- male and female
(g)                To insert flatus tube
(h)                To do pleural tap, Ascitic tap & lumbar puncture
(i)                  Insert intercostal tube to relieve tension pneumothorax
(j)                 To control external Haemorrhage. 

IV    Anaesthetic Procedure           

(a)    Administer local anaesthesia and nerve block
(b)    Be able to secure airway potency, administer Oxygen by Ambu bag. 

V.    Surgical Procedures 

(a)    To apply splints, bandages and Plaster of Paris (POP) slabs;
(b)    To do incision and drainage of abscesses;
(c)    To perform the management and suturing of superficial wounds;
(d)    To carry on minor surgical procedures, e.g. excision of small cysts and nodules, circumcision, reduction of paraphimosis, debridement of wounds etc.
(e)    To perform vasectomy;
(f)    To manage anal fissures and give injection for piles. 

VI    Mechanical Procedures 

(a)    To perform thorough anternatal examination and identify high risk pregnancies.
(b)    To conduct a normal delivery;
(c)    To apply low forceps and perform and suture episiotomies;
(d)    To insert and remove IUD’s and to perform tubectomy 

VII    Paediatrics 

(a)    To assess new borns and recognise abnormalities and I.U. retardation
(b)    To perform Immunization;
(c)    To teach infant feeding to mothers;
(d)    To monitor growth by the use of ‘road to health chart’ and to recognize development retardation;
(e)    To assess dehydration and prepare and administer Oral Rehydration Therapy (ORT)
(f)    To recognize ARI clinically; 

VIII      ENT Procedures: 

(a)    To be able to remove foreign bodies;
(b)    To perform nasal packing for epistaxis;
(c)    To perform trachesotomy 

IX            Ophthalmic Procedures: 

(a)                To invert eye-lids;
(b)               To give Subconjunctival injection;
(c)                To perform appellation of eye-lashes;
(d)               To measure the refractive error and advise correctional glasses;
(e)                To perform nasolacrimal duct syringing for potency

X. Dental Procedures: 

To perform dental extraction 

XI    Community Healthy: 

(a)    To be able to supervise and motivate, community and para-professionals for corporate efforts for the health care;
(b)    To be able to carry on managerial responsibilities, e.g.Magangement of stores, indenting and stock keeping and accounting
(c)    Planning and management of health camps;
(d)    Implementation of national health programmes;
(e)    To effect proper sanitation measures in the community, e.g.disposal of infected garbage, chlorination of drinking water;
(f)    To identify and institute and institute control measures for epidemics including its proper data collecting and reporting. 

XII    Forensic Medicine Including Toxicology 

(a)    To be able to carry on proper medicolegal examination and documentation of injury and age reports.
(b)    To be able to conduct examination for sexual offences and intoxication;
(c)    To be able to preserve relevant ancillary material for medico legal examination;
(d)    To be able to identify important post-mortem findings in common un-natural deaths. 

XII    Management of Emergency 

(a)    To manage acute anaphylactic shock;
(b)    To manage peripheral vascular failure and shock;
(c)    To manage acute pulmonary oedema and LVF;
(d)    Emergency management of drowning, poisoning  and seizures
(e)    Emergency management of bronchial asthma and status asthmaticus;
(f)    Emergency management of hyperpyrexia;
(g)    Emergency management of comatose patients regarding airways, positioning prevention of aspiration and injuries
(h)    Assess and administer emergency management of burns

APPENDIX-C

Prescribed Teaching Hours and Suggested Model Time Tables:- 

Following minimum teaching hours are prescribed in various disciplines: 

A.    Pre-Clinical Subjects :  (Phase-1-First and Second Semester) 

Anatomy                                    650 Hrs.

Physiology                                 480 Hrs.

Biochemistry                               240 Hrs.

Community Medicine                     60 Hrs. 

B.    Para-Clinical Subjects: (Phase-II-5th to 7th Semester) 

Pathology                               300 Hrs.

Pharmacology                        300 Hrs.

Microbiology                          250 Hrs. 

                        Community Medicine             200 Hrs. (including 8 weeks postings of 3 hrs each)

                        Forensic Medicine                 100 Hrs.

Teaching of para-clinical subjects shall be 4 hrs per day in 3rd Hrs Semester and 3Hrs per day in 4th and 5th Semesters (See attached Time Table) 

C.    Clinical Subjects  

1.    Clinical postings as per chart attached.
2.    Theory lectures, demonstrations and Seminars etc.in addition to clinical postings as under.  The clinical lectures to be held from 4th Semester onwards (See attached Time Table)

-           Gen-Medicine            300 Hours              Gen. Surgery                    300 Hours

-            Paediatrics               100      ”                 Orhopedics                      100      “

-           T.B. and Chest           20        “                 Ophthalmology                100      “

-            Psychiatry                20        “                  ENT                                70       “

-           Skin and STD             30        “                  Radiology                        20      “

-           Community Medicine  50        “                   Dentistry                         10      “

-            Anaesthesia              20        “                  Obst & Gynae.               300      "                                                                                     inclusive 

 Note:  

This period of training is minimum suggested.  Adjustments where required depending on availability of time be made.This period of training does not include university examination period. Extra time available be devoted to other Sub-specialities. During semesters 3 to 9 following clinical postings for each student, of 3 hrs. duration is suggested for various departments after introductory course in Clinical Methods in Medicine and surgery of 2 weeks each for the whole class. 

Subjects

3rd Sem- ester weeks

4th  Sem- ester weeks

5th Sem- ester weeks

6th Sem- ester weeks

7th Sem- ester weeks

8th Sem- ester weeks

9th Sem- ester weeks

Total

General Medicine

6

-

4

-

4

6

6

26

Paediatries

-

2

-

2

2

4

-

10

TB and Chest

-

2

-

-

-

-

-

02

Skin and STD

-

2

-

2

-

2

-

06

Psychiatry

-

-

2

-

-

-

-

02

Radiology

-

-

-

-

2

-

-

02

Gen Surgery

6

-

4

-

4

6

6

26

Orthopaed-ics

-

-

4

4

-

-

2

10

Opthalmo-logy

-

4

-

4

-

-

2

10

ENT

-

4

-

4

-

-

-

08

Obst. &Gyn.
And Family Planning

2

4

4

-

4

4

6

24

Comm. Med.

4

4

-

4

-

-

-

12

Casualty

-

-

-

2

-

-

-

02

Dentistry

-

-

-

-

2

-

-

02

Total

18

22

18

22

18

22

22

142

Clinical methods in Medicine and Surgery for whole class will be for 2 weeks each respectively at the start of 3rd semsester.

This posting will include training in Radiodiagnosis & Radiotherapy where existent.

This posting includes exposure to Rehabilitation Physiotherapy

This posting includes exposure to laboratory medicine and infectious diseases.

This posting includes exposure to dressing and Anaesthesia

This include maternity training and Family medicine and the 3rd semester posting shall be in Family Welfare Planning.

PHASE –II

Third Semester

Days/8-9       9-10      10-11      11-12       12-1    
Time

1-2

2-3               3-4

Mon   Para           Clinical Postings          Para
         Clinical                                          Clinical
         Lectures                                        Lectures

Tues     do                    do                       do 

Wed     do                     do                       do 

Thurs    do                    do                       do 

Fri         do                    do                       do 

Sat        do                    do                       do

 

 

L

H

Practicals

 

Para-Clinical 

Do 

Do 

Do 

Do

  Note : These are suggested time tables. Adjustments where required, depending upon the availability of time and facility, be made.

Fourth and Fifth Semester

Days/8-9       9-10      10-11      11-12          12-1  
Time

1-2

2-3               3-4

 Mon  Lectures        Clinical Postings        Lectures  
         In Clinical                                       in para-clinical     
         Subjects                                        subjects      

Tues     do                    do                       do 

Wed     do                     do                       do 

Thurs    do                    do                       do 

Fri         do                    do                       do 

Sat        do                    do                       do

 

 

 

 L 

H

Practicals  

Para-Clinical

Do  

Do  

Do  

Do

Sixth,Seventh,Eighth & Ninth Semester

Days/8-9       9-10      10-11      11-12          12-1  
Time

1-2

2-3               3-4

 Mon  Lectures        Clinical Postings        Lectures  
         In Clinical                                       in Demonstration   
         Subjects                                        in clinical subjects      

Tues     do                    do                       do 

Wed     do                     do                       do 

Thurs    do                    do                       do 

Fri         do                    do                       do 

Sat        do                    do                       do

 

 

 

 L 

H

Practicals Demonstrations in Clinical Subjects


Do  

Do  

Do  

Do

Note: These are suggested time tables. Adjustments where required, depending upon the availability of time  and facility, be made.
 
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