Syllabus - MBBS

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SyllabusMBBSat the AIIMSAll India Institute of Medical SciencesAnsari Nagar, New Delhi- 110029

SyllabusMBBSat theAIIMS

ii

iiiSyllabusMBBSat theAIIMSAll India Institute of Medical SciencesNew Delhi - 110 029

ivAcademic AffairsConcerned OfficialsDr. P. Venugopal– DirectorDr. Kusum Verma– Dean (Acad.)Dr. T.P. Singh– Dean (Exam.)Dr. Nikhil Tandon– Sub-Dean (Acad.)Dr. K.K. Deepak– Professor-in-charge (Exam.)Shri V.P. Gupta– Registrar All India Institute of Medical Sciences, 2003First edition 2003Second edition July 2005Typset and Printed by :Saurabh Printers Pvt. Ltd. B-280, Okhla Industrial Area, Phase-I, New Delhi-110020

vSYLLABUS–COMMITTEE1.Dr. Kusum VermaChairpersonProf. & Head, Department of Pathology2.Head of the Department of AnatomyMember3.Head of the Department of BiochemistryMember4.Head of the Department of PhysiologyMember5.Head of the Department of MicrobiologyMember6.Head of the Department of Forensic MedicineMember7.Head of the Department of PharmacologyMember8.Head of the Department of MedicineMember9.Head of the Department of PaediatricsMember10. Head of the Department of SurgeryMember11. Head of the Department of Obst. & Gynae.Member12. Head of the Department of Community MedicineMember13. Head of the Department of PsychiatryMember14. Head of the Department of Derma. & Venereo.Member15. Head of the Department of OrthopaedicsMember16. Head of the Department of ENTMember17. Head of the Department of OphthalmologyMember18. Head of the Department of AnaesthesiologyMember19. Dr. B.V. Adkoli, CMETMember20. Dr. Y.K. Joshi, Sub-Dean (Acad.)Member21. Shri V.P. Gupta, RegistrarMember-Secretary

viPREAMBLEThe Health Survey and Development Committee, popularly known as the Bhore Committee, in itsreport published in 1946, recommended very strongly the establishment of a national medicalcenter at Delhi which will concentrate on training of highly qualified teachers and research workersin order that a steady stream of these could be maintained to meet the needs of the rapidly expandinghealth activities throughout the country. After the attainment of independence the Union Ministry ofHealth proceeded to implement this challenging idea and a magnificent grant of one million poundsby the Government of New Zealand through the Colombo Plan helped to translate the idea intoreality. An act of Parliament in 1956 established the All India Institute of Medical Sciences as anAutonomous Institution of National importance and defined its objectives and functions.The prime concern of the Institute is to develop patterns of teaching in undergraduate andpostgraduate medical education in all the branches so as to demonstrate a high standard of medicaleducation to all medical colleges and other allied institutions in India. This educational experienceis imparted in an atmosphere of research.By virtue of the Act, the Institute grants its own medical degrees and other academic distinctions.The degrees granted by the Institute under the All India Institute of Medical Sciences Act arerecognized medical qualifications for the purpose of the Indian Medical Council Act and,notwithstanding anything contained therein, are deemed to be included in the first schedule of thatAct, entitling the holders to the same privileges as those attached to the equivalent awards from therecognized Universities of India respectively.The syllabus for MBBS has been developed in consultation with the faculty of the concerneddepartments and further scrutinized by the Academic Section under the supervision of the Dean(Prof. P. Venugopal).

viiCONTENTSS. No.SubjectPage No.1.Anatomy . 12.Biochemistry . 123.Physiology . 194.Forensic Medicine & Toxicology . 285.Microbiology . 366.Pathology . 497.Pharmacology . 578.Anaesthesiology . 619.Community Medicine . 6410.Dermatology & Venereology . 8611.Medicine . 8912.Obstetrics & Gynaecology . 10513.Ophthalmology . 11214.Orthopaedics . 11915.Otorhinolaryngology . 12416.Paediatrics . 12817.Psychiatry . 14218.Surgery . 14619.Internship . 157

viiiINTRODUCTIONAll India Institute of Medical Sciences (AIIMS) was established by the Act of Parliament in 1956 as anautonomous institute to set patterns in Undergraduate and Postgraduate Medical Education in all itsbranches to so as to demonstrate a high standard of medical education. This is the only institute outsidethe jurisdiction of Medical Council of India to encourage experiments in the curriculum. The Courseleading to the Degree of MBBS has been in existence since 1956. It mainly follows a disciplinarystructure. However, since inception, AIIMS has been constantly upgrading its course content in tunewith the changing needs. Many alterations have taken place during the last fifty years, which have beenreflected in the present curriculum document.DurationThe MBBS course comprises four and a half years, followed by compulsory rotatory internship of oneyear. The course follows semester system, each semester consisting of six months. The MBBS courseis divided in to three phases, viz., Pre-clinical, Para-clinical and Clinical Phase, during which followingsubjects are introduced:PhaseSemestersSubjects coveredPre-clinical1 – 2 : Two SemestersAnatomy, Bio-chemistry, PhysiologyPara-clinical3 – 5 : Three SemestersCommunity Medicine; Forensic Medicine,Pathology, Pharmacology, Microbiology, Clinicalpostings in wards, OPDs to begin here;Clinical6 – 9 : Four SemestersCommunity Medicine, Medicine and alliedsubjects (Psychiatry, Dermatology); Obst.Gynae.; Pediatrics;Surgery and allied subjects (Anesthesiology,E.N.T., Ophthalmology, Orthopedics);Clinical postings;

ixExamination ScheduleThere shall be three professional examinations as follows:First Professional Exam.End of 2nd SemesterSecond Professional Exam.End of 5th SemesterFinal Professional Exam.End of 9th SemesterIn addition, Mid – Semester, End – Semester Examinations and End – posting assessments are heldregularly.The total weightage to the internal assessment is 50%, both in the theory and practical /clinicalassessment.Goals and objectives of undergraduate course (MBBS)At the end of the MBBS course, the learner shall be able to:1. Diagnose and manage common health problems of the individual and the community appropriate tohis/her position as a member of the health team at primary, secondary and tertiary levels;2. Be competent to practice preventive, promotive, curative and rehabilitative medicine in respect tothe commonly encountered health problems;3. Practice Evidence Based Medicine, appreciating the rationale for different therapeutic modalitiesand be familiar with the administration of “essential drugs” and their common side effects;4. Appreciate the psycho-social, cultural, economic, and environmental factors affecting health, anddevelop humane attitude towards the patients/relatives, in discharging one’s professionalresponsibilities;5. Be familiar with the various National Health Programs, and the ways in which they are beingimplemented;6. Acquire basic management skills in the area of materials, financial and human resources;7. Demonstrate communication skills, both verbal and written to establish effective communicationwith the clients (patients, relatives, and general public), health team partners, and scientific community;8. Practice medical ethics in patient care, service delivery, and research.9. Develop attitude for self learning and acquire necessary skills including the use of appropriatetechnologies, for pursuing self directed learning for a life time.

Anatomy1ANATOMYTotal duration of course is one year. It comprises of two semesters I and II. Each semester is of sixmonths duration.Course commences from 1st August every year and ends on 15 June following year.The subject of anatomy is taught under the following heads :1. Gross anatomy2. Microanatomy3. Embryology and Genetics4. NeuroanatomyTotal number of teaching hours are approximately 541.Distribution of teaching hours for theory and practicals are as follows :SubjectApproximate No. of hours taught1. Gross AnatomyLectures38Practicals3492. MicroanatomyLectures20Practicals433. racticals1

2Syllabus MBBS — AIIMS4. NeuroanatomyLectures19Practicals27Total No. of teaching hours in Anatomy541(Theory and Practicals)OBJECTIVESAt the end of the course, the student should be able to: Comprehend the normal disposition, inter-relationships, gross, functional and applied anatomy ofthe various structures in the body. Identify the microscopic structures of various tissues, and organs in the human body and correlatethe structure with the functions as a prerequisite for understanding the altered state in variousdisease processes. Comprehend the basic structure and connections between the various parts of the central nervoussystem so as to analyze the integrative and regulative functions on the organs and systems. He/Sheshould be able to locate the site of gross lesions according to the deficits encountered. To understand the basic principles of embryology including genetic inheritance and stages involvedin development of the organs and systems from the time of conception till birth. The student shouldrecognise the critical stages of normal development and the effects of common teratogens, geneticmutations and environmental hazards on it. He/She should be able to explain the developmental basisof the occurrence of major variations, abnormalities and congenital anomalies.COURSE CONTENT1. Gross AnatomyIntroduction to Anatomy, nomenclature, anatomical position, planes, tissues and movements.I. Osteology(a) Names of the bones of the body and their position; classification of the bones with examples;general features of the bone and normal development; microscopic anatomy of bone; general patternof blood supply; ossification of the bones of the limbs for age determination. X-rays of bones.(b) Process of repair of bone.2. Muscular System(a) Classification and identification of the muscles of the body: main attachments, nerve supply andaction(s), microscopic anatomy of muscles and the nerve terminations.(b) Details of attachments of the muscles; ultrastructural features of muscle; mechanism of the movementcaused by the muscle/muscles and various forces exerted by them and their detailed action(s).3. Arthrology(a) Definition and classification of joints, general features of different types of joints; detailed study ofmajor joints of the limbs and movements performed at various joints in the body.

Anatomy3(b) Microscopic anatomy of articular cartilage; maintenance of articular cartilages; blood supply andnerve supply of the joints.4. Cardio Vascular System(a) Normal position, external features and parts of the heart; internal features of the chambers of heart,names of the blood vessels and venous drainage of the organs, structures and body as a whole,conducting system of heart, fibroskeleton of heart.(b) Variation(s), developmental anomalies of heart and blood vessels, valvular defects and their effectsin pathogenesis of the anomalies.5. Respiratory System(a) Position, parts, relations, blood supply of upper and lower respiratory tract. Pleura, its reflection,nerve supply, pleural recesses and their significance, bronchopulmonary segments, their importance.(b) Mechanism of respiration6. Digestive System(a) Position, extent, parts, relations, blood supply, nerve supply, lymphatic drainage and sphincters ofthe gastrointestinal system.(b) Sphincteric action including functional implications.7. Genito-Urinary System(a) Parts, position, relations, blood supply, nerve supply and lymphatic drainage of uterus, cervix,vagina, ovary, ovarian duct, testes, epididymis, seminal vesicle, ductus deferens, prostate, kidney,ureter, urinary bladder and urethra(b) Innervation of urinary bladder in detail8. Endocrine System and Individual Endocrine Glands(a) Various endocrine glands, their location, relations, blood supply, nerve supply and lymphatic drainage.(b) Clinical manifestations of common endocrine disorders.9. Nervous System and its components(a) Parts of nervous system, neuron meninges, nerve terminals, neuroglia, myelination, degenerationand regeneration, ventricles, CSF, spinal cord and its blood supply. Motor and sensory pathways,cranial nerves, thalamus, cerebellum, limbic and autonomic pathways. Functional cortical areas,motor and sensory cortex and their blood supply.10. Special Sensory Organs(a) Gross Anatomy of :(i) eye ball, extra ocular muscles their nerve supply and actions (s)(ii) ear(iii) nose

4Syllabus MBBS — AIIMS(iv) tongue, its musculature blood supply and lymphatic drainage.11. Lymphatic System(a) Location of the major groups of the lymphnodes of the body and their drainage areas. Grossanatomy of the major lymphatics specially thoracic duct and its tributaries.12. Surface Anatomy(a) Surface features of the body and projection of the outline of heart, its borders, surfaces and valves,lungs, their borders, fissures and hila, pleura, liver, kidneys and various abdominal and pelvic organsand important vessels and nerves13. Cross Sectional AnatomyCross sections of thorax, abdomen and pelvis to understand the interrelationship of organs andstructures.II. MicroanatomyMicroscope and basic principles of microscopy, commonly used stains, basophilic and acidophilicstaining reactions and their significance. Commonly encountered artifacts. Brief principle of electronmicroscopy and interpretation of ultrastructural features.GENERAL HISTOLOGYCell : detailed structure of cell and its components and their functional mechanisms.Four primary tissuesEpithelium : Microscopic characteristics, types, functions, distribution, basal lamina, cell junctions,specialization of the cell surface and their structural details and functions; metaplasia.Connective tissue : Cells, fibers and their structural features and functions. Intercellular substances,amorphous ground substance, types of connective tissue (loose areolar tissue, dense connective tissue)and their distribution. Specialized connective tissue : different types of cartilages and their functions anddistribution. Bone : Cells, bone matrix, structural features of compact and cancellous bone, their distributionand functions, ossification, blood supply of a long bone.Muscle : General features, detailed structure of : skeletal muscle, and molecular mechanisms ofcontraction, innvervation of skeletal muscle, neuromuscular junction, morphological and histochemicalbasis of classification into type I and type II muscle fibers and their significance, structural and functionalcharacteristics of cardiac and smooth muscle; innvervation of cardiac and smooth muscle.Nervous tissue : Structural characteristics of a neuron, axon and dendrties. Different types of neuronsand their specific structural and functional features and distribution. Axonal transport, synapse,morphological and functional characteristics of different types of synapses. Neuroglia : types, structureand functions, blood brain barrier. Brief cytoarchitecture of the central nervous system, regeneration inCNS with particular emphasis on stem cells. Sensory and autonomic ganglia, peripheral nerves, myelinand myelination, degeneration and regeneration in peripheral nerves.Histology of various organs/organ systems

Anatomy5Exocrine glands : Characteristics, simple and compound glands; types of secretions, modes of secretion,detailed structural features of a serous secreting cell and mucous secreting cell, serous and mucousacini, duct system, features of salivary glands, exocrine pancreas, sweat and sebaceous glands, mammarygland, bulbourethral gland etc.Circulatory system : Structural features of heart; conducting and distributing arteries and arterioles;types of capillaries, their structural features and distribution and microcirculation, detailed structure ofendothelium; structural characteristics of large and small veins and venules arterio-venous shunts,lymphatics.Respiratory system : Structural features of nose, nasopharynx, larynx, trachea, principal brochi, lungincluding intrapulmonary bronchi, bronchioles, alveolar ducts, atria, alveoli, blood-air-barrier. Functionsof different parts of respiratory system.Skin and nerve-end-organs : Thick, thin and hairy skin, cell renewal and pigmentation of skin, skinappendages, healing of skin wounds, sensory receptors of skin. Functions of skin.Immune system and lymphoid organs : Lymphocytes, their subtypes and functions. Humoral and cellmediated immunity. Thymus, lymph nodes, spleen, tonsils and other mucous associated lymphoid follicles.Digestive system (GIT) : General organization, oral cavity, lip, cheek, tongue, taste buds, associatedsalivary glands. Layers of tubular digestive tract, esophagus, stomach, small intestine, gastroesophagealjunction, gastroduodenal junction, large intestine, anal canal and rectoanal junction. Liver, internalorganization of liver, liver lobule, liver acinus, significance of zonation in liver acinus, liver sinusoids,detailed structure of hapatocyet, bile canaliculi, bile ducts, gall bladder, bile duct and pancreas.Endocrine glands : Thyroid, parathyroid, Islets of Langerhan’s gland, adrenal cortex and medulla, theirstructural details, functional mechanisms, hypophysis cerebri, cell types secretion and their functions,hypophyseal portal circulation, common endocrine disordersUrinary system : Detailed microscopic structure of kidney, cortex, medulla, pyramids, medullary rays,cortical columns, glomerulus, nephron, glomerular filtration juxtaglomerular apparatus, its structuralfeatures and functions, renal interstitium, collecting ducts, renal sinus, minor and major calyces,microcirculation of kidney, histophysiology of the kidney, renal pelvis and ureters, urinary bladder andurethra.Female reproductive system : Ovary, ovarian stroma, primary and secondary graafian follicles, functionsof various constitutents and structural de

Head of the Department of Community Medicine Member 13. Head of the Department of Psychiatry Member 14. Head of the Department of Derma. & Venereo. Member 15. Head of the Department of Orthopaedics Member 16. Head of the Department of ENT Member 17. Head of the Department of Ophthalmology Member 18. Head of the Department of Anaesthesiology Member

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