National Postgraduate Medical College Of Nigeria
NATIONAL POSTGRADUATE MEDICAL COLLEGE OFNIGERIAFACULTY OF INTERNAL MEDICINEFELLOWSHIP PROGRAMME2016CURRICULUM FOR THE JUNIOR RESIDENCY TRAINING1
TABLE OF CONTENTS1. INTRODUCTION 31,1 Authority31.2 Vision and Mission of the College 31.3 Vision of the Faculty 31.4 Philosophy 31.5 Objectives of training 41.6 Structure and Mode of Instructions 41.7 Training centres41.8 Admission requirements 41.9 Registration as Associate Fellow 42. JUNIOR RESIDENCY (PART 1 FMCP) 42.1 Introduction 42.2 Goals, Objectives and Outcome of Junior Residency 52.3 Training format of Junior Residency 52.4 Syllabus for Junior Residency with Tables of Contents for sub-specialty rotations 72.5 Assessment 592.5.1 Formative 592.5.2 Summative 59a) Entry requirements for examination 59b) Structure of the part 1 FMCP examination 60c) Conditions for a pass 583.0 Appendices 61I Training and Examination for Primary FMCP 61II Curriculum development/reviw procedureIII Course credit weighing of syllabus63IV Annual evaluation form 64262
1.0 INTRODUCTIONThe National Postgraduate Medical College of Nigeria started as a fellowship programme in 1970 under theNigerian Medical Council. This transmutated in 1979 through the promulgation of Decree 67, establishingthe National Postgraduate Medical College of Nigeria (NPMCN). This was the premier medical academic cumprofessional programme in sub-Saharan Africa. The programme is unique in combining academic andprofessional training in medical postgraduate courses. The programme in Medicine was termed a Fellowshipin Physic. The acronym, FMCP (Fellow of Medical College in Physic) has remained.1.1 AuthorityDecree 67 of 1979 setting up the Postgraduate Medical College empowers faculties to conduct Examinationsand certify candidates to be holders of the FMCP under the direction of the College. Section 106 of thedecree 67 stipulates that a candidate offering himself or herself for the series of Examinations for thefellowship of the Faculty shall satisfy the Faculty board, that he/she is in possession of and is therein namedas a holder of a certificate from an institution recognized by the College showing that he/she hassatisfactorily attended the prescribed period.1.2 Vision and Mission of the CollegeVision statementThe National Postgraduate Medical College of Nigeria aims to produce medical and dental specialists of thehighest standards who will provide world class services in teaching research and health care.Mission statementThe mission of the college is to plan, implement, monitor and evaluate postgraduate programmes requiredto produce medical and dental specialists of the highest quality, competence and dedication who willprovide teaching and optimal healthcare for the people. Lifelong learning will be maintained by continuingprofessional development programmes of the college.1.3 Vision Statement of the FacultyThe Faculty of Internal Medicine of the National Postgraduate Medical College of Nigeria aims to producephysicians of the highest standards in the various subspecialties who will provide world class services inteaching, research and health care.1.4 Philosophy of the Fellowship Programme in Internal MedicineThe Faculty of Internal Medicine recognizes the universality of Medicine and the need for lifelong learningfor practicing Physicians. Therefore physicians certified by the Faculty must be adequate in knowledge, skillsand attitude to practice Medicine in Nigeria and be able to adapt to practice anywhere in the world and beof good character. In addition, the certified specialist Internist should possess management skills to lead thehealth team, offer humane and ethical clinical services. In addition he/she should be able to assume otherhigher administrative and leadership responsibilities/roles.3
1.5 Objectives of the Training Programme1. To train physicians capable of integrating clinical practice with effective teaching and basic clinicalresearch.2. To educate and mentor physicians to maintain their commitment to the profession.3. To train physicians to be committed to innovations and research, ethical conduct, lifelong learning andprofessionalism including evidence based and telemedicine4. To equip the physicians with knowledge and skills to prepare them for higher roles in medical practice,training and administration.5. To train physicians who will be able to exhibit appropriate communication skills and attitudes in relatingto members of the health team and patients/relatives.1.6 Structure and Mode of InstructionThis is a staggered, supervised training of minimum of 6 years, leading to the primary, Part I and Part II (final)FMCP examinations.Mode of instructions consists of lectures, tutorials, seminar presentations, skills acquisition (ward/grand rounds,clinics and clinical drills), case presentation, update courses and dissertation driven by strong mentorship.1.7 Training CentersTraining is undertaken in an accredited institution, the updated list of which is available from the college website (www.npmcn.edu.ng).1.8 Admission RequirementsTo be admitted into the programme, the applicant must have passed or be exempted from the primaryexamination of the National Postgraduate Medical College of Nigeria in Internal Medicine and beemployed/affiliated with an accredited institution.1.9 Registration as Associate FellowThe trainee is required to register as an associate fellow after passing or exemption from the primary FMCPexamination and has secured a placement in an accredited training centre.4
2.0 JUNIOR RESIDENCY FOR THE FMCP2.1 IntroductionJunior Residency is a critical stage of the FMCP Programme. At this stage the trainee physician is prepared totake on the calling and philosophy of an internist. This period must be spent in accredited traininginstitutions which offer a variety of subspecialist services in a number of disciplines both in internal medicineand related specialties.Successful completion and certification qualifies the candidate to progress to senior residency position in asubspecialty or general internal medicine.2.2 Goals, Objectives and Outcome of Junior Residency2.2.1 GoalsThe FCMP Junior Residency programme aims to ensure that1. The trainee physician acquires adequate knowledge, skills, attitudes and behavior essential for thepractice of internal medicine.2. The trainee physician is prepared for lifelong learning, research, and evidence based medicalpractice.3. The trainee physician acquires teaching skills2.2.2 ObjectivesAt the end of the junior residency, the trainee is expected1. To demonstrate competence in the diagnosis of prevalent and important medical conditions.2. To initiate and monitor rational pharmacologic and non-pharmacologic treatment.3. To demonstrate competence in resuscitation and management of critically ill patients and acutemedical emergencies.4. To demonstrate knowledge, skills, attitudes and conduct appropriate for the level of training inpatient management.5. To audit all aspects of patient care, and apply the outcome in maintaining standards and improvingquality of care.6. To communicate effectively with patients, patients’ relations, colleagues, other health personnel,hospital authorities and the general public.7. To demonstrate the ability to effectively impart the skills and knowledge acquired to otherdoctors, medical students, and allied health professionals.8. To educate patients, their caregivers and the community on holistic health care.9. To demonstrate effective leadership and management skills.10. To demonstrate appropriate level of competence in medical writing and appraisal of medicalliterature.2.3 Training Format of Junior Residency(See also summery of rotations under appendix III)The Junior Residency training programme shall last a minimum of 24 months exclusive of leave periods.During this period, the resident shall spend a minimum of three months each in any 6 of the followingsubspecialties (Totaling 18 months):5
1.2.3.4.5.6.7.CardiologyEndocrinology, Diabetes and MetabolismDermatology and Genitourinary tory Medicine2.3.1 Elective PostingThe resident is expected to spend one month in any of the following specialties1. Clinical Haematology/Medical Oncology2. Infectious disease/HIV Medicine3. Clinical Pharmacology & Therapeutics4. Critical Care/Intensive care medicine5. Rheumatology6. Geriatric medicine2.3.2 Mandatory Posting1. Accident and Emergency medicine.Residents are expected to spend One month in the accident and emergency.This is WITHOUT PREJUDICE to the calls they are expected to take THROUGHOUT the residencytraining.2.3.3 Postings in Allied DisciplinesDuring the 24 month training period, the trainee shall have a four-month compulsory rotation in otherdepartments relevant to the practice of internal medicine as follows:a. Radiology – one month – during which the candidate would interpret plain films and participate incontrast studies and other imaging techniques relevant to the discipline.b. Psychiatry – one month – during which the candidate shall be exposed to recognition and managementof acute Psychosis, organic brain syndrome, psychosomatic illnesses, psychiatric manifestation ofsystemic diseases and other psychiatric conditions relevant to the practice of medicine.c. Laboratory medicine – two months – divided into two weeks each in the departments of:i. Haematology and Blood transfusionii. Chemical Pathologyiii. Microbiology and Parasitology and6
iv. Pathology (Morbid Anatomy)2.3.4 Procedures and Case ReportWhile doing the subspecialties rotations, the trainee should perform/ participate in the proceduresprescribed in section 2 of this curriculum and the log book, for which he/she should be signed up bythe Consultants in the subspecialty. The trainee is expected to have performed/participated in theminimum number prescribed for each procedure at the end of the training period and beforepresenting himself or herself for the part I examination.During each subspecialty rotation, the trainee should write-up and present three (3) case reports (withbrief literature review) and be graded and signed up by the consultant-in-charge of the patient. This isin any 6 of the subspecialties listed in Section 2.3 above.During Laboratory Medicine rotation, the trainee shall participate in laboratory procedures relevant toInternal Medicine and have an in-depth understanding of the interpretation of the results and commonerrors of determination. The candidates should be signed up by the supervising consultant.2.4Syllabus for Junior Residency and Course credit weightingThe syllabus for this part covers all diseases in all sub-specialties of internal medicine. It is expected thatcandidates must be proficient in the performance of specialty-oriented skills and procedures listed and besigned up for these in the logbook, (obtainable from the Faculty Secretary or College Registrar). The topicscovered in standard postgraduate medical textbooks in Internal medicine as well as standard texts intropical medicine are recommended for comprehensive coverage. This should be supplemented by sourcesof current updates.The Tables of Contents arranged by sub-specialties provide the details with regards to contact hours,percentage coverage of course content, learning objectives, credit units and modes of delivery. The levels ofcompetence desired are divided into three:Level I is mainly knowledgeLevel II involves comprehension and application of knowledgeLevel III is a combination of analysis, synthesis and evaluation.This syllabus is weighted in accordance with standard definition of credit units for the college of medicine details as shown in appendix III. The trainee is expected to acquire a minimum of 167 credit units in the 24months period of junior residency.2.4.1 General Knowledge and Skills: 2.4.2Good medical practice and clinical care including history and physical examination.Effective communication with patients, relations, colleagues, public, etc.Care of the terminally ill.Attitudes and conduct – this requires good mentorship at all levels of training.7
Professional, ethical confidentiality and medical-legal and other related issues involved in teaching,training, self/long-term learning and research.Acquisition of leadership skills, effective time management, admissions and dischargesLearn to work with peers, seniors, juniors and other cadres of staff.Proper carriage, comportment and descent/ respectable dressing.8
2.4.3 Clinical CardiologyTitle/Theme/DomainSpecific Topics (knowledge, skills &attitude)% CoursecoverageLessonObjectivesTotalCredit(s)Basic concepts incardiologyCardiovascular embryology,anatomy, physiology,pathophysiology, pathology andpharmacology1. Clinical assessment – detailedcardiovascular history and physicalexamination.2. Non-invasive cardiovascularevaluation:- simple bedside evaluation- electrocardiography (resting)- ambulatory BP monitoring- chest radiography- electrocardiography (stress andambulatory)introduction to echocardiographychest/cardiac CT3. Others:- fluid management including CVPinsertion and monitoring, acid andelectrolyte imbalance, oxygentransportation1. Hypertension and target organdamage including hypertensiveheart disease2. Risk factors for cardiovasculardiseases3. Heart failure4. Valvular heart disease5. Heart muscle disease6. Congenital heart disease7. Ischemic heart disease8. Pericardial disorders9. Pulmonary heart disease10.Infective endocarditis11. Rhythm and conductionabnormalities12. Peripheral vascular disorders13. Cardiac tumors14. Diseases of great vessels15.Thromboembolic disorders16. Preventive cardiologyDiuretics, anti-arrhythmic drugs,antihypertensive drugs,sympathomimetics, cardiacglycosides, anti-failure drugs,coronary vasodilators,anticoagulants, anti-platelets,fibrinolytic agents, lipid regulatingagents15%Level 320%Level 3Evaluation ofcardiovascular structureand functionClinical modulesCardiovascularpharmacology andtherapeuticsMode ofassessment3Mode ofDeliveryCode1, 2, 3 & 641,2,3,4,5&6OSCEMCQSAQEssayLog tation22, 3, 4, 5, 6&7MCQMCQ, SAQLevel 3Level 2Level 2Level 335%Level 3Level 3Level 2Level 2Level 2Level 2Level 2Level 2Level 2Level 2Level 210%Level 2Level 2Level 2Level 2Level 3Level 3OSCESAQ9
CardiovascularemergenciesCardio-pulmonary resuscitation(‘ABCD’), shock – cardiogenic shockand circulatory collapse, acutepulmonary oedema, cardiactamponade, malignantarrhythmias, hypertensiveemergencies, dissectinganeurysms, myocardial infarction,pulmonary embolism20%Level 341,2,3, 4, 5,6, & 7OSCEMCQEssayClinicalPresentationMode of delivery code: Lectures (1), Tutorials (2), Seminars (3), Clinicals/practicals (4), Self-directed learning (5), Assignments (6),Conferences (7)10
2.4.4 ENDOCRINOLOGY, DIABETES AND METABOLISMTHEMESPECIFIC TOPICS,KNOWLEDGE, ATTITUDES,AND SKILLSDOMAIN: 1. ENDOCRINOLOGY 40%BASIC CONCEPTBasic medical scientificaspects of endocrinologyKnowledge : Ability to describeanatomy andphysiology of theHPAxis, Mechanism of actionof peptide and steroidhormones. To describe negativefeedback mechanism,diurnal rhythms Compare the basicdynamic endocrinetests% OFCOURSELEARNINGMODE OFOBJECTIVESDELIVERYUSINGTAXONOMYFORM/SUMLectLevel 1& OD OFASSESSMENTCBDMCEXDOPSMcqsEssaysAssignmLog bookOSCETOTALCREDITS UNITS1ENDOCRINE GLANDS AND ENDOCRINOPATHIESDISORDERS OFTHEHYPOTHALAMUSAND PITUITARYDISORDERSAcromegalyShort statureHyperprolactinemiaHypopituitarismDiabetes InsipidusKnowledge: Ability to Describe Clinicalfeatures of the abovedisorders The discussPathophysiology Discuss Differentialdiagnosis List types ofLaboratory tests Ability to interpret labdiagnosis Ability to make adiagnosis Discuss the treatmentSkills To takeanthropometricmeasurements To perform visual fieldassessment clinically To request theappropriateinvestigation for eachof the diseaseLevel 1,2,311CBDMCEXDOPSMcqsEssaysAssignmLog bookOSCE1
Ability to interpret theCT of the skull To demonstrate thephysical signs of thelisted disordersAttitudes: Need to recognize themultidisciplinaryapproach tomanagement andwhen to referTHYROIDDISORDERSBasic : Ability to describeanatomy of the thyroidglandLEVEL 1,2,3Discuss the regulation ofthe HPT axis (Thyroidfunction)Biosynthesis of thyroidhormoneDisorders of physiologyand biochemistry ofthyroid hormones andTSH and IodinemetabolismKnowledge List types of thyroidhormone Describe thyroidhormone synthesisincluding ditisThyroid cancersKnowledge: List the disorders ofthe thyroid gland Ability to list S&S ofthe thyroid disordersabove List types of tests forevaluating thyroiddisease To interpret TFT Compare and contrastthyrotoxicosis due toGraves’ disease and12CBDMCEXDOPSMcqsEssaysAssignmLog bookOSCE3
ADRENAL GLANDDISODERSToxic Nodular goitre Ability to make adiagnosis of the abovethyroid disorders To describe theradioiodine processand interpret theresults Discuss the effect ofpregnancy on thyroidfunction and theirinterpretationSkills: To request theappropriate TFT in agiven patient To demonstrate thephysical signs of thelisted disorders Ability to manage theabove conditionsAttitude To recognize when torefer the aboveconditions Ability to recognize theduration of treatment Recognize the need tomonitor Recognize the need toreport to seniorsBasic : Ability to describeanatomy physiology of theadrenal glandLEVEL 1, 2,3Discuss the regulation ofthe HPA axisDescribe the Biosynthesisof corticosteroidshormoneDisorders of physiologyand biochemistry ofAdrenal disordersincluding regulation of Naand KCushing’s diseaseConn syndromeCAHAdrenocortical failurePheochromocytomaElectrolyte imbalanceKnowledge Describe the13CBDMCEXDOPSMcqsEssaysAssignmLog bookOSCE2
metabolism ofcathecolaminesincluding urinarymetabolites Describe the test forevaluation ofadrenocortical andadreno medulladisorder Discuss the endocrinehypertension Discuss and interpretthe procedure ofbasal and dynamic testin the evaluation ofthe above conditionsSkills To request theappropriate tests in agiven patient To demonstrate thephysical signs of thelisted disorders To be able todistinguish simpleobesity from Cushing’ssyndrome Ability to manage theabove conditions To perform andinterpretDexamethasonesuppression and ACTHstimulation test Ability to diagnose andmanageAttitudes Recognize need toreport to seniors Ability to recognize theduration of treatment Recognize the need tomonitor treatment Recognize the need toteach patients lifesaving skills Ability to deliverpatient educationBONE ANDCALCIUMMETABOLISMBasic: Ability to describehistology and biology ofboneRegulation of calciummetabolismLEVEL 1,2,31Hyperparathyroidism/Hyp14
ercalcemiaGonadal disordersHypoparathyroidism/HypocalcaemiaDisorders of Vitamin DBone disorders – Paget,osteomalacia,OsteoporosisKnowledge Describe the test forevaluation of calciumand BMD and FRAX To determinecorrected calcium levelSkills Ability to diagnose andmanage the aboveconditions To demonstrate thephysical signs of thelisted disorders To be able todistinguishosteomalacia andOsteoporosisAttitude To recognize when torefer the aboveconditions Ability to recognize theduration of treatment Recognize the need tomonitor Recognize the need toreport to seniorsRegulation of the Pituitarygonadal axisOvarian and testicularMale hypogonadismFemale infertilityEDOvarian disorders:Polycystic ovarian diseaseTurner’s syndromeKnowledge Discuss thepathophysiology ofthese diseaseconditions List the clinicalfeatures of the aboveconditions Discuss the differentialdiagnosis of the aboveconditions List the investigations115
and theirinterpretation Discuss themanagement of eachof themSKILLS Ability to request forappropriate tests andinterpret the results Ability to measure andinterpret theanthropometricmeasure Ability to manage theabove conditionsAttitude Recognize the role ofthe Endocrinologist inthe management ofthese conditions To recognize when torefer the aboveconditions Recognize need toreport to seniors Recognize themultidisciplinary treatapproachDOMAIN: 2. DIABETES MELLITUS AND PANCREAS 30%The ScientificKnowledge:foundations for Describe the anatomythe Managementand physiology of theof diabetesendocrine pancreasmellitus Carbohydratemetabolism includingDiagnosis androle of Endocrinegeneralpancreas and themanagement ofIncretinsdiabetes mellitus Describe and classifyAcutecarbohydrateComplications ofintolerance using WHODMclassification Discuss theManagement ofaetiopathogenesis andPatients withpathophysiology of T1Diabetes duringand T2 DMAcute Illness orSurgery To compare T1 and T2DMPregnancy in To describe the clinicalDiabetes Mellitusfeatures of DMDiabetes in the The principles ofOlder Adultlifestyle managementChronicLEVEL 1,2,316CBDMCEXDOPSMcqsEssaysAssignmLog bookOSCE6
Complications ofDiabetes Discuss thecharacteristics of theinjectables and noninjectable bloodglucose loweringagents Describe themonitoring of DMcontrol Discuss thecomponent ofMetabolic syndromerelate the treatmentof types of diabetes totheSkills: Be able to elucidate anappropriate historyand interpret testsdone to differentiatedifferent types ofdiabetes To perform urinalysisand 24hr urinecollection Educate patients in theuse of injectablesespecially insulindelivery devicesincluding syringes,pens Educate patients in theuse of self-bloodglucose monitoringsystems Educating patients oninjectables in type 2diabetesAttitudes To recognize theimplications andconcerns arising froma diagnosis of diabetesand provide adviceappropriately To recognize theimportance of teammanagement To recognize the17
misconception ofmyths as a barrier tomanagement To recognize thecentral role of thepatient and theiractive participation inthe team managementof their diabetesMacrovascular DiseaseComplications in diabetesMicrovascular ChronicComplications ofDiabetesFoot Disease Problems inPeople With DiabetesMellitusDOMAIN: 3. METABOLIC DISORDERS 7.5%DISORDER OFKnowledgePURINE AND Describe thePYRIMIDINEpathophysiology ofMETABOLISMhyperuricemia and the(Including uric aciddisease conditiondisorders)associated with it Describe the clinicalpresentation Describe the methodsof treatment ofhyperuricemia andassociated diseasesHEAMKnowledgeMETABOLISM Describe the(Porphyria)pathophysiology of thecondition List the main clinicalfeatures and thedifferential diagnosisof the condition Recognize thepresentation of thesediseaseSTORAGE DISEASE(Glycogen andLipid Storage)LIPID mLog bookOSCEKnowledge Describe thepathophysiology of thecondition List the different maintypes List the different waysthe condition maypresentKnowledge Basic knowledge oflipid metabolism181
ELECTROLYTESDISORDERS(hypo Na, hyperNa,HypoK, Hyper K Classify primarycondition List the conditionsassociated withsecondarydyslipidemia Describe its role inDM, heart disease,metabolic syndromeand ischemic heartdiseaseKnowledge List the causes Describe thepresentations Discuss thepathophysiology Describe theinvestigations Discuss the differentialdiagnosis Discuss themanagementSkills Ability to select theright tests Ability to make aclinical diagnosis Ability to manage andinitiate treatment ofthe above metabolicconditions in its acuteand chronic form Ability to make adietary prescriptionDOMAIN: 4. ADULT NUTRITION & OTHERS 7.5%NUTRITIONALObesityDISORDERSKnowledge Describe the basicconcept of humannutrition includingnutritionalrequirements inspecific condition e.g.pregnancy Clinical and laboratoryassessment of obesity Discuss the differentialdiagnosis of obesity List complications ofobesity Discuss the principlesof management ofsimple obesityCBDMCEXDOPSMcqsEssaysAssignmLog bookOSCE192
Skills Ability to takeanthropometricmeasurement Use themeasurements toclassify obesity Ability to take a diethistory Ability to offernutritional advise indifferent medicalconditionAttitude Ability to recognize thechallenges oftreatment Recognize themultidisciplinaryapproach tomanagement andneed to avoid beingjudgmentalEating disorders Anorexia Nervosa andBulimiaKnowledge Identify the clinicalfeature and distinguishbetween them Identify differentialdiagnosis andmanagement themSkillsAbility to make adiagnosis and outline theprinciple of treatMedical NutritionalTherapy(MNT)Describe MNT andcounsel(s) and prescribediet(s)Vitamin and iodine def.DOMAIN:5 ENDOCRINE &METABOLIC EMERGENCIES AND MISCELLANOUS DISORDERS 15%Thyroid crisisEMERGNGENCIESMyxedema comaAdrenal crisisHyper and HypocalcaemiacrisisHyperglycaemicemergencies –DKA, HHSHypoglycaemicemergenciesKnowledge Discuss thepathophysiology of20CBDMCEXDOPSMcqsEssaysAssignmLog bookOSCE2
each condition Describe the clinicalfeatures andpresentation of each List common causes ofthese conditionsincluding thedifferential diagnosis Describe the point ofcare of each Describe the approachto diagnosis andmanagementSkills Ability to perform therelevant bedside andpoint of careinvestigation Ability to request forrelevant investigation Ability to interpret theresults Ability to initiatetreatment andmonitor response totreatmentAttitude To recognizeemergency nature Ability tocommunicate torelatives To consult and referMISCELLANOUSSteroid and otherhormonal abuseList commonly abusedhormone such as steroid,GH, thyroxineList the complications ofhormone abuseDescribe the approach ofmanagement of abuseand complications1MENSParaneoplastic syndromeThyroidcancer,APUDOMAS,Adrenalcancers, Pituitary cancersKnowledge Describe their clinicfeatures21
Ability to offerdifferential diagnosisSkills Ability to offerscreening test andinterpret(s) Ability to initiatemanagement includingreferral Ability to counselpatients and relativesAttitude To recognize theimplication ofdiagnosis and impacton family Recognize theimportance ofeffectivecommunication Recognize the multidisciplinary and thepsychosocial nature22
2.4.5Gastroenterology & HepatologyTitle/ Theme orDomainSpecific topics, knowledge,attitude, skillsMode gtaxonomy)Method ofAssessments%Introduction toGastroenterology& HepatologyBasic concepts, anatomy,physiology and pathology of theliver. gastrointestinal tract (GIT).Hepatic function and structure,hepatic blood supply, portal veinand portal hypertension.Gastrointestinal system fromoesophagus to small and largebowel and adnexal structures.1-3, 510Level I,II2MCQ, EssaysBasic Clinical GITand hepatologySymptoms and signs in liver and GITdiseases including jaundice andascites. Relevant clinicalexamination, investigations leadingto diagnosis.1-515Level3MCQ, essay,Clinical orCasepresentation, DOPSInterpretation & Evaluation ofabnormal liver function tests andother gastrointestinal functiontests. Compare and contrastdifferent profiles of liver tests inappropriate clinical situations likeheamolytic, hepatocellular andcholestatic jaundice.Etiology and pathophysiology ofacute and chronic liver disease andtheir complications: This includesknowledge of viral hepatitis,autoimmune hepatitis, fatty liverdisease and drug-induced liverinjury. Hepatic infections and focalbenign and malignant liverconditions. Clinical managementguidelines for common liverconditions.1-52Casepresentation, log book,MCQ3Essay, MCQ,casePresentationSymptomatic syndromes such asdyspepsia, dysphagia, acute andchronic abdominal pain. Acid-pepticdiseases including (but not limitedto) GERD, Peptic ulcer diseases,functional diseases and1-53Essay, MCQ,CasepresentationLaboratoryInvestigations ingastrointestinaltract and liverLiver diseasesDisorders ofeosophagus,stomach andduodenumI,II, III10LevelI, II, III1-515LevelI, II, III15LevelI, II, III23
complications.Disorders ofSmall bowel andcolon.Disorders of thePancreases &biliary treeTropical andMiscellaneousdiseasesRadiological andEndoscopicclinicalcompetencyClinicalemergencies inGastroenterology& HepatologySpecific clinicalcompetencies inHepatology &GastroenterologySymptomatic syndromes such asacute and chronic diarrhea.Diseases such as malabsorbtionsyndrome, Inflammatory boweldisease, Irritable bowel syndrome,Diverticular Disease.Acute and Chronic PancreatitisBiliary disease including gall stonedisease and obstructive jaundice.Parasitic and other infections of thebowel and liver. This includesAmoebic liver disease, hyperimmune malarial splenomegaly,abdominal tuberculosis andPeritoneal diseasesNutritionKnowledge and observation ofupper and lower GI endoscopyincluding indications,contraindications andcomplications. Proctoscopy andrectal snip.Percutaneous liver biopsy,Interpretation of Ultrasound scanKnowledge of advanced endoscopicprocedures like ERCP andendoscopic Ultrasound scanUpper and lower gastrointestinalbleeding, Hepatic encephalopathy,acute (medical) abdomen, severeinflammatory bowel disease, severeascites1-510LevelI,II2Essay, MCQ,Casepresentation1-55LevelI, II11-55Level1Essay, MCQ,CasepresentationEssay, MCQ,CasepresentationAbdominal paracentesis (P)Fine needle aspiration biopsy.Liver biopsy (O)Upper abdominal Ultrasound (O)Peritoneal biopsy (O)1-5I, II1-55Level1I, II1-55LevelEssay, MCQ,casepresentation1I, II, III5LevelI, II241Essay, Logbook,
2.4.6NEPHROLOGYCourse titleSpecific topics,knowledge, attitude andskillsMode ofdelivery% ofcoursecoverageBASIC CONCEPTSTo describe andcomprehend the anatomyand physiology of thekidney.To elicit symptoms andsigns and makeappropriate diagnosis ofkidney diseases.Discuss investigations andcomprehend diagnosis ofrenal disease. (Includingprocedures; renalbiopsy,IVU etc),Demonstrate ability tointerpret data inNephrology.Describe watermetabolism, Explain,interpret and recognizethe importance ofdisorders of sodium,potassium, magnesiumand calcium, includingacidosis and alkalosis.-Outline the definition,- describe theepi
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