SALIENT FEATURES OF REGULATIONS ON GRADUATE MEDICAL EDUCATION, 1997

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

 Elective Postings

Elective Subject :- 

Elective posting will include Two of the following for 15 days in each subject.

1. Dermatology and Sexually Transmitted Diseases.
2. Psychiatry
3. Tuberculosis and Respiratory Diseases
4. Anesthesia
5. Radio-diagnosis
6. Physical Medicine and Rehabilitation
7. Forensic Medicine and Toxicology
8. 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

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 4thSemester 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. 

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

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

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

Fourth and Fifth Semester

Sixth,Seventh,Eighth & Ninth Semester