MBBS Programme Handbook Revised Sep 2011 Distribution Version PDF

Educating Tomorrows Leaders
AIMST University
Faculty of Medicine
Year 1 and 2 MBBS Programme Handbook

Revised September 2011
Year 1 and 2 MBBS Programme Handbook of the Faculty of Medicine, AIMST University [Revised Sep 2011]
Published September 2011 Copyright 2011, All rights reserved, AIMST University. No part
of this handbook may be reproduced in any form without the written permission of the ViceChancellor of AIMST University.
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Contact Information:
AIMST University, Jalan Semeling Bedong, 08100 Bedong, Kedah, Malaysia Website:
http://www.aimst.edu.my; Phone: +604-429-8000; Fax: +604-429-8007
Questions regarding the contents of this handbook should be addressed to:

The Office of the Dean, Faculty of Medicine, AIMST University, Jalan Semeling Bedong, 08100
Bedong, Kedah Darul Aman, Malaysia; Phone: +604-429-8000; Fax: +604-429-8083
Preclinical Coordinator Dr Gokul Shankar, ext 3041, gokkavi@gmail.com
Academic Coordinator Dr Bharathi Sengodan, ext 1332, b.sengodan@gmail.com
Deputy Dean (Preclinical) Dr P K Rajesh, ext. 3030, depdeanpreclinical.aimst@gmail.com
Dean Professor K R Sethuraman, ext. 8124, dean.aimst@gmail.com
Notes for Students:

This handbook is intended to provide you with information about the overall objectives of the
MBBS programme, an overview of the MBBS programme, organisation of the Faculty of
Medicine, and details of courses in Years 1 and 2 of the MBBS programme.
Previous versions of this handbook are obsolete.
The Faculty reserves the right to modify the contents of this handbook without prior notice.
Students in Years 1 & 2 of the MBBS programme will be informed if this handbook is revised.
Besides this Handbook, you are advised to refer to the following sources of information as is
appropriate; these may also be updated from time to time. Please refer to the latest version of
each:
AIMST University Undergraduate Handbook [2009]: This contains important information

pertaining to academic programmes offered by the University, the Universitys rules regarding
assessment of academic performance, policy statements regarding fees, library, student
affairs, and student support services.
AIMST University Examination Rules and Regulations [2008]: This is available as a PDF
document and contains information on rules and regulations governing examinations
conducted by the University. This document is available on the University website.
Rules and Regulations of MBBS Professional Examinations [Revised Aug 2010]: This is
available as a PDF document and contains the Rules and Regulations of MBBS Professional
Examinations.
Table of Contents
Page
List of Abbreviations used in this Handbook
Vision and Mission of the Faculty of Medicine
Objectives of the MBBS programme
From the Deans Desktop
10
Organisation of the Faculty of Medicine
12
Contact Information for Staff in Faculty of Medicine
13
Overview of the Preclinical Phase of the MBBS programme
19
Courses in Year 1 at a glance
21
Courses in Year 2 at a glance
22
Academic Calendars [Year 1 and 2]
23
Teaching-Learning Methods in Years 1 and 2
25
Teaching Hospitals affiliated with AIMST University
28
Student Attendance in Classes
29
Code of Conduct
30
Dress Code
31
Mentor-Mentee System
32
Details of Courses in Year 1:

MCBM Element 1: Structure of the Human Body I
33
MCBM Element 2: General Physiology, Basics of Haematology, Nerve-muscle Physiology
37
MCBM Element 3: Proteins, Enzymes and Molecular Biology
43
MCBM Element 4: General Pharmacology and Autonomic Pharmacology
47
MCBM Element 5: Nutrition, Metabolism and Metabolic Diseases
50
MCBM Element 6: Immunity, Infection, Inflammation and Repair
54
MCBM Element 7: Neoplasia
60
MCBM Element 8: Structure of the Human Body II
63
HBM Element 1: Society, Health and Medicine
67
HBM Element 2: Epidemiology
69
HBM Element 3: Biostatistics
72
HBM Element 4: Ethics in Medicine
75
HBM Element 5: Primary Care Interface
78
Details of Courses in Year 2:

Cardiovascular System (CVS)
80
Respiratory System (RS)
87
Gastrointestinal System (GIT)
94
Central Nervous System (CNS)
99
Endocrine & Reproductive System (ER)
107
Renal System
113
Haematology
117
First Clinical Attachment
119
Special Study Module
122
Recommended Books (Essential Reading) in Year 1 and Year 2
127
Assessment of Academic Performance (Years 1 and 2)
132
Scheme of MBBS Professional Examination I
134
Continuous Assessment in MCBM
134
Continuous Assessment in HBM
136
Scheme of Final Examinations in Year 1
138
Scheme of MBBS Professional Examination II
141
Scheme of Continuous Assessment in Year 2 Courses
142
Scheme of Final Examinations in Year 2
145
Safety Guidelines
146
Student Feedback about the Programme
148
Selected External Web Links
149
Selected Internal Telephone Extensions
150
List of Abbreviations used in this Handbook:

Ana Anatomy
Bio Biochemistry
CA Continuous Assessment
Cli Clinical
CNS Central Nervous System
CVS Cardiovascular System
D Dissection
DSL Directed Self-Learning
ER Endocrine and Reproductive System
FE Final Examination
GIT Gastrointestinal System
HBM Human Basis of Medicine
HSB Hospital Sultanah Bahiyah, Alor Star
IRS Interactive Review Session
L Lecture
LAQ Long Answer Question(s)
MCBM Molecular & Cellular Basis of Medicine
MCQ Multiple-Choice Question(s)
MDL Multidisciplinary Laboratory
Med Medicine
Mic Microbiology
MOH Ministry of Health, Government of Malaysia
OSCE Objective Structured Clinical Examination
OSPE Objective Structured Practical Examination
P Practical
Path Pathology
PBL Problem-Based Learning
Paed Paediatrics
Phar Pharmacology
Phy Physiology
RH Renal System and Haematology
RS Respiratory System
SAQ Short Answer Question(s)
SSM Special Study Module
Sur Surgery
TBA To be advised
Vision and Mission of the Faculty of Medicine,

AIMST University
Our vision is to achieve national and international recognition for excellence in building
scholarship and professional competence in our medical students.
Our mission is to empower our graduates with the knowledge, skills and values needed to deliver
humanistic and evidence based quality-healthcare in Malaysia and rest of the world and with an
aptitude for continuing professional development.
Objectives of the MBBS programme:

Upon completion of formal undergraduate training, medical graduates would have acquired or
developed sufficient knowledge, competency and attitudes necessary to function as effective
providers of ethical and evidence based primary health care.
To achieve this, at the end of this course, the graduate would be able to:
Apply the basic scientific principles of various branches of medicine in his/her practice;
Apply clinical skills to recognise and manage common health problems including their
physical, emotional and social aspects with relevance to the individual and to the family;
Exhibit awareness of the psychological and economic aspects of health and disease;
Competently deal with medical emergencies to provide effective first contact care;
Define and manage the health problems of the community he/she serves; to achieve this he/
she would be able to:
o
Organise a preliminary survey to study the pressing health problems of the area;
Initiate a plan of action to manage the most important problems according to national
priorities, particularly the national health, and disease control programmes;
Organise prevention and control of common communicable disease;
Help organise health care delivery in times of calamities;
Work as an effective member of the health team;
Plan and implement effective health education programmes;
Perform administrative functions expected of them at primary care health facilities;
Realise his/ her limitations as a primary care provider and be willing to refer deserving
patients for further consultation at the appropriate time to appropriate specialised healthcare;
Execute common medico-legal procedures;
Subject himself / herself to life-long continuing education;
Develop a critical and evidence based approach to solving patients problems;
Respect and practise medical ethics as enunciated by the Malaysian Medical Council.
The MBBS programme is designed to enable students to acquire the required level of
competence in each of the following domains:
Cognitive Domain (Knowledge)
Students need to acquire adequate knowledge of the biological, behavioural, clinical, ethical and
socioeconomic sciences that are relevant to the understanding of health and illness and to the
provision of health care to an individual, a family and the community.
Essential content areas that must be learnt in appropriate segments of the course include the
following:
Structure, growth and function of cells, tissues, organ systems and life cycle
Nutrition
Aetiology, natural history, prognosis, treatment and management of common ailments in all
age groups
Womens health, sexuality, pregnancy and birth, antenatal and postnatal care, common
obstetric emergencies, termination of pregnancy and family planning
Death and dying
Management of pain, palliative care, amelioration of suffering and disability
Care of the elderly
Health education / promotion, health maintenance, counselling.
Medical humanities - human relationships as well as interactions with the environment that
affect health and health care
Socio-cultural aspects of medicine
Family health, violence and abuse
Public / community health (including occupational health)
Socially responsible health care systems including meeting health care needs of the
disadvantaged groups, and resource allocation
Research methodology, biostatistics and evidence-based medicine
Ethical problems in medicine
Medical jurisprudence
Awareness of new technology in medicine (for example, medical informatics) and related
sciences and its applications to the practice of medicine
Psychomotor Skills
Upon completing the undergraduate medical programme, the graduate should demonstrate the
following skills:
Ability to take an accurate, organised and problem-focused medical history using appropriate
perspective, tact and judgement;
Ability to perform an accurate physical and mental state examination;
Ability to interpret and integrate history and findings on physical examination and the ability to
apply judgement to arrive at a provisional / or differential diagnosis;

Ability to formulate a management plan with rational and efficient use of investigational
modalities and the ability to execute the plan of management in concert with the patient;
Ability to communicate clearly, considerately and sensitively with patients, relatives,

colleagues, nurses and other health professionals and the general public. This includes the
ability to counsel sensitively and effectively and the provision of information in a manner that
ensures that patients and their family members are truly informed when consenting to any
medical advice or procedure.
Ability to recognise serious illness and the ability to perform common manual and life saving
procedures such as caring for the unconscious patient, cardiopulmonary resuscitation,
managing common obstetric emergencies, passage of an endotracheal tube, insertion of an
intravenous line, insertion of a nasogastric tube, passage of a urinary catheter;
Ability to pursue independent inquiry and to use current technologies to search for new
information, to critically appraise it and to integrate it toward improving practice.
Affective Domain (Attitudes, Professional Behaviour)

The MBBS programme should lead to the acquisition and inculcation of appropriate values,
attitudes, professional conduct and observance of medical ethics that are fundamental to ethical
practice of medicine. Students should be encouraged to cultivate the following values:
Understanding and respect for all patients of different religious, cultural and social values;
Adherence to ethical standards as enunciated by the Malaysian Medical Council;
Concern to ease pain and suffering;
Awareness of the need to communicate clearly and sensitively with patients and their families
and to involve them fully in planning and executing the plan of management;
Desire to achieve optimal patient care at the lowest cost, deriving the maximum benefit from
the available resources;
Concern for the best interest of patients and community and avoiding overly pecuniary self
interest;
Ability to work effectively in a team and to collaborate with other health care professionals;
Responsibility to maintain standards of medical practice at the highest possible level through
continuing medical education throughout their professional career;
Ability to recognise when they have exceeded their capability to manage a clinical problem
safely and efficiently and to consult or refer the patient immediately; and
Awareness that it is not always in the best interest of the patient or their family to do
everything that is technologically possible to make a precise diagnosis or to attempt to modify
the course of a disease.
From the Deans Desktop

Congratulations to you all for deciding to take the plunge to become a medical professional. The
Faculty of Medicine wishes you all a safe, smooth and effective passage through our MBBS
programme! The human body is incredibly complex and comprises of several systems, which act
in harmony during health. The study of human body in health and disease is therefore very tough,
time consuming and challenging.
The following ideas are useful for efficient learning; i.e., to learn better in less time.
First of all, learn how to set your goals and manage your time effectively [1].
Set realistic goals - your goals must be achievable by you.
Begin with short-term goals - make up a weekly list of things to accomplish.
Start everyday with a "to-do" list and set priorities.
Monitor progress - keep track of the time spent on each and what you accomplished.
Reward yourself for completing the "to-do" list.
Adopt effective study habits to comprehend and learn. PSQ5R is a formula that stands for the
basic steps in learning from reading in an efficient manner. The P stands for Purpose, the S for
Survey, the Q for Question, the 5-Rs for Read Selectively, Recite, Reduce-record, Reflect, and
Review [2].
1. Purpose Why are you reading this chapter, and what do you want to get out of it? When
you have accomplished your purpose, stop reading.
2. Survey-Skim Scan to grasp the main features of the chapter to find out what ideas,
problems and questions are being discussed. This survey should take you no more than a
minute or two.
3. Question Yourself What do I already know about this topic? to activate prior knowledge.
Then turn the first heading into a question, to which you will be seeking the answer when you
read. For example, if you plan to study the chapter on cardiac cycle try and recapitulate
things you already know about it. Next, as you read the lesson, if the first heading is
components of cardiac cycle, turn it in to a question: What are the components of the
cardiac cycle? Then proceed to study the section to find out the answer.
4. Read Selectively Read to find the answers to your question. In most well written lessons,
reading the first few lines of each paragraph will get you the answers.
5. Recite Without looking at the book, recite the answers to the question, in your own words.
If you cannot do it well, study that section again.
6. Reduce-Record Make a brief note of the question and your answers. The answers should
be outlined - not written as long sentences.
10
7. Reflect Comprehension and retention are increased when you "deliberate" on new
information. This is to relate one part with another, to make categories, to compare and
contrast with related concepts, to connect it with your other knowledge and personal
experience, and in general to organise and reorganise it. This may be done in your mind's
eye or on paper (called a mind map).
8. Review Survey your notes to see them as a whole. This may help in putting it all together.
Then recite, using the questions or other cues as starters for recall of facts. This type of
review can be carried out in a few minutes, and should be done every week or two with
important topics until they get embedded in your active memory.
Keep track of those that work best for you and make them part of your "study habits."
Best wishes,
Professor K R Sethuraman
Dean, Faculty of Medicine &
Deputy Vice-Chancellor (Academic & International Affairs),
AIMST University
References (accessed 28 Aug 2010)

1. Beach HD and Parsons JA. Study tactics checklist. http://tiny.cc/hypn1
2. Reading to Comprehend and Learn. http://tiny.cc/epg0z
11
Organisation of the Faculty of Medicine
12
13
Contact Information for Staff in Faculty of Medicine

Functionaries attached to the Office of the Dean:
Position
Name
Ext.
E-mail
Dean
Professor K R Sethuraman
8124
dean.aimst@gmail.com
Deputy Dean (Clinical)
Dr Aruljoethy Ratnasingam
3021
deputydeanaimst@gmail.com
Deputy Dean (Preclinical)
Dr P K Rajesh
3030
depdeanpreclinical.aimst@gmail.com
Head of Hospital Liaison Unit
Dato Dr Hasnah Bt. Ismail
8130
dato.dr.hasnah@gmail.com
Residential Programme
Dato Wira Dr L R Chandran
8020
chitsree@gmail.com
Asst Registrar
Mr.Azhar Md Bin Ghouse
8123
azharmghouse@gmail.com
Clinical Coordinator
Dr Kyaw Min
8094
dr_kyawmin@yahoo.com
Preclinical Coordinator
Dr Gokul Shankar
3041
gokkavi@gmail.com
Academic Coordinator
Dr Bharathi Sengodan
1332
b.sengodan@gmail.com
Administrative Officer
Ms Balabuaneswari Devi
8130
buanadevi@yahoo.com
Administrative Officer
Ms Puvaneswary
8130
pooveneswary@aimst.edu.my
Administrative Assistant
Ms Rathneswary
8222
rathneswary@gmail.com
angela_jeevamalar@yahoo.com
Supervisor at HSB, Alor Star
Arumugam
Administrative Assistant
Ms Angela Jeevamalar
8222
Office Assistant
Mr Meiyalagan Vittiveeloo
8222
Coordinators [Heads] of Academic Units [Departments]:
Unit
Name of Unit Coordinator
Ext.
Anatomy
Professor Dr R Arulmoli
3004
Physiology
Professor Dr Ramesh Kumar Marya
8072
Biochemistry
Professor Dr Tham Sock Ying
8018
Pathology
Professor Dr S Datta Gupta
3024
Microbiology
Professor Dr Harcharan S Sidhu
8042
Pharmacology
Professor Dr C Arun Kumar
8067
Clinical Skills Centre
Professor Dr Ernest T Larmie
3032
Medical Education
Professor Dr K A Narayan
8129
Medicine
Professor Dr A P Singh
8069
Surgery
Professor Dr U K Shrivastava
8068
Community Medicine
Professor Dr K A Narayan
8129
Paediatrics
Associate Professor Dr Usha Singh
1332
Obstetrics & Gynaecology
Professor Dr Riptinder Singh
8073
Orthopaedics
Professor Dr Ashutosh S Rao
3028
Psychiatry
Lecturer Dr P S Srikumar
8220
ENT
Senior Associate Professor Dr Ihab ElSayed Mohd
8095
Ali
Ophthalmology
Senior Associate Professor Dr Christina Gellknight
8018
Dermatology
Senior Associate Professor Dr Mariette DSouza
8099
Radiology
Senior Lecturer Dr C S Singh
8097
Anaesthesiology
Lecturer Dr G Prabhakar
3039
Family Medicine
Senior Lecturer Dr R Sawri Rajan
3041
14
Faculty Members by Unit [Department]: ADH Anatomy Dissection Hall; MDL Multidisciplinary
Laboratory; adj. adjacent;
Name
Ext.
~ Location of Office
Professor Dr R Arulmoli
3004
Adjacent ADH
Senior Associate Professor Dr G Chandralekha
3041
Lecturers Office opposite ADH
Associate Professor Dr Gandakota Ravindranath
3003
Adjacent ADH
Dr.A .Prassana Veerakumar Senior Lecturer
3039
Dr.Siva Vadivel Lecturer
3039
Dr.Namani Sathyanarayana Lecturer
8098
Lecturers Office, Floor 1
Professor Dr Ramesh K Marya
8072
Professor Dr Neena Bhattacharya
3023
Senior Associate Professor Dr N Nagaraja Kumari
8099
Senior Associate Professor Dr Usha Kumari
8063
Senior Associate Professor Dr Hla Than
8097
Dr.Rekha Baliga Senior Lecturer
3011
Lecturers Office, MDL 2, Floor 1
Dr Gulpreet Singh, Lecturer
3011
Lecturers Office, MDL 2, Floor 1
Dr.Paripelli Sunitha,Lecturer
3006
Adj. Physiology Lab, Floor 1
Professor Dr Tham Sock Ying
8094
Associate Professor Dr Girish Prabhu
8092
Associate Professor Dr P Kumar
3048
Ms. R Jegathambigai, Lecturer
3006
Ms. K Rohini, Lecturer
3003
Ms. V Sridevi, Lecturer
3006
Mr. Balasundaram, Lecturer
3039
Dr Sam Annie Jeyachristy, Lecturer
8094
Professor Dr C Arun Kumar
8067
Dr.Soe Aung Myint Tutor
8094
Anatomy
Physiology
Biochemistry
Pharmacology
15
Name
Ext.
~ Location of Office
Professor Dr S Datta Gupta
3024
Associate Professor Dr Bharathi Sengodan
1332
Dr Aye Aye Tun, Lecturer
8094
Dr Yupa Min Lecturer
3006
Professor Dr Harcharan S. Sidhu
8042
Admin. Building, Floor 3
Senior Associate Professor Dr P K Rajesh
3030
Deputy Deans Office, Floor 3
Dr. John Thambiraja, Senior Lecturer
8092
Dr Gokul Shankar, Senior Lecturer
3041
Dr Jeyakumar Nelson, Lecturer
3006
Ms V Remya, Lecturer
3006
Ms R Venkatajyothi, Senior Lecturer
3039
Professor Dr K R Sethuraman
8124
Deans Office, Floor 2
Professor Dr A P Singh
8069
Additional Professor Dr S Nandakumar
8090
Senior Associate Professor Dato Wira L R Chandran
8020
Associate Professor Dr K K Perumal
8066
Associate Professor Dr P Suresh,
8066
Dr Soetjipto Adi, Lecturer in Cardiology
3041
Dr Kyaw Min, Lecturer in Tropical Medicine
8091
Dr Nan Nitra Than, Lecturer in Tropical Medicine
3012
Professor U K Shrivastava
8068
Senior Associate Professor Dr.Sein Wein
8064
Visiting Professor Dr Moses Dass
8096
Associate Professor Dr J Dasgupta
8020
Associate Professor Dr Neoh Chin Boon
8096
Associate Professor Dr.Krishna Kumar Mallick
8098
Visiting Professor Dr.Ian Rogers
8020
Pathology
Microbiology
Medicine
Surgery
16
OB-GYN
Professor Dr.Riptinder Singh
8073
Senior Associate Professor Dr.Arumainathan
8095
Senior Associate Professor Dr.AB Chattopadhyay
8065
Associate Professor Dr.N Jack
8065
Senior Associate Professor Dr.Philomena DSouza
1331
Associate Professor Dr.Usha Singh
1332
Associate Professor Dr.M Mahesh Kumar
8062
Dr.Lei Lei Lecturer
8094
Dr.Tin New Latt Lecturer
8094
Professor Dr.Ashutosh S Rao
8065
Senior Associate Professor Dr.R Aruljoethy
8065
Deputy Deans Office, Floor 3
Senior Associate Professor Dr.Myint Swe
8064
Dr P S Srikumar, Lecturer
3039
Dr Raman Krishnan, Lecturer
3039
Dr.Jaikumar Velayudham, Lecturer
3012
Ms Magespary, Lecturer
1331
Professor Dr.Ernest T Larmie
3032
Clinical Skills Centre, Floor 3
Dr K Narendiran, Lecturer
3069
Dr Shobha Subramanian, Clinical Tutor
3033
8132
Director of medical education
Paediatrics
Orthopaedics
Psychiatry
Clinical Skills Centre
Community Medicine
Professor Dr.K A Narayan
office ,Floor 3
Associate Professor Dr.Leela Anthony Joe
8063
Associate Professor Dr.Kyi Kyi Sein
1334
Dr R Sawri Rajan, Senior Lecturer
3039
Dr.Ladish Krishnan Senior Lecturer
3012
17
Dr.Theingi Maung Maung Senior Lecturer
8094
Dr.Ei Ei , Lecturer
8094
Dr.Prakash Shah Lecturer
3041
Dr Lely Lubna, Tutor
3006
8095
8018
Senior Associate Professor Dr.Christina Gellknight
1333
Associate Professor Dr.P L Narayanan
8020
Associate Professor Dr.Prabal Bhargava
8020
Dr Sony K Jose Lecturer
3006
8099
8097
3039
3041
Ms S Chithra, Tutor, MDL
3009
Multidisciplinary Lab 1, Floor 1
Mr. S. Ganesan, Senior Lab Technologist, MDL
3005
Multidisciplinary Lab 2, Floor 1
Pn Mahani Bt Ibrahim, Nursing Officer, CSC
3036
Ms. Elizabeth H Theophilose, Clin Nursing Instructor,
3036
ENT
Senior Associate Professor Dr.Ihab El Sayed Mohd
Ali
Dr C Vijaya, Lecturer
Ophthalmology
Dermatology
Senior Associate Professor Dr.Mariette DSouza
Radiology
Dr C S Singh, Senior Lecturer
Anaesthesiology
Dr G Prabhakar, Lecturer
Family Medicine
Dr R Sawri Rajan, Senior Lecturer
Staff
CSC
En Suib Bin Darus, Lab Technologist, Anatomy
Department of Anatomy, Floor 1
En Jamaludin Bin Idrus, Lab Technologist, Anatomy
Department of Anatomy, Floor 1
Mr Subramanian .T, Lab Technologist, CSC
3036
18
Overview of the Preclinical Phase of the MBBS Programme

The MBBS programme is a 5 year programme; the first 2 years is the preclinical phase of the
programme, and thereafter most of the programme is offered in a clinical context. Upon
successful completion of programme requirements, the graduate is awarded the degree Bachelor
of Medicine and Bachelor of Surgery (abbreviated as MBBS) by AIMST University. The
preclinical phase of the programme is designed to train you to a level that is optimum to pursue
clinical training and detailed study of the causes, mechanisms, prevention, diagnosis and
management of clinical conditions and syndromes as well as promotion of health in years 3-5 of
the programme.
At the time of starting this programme, the MBBS curriculum was modelled on the
undergraduate medical curriculum then adopted by the Bristol University, UK, with elements
incorporated to take cognizance of local needs and at the same time guided by the requirements
of the Malaysian Medical Council. Subsequently, the Faculty of Medicine has reviewed the core
curriculum to enhance its suitability to local needs and revised it in keeping with some recent
advances in the field of medicine and changing trends in patterns of disease.
The main objective of the Year 1 programme is to facilitate learning in basic medical sciences
and at the same time inculcate humanistic values central to the practice of medicine. Accordingly,
courses in Year 1 are classified on the basis of the following two themes: Molecular and Cellular
Basis of Medicine (MCBM), and Human Basis of Medicine (HBM). MCBM courses aim to provide
the scientific background required for study of the structure, function and diseases of organ
systems in year 2 of the programme. HBM will introduce you to people as individuals individuals
who are part of a society, as patients seeking healthcare. HBM consists of a module that offers
instruction in ethical principles that govern the practice of medicine. Additionally, it consists of
modules intended to deliver core content in basic principles of epidemiology and statistics and
their applications in medical practice and research. As part of the HBM course, you will interface
with primary health care and become familiar with its organisation and functions, and also learn
how to listen to patients narration of their problems. The combination of MCBM and HBM in year
1 is intended to ensure that you view the practice of medicine as requiring the application of a
body of scientific information not to machines but to human beings each with distinct problems,
feelings and emotions. MCBM is a composite of 8 Elements and HBM is a composite of 5
Elements (see Page 18). MCBM Elements 1-3 and part of Element 6 run in parallel with HBM
Elements 1 and 2 in Term 1 of Year 1. MCBM Elements 4-8 run in parallel with HBM Elements 35 in Term 2 of the Year 1 programme.
The objectives of the Year 2 programme are to ensure that you learn the structure and
function of various organ systems and the central nervous system, pathologic changes seen in
common disease states affecting organs and organ systems, the rationale for the use of drugs
19
and other therapeutic modalities to treat diseases, and the clinical features of common clinical
conditions affecting various organ systems. The Year 2 programme is integrated and uses an
organ system approach; i.e., core content in the basic and clinical sciences is organised by
organ systems and not by discipline. The sequence of courses is outlined on Page 18. A notable
feature of the revised curriculum is the integration of clinical skills training primarily into the
following four systems courses cardiovascular system, respiratory system, gastrointestinal
system and central nervous system. For example, during the cardiovascular system course, once
you have learnt about the structure and function of the heart and blood vessels and mechanisms
of common disease processes affecting the heart and blood vessels, you will learn how to obtain
history from an individual presenting with breathlessness and chest pain. Additionally, you will
learn basic clinical skills needed to perform a physical examination of the cardiovascular system.
Thus, in each organ system course, Teaching-Learning (T-L) experiences are sequenced to
facilitate construction of a knowledge base essential for learning medicine in a clinical context in
the rest of the programme. The clinical attachment in Term 2 is organised to help you become
acquainted with the structure and functional organisation of a tertiary care hospital and to provide
early opportunities for developing your skills to communicate with patients as well as with
healthcare professionals.
20
21
Courses in Academic Year 1 at a Glance:

Molecular and Cellular Basis of Medicine (MCBM)
Element
Title
Structure of the Human Body I
Course Code
MMCM 31103
Term
Contact
Element
hours
Coordinator
52
Dr G. Ravindranath
Dr. A. Prassanna
General Physiology, Basics of
MMCM 31103
50
Dr Rekha
MMCM 31104
54
Dr.S.Annie
Haematology and Nerve-Muscle

Physiology
3
Proteins, Enzymes and Molecular

Biology
Jeyachristy / Ms
Rohini
General Pharmacology and
MMCM 31104
31
Autonomic Pharmacology
5
Metabolism, Metabolic Diseases
Kumar
MMCM 31104
55
and Nutrition
6
Professor C Arun
Dr.P. Kumar/ Ms.

Jegathambigai. R.
Immunity, Infection, Inflammation
MMCM 31105
1-2
91
Dr P K Rajesh
MMCM 31105
16
Dr Bharathi
and Repair
7
Neoplasia
Sengodan
8
Structure of the Human Body II
MMCM 31103
44
Dr. A. Prassanna
Dr G. Ravindranath
Human Basis of Medicine (HBM)

Element
Title
Course Code
Term
Contact
Element
hours
Coordinator
Society, Health and Medicine
MHBM 31101
16
Dr Thengi
Epidemiology
MHBM 31102
32
Dr Ei Ei
Biostatistics
MHBM 31102
46
Dr Ei Ei
Ethics in Medicine
MHBM 31101
16
Dr Thengi
Primary Care Interface
N/A
30
Dr Lely Lubna
22
Courses in Academic Year 2 at a Glance:

Title
Course
Term
Code
Contact
Course Coordinator(s)
hours
Cardiovascular System
MCVS 32101
106
Ms. Sridevi Viswanathan
Respiratory System
MRES 32102
100
Dr N Nagaraja Kumari
Ms. Rohini Karunakaran
Gastrointestinal System
MGIT 32103
100
Dr Jeyakumar Nelson
Dr.S.Annie Jeyachristy
Central Nervous System
MCNS 32105
135
Dr Usha Kumari
Dr Gokul Shankar
3 wks
Dr P Suresh
Dr Gokul Shankar
Endocrine & Reproductive
MERS 32106
90
System
Renal System &
Haematology
Dr Girish Prabhu
Ms Remya V
MREH 32104
85
Professor Neena Bhattacharya

Dr P.Kumar
Registration for courses in a Term: You must register for courses in a Term on the first day of
each Term of the programme. Registration forms are available at the Deans Office
Academic Year 1 Calendar [17 Aug 2011 15 Aug 2012 for MBBS Batch 17]
Academic
Dates
Description
Week
12
15 Aug 26 Aug
HBM Elements 1-2; MCBM Elements 1-3 & 6 in parallel
29- 2 Sep
49
5 Sep 14 Oct
10
17 21 Oct
Continuous Assessment 1
11
24 28 Oct
Break
12-19
31Oct 23 Dec
20 -21
26 Dec 6 Jan 2012
22
9 13 Jan 2012
*23 27
16 Jan 17 Feb
HBM Elements 3-4; MCBM Elements 4-8 in parallel
28
20 Feb 24 Feb
Break
29 31
27 Feb 16 Mar
32
19 23 Mar
33
26 30 Mar
34 35
2 13 Apr
36 40
16 Apr 18 May
41
21 25 May
42 43
28 May 8 Jun
44 46
11 29 Jun
47 52
2 Jul 10 Aug
Break

Term 1 Break
HBM Element 5 Primary Care Interface

Revision
PE I Final Examination
End of Year 1 Vacation/Remedial Programme[PE I Final Supplementary Examination]
Academic Year 2 Calendar [16 Aug 2011 15 Aug 2012 for MBBS Batch 16]
Academic
Dates
Description
Week
1-2
16 26 Aug 2011
29 - 2 Sep
Break
4 -7
5 30 Sep
8 10
3 21 Oct
Respiratory System
11
24 -28 Oct
Break
12-13
29 Oct 11 Nov
Respiratory System
14 18
14 Nov 16 Dec
Gastrointestinal System
19 20
19 Dec 1 Jan 2012
21 27
2 Jan 17 Feb
28
20 Feb 24 Feb
29 31
27 Feb 16 March
Term 1 Break; 19 Dec onward - PE I [Final Attempt]

Central Nervous System
Break
Remedial Postings
23
32 36
19 March 20 Apr
Endocrine and Reproductive System
37 41
23 Apr 25 May
Renal System and Haematology
42 - 44
28 May 15 Jun
Revision
45 48
18 Jun - 13 Jul
Professional Examination II
49 52
16 Jul 10 Aug
End of Year 2 Vacation ,[PE II Final - Supplementary Examination]
24
Teaching-Learning (T-L) Methods in Years 1 and 2:

In keeping with the vision and mission of the Faculty and the objectives of the MBBS programme,
a variety of T-L methods are used to facilitate learning. A significant fraction of core content in
Year 1 and Year 2 is delivered using lectures. Typically, lectures are presented as PowerPoint
presentations and last between 40-50 minutes. You are encouraged to contribute to making
lectures interactive you are welcome to ask questions or seek clarifications during or at the end
of a lecture. Please also make notes (they may be sketchy) as you understand new concepts
during lectures. These are often invaluable and may help you revise and consolidate what you
learnt.
Lecturers typically leave an electronic copy of their presentation for you to print out. However,
please be informed that PowerPoint presentations are not meant to contain all material that you
are expected to learn. Typically, PowerPoint slides will contain only an outline of the material
presented by the lecturer and therefore reading a PowerPoint presentation cannot substitute for
attending and actively listening to lectures. You are advised to supplement your reading of lecture
notes by referring to recommended textbooks. For courses in Year 1, a list of textbooks and
references recommended for each course is provided as part of course details. Textbooks and
other references recommended for courses in Year 1-2 are listed on pages 106-107. Lecturers
may recommend additional reading as appropriate for the lecture or lab session in question.
Please follow their advice. PowerPoint presentations provided by lecturers are intended only for
your personal use commercial use of these presentations or other study material provided by
lecturers is prohibited. You are not authorised to post them on the internet without explicit
permission from the lecturer concerned.
Practical classes are structured to suit the objectives of the session in question. In year 1,
practical sessions typically last 3 hr while in year 2, a session is typically 2 hr. Anatomy dissection
and histology lab sessions are 2 hr sessions. Lecturers may assign you work based on practical
experiments or demonstrations. You are expected to complete and submit these assignments on
time to the course coordinator concerned.
Interactive Review Sessions (IRS) is held to help review and consolidate material covered in
recent lectures and or practicals. Their main purpose is to provide you opportunities to seek
clarifications and feedback from lecturers. You are advised to use these opportunities effectively.
During these sessions, lecturers may test your understanding of material covered in recent
lectures by asking questions, using problem-solving exercises etc.
25
Problem-based learning (PBL) is a T-L strategy that uses problems based on actual or
simulated clinical cases as the basis for triggering learning of core knowledge. Clinical cases are
formulated based on intended learning outcomes; alternately, authentic cases that would provide
the basis for achieving intended learning outcomes are used. PBLs are typically a small group
activity and consist of about 10-12 students in a group along with a facilitator. The case is not
released to students in its entirety but gradually as triggers; students explore these triggers
collaboratively and formulate learning objectives, generate hypotheses, discuss them, and make
a list of relevant learning issues or objectives they need to achieve in order to solve this or a
similar problem. The emphasis, at least in year 2, is on learning basic science content relevant to
the case in question. Students work on these objectives singly or in smaller groups and come
back to present their learning in the next session share it and discuss it amongst colleagues in
the group and the facilitator. The role of the facilitator is to provide a scaffold rather than being
prescriptive about what happens in the session. Typically, a PBL scenario is held over 3 sessions
(each 2 hr) that span about 10 days. Overall, this strategy is learner-centred and besides serving
as a stimulus to foster learning of basic science content, several other attributes of the PBL
process such as the opportunity to think independently, learn how to solve problems, learn
collaboratively, take ownership of ones learning are expected to contribute to the overall
professional development of students.
Student Presentations: Besides student presentations that occur in PBL, some courses feature
student presentations of core content usually at the end of a course for example, emerging
infectious diseases in MCBM Element 6. Topics for student presentations may change from time
to time. Although three or four students make the presentation, this is intended to be a group
effort and all students in a group are expected to be able to answer questions from faculty
members moderating the session and or other students. These provide an opportunity for
students to learn how to present information to their peers in a formal classroom setting.
Case Discussions: Discussion of cases is used especially in the Ethics in Medicine module in
HBM to drive learning, exemplify core content delivered in lectures. Case discussions are also
integrated into lectures in many courses and contribute to enhancing the interactivity of the T-L
experience. The endocrine and reproductive system course also features clinical case
discussions in a large classroom setting.
Problem Solving Exercises: These are used to sensitise students to the potential application of
core knowledge they are usually integrated into lectures. Lecturers may give problems for
students to attempt to solve by themselves and then discuss them in a subsequent session. The
26
last session of a PBL also features problem-solving exercises one of the intended outcomes of
the PBL process is the ability to solve problems of a nature similar to that discussed in the PBL.
Directed Self-Learning (DSL) :
Directed Self-Learning is essential to meet the challenges
intoday's healthcare environment. The field of medicine is vast; it is impossible as well as

undesirable to cover all required material in lectures or practical sessions. We strongly believe
that it is important for you to begin to take responsibility and ownership of what you learn. We
advise you to make effective use of the facilities available to you the anatomy museum, the
pathology museum, access to the Internet, books, the universitys online subscriptions to
textbooks and journals, and CD-ROMs in the library. You are advised to use DSL time effectively
to learn and reflect upon content taught in lectures, work on PBLs as well as learn topics that
faculty members post specifically for directed self-learning. You may go to the library or form
small groups, study and discuss whichever way suits you best. If you would like to seek
clarifications, please make an appointment with faculty members and have your questions sorted
out. Please note that DSL topics will also be tested in continuous assessment as well as the final
exams. In year 2, you may use some of your DSL time for completing your Special Study Module
see the section on SSM below.
Special Study Modules (SSM): During the course of your preclinical studies, you will
undoubtedly come across facts and phenomena that puzzle you and lead to questions that you
are not able to answer easily. A chapter in a course or a lecture or a PBL tutorial may turn out to
be of great interest to you and you may want to study about it in greater detail. However, the fact
that great details of a phenomenon may not get tested in examinations should not in itself
extinguish your curiosity to explore and discover in fact, this curiosity is fundamental to
meaningful learning. The undergraduate programme is designed to encourage you to pursue
topics or questions that interest you and or develop skills that may be of use to you in the practice
of medicine but are not already covered in the core curriculum thus the term Special Study. For
more details on Special Study Modules, see pages 101-105.
27
Teaching Hospitals Affiliated with AIMST University:

The following hospitals of the Ministry of Health, Government of Malaysia are utilised for clinical
training of undergraduate medical students from AIMST University.
Hospital Sultan Abdul Halim, Jalan Lencongan Timur, Bandar Amanjaya, 08000 Sungai
Petani, Kedah; website: http://hsah.moh.gov.my; e-mail: hsah@moh.gov.my; phone: 044457333; fax: 04-4480092
Hospital Sultanah Bahiyah, Km 6 Jalan Langgar, 05460 Langgar, Alor Star, Kedah;
website: http://hsbas.moh.gov.my/ e-mail: hsb@moh.gov.my; phone: 04-7406233; fax: 047350232
Hospital Yan, 06900 Yan, Kedah; website: http://hyan.moh.gov.my; e-mail:

hyan@kdh.moh.gov.my; phone: 04-4655333; fax: 04-4655960.
Hospital Jitra, Jalan Changlun, 06000 Jitra, Kedah
Hospital Sik, 08200 Sik, Kedah; phone: 04-4695333; fax: 04-4695990
Besides this, the following community polyclinics may also be used for training:
Klinik Kesihatan Pokok Sena
Klinik Kesihatan Jalan Putra
Klinik Kesihatan Kuala Kedah
Klinik Kesihatan Merbok
Klinik Kesihatan Kota Kuala Muda
Klinik Kesihatan Bukit Selambau
Klinik Kesihatan Kepala Batas
Klinik Kesihatan Tunjang
Klinik Kesihatan Changloon
Klinik Kesihatan Naka
Klinik Kesihatan Jeniang
Klinik Kesihatan Bandar Sik
28
Attendance in Classes:
You are strongly advised to attend all scheduled classes. A student must have at least 80%
attendance in a course to be eligible to appear in the Final Examination in the corresponding
Course (or Subject of Examination). Please see the section on eligibility criteria for appearing in
Professional Examinations in Rules and Regulations of MBBS Professional Examinations, August
2010]. Leave of absence will be granted for medical reasons, on humanitarian grounds, and for
other compelling reasons that justify grant of leave.
Applying for leave:

Planned leave of absence: If you anticipate the requirement for leave, then, you are required to
complete the form available for application for leave, sign it, obtain prior approval of lecturers
concerned and submit it to Preclinical Coordinator Dr Gokul Shankar or direct to Deans Office.
Emergency leave of absence: If your absence from class could not be anticipated earlier, then,
you may submit your application by e-mail as an attachment to the lecturers concerned and Cc
your e-mail to preclinical coordinator Dr Gokul Shankar (e-mail:gokkavi@gmail.com). Alternately,
you can sign and fax your leave application form to Deans Office: +604-429-8083; please mark it
to the attention of the lecturers concerned as well as preclinical coordinator Dr Gokul Shankar.
If the reason for absence was due to illness of some kind, then, a medical certificate to that effect
must be furnished when you return to attend classes. If a student is absent on 3 consecutive
working days or more than 3 days in a week without prior approval, course coordinators will bring
this to the attention of the preclinical deputy dean or dean.
Attendance at Continuous Assessment Tests: You are advised not to miss any Continuous
Assessment (CA) test unless approval has been previously obtained from the Deputy Dean or
Dean. According to the Rules and Regulations of MBBS Professional Examinations (August
2010), A student who is absent from a Continuous Assessment test for whatever reason must
submit a letter to the Dean of the Faculty stating the reason(s) and attach supporting
documentation (example, medical certificate) within 48 hours of the test, or else the student shall
be considered as having failed in the test. A copy of this should also be submitted within the
same timeline to the Course Coordinator / Head of Department concerned and the Clinical /
Preclinical Coordinator as may be appropriate. These shall be treated on a case by case basis
and a decision made by the Dean in conjunction with the Deputy Deans and Coordinator(s) of
that particular course
29
Code of Conduct for AIMST students attached to hospital and health

facilities of the Ministry of Health (MOH), Government of Malaysia
The Ministry of Health, Government of Malaysia has issued a Code of Conduct* for AIMST
students attached to hospital and health facilities of the Ministry of Health.
Students are expected to conduct themselves in a seemly manner that is unlikely to cause
offence to members of the general public. In particular, while attending a hospital or
community polyclinic, all students must be dressed in a manner acceptable to hospital staff
and patients and courteous to patients at all times.
All students are required to attend all teaching sessions appropriate for the course in which
they are enrolled. If for any reason, a student is unable to attend a scheduled clinical teaching
session, examination or any other assessment procedure, he/she should wherever possible
obtain the prior approval of his/her teacher. Where this is not possible, the student must
provide an explanation for his/ her absence as soon thereafter.
Each student must obey all laws of Malaysia and conform to expected norms of good conduct
and behaviour in Malaysia during transport to and from the hospitals and during the course of
their training in MOH hospitals and health facilities.
Students are expected to treat buildings, library books, apparatuses and other facilities
provided by AIMST University and the MOH with care and respect. Any student found
damaging AIMST or MOH property will be required to pay for its repair or replacement.
Smoking of tobacco is prohibited in AIMST University premises, and all hospitals and health
facilities.
Students attending teaching sessions in MOH hospitals and health facilities should always be
in proper attire and display the AIMST ID card.
While talking to patients or examining them, students must first identify themselves as
medical students and get patients permission before they carry out any procedure. They
should at no time give the impression to patients that they are qualified doctors.
Students are not allowed to examine a patient of the opposite sex unless a nurse or another
person of that sex is in attendance.
Students shall abide by all the rules, regulations and procedures of the MOH hospital and
health facilities in which they train.
Students shall handle all patient records in strict confidence and shall not divulge any
information concerning patient care to unauthorised personnel.
Students shall follow the rules prescribed for infection control in the wards as well as health
facilities.
*Reference: Page 16 of Memorandum of Understanding signed March 2004 between Ministry of Health, Government of
Malaysia and Asian Institute of Medicine, Science & Technology (AIMST)
30
Dress Code:
You are reminded that this is a professional school. Although you are not a doctor yet, we and the
general public expect you to conduct yourself in a manner that is expected of physicians. This
also applies to personal grooming and the dress you wear in classes and in public places in
campus and while in hospitals and other health facilities. The intention of the dress code is to
contribute to your overall professional development. What is appropriate and what is not is
clarified below:
Male students:
You must be in clean, well-pressed, formal attire. Shirts must be collared, fully buttoned and
tucked in. Trousers must be long but should not drag the floor. ID card should be worn at all
times. Jeans, T-shirts and clothing with inappropriate slogans are unacceptable.
Footwear must be well kept wear formal shoes and socks; sports shoes, running shoes,
sandals, flip-flops and sneakers are not allowed.
Hair must be well combed - length of hair should be above the top collar line. No ponytails.
Fingernails must be clean and short.
No ear rings, tongue rings, nose rings, or other similar adornment.
Female students:
You must be in clean, well-pressed formal attire. Blouse with knee length skirt or knee length
dress or long pants are preferred. ID card should we worn at all times. Pants worn below the
waistline and or dragging on the floor are unacceptable. Clothing with inappropriate slogans
is unacceptable. Fish-net stockings / hosiery and other see through clothing, plunging
necklines, spaghetti string blouses, jeans, T-shirts, three-quarter pants, revealing the navel
are all unacceptable.
Footwear must be well kept wear formal shoes or dress slippers; sports shoes, running
shoes, sandals, flip-flops and sneakers are not acceptable.
Hair must be well combed, tied or pinned to avoid hair falling all over the face; length must
be above the bottom line of the collar; all long hair must be tied up neatly.
Only 1 pair of earrings is allowed. Fingernails must be clean and short. Light make-up is
acceptable. Multiple pairs of earrings, long dangling earrings, tongue rings and excessive
jewellery is not acceptable.
Additionally, you are required to wear the white coat when interacting with patients (real or
standardised) and in the laboratory.
31
Mentor-Mentee System:
The medical programme is quite long and can often be stressful. Students often require guidance,
advice and support to help them cope with demands placed by a rigorous system of education
and assessment. As students, you may require support or guidance with different things
planning your work, learning strategies, strategies to do well in tests, professional development,
or help identifying and or solving specific problems that affect academic performance.
Because your mentors are older, they are much more experienced remember they have all
passed a similarly rigorous system of education, training, and have either practiced medicine for
several years and or have taught and encountered several students in their careers. The mentors
role centres on supporting the mentee (mentors student) to strengthen his/her competencies to
improve his/her academic performance and professional development.
Please understand that mentors primary job is not to teach you subject material you are unable
to understand if you need any specific help understanding subject material, you should contact
teacher(s) concerned. In contrast, your mentor (an academic member of the Faculty of Medicine)
may not even teach the same subject as you are now learning in the programme. The mentors
focus is on determining the kind of help the mentee requires, and in the provision of constructive
feedback. However, this system is driven by the mentee - as a mentee, you should initiate
mentor-mentee interactions. Meetings are recorded by the mentor in the Mentor-Mentee Log
Book. Any counselling that occurs is initiated by the mentee and is voluntary.
Discuss with your mentor whether suggested solutions are working for you. Over a period of time,
the mentor-mentee relationship develops into a highly trusted professional relationship that
benefits the mentee and promotes his/her overall professional development. In case, you find it
difficult to meet your mentor, you may contact him/her by e-mail, phone.
First year students are required to meet with their mentors every first Friday between 2 and 3 pm.
Second year students are required to meet with their mentors every second Friday between 2
and 3 pm. Additional meetings may be scheduled as needed. If you will find it difficult to meet with
your mentor during this time, you must keep him/her informed of this and schedule meetings at a
time convenient to both of you.
There is an additional central system of e-mentoring support that you may use for example when
it is difficult to meet or contact your mentor. You may contact (or e-mail) the coordinator of the
Mentor-Mentee Programme Dr Bharathi Sengodan (b.sengodan@gmail.com) or preclinical
coordinator Dr Gokul Shankar (e-mail:gokkavi@gmail.com). To be referred to appropriate
sources of support.
32
Details of Courses in Year 1

MCBM Element 1: Structure of the Human Body 1
Course Code: MMCM 31103
Organised and conducted by the Unit of Anatomy
Synopsis: This Element aims to provide the learner with basic information about the structure of
the human body. To this end, students will be taught the gross and microscopic anatomy of
tissues of the human body. Element 1 and Element 8 of the MCBM course are essentially a
continuum of basic learning about the structure of the human body. MCBM Elements 1, 2 and 8
together constitute MCBM I (one of the Components of Professional Examination I). Material in
MCBM Elements 1 and 8 complements that in Element 2 [Physiology] and Elements 3 and 5
[Biochemistry]. This will form the basis for further learning of the gross anatomy, microscopic
anatomy and development of tissues in various courses in Year 2 of the programme.
Objectives:
At the end of this Element, the learner is expected to be able to:
Use terms used to describe the anatomy and histology of the human body;
Use a compound microscope correctly to examine human tissues;
Identify and differentiate different types of human tissues under the microscope;
Describe the histologic features of different types of tissue;
Rationalise the structure-function relationships of bones of the axial and appendicular

skeleton;
Identify bones, joints, muscle groups of the upper and lower limbs and their nerve and
blood supply; and
Describe the functional organisation of the central nervous system and the peripheral
nervous system.
T-L methods: 18 lectures, 4 IRS, 12 dissection sessions, 6 histology laboratory sessions.

Contact hours: 58 hours
33
The Curriculum:
Lectures:
1. Introduction: anatomical terms; anatomical positions; regions of the body; organ systems;
ways of describing and visualising the human body.
2. Epithelia and glands: classification of epithelia; distribution and functions of various
epithelia; classification of glands.
3. Connective tissue: types of cells in connective tissue; composition of extracellular matrix;
superficial and deep fasciae, their function and clinical importance; skin and its appendages.
4. Histology of cartilage, bones and muscle: types of cartilage - hyaline, elastic and fibro
cartilage; basic facts about bone structure and development of bones. Different types of
muscles; histology of skeletal, cardiac and smooth muscle.
5. Histology of neural tissue and blood vessels: Histological structure of neuron; types of
neurons; types of neuroglial cells; histological features of a mixed nerve. Blood vessels
microscopic structure of arteries &, veins
6. Histology of lymphoid tissue: structure of lymphoid tissue; lymph node, spleen, thymus and
mucosa associated lymphoid tissue.
7. General anatomy of bones: the axial and appendicular skeleton; periosteum; types of
bones; architecture of bones; tensile strength of bones.
8. Upper Limb [Part 1]: Bones: Parts, features and attachments of bones of upper limb:
clavicle, scapula, humerus, radius, ulna and carpal bones.
9. Upper Limb [Part 2]: Muscles of the upper limb; origin and insertion, nerve supply and
anatomy of the cubital fossa; anatomy of the carpal tunnel.
10. Upper Limb [Part 3]: Blood supply and lymphatic drainage of the upper limb; nerve supply of
the upper limb the brachial plexus and major nerves of the upper limb; anatomy of the
axilla; major vessels of the upper limb.
11. Upper Limb [Part 4]: Joints and ligaments of the upper limb; movements at each joint.
12. Lower Limb [Part 1]: Bones: Parts, features and attachments of bones of lower limb: hip
bone, femur, tibia, fibula and tarsal bones.
13. Lower Limb [Part 2]: Muscles and muscle groups of the lower limb; innervation of muscles
of lower limb; the concept of muscle pump; joints on which muscles and muscle groups act
and movements they produce; anatomy of the femoral canal, adductor canal and popliteal
fossa
14. Lower Limb [Part 3]: blood supply and lymphatic drainage of the lower limb; nerve supply of
the lower limb - the lumbar plexus and major nerves of the lower limb.
15. Lower Limb [Part 4]: Joints and ligaments of the lower limb; movements at each joint.
16. Vertebral column [Part 1]: Bones: Parts, features and attachments of vertebrae: cervical,
thoracic, lumbar, sacrum and coccyx.
34
17. Vertebral column [Part 2]: Joints and ligaments of vertebral column and muscles producing
movements at these joints
18. Thorax: bones and muscles of the thorax; intercostals space and contents; diaphragm;
anatomy of the breast; clinical relevance of lymphatic drainage of the breast; an overview of
organs present in the thoracic cavity; mediastinum.
Dissection Sessions & Histology Lab Sessions (18 sessions, 2 hours each):
1. Introduction: anatomical position; names of bones and their arrangement, function of
skeleton and joints axial and appendicular skeleton
2. Histology: Parts of the microscope
3. Histology: epithelia and glands
4. Histology: connective tissue and skin
5. Histology: cartilage, bone and muscle
6. Histology: nervous tissue and blood vessels
7. Histology: lymphoid tissue
8. Dissection: Upper Limb [Part 1]: Bones: Parts, features and attachments of bones of upper
limb clavicle, scapula, humerus, radius, ulna and carpal bones.
9. Dissection: Upper Limb [Part 2]: Muscles of the upper limb: origin, insertion, nerve supply
and action; anatomy of the cubital fossa; anatomy of the carpal tunnel.
10. Dissection: Upper Limb [Part 3]: Blood supply and lymphatic drainage of the upper limb;
nerve supply of the upper limb the brachial plexus and major nerves of the upper limb;
anatomy of the axilla; major vessels of the upper limb.
11. Dissection: Upper Limb [Part 4]: Joints and ligaments of the upper limb; movements at
each joint.
12. Dissection: Lower Limb [Part 1]: Parts, features and attachments of bones of lower limb:
hip bone, femur, tibia, fibula and tarsal bones.
13. Dissection: Lower Limb [Part 2]: Muscles and muscle groups of the lower limb; innervation
of muscles of lower limb; the concept of muscle pump; joints on which muscle and muscle
group act and movements they produce; anatomy of the femoral triangle, femoral canal,
adductor canal and popliteal fossa.
14. Dissection: Lower Limb [Part 3]: Blood supply and lymphatic drainage of the lower limb;
nerve supply of the lower limb the lumbar plexus and major nerves of the lower limb.
15. Dissection: Lower Limb [Part 4]: Joints and ligaments of the lower limb; movements at
each joint.
16. Dissection: Vertebral column [Part 1]: Bones, Parts, features and attachments of
vertebrae; cervical, thoracic, lumbar, sacrum and coccyx.
35
17. Dissection: Vertebral column [Part 2]: Joints and ligaments of the lower limb: movements
at each joint
18. Dissection: Thorax: bones and muscles of the thorax; intercostals space and contents;
diaphragm; anatomy of the breast; clinical relevance of lymphatic drainage of the breast; an
overview of organs present in the thoracic cavity; mediastinum.
Essential Reading:
Chaurasia Human Anatomy Volume 1, 2&3 ISBN-10 / ASIN: 8123911556 (v.1) ISBN
8123911564 (v.2) ISBN 8123911572 (v.3)Frank.H.Netter Netters Atlas of Human Anatomy
ISBN 9780808924234
Inderbir Singh Textbook of Human Histology Publisher Jaypee ISBN 9788180618093
Thomas W Sadler Langmans Embryology Published by Lippincott Williams & Wilkins,ISBN
9788184732207
Moore KL, Agur AMR. Essential Clinical Anatomy, Published by Lippincott Williams & Wilkins,
2006, ISBN 078176274X [or]
Snell RS. Clinical Anatomy - An Illustrated Review with Questions and Explanations, Lippincott
Williams & Wilkins, 2003, ISBN 0781743168
Other Recommended Texts and References:

Abrahams PH, Boon J, Hutchings RT, and Spratt JD. Mc Minn's Clinical Atlas of Human
Anatomy, Mosby, 2007, ISBN 0323036058
Drake RL, Vogl W, Mitchell AWM, Gray H, Tibbitts R, and Richardson P. Gray's Anatomy for
Students, Illustrated by Richard Tibbitts, Paul Richardson. Elsevier Churchill Livingstone, 2004,
ISBN 0443066124.
Gray H, Standring S, Ellis H, and Berkovitz BKB. Gray's Anatomy: The Anatomical Basis of
Clinical Practice, Elsevier Churchill Livingstone, 2005, ISBN 0443071683
Mc Minn RMH et al. Mc Minns Functional and Clinical Anatomy, Mosby, 1995, ISBN
0723409676
36
MCBM Element 2: General Physiology, Basics of Haematology,

and Nerve - Muscle Physiology
Organised and conducted by the Unit of Physiology
Synopsis: This course is designed to help the learner acquire core knowledge in the areas of
general physiology, basics of haematology and nerve muscle physiology. This Element is
completed in Term 1 of Year 1. MCBM Elements 1, 2 and 8 together constitute MCBM I (one of
the Components of Professional Examination I). Material in this Element complements that in
MCBM Elements 1 and 8 [Anatomy] and Elements 3 and 5 [Biochemistry]. Material taught in this
Element will form the basis for other MCBM courses in Term 2 of the programme as well the
systems courses taught in Year 2 of the programme.
Objectives:
At the end of this Element, the learner is expected to be able to:
Describe the structure and function of the eukaryotic cell membrane;
Classify and describe mechanisms of transport that operate to transport molecules across the
cell membrane with suitable examples;
Briefly illustrate different types of intercellular communication;
Classify body fluid measurements and describe the principle used in measuring them;
Illustrate the terms osmosis, osmolality, and tonicity; calculate osmolality of solutions and
classify dehydration based on tonicity of ECF;
Describe the concept of homeostasis with suitable examples and describe how homeostatic
mechanisms operate;
Classify formed elements of blood; describe how they are produced; and describe the
morphology of formed elements of blood and their functions;
Define anaemia, and predict the consequences of anaemia;
Describe the ABO and Rh system of blood groups and consequences of ABO and Rh
incompatibility;
Describe the mechanism of haemostasis;
Describe the functional organisation of neurons and glial cells;
Describe the mechanism of resting membrane potential and excitability of nerve and muscle;
Describe the functional organisation, the mechanism of excitation and contraction of skeletal,
cardiac and smooth muscle;
Describe similarities and differences in the functional organisation, electrical and mechanical
properties of different types of muscle;
37
Describe the mechanism of neuromuscular transmission with special reference to the

neuromuscular transmission in skeletal muscle;
Describe the basic mechanism of synaptic transmission and the types of responses produced
in postsynaptic neurons; and
Describe the structural and functional organisation of the autonomic nervous system.
T-L methods: 31 lectures, 8 interactive review sessions, 4 practicals (8 hr), 2 revision

sessions and 3 assignments
Contact hours: 51
The Curriculum:
Lectures:
General Physiology
1. What is medical physiology and why and how should you learn it?
2. Structure and function of the eukaryotic cell membrane: the fluid mosaic model of the
eukaryotic cell membrane; constituents of cell membrane; properties of the cell membrane;
types of proteins present in the cell membrane; modifications of the cell membrane tight
junctions, gap junctions, desmosomes, hemidesmosomes; examples of functions performed
by proteins in cell membrane.
3. Transport across cell membranes: classification of mechanisms of transport across cell
membrane passive transport (diffusion) versus active transport, types of active and passive
transport with examples for each, transcellular and paracellular transport; mechanisms
mediating transport channels and transporters, classification of channels, nomenclature for
transporters.
4. Regulation of the cell cycle: review of biologic significance of mitosis and meiosis; the
phases of the cell cycle; checkpoints in the cell cycle; regulation of the cell cycle; a note on
cyclins; consequences of dysregulation of the cell cycle.
5. A primer in intercellular communication: the need for communication between cells;
clarification of terms endocrine, paracrine, neurocrine, autocrine and juxtacrine
communication with examples for each; differences between these types of intercellular
communication.
6. Body fluid compartments: body fluid volumes in a healthy 70 kg adult male; principle used
in the measurement of body fluid volumes the indicator dilution principle; indicators for
various body fluid compartments; transcellular fluids; body composition - lean body mass, fat
mass, the principle used in the estimation of body fat content.
7. Osmosis, osmolality of body fluids & tonicity of physiologic solutions: clarification of
terms osmosis, osmotic pressure, osmotic equilibrium, osmole, osmolality, osmolarity,
38
effective and ineffective osmole with examples for each; the normal osmolality of plasma; the
equation for calculating plasma osmolality; calculating osmolality of a solution; the difference
between osmolality and tonicity of solutions; classification of dehydration on the basis of
tonicity of plasma; the physiologic rationale for differences in the treatment of different types
of dehydration; effects of administration of various solutions on osmolality and volumes of ICF
and ECF.
8. The concept of homeostasis: the concept of homeostasis; examples of homeostatic
mechanisms; references to Claude Bernards philosophy of constancy of the internal
environment; common misconceptions about homeostasis; clarification of the term steady
state;
9. Homeostatic control systems: components of a negative feedback control system
sensor, integrator, actuator, effector, and the mechanism of operation of a negative feedback
control system; negative feedback versus positive feedback; vicious cycle; feedback control
versus feedforward control with examples of each; capacity of homeostatic mechanisms.
Basics of Haematology
10. Bone marrow and haematopoiesis; classification of formed elements of blood: sites of
haematopoiesis at various stages in life; cells in the bone marrow; brief references to
modulation of haemopoiesis by haematopoietic growth factors (cytokines); classification of
formed elements of blood.
11. Structure and function of red blood cells (RBC): the electron microscopic structure of
RBC, the cytoskeleton in the RBC, differences between RBC and other cells; the basic
structure of haemoglobin; the reactions of haemoglobin with oxygen; oxygen carrying
capacity of haemoglobin; differences between Hb A and Hb F.
12. Erythropoeisis: steps in erythropoeisis; regulation of erythropoeisis; the role of
erythropoietin; other hormones regulating erythropoeisis; the role of vitamins and minerals in
erythropoeisis; consequences of deficiency of iron, vitamin B12, pyridoxine, folate on
erythropoeisis; iron metabolism.
13. Anaemia: normal blood haemoglobin levels in males, females, infants and children; definition
of anaemia; the physiologic basis for symptoms in individuals with anaemia; principles and
methods used in the estimation of haemoglobin; RBC indices MCV, MCH, MCHC, and red
cell diameter; classification of anaemias on the basis of RBC indices.
14. Blood groups: the basis for blood grouping; antigens in the ABO and Rh system;
Landsteiners law; basic principles used to determine compatibility prior to transfusion
universal donor, universal acceptor, cross matching; consequences of ABO and Rh
incompatibility reference to the mechanism of haemolytic disease of the newborn.
39
15. Leukocytes: an overview of leucopoiesis; morphology of various types of WBC as seen in a

stained blood smear; an overview of functions of leukocytes; the normal total leukocyte count;
the differential leukocyte count; common causes of leukocytosis and leukopenia; the
physiologic significance of leukocytosis; the distinction between leukocytosis and leukemia.
16. Plasma: the composition of plasma; packed cell volume (haematocrit); the relationship
between plasma volume and blood volume; physiologic functions of plasma proteins.
17. 2 lectures 17 and 18 on Haemostasis: platelets and their role in haemostasis; the clotting
cascade extrinsic, intrinsic and final common pathways; nomenclature of clotting factors;
synthesis of clotting factors; role of vitamin K in haemostasis; fibrin stabilisation; the
mechanism of fibrinolysis; clot retraction; anticoagulants in vitro versus in vivo and their
mechanism of action; consequences of deficiencies of platelets and clotting factors; bleeding
time, clotting time, prothrombin time and activated partial thromboplastin time.
Nerve-Muscle Physiology
19. Functional organisation of neurons and glia: functional organisation of neurons;
axoplasmic transport; glial cells types and functions; the role of Schwann cells;
neurotrophins.
20. 2 lectures 20 and 21 on Membrane potentials: genesis of the resting membrane potential;
measuring RMP; forces affecting ion flux across cell membranes the electrical and
chemical gradients and membrane permeability to ions; equilibrium potential of an ion - the
Nernsts equation; factors affecting the magnitude of RMP; effects of hyperkalemia and
hypokalemia on the RMP; the meaning of the term excitability; excitable tissues; responses
to sub threshold stimuli; the electrical response to a threshold stimulus; the all-or-none
phenomenon; the difference between electrotonic potentials and action potentials;
accommodation; refractory period in excitable tissue and the basis of refractoriness.
22. Properties of mixed nerve; nerve fibre types and function: properties of mixed nerve; the
compound nerve action potential; Erlanger-Gasser classification of nerve fibres; functions
mediated by different types of nerve fibres; differences in susceptibility of various types of
fibres to pressure, hypoxia and anaesthetics.
23. Functional organisation of skeletal, smooth and cardiac muscle
24. Neuromuscular transmission: the mechanism of transmission of impulse from nerve to
muscle special reference to neuromuscular transmission at the skeletal muscle
neuromuscular junction; the motor end plate potential; excitation-contraction coupling; the
pathogenesis of muscle weakness in myasthenia gravis and cobra venom intoxication.
25. Mechanism of contraction and relaxation of skeletal muscle: sequence of events starting
from depolarisation of muscle to muscle contraction; molecular basis of muscle contraction
40
and relaxation with special reference to skeletal muscle; mechanism of contraction of smooth
muscle; mechanism of contraction of cardiac muscle.
26. Properties of skeletal muscles in the intact organism: clarification of terms tone, motor
units, recruitment, innervation ratio; the mechanism of tone in skeletal muscle; types of
muscle fibres; the size principle; the compound muscle action potential and the surface
electromyogram; consequences of denervation of skeletal muscle.
27. Comparison of properties of skeletal, smooth and cardiac muscle: comparison of
functional organisation, electrical properties and mechanical properties of skeletal, cardiac
and smooth muscle.
28. Smooth muscle: Types ,properties, contraction and relaxation : Comparison of properties of
skeletal, smooth and cardiac muscle: comparison of functional organization, electrical
properties and mechanical properties of skeletal, cardiac and smooth muscle
29. Synapses: the basic structure of a neuronal synapse; types of synapses axosomatic,
axodendritic and axoaxonic synapses; the basic mechanism of synaptic transmission; types
of responses of postsynaptic neurons - excitatory and inhibitory postsynaptic potentials and
action potentials; the difference between postsynaptic potentials and action potentials;
classification of neurotransmitters and synapses as excitatory and inhibitory; the meaning
of synaptic integration; synaptic delay; synaptic fatigue.
30. Structural and functional organisation of the autonomic nervous system (ANS):
clarification of terms preganglionic and postganglionic neurons, effectors; neurotransmitters
released by preganglionic and postganglionic neurons in the two limbs of the ANS; the
craniosacral and thoracolumbar outflow from the central nervous system; the
parasympathetic nervous system as an anabolic system; reference to the sympathetic
nervous system as a mediator of emergency functions; some examples of effects of
activation of sympathetic nervous system; parasympathetic nervous system.
31. Neurotransmitters and neurotransmitter receptors in the ANS: nicotinic and muscarinic
cholinergic receptors; types of adrenergic receptors; examples of physiologic effects
mediated by each of these receptors; cotransmitters in the ANS; nonadrenergic
noncholinergic neurotransmission in the ANS.
Practical Sessions:
1. Determination of blood group
2. Differential leukocyte count
3. Determination of bleeding time, clotting time
4. Determination of motor nerve conduction velocity
41
42
Essential Reading:
nd
Marya RK. Medical Physiology, CBS Publishers, New Delhi, 2 edition, ISBN 8123909640 [or]
Ganong WF. Review of Medical Physiology, Mc Graw Hill Professional, 2005, ISBN 0071440402
Marya RK. Pathophysiology, CBS Publishers, New Delhi, 2006, ISBN 8123913443 [or]
McPhee SJ, Lingappa, Ganong WF. Pathophysiology of Disease, Mc Graw Hill, 2006, ISBN
007144159X

R.K.Marya ,Textbook of Medical Physiology ,CBS Publishers and distributors ,ISBN
9788123918471
Berne RM, Levy MN, Koeppen BM, and Stanton BA. Physiology, Mosby, 2004, ISBN
0323033903
Bijlani R L. Understanding Medical Physiology, 3rd ed., Jaypee Publishers, 2004.
th
Bullock J, Boyle J, Wang MB. Physiology, National Medical Series for Independent Study, 4
edition, 2001, Lippincott Williams & Wilkins, ISBN 0683306030
Ganong WF. Review of Medical Physiology, Mc Graw Hill Professional, 22nd edition, 2005, ISBN
0071440402
Guyton AC and Hall JE. Textbook of Medical Physiology, 11th ed. Philadelphia: Saunders,
2005.
Johnson LR, Essential Medical Physiology, Elsevier, 2003.
Marya RK et al. Learning Physiology Through New Style MCQ. CBS Publishers, 2001
Silverthorn DU. Human Physiology - An Integrated Approach. Pearson Education Limited, 2003,
ISBN 0131020153
Tortora GJ, Grabowski SR, and Derrickson BH. Introduction to the Human Body, The
Essentials of Anatomy and Physiology, Published by John Wiley & Sons, 2006, ISBN
0471691232
Widmaier EP, Raff H, and Strang KT. Vander's Human Physiology: The Mechanisms of Body
Function, McGraw-Hill, 2007, ISBN 007304962X
MCBM Element 3: Proteins, Enzymes and Molecular Biology

Organised and conducted by the Unit of Biochemistry
Synopsis: This course is intended to help you acquire core knowledge required for
understanding functions of cells you will learn about the structure and functions of proteins and
enzymes and the fundamentals of molecular biology. The relevance of this core knowledge to
clinical medicine will be illustrated as appropriate. This Element is linked with MCBM Element 5
(taught in Term 2) which will offer instruction in nutrition, metabolism and disorders of
metabolism.Content taught in this Element is complementary to content in MCBM Element 2 & 4.
Objectives:
At the end of this Element, the learner should be able to:
Describe the chemistry, function and classification of carbohydrates, lipids, proteins and
amino acids.
Describe the role of body proteins in health and disease.
Describe methods used to separate proteins.
Explain the basic and clinical aspects of enzymology and regulation of enzymatic activity.
Describe the structure of DNA and the mechanism of DNA replication and DNA repair.
Define, classify and describe the consequences of mutations in DNA.
Explain the molecular mechanisms of gene expression and regulation, the principles of
recombinant DNA technology and their application in medicine.
Describe the biochemical genetics of human disease.
T-L methods: 27 lectures, 4 practicals, 13 IRS and 2 sessions for student presentation
Contact hours: 54
The Curriculum:
Lectures:
1. Chemistry of carbohydrates: Classification of carbohydrates; overview of the chemistry of
glucose with emphasis on numbering of carbon atoms, isomers, ring formation and glycosidic
linkages; important disaccharides, polysaccharides, and mucopolysaccharides
(glycosaminoglycans)
43
2. Chemistry of lipids: Classification of lipids; brief overview of fatty acids, phospholipids,

triacylglycerols and cholesterol; eicosanoids and their biochemical actions.
3. Chemistry of Proteins: Role of protein molecules in cells; structure of amino acids;
classification of amino acids; effect of pH on side chain, ionisation (isoelectric pH); formation
of the peptide bond.
4. Protein structure: Levels of protein structure (primary, secondary, tertiary and quaternary);
forces which determine protein structure; protein folding and its importance; prion proteins;
pathogenesis of prion diseases.
5. Biological membranes: Introduction to membranes; functions of membranes; components
of membranes; membrane lipids - phospholipids, glycolipids and cholesterol; the importance
of cholesterol in cell membranes; membrane proteins (integral and peripheral proteins); the
fluid mosaic model of membrane structure.
6. Transport of solutes across membranes: Passive transport simple diffusion; facilitated
diffusion; ungated, ligand gated and voltage gated channels; ionophores; active transport
Na-K ATPase (the sodium-potassium pump), cotransporters, calcium pump; facilitated
transport types of carrier proteins (uniport, antiport and symport); clinical importance of
solute transport across membranes.
7. Techniques for separation of proteins and amino acids: Methods used for isolating and
studying proteins; principles, types and clinical applications of chromatography; principles,
types and clinical applications of electrophoresis.
8. Plasma proteins (clinical applications): Proteins in plasma; separation of plasma proteins;
functions of plasma proteins; clinical disorders (hypoproteinemia and hyperproteinemia).
9. Proteins: structure-function relationships [Part 1]: Structure of myoglobin and
hemoglobin, hemoglobin derivatives, structure-function relationships in myoglobin and
hemoglobin, formation of methemoglobin and its clinical significance.
10. Proteins: structure-function relationships [Part 2]: Structure, functions and biosynthesis
of collagen, diseases related to collagen abnormalities. Structure and organization of major
proteins of muscle.
11. Enzymes: Basic concepts of catalysis; classification of enzymes; coenzymes; mechanism of
action of enzymes.
12. Enzyme kinetics: Factors affecting enzyme activity; importance of the Km value; types of
enzyme inhibition and their clinical applications.
13. Diagnostic and Therapeutic use of enzymes: Factors determining release of enzymes
from cells; isoenzymes; diagnostic and therapeutic importance of enzymes;
14. Two lectures 14 and 15 on Fundamentals of molecular biology and genetics: Structure of
nitrogenous bases (purines and pyrimidines). Structure, function and biological role of
nucleosides and nucleotides. Structure, function and types of nucleic acids (DNA and RNA).
44
Structure and organisation of chromatin and nucleosome; organisation of genetic information

into chromosomes, construction of a karyotype. Flow of biological information; Overview of
mitosis and meiosis; significance of genetics in medicine.
16. DNA replication in prokaryotes and eukaryotes: The semiconservative
mechanism of DNA replication; initiation of replication; elongation of DNA polymers;
DNA polymerases; inhibitors of replication; and telomeres
17. Mutation: Definition of mutation; mutagens; types of mutation
18. DNA repair: Types of DNA damage; DNA repair mechanisms; defects in DNA repair
mechanisms.
19. Transcription in prokaryotes and eukaryotes: Definition and phases of transcription in
prokaryotes and eukaryotes; processing of primary transcript; inhibitors of transcription;
reverse transcription.
20. Translation in prokaryotes and eukaryotes: Genetic code; the wobble hypothesis. The
definition and phases of translation in prokaryotes and eukaryotes; post-translational
modification; inhibitors of translation; cellular targeting of proteins.
21. Regulation of Gene Expression: Organisation of prokaryotic and eukaryotic genes
definition of terms; operons; positive and negative control of gene expression. Organisation of
eukaryotic genes into introns and exons; regulation at the level of posttranscriptional
processing and posttranslational modification.
22. Genetic engineering (recombinant DNA technology): Recombinant technology and its
significance; DNA amplification cell based cloning; tools required for cloning; restriction
enzymes and restriction map; transformation; screening for recombinant vectors;
23. Techniques used in recombinant DNA technology: DNA amplification polymerase chain
reaction, genomic DNA library and cDNA library; nucleotide probes; blotting techniques;
restriction fragment length polymorphisms;
24. Two lectures 24 and 25 on Applications of genetic engineering: Production of therapeutic
proteins; viral vaccines; transgenic animals; gene therapy; Sequencing; Human Genome
Project.
26. Numerical and structural abnormalities of chromosomes: Non-disjunction; X
chromosome inactivation; autosomal abnormalities; sex chromosomal abnormalities.
Syndromes associated with structural abnormalities in chromosomes; translocations; fragile X
syndrome.
27. Introduction to single gene disorders: Single gene disorders; pedigree analysis; autosomal
dominant, autosomal recessive, X-linked dominant, X-linked recessive and Y-linked
inheritance
45
Practicals [4 sessions 3 hr each]

1. Introduction to laboratory techniques and basic concepts in biochemical calculations.
2. Serum enzyme diagnosis: Estimation of alanine transaminase; gamma glutamyl transferase
and creatine kinase.
3. Total serum protein and serum albumin estimation: Estimation of proteins and the
albumin/globulin ratio clinical case studies with interpretation of values.
4. Basics of molecular genetics: Preparation of DNA and identification of DNA using
electrophoresis.
Student Presentation: Topics are changed every year
Essential Reading:
Lippincott's Illustrated Reviews: Biochemistry (Lippincott's Illustrated Reviews Series) Richard A.
Harvey PhD, Denise R. Ferrier 5th Edition (2011) ISBN-10 1-6083-1412-X ISBN-13 978-1-608314126.
Other Recommended texts and references:

Textbook of Biochemistry for Medical Students 6th Edition DM Vasudevan , S Sreekumari &
Vaidyanathan Kannan ISBN 978-93-5025-016-7
Harper's Illustrated Biochemistry, 28th Edition (LANGE Basic Science) Robert Murray, Victor
Rodwell, David Bender, Kathleen M. Botham, P. Anthony Weil, Peter J. Kennelly. ISBN-10:
0071625917 | ISBN-13: 978-0071625913 |
h
Textbook of Biochemistry with Clinical Correlations, 7 edition 2010, Devlin TM. Wiley Medical,
ISBN 978-0-470-28173-4
46
MCBM Element 4:
General Pharmacology & Autonomic Pharmacology
Organised and conducted by the Unit of Pharmacology
Synopsis: This Element is designed to deliver basic and core content in general pharmacology
and autonomic pharmacology. Much of the content taught in MCBM Elements 2 and 3 (in Term 1
of Year 1) is prerequisite to understanding the rationale and mechanism of action of drugs.
Objectives:
At the end of this Element, students are expected to be able to:
Use terms commonly used in pharmacology;
Identify sources of drugs and sources of drug information;
List the advantages and disadvantages of various routes of drug administration;
Apply principles of clinical pharmacokinetics to dosage schedules;
Briefly explain the pharmacodynamics of drugs including adverse drug reactions and drug
safety;
Define compliance, prescription drugs, over the counter drugs, essential drugs;
State the various phases involved in the introduction of new drugs into therapeutics;
Name, classify and identify the roles of cholinergic and adrenergic receptors and their role in
the control of function of various organ systems.
Describe the mechanism of synthesis, storage, release and inactivation of neurotransmitters

at cholinergic and adrenergic synapses;
List the major classes of drugs influencing cholinergic and adrenergic neurotransmission,
their mechanism of action, pharmacologic effects and clinical uses; and
Classify skeletal muscle relaxants and describe their mechanism of action, pharmacologic
effects and clinical uses.
T-L methods: 20 lectures, 5 interactive review sessions, 2 practical sessions
Contact hours: 31
47
The Curriculum:
Lectures:
General Pharmacology
1. Introduction to pharmacology: history of pharmacology, scope of pharmacology,
nomenclature of drugs, and sources of drugs.
2. Basic pharmacokinetics [Part 1]: routes of drug administration; absorption of drugs; various
routes of drug administration advantages and limitations of each; factors affecting
absorption of drugs and bioavailability.
3. Basic pharmacokinetics [Part 2]: distribution of drugs, binding of drugs to proteins in
plasma; steps in biotransformation of drugs
4. Basic pharmacokinetics [Part 3]: routes of excretion of drugs; factors altering
pharmacokinetics
5. Clinical pharmacokinetics [Part 1]: the concept, measurement and significance of half life,
steady state concentration, clearance, and kinetics of elimination of drugs
6. Clinical pharmacokinetics [Part 2]: Dosage schedules; factors influencing dosage and
scheduling of drug dosages; therapeutic drug monitoring.
7. Pharmacodynamics: the mechanism of action of drugs with an emphasis on the concept of
drug action on specific cellular receptors and the role of second messengers.
8. Factors modifying drug action; potency and efficacy of drugs: effect of various factors
such as age, sex, multiple drug therapy, tolerance, pharmacogenetics etc on drug action and
its clinical significance; potency and maximal efficacy of drugs and their role in determining
choice of drugs.
9. Drug safety; adverse drug reactions: various adverse effects of drugs and therapeutic
index of drugs.
10. Miscellaneous topics: development and evaluation of new drugs; authenticated sources of
information on drugs; polypharmacy; compliance with drug therapy; rational drug therapy; the
concept of essential drugs.
Autonomic Pharmacology
11. Organisation of the autonomic nervous system and somatic nervous systems in
relation to their neurotransmitters and receptors
12. Cholinergic transmission: synthesis, storage and release of acetylcholine from neurons;
classification of cholinergic receptors; cholinomimetics; cholinergic drugs: esters of choline
and cholinomimetic alkaloids.
13. Anticholinesterases: the mechanism of action of anticholinesterases; reversible and
irreversible anticholinesterases and examples of each; pharmacological actions and clinical
uses of anticholinesterases; the rationale for their use in myasthenia gravis.
48
14. 2 lectures 14 and 15 on Anticholinergic drugs: examples; pharmacological actions; clinical

uses; adverse effects; uses and adverse effects; treatment of irreversible anticholinesterase
poisoning; clinically useful ganglion blockers.
16. Skeletal muscle relaxants: classification, examples, mechanism of action, pharmacological
actions, drug interactions, toxicity and clinical uses of neuromuscular blockers.
17. Adrenergic transmission and adrenoceptors: synthesis, storage and release of
noradrenaline and adrenaline; pharmacology of adrenergic transmission and drugs acting on
adrenergic receptors.
18. Sympathomimetics: pharmacology and the potential clinical uses of nonselective and
selective agonists; direct and indirectly acting sympathomimetic agents.
19. Alpha-adrenergic receptor blockers: classification, mechanism of action, therapeutic uses
and adverse effects of alpha-adrenergic receptor blockers.
20. Beta-adrenergic receptor blockers: classification, mechanism of action, therapeutic uses
and adverse effects of beta-adrenergic receptor blockers.
Practicals:
Dosage formulations
Prescription writing
Essential Reading:
Tripathi Essentials of Medical Pharmacology,Jaypee publishers,ISBN 9788184480856
Katzung BG. Basic & Clinical Pharmacology, Mc Graw Hill Professional, 2006, ISBN
0071451536
Recommended texts and references:
Bennett PN, Brown MJ. Clinical Pharmacology, Churchill Livingstone, 2007, ISBN 0443102449
Curtis M, Page C, Curtis M, Walker M, Sutter M, Hoffman B. Integrated Pharmacology, Mosby,
2004, ISBN 0323035698
Goodman LS, Brunton LL, Gilman A, Lazo JS, Gilman AG, and Parker KL. Goodman and
Gilmans The Pharmacological Basis of Therapeutics, McGraw-Hill, 2006
Howland RD, Mycek MJ, Harvey RA, Champe PC. Pharmacology (Lippincotts Illustrated
Reviews), Lippincott Williams & Wilkins, 2005, ISBN 0781741181.
Rang HP, Dale MM, Ritter JM, Lamb P, Flower RJ. Rang and Dales Pharmacology, Churchill
Livingstone, 2007, ISBN 0443069115
Tripathi KD. Essentials of Medical Pharmacology, Jaypee Brothers, 1988, ISBN 8171790
49
MCBM Element 5: Metabolism, Metabolic Diseases & Nutrition

Organised and conducted by the Unit of Biochemistry
Synopsis: This Element is intended to deliver core knowledge about the design and operation of
various metabolic pathways in cells, inborn and acquired metabolic diseases, as well as nutrition.
The relevance of this core knowledge to clinical medicine will be illustrated throughout this
Element. This Element is linked with MCBM Element 3 (taught in Term 1) which deals with
proteins, enzymes and the fundamentals of molecular biology and is complementary to content in
MCBM Elements 2, 4.
Objectives:
At the end of this Element, the learner should be able to:
Describe the metabolism of carbohydrates, lipids, proteins and nucleotides.
Describe the synthesis of heme and the porphyrias.
Describe how each of the above pathways is regulated.
Describe the biochemical mechanisms that operate to maintain blood glucose level.
Appreciate that deficiencies of not only enzymes but also cofactors can result in disorders of
metabolism.
Describe the relationship between metabolism of carbohydrates, proteins and lipids.
Discuss how metabolism of energy substrates is regulated in the fasting state, fed state,
muscular exercise and diabetes mellitus.
Describe the basic mechanism of electron transport and oxidative phosphorylation.
Briefly discuss how brown adipose tissue contributes to thermogenesis.
Describe the exogenous and endogenous pathways for transport of lipids.
Elaborate the steps involved in the catabolism of amino acids.
Describe how ammonia is detoxified.
Appreciate that there are mechanisms to synthesise some amino acids de novo.
Explain the terms RDA, caloric value of food and the importance of a balanced diet.
Explain what is meant by nitrogen balance and how this can be assessed.
Explain how carbohydrates, proteins and lipids are digested and absorbed.
List the sources and discuss the biochemical actions, effects of deficiency and excess of
vitamins and minerals.
T-L methods: 35 lectures, 12 interactive review sessions, 2 practicals, 2 student

presentation
50
Contact hours: 55
The Curriculum
Lectures:
1. Introduction to metabolism. Definition of metabolism: anabolism and catabolism; Overview
of carbohydrate metabolism.
2. Glycogen Metabolism and disorders Part I: Glycogen synthesis and breakdown
3.
Glycogen Metabolism and disorders Part II Regulation of glycogen metabolism;Glycogen

storage diseases.
4. Glycolysis: Reactions of glycolysis, regulation of glycolysis, inhibitors of glycolysis; the

Rapoport Luebering shunt,oxidation of pyruvate; the importance of acetyl CoA.
5. Gluconeogenesis: An outline of the role of liver in glucose homeostasis; the Cori cycle; the
glucose alanine cycle; the gluconeogenic pathway synthesis of glucose from alanine,
lactate and glycerol. Regulation of gluconeogenesis.
6. TCA cycle: Reactions of TCA cycle and its regulation; inhibitors of TCA cycle; amphibolic
role and anapleurotic reactions.
7. HMP shunt and uronic acid pathway: The generation of NADPH by the pentose
phosphate pathway; the significance of HMP shunt; glucose 6 phosphate dehydrogenase
deficiency.
8. Regulation of blood glucose levels: Regulation of blood glucose; metabolic derangements
in diabetes.
9. Metabolism of fructose, galactose and alcohol and its clinical relevance: metabolism of
Fructose, galactose and alcohol; Fructosuria, hereditary fructose intolerance (fructose
poisoning), galactosemia.
10. Introduction to lipid metabolism and oxidation of fatty acids I: A brief overview of the
metabolism of lipids; transport of fatty acids into mitochondria; the beta oxidation of fatty
acids ; energetics of beta oxidation of fatty acids.
11. Oxidation of fatty acids II: Alpha and omega oxidation of fatty acids, Metabolic defects of
fatty acid oxidation. Overview of breakdown of triacylglycerol in adipose tissue. Eicosanoid
metabolism.
12. Metabolism of ketone bodies: Ketogenesis; transport and breakdown of ketone bodies;
excessive production of ketone bodies in diabetes and starvation.
13. Fatty acid synthesis: Synthesis of fatty acids and its regulation. Overview of synthesis of
triacylglycerol in adipose tissue.
14. Metabolism of Cholesterol: Biosynthesis of cholesterol (in detail up to the level of
mevalonate and only a brief description thereon). Regulation of cholesterol synthesis; the
catabolism and excretion of cholesterol.
51
15. Metabolism of lipoproteins: Classification and importance of lipoproteins; the exogenous

and endogenous pathways for transport of lipids; disorders of lipid transport.
16. Bioenergetics, mitochondria and the electron transport chain: Introduction to
bioenergetics; structure of the mitochondrion; the electron transport chain; inhibitors of the
electron transport chain; the P/O ratio.
17. Oxidative phosphorylation: Outline of the chemiosmotic theory of oxidative
phosphorylation; inhibitors of oxidative phosphorylation; the mechanism of action of
uncouplers; the mechanism of thermogenesis in brown adipose tissue.
18. Metabolism of proteins [Part 1]: Important reactions in amino acid catabolism eg.
Transamination, decarboxylation, oxidative deamination; disposal of ammonia and the urea
cycle; disorders of the urea cycle.
19. Metabolism of proteins [Part 2]: Metabolic fate of amino acid carbon skeleton; overview of
metabolism of glycine, phenylalanine, tryptophan, tyrosine, and sulphur -containing amino
acids.
20. Metabolism of proteins [Part 3]: Defects in amino acid metabolism e.g Tyrosinemia,
phenylketonuria, alkaptonuria, albinism, carcinoid syndrome, maple syrup urine disease,
Hartnups disease,Homocystinuria.
21. Haem synthesis: Reactions and regulation of haem synthesis ; porphyrias.
22. Intermediary metabolism: The relation between metabolism of carbohydrates, amino acids
and lipids; metabolism in the fasted state, fed state and during exercise metabolic profiles
in muscle, liver and adipose tissue during these states.
23. Metabolism of nucleotides: Outline of de novo biosynthesis of purine and pyrimidines;
sources of atoms of purine and pyrimidine rings. Salvage pathway and its defects.
Degradation of purine and pyrimidine nucleotides; formation of uric acid; hyperuricemia
(gout). Severe combined immunodeficiency.
24. Basic principles of nutrition and importance of nutrition in metabolic disorders: Dietary
requirements; estimating nutrient intake; recommended daily intake; energy balance;
estimating energy expenditure; caloric value of food items; food guides.
25. Digestion of carbohydrates and nutritional importance of carbohydrates I: Digestive
enzymes, their action on dietary carbohydrates. Absorption of monosaccharides. Disorders of
digestion and absorption.
26. Digestion of carbohydrates and nutritional importance of carbohydrates II Nutritional
role of carbohydrates in diet; role of dietary fibre; glycemic index.
27. Digestion of lipids and Nutritional importance of lipids I: Digestive enzymes, their action
on dietary lipids. Absorption of lipids. Disorders of digestion and absorption.
28. Digestion of lipids and Nutritional importance of lipids II: Nutritional role of lipids;
naturally occurring fatty acids; relative proportion of fatty acids in lipids.
52
29. Digestion of proteins and Nutritional aspects of proteins I: Digestive enzymes, their
action on dietary proteins. Absorption of amino acids. . Disorders of digestion and absorption.
30. Digestion of proteins and Nutritional aspects of proteins II: Nutritional role of proteins;
protein turnover and amino acid pool; nitrogen balance and assessment of nitrogen balance;
Assessment of protein quality; protein-energy malnutrition.
31. Fat soluble vitamins: Classification of vitamins, chemistry, source, daily requirement,
biochemical role, and deficiency disorders of fat-soluble vitamins.
32. 2 lectures 32 and 33 : Water soluble vitamins : Chemistry, source, daily requirement,
biochemical role and deficiency disorders of water-soluble vitamins.
34 & 35. 2 lectures:Trace elements: Classification of minerals. Biochemical functions of major
and minor trace elements.
Practicals:
1. Practical on nutrition
2. Screening urine for inborn errors of metabolism aminoaciduria
3.
Essential Reading:
Lippincott's Illustrated Reviews: Biochemistry (Lippincott's Illustrated Reviews Series) Richard A.
Harvey PhD, Denise R. Ferrier 5th Edition (2011) ISBN-10 1-6083-1412-X ISBN-13 978-1-608314126.

Textbook of Biochemistry for Medical Students 6th Edition DM Vasudevan , S Sreekumari &
Vaidyanathan Kannan ISBN 978-93-5025-016-7
Harper's Illustrated Biochemistry, 28th Edition (LANGE Basic Science) Robert Murray, Victor
Rodwell, David Bender, Kathleen M. Botham, P. Anthony Weil, Peter J. Kennelly. ISBN-10:
0071625917 | ISBN-13: 978-0071625913 |
h
Textbook of Biochemistry with Clinical Correlations, 7 edition 2010, Devlin TM. Wiley Medical,
ISBN 978-0-470-28173-4
53
MCBM Element 6: Infection, Immunity, Inflammation, Cell injury and Repair

Organised and conducted by the Units of Microbiology and Pathology
Synopsis: This Element will provide core knowledge about the world of microbes that challenge
the human immune system, how our immune system is designed to meet this challenge,
mechanisms of infectious diseases caused by bacteria, viruses, fungi, and helminths - their
clinical features, laboratory diagnosis, drugs used in the treatment of infections, and principles
and methods of sterilisation and disinfection. You will realise that this knowledge is fundamental
to understanding the clinical features, clinical diagnosis, prevention and management of
infectious diseases. The last quarter of the Element is devoted to providing core knowledge about
the basic causes, mechanisms and types of cell injury and the mechanisms, types and outcome
of inflammatory processes.
Objectives:
At the end of this course the student should be able to:
Discuss the organisation of the immune system, and define and distinguish between active
and passive immunity, innate and acquired immunity, cell-mediated versus humoral
immunity, and primary and secondary immune response;
Describe the mechanism of the cell-mediated and humoral immune response;
Briefly discuss how the immune response is regulated and give examples of defects known to
result in autoimmune diseases;
Discuss the role of cytokines as mediators and regulators of the immune response;
Describe the role of complement proteins in plasma;
Discuss the consequences of immunodeficiency;
Describe the rationale for vaccination and outline the schedule of immunisation used in
Malaysia;
Appreciate differences in structure and physiology of bacteria, viruses and human cells;
Discuss mechanisms by which pathogens evade immune response and persist in the host;
Discuss the concepts of commensalism and pathogenicity, microbial properties relating to

pathogenesis and the links between commensalism and opportunistic infections;
Discuss the epidemiology of common infections acquired in the community and the hospital;
Elaborate upon pathogenesis, clinical features and laboratory diagnosis of infections caused
by Gram positive cocci, Gram negative cocci, mycoplasma, chlamydiae, rickettsiae,
enterobacteria, protozoans, viruses, fungi and helminths;
54
Discuss the principles underlying methods of sterilisation, disinfection and aseptic procedures
into day to day practice in the hospital;
Describe the mechanisms of action of each of the major antimicrobial agents and their
antimicrobial spectra;
Discuss mechanisms of resistance to an antimicrobial agent;
Gram stain, observe and interpret a smear of body fluid / infectious material;
Isolate bacterial colonies on pure culture;
Perform antibiotic susceptibility testing and interpret an antibiogram;
Discuss factors influencing the choice of use of antibiotics in a given situation;
Explain the causes, mechanisms, local and systemic effects of acute and chronic
inflammation;
Discuss the causes, types, mechanisms and consequences of cell injury; and
Discuss the mechanisms involved in repair of tissues following injury with special reference to
wound healing in the skin.
T-L methods: 51 lectures, 7 practicals, 2 symposia, and 13 IRS.

Contact hours: 91
The Curriculum
Lectures:
Immunity, Infectious Diseases
1. Basics of immunity: the meaning of the terms antigen, antibody, immunity; classification of
immunity - innate versus acquired immunity, active versus passive immunity, cell mediated
and humoral immunity; structure of antigens, characteristics of antigens; T dependant and T
independent antigens.
2. Antibodies: classification of immunoglobulins; structure of immunoglobulins; production of
antibodies by plasma cells; genes mediating isotype (class) switching; laboratory use of
antibodies.
3. Complement system: the classical and alternate pathways and their regulation;
physiological and pathological role of complement.
4. 2 lectures 4 and 5 on The immune response: properties of the immune response; cells
involved in the immune response; CD markers; maturation of T and B cells; types of T cells;
the mechanism of cell mediated immunity; the mechanism of humoral immunity; the link
between cell mediated immunity and humoral immunity; primary immune response versus
secondary immune response; characteristics of the immune response specificity, memory
and tolerance to self antigens.
55
6. Cytokines: their structure; general properties; cytokines mediating immune response; their
role in haemopoiesis; their role in growth and differentiation of lymphocytes.
7. Major histocompatibility complex (MHC): complex I, II, structure, physiologic importance,
transplantation; testing for histocompatibility.
8. Hypersensitivity: the meaning of hypersensitivity in relation to the immune response;
classification of hypersensitivity, examples of each type and the mechanism of each type of
hypersensitivity reaction the mechanism of anaphylaxis; antibody mediated effector
mechanisms; immune complex mediated inflammation and injury and the delayed
hypersensitivity reaction.
9. Immune tolerance: the meaning and mechanism of immunologic tolerance to self antigens;
mechanisms postulated to lead to development of autoimmune diseases.
10. Immune deficiency: primary and secondary immunodeficiency; congenital
immunodeficiency; iatrogenic immunodeficiency; consequences of immunodeficiency.
11. 2 lectures 11 and 12 on Infection and immunity: in bacterial, viral and parasitic infections
13. Principles of immunisation and the immunisation schedule: principles of immunisation;
immunisation schedule; difficulties in vaccine design and delivery; commonly used vaccines;
antigen delivery systems; adjuvants.
14. Introduction to microbiology and bacterial structure: an overview of the relationship
between man and bacteria in health and disease; an introduction to bacterial structure and
special reference to the differences between eukaryotic cells and prokaryotic bacteria;
structure of bacteria; differences between Gram-positive and Gram-negative organisms
15. Bacterial taxonomy and physiology: physiological characteristics of medically important
bacteria and how these can be used to classify them; an introduction to the physiology and
structure of bacteria and how this aids their ability to cause disease; a brief overview of how
bacteria can sense and respond to changes in the external environment.
16. Bacterial genetics: basic principles of molecular biology; extrachromosomal genetic
elements; genotypic and phenotypic variations; mutation; transformation; transduction;
lysogenic conversion; conjugation, transfer factors; genetic mechanisms of drug resistance,
transposons.
17. Normal bacterial flora; host-parasite relationship: commensals; examples of symbiotic
relationship between bacteria and humans; factors known to alter this relationship; an
overview of the dynamic interaction between parasites and the human host during health and
disease; illustration of the balance between host defence mechanisms and parasitic virulence
determinants.
18. Infections caused by gram positive cocci: staphylococcal and streptococcal infections with
examples of important diseases caused by them; general concepts in the laboratory
diagnosis of infections with gram positive cocci.
56
19. Mycoplasma, chlamydia and rickettsial Infections [Part 1]: classification; general
characteristics; cultivation; pathogenicity; pathogenesis; laboratory diagnosis; epidemiology;
prophylaxis; and treatment.
20. Mycoplasma, chlamydia and rickettsial Infections [Part 2]: classification; general
characteristics; cultivation; pathogenicity; pathogenesis; laboratory diagnosis; epidemiology;
21. 2 lectures 21 and 22 on Spirochetes: classification; general characteristics of treponemes,
leptospira, and borrelia; pathogenicity; pathogenesis; laboratory diagnosis; epidemiology;
23. 2 lectures 23 and 24 on Enterobacteriaceae: Escherichia coli, Salmonella, Shigella and
other members of enterobacteriaceae - general properties; pathogenicity; and laboratory
diagnosis.
25. Gastrointestinal bacterial infections: Vibrionaceae; Helicobacter, Campylobacter general
properties; pathogenicity; and laboratory diagnosis.
26. Anaerobic infections: sporing and nonsporing anaerobes; Clostridia and clostridial
infections - tetanus, food poisoning, gas gangrene and infections due to bacterioides.
27. 4 Lectures 27-30 on Intestinal protozoa; blood and tissue protozoa; intestinal
helminths; tissue helminths: basic concepts in parasitology; common parasitic infections;
life cycle of medical important parasites, an overview of mechanisms and features of
infections caused by them this block of lectures is augmented by thematic student
presentations the wormy world.
31. Viral structure and replication: size, structure and composition of viruses and how they
differ from bacteria; differences in structure between viruses and the variability of viral
genomes; how viruses replicate and how this differs from bacterial replication; how viral
replication damages the host cell; principles of laboratory diagnosis of viral infections.
32. Lectures 32-35 Common viral diseases: structure, modes of transmission; common
diseases, clinical presentation, laboratory diagnosis, and prophylaxis of infections with the
following viruses: HIV, dengue, rabies, herpes; emerging viral infections (influenza, Nipah).
36. Introduction to mycology; superficial mycosis: an introduction to the biology of fungi and
fungal infections; classification of fungi according to cell morphology and sexual spore
formation; principles of laboratory diagnosis of fungal infections; causes of superficial
mycoses; mode of acquisition of infection; predisposing factors; clinical manifestations;
laboratory diagnosis; prophylaxis.
37. Subcutaneous / deep mycoses: fungi associated with deep mycoses; mode of acquisition
of infection; predisposing factors; clinical manifestations; laboratory diagnosis; prophylaxis
38. Opportunistic mycoses
57
39. Epidemiology of infectious diseases: the importance of knowing and understanding the
epidemiology of infectious diseases; the mechanisms by which pathogens spread;
microbiologic tools used to investigate an epidemic; prevention of infectious diseases.
40. Principles of sterilisation and disinfection: the meaning of sterilisation, disinfection;
modern methods of sterilisation and disinfection and their efficacy.
41. Antimicrobials: introduction; discovery and development of antibiotics; mechanism of action
of antibiotics; bactericidal and bacteriostatic drugs; an overview of currently available agents
in terms of their microbial and molecular targets with examples; anti-bacterial agents; antiviral agents; anti-fungal agents; an overview of specific requirements that must be met for an
antimicrobial agent to be useful in clinical practice.
42. Important antibiotics and antimicrobial resistance: a detailed account of antibiotics which
act on the cell wall of bacteria with examples of the precise mechanisms of action and the
range of organisms for which commonly used agents are useful; factors affecting the choice
of an antimicrobial for treatment, the problem of antibiotic resistance.
Inflammation and Repair
43. Introduction to pathology: overview of pathology as a subject concerned with

understanding disease processes, its various subdivisions and the role of pathology in the
utility of diagnosis of diseases and interpretation of laboratory tests.
44. 2 lectures 44 and 45 on Cell Injury: etiology, types, mechanisms, pathogenesis and
morphology of reversible and irreversible cell injury; etiologies, cells involved, morphology,
mechanism and types of cell death: necrosis and apoptosis.
46. Cellular adaptation: patterns of cellular and tissue adaptations - atrophy, hypertrophy,
hyperplasia; and the phenomenon of metaplasia and dysplasia with examples of each.
47. Cellular accumulation: accumulation of pigments, fat, protein, calcium in cells pathologic
features and clinical significance; etiopathogenesis, types, identification and effects of
amyloidosis
48. 2 lectures 48 and 49 on Acute inflammation: acute inflammation, the early local vascular
response, cellular events, causes and effects, clinical signs, mediators of inflammation,
salient morphological features and diseases related to defects in the inflammatory response.
50. Chronic inflammation: chronic inflammation; characteristics of chronic inflammation, its
clinical effects; specialised form of chronic inflammation - granulomatous inflammation; the
distinction between acute and chronic inflammation.
51. Healing and repair: organisation and processes of tissue repair and healing; wound healing
process in the skin
58
Practicals (7 practicals, 3 hr each)

1. Examination of clinical specimens for presence of microbes; environmental microbiology
2. Growth and identification of micro organisms
3. Antibiotic sensitivity testing
4. Parasites
5. Yeasts and filamentous fungi
6. Inflammation
7. The haematopoietic response to inflammation
Symposia (2 symposia, 3 hr each)

1. The wormy world
2. Emerging and re-emerging infections
Essential Reading:
Mims CA, Dockrell H, Roitt I, Goering R, Wakelin D, Zuckerman M. Medical Microbiology,
Elsevier Mosby, 2004, ISBN 0323035752
The corresponding chapters in Vinay Kumar, Abul K Abbas, Nelson Fausto and Richard
th
Mitchell , Robbins Basic Pathology, Saunders Elsevier, 8 International Edition, ISBN 978-08089-2366-4

Microbiology:
Ananthanarayan R & Paniker CKJ. Textbook of Microbiology, 8th edition. Orient Longman,
2009
Helbert M & Nairn R. Immunology for Medical Students, Mosby, 2006, ISBN 10: 0-323-04331-3
Murray PR, Rosenthal KS, Pfaller MA. Medical Microbiology, Mosby, Elsevier, 2005, ISBN
0323033032
Sidhu HS, Kumari G and Rajesh PK. AIMST Microbiology Laboratory Manual, 2005 [contact Dr
P K Rajesh (rajesh.perumbilavil@gmail.com) for an electronic version]
Rajesh PK, Sidhu HS, AIMST FOM, Year 1 and Year 2 Microbiology Practical Log Book,
Updated 2011. An electronic version will be provided before the practical sessions commence.
Pathology:
Curran RC and Crocker J. Currans Atlas of Histopathology, Harvey Miller, London, 2000,
Harsh Mohan. Pathology: a quick review and MCQs. Anshan, 2005, ISBN 1904798209
Underwood JCE. General and Systematic Pathology, Churchill Livingstone, 2004, ISBN
0443073341
59
MCBM Element 7: Neoplasia

Organised and conducted by the Unit of Pathology
Synopsis: This course discusses both benign tumours and cancer with a focus on the basic
morphological and biologic properties of tumours, the understanding of the molecular basis of
carcinogenesis, interactions of tumours with the host and the host response to tumours along with
sections giving an overview of the clinical presentation of malignancy and the approach to
laboratory diagnosis of cancer.
Objectives:
At the end of this Element, the student should be able to:
Define neoplasia and distinguish it from hyperplasia and hypertophy.
Appreciate that the incidence of various cancers is influenced by age, gender, geographical
and other factors;
Discuss characteristics of a benign and malignant neoplasm in terms of gross, cytologic,

cytologic and architectural changes, cell differentiation, growth pattern, patterns of invasion
and metastasis.
Describe the fundamental changes in cell physiology that determine malignant phenotype
List carcinogens and describe mechanisms by carcinogens induce the development of

tumours in normal tissues;
Describe the molecular basis of carcinogenesis and the role of tumour suppressor genes in
preventing the formation of tumours;
Describe stages in the evolution of a malignant neoplasm in reference to the adenomacarcinoma model of colon cancer;
Discuss limitless replicative potential of tumours and angiogenesis associated with tumours.
Explain how the host (especially the immune system of the host) responds to the presence of
a tumour;
Describe how tumours metastasise;
Discuss methods used in the diagnosis of malignancy including cytology, histopathology,

frozen sections, biochemical, molecular and tumour markers;
Describe the clinical effects of persistence of a malignant tumour;
Appreciate that it is possible to detect cancer at an early stage by applying sensitive

screening methods;
60
T-L methods: 8 lectures, 2 practicals and 2 IRS

Contact hours: 16 hr
The Curriculum
Lectures
1. Introduction to neoplasia; epidemiology and classification of tumours: the definition of
neoplasia; the basis of histological classification of tumours; differentiation of tumours;
classification according to the organ of origin, tissue of origin, histological type, behaviour
(benign or malignant), clinical behaviour; basis of prognostication of tumours by grading and
staging; the distinction between benign and malignant tumours with reference to gross,
microscopic, architectural patterns, cell differentiation, growth patterns, invasion and
metastatic potential; incidence and prevalence of cancers with special reference to Malaysia.
2. 2 Lectures 2 and 3 on Molecular basis of cancer: Fundamentals of molecular basis of
cancer, fundamental changes in cell physiology that determine malignant phenotype of a cell;
definition and classification of proto-oncogenes, oncoproteins; inheritance of oncogenes and
tumour suppressor genes (Knudsons two-hit theory of cancer causation), tumour
angiogenesis.
4. Carcinogenic agents and their cellular interaction: carcinogenesis; chemical carcinogens;
radiation carcinogens; microbial carcinogens
5. Invasion and metastasis of cancer: modes of spread of cancer, the metastatic cascade
(extracellular matrix invasion, vascular dissemination, homing), molecular genetics of
metastasis development, grading and staging of malignancies.
6. Tumour immunity: tumour immunity, tumour antigens, anti-tumour effector mechanisms.
7. Diagnosis of cancer: histological, cytological, immunohistochemical, and molecular
diagnostic tools for diagnosis of cancer; tumour markers.
8. Clinical features of neoplasia; the prevention of cancer the effects of tumour on host
(cachexia, paraneoplastic syndromes); cytological, immunohistochemical and molecular
diagnostic tools for diagnosis of cancer; tumour markers; prevention of cancer; screening for
cancer.
Practicals:
1. Types of cancer: Students will be shown specimens, microscopic slides and posters of
epithelial and mesenchymal tumours.
2. Spread of cancer: Students will be shown how to identify the presence of a metastatic lesion
in an organ and will learn how to differentiate metastases from primary tumours.
61
Essential Reading:
th
Mitchell Robbins Basic Pathology, Saunders Elsevier, 8 International Edition, ISBN 978-08089-2366-4
Other Reference:
0443073341
62
MCBM Element 8: Structure of the Human Body 2

Organised and conducted by the Unit of Anatomy
Synopsis: This Element, essentially a continuum of MCBM Element 1, aims to provide the
learner with basic information about the structure of the human body specifically head and neck
and provides an overview of the anatomy of the nervous system. MCBM Elements 1, 2 and 8
together constitute MCBM I (one of the components of Professional Examination I). Material in
MCBM Elements 1 and 8 complements that in Element 2 [Physiology] and Elements 3 and 5
[Biochemistry]. Material learnt in this Element will form the basis for further study of the gross
anatomy, microscopic anatomy and development of tissues in the Organ Systems courses in
Year 2 of the programme.
Objectives:
At the end of this Element, the learner should be able to describe the:
Anatomy of the anterior abdominal wall, abdominal and pelvic viscera;
Reflections of the peritoneum;
Anatomy of the scalp, face and lacrimal apparatus;
Anatomy of the skull and cranial cavity;
Anatomy of structures in the triangles of the neck,
Anatomy of the pharynx, larynx;
Anatomy of the infratemporal fossa;
Anatomy of the eye and ear;
Anatomical organisation (including meninges) of the central nervous system;
Anatomical organisation of peripheral nerves (somatic and autonomic nerves); and
The events that occur in utero following fertilisation of the female gamete.
T-L methods: 16 lectures, 12 dissection sessions, 4 IRS

Contact hours: 44
The Curriculum:
Lectures:
1. Anterior abdominal wall: musculature and fascial layers; formation of rectus sheath and its
contents; relevance to surgical incisions; areas of natural weakness and development of
herniae; boundaries of inguinal canal; dermatomes and the concept of referred pain.
63
2. Abdominal organs and peritoneum: disposition of abdominal organs and their inter
relationships; reflection of peritoneum on the abdominal organs; different folds, omentum,
ligaments and peritoneal fossae; greater and lesser sacs of peritoneum; foramen of Winslow.
3. Posterior abdominal wall & Pelvis: Muscles, vessels and nerves of posterior abdominal
wall; Pelvis: Bony pelvis, reflection of peritoneum in pelvic floor, pelvic diaphragm. Blood
vessels of pelvis and overview of pelvic contents; pelvic viscera.
4. Head & Neck [Part 1]: Skull and cranial cavity: skull bone; anterior, middle and posterior
cranial fossae.
5. Head & Neck [Part 2]: Scalp, face and lacrimal apparatus: different layers of scalp and their
clinical importance; muscles of facial expression, nerve supply of face; blood supply and
lymphatic drainage of face; lacrimal apparatus.
6. Head & Neck [Part 3]: Triangles of neck: anterior and the posterior triangles of the neck;
their boundaries and contents.
7.
Head & Neck [Part 4]: Infratemporal fossa: maxillary artery,mandibular nerve; muscles of
mastication and temporomandibular joint.
8. Head & Neck [Part 5]: Orbit & Eye: Bony orbit, structure of the eye ball; extra ocular
muscles: their innervation,nerves and vessels of orbit.
9. Head & Neck [Part 6]: Ear: anatomy of the ear - external, middle and internal ear; tympanic
membrane; ear ossicles; bony and membranous labyrinth.
10. Brain, its meninges and spinal cord: major divisions of the brain, meninges & CSF
11. Cranial nerves: origin and course of cranial nerves; structures innervated by cranial nerves.
12. Peripheral nerves and autonomic nerves: organisation of somatic and autonomic nervous
systems; anatomical organisation of reflexes and their clinical importance; lumbar puncture
13. Embryology [Part 1]: Fertilisation, implantation: hormonal events resulting in ovulation;
fertilisation; changes in the zygote following fertilisation; implantation.
14. Embryology [Part 2]: Formation of the trilaminar embryo disc: the establishment of the
uteroplacental circulation, enlargement of the syncytiotrophoblast; formation of germ
layers.
15. Embryology [Part 3]: Neurulation: establishment of the cranio-caudal axis;
somatogenesis; origin of bone and muscle tissues; formation of neural tube and the
primitive gut: foregut, midgut and hindgut.
16. Embryology [Part 4]: Pharyngeal arches: Formation and derivatives of arches,clefts and
pouches.
64
Dissection [12 sessions, 2 hr each]

1. Anterior abdominal wall: surface anatomy and division into clinical areas; demonstration of
rectus sheath and its contents; relevance to surgical incisions; areas of natural weakness;
inguinal canal.
2. Abdominal organs and peritoneum: demonstration of different abdominal organs and their
interrelationships; examination of palpable organs; reflections of peritoneum on abdominal
organs; different folds, omentum, ligaments and peritoneal fossae; blood supply of viscera;
demonstration of the foramen of Winslow.
3. Posterior abdominal wall & Pelvis: Muscles,vessels and nerves of posterior abdominal
wall. Pelvis:Bony pelvis, reflection of peritoneum in pelvic floor, pelvic diaphragm. Blood
vessels of pelvis and overview of pelvic contents; pelvic viscera.
4. Skull & cranial cavity: the anatomy of skull and the cranial fossae.
5. Scalp, face and lacrimatory apparatus: different layers of scalp,blood supply,nerve supply
and their clinical importance; muscles of facial expression, nerve supply of face; blood supply
and lymphatic drainage of face and lacrimal apparatus.
6. Triangles of neck: posterior triangle and anterior triangle; subdivisions, boundaries and
contents.
7. Infratemporal fossa: maxillary artery ,mandibular nerve; muscles of mastication;
temporomandibular joint.
8. Orbit & eye: bony orbit,structure of the eye ball; extra ocular muscles: their innervation,
nerves and vessels of orbit.
9. Ear: anatomy of the ear - external, middle and internal ear; tympanic membrane; ear
ossicles; bony and membranous labyrinth.
10. Brain, spinal cord: major divisions of the brain; spinal cord and meninges.
11. Cranial nerves: cranial nerves at the base of the brain.
Essential Reading:
Williams & Wilkins, 2003, ISBN 0781743168 [or]
Mc Minn RMH et al. Mc Minns Functional and Clinical Anatomy, Mosby, 1995, ISBN
0723409676
Abrahams PH, Boon J, Hutchings RT, and Spratt JD. Mc Minn's Clinical Atlas of Human
Anatomy, Mosby, 2007, ISBN 0323036058
65
Drake RL, Vogl W, Mitchell AWM, Gray H, Tibbitts R, and Richardson P. Gray's Anatomy for
Students, Illustrated by Richard Tibbitts, Paul Richardson. Elsevier Churchill Livingstone, 2004,
ISBN 0443066124.
Gray H, Standring S, Ellis H, and Berkovitz BKB. Gray's Anatomy: The Anatomical Basis of
Clinical Practice, Elsevier Churchill Livingstone, 2005, ISBN 0443071683
2006, ISBN 078176274X
Sadler TW, Langman J, and Leland J. Langman's Medical Embryology, Published by Lippincott
66
HBM Element 1: Society, Health and Medicine

Course Code: MHBM 31101
Organised and conducted by the Unit of Community Medicine
Synopsis: This Element is designed to help you understand the variety of social factors that
influence perception of health, illness and the impact of illness.
Objectives:
Upon completing this Element, you should be able to:
View peoples behaviour from a sociological perspective and apply it to a variety of social
problems and situations;
Appreciate the influence of culture gender, ethnicity, social structure and health systems on
illness behaviour;
Appreciate the dynamics in the relationship between a doctor and patient; and
Appreciate the role of good communication in health care.
T-L methods: 8 lectures; 8 interactive sessions with case studies
Contact hours: 16
The Curriculum:
1. Social determinants of health and disease: theories of health and disease; social and
psychological factors affecting health; biological pathways of social causes of disease.
2. Perceptions and experiences of illness and disability: ways in which health is
conceptualised; the distinction between illness and disability; the distinction between lay
experiences of living with chronic illness and professional understanding of the management
of chronic illness; models of disability; the distinction between a social and a medical model
of disability; stigma and social dimensions of perceived stigma; how issues of labelling,
stigma and embarrassment affect those with chronic disease; improving quality of life in
incurable conditions.
3. Family, society and sick role: family role and society; family relationships in contemporary
society; family interaction and the sick role.
4. Communication and interviewing: different components of the communication process;
barriers impeding communication; skills needed to be an effective interviewer; probing,
reflecting, paraphrasing and summarising.
67
5. Gender and health: the distinction between sex and gender; ways in which gender affects
health and illness; methods to overcome negative influences of gender on health of
individuals and families.
6. Doctor-patient relationship: the sick role; the traditional view of the doctor-patient
relationship and potential problems with this point of view; different types of doctor-patient
relationships from the paternalist to the shared and consumerist approach; the concepts of
shared decision making and concordance and their relevance to medical practice.
7. Seeking health care and medical pluralism: the concept of the 'clinical iceberg'; how lay
people decide when something is wrong; 'social triggers' which can influence the decision to
seek medical help; role played by others in influencing the decision to seek help (lay referral
system); cultural variations in health-seeking behaviour; the concept of medical pluralism (the
co-existence of different medical traditions), and the key features of medical pluralism; healthseeking limited by availability of health care; a non-biomedical framework for understanding
health care systems.
8. Social structure and health: social patterns in health and illness across time and place and
different social groups; how sociology uses ideas about the structure of societies to
understand patterns of health and illness; class, poverty, gender and race how position or
status in a society or hierarchy can influence health and illness.
References:
Cockerham. Outlines & Highlights for Medical Sociology by Cockerham, Cram101, 2006.
Lomas P. Personal disorder and family life, Transaction Publishers, 1998.
Macionis JJ. Sociology: A Global Introduction, Prentice Hall, 2000, ISBN 0130184950
Scambler G. Sociology as Applied to Medicine, Elsevier Health Sciences, 2003, ISBN
0702026654
68
HBM Element 2: Epidemiology

Synopsis: The focus of this Element will be on helping you learn the scientific method of
investigating, analysing, preventing and controlling health problems in a population.
Objectives:
At the end of this module, the student should be able to:
Describe the basic concepts, principles and methods of epidemiology and their
applications in public health and research;
Discuss the factors which affect disease patterns and describe disease patterns in
developing and developed countries;
Describe the influence of environmental, behavioural and social factors, infectious

agents, and chronic degenerative illnesses on the health of a population;
Measure occurrence of health related status in human populations using epidemiological

methods and the use of routinely available data sources;
Describe the main types of epidemiological studies, their advantages and disadvantages
and identify study designs used in medical research; and
Describe how causation and risk are determined.
T-L methods: 16 lectures; 8 interactive 2 hours PBL sessions.

Contact Hours: 32
The Curriculum:
Lectures:
1. Introduction to this course: course objectives, organisation, textbooks, and assessment.
2. Dynamics of health: what is health; the philosophy of health; natural history of disease;
disease prevention and measures of health - mortality and morbidity, life expectation, healthy
life expectancy and life expectancy free of disabilities, quality adjusted life years (QALYs),
and disability-adjusted life years (DALYs).
3. Introduction to epidemiology and epidemiological concepts: definition, scope, uses of
epidemiology; basic epidemiological concepts (communicable and non-communicable
diseases), the epidemiological triad: agent, host and environment and (vectors); spectrum of
diseases, the iceberg phenomenon; characteristics and importance of chronic
noncommunicable diseases.
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4. Measuring health and morbidity: measures of disease frequency; prevalence and factors
affecting prevalence; incidence rate; cumulative incidence rate.
5. Measuring health and disease mortality: mortality rates - crude death rate; infant
mortality rate; maternal mortality rate.
6. Epidemiological studies and observational studies - cross sectional studies:
classification and overview of epidemiological studies; types, uses and limitations of
descriptive studies; describing disease patterns in a population and application in clinical
practice; analysis of descriptive data: time, person, place; types of observational studies;
cross sectional study -design, objectives, uses, advantages and disadvantages.
7. Case control studies and cohort studies: relationship and role of analytical
epidemiological studies; types of analytical studies; case control and cohort study design,
objectives and uses; advantages and disadvantages of case control and cohort studies;
comparison of case control and cohort studies
8. Risk: define risk, risk factors and different types of risks; measurement, assessment and
interpretation of risk in epidemiological studies; communication of information about risk.
9. Interventional studies: difference between randomised and non-randomised intervention
studies and observational studies; key features of randomised controlled trials and reasons
for their importance; obstacles to doing randomised controlled trials.
10. Patterns of diseases in Malaysia and worldwide: characteristics of a developing country;
population structure and population pyramid; morbidity and mortality patterns in developed
and developing countries; major health problems in developing countries and solutions.
11. Screening: definition and rationale for screening; types of screening programmes; criteria for
screening programmes; intervals for screening bias; ethical considerations.
12. Causation: differences between association and causation; the framework against which
causation may be judged in epidemiological terms.
13. Disease prevention and health promotion: definition, levels of prevention; the concept and
principles of health promotion and health education; health promotion programmes; ethics of
health promotion.
14. Communicable disease epidemiology: definition of epidemiological terms; control of
communicable disease host resistance, chain of infection, transmission, international
health, surveillance, notification of disease and legislation; epidemic investigation and
management.
Seminars:
1. Health care system
2. Data analysis of health and morbidity surveys of Malaysia
70
Problem based learning sessions (with a brief statement of objectives of each session):
1. Descriptive data presentation, analysis, interpretation I
Discuss different types of data and to discuss the analysis and interpretation of data
presented in various studies.
2. Descriptive data presentation, analysis, interpretation II
Discuss the presentation of descriptive data and to discuss how to analyse and interpret data
presented in various studies
3. Descriptive data presentation, analysis, interpretation II I
Discuss the presentation of descriptive data and to discuss how to analyse and interpret data
presented in various studies
4. Designing case control & cohort studies
Explain the steps in designing various studies and the methodology of analysis.
5. Estimating and interpreting risk in a clinical setting
Estimate and interpret analytical epidemiological data; interpretation of risk in a clinical
setting.
6. Screening
To understand the principles of screening and application of the screening tests and to
identify the components of evaluation of screening tests
7. Interpretation of studies I
To identify the design and interpret the results of a study
Critically evaluate the methodology and the results of a study.
8. Interpretation of studies II
To identify the design and interpret the results of a study
Critically evaluate the methodology and the results of a study.
Required Reading:
Abdul Rashid Khan, K A Narayan. Lecture Notes in Epidemiology, AIMST University 978-98343522-0-2 [or] Gordis L. Epidemiology, Saunders, 2004 ISBN 0721603262
Recommended Reading:
Beaglehole R, Bonita R and Kjellstrom T. Basic Epidemiology, World Health Organisation,
2006, ISBN 9241547073
Farmer RDT, Lawrenson R. Epidemiology and Public Health Medicine [Lecture Notes],
Blackwell Publishing, 2004, ISBN 1405106743
Jekel JF, Elmore JG, Katz DL. Epidemiology, Biostatistics and Preventive Medicine; WB
Saunders, 2001, ISBN 0721690793
Park K. Parks Textbook of Preventive & Social Medicine. Banarsidas Bhanot ISBN
8190128280
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HBM Element 3: Biostatistics

Synopsis: The main emphasis in this element is on teaching students basic principles of
statistics and their application in understanding and critically evaluating articles and reports in
medical journals and in the conduct of simple research. The course will introduce students to both
descriptive statistics and inferential statistics. Lectures are complemented by an equal duration of
hands-on training with data analysis in the computer laboratory.
Objectives:
At the end of this module, the student should be able to:
Describe the basic concepts, principles and methods in the field of statistics and its
applications in public health, medicine and research;
Collect, organise and analyse their data scientifically;
Present the findings of statistical analysis in the form of tables charts and graphs
Differentiate descriptive and inferential statistics;
Describe the purpose and the basic concept of each statistical procedure and tests of
significance; and
Critically analyse a journal article.
T-L methods: lectures and practical sessions in computer lab
The Curriculum [sequence of T-L experiences lectures as well as lab sessions]

L1 - Introduction to statistics: what is biostatistics; the need for statistics in medicine; the
difference between data and information; sources of data advantages and disadvantages of
each.
Practical: Brain storming on data collection
L2 - Types of data and data collection: primary, secondary and tertiary data; categorical
versus numerical data; data collection methods and tools; developing and using instruments
for data collection; using a computer to analyse data; making frequency tables
Practical: Data collection by students
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L3 - Sampling and sampling methods: defining a population, sample; different methods of

sampling their advantages and disadvantages; selecting a suitable sampling method for a
given situation; calculating sample size
Practical: Sampling methods and data collection
L4 - Descriptive statistics - numerical summaries: the definition, calculation, uses and

limitations of mean, median and mode; differences between various measures of dispersion
and their uses; calculating summary statistics for a given data set; constructing a frequency
table.
Practical: Numerical summaries for data.
L5 - Descriptive statistics - graphical summaries: selecting a suitable graph for a data set;
identifying various types tables, charts, and graphs used in data presentation; selecting
appropriate diagrammatic presentations for different types of data obtained in a survey;
generating bar chart, pie chart, histogram, stem and leaf plot, box and whisker plot, scatter
diagram for a data set using a computer.
Practical: Graphical summaries for data.
L6 - Clinical measurement: clinical measurement and its significance in medicine; sources

of variation in data collection and interpretation; accuracy, precision and bias in data
collection; diagnostic measures yielding data and their validity; measures to minimise
variability
Computer lab exercise: data collection using different instruments
L7 - Probability and the normal distribution: laws of probability; different types of

probability distribution and its importance in data analysis.
Session 8 - Student Presentation
L9 - Statistical significance and hypothesis testing: inferential statistics; confidence

interval and calculation of confidence intervals.
L10 - Statistical tests: research hypothesis; statistical hypothesis; research and statistical
hypothesis for different types of data; the difference between type I and type II errors;
choosing a statistical test
L11 - Comparing means (Computer Lab Session): Choose and apply statistical tests for
comparing mean using computer software.
L12 - Chi square test: choosing and applying statistical tests for comparing proportions
L13 - Comparing proportions: choosing and applying statistical tests for comparing
proportions.
L14 - Correlation and regression
Session 15: Student presentation
Session 16: Critical appraisal of medical literature: steps in the review of a scientific
article; searching print and electronic media for medical literature; selecting an appropriate
73
article for review; identifying the research question, study design, sampling methods and
statistical tests, summarising and discussing the salient findings and discussing the strengths
and weaknesses of a study.
Daly LE, Bourke GJ. Interpretation and Uses of Medical Statistics, Blackwell Publishing, 2000,
ISBN 0632047631
Farmer RDT, Lawrenson R. Epidemiology and Public Health Medicine [Lecture Notes],
Blackwell Publishing, 2004, ISBN 1405106743
Hill AB. A Short Textbook of Medical Statistics, Hodder and Stoughton, 1977, ISBN 0340219572
Jekel JF, Elmore JG, Katz DL. Chapter 14, In: Epidemiology, Biostatistics and Preventive
Medicine; WB Saunders, 2001, ISBN 0721690793
Moore DS. The Basic Practice of Statistics, Academic Internet Publishers, 2006, ISBN
142881437X
Munro BH. Chapter 2 In: Statistical Methods for Health Care Research, Lippincott Williams &
Wilkins 2005, ISBN 078174840
74
HBM Element 4: Ethics in Medicine

The MBBS programme seeks to train you into doctors who are not only professionally competent
but who also promote the health and welfare of the people they treat, respecting their dignity,
autonomy and rights. For this, you need to understand the universal principles of ethics and their
applications to medical practice. This Element will provide you with the required knowledge base
and exemplify it with suitable illustrations.
Objectives:
At the end of this course, students will be able to:
Describe ethical principles and values underpinning good medical practice with suitable
examples;
Start to think critically about ethical issues in medicine reflecting upon their own beliefs and
ethics;
Demonstrate an understanding of alternative and sometimes competing approaches and to

be able to argue and contribute to informed discussions and debates on ethical issues in
medical practice;
List duties of doctors as enunciated by the institutions which regulate or influence medical
practice;
Describe legal processes involved in medical practice and legal obligations of medical
practitioners to an extent sufficient to enable them to practice medicine effectively and with
minimal risk;
Appreciate that unethical and legal reasoning and critical reflection are natural and integral
components in their clinical decision making and practice; and
Understand that ethical and legal issues arise not only in extraordinary situations in medicine
but occur in everyday practice.
T-L methods: lectures and interactive discussions of cases.
Contact hours: 16; this element consists of 8 lectures including patient case scenarios and
a group discussion (two hours each).
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The Curriculum:
1. Introduction to medical ethics: medical ethics; the Hippocratic Oath; principles of ethics.
2. Confidentiality: what is confidentiality, the importance of confidentiality; exceptions to
confidentiality; breach of confidentiality
3. Informed consent and refusal to treatment: informed consent; criteria for consent to be
valid; situations that require informed consent; situations in which it is appropriate or
inappropriate to question a patient's ability to participate in decision making; course of action
when informed consent cannot be obtained; implied consent; negotiating a refusal of life
sustaining treatment or demand for futile treatment.
4. Truthfulness: moral dilemmas of truth telling in medicine; arguments supporting truth telling;
exceptions to truth telling.
5. Medical research: historical events that have influenced current ethical guidelines and
regulations; fundamental principles of ethics that govern conduct of research involving human
participants; the role of international guidelines in the protection of human subjects
participating in research; issues to consider when selecting participants for a study and
policies and regulations that apply to special groups; privacy and confidentiality as it applies
to protecting human participants; maintaining privacy and confidentiality throughout the
process of research; elements of informed consent that should be included in documentation
of informed consent; conditions that may affect a person's capacity to consent; emerging
issues in informed consent; special challenges to investigators conducting international
research.
6. Resource allocation: resources of the national health care delivery system; allocation of
health care resources in the context of theories of justice; rationing and fair and equitable
distribution of health resources; boundaries of responsibility of individuals for their own illness
and ethical considerations.
7. Ethical issues in health promotion: the conflict between the goals of health promotion and
the rights of individuals as personal autonomy; relevance of the amount of beneficence and
non-maleficience that may arise from health promotion initiatives; ethical principle of justice in
relation to benefits to the health of the public as compared to the amount of funding needed
for health promotion activities with the goal of reducing inequities in health between the rich
and poor in a population.
8. Good medical practice: golden rules of good medical practice; code of professional
conduct; infamous conduct; regulatory bodies governing medical practice in Malaysia.
76
References:
A Campbell, G Gillett, G Jones. Medical Ethics, Oxford University Press, 2001, ISBN
0195584457
General Medical Council, UK. Tomorrows Doctors http://tiny.cc/tc79b
Malaysian Medical Association. Code of Medical Ethics. Malaysian Medical Association. Feb
2002
Malaysian Medical Council. Code of Professional Conduct available at

http://mmc.gov.my/v1/docs/Code_of_Professional_Conduct.pdf
Malaysian Medical Council. Duties of a Doctor. available at

http://mmc.gov.my/v1/docs/Duties%20of%20A%20Doctor.pdf accessed 15 Sep 2008
Website of the University of Washington School of Medicine. Ethics in Medicine.

http://depts.washington.edu/bioethx/topics/index.html accessed 15 Sep 2008
77
HBM Element 5: Primary Care Interface

Organised by the Unit of Community Medicine
Aims:
This Element aims to introduce students to:
Clinical problem solving with an emphasis on patient's problem / diagnosis;
Primary and secondary care interface with an emphasis on patient's narration of his / her
hospital experiences;
The use of communication skills both with patients and with colleagues; and
The infrastructure of health systems.
Objectives:
At the end of the course the students should be able to:
Record the clinical problem(s) / episodes of illness of the patient;
Collect information on a patients experience while he/she is admitted in the hospital;
Describe the infrastructure for public health in a state and the system of referral between
institutions;
List the different categories of health personnel and discuss their roles in the care of the
patient at different levels; and
Discuss the principles of health economics and their relevance to health care.
Be familiar with the following clinical skills / techniques performing basic life support; hand
washing and gloving; transferring a patient; and bandaging
This Element consists of 10 afternoon sessions (3 hr each) and will be conducted at Hospital
Sungai Petani and Hospital Yan. 6 days will be devoted to interface with primary heath care and 4
days are allotted for training students in basic life support.
T-L methods:
Students will collect the data based on the following:
Hospital infrastructure
Morbidity patterns
Drugs and supplies
Referral system
Health economics
Students will visit the following areas in the hospital / health centre:
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Administrative Office
Wards in the following departments: Medicine, Surgery, OB-GYN, Pediatrics
Emergency & Outpatient Departments
Pharmacy / Drug store
Laboratory
Students will learn the following techniques in the Clinical Skills Centre:
Basic Life Support
Patient Transfer
Bandaging
Medical Handwashing
Gloving
Students will be briefed about the objectives of the programme before they go to the hospital.
Each student will be assigned respective areas in the hospitals to write up during their postings.
Specific questionnaire will be given to each group of students to collect relevant data from
respective areas in the hospital. The write up must briefly describe the following:
The infrastructure available at each level of the health care delivery system;
The expenditure involved at each level of health care;
Patients illness or clinical problems and the morbidity pattern;
Patients narration of his/her hospital experience, including whether patient was referred and
if so the procedure used to refer him to the hospital;
Brief description of the socio-economic disruption the individual/family faces due to the
illness;
When and with whom patient seeks follow-up care on discharge from the hospital; and
Comment on the referral system practiced in Hospital Sungai Petani, Yan and Klinik
Kesihatan, Merbok.
Total contact hours: 30 hours
79
Details of Courses in Year 2

Cardiovascular System (CVS)
Course Code: MCVS 32101
Synopsis: This course is intended to prepare you to learn cardiovascular medicine from patients
with problems affecting the CVS in the clinical phase of the programme. Thus, it is designed to
provide you with core knowledge of the structure and functions of the CVS. This is followed by
lectures on pathological processes and pathogenetic mechanisms underlying various clinical
conditions affecting this system, aetiologies, mechanisms and clinical features including infections
affecting this system and the rationale for the use of drugs in specific conditions affecting this
system. 20 hr of clinical skills training is integrated into this course this will provide you with
basic information regarding history taking from patients with cardiovascular symptoms,
performing a physical examination of the CVS. Additionally, there are clinical lectures covering
the aetiology, pathogenesis, clinical features and principles of management of important and or
common clinical conditions such as hypertension, or lectures on clinical approach to patients with
specific symptoms (example angina) affecting the CVS. 2 PBL scenarios designed to foster
learning of basic science content relevant to medicine augment this sequence of T-L experiences.
Objectives:
At the end of this course, the learner should be able to:
Describe the anatomy of the heart and great vessels originating from the heart;
Describe the histological features of blood vessels;
Describe the sequence of events in the embryological development of the heart;
Describe the origin and conduction of the cardiac impulse;
Describe how heart rate is regulated by the autonomic nervous system;
Describe how a 12 lead ECG is recorded, waves, complexes and intervals in a normal ECG
and the physiologic basis of each wave, wave complex and interval;
Describe the sequence of electrical events and mechanical events in the cardiac cycle;
Describe how cardiac output is regulated to meet tissue demands for nutrients and oxygen;
Elaborate on physical laws applicable to understanding functions of the heart and dynamics
of blood and lymph flow;
Describe the functional organisation of the microcirculation and mechanisms by which tissues
regulate their own blood flows;
Elaborate on the role of neural and humoral mechanisms that regulate cardiovascular
function;
80
Describe how arterial blood pressure is regulated by arterial baroreceptors and other
mechanisms;
Describe the mechanisms that operate to maintain blood volume;
Describe the pathogenesis of circulatory shock and the physiologic compensatory

mechanisms that operate in an individual with hypovolemic shock;
Classify circulatory shock describe the difference between each of the following types:
hypovolemic shock, cardiogenic shock, obstructive shock and distributive shock;
Describe the mechanisms of hemodynamic disorders including oedema, shock, thrombosis,

embolism, heamorrhage, and infarction
Discuss how lipids are transported in circulation and the consequences of excess or
deficiency of components involved in the transport of lipids;
Discuss the risk factors, aetiology, pathogenesis, clinical consequences and complications of
atherosclerosis;
Describe the aetiology, pathogenesis, clinical features of hypertension;
Classify drugs used in the management of hypertension based on cellular mechanism of

action and site(s) of action;
Describe the mechanism of action, the pharmacologic effects, therapeutic uses, adverse
effects and contraindications of each class of antihypertensive drugs;
Describe the clinical consequences of complete occlusion of blood supply to a portion of the
heart; describe the principles used in the management of myocardial infarction, and describe
the mechanism of reperfusion injury;
Give examples of anticoagulants. Classify anticoagulants; describe their mechanism of

action, therapeutic uses and adverse effects;
Give examples of antiplatelet drugs, fibrinolytics, and anti-fibrinolytic drugs. Describe the
mechanism of action, therapeutic uses and adverse effects of each class of drugs or a
prototype of each of these classes.
Outline the clinical approach to a patient with angina;
Outline the clinical approach to a child suspected to have congenital heart disease;
Classify drugs that are used in the management of ischaemic heart disease and describe
their mechanism of action, therapeutic indications, adverse effects and important drug
interactions;
Obtain history from a standardised patient with one of the following symptoms dyspnoea on
exertion, chest pain on exertion, pedal oedema, and cyanosis;
Perform cardiopulmonary resuscitation;
Perform physical examination of the cardiovascular system in healthy human subjects;
Describe the aetiology, pathogenesis, clinical features and principles of management of

congestive heart failure;
81
Classify drugs used in the management of heart failure; describe their mechanism of action,
therapeutic indications and adverse effects;
Enumerate microbial causes of infections of the heart, their pathologic and clinical features,
laboratory diagnosis; and
Discuss the effects of psychologic stress on the cardiovascular system.
T-L methods (hr): 43 lectures, 11 IRS, 4 dissection sessions, 5 practicals, 10 clinical skills
training sessions; 2 PBL; and 1 session for student presentation.
The Curriculum:
Lectures:
1. [Med] Introduction: cardinal symptoms of cardiovascular disease; epidemiology of
cardiovascular disease
2. [Phy] Electrical and mechanical properties of the heart [Part 1]: origin of the cardiac
impulse; pacemaker potentials; the conduction system of the heart; autonomic modulation of
SA nodal function
3. [Ana] Pericardium: position, extent, relations and structure, blood supply, nerve supply,
lymphatic drainage, functions and applied anatomy of fibrous pericardium; serous
pericardium: its disposition, pericardial cavity, recesses and boundaries; blood supply, nerve
supply, lymphatic drainage and clinical significance of serous pericardium.
4. [Ana] Gross anatomy of the heart: shape, size, chambers, grooves, surfaces, borders and
relations; external features, relations, internal features and blood supply of each chamber of
the heart; orifices and septa separating the different chambers of the heart; surface marking
and surgical anatomy of the heart.
5. [Ana] Blood supply and nerve supply of the heart: gross anatomy of the right and left
coronary arteries; venous drainage of the heart; formation, sites, distribution and functions of
cardiac plexuses
6. [Ana] Great vessels: origin, course, termination, relations and branches of different parts of
aorta, pulmonary trunk and origin, course, termination, relations and tributaries of superior
and inferior vena cavae.
7. [Phy] 2 lectures (7 and 8) on Electrical and mechanical properties of the heart [Part 2
and 3]: the electrocardiogram leads, electrodes, classification of ECG leads, the 12
standard leads, Einthovens triangle, normal ECG waves, complexes and intervals, the
meaning of mean QRS axis in the frontal plane; relationship between action potential in
single muscle cells and the surface ECG; recording and interpretation of the ECG.
82
9. [Phy] Cardiac cycle [Part 1]: mechanical events in the cardiac cycle, volumes and pressure
changes in cardiac chambers and the great vessels during the cardiac cycle.
10. [Phy] Cardiac cycle [Part 2]: arterial pulse, atrial pressure changes and the jugular venous
pulse, heart sounds and murmurs.
11. [Ana] Histology of the heart, blood vessels and lymphatics: histology of different layers
of the heart; connective tissue framework of the heart and components of conducting system
of the heart; structure of the wall of the blood vessels and lymph vessels.
12. [Phy] 2 lectures 12 and 13 on Cardiac output: definition, methods of measurement, factors
affecting cardiac output preload, afterload and myocardial contractility; autonomic
regulation of heart rate and stroke volume; the cellular mechanism of action of acetylcholine
and norepinephrine on the heart; the relationship between preload and cardiac output (the
Frank-Starling mechanism), the relationship between frequency of contraction and force of
contraction (the Bowditch effect), cardiac output during exercise; the relationship between
cardiac output and myocardial oxygen consumption.
14. [Ana] 2 lectures 14 and 15 on Embryology of the heart: angioblastic tissue and cardiogenic
area; formation of aorta, heart tube its different chambers and foldings; partitioning of the
primitive heart chambers; fate of different parts of the primitive heart tube; formation of the
aorta and pulmonary trunk; developmental anomalies of the heart; development of the major
arteries and veins; foetal circulation and the changes taking place in it after birth.
16. [Cli] Clinical approach to congenital heart disease
17. [Phy] Haemodynamics: functional organisation of the microcirculation; the relationship
between pressure, flow and resistance; basic physical laws applicable to analysis of
cardiovascular function (the relationship between velocity, flow and surface area; the
Poiseuille-Hagen formula; the relationship between viscosity and resistance; the law of
Laplace); the capillary circulation; forces affecting fluid movement across the capillaries;
lymphatic circulation; basic mechanisms of oedema; venous circulation (venous pressure,
effects of thoracic pump and muscle pump on venous return, central venous pressure)
18. [Phy] 2 lectures 18 and 19 on Regulation of tissue blood flow and regulation of arterial
blood pressure: the meaning and mechanism of autoregulation of tissue blood flows;
theories of autoregulation the metabolic theory, myogenic theory and the tissue pressure
hypothesis of blood flow regulation; the effects of products of metabolism on tissue blood
flow; neural influences on tissue blood flow; hormonal and paracrine regulators of tissue
blood flow. Regulation of arterial blood pressure: determinants of arterial blood pressure;
innervation of blood vessels; regulation of vascular resistance by vasomotor centre; afferents
to the vasomotor area special reference to the role of the arterial baroreceptors in the
regulation of blood pressure; the mechanism of the arterial baroreflex; an overview of lowpressure baroreceptors (volume receptors)
83
20. [Phy] The coronary circulation and the cutaneous circulation: effects of pressures in
cardiac chambers on coronary blood flow; regulation of coronary blood flow; consequences of
myocardial ischemia; an overview of cutaneous circulation with special reference to the white
reaction and the triple response.
21. [Bio] Role of lipids in cardiovascular disease: the role of dietary lipids in cardiovascular
health and revision of the metabolism of lipoproteins and understand its disorders.
22. [Path]Pathology of atherosclerosis: morphologic features, pathogenesis of atherosclerotic
plaques.
23. [Bio] Biochemical aspects of cardiovascular disease I: role of free radicals and antioxidants
in cardiovascular health and disease and the role of oxidized LDL in atherosclerosis
24. [Bio] Biochemical aspects of cardiovascular disease II: importance of nitric oxide in
cardiovascular health and the biochemical events in ischemia and reperfusion injury.
25. [Phy] Regulation of blood volume: normal blood volume in various ages; the relationship
between blood volume, cardiac output and blood pressure; mechanisms of regulation of
blood volume; cardiovascular responses to hypovolemia.
26. [Path] Haemodynamic disorders I: definition, causes, pathogenesis , morphology and
clinical consequences of congestion, hyperaemia, haemorrhage, oedema and circulatory
shock
27. Path] Haemodynamic disorders II: definition, causes, pathogenesis, morphology and
clinical consequences of thrombosis, embolism and infarction.
28. Med] Hypertension: aetiology, pathogenesis, signs and symptoms, clinical approach to a
patient with hypertension
29. [Phar] 2 lectures 29 and 30 on Antihypertensive drugs:.
30. [Phar] Antihypertensive drugs: classification of drugs used in the treatment of hypertension
with examples of each; mechanism of the antihypertensive effect of beta-blockers, alphablockers, calcium-channel blockers, ACE inhibitors, angiotensin II receptor blockers, centrally
acting sympatholytics, diuretics and directly acting vasodilators; indications, contraindications,
adverse effects of various classes of antihypertensive drugs
31. [Med] Clinical consequences of atherosclerosis and clinical approach to a patient with
angina and coronary artery disease: the consequences of atherosclerotic disease in
different vascular beds; clinical approach to a patient with angina; risk factors for ischemic
heart disease (coronary artery disease); myocardial infarction signs, symptoms, diagnosis,
and principles of management
32. [Phar]Antihyperlipidemic drugs : antihyperlipidemic drugs and measures to control
hyperlipidemia
33. Phar] 2 lectures 33 and 34 on Antihypertensive drugs:
84
34. Phar] Antihypertensive drugs: classification of drugs used in the treatment of hypertension
with examples of each; mechanism of the antihypertensive effect of beta-blockers, alphablockers, calcium-channel blockers, ACE inhibitors, angiotensin II receptor blockers, centrally
acting sympatholytics, diuretics and directly acting vasodilators; indications, contraindications,
adverse effects of various classes of antihypertensive drugs.
35. [Phar] Drugs for the treatment of ischaemic heart disease: classification of drugs used for
treatment of ischaemic heart disease; their mechanism of action; clinical uses and adverse
effects of nitrates, calcium channel blockers and beta-blockers.
36. [Med] Heart failure: definition, aetiologies, risk factors and clinical features; clinical approach
to a patient with heart failure; principles of management of heart failure.
37. [Phar] Drugs used in the management of heart failure: the mechanism of action,
therapeutic uses and adverse effects of digoxin and ACE inhibitors in heart failure; other
drugs used in the management of heart failure.
38. [Med] Cardiac arrhythmias: classification of arrhythmias by site of origin; mechanisms of
arrhythmogenesis; abnormalities of impulse generation; abnormalities of impulse conduction;
the re-entry phenomenon.
39. [Phar] Antiarrhythmic drugs: clinical uses and adverse effects of antiarrhythmic drugs.
40. [Mic] Infective endocarditis, myocarditis, and pericarditis: microbial causes of
endocarditis, myocarditis and pericarditis, laboratory diagnosis.
41. [Path] Endocarditis and rheumatic heart disease: causes of endocarditis; factors
predisposing to infective endocarditis; pathology of endocarditis; pathogenesis of rheumatic
heart disease; pathology of rheumatic endocarditis.
42. [Mic] Septicaemia: definition; transient bacteraemia and sustained bacteraemia without
organ dysfunction; laboratory diagnosis.
43. [Cli] Stress and the cardiovascular system: the effects of psychologic stress on the
cardiovascular system.
Dissection:
1. Revision of boundaries of the thorax; mediastinum: divisions and contents of each division;
pericardium: function, transverse and oblique sinuses; heart: external and internal structure;
blood supply of the heart
2. Innervation of the heart; arterial tree: aorta and its main branches in thorax, abdomen and
pelvis, head, limbs; veins: superior and inferior vena cavae and their tributaries.
Practicals:
1. [Ana] Histology of heart, blood vessels and lymphatics
2. [Phy] Electrocardiography
85
3. [Phy] Measurement of blood pressure

4. [Phar] Drug dose calculations
5. [Path] Cardiovascular pathology
PBL: 2 scenarios (topics may change from time to time)
Student Presentations: 1 (topic may change from time to time)
IRS [11]: Anatomy 2, Physiology 2, Biochemistry 1, Pathology 1, Pharmacology 2, Microbiology

1, Medicine 2.
Clinical Skills Training

20 hr covering the following skills:
C1:History taking from a patient (cardinal symptoms of cardiovascular disease)
C2:General examination of the cardiovascular system (General examination; vital signs;

peripheral pulses)
C3:Specific examination of the precordium
C4:Blood pressure measurement
C5:Listening to normal heart sounds
C6: Recording and interpretation of a resting 12-lead electrocardiogram
C7:Radiographic examination:
C8:Cardiopulmonary resuscitation
C9: Interactive session with METI mannequin ( Hypovolemic shock)
C10:History taking and role play
C11: Hand washing and gloving
Essential Reading:
Books
The corresponding chapters of preclinical chapters to be read from the books recommended in
year 1 (Anatomy Physiology, Biochemistry, Microbiology, Pathology &Pharmacology)
Davidsons Nicki.R.Colledge,Brian R Walker,Stuart H Ralston Davidsons Principles and
Practice of Medicine, Churchill Livingstone,Elseiver ,ISBN 13-9-780-7020-3084-0
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Respiratory System (RS)

Course Code: MRES 32102
Synopsis: This course is intended to prepare you to learn respiratory medicine from patients
with problems affecting the RS in the clinical phase of the programme. Thus, it is designed to
provide you with core knowledge of the structure and functions of the RS. This is followed by
lectures on pathological processes and pathogenetic mechanisms underlying various clinical
conditions affecting this system, aetiologies, mechanisms and clinical features of infections
affecting this system and the rationale for the use of drugs in specific conditions affecting this
system. 20 hr of clinical skills training is integrated into this course this will provide you with
basic information regarding history taking from patients with respiratory symptoms, performing a
physical examination of the RS. Additionally, there are clinical lectures covering the aetiology,
pathogenesis, clinical features and principles of management of important and or common clinical
conditions such as chronic obstructive pulmonary disease or lectures on clinical approach to
patients with specific syndromes (example, pneumonia) affecting the RS. Two PBL scenarios
designed to foster learning of basic science content relevant to medicine augment this sequence
of T-L experiences.
Objectives:
At the end of this course, the student should be able to:
List the cardinal symptoms of respiratory disease;
Describe the functional organisation of the respiratory system;
Describe the gross anatomy and histology of the upper and lower respiratory tracts;
Describe the gross anatomy of the lungs and pleura;
Describe the mechanism of inspiration and expiration;
Define all lung volumes and capacities and discuss factors affecting vital capacity;
Describe how airways resistance is regulated;
Describe the mechanism of gas exchange in the lungs;
Describe the mechanism of transport of oxygen and carbon dioxide in blood;
Describe how respiration is regulated;
Discuss the cardio respiratory adjustments that occur during exercise, and at high altitudes
and when barometric pressure is raised;
Describe how pH of body fluids is regulated
Describe the pathophysiology of restrictive and obstructive lung disease and highlight the
differences between these two conditions;
Discuss the aetiology, clinical features and principles of management of bronchial asthma
and chronic obstructive pulmonary disease;
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Describe the mechanism of action of drugs used in the management of bronchial asthma;
Outline indications for oxygen therapy, discuss the mechanism of its benefits;
List some indications for hyperbaric oxygen therapy; briefly explain the rationale for
hyperbaric oxygenation; briefly describe oxygen toxicity;
List common infectious diseases of respiratory disease and describe the clinical features of
these conditions
Elicit history from a patient with one or more of the following symptoms or problems
dyspnoea, wheezing, cough, and chest pain.
Perform physical examination of the respiratory system in healthy human subjects;
Describe the pathologic features of pneumonia, asthma, COPD;
Classify antibiotics based on their mechanism of action, site of action and spectrum of
antimicrobial activity;
Describe the principles of antimicrobial therapy;
Recognize the problem and mechanism of antimicrobial resistance.
Discuss the clinical approach to a patient suspected to have pneumonia;
Discuss the clinical approach to a patient with pleural effusion;
Describe the aetiology, epidemiology pathogenesis, clinical features, laboratory diagnosis,

principles of management and complications of pulmonary tuberculosis;
Classify drugs used in the treatment of tuberculosis, their mechanism of action, their uses
and side effects and describe the pharmacologic management of pulmonary tuberculosis.
Discuss the risk factors, clinical features and pathologic features of cancer of the lung and
pleura.
T-L methods: 43 lectures, 9 IRS, 3 practicals, 4 dissection sessions, 2 PBL, 20 hr clinical

skills training and 1 symposium.
Contact hours: 100
The curriculum:
Lectures:
1. [Med] Introduction: cardinal symptoms of respiratory disease; an overview of common
clinical conditions affecting the respiratory system
2. [Ana] Anatomy of the nose and paranasal sinuses: gross anatomy of the nasal cavity and
paranasal air sinuses; blood supply and nerve supply of the nose and sinuses
3. [Ana] Gross anatomy of the upper respiratory tract: anatomy of the larynx, trachea
4. [Ana] Gross anatomy of the lower respiratory tract: pleura; gross anatomy of the lungs;
bronchopulmonary segmentation and its significance
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5. [Phy] Mechanics of breathing: functional anatomy of the conducting zone (dead space) and
the respiratory zone; the mechanism of inspiration and expiration; muscles of inspiration and
expiration; definition of the terms tidal volume, respiratory minute volume and alveolar
ventilation, anatomic dead space.
6. [Ana] Histology of the respiratory tract
7. [Ana] Development of the respiratory system
8. [Phy] Lung volumes and capacities: definitions of lung volumes and capacities;
measurement of vital capacity; a note on methods used for determination of total lung
capacity; typical values of lung volumes and capacities in a healthy adult male; performing
the forced vital capacity manoeuvre; factors affecting vital capacity;
9. [Phy] Lung compliance and airways resistance: the meaning of lung compliance; lung
compliance, thoracic compliance and respiratory system compliance; normal compliance; the
role of pulmonary surfactant; autonomic innervation of the bronchi and bronchioles; bronchial
tone; regulation of airways resistance; FEV1/FVC as an index of airways resistance; clinical
utility of PEFR and MMEFR as indices of airways resistance; the concept of work of
breathing.
10. [Phy] Gas exchange in the lungs: differences in ventilation and perfusion in different parts
of the lung (zones 1-4); the meaning of dead space; the distinction between anatomic dead
space and physiologic (total) dead space; Bohrs equation to estimate total dead space; the
meaning of shunt; the alveolar gas equation; diffusion limited and flow limited exchange;
diffusing capacity of the lung for oxygen, carbon dioxide and carbon monoxide.
11. [Phy] Pulmonary circulation: functional organisation of the pulmonary circulation;
characteristics of the pulmonary circulation; differences between systemic and pulmonary
circulation; the effect of gravity on pulmonary blood flows; ventilation-perfusion ratios;
pulmonary circulation as a reservoir of blood; regulation of pulmonary blood flow; metabolic
and endocrine functions of lungs.
12. [Phy] Transport of O2: oxygen delivery to tissues; reactions of haemoglobin and oxygen; the
oxygen-haemoglobin dissociation curve; factors affecting the affinity of haemoglobin for
oxygen (including the Bohr effect); differences in the oxygen dissociation curves of Hb A, Hb
F and myoglobin; the role of myoglobin.
13. [Phy] Transport of CO2: the fate of carbon dioxide in blood; chloride shift; the Haldane effect.
14. [Bio] Regulation of pH [Part 1]: acid-base chemistry; buffers; pH homeostasis; the
Henderson-Hasselbalch equation; sources of H ions in the body; pH regulation inside cells.
15. [Bio] Regulation of pH [Part 2]: regulation of pH of ECF; the speed of compensatory
responses; acidosis; alkalosis; respiratory and metabolic acid base disturbances; clinical
evaluation of acid base status.
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16. [Phy] Regulation of respiration [Part 1]: brain stem regulation; neural basis of
breathing;pontine and vagal influence; non chemical influences on respiration; rate and depth
of respiration; regulation of respiration during sleep
17. [Phy] Regulation of respiration[Part 2]: central and systemic arterial chemoreceptors;
Neural control of breathing ; chemical control of breathing carotid and aortic bodies ; central
chemoreceptors; ventilatory responses to changes in acid-base balance, carbon dioxide, and
hypoxia and the effect of hypoxia on the carbon dioxide response curve; effect of H ions on
the CO2 response curve; effects of breath holding;
18. [Phy] Respiratory adjustments in health and disease [Part 1] (Hypoxia, Cyanosis)
hypoxia classification of tissue hypoxia and examples of each, distinguishing types of
hypoxia; effects of hypoxia on the brain; dyspnoea, tachypnoea as consequences of hypoxia;
examples of diseases characterised by hypoxic hypoxia; ventilation-perfusion imbalance a
common cause of hypoxic hypoxia; effect of carbon monoxide on oxygen transport the
mechanism of cyanosis; effects of exercise changes in ventilation during exercise
19. [Phy] Respiratory adjustments in health and disease [Part 2] (High altitude physiology
and Drowning) delayed effects of high altitude; acclimatisation; pathophysiology of drowning;
periodic breathing meaning, examples, Cheyne-Stokes respiration; abnormal patterns of
breathing
20. [Phy] Respiratory adjustments in health and disease [Part 3] (Effects of high barometric
pressure and artificial respiration) effects of decreased barometric pressure relation
between altitude, barometric pressure and maximum oxygen tension of arterial blood; effects
of increased barometric pressure nitrogen narcosis, high pressure nervous syndrome;
consequences of decompression decompression sickness; air embolism; Caissons
disease ;artificial breathing the difference between normal breathing and mechanical
ventilation;
21. [Med] Oxygen therapy, hyperbaric oxygen therapy and oxygen toxicity: common
indications for oxygen therapy; methods of administering oxygen; conditions in which oxygen
therapy is of limited value (deoxygenation due to right-to-left intracardiac shunting); the
rationale for hyperbaric oxygenation; some indications for hyperbaric oxygenation; oxygen
toxicity.
22. [Bio] Biochemical basis of respiratory disease: biochemical processes in common
respiratory diseases
23. [Path] Pathology of common respiratory conditions [Part 1]: (common acute
conditions) Etiology, pathogenesis, morphology and clinical correlation of acute respiratory
distress syndrome, pneumonia and pulmonary embolism.
24. [Phy] Pathophysiology of obstructive and restrictive lung disease: pathophysiology of
obstructive versus restrictive lung disease; pulmonary function test patterns in obstructive
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versus restrictive disease; effects of obstructive and restrictive lung disease on arterial blood
oxygenation.
25. [Path] Pathology of common respiratory conditions [Part 2]: (Obstructive airway
disease) Etiology, pathogenesis, morphology and clinical correlation of emphysema, chronic
bronchitis, and bronchial asthma
26. [Rad] Imaging of the chest: chest x-ray; normal patterns; identification of common
abnormalities in a chest x-ray.
27. [Med] Obstructive airway disease: aetiology, pathogenesis and clinical features of asthma
& COPD; the distinction between asthma and COPD; principles of management of asthma
and COPD
28. [Phar] Drugs used in the management of bronchial asthma and cough: the rationale for
the use of beta-2 adrenergic receptor agonists, methylxanthines, corticosteroids, mast cell
stabilisers, and leukotriene receptor blockers in the management of asthma; adverse effects
of these drugs; drugs contraindicated in asthma; antitussives uses, adverse effects and
contraindications.
29. [Path] Pathology of common respiratory conditions [Part 3]: (Common chronic
conditions) Etiology, pathogenesis, morphology and clinical correlation of atelectasis,
bronchiectasis and pneumoconiosis.
30. [Mic] Bacterial infections of the respiratory tract: common bacterial causes of respiratory
infections; host factors predisposing to infections; pathogenesis; laboratory diagnosis.
31. [Phar] Antibiotic therapy [Part 1]: Introduction to general principles of chemotherapy:
classification of antimicrobial agents; adverse drug reactions; rationale for combining
antimicrobials; prophylactic use of antimicrobials; the pharmacology of sulphonamides and
cotrimoxazole, fluoroquinolones.
32. [Phar] Antibiotic therapy [Part 2]: penicillins and cephalosporins; macrolide antibiotics;
aminoglycoside antibiotics.
33. [Phar] Antibiotic therapy [Part 3]: broad spectrum antibiotics, metronidazole;
miscellaneous antimicrobial agents, antifungal agents.
34. [Mic] Viral infections of the respiratory tract: aetiology, clinical features and laboratory
diagnosis of viral infections of the respiratory tract.
35. [Phar] Antiviral drugs
36. [Med] Clinical approach to pneumonia: common causes of community acquired
pneumonia; hospital acquired pneumonia; clinical features of pneumonia; clinical approach to
a patient with pneumonia; complications of pneumonia.
37. [Paed] Common respiratory illnesses in children; classify, etiopathogenesis of
pneumonia, Bronchiolitis and asthma; approach to management; prevention and control in
the community
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38. [Path & Micro] Tuberculosis: Immunopathogenesis, Pathology and Laboratory

Diagnosis: Aetiology, immunopathogenesis, clinical course, laboratory diagnosis,
morphology and complications.
39. [Med] Epidemiology, clinical manifestations and complications of TB: epidemiology of
TB; clinical features and complications of primary pulmonary tuberculosis and post-primary
tuberculosis; principles of treatment.
40. [Phar] Antimycobacterial drugs and the treatment of TB
41. [Path] Cancer of the lung and pleura: aetiology, epidemiology, risk factors, pathologic
features of cancer of the lung and pleura.
42. [Med] Pleural effusion: what is pleural effusion; common causes, mechanism and clinical
signs of pleural effusion; clinical approach to a patient with pleural effusion.
Dissection (4 sessions 2 hr each)

1. Gross anatomy of the nasal cavity, paranasal sinuses and pharynx
2. Gross anatomy of the larynx
3. Gross anatomy of the thorax
4. Lower respiratory tract; lungs and pulmonary circulation
Practicals:
1. Histology of the respiratory tract
2. Spirometry
3. Respiratory pathology
PBL 2 scenarios (these change from time to time)
Symposium 1 (topic may change from time to time)
Clinical Skills Training 20 hr covering the following
History taking from a patient with cardinal symptoms of respiratory disease
Physical examination of the respiratory system (general examination, and specific

examination of the chest
Breath sounds; recognition of abnormal breath sounds
Chest X-ray, normal chest x-ray, some common abnormal patterns
An interactive clinical case scenario (using METI mannequin): hypoxia, hypercapnia.
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Interactive Review Sessions [9]

Anatomy 1, Physiology 2, Biochemistry 1, Pathology 1, Microbiology 1, Pharmacology 2,
Medicine 1
Essential Reading:
Books
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Gastrointestinal System (GIT)

Course Code: MGIT 32103
Synopsis: This course is intended to prepare you to learn gastrointestinal medicine from
patients with problems affecting the GIT in the clinical phase of the programme. Thus, it is
designed to provide you with core knowledge of the structure, functional organisation and
functions of various parts of the gastrointestinal tract (GIT). This is followed by lectures on
pathological processes and pathogenetic mechanisms underlying various clinical conditions
affecting this system, aetiologies, mechanisms and clinical features of infections affecting this
system and the rationale for the use of drugs in specific conditions affecting this system. 20 hr of
clinical skills training is integrated into this course this will provide you with basic information
regarding history taking from patients with gastrointestinal symptoms, performing a physical
examination of the abdomen. Additionally there are clinical lectures covering the aetiology,
conditions such as cirrhosis of the liver or lectures on clinical approach to patients with specific
syndromes (example, chronic hepatitis, and malabsorption) affecting the GIT. Two PBL scenarios
designed to foster learning of basic science content applicable to medicine augment this
sequence of T-L experiences.
Objectives:
List the cardinal symptoms of gastrointestinal disease;
Describe the functional organisation of the GIT;
Describe the gross anatomy of the oral cavity, salivary glands, oesophagus, stomach, liver,
spleen, pancreas, the small and large intestine, rectum and anal canal;
Describe the role of the enteric nervous system and gastrointestinal hormones in regulating
GI function;
Describe the functions of the salivary glands, stomach, liver, small intestine and large
intestine and their secretions;
Describe the pathology of salivary gland tumours, Barretts oesophagus, oesophageal

cancer, peptic ulcer disease (acid-peptic disease), hepatitis, cirrhosis of the liver, neoplasms
of the liver, small and large intestine;
Enumerate the aetiology, pathogenesis and clinical features of common microbial and
parasitic infections affecting the GIT;
Discuss the mechanism of action and side effects of drugs used in the management of peptic
ulcer disease (acid-peptic disease);
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Describe the mechanism of action, indications and contraindications for each of the following
- prokinetics, antiemetics, and drugs modulating colonic motility;
Elicit history from a patient with one or more of the following symptoms or problems
vomiting, haematemesis, epigastric discomfort, jaundice, abdominal pain, loose stools;
Perform physical examination of the abdomen in healthy human subjects;
Describe the aetiology, clinical features and principles of management of the following
conditions: peptic ulcer disease (acid-peptic disease), cirrhosis of the liver, inflammatory
bowel disease, conditions affecting colonic motility;
Discuss the clinical approach to a patient with chronic hepatitis; and
Discuss the clinical approach to a patient suspected to have a malabsorption syndrome.
T-L methods: 44 lectures, 8 interactive review sessions, 4 practicals, 4 dissection sessions, 2

PBL, 20 hr of clinical skills training and 1 quiz session.
Contact hours: 100

The curriculum:
Lectures:
1. [Med] Introduction to gastrointestinal medicine: cardinal symptoms of gastrointestinal
disease; common clinical conditions affecting the gastrointestinal system.
2. [Phy] Functional organisation of the GIT: functional organisation of structures that make
up the wall of the GIT; the enteric nervous system (ENS) the submucosal and the myenteric
plexus; extrinsic regulation of the ENS by autonomic input to the GIT; brief review of
properties of visceral smooth muscle; the basic electrical rhythm of the GIT; an introduction to
peristalsis; a note on the general role of gastrointestinal hormones as regulators of GI
function.
3. [Ana] Gross anatomy of the oral cavity, tongue, salivary glands
4. [Ana] Histology of salivary glands, esophagus, stomach
5. [Phy] Saliva: synthesis, secretion, composition, functions, regulation of salivation and
consequences of deficiency in salivation
6. [Ana] Gross anatomy of oesophagus and stomach
7. [Phy] Secretory and digestive functions of the stomach: the mechanism of gastric acid
secretion by parietal cells; defence against gastric acid and pepsin; regulation of gastric acid
secretion; intrinsic factor.
8. [Phy] Gastrointestinal motility [Part 1]: the function of motility; the mechanism of
peristalsis; mediation of motility by the ENS; neural and humoral regulation of motility;
regulation of gastric emptying
9. [Ana] Gross anatomy of the liver, gall bladder and biliary system
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10. [Ana] Gross anatomy of the pancreas and spleen

11. [Ana] Histology of the liver, exocrine pancreas and small intestine
12. [Phy] Bile: synthesis, secretion, flow and composition of bile; enterohepatic circulation;
regulation of bile secretion; functions of gall bladder; pathogenesis of gall stones;
consequences of obstruction of the biliary tree.
13. [Bio] Metabolism of bile : metabolism and excretion of bilirubin and bile acids/salts, the
mechanism of jaundice, classification of hyperbilirubinemia
14. [Bio] Disposal of ammonia, ammonia toxicity, pH regulation by the liver : sources of
ammonia and its disposal; liver in acid base regulation
15. [Phy] Pancreatic juice & Intestinal secretion: synthesis, secretion, composition of
pancreatic juice and intestinal secretion; the basic mechanism of water flux across GI
epithelium; neural and humoral regulation of pancreatic and intestinal secretions.
16. [Bio] Liver and pancreatic function tests: interpretation and evaluation liver and pancreatic
function in common diseases of the liver and pancreas
17. [Ana] Gross anatomy of the small intestine
18. [Ana] Gross anatomy of the large intestine, rectum and anal canal
19. [Ana] Development of the gastrointestinal tract
20. [Phy] 2 Lectures 20 and 21 on Digestion and absorption of carbohydrate, fat, protein;
and absorption of vitamins, and minerals: brief review of enzymes that are involved in the
digestion of carbohydrates, protein and fat; physiologic conditions for optimum action of
digestive enzymes; mechanism of absorption of products of digestion the role of bile in the
emulsification of fat; sites of absorption of vitamins, minerals.
22. [Phy] Gastrointestinal motility [Part 2]: digestive versus interdigestive motility; propulsive
movements versus mixing movements; differences in motility in different segments of the
GIT; function of each type of movement; vomiting the basic mechanism, common causes of
vomiting; consequences of protracted vomiting.
23. [Phy] Functions of the colon: water and electrolyte handling in the colon; colonic motility;
reference to gastroileal and the gastrocolic reflex; the mechanism of defaecation; effects of
colectomy; the mechanism of congenital megacolon.
24. [Path] Gastrointestinal pathology [Part 1]: pathology of salivary gland tumours; reflux
esophagitis, Barretts oesophagus, oesophageal cancer
25. [Path] Gastrointestinal pathology [Part 2]: pathology of gastritis, peptic ulcer and gastric
carcinoma
26. [Path] Gastrointestinal pathology [Part 3]: pathology of hepatitis, cirrhosis, hepatocellular
carcinoma
27. [Path] Gastrointestinal pathology [Part 4]: neoplasms of small and large intestine
28. [Mic] 2 lectures 28 and 29 on Bacterial infections of the GIT
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30. [Mic] Viral diseases of the liver: aetiology, epidemiology, pathogenesis of hepatitis A-E;
newer hepatitis viruses.
31. [Mic] Viral gastroenteritis: aetiology, epidemiology, clinical features and laboratory
diagnosis of viral gastroenteritis.
32. [Mic] Parasitic infections of the GIT: aetiology, epidemiology, clinical features and
laboratory diagnosis of parasitic infections of the GIT.
33. [Mic] Applied microbiology of the GIT: functional organisation and functions of mucosa
associated lymphoid tissue, oral vaccines.
34. [Phar] Pharmacologic treatment of peptic ulcer: classification of drugs used in the
treatment of peptic ulcer, mechanism of action of these drugs, uses, therapeutic effects and
side effects; drugs used to eradicate H.pylori infection.
35. [Phar] Prokinetics and antiemetics: mechanism of action, indications, contraindications
and adverse effects
36. [Med] Diseases of the oesophagus and stomach
37. [Med] Diagnostic approach to chronic hepatitis
38. [Phy / Cli] The mechanism of clinical manifestations of portal hypertension [30 min]
39. [Med] Cirrhosis and liver cell failure: aetiopathogenesis, clinical features, diagnosis and
complications of cirrhosis; clinical features of hepatocellular failure
40. [Sur] Common surgical conditions affecting the hepatobiliary system and pancreas
41. [Med] Clinical approach to maldigestion and malabsorption
42. [Med] Inflammatory bowel disease: aetiology, pathogenesis, clinical features, diagnosis,
and principles of management of inflammatory bowel disease.
43. [Phar] Drugs used in the treatment of constipation and diarrhoea
44. [Med] Disorders of colonic motility: constipation, irritable bowel syndrome
Dissection:
1. Gross anatomy of the oral cavity, tongue, salivary glands
2. Gross anatomy of oesophagus and stomach
3. Gross anatomy of the liver, gall bladder, biliary system, pancreas and spleen
4. Gross anatomy of large intestine, rectum & anal canal
Practicals:
1. Histology of the GIT (Session 1)
2. Histology of the GIT (Session 2)
3. Liver and pancreatic function tests
4. Gastrointestinal pathology
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Clinical Skills Training

20 hr covering the following
1. History taking (cardinal symptoms of gastrointestinal disease)
2. Physical examination of the abdomen and palpation of the kidneys
3. Examination of the rectum
4. Radiological examination & imaging of the GIT (barium meal, barium meal follow through,
barium enema) and CT scan of abdomen
5. Insertion of a nasogastric tube
6. Intramuscular and subcutaneous injection
7. Interactive clinical case scenario using METI manikin
PBL 2 scenarios (these change from time to time)
Interactive Review Sessions (8)

Anatomy 2, Physiology 2, Pathology 1, Microbiology 1, Medicine 2
Quiz Gut Questions [1 hr]
Essential Reading:
Books
Norman.S.Williams ,Christopher J.K.Bulstrode & P.Ronan O Connell Bailey & Loves Short
Practice of Surgery, Edward Arnold publishers ,ISBN 9780340939376
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Central Nervous System (CNS)

Course Code: MCNS 32105
Synopsis: This course is designed to provide you with core knowledge of the structure,
functional organisation and functions of the central nervous system. This is followed by lectures
on pathological processes and pathogenetic mechanisms underlying various clinical conditions
affecting this system, aetiologies, mechanisms and clinical features of infections affecting this
system and the rationale for the use of drugs in specific conditions affecting this system. 20 hr of
clinical skills training is integrated into this course this will provide you with basic information
regarding history taking from patients with symptoms of CNS disease, performing a clinical
examination of the CNS. Additionally there are clinical lectures covering the aetiology,
conditions such as cerebrovascular disease. Two PBL scenarios designed to foster learning of
basic science content applicable to clinical practice augment this sequence of T-L experiences.
Objectives:
At the end of this course, the learner should be able to:
Describe the organisation of the meninges around the brain and the spinal cord;
Describe the anatomy of the cerebrum, cerebellum, diencephalon, basal ganglia, cerebral
ventricles, and the spinal cord;
Describe the composition, secretion, circulation and functions of CSF;
Discuss the mechanism of integration of synaptic inputs on a postsynaptic neuron;
State and illustrate general principles of sensory physiology;
Describe the physiologic mechanism and function of the stretch reflex;
Describe the physiologic mechanism and function of withdrawal reflexes;
Describe how we are able to perceive touch, pressure, temperature, and noxious stimuli;
Elaborate how information from sensory receptors in the eyes, ears, olfactory mucosa, taste
buds reaches the brain and the perceptions that result;
Describe the role of the ascending reticular activating system in arousal;
Describe the characteristics of EEG waves seen in various physiologic states;
Describe the aetiology and clinical features of epilepsy;
Describe the role of the cerebral cortex, cerebellum, thalamus, basal ganglia and motor
pathways in the regulation of posture and movement;
Describe the functional organisation and functions of the limbic system and the
hypothalamus;
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Describe the physiologic basis of higher functions of the nervous system;
Classify, give examples and describe the mechanism of action, pharmacologic effects,
therapeutic uses, adverse effects of each of the following classes of drugs: analgesics, local
and general anaesthetics, anxiolytics, antidepressants, anti-epileptics and alcohol.
List common bacterial, viral and other causes of infections of the CNS and describe the
laboratory methods used for diagnosing these infections;
Describe the aetiology and pathologic features of common tumours of the CNS;
Describe the aetiology, epidemiology and risk factors for dementia and clinical approach to a
patient with dementia;
Describe the aetiology, clinical features of common disorders of language and speech; and
Describe the aetiology, epidemiology, risk factors, pathogenesis, and clinical manifestations
of cerebrovascular disease.
T-L methods: 57 lectures, 12 IRS, 7 dissection sessions, 6 practical sessions, 3 PBL, 20 hr

of clinical skills training, 1 session for student presentations.
Contact hours: 135 hr
The curriculum:
Lectures:
1. [Med] Introduction to clinical neurology: Importance of the nervous system and muscle to
normal function; prevalence and importance of CNS dysfunction; the spectrum of CNS
infections; epidemiology of common clinical conditions affecting the CNS in Malaysia.
2. [Ana] Meninges and blood supply to the brain: organization and characteristics meninges;
bilaminar structure of the duramater, reflections of the meninges; arteries supplying the
cerebrum - cortical and central branches, circle of Willis and venous sinuses within the cranial
cavity; blood supply of the brain stem and cerebellum and spinal cord.
3. [Ana] Spinal cord: extent; dimensions; external features; spinal segments: definition;
internal structure: grey matter - parts, group of neurons and their functions, and white matter parts, location of ascending and descending tracts and their functions; applied anatomy.
4. [Ana] Brain stem: external features of midbrain, pons and medulla; transverse sections of
the midbrain at the level of superior and inferior colliculi; transverse section of the pons at the
level of facial colliculus; transverse section of medulla at the level of lemniscal decussation,
pyramidal decussation, olivary nucleus.
5. [Ana] Cerebellum: anatomical subdivisions: important fissures and lobes; morphological and
functional subdivisions: their major connections, functions and applied anatomy; connections:
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afferent and efferent connections, extent and fibres passing through cerebellar peduncles;
intra-cerebellar nuclei: their connections.
6. [Ana] Cerebrum: external features: surfaces, borders, poles, lobes, sulci and gyri; functional
areas: position, connections, functions and applied anatomy.
7. [Ana] Histology of the CNS: histology of the cerebral cortex, cerebellum and spinal cord
8. [Ana] Diencephalon: position and parts; thalamus position, parts, nuclear groups, applied
anatomy; position and connections of the medial and lateral geniculate nuclei; important
nuclei in the hypothalamus; the epithalamus.
9. [Ana] Basal ganglia and white matter of the brain: parts of the basal nuclei, connections
and applied anatomy; white matter in the brain association fibres, corpus callosum, internal
capsule. Basal nuclei: parts (caudate nucleus, lentiform nucleus, amygdaloid nucleus, corpus
striatum), their position and relations functions; and applied anatomy
White matter of the cerebrum: association fibres: classification, examples; commissural
fibres: examples, their position and areas connected by them; corpus callosum: position,
parts, relations, area connected by different parts, blood supply and applied anatomy;
projection fibres: examples; internal capsule: position, parts, relations, fibres passing through
different parts, blood supply and applied anatomy.
10. [Ana] Ventricles of the brain: Fourth ventricle: Position, boundaries: roof, floor (rhomboid
fossa) and lateral boundary, communications and recesses; third ventricle: position,
boundaries, recesses and communications; lateral ventricle: position, parts and boundaries of
each of the parts
11. [Phy] Cerebrospinal fluid: secretion, composition, circulation, and reabsorption of CSF;
blood-brain versus blood-CSF barriers; intracranial pressure (CSF pressure); assessment of
intracranial tension; obtaining CSF for analysis; the basic mechanism of hydrocephalus.
12. [Ana] Development of the CNS: development of the CNS starting from the neural tube;
explanation of how the brain and spinal cord are organized, the main divisions of forebrain,
mid brain and hind brain; sub-divisions: telencephalon, diencephalon, mesencephalon,
metencephalon and myelencephalon and the main structures found within these regions; the
relationship of the cerebro-ventricular system to the various regions; congenital
abnormalities: anencephaly and spina bifida.
13. [Phy] Neuroanatomy jargon [30 min]: clarification of terms nucleus, ganglion, orders of
neurons in sensory pathways, lemniscus, fasciculus, upper motor neuron versus lower motor
neuron; types of upper motor neurons.
14. [Phy] Synaptic integration: review of the mechanism of synaptic transmission; excitatory
and inhibitory postsynaptic potentials; spatial and temporal summation of postsynaptic
potentials; inhibition and facilitation at synapses - types and mechanisms of synaptic
inhibition and facilitation, the phenomenon of integration of synaptic inputs.
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15. [Phy] General principles of sensory physiology: principal sensory modalities; receptor
(generator) potential in sensory neurons e.g., the Pacinian corpuscle; coding of stimulus
location, intensity, and modality.
16. [Phy] 2 lectures 16 and 17 on Reflexes: definition; the Bell-Magendie law; mechanism of the
monosynaptic reflex [the stretch reflex]; role of the muscle spindle in regulation of muscle
length and force; mechanism of tone in skeletal muscles; the withdrawal reflex: mechanism,
significance and properties; the final common path for skeletal muscle contraction
18. [Phy] Somatosensory pathways: the dorsal column-medial lemniscus system; the
spinothalamic system; the sensory modalities transmitted through these pathways; cortical
representation of somatic sensation; synthetic senses; role of the neocortex in sensory
perception
19. [Phy] 2 lectures 19 and 20 on Physiology of pain: the definition of pain; nociceptors;
pathways for transmission of pain; fast vs. slow pain; somatic vs. visceral pain; the
mechanism of referred pain and the dermatomal rule; corticofugal modulation of pain
transmission [the gate control mechanism]; the endogenous analgesia system; physiologic
strategies for alleviation of pain
21. [Phar] Opioid analgesics: classification (based on chemical, receptor action and therapeutic
efficacy); pharmacological actions; adverse effects; treatment of overdosage;
contraindications, routes of administration and uses of natural, semisynthetic and synthetic
opioids; opioid antagonists and their role in therapeutics.
22. [Phar] Non-steroidal anti-inflammatory drugs (NSAIDs): classification (based on chemical
structure and therapeutic efficacy); pharmacological actions; uses; routes of administration;
adverse effects; contraindications for use; treatment of overdosage.
23. [Phar / Anaes] Local anaesthetics: basic mechanism of action; uses; routes of
administration; uses and adverse effects of commonly used agents.
24. [Phar / Anaes] General anaesthetics: definition of general anaesthesia; principles of
administration of general anaesthetics; classification of general anaesthetics, uses, adverse
effects of individual anaesthetic agents; preanaesthetic medication.
25. [Phy] 3 lectures 25-27 on Physiology of vision: Functional anatomy of the eye; the retina
rod cells, cone cells; functions of rods and cones; the mechanism of dark adaptation; effects
of vitamin A deficiency; the Young-Helmholtz theory of colour vision; the image forming
mechanism accommodation; near point, near response, pupillary reflex responses to light;
common defects of the image forming mechanism [myopia, hypermetropia, astigmatism]; the
visual pathway; functions of the primary visual cortex and visual association areas; effects of
lesions in the visual pathway; types of eye movements; role of the superior colliculi in
regulation of ocular movements
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28. [Phy] 3 lectures 28-30 on Physiology of audition: Functional organisation of the external
ear, middle ear, inner ear ; functions of the tympanic membrane and middle ear ossicles;
mechanisms of conduction of sound waves to the fluid of the inner ear ; the travelling wave
theory of excitation of hair cells in the basilar membrane; the auditory pathway; functions of
relay centres in the auditory pathway; functions of the primary auditory cortex and auditory
association areas; the principles used in performing tests of hearing; an introduction to
audiometry; the mechanism and clinical significance of otoacoustic emissions; an introduction
to brain stem auditory evoked potentials
31. [Phy] Physiology of equilibrium: organisation of utricle, saccule and semicircular canals;
functional roles of utricle, saccule and semicircular canals; the vestibular pathway; efferent
responses initiated by stimulation of the vestibular apparatus; the vestibule-ocular reflex (the
dolls eye reflex); the caloric stimulation test; symptoms of vestibular dysfunction
32. [Phy] Physiology of smell and taste: receptors for odorants; the olfactory pathway;
abnormalities of olfaction; gustatory receptor cells; taste pathways; basic taste modalities;
abnormalities of gustation.
33. [Phy] The thalamus and the ascending reticular activating system: the thalamus; the
reticular formation; the ascending reticular activating system [ARAS]; nonspecific vs. specific
thalamocortical projections; role of the ARAS; effects of lesions in the brain stem reticular
formation & ARAS
34. [Phy] The electroencephalogram: the EEG in the awake state; patterns of sleep [slow wave
sleep and REM sleep]; the EEG during sleep; concomitants of REM sleep
35. [Med] Clinical applications of EEG; aetiology and clinical features of epilepsy
36. [Phar] Drug treatment of epilepsy: classification, pharmacologic effects, uses and adverse
effects of antiepileptic drugs.
37. A block of 4 lectures 37-40 on Regulation of posture & movement:
Part 1: Corticospinal & corticobulbar systems - primary motor area; supplementary motor
area; premotor area; the corticospinal tract and its termination, its role in movement, its effect
on stretch reflexes; effects of lesions in the corticospinal tract.
Part 2: Posture regulating mechanisms (2 lectures): spinal integration of stretch reflexes the acute and chronic effects of complete transection of the spinal cord; locomotion
generators in the spinal cord; the mass reflex; supraspinal regulation of stretch reflexes: the
mechanism of decerebrate rigidity; effects of decortication on stretch reflexes: decorticate
rigidity
Part 3: Role of the basal ganglia in the regulation of posture and movement; role of the
cerebellum in the regulation of posture and movement.
41. [Phy] Functions of the hypothalamus: role in regulation of appetite; role in regulation of
circadian rhythms; role in temperature regulation
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42. [Phy] Functional organisation and functions of the limbic system: the limbic cortex;
differences between limbic and neocortex; the Papez circuit; reward and punishment centres
in the brain; connections of the limbic system with the hypothalamus.
43. [Phar] Anxiolytic drugs: classification, pharmacologic effects, therapeutic uses, adverse
effects, contraindications, and treatment of overdosage.
44. [Phar] Antidepressant drugs: classification, pharmacologic effects, therapeutic uses,
adverse effects of antidepressants and mood stabilisers.
45. [Phar] Alcohol metabolism; drug tolerance and dependence: brief review of
pharmacology of alcohol outlining saturation kinetics and therapeutic uses; definition of
alcohol addiction; treatment of alcohol dependence.
46. [Phy] Higher functions of the nervous system [Part 1]: Learning and memory the
definition of learning and memory; implicit versus explicit memory; short-term versus longterm memory; mechanisms of learning: habituation, sensitisation, learning by conditioning,
learning by association; intercortical transfer of memory; storage of memory; the basic
mechanism of formation of long term memories (consolidation) long-term potentiation; the
role of the hippocampus.
47. [Phy] Higher functions of the nervous system [Part 2]: functions of multimodal
association areas in the cerebral cortex; the concept of complementary specialisation of
cerebral hemispheres; the phenomenon of cortical plasticity; functions of the categorical and
representative hemispheres.
48. [Med] Disorders of language and speech: aphasia, dysarthria, apraxia, and other types of
impairment of speech.
49. [Mic] Bacterial meningitis: aetiology, laboratory diagnosis of bacterial meningitis; rational
use of antibiotics in meningitis;
50. [Mic] 2 lectures 50 and 51 on Viral infections of the central nervous system
52. [Mic] Other CNS infections: parasitic and fungal infections of the CNS
53. [Path] Tumours of the central nervous system
54. [Psych] Dementia and disorders of cognition
55. [Phar] Antipsychotic drugs: classification, pharmacologic actions, uses and adverse
effects.
56. [Med] Common demyelinating, metabolic and neurodegenerative diseases: an overview
of the etiology, pathogenesis and clinical features of Guillain-Barre syndrome; multiple
sclerosis; motor neuron disease; Parkinsons disease; Alzheimers disease.
57. [Med] Cerebrovascular disease: risk factors, aetiopathogenesis, epidemiology,
classification, clinical features
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Dissection (7 sessions 2 hr each):

1. Gross topography of the CNS, meninges, spinal cord, blood supply of the brain and spinal
cord
2. Brain stem
th
3. Cerebellum and 4 ventricle

4. Cerebrum: surface, sulci, gyri, functional areas
5. Diencephalon and third ventricle
6. Cerebral white matter and basal nuclei
7. Lateral ventricles
Practicals (6 sessions 2 hr each)

1. [Ana] Histology of the central nervous system
2. [Phy] Electromyography
3. [Phy] Visual field testing by perimetry
4. [Phy] Audiometry
5. [Mic] CNS infections
6. [Path] Tumours of the central nervous system
Clinical Skills Training 20 hrs covering

1. History taking
2. Clinical examination of the sensory system
3. Clinical examination of the motor system (including reflexes)
4. Clinical examination of cranial nerves
5. Clinical examination of special senses
6. Clinical examination of higher functions
7. Systematic approach to interpreting a CT of brain
8. Interactive acute care clinical scenario (using METI): coma
PBL 3 scenarios (the scenarios change from time to time)
IRS [12 hr]; Anatomy 2, Physiology 7, Microbiology 1, Pharmacology 1, Medicine 1
Student Presentation 2 hr session (topic changes from time to time)
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Essential Reading:
Books
Special references for CNS course:

Snell RS. Clinical Neuroanatomy, Lippincott Williams & Wilkins, 2005, ISBN 0781759
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Endocrine and Reproductive System

Course Code: MERS 32106
Synopsis:
This course is designed to provide you with core knowledge of the structure, functional
organisation and functions of various endocrine glands as well as the reproductive system. This is
followed by lectures on pathological processes and pathogenetic mechanisms underlying various
clinical conditions affecting this system, aetiologies, mechanisms and clinical features of
infections affecting this system and the rationale for the use of drugs in specific conditions
affecting endocrine glands. You will realise that the consequences of excess or deficiency of a
hormone are almost entirely predictable from their physiologic actions. In fact, the physiologic
effects of most hormones have been deduced from manifestations that occur when there is a
deficiency or excess of these hormones in clinical conditions. There are clinical sessions that will
use case studies to demonstrate application of the importance of basic knowledge of the structure
and functions of the endocrine and reproductive system to clinical practice. Two PBL scenarios
designed to foster learning of basic science content applicable to clinical practice augment this
sequence of T-L experiences.
Objectives:
Describe the gross and microscopic anatomy of the pituitary gland, thyroid gland, parathyroid
gland, adrenal gland, testes and ovaries; and the microscopic anatomy of the endocrine
pancreas;
List the hormones released by the pituitary gland and describe their physiologic effects;
Describe how the hypothalamus regulates the functions of the pituitary gland;
Describe the cellular mechanisms of action of hormones;
Describe the structure, synthesis, secretion, transport, metabolism and physiologic effects of
the following hormones growth hormone, thyroid hormones, parathyroid hormone, insulin,
glucagon, cortisol, catecholamines from the adrenal medulla, male and female sex
hormones;
Describe how the function of each endocrine gland is regulated;
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Predict the clinical manifestations excess or deficiency of a particular hormone based on

his/her knowledge of physiologic effects of each hormone
Interpret laboratory data of hormone levels in conjunction with clinical information and make
functional diagnoses, and if appropriate localise the site of defect, based on his/her
knowledge of regulation of secretion of various hormones;
Demonstrate familiarity with principles that underlie the use of biochemical tests of endocrine
function;
Discuss the pharmacologic effects, therapeutic uses and adverse effects of corticosteroids;
Briefly describe histopathologic, morphologic features and clinical consequences of common

neoplasms of endocrine glands;
Describe the development of the reproductive system, and the causes and consequences of
common abnormalities of development of the reproductive system;
Describe the gross and microscopic anatomy of the male and female reproductive systems.
Describe the physiologic functions of the testes and ovaries, and the physiologic effects of
testicular and ovarian hormones;
Describe the mechanism of puberty and physiologic changes occurring at the time of puberty;
Describe the phases of the menstrual cycle and regulation of reproductive function in
females;
Describe the steps involved in spermatogenesis and regulation of reproductive function in

males;
Describe the mechanism of the male sexual response and the female sexual response;
Briefly describe the causes, clinical manifestations of hypogonadism in males and females;
Describe the mechanism of fertilisation and changes following implantation of the fertilised
ovum;
Describe the structure and physiologic functions of the placenta and the foeto-placental unit;
Describe the physiologic adaptations that occur in a pregnant woman;
Describe the foetal circulation and discuss the differences between circulation in the foetus
and the adult;
Describe the mechanism of parturition;
Describe how functions of mammary glands are regulated;
Describe the clinical approach to a couple with infertility;
Classify tumours affecting the male and female reproductive systems and briefly discuss the
pathologic and clinical features of each of them;
Describe the causes, epidemiology, clinical features, laboratory diagnosis, prevention and
antimicrobial treatment of common sexually transmitted infections;
Describe the mechanism of action, uses and adverse effects of hormonal contraceptives; and
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Demonstrate familiarity with ethical issues in reproductive medicine.
T-L methods: 44 lectures, 4 dissection sessions, 4 practicals, 3 clinical sessions, 2 PBL, 9

interactive review sessions, 1 session for student presentations.
Contact hours: 90
The curriculum:
Lectures:
Endocrinology
1. [Med] Introduction to clinical endocrinology
2. [Ana] Anatomy of the pituitary, adrenal, thyroid & parathyroid
3. [Ana] Histology of the pituitary, adrenal, thyroid & parathyroid
4. [Ana] Development of the pituitary, adrenal, thyroid & parathyroid
5. [Phy] 2 lectures 5 and 6 on Pituitary gland: hormones produced by the anterior,
intermediate and posterior pituitary; the hypothalamo-pituitary axis; growth hormone
structure, mechanism of action, physiologic effects of growth hormone and somatomedins;
the physiology of growth; consequences of pituitary hyperfunction and pituitary insufficiency;
the physiologic effects of oxytocin.
7. [Phy] Thyroid gland: iodine metabolism in thyroid gland; synthesis of thyroid hormone;
transport of T4 and T3 in blood; physiologic effects of thyroid hormones; regulation of thyroid
secretion.
8. [Path] Diseases of the thyroid gland: aetiology, pathology of neoplastic and nonneoplastic
conditions affecting the thyroid gland
9. [Phar] Drug therapy for hypothyroidism and hyperthyroidism
10. [Med] Hypothyroidism and hyperthyroidism: aetiology, clinical features, diagnosis, and
principles of management of hypothyroidism and hyperthyroidism
11. [Phy] Parathormone and regulation of plasma calcium: distribution of calcium in normal
human plasma; brief overview of bone growth and turnover; the regulation of synthesis of 1,
25 dihydroxycholecalciferol; regulation of ionised calcium in plasma the role of PTH, vitamin
D, calcitonin and other factors; pathophysiologic consequences of hypoparathyroidism and
hyperparathyroidism.
12. [Phy] 2 lectures 12 and 13 on Adrenal gland: adrenal cortex - hormones produced by each
zone of the adrenal cortex; the mechanism of action and physiologic effects of
glucocorticoids; consequences of glucocorticoid excess and deficiency; regulation of
adrenocortical function by ACTH; circadian rhythm in ACTH secretion; changes in adrenal
responsiveness caused by suppression of ACTH release. Adrenal medulla hormones
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secreted by the adrenal medulla; physiologic effects of epinephrine, norepinephrine and

dopamine; regulation of adrenal medullary secretion; pathophysiologic consequences of an
epinephrine or norepinephrine secreting tumour
14. [Phar] Pharmacology of corticosteroids: mechanism of action, uses, adverse effects of
glucocorticoids
15. [Path] Neoplasms of the pituitary and adrenal gland
16. [Phy] 2 lectures 16 and 17 on Endocrine functions of the pancreas: secretion of insulin,
half-life of insulin versus C-peptide; physiologic effects of insulin and other hormones of the
endocrine pancreas glucagon and somatostatin; consequences of insulin deficiency, insulin
resistance the pathophysiology of diabetes mellitus; consequences of insulin excess; the
mechanism of clinical manifestations of hypoglycaemia.
18. [Phar] Pharmacologic management of diabetes: oral antidiabetic drugs classification,
mechanism of action & pharmacologic effects, insulin therapy, newer antidiabetic drugs.
19. [Med] Diabetes Mellitus: Types, aetiology, pathogenesis, diagnostic criteria, clinical
features, the distinction between type I and type II diabetes.
20. [Bio] Laboratory evaluation of endocrine function: theoretical and practical considerations
in testing hormone levels and endocrine responses.
Reproductive System:
21. [Cli] Introduction to reproductive medicine
22. [Ana] Gross anatomy of female internal genitalia
23. [Ana] Gross anatomy of male internal genitalia
24. [Ana] Gross anatomy of male and female external genitalia
25. [Ana] Histology of the male and female genital tract
26. [Ana] Development of the urogenital system
27. [Phy] Regulation of development of the gonads in intrauterine life: the default genetic
programme for development of gonads; hormones produced by the embryonic testes; the
role of testosterone, dihydrotestosterone, Mullerian inhibiting substance in the development
of gonads; mechanisms of male and female pseudohermaphroditism defects implicated in
congenital adrenal hyperplasia and testicular feminising syndrome.
28. [Phy] Puberty: the definition of puberty; the meaning of thelarche, pubarche, menarche and
adrenarche; secondary sexual characteristics; control of the onset of puberty; pituitary
gonadotropins; the mechanism of action and physiologic effects of testosterone and
dihydrotestosterone; regulation of testicular function; meaning and mechanisms of
precocious, delayed or absence of puberty.
29. [Phy] Spermatogenesis and the male sexual response: functional organisation of the
seminiferous tubules, the blood-testis barrier; spermatogenesis; further development of
110
spermatozoa; factors affecting spermatogenesis; the normal composition of semen; the male
sexual response the mechanism of penile erection and ejaculation.
30. [Phy] Menstrual cycle: the ovarian cycle; the endometrial cycle; normal menstruation; cyclic
changes in the uterine cervix; vaginal cycle; cyclic changes in the breasts; indicators of
ovulation.
31. [Phy] Ovarian hormones: hormones produced by the ovary; mechanism of action and
physiologic effects of estrogens; other ovarian hormones relaxin, inhibin; regulation of
ovarian function; mechanisms causing luteolysis; physiologic mechanism of action of
contraceptives.
32. [Phy] Gametes, conception and early pregnancy: the mechanism of fertilisation; why the
foetal graft is not rejected; endocrine changes in pregnancy the role of human chorionic
gonadotropins, human chorionic somatomammotropin and other placental hormones.
33. [Phy] Placental and foetal circulation; functions of the placenta: placenta the foetal
lung; foetal circulation; the foeto-placental unit; assessment of placental function; changes in
foetal circulation at birth.
34. [Phy] Adaptations to pregnancy: brief review of physiologic adaptations in the pregnant
woman. Parturition the trigger and the mechanism of parturition; the role of oxytocin;
mechanisms that prevent excessive blood loss from the uterus during parturition. Lactation
hormones affecting mammary glands, lactopoiesis and lactation; the milk ejection reflex.
35. [Cli] Male infertility: clinical definition, aetiology of male infertility, approach to a patient with
infertility, investigations and principles of management.
36. [Cli] Menopause; Ovarian failure: Menopause: the meaning of menopause; the definition
of menopause; mechanism of menopause; clinical problems in postmenopausal women and
principles of management of these symptoms; premature menopause. Ovarian failure aetiology of ovarian failure; consequences of ovarian failure.
37. [Sur and Path] Benign diseases of the breast
38. [Path] Pathology of breast cancer: aetiopathogenesis (risk factors), classification of breast
malignancies; gross and microscopic features.
39. [Path] Tumours of the testes, prostate: aetiology, classification, histologic and gross
morphologic features of neoplasms of the testes and prostate.
40. [Path] Overview of tumours of the female genital tract: an overview of benign and
malignant neoplasms of the ovary, uterus and uterine cervix.
41. [Mic] 2 lectures 41 and 42 on Sexually transmissible infections: aetiology, epidemiology,
pathogenesis, clinical features, and laboratory diagnosis, prevention and antimicrobial
treatment of common sexually transmitted infections.
43. [Phar] Basics of hormonal contraception
44. [Cli] Ethical issues in the manipulation of human reproduction
111
Dissection:
1. Pituitary and adrenal
2. Pelvis
3. Female genital tract
4. Male genital tract
Practicals:
1. [Ana] Histology of the pituitary, thyroid, parathyroid and adrenal glands
2. [Ana] Histology of male and female reproductive tract
3. [Path] Endocrine and reproductive pathology
4. [Mic] Reproductive tract infections
Clinical Sessions [3 sessions, 2 hr each]:

1. Case studies in Endocrinology
2. Manipulation of fertility
3. Parturition
PBL: 2 PBL scenarios (the scenarios will change from time to time)
Student Presentations: topic may change from time to time.
IRS [9]
Anatomy 1, Physiology 2, Pathology 1, Pharmacology 1, Microbiology 1, Medicine 1, Obstetrics &
Gynaecology 1
Essential Reading:
Books
Norman.S.Williams ,Christopher J.K.Bulstrode & P.Ronan O Connell Bailey & Loves Short
Practice of Surgery, Edward Arnold publishers ,ISBN 9780340939376
References in Endocrinology:
Greenspan FS and Gardner DG. Basic & Clinical Endocrinology, McGraw-Hill Professional,
2003, ISBN 0071402
112
Renal System
Course Code: MREH 32104
Synopsis: This course is designed to provide you with core knowledge about the structure,
functional organisation and functions of the kidneys and the urinary tract. This is followed by
lectures on pathological processes affecting the kidneys (example, pathology of glomerular
diseases), and causes, features, diagnosis of infections of the urinary tract. You will realise that
effects of drugs used to alter tubular function (example, diuretics) can be predicted using your
knowledge of physiologic mechanisms of solute handling by the kidney. How renal function can
be assessed will be alluded to. Finally, there are two clinical lectures to provide an account of the
aetiology, pathogenesis, clinical features and principles of management of acute and chronic
renal disease. Two PBL scenarios designed to foster learning of basic science content applicable
to clinical practice augment this sequence of T-L experiences.
Objectives:
At the end of this course, the learner will be able to:
Describe the gross anatomy of the kidneys and the urinary tract and the microscopic anatomy
of the nephron and the urinary tract;
Appreciate why kidneys are endowed with a tremendous blood flow (nearly 20% of cardiac
output);
Describe how glomerular filtration rate and renal blood flow are regulated and predict the
consequences of changes in renal blood flow in physiologic or disease states;
Describe how each segment of the nephron contributes to handling solute and water;
Describe renal mechanisms for regulating water excretion;
Describe renal mechanisms for regulating osmolality of body fluids;
Describe the role of the kidneys in the maintenance of acid-base balance;
Appreciate the role of the kidneys in the pathogenesis of conditions such as hypertension and
heart failure;
Classify diuretics. Describe the mechanism of action of different diuretics, indications, and
side effects of each class of diuretics;
Describe how micturition is controlled and predict effects of lesions affecting different
components of the micturition reflex;
Classify tests used to assess renal function and explain the rationale for the use of these
tests and how they are altered in acute or chronic renal disease;
Classify diseases that affect the glomeruli and discuss the pathogenesis and pathologic
features of these conditions;
113
Mention microbes commonly implicated in urinary tract infections and describe the clinical
features and laboratory diagnosis of urinary tract infections;
Describe the aetiology, pathogenesis, clinical features and principles of management of

nephritic and nephrotic syndrome; and
Enumerate common causes and describe the pathogenesis, clinical features and principles of
management of acute and chronic renal failure.
T-L methods: 28 Lectures, 4 Practicals, 2 Dissection Sessions, 2 PBL, 9 Interactive Review

Sessions, 4 hr clinical skills training; 1 session for Student Presentations
Total contact hours: 68

The Curriculum:
Lectures
1. [Med] Introduction to renal medicine: the scope of renal medicine; symptoms and signs of
renal dysfunction.
2. [Ana] Anatomy of the kidneys and ureters: gross anatomy of the kidneys and ureters
their anatomic relations, blood supply, lymphatic drainage and nerve supply.
3. [Ana] Anatomy of urinary bladder, prostate and urethra: gross anatomy of the urinary
bladder, prostate and urethra their anatomic relations, blood supply, lymphatic drainage
and nerve supply.
4. [Phy] Overview of renal physiology: functional anatomy of the nephron; cortical versus
juxtamedullary nephrons; functional anatomy of the juxtaglomerular apparatus.
5. [Ana] Histology of the nephron and urinary tract
6. [Ana] Development of the kidneys and the urinary tract
7. [Phy] Renal blood flow: renal blood flow, renal plasma flow, the relationship between renal
blood flow, renal plasma flow and GFR, the concept of renal clearance, measurement of
renal plasma flow, regulation of renal blood flow, regional variations in renal blood flow,
extrinsic regulation of renal blood flow, autoregulation of renal blood flow.
8. [Phy] Glomerular filtration: glomerular ultrafiltration, factors determining glomerular filtration
rate, meaning of glomerular filtration rate (GFR), measurement of GFR, extrinsic regulation of
GFR, mechanisms of autoregulation of GFR.
9. [Phy] Tubular function [Part 1]: tubular handling of glucose, amino acids, phosphate,
organic acids, organic bases and ions; tubuloglomerular feedback.
10. [Phy] Tubular function [Part 2]: renal mechanisms for conservation of body fluid volumes;
the countercurrent mechanism; renal regulation of potassium excretion.
114
11. [Bio] 2 lectures 11 and 12 on Role of kidneys in acid-base balance: mechanism of

bicarbonate reabsorption by the nephron; the mechanism of secretion of H ions into tubular
fluid; buffers in tubular fluid and urine; renal ammoniagenesis as an adaptive mechanism in
chronic renal disease; titratable acidity of urine; anion gap in urine.
13. [Phy] Role of kidneys in regulation of body fluid volumes: the need to regulate body fluid
volumes; mechanisms sensing blood volume integration of inputs by the brain and
neural (sympathetic) and humoral mechanisms (renin angiotensin aldosterone system,
natriuretic peptide, antidiuretic hormone, glucocorticoids) affecting renal excretion of salt and
water.
14. [Phy] Role of kidneys in regulation of osmolality of body fluids: the need to regulate
osmolality of body fluids; osmoreceptors; humoral mechanisms affecting renal excretion of
water special reference to the role of antidiuretic hormone.
15. [Phy] Control of micturition: functional anatomy of the bladder, innervation, the micturition
reflex, and abnormalities of micturition.
16. [Phar] 2 lectures 16 and 17 on Diuretics: mechanism of action, indications and adverse
effects.
18. [Bio] 2 lectures on 18 and 19 on Renal function tests: tests of glomerular function; tests of
tubular function.
20. [Path] 2 lectures 20 and 21 on Glomerular pathology [Part 1]: classification of glomerular
diseases, pathogenetic mechanisms; pathologic features of various glomerulopathies.
22. [Mic] 2 lectures 22 and 23 on Urinary tract infections: aetiology, pathogenesis, clinical
features and laboratory diagnosis.
24. [Med] Acute renal failure: aetiology, clinical manifestations, diagnosis and principles of
management.
25. [Paed] The nephritic syndrome in childhood
26. [Path] Tumours of the kidney and urinary tract
27. [Med] 2 lectures 27 and 28 on Chronic renal disease: aetiology, clinical manifestations,
diagnosis and principles of management.
Practicals:
1. [Ana] Histology of the kidneys and the urinary tract
2. [Phy] Role of kidneys in the regulation of body fluid volumes
3. [Path] Renal pathology
4. [Integrative] Qualitative and quantitative analysis of urine
115
Dissection:
Gross anatomy of the kidneys and the urinary tract [2 sessions]
Clinical Skills:
Urinary bladder catheterization
Reading a plain x-ray of kidneys, ureter and bladder (KUB), and Intravenous Urogram (IVU)
PBL: there are 2 PBLs (scenarios will change from time to time)
Student Presentations: the topic may change from time to time
Interactive Review Sessions [9]

Anatomy 2, Physiology 2, Pathology 1, Pharmacology 1, Microbiology 1, Medicine 2
Essential Reading:
Books
Lote CJ. Principles of Renal Physiology, 2000, Springer, ISBN 0792361784
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Haematology
Course code: MREH 32104
Organised by the Unit of Pathology
Synopsis: The main aim of this course is to provide an account of the etiology, pathogenesis
and pathologic features of diseases affecting the bone marrow and formed elements of blood.
The course will emphasise the utility of the knowledge base imparted to clinical practice. The
course assumes prior knowledge of basics of haematology already dealt with in Element 2 of the
MCBM course in year 1 of the programme.
Objectives: At the end of this course, the learner should be able to:
Classify anaemias based on aetiology and pathogenetic mechanisms and describe the
pathologic features and laboratory diagnosis of various types of anaemias;
Classify and discuss the etiology, pathogenesis, pathologic features and laboratory diagnosis
of leukopenia, leukocytosis, leukaemias and lymphomas;
Discuss the manifestations of deficiencies of clotting factors on haemostasis;
Discuss the manifestations of disseminated intravascular coagulation; and
Discuss the principles and methods of pre-transfusion compatibility testing and transfusion
reactions;
Describe pharmacologic management of anemia;
Describe the management of iron toxicity.
T-L methods: 11 lectures, 2 IRS, 2 practicals

The Curriculum:
Lectures:
1. Overview of hematology: overview of hematology, normal development and function of
blood cells; definition, classification and overview of anaemias.
2. 2 lectures 2 and 3 on Anaemias: pathological features of iron deficiency anaemia,
megaloblastic anemias and pernicious anaemia; haemolytic anemias - sickle cell anaemia,
thalassemia, hereditary spherocytosis and autoimmune haemolytic anaemia.
4. 2 lectures 4 and 5 on Disorders of leucocytes: aetiology and pathogenesis of
leucocytosis; agranulocytosis, leucopenia, leukemoid reactions; classification of acute and
chronic lymphoblastic leukemia; acute and chronic myeloblastic leukemia
117
6. Myeloproliferative myelodysplastic disorders and multiple myeloma: polycythemia,

myelofibrosis, essential thrombocythemia and myelodysplastic syndromes; multiple myeloma
7. Lymphomas: classification and pathological features of non-Hodgkins lymphomas and
Hodgkins lymphoma
8. Platelet disorders: thrombocytosis and thrombocytopenia, bleeding disorders related to
defective platelet function
9. Bleeding disorders related to abnormalities in clotting factors: haemophilia, Von
Willebrand disease, disseminated intravascular coagulopathy
10. Transfusion medicine: blood groups; routine pre-transfusion compatibility testing; the
mechanism of transfusion reactions.
11. Pharmacological treatment of anaemia
Practicals (2 sessions; 2 hr each)

Interpretation of abnormalities in the peripheral blood smear
Essential reading
th
A.V. Hoffbrand , PAH Moss and J.E. Pettit Essential Haematology
118

Term 2 of Year 2
Duration: 3 weeks
Overview: Although you are only in the second year of the programme, it is necessary to now
obtain an idea of how the core knowledge you are accumulating in the basic sciences is applied
in the context of patient care. As a first step to achieving this, the revised curriculum features the
integration of clinical skills training into the CVS, RS, GIT and CNS courses so that you are
trained in taking a history and acquiring basic skills required to perform a physical examination in
the rather controlled environment of the clinical skills centre. As a second step, there is a threeweek clinical attachment that is primarily intended to sensitise you to the real world of human
illnesses and means of caring for them. This attachment will be your first visit to a tertiary health
care centre as a medical student. Undoubtedly, this is going to be a memorable and academically
rewarding experience. During this attachment, you will have the opportunity to observe patients
being diagnosed and treated in medical and surgical wards. You will start to interact with patients
on a one-to-one basis taking detailed medical histories and performing physical examinations.
The acquisition of clinical skills takes time. Doctors continue to learn throughout their career and
you are at the very beginning of this process. Many students find the transition from lecture
intensive courses in medical school to experiential learning in a hospital environment stressful.
Anxieties about asking personal questions and performing physical examinations are quite
common. If any aspect of your work worries you, please bring it to the attention of your immediate
supervisor.
Note: Students must provide evidence that they have received the recommended course of
Hepatitis B vaccine before their first clinical attachment. This is as per MOH recommendations.
Structure of the First Clinical Attachment (by rotation):

Week 1
CLINICAL LAB
Week 2
Medicine / Surgery
Week 3
Clinical Skills Training at Clinical Skills Centre
119
Objectives:
To provide you with opportunities to:
Take history from patients with specific symptoms;
Learn how to record vital signs (BP, pulse, JVP);
Learn how to examine organ systems;
Sensitise you to examine the patient as a whole instead of focusing on signs;
Learn how to read and write case notes;
Appreciate the impact of psychologic and social factors on physical illness;
Become familiar with the role of nursing, pharmacy, radiology, and clinical
pathology departments in a tertiary care health centre
Become familiar with infection control procedures used in a large hospital
Attendance and Assessment: Attendance for all sessions in the clinical curriculum is
compulsory. This includes the teaching in the Faculty during this attachment, bedside teaching
and attendance at the hospitals for the practice of clinical skills. There will be no formal
examination of your skills or knowledge at this stage. However, at the end of this attachment,
you will have an assessment and your teachers will provide you with useful feedback. Your
supervisors will assess your performance as satisfactory or otherwise with respect to your
personal grooming and adherence to the dress code specified in this document, attendance,
punctuality, behaviour toward patients, colleagues and healthcare professionals. Your teachers
will point out anything that they perceive as unsatisfactory to you during your teaching, so that
you have an opportunity to address the issue. However, if a problem remains then it will be
reported to the preclinical deputy dean and you will be asked to discuss the issue with him/her.
Do not under any circumstance:

1. violate the prescribed described Dress Code and bedside manners.
2. initiate, alter or stop treatment of a patient on your own. This must be performed only by the
registered medical practitioner caring for them.
3. prescribe, request radiological examinations or other diagnostic investigations or order
blood to be cross matched. If students complete an order form for any of these purposes, it
must be signed by the registered medical practitioner supervising them before it is carried
out;
4. give patients at any time the impression that you are a qualified medical professional
introduce yourself to them as an undergraduate medical student in training;
5. take history or perform a physical examination or undertake a procedure on a patient
without obtaining an informed consent. If this is not practicable (as in the case of patients
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who for whatever reason cannot provide informed consent), the student must seek the
permission of the physician caring for this patient.
6. However, remember that in the case of an emergency for example, when you witness a
cardiac arrest out of the hospital, medical students have the same rights and
responsibilities as any other citizen of this country.
1. Swash M. Hutchisons Clinical Methods, W B Saunders, 1995, ISBN 0702016756
2. Lumley JSP. Hamilton Baileys Physical Signs: Demonstration of Physical Signs in Clinical
Surgery, Hodder-Arnold Publication, 1997, ISBN 0750616210
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Special Study Module (SSM)

In the preclinical years, the SSM programme is intended to provide you with an opportunity to
1. Engage in in-depth study of something related to medicine and health care that interests you
but is not covered in detail in the core curriculum
2. To read and present your understanding of primary biomedical literature (for example, a
journal article resulting from original research) in your own words;
3. To present a review of literature on a topic not already covered in significant detail in the core
curriculum.
The main feature of the Special Study Programme is that it is intended to be learner centred and
learner driven. Your supervisor will not be very prescriptive about what you should do but will
offer guidance as to how you can go about achieving the primary objectives of this exercise.
The SSM Webpage of the Faculty of Medicine is http://groups.google.com/group/ssm-at-aufom

Alternately, click on this Link http://tiny.cc/7a5e1
Types of Special Study:

The SSM programme is necessarily flexible and there are different approaches you can take and
we encourage you to be as imaginative as possible. Some of the approaches are briefly
described below:
1. Review of literature on a focused topic: In the past, we have had students often
choosing topics such as diabetes, hypertension, obesity, and asthma for detailed study.
Although some are well written, the fact that exhaustive chapters on these conditions are already
available in routinely used textbooks may discourage you from embarking on an active review of
literature. If you wish to review literature, you are encouraged to identify a somewhat focused
topic rather than very broad ones. Some examples of topics considered focused enough for
undergraduates are listed below:
Tissue based renin angiotensin systems
Pharmacogenomics and individualised drug therapy
Reprogramming differentiated cells into pluripotent stem cells
Nanotechnology: promises and pitfalls
Analysis of skewed data from smaller samples
Music therapy
Globalisation of healthcare
Health consequences of global warming
Vaccines for controlling blood pressure: possibilities and pitfalls
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You are expected to present a written account of your understanding of what you review in your
own words. A well written essay of about 15 double spaced pages (about 3000 words) would be
acceptable these word limits are for guidance only, and it is the quality of your review that is
important.
2. Undertaking courses / online modules to augment your knowledge in a

particular topic or area: You are encouraged to undertake taught modules or online courses.
In this case, a detailed written report is not required but you must demonstrate proficiency in the
subject area covered by that module by passing a Post-test these are often part of the course.
You need to be certified as having taken and completed the course successfully. For example,
the World Medical Association offers an ethics module (visit http://www.wma.net/e/ for details).
Facilitators would additionally test your proficiency in the same area and assess the quantum of
work you have undertaken before approving your SSM.
3. Reviewing literature with the intention to answer a specific question: You may
have come across questions that you do not have an obvious answer for although you have
searched for it in textbooks, lecture notes etc. It may be a good idea to explore published
literature to answer your question: For example, what determines whether an individual infected
with M. tuberculosis develops clinically active form of the disease? is quite a specific question for
which there is probably no straightforward answer at least, this is complex enough to merit a
scholarly discussion. Obviously, your question has to be well formulated as well as merit this
approach i.e., the answer should not be obvious. Check with some of your colleagues and your
supervisor before you proceed with this approach. For example, one of our students Yugaseelan
recently insisted on knowing how bilirubin enters the blood stream in Dubin-Johnson syndrome
and he eventually found that out by reviewing published literature. The essence of his SSM How
does conjugated bilirubin appear in the blood stream? is published and available online at
http://advan.physiology.org/cgi/content/full/31/4/370. This is a very fundamental question but you
are unlikely to find this out if you just read the textbooks you routinely use.
4. Reviewing one or two scholarly journal articles: You may select one peer reviewed
journal article (it may be a research article or an article whose subject content merits multiple
perspectives) that interests you, read it thoroughly and critically and write a balanced, pointed,
scholarly commentary on that article in your own words. The length of your commentary may be
about 1000 words. Choosing a suitable article is very important. Please consult with your
facilitator once you have selected an article or your facilitator may help you select one. It would
be nice if the article is in someway related to the course(s) you have recently finished so that it
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will help you build upon what you have learnt and strengthen your understanding of something
interesting and important. As an example, see Esmail A. Failure to act on good intentions, BMJ,
2005; available online at http://www.bmj.com/cgi/content/full/330/7500/1144. You may choose an
article of this kind after you complete the ethics module in HBM.
As another example, see Miller BF et al. Haematological and acid-base changes in men during
prolonged exercise with and without sodium lactate infusion. Journal of Applied Physiology 2005;
free full text at http://jap.physiology.org/cgi/content/full/98/3/856, is an original research article and
your commentary on this may consist of sections like what was the purpose of this study; what
did the authors do; why they did what they did; what they found; how they interpret their
observations; their conclusion; your interpretation of the same data and your conclusions. It is a
good idea for you to discuss the article with your facilitator before you write your commentary.
Also, it is a good idea to select an article and approach a potential facilitator who may be
interested in the subject content covered by the article.
5. Other types of SSM: You do not have to be alone when SSM are done. You can form
groups of 3-5 students, identify a theme for a scholarly debate and approach potential faculty
facilitators. The proceedings of the debate can be presented as a Special Study Module. If you
are good with computers and programming, you can develop learning modules that your
colleagues may find helpful. If you have alternate ideas for an SSM, please consult your facilitator
or the SSM Coordinator R Jegathambigai (jegathas@yahoo.com)
You will be allotted a faculty supervisor. You are advised to meet your supervisor first to express
the area(s) on which you propose to do a SSM. Please seek your supervisors advice and
feedback as often as they advice. Please note that the topic for special study has to be chosen by
the student and negotiated with the supervisor it does not have to necessarily match the
interests and expertise of your facilitator.
Time to spend on an SSM: As a general guideline, you should spend about 40 hours for
planning, preparing, making drafts, writing and finalising your SSM. There is plenty of time for
directed self-learning built into the timetable. You can make use of some of this time for preparing
your SSM.
Preparing your report: Except when you undertake a taught module or an online course, you
are required to prepare a report of your special study. So that no important section is omitted, a
template is provided as a Microsoft Word document at the SSM Webpage to help you prepare
your report. Please do not change font and font sizes. Double-space all parts of your report
including tables, figures and references. More details on presenting a written report of your work
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including guidelines for writing references are also available at the SSM webpage. When you
have undertaken a taught module, print a copy of the course content and certificate of completion
of the course and submit it to your supervisor.
References: In doing your work and preparing your report, you may be collecting information
from a variety of sources books, journal articles, internet etc. It is important to refer to the exact
sources in some way; with few exceptions, most of them are listed as References in your report.
This serves two purposes. First, readers who are interested in the references should have the
necessary information to access the references. Second, in a written or even or a spoken
account, it is important to distinguish our understanding or point of view from the point of view of
others, and other factual information already published elsewhere. Guidelines for writing
references are available at the SSM webpage.
What to cite and what not to cite? As a general rule, avoid citing literature that is unlikely to
have undergone peer review. For example, if you arrive at important conclusions regarding the
effects of smoking on cardiovascular health from a casual blog post, it is possible that an
individual working for the tobacco industry might have written this and the conclusions you arrive
at based on this post alone may be misleading. Of course, you may cite it if this is the very
background to you what you plan to investigate. A simple tip for bypassing literature that has not
been peer reviewed is to use Google Scholar rather than Google as the search engine for
searching scholarly content on the internet. However, please note that Google Scholar does not
index all scholarly content on the web. PubMed http://www.pubmed.org is a database of abstracts
maintained by the National Library of Medicine, USA.
Ethical guidelines: Plagiarism is presenting someone elses work as our own. Often, at least
amongst students and young researchers this is unintentional and due to ignorance. You are
advised to read this article published by the Publications Committee of the American
Physiological Society: What you need to know about ethical issues when writing a scientific paper
[available at http://www.the-aps.org/publications/ethicalposter-aps.pdf accessed Aug 2010]
You may find it difficult to better express something already very well said. For example, Lubert
Stryer succinctly summarised the link between energy transduction processes in the universe
thus: Life is powered by proton batteries that are ultimately energised by the sun. You can quote
the author verbatim, or paraphrase it (i.e., use your own words to describe what you understand
from this). The above statement by Stryer may be paraphrased like this for example: ATP
synthesised using proton batteries generated in the mitochondria energises all life processes. But
the ultimate source of all this energy is the sun. Having paraphrased it, you should cite the author
125
who gave you this impression. With the facility of the internet, it is not difficult to plagiarise; it is
also not difficult to tell if a piece of work is plagiarised. Because presentation and publication of
research papers, reviews and other articles in journals and other media is weighed into evaluating
students and academics for eligibility for grades and promotions, plagiarism is considered a
serious form of scientific misconduct.
Writing style: Use simple English. Avoid lengthy sentences. Please avoid using abbreviations. If
they must be used, they must be defined at first mention, and a list of abbreviations is best
provided at the beginning.
Having your work reviewed: Please submit drafts of your SSM to your supervisor well in
advance of deadlines. It is a good idea to present the progress of your work at periodic intervals
or as often as the supervisor wishes to see.
Submitting your SSM: Please submit one hard copy of a completed SSM to your supervisor.
Your supervisor will evaluate it, and if it is approved you can then submit it to the SSM
Coordinator and it will eventually be submitted to Deans Office. SSMs without your signature and
the signature of your supervisor will not be accepted as complete. If your supervisor requests a
hard copy of your SSM for his/her records, you can submit another copy to him/her. Please
retain a hard copy of your SSM for your records, as the copy you submit to Deans Office will
not be returned.
Deadline for submission: SSMs complete in all respects and approved by the supervisor must
be submitted to the Deans Office 6 weeks before the start of Year 2 Final Examinations.
Assessment of your SSM: The SSM programme exemplifies the Facultys keenness in having
you begin to assume responsibility for your learning. In the end, you must be satisfied that you
significantly improved on some front. Your supervisor will certify if the quality of your work is
satisfactory or not. We wish to strongly encourage you to publish your SSM in an appropriate
peer reviewed forum. Regardless of the subject area in which you have worked (it could be
anatomy, physiology, medicine, statistics, or anything clearly related to health and healthcare),
we believe that the quality of your SSM indicates something about your knowledge, skills and
potential. For this reason, you can use good SSM to your advantage if you happen to be called in
for viva-voce for possible redemption from borderline scores, a SSM done well may impress the
panel of examiners compared to a poorly conceived and poorly prepared piece of work.
126
Essential Reading for Year 1 and 2:

In addition to books listed below, Faculty members may suggest specific reading for certain
topics. Please follow their advice. Please also note references listed for each course under the
respective courses in Year 1 and 2.
Anatomy:
Chaurasia Human Anatomy Volume 1, 2&3 ISBN-10 / ASIN: 8123911556 (v.1) ISBN
8123911564 (v.2) ISBN 8123911572 (v.3)Frank.H.Netter Netters Atlas of Human Anatomy
ISBN 9780808924234
Inderbir Singh Textbook of Human Histology Publisher Jaypee ISBN 9788180618093
Thomas W Sadler Langmans Embryology Published by Lippincott Williams & Wilkins,ISBN
9788184732207
2006, ISBN 078176274X [or]
Physiology:
nd
Marya RK. Medical Physiology, CBS Publishers, New Delhi, 2 edition, ISBN 8123909640 [or]
Ganong WF. Review of Medical Physiology, Mc Graw Hill Professional, 2005, ISBN 0071440402
Marya RK. Pathophysiology, CBS Publishers, New Delhi, 2006, ISBN 8123913443 [or]
McPhee SJ, Lingappa, Ganong WF. Pathophysiology of Disease, Mc Graw Hill, 2006, ISBN
007144159X
Guyton AC and Hall JE. Textbook of Medical Physiology. Elsevier Saunders, 2006, ISBN
0721602401 [or] Review: Barrett KE, Barman SM, Boitano S, Brooks H. Ganongs Review of
Medical Physiology, Mc Graw Hill Co, 2009 [full text access available via
http://www.accessmedicine.com [Institutional user name and log in required]
Pathophysiology:
Marya RK. Pathophysiology, CBS Publishers, New Delhi, 2006, ISBN 8123913443 [or] McPhee
SJ, Lingappa VR, Ganong WF. Pathophysiology of Disease. An Introduction to Clinical
Medicine, McGraw-Hill Professional, 2006, ISBN 007144159X full text access available via
http://www.accessmedicine.com [Institutional user name and log in required]
127
128

Berne RM, Levy MN, Koeppen BM, and Stanton BA. Physiology, Mosby, 2004, ISBN
0323033903
Bijlani R L. Understanding Medical Physiology, 3rd ed., Jaypee Publishers, 2004.
th
Bullock J, Boyle J, Wang MB. Physiology, National Medical Series for Independent Study, 4
edition, 2001, Lippincott Williams & Wilkins, ISBN 0683306030
Ganong WF. Review of Medical Physiology, Mc Graw Hill Professional, 22nd edition, 2005, ISBN
0071440402
Marya RK et al. Learning Physiology Through New Style MCQ. CBS Publishers, 2001
Silverthorn DU. Human Physiology - An Integrated Approach. Pearson Education Limited, 2003,
ISBN 0131020153
Tortora GJ, Grabowski SR, and Derrickson BH. Introduction to the Human Body, The
Essentials of Anatomy and Physiology, Published by John Wiley & Sons, 2006, ISBN
0471691232
Widmaier EP, Raff H, and Strang KT. Vander's Human Physiology: The Mechanisms of Body
Function, McGraw-Hill, 2007, ISBN 007304962X
Biochemistry:
Essential Reading:
Vasudevan DM and Sreekumari S. Textbook of Biochemistry (for medical students), 2005,
Jaypee Brothers Medical Publishers, ISBN 8180613690 [or]
Richard A. Harvey PhD, Denise R. Ferrier, Lippincott's Illustrated Reviews: Biochemistry
(Lippincott's Illustrated Reviews Series) 5th Edition (2011) ISBN-10 1-6083-1412-X ISBN-13 9781-608-314126.

Brown TA. Genomes, Wiley Liss 1999, ISBN 0471316180
Devlin TM. Textbook of Biochemistry with Clinical Correlations, 2005, Wiley Medical, ISBN
0471814628
Murray RK, Granner DK, Mayes PA and Rodwell VW. Harpers Illustrated Biochemistry, 2007,
Mc Graw Hill
Nelson DL, Cox MM. Lehninger Principles of Biochemistry, 2003
Weaver RF. Molecular Biology, 2004, Mc Graw Hill, ISBN 0072846119
Microbiology:
Essential Reading:
th

Microbiology:
Ananthanarayan R & Paniker CKJ. Textbook of Microbiology, 8th edition. Orient Longman,
2009
Helbert M & Nairn R. Immunology for Medical Students, Mosby, 2006, ISBN 10: 0-323-04331-3
Murray PR, Rosenthal KS, Pfaller MA. Medical Microbiology, Mosby, Elsevier, 2005, ISBN
0323033032
Sidhu HS, Kumari G and Rajesh PK. AIMST Microbiology Laboratory Manual, 2005 [contact Dr
P K Rajesh (rajesh.perumbilavil@gmail.com) for an electronic version]
Rajesh PK, Sidhu HS, AIMST FOM, Year 1 and Year 2 Microbiology Practical Log Book,
Updated 2010. An electronic version will be provided before the practical sessions commence.
Pathology:
Vinay Kumar, Abul K Abbas, Nelson Fausto and Richard Mitchell Robbins Basic Pathology,
th
Saunders Elsevier, 8 International Edition, ISBN 978-0-8089-2366-4

0443073341
Curran RC and Crocker J. Currans Atlas of Histopathology, Harvey Miller, London, 2000,
Harsh Mohan. Pathology: a quick review and MCQs. Anshan, 2005, ISBN 1904798209
0443073341
129
Pharmacology:
Essential Reading:
Tripathi Essentials of Medical Pharmacology,Jaypee publishers,ISBN 9788184480856
Katzung BG. Basic & Clinical Pharmacology, Mc Graw Hill Professional, 2006, ISBN
0071451536
Recommended texts and references:
Bennett PN, Brown MJ. Clinical Pharmacology, Churchill Livingstone, 2007, ISBN 0443102449
Curtis M, Page C, Curtis M, Walker M, Sutter M, Hoffman B. Integrated Pharmacology, Mosby,
2004, ISBN 0323035698
Howland RD, Mycek MJ, Harvey RA, Champe PC. Pharmacology (Lippincotts Illustrated
Reviews), Lippincott Williams & Wilkins, 2005, ISBN 0781741181.
Rang HP, Dale MM, Ritter JM, Lamb P, Flower RJ. Rang and Dales Pharmacology, Churchill
Livingstone, 2007, ISBN 0443069115
Tripathi KD. Essentials of Medical Pharmacology, Jaypee Brothers, 1988, ISBN 81717909
Reference: Goodman LS, Brunton LL, Gilman A, Lazo JS, Gilman AG, and Parker KL.
Goodman and Gilmans The Pharmacological Basis of Therapeutics, McGraw-Hill, 2005, ISBN
0071422803 [full text access available via http://www.accessmedicine.com Institutional user
name and log in required]
Epidemiology:
Abdul Rashid Khan, K A Narayan. Lecture Notes in Epidemiology, AIMST University 978-98343522-0-2 [or]
Gordis L. Epidemiology, Saunders, 2004 ISBN 0721603262
Statistics:
Hill AB. A Short Textbook of Medical Statistics, Hodder and Stoughton, 1977, ISBN 0340219572
[or]
Swinscow TDV, Campbell MJ. Statistics at Square One. 2002, BMJ, ISBN 0727915525.
Ethics:
A Campbell, G Gillett, G Jones. Medical Ethics, Oxford University Press, 2001, ISBN
0195584457
Malaysian Medical Association, Case Studies in Medical Ethics, Contact Kumar at 0340411375 or e-mail ethics@mma.org.my
130
Clinical Medicine and Surgery:

Douglas G, Nicol EF, Robertson CE. Macleods Clinical Examination, Churchill Livingstone,
2005, ISBN 0443074046 [or]
Swash M. Hutchisons Clinical Methods, W B Saunders, 1995, ISBN 0702016756 [or]
Lumley JSP. Hamilton Baileys Physical Signs: Demonstration of Physical Signs in Clinical
Surgery, Hodder-Arnold Publication, 1997, ISBN 0750616210
Boon NA, Colledge NR, Davidson S, Walker BR, Hunter JAA. Davidsons Principles and
Practice of Medicine, Elsevier, 2006, ISBN 0443100578 [or]
Kumar PJ and Clark M. Kumar & Clark Clinical Medicine, Elsevier Saunders, 2005, ISBN
0702027634
131
Assessment of Academic Performance:

Assessment serves several purposes. Timely feedback from teachers is intended to help you
remedy defects in learning before these misconceptions affect subsequent learning. This type of
assessment (often called formative assessment) occurs in interactive review sessions, one-toone meetings with lecturers, during PBL review sessions, case discussions, clinical skills training
sessions etc. Additionally, the Faculty has a more formal mechanism of periodically assessing
your competency and for providing you with feedback before you appear in the Final
Examinations (see definition below). These are called Continuous Assessment (CA) tests they
are notified tests held during and or at the end of each course in the MBBS programme. Please
note that dates of CA tests are fixed in the sense you can see from the academic calendar when
you will have CA tests in Year 1 of the programme. The exact schedule of CA Tests in Year 1 will
be displayed on the Facultys Notice Board at least 2 weeks in advance of the test. For example
in MCBM Element 2 (a course taught in Term 1 of Year 1), two CA tests are held one midterm
and one at the end of Term 1. In year 2, each system course ends with a CA Test.
Professional Examinations (PE) are summative assessments of academic performance.

These are used to determine if you have acquired the minimum level of competence required for
progressing to the next phase of the programme and eventually graduate as a doctor ready to
serve society i.e., pass / fail decisions are made. Each Professional Examination consists of
two or more Components and we refer to them as Exam Components.
The part of a Professional Examination that is held at the end of an academic year is called the
Final Examination. The Final Composite Score in each Component of a PE is a composite of
your CA Score in that Component and the score you obtained in the Final Examination in that
Component in the ratio 30 : 70 respectively. One needs to obtain a Final Composite Score of at
least 50% in each Component of PE to be considered as having Passed that Component.
Besides this, you need to obtain a CA score of at least 40% in each Component of PE I to qualify
to appear in the Final Examination in the corresponding Exam Component (for details see Rules
and Regulations of MBBS Professional Examinations, AIMST University, Revised August 2010).
Please ensure that you do not miss CA tests except when there are reasons that have been
accepted by the Dean as compelling, or can be justified to be compelling ground for absence as
stipulated by the Universitys Rules.
Both CA tests and Final Examinations use a variety of testing instruments to assess your
competence in various domains (knowledge, skills, and attitudes). You should plan ahead and
prepare well for your examinations and use exams to positively influence your learning.
132
The Grading Scheme* used on the Final Composite Score obtained in Professional Examinations
is as follows:
% Final Composite Score in an Exam Component
Grade
80-100
75-79
A-
70-74
B+
65-69
60-64
B-
55-59
C+
50-54
Below 50
The Final Examination held at the end of an academic year is often referred to as the Main
Examination. Depending on results of this Main Examination, the University additionally conducts
Final Examinations that, in Years 1 and 2, begin 3-5 weeks from the date of declaration of the
results of the Main Examination. These are called Supplementary Examination(s). They
provide a student who has failed in less than a stipulated number of Exam Components an
opportunity to reappear in the failed Exam Components and possibly progress to the next phase
of the programme without losing considerable time. However, the only Grades awarded in the
Supplementary Examination are C for Pass and F for Fail respectively. More details can be found
regarding Supplementary Examinations in Rules and Regulations of MBBS Professional
Examinations, AIMST University, Revised August 2010.
133
SCHEME OF PROFESSIONAL EXAMINATION I (PE I):
The Rules and Regulations of this Examination are mentioned in the document Rules and
Regulations of MBBS Professional Examinations, AIMST University, Revised August 2010.
Please read and be familiar with them. Below is only a summary of the Scheme of this
Examination. PE I has a total of 6 Exam Components 5 Theory Components (MCBM I, MCBM
II, MCBM III, HBM I and HBM II) and an Objective Structured Practical Examination [OSPE]. The
Final Examination in each Component is held at the end of Academic Year 1. The OSPE tests
practical skills taught across all three MCBM courses.
The Final Composite Score on which Pass/Fail decisions are made in each Component of PE I
is calculated for a maximum of 100 marks. This Score is a composite of the Continuous
Assessment (CA) Score and the score obtained in the Final Examination in the corresponding
Component in the ratio 30: 70 respectively.
Continuous Assessment (CA) in Year 1:
MBBS YEAR 1 CAS AFTER EVERY 8 WEEKS OF T/L
CA 1
CA 2
CA 3
CA 4
MCBM I
MCBM I
MCBM II
MCBM II
Element 1(1)
Element 1(2)
Element 4
Element 4
MCBM I
MCBM I
MCBM II
MCBM II
Element 2(1)
Element 2(2)
Element 5
Element 5
MCBM II
MCBM II
MCBM III
MCBM III
Element 3(1)
Element 3(2)
Element 6B/7 (1)
Element 6B/7 (2)
MCBM III
MCBM III
MCBM I
MCBM I
Element 6A/D (1)
Element 6A/D (2)
Element 8(1)
Element 8(2)
HBM -I
HBM -II
HBM -I
HBM -II
Society Health
Epidemiology(2)
Ethics
Statistics (2)
HBM -II
OSPE (1)
HBM -II
OSPE (2)
Epidemiology(1)
Elements1,2,3
Statistics (1)
Elements 4,5,6,7,&8
and Medicine
Continuous Assessment (CA) in MCBM:

Theory Components: In all MCBM elements, CA tests usually consist of a combination of
objective type questions; short-answer and/or long answer questions. Element Coordinators may
also use appropriate alternate testing instruments for assessing your competence. As an
example, extended matching items may be used instead of MCQ.
134
135
How is the consolidated CA score in each of the MCBM Theory Components derived?
Raw scores obtained in the various CA tests will be averaged and scaled down as summarised in
the Table below to derive your consolidated CA Score in MCBM I, MCBM II and MCBM III.
Exam
Marks
Marks
Total Marks
MCBM I
Elements 1 + 8: 15
Element 2: 15
30
MCBM II
Elements 3 + 5: 18
Element 4: 12
30
MCBM III
Element 6: 24
Element 7: 6
30
Component
Assignments /Short formative assessments may comprise upto 20% of continuous assessment
marks.
Practicals: An Objective Structured Practical Examination (OSPE) will be held during the
Continuous Assessment tests held at the end of Term 1 and Term 2. This will test practical skills
taught in MCBM courses. The Preclinical Coordinator will inform you well in advance the number
of stations from each Element of the course. The consolidated CA score in OSPE will be
computed for a maximum of 30 and derived as summarised below:
For CA1 Test, the number of Stations from various Elements is as follows:
MCBM Element
Stations
Marks
Scaled to
Max (A)
Histology (Element 1)
10
20
Physiology (Element 2)
10
Biochemistry (Element 3)
10
12
For CA2 Test, the number of Stations from various Elements is as follows:
MCBM Element
Stations
Marks
Scaled to
Max (B)
Pharmacology (Element 4)
Biochemistry (Element 5)
Microbiology (Elements 6A-6C)
Pathology (Element 6D and 7)
16
Anatomy (Element 8)
12
24
18
Weighted
Score
Your performance in the OSPE CA Test at the end of Term 1 [Elements 1-3] A
Max 12
Your performance in the OSPE CA Test at the end of Term 2 [Elements 4-8] B
Max 18
A + B scaled to
Max 24
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Prompt Submission of Completed Lab Reports [MCBM Elements 1-8]
Max 6
Total
Max 30
Continuous Assessment (CA) in HBM:

The duration of a CA test is typically about 2 hr. For Elements 1 and 4, there is only one CA test
at the end of the respective Elements. For Elements 2 and 4 there are 2 CA tests in each - one in
the middle of the Term in which the course is taught and one at the end of the corresponding
Element.
Element 1: Society, Health and Medicine

The question below appeared in a previous test. This is one question consisting of three subquestions.
1a
What is the social importance of doctor-patient relationship?
[3 marks]
1b
Explain the Parsons model of the sick role and the doctors role.
[3 marks]
1c
Discuss different types of doctor-patient relationship with appropriate examples.
[4 marks]
A paper typically consists of 4-5 questions. The recommended time for answering a question is
about 20 minutes.
Element 2: Epidemiology
The test consists of 2 sections Short answer questions and long answer questions consisting of
3-5 questions of which 3 have to be answered.
Element 3: Biostatistics
1. Short answer questions (usually involving interpretation of data)
Element 4: Ethics in Medicine

The test will consist of 3-4 modified essay questions. Given below is an example of a question
that appeared in a previous examination in the section on Ethics in Medicine:
Mrs. E is 80 years old and lives alone in an apartment. She has never had a serious illness. She
is admitted to hospital after falling on the stairs and suffering a fracture of the femoral neck and is
advised surgery by the orthopaedic surgeon for quick recovery. Before the surgery she is
diagnosed as having critical aortic stenosis. This diagnosis was confirmed by echocardiography.
The anaesthetist says that serious risks are associated with the surgery. Mrs. E says she does
not want to know about them. She wants her hip fixed because she simply cannot live with
reduced mobility. The anaesthetist feels that he has a duty to disclose the risks of anaesthesia.
137
Mrs. E has asked the anaesthetist not to disclose risks associated with hip surgery. She says that
her goal is to be able to walk and that further suffering from pain and immobility is not acceptable
to her. She tells the anaesthetist that any further discussion of risks will not change her mind but
might upset her.
Answer the following questions:

1a
Discuss the ethical issues applicable in this case.
[2 marks]
1b
Can the anaesthetist deny giving treatment in this case? Discuss.
[4 marks]
1c
What should the anaesthetist and surgeon do in this situation?
[4 marks]
How is your consolidated CA score in HBM I derived?

Raw scores you obtain in the CA tests in Elements 1 and 4 will be averaged and reduced to a
maximum of 30 marks.
How is your consolidated CA score in HBM II derived?

Raw scores you obtain in the CA tests in Elements 2 and 3 will be averaged and reduced to a
maximum of 30 marks.
Scheme of Final Examinations in MBBS PE I:

Note that one of the eligibility criteria to appear in any Component of Professional Examination I
is that a CA score of 40% is required in that Component. Please note that as summarised below,
each Exam Component is a composite of two or more Elements. The OSPE tests practical skills
across all three MCBM courses. The relative distribution of marks for each Element in Theory
Components is as tabulated below:
Subject:
Paper Code:
Element
Element
MCBM I
MMCM 31103
Elements 1 + 8 50%
Element 2 50%
MCBM II
MMCM 31104
Elements 3 + 5 60%
Element 4 40%
MCBM III
MMCM 31105
Element 6 80%
Element 7 20%
HBM I
MHBM 31101
Element 1 50%
Element 4 50%
HBM II
MHBM 31102
Element 2 50%
Element 3 50%
The scheme of Theory Papers (each of 3 hr duration, max 100 marks) in MCBM courses is as
follows:
Type of
Number of
Maximum
Average Time
Total Marks
Question
questions
marks per
Recommended
for this
Question
per Question
Section
MCQ*
50
About 1 min
50
SAQ
About 12 min
30
LAQ
10
About 24 min
20
*Multiple-Choice Questions: each question will be followed by four options. Only one response is correct.
Sometimes, one response is the best (or most appropriate) in comparison to the remaining three options.
You are instructed to Select the Single Best Response in each case. There is no negative marking for an
incorrect response.
The Score obtained for 100 shall be reduced to a maximum of 70 marks. This will be added to the
CA score (max 30) you obtain in the corresponding MCBM course to derive the Final Composite
Score for a maximum of 100 marks.
HBM I consists of 2 sections as indicated below. Both sections carry equal marks.
Section A Society, Health and Medicine [90 min]
Section B Ethics in Medicine [90 min]
138
Section
Type
No. of
Maximum
Maximum
Average Time
Questions
Marks per
marks for
Recommended
Question
this
per Question
Section
Society Health &
SAQ
15
About 12 min
Medicine
LAQ
10
20
About 24 min
Ethics in Medicine
SAQ
15
About 12 min
LAQ
10
20
About 24 min
70
Total Marks
The Score you obtain in the Final Examination for 70 will be added with your consolidated CA
score (max 30 marks) in HBM I to derive a Final Composite Score for a maximum of 100 marks.
HBM II consists of the following two sections as indicated below. Both sections carry equal
marks.
Section A Epidemiology [90 min]
Section B Biostatistics [90 min]
Section
Type
No. of
Marks per
Maximum
Average Time
questions
question
marks
Recommended
per Question
Epidemiology
Biostatistics
SAQ
15
About 12 min
LAQ
10
20
About 24 min
SAQ
15
About 12 min
LAQ
10
20
About 24 min
70
Total
The Score you obtain in the Final Examination for 70 will be added with your consolidated CA
score (max 30 marks) in HBM I to derive a Final Composite Score for a maximum of 100 marks.
OSPE: In the OSPE, the number of Stations in the Final Examination by discipline is as follows.
Each Station is typically about 2 min.
139
MCBM Elements
Stations
Max Marks
Elements 1 & 8
15
30
Element 2
10
Elements 3 & 5
Element 4
Elements 6A, 6B, 6C
Element 6D & 7
10
Total
35
70
Marks obtained in the Final Examination (Max 70 marks) will be added with the consolidated CA
score in OSPE (max 30 marks) to derive a Final Composite Score for a maximum of 100 marks.
140
SCHEME OF PROFESSIONAL EXAMINATION II (PE II)

The Rules and Regulations of this Examination are mentioned in the document Rules and
Regulations of MBBS Professional Examinations, AIMST University, and Revised August 2010.
Please read and be familiar with them. Below is only a summary of the Scheme of this
Examination. PE II has a total of 7 Exam Components listed below 6 Theory Components and
an Objective Structured Practical & Clinical Examination [abbreviated OSPE-OSCE]. The Final
Examination in each Component is held at the end of Academic Year 2. The OSPE-OSCE tests
practical and clinical skills taught across all of the courses.
Cardiovascular System [MCVS 32101]
Respiratory System [MRES 32102]
Gastrointestinal System [MGIT 32103]
Central Nervous System [MCNS 32105]
Endocrine and Reproductive System [MERS 32106]
Renal System and Haematology [MREH 32104]
OSPE-OSCE
The Final Composite Score on which Pass/Fail decisions are made in each Component of PE II
is calculated for a maximum of 100 marks. This Score is a composite of the Continuous
Assessment (CA) Score and the score obtained in the Final Examination in the corresponding
Component in the ratio 30: 70 respectively.
141
142
Continuous Assessment in Year 2 Courses:

There will be a written CA test as well as an OSPE/OSCE at the end of each of the following
Courses (Cardiovascular System; Respiratory System; Gastrointestinal System; Central Nervous
System; Endocrine and Reproductive System; and Renal System and Haematology). The
Scheme of the written test (duration 2 hr) is as follows:
Type of Question
Number of
Average Time
Maximum
Total
Questions
Recommended
Marks per
Marks for
per Question
Question
this
Section
Multiple-Choice Questions
35
About 1 min
35
Short-Answer Questions
10-12 min
25
Long-Answer Questions
20-24 min
20
10
Total Marks
70
Derivation of CA Score in each System Course (for Theory Components):

Reduced to
Your CA Score in the Written Test (max 70)
Max 24
Your Score in PBLs* in that Course
Max 6
Total (max) Consolidated CA Score 30
PBLs* Evaluation Scheme

Attendance/Punctuality: 1.5 marks per PBL (0.5 per session)
Participation (including communication skills) -2 marks per PBL
Learning outcomes (Handwritten write ups) 1.5 marks per PBL
Total 5 marks
As each system in Year 2 has two assessable PBLs, the PBL tutorial will be marked as
recommended above to a total mark of 10
Additionally a PBL based question will be included (additionally along with the CA theory
paper)
The total marks obtained in PBL (inclusive of 2 PBLs and the marks from the PBL theory
question) will be scaled to be determined out of 6 marks
Continuous Assessment in Practical and Clinical Skills:

An OSPE-OSCE is held at the end of each System Course. This CA will consist of a total of about
20-25 Stations. The relative proportion of marks for practical skills in the Basic Sciences (i.e.,
anatomy, histology, physiology, biochemistry, pharmacology, microbiology and pathology
combined) and that for clinical skills taught as part of the clinical skills training programme is 1: 1
for the following courses: Cardiovascular System; Respiratory System; Gastrointestinal System;
and Central Nervous System. For the Renal System & Haematology and Endocrine &
Reproductive System courses, this proportion is 70% (for practical skills in basic sciences) and
30% (for clinical skills).
Amongst the Basic Sciences, the relative proportion of marks for anatomy and histology versus
all other basic sciences (biochemistry, physiology, pathology, pharmacology, and microbiology)
combined is 1: 1. Course coordinators (or the Preclinical Coordinator) will notify you of the
number of Stations in each discipline in advance of the test. The CA Score you obtain in the
OSPE-OSCE test in each of the six systems courses will be reduced to a maximum of 4 marks.
Additionally, lab reports for practicals must be submitted on time as assigned by faculty members.
In each of the six courses, a maximum of 1 mark (i.e., 20% of the CA score) is awarded for all lab
reports submitted in that course. These will be added to obtain a CA score for a maximum of 30
marks for the OSPE/OSCE Component of the Final Examination.
Subcomponents of the CA
Score in OSPE-OSCE
CVS, RS, GIT and
Renal System &
CNS Courses
Haematology; and
Endocrine &
Reproductive System
Raw Score scaled to
Raw Score scaled to a
a maximum of
maximum of
Anatomy & Histology
1.5
Other Basic Sciences
1.5
Clinical Skills
All Lab Reports in the Course
Total
Course Coordinators may use appropriate alternate testing instruments for assessing cognitive
competence. For example, modified essay questions may be used in lieu of LAQ; and extended
matching items may be used in lieu of MCQs of the single best response type but you will be
notified in advance of any deviation from the scheme outlined above. Note that you are required
143
144
to have a consolidated CA score of at least 40% in each of 7 Components of PE II in order to

qualify to appear in the Final Examination in the corresponding Exam Component. The course of
action for candidates scoring below 40% is described below (next page).
COURSE OF ACTION BASED ON

CA SCORES IN SYSTEMS COURSES IN ACADEMIC YEAR 2
Students with CA Score
CA Score <40% in an Exam Component
40% in an Exam
Component
Remedial Examination
Eligible to Appear in the
Compulsory for all who score less than 39 marks and
Main Examination in that
Optional for candidates who score 40-49 marks in the
Component
main CA.
The maximum marks which can be awarded is fixed as
50%
Score 40%
Score <40%
Eligible to Appear in Main
**Barred from appearing in Main
Examination
Examination in that Component

Eligible to Appear in Supplementary
Examination in that component
(considered 2nd attempt);
*Other eligibility criteria i.e., payment of all fees due, and 80% attendance requirement in all
courses apply; In each component of Professional Examination I, there are multiple CA tests and
therefore a candidate who obtains a CA score of less than 40% will be ineligible to appear in the
Main Exam in the corresponding component(s), and remedial measures would be prescribed to
determine eligibility to appear in the Supplementary Exam in the respective component(s). *This
flow chart above is only intended to be a Summary. For complete information, see the Rules
and Regulations of MBBS Professional Examinations [Revised Aug 2010].
** Final deciding authority will be the academic council of the faculty of medicine
Scheme of Final Examinations in PE II:

The scheme of each Theory Component (each is a 3 hr written paper) is as follows:
Type of
Number of
Maximum
Average Time
Total
Total time
Question
Questions
Marks per
Recommended
marks
for this
Question
per Question
for this
Section
Section
Multiple-Choice
50
About 1 min
50
60-65 min
10-12 min
30
Min 2 hr
20
20-24 min
20
100
Questions
(MCQ)*
Short Answer
Questions (SAQ)
Long Answer
Questions (LAQ)
Total Max Marks
*Multiple-Choice Questions: each question will be followed by four options. Only one response
is correct. Sometimes, one response is the best (or most appropriate) in comparison to the
remaining three options. You are instructed to Select the Single Best Response in each case.
There is no negative marking for an incorrect response.
In each Theory Component, the score you obtain out of 100 will be reduced to a maximum of 70
marks. This will be added with the CA Score (max 30) in the Theory Component of the
corresponding Course to calculate a Final Composite Score for a maximum of 100 marks. A
minimum of 50% Composite marks is required for a Pass in each Component of this Examination.
OSPE-OSCE: The Final Examination consists of a total of about 40-45 Stations in all. Each
Station is typically about 2 min. Clinical Skills Stations are typically 4 min. The Preclinical
Coordinator or the Examination Coordinator will notify you in advance of the number of Stations
by course. Overall, the weightage for Clinical Skills versus that for practical skills in the Basic
Sciences is 50% each. Amongst the basic sciences in a System Course, the relative proportion of
marks for anatomy and histology versus the other basic sciences (physiology, biochemistry,
pathology and microbiology) is 1: 1.
145
Safety Guidelines:
The medical programme consists of lectures, laboratory sessions, and training in hospitals and
the community. Laboratories, by their nature, require those working in them to be highly aware of
the safety implications of that particular working environment. The Faculty wishes to establish and
maintain a working environment in which the physical and mental well-being of staff and students
is maintained at the highest levels practicable, and to provide a basis whereby safety problems
arising in the working environment may be solved in cooperation with people concerned.
It is foreseeable that some students may experience allergic reactions upon exposure to chemical
reagents used in laboratories or in a hospital environment. It is essential for students to inform
their supervisors if they have an existing medical condition or develop any medical condition that
may affect their ability to participate fully in the course of study. This should be done as soon as
possible. This will enable the student and the University to discuss and agree on appropriate
health and safety procedures to facilitate continuation of studies.
You are required to be vaccinated against hepatitis B for your own safety. You must provide
evidence of vaccination against hepatitis B prior to the first clinical attachment in Year 2.
Safety Precautions and Code of Conduct in Laboratories:

Students are expected to be display a high order of discipline and common sense while
working in the laboratories.
You must cooperate with the Faculty to the extent required to enable it comply with
prescribed standards for quality and safety in the laboratory.
Take note of the location of the first aid cabinet in each laboratory.
Please be aware of the location of emergency exits, emergency shower, and fire
extinguishers and be familiar with their use.
If you are ordered to exit the laboratory in the case of an emergency, exit it at once without
stopping to pick your belongings.
If there is an accident, call for help dont be afraid to shout for help. Report all accidents no
matter how trivial they may seem to faculty members supervising that session.
Students are not allowed to enter the storage areas in laboratories.
Dont bring food items into the laboratory.
Storing food items in lab refrigerators is strictly prohibited.
Eating, drinking or smoking is strictly forbidden in the laboratory.
Protective clothing (example, white coats and gloves) must be worn while working in the
laboratory as may be required for the experiments in question. Students must wear covered
shoes, and long hair must be tied neatly while working in the laboratory.
146
Laboratory work must be performed only during normal working hours. No laboratory work of
any kind should be undertaken after office hours unless at least two persons are present in
the laboratory.
Students will be required to record in the lab register items they borrow for experiments.
If in doubt about how to use equipment, dont use it ask the tutor in charge of that session
before you use it.
All chemicals in the lab whether solid, liquid or gas, and body fluids must be considered
potentially hazardous.
Report spillage of chemicals or body fluids to the lab assistant immediately. Spillages must
be cleaned immediately.
All experiments that require the usage of flammable, corrosive or highly concentrated
chemicals must be conducted using appropriate safety tools such as gloves and face mask.
Breakage of glassware or breakdown of equipment must be reported immediately to the

laboratory technologist.
All equipment and glassware must be cleaned and returned to their respective places
carefully.
Students must clean up their work area after each lab session. The laboratory must be kept
clean at all times; all solid wastes must be disposed into appropriate trash bins. All sharps
must be disposed into special sharps containers.
Students must wash their hands with detergent and dry their hands with paper towels after
each lab session.
Contaminated items and disposables must not be left on the table; they must be placed in
appropriate waste bins for sterilisation.
Chairs must be arranged neatly before leaving the laboratory.
Action will be taken against students who do not adhere to the rules mentioned above.
147
Student Feedback:
Your input regarding the curriculum and other issues potentially affecting your academic
performance is essential for improving the quality of the MBBS programme. The Quality
Assurance Division of the university periodically collects feedback from you about your
assessment of effectiveness of individual teachers.
Course coordinators solicit written feedback regarding specific courses usually at the end of each
course. Please respond to their request your comments on strengths and weaknesses of any
aspect of the intended curriculum, the taught curriculum, assessment of your performance are
welcome. These are inputted to strengthening the curriculum.
You do not have to wait till the end of the course to provide feedback or bring to our attention
issues regarding the programme that. There is a suggestion box in the Security Office in the
Medical Building you can make use of for this purpose. Identifying yourself with unsolicited
comments is optional. Comments and feedback from students will be used by the Faculty of
Medicine and the University solely for evaluating the programme and improving its quality.
148
Selected External Web links

Weblinks below were last accessed 15 August 2010 they are classified and listed in
alphabetical order. By clicking on links in this page you are navigating to a website maintained by
a third party. Inclusion of a link does not imply endorsement of content in these websites by the
Faculty of Medicine or AIMST University. If you would like to suggest a link for inclusion in this
list, please e-mail Academic Coordinator Dr.Bharathi Sengodan[b.sengodan@gmail.com]
Organisations:
Kementerian Kesihatan Malaysia, Ministry of Health http://mohcube.moh.gov.my/
Malaysian Medical Association http://www.mma.org.my/
Malaysian Medical Council http://www.mmc.gov.my/v1/
World Health Organisation http://www.who.int/en/
World Medical Association http://www.wma.net/e/
UNICEF, Malaysia http://www.unicef.org/malaysia/
Online Textbooks and References:

Access Medicine http://www.accessmedicine.com/ Log in with Institutes Username & Password.
mdconsult http://www.mdconsult.com Log in with Institutes Username & Password.
Databases of abstracts of biomedical literature:

PubMed, National Library of Medicine, USA http://www.pubmed.org
Scopus http://www.scopus.com
HighWire http://highwire.stanford.edu
An Engine for Searching Scholarly Content on the Web:

Google Scholar http://scholar.google.com.my/
Selected Open Access Forums (Journals):
Medscape http://www.medscape.com/home
Student BMJ http://student.bmj.com/
E-Medicine http://www.emedicine.com/
For links to free journal articles online visit http://www.freemedicaljournals.com
149
150
Selected Internal Telephone Extensions in AIMST University

AIMST University Reception Ms Vidya & Ms Santhy
1900 / 1901
University Examinations Division
1015 /1020
Medical & Biological Sciences Building Security Office
3002
AIMST Security Guard House
8142
AIMST Clinic
5023 / 5024
AIMST Library
6111 / 6112
Information Technology Division
1033
For an exhaustive list, please see the AIMST University Internal Telephone Directory available at
http://www.aimst.edu.my/hrd/telephone_directory.htm
**********************

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Educating Tomorrows Leaders

Year 1 and 2 MBBS Programme Handbook

Questions regarding the contents of this handbook should be addressed to:

Notes for Students:

Previous versions of this handbook are obsolete.

AIMST University Undergraduate Handbook [2009]: This contains important information

Vision and Mission of the Faculty of Medicine

Objectives of the MBBS programme

From the Deans Desktop

Organisation of the Faculty of Medicine

Contact Information for Staff in Faculty of Medicine

Overview of the Preclinical Phase of the MBBS programme

Courses in Year 1 at a glance

Courses in Year 2 at a glance

Academic Calendars [Year 1 and 2]

Teaching-Learning Methods in Years 1 and 2

Teaching Hospitals affiliated with AIMST University

Student Attendance in Classes

Details of Courses in Year 1:

MCBM Element 2: General Physiology, Basics of Haematology, Nerve-muscle Physiology

MCBM Element 3: Proteins, Enzymes and Molecular Biology

MCBM Element 4: General Pharmacology and Autonomic Pharmacology

MCBM Element 5: Nutrition, Metabolism and Metabolic Diseases

MCBM Element 6: Immunity, Infection, Inflammation and Repair

MCBM Element 7: Neoplasia

MCBM Element 8: Structure of the Human Body II

HBM Element 1: Society, Health and Medicine

HBM Element 2: Epidemiology

HBM Element 3: Biostatistics

HBM Element 4: Ethics in Medicine

HBM Element 5: Primary Care Interface

Details of Courses in Year 2:

Respiratory System (RS)

Gastrointestinal System (GIT)

Central Nervous System (CNS)

Endocrine & Reproductive System (ER)

First Clinical Attachment

Special Study Module

Recommended Books (Essential Reading) in Year 1 and Year 2

Assessment of Academic Performance (Years 1 and 2)

Scheme of MBBS Professional Examination I

Continuous Assessment in MCBM

Continuous Assessment in HBM

Scheme of Final Examinations in Year 1

Scheme of MBBS Professional Examination II

Scheme of Continuous Assessment in Year 2 Courses

Scheme of Final Examinations in Year 2

Student Feedback about the Programme

Selected External Web Links

Selected Internal Telephone Extensions

List of Abbreviations used in this Handbook:

Vision and Mission of the Faculty of Medicine,

Objectives of the MBBS programme:

Organise prevention and control of common communicable disease;

Help organise health care delivery in times of calamities;

Work as an effective member of the health team;

Plan and implement effective health education programmes;

Perform administrative functions expected of them at primary care health facilities;

Execute common medico-legal procedures;

Subject himself / herself to life-long continuing education;

Develop a critical and evidence based approach to solving patients problems;

Death and dying