MBBS Curriculum 1st Revision 2014 15122014

MAHSA UNIVERSITY
FACULTY OF MEDICINE
CURRICULUM FOR MBBS PROGRAM
1st revision
September 2014
Contents
Introduction....................................................................................................................................................... 1
Vision and Mission of the Faculty of Medicine ............................................................................... 2
GENERAL OBJECTIVES of the Medical Degree Programme (PEO) ...................................... 3
Programme Learning Outcomes (PLO) ............................................................................................. 3
Structure of the MBBS Programme ...................................................................................................... 6
Phase I: Preclinical Phase ........................................................................................................................ 13

Objectives of the Phase-1 ......................................................................................................................... 14
Desired Learning Outcomes of the Phase-1 .................................................................................. 14
Biomedical Science Block – BMS .......................................................................................................... 18

Basic Mechanisms of Disease Block – BMD .................................................................................... 35
Genetics, Immunology & Molecular Medicine Block – GIM .................................................. 54
Cardiovascualr System Block – CVS.................................................................................................... 63

Haemopoietic System Block – HEM .................................................................................................... 80
Respiratory System Block – RSP .......................................................................................................... 96
Gastrointestinal System & Nutrition Block – GIN .................................................................... 111

Musculoskeletal System Block – MSK ............................................................................................ 134
Urinary System Block – URI ................................................................................................................. 153
Nervous System Block – NVS ............................................................................................................... 166

Reproductive System Block – RPD ................................................................................................... 184
Endocrine System and Metabolism Block – EDM .................................................................... 200
Early Clinical Skills Module – ECE..................................................................................................... 217

Epidemiology and Biostatistics - EPI-BIO .................................................................................... 235
Medicine (Year-3) ...................................................................................................................................... 253

Surgery (Year-3) ......................................................................................................................................... 265
Obstetrics & Gynaecology (Year-3) ................................................................................................. 271
Paediatrics (Year-3) ................................................................................................................................. 286
Psychological and Behavioural Medicine (Year-3) ................................................................ 291
Rural Health (Year-3) .............................................................................................................................. 297
Medicine (Year-4) ...................................................................................................................................... 308
Surgery (Year-4) ......................................................................................................................................... 314
Orthopaedics (Year-4) ............................................................................................................................ 320
Primary Care Medicine (Year-4) ....................................................................................................... 325
Anaesthesia (Year-4) ............................................................................................................................... 337
Criticl and Palliative Care (Year-4) ................................................................................................. 346
Emergency Medicine (Year-4) ............................................................................................................ 356
Ophthalmology (Year-4) ........................................................................................................................ 365
Otorhynolaryngology (Year-4) .......................................................................................................... 369
Forensic Medicine (Year-4) ................................................................................................................. 375
Urban Health (Year-4) ............................................................................................................................ 393
Medicine (Year-5) ...................................................................................................................................... 402

Surgery (Year-5) ......................................................................................................................................... 410
Obstetrics and Gynaecology (Year-5) ............................................................................................ 418
Paediatrics (Year-5) ................................................................................................................................. 429
Orthopaedics (Year-5) ............................................................................................................................ 435
Primary Care Medicine (Year-5) ....................................................................................................... 440
Radiology (Phase-2) ................................................................................................................................. 460
Dermatology (Phase-2) .......................................................................................................................... 466
Curriculum Review Committee
Advisor: Prof. Dr. Abdul Rahim Md Noor (Dean)
Chairman: Assoc. Prof. Dr. Ganesh Ramachandran (Deputy Dean – Academic)
Deputy. Chairman: Prof. Dr. Sarmishtha.Ghosh (Head of the Curriculum Committee)
Members: Assoc. Prof. Dr. Chitra Govindaraja (Head of Assessment Committee)

Assoc. Prof. Dr. Mustafa Ahmed Jirjees
Dr. Lilli Jacob
Dr. Heethal Jaiprakash
Dr. Aung Ko Ko Min
Azhar Hussein (Student Representative)
Kenneth Wong Chenfei (Student Representative)
MBBS Curriculum Introduction
Introduction
The review of MAHSA MBBS curriculum takes into account inputs from the staff, students, external
examiners, advisory board and professional bodies. The revised curriculum does not exceed 30% of the
original curriculum and was endorsed by the Faculty Academic Board on 19th August and by the Senate
on 26th August 2014.
The review is mainly done in the phase-1 looking into the relevancy of the contents, overlapping of the
topics, sequencing of the lectures and modification of the assessment methods.
The MBBS programme is a 5-year course and is conducted in two phases:
a) Phase I (2 years) –
- The normal structure and function of the human body
- Reaction to injury
- Management in a systematic manner
- Early clinical exposure during preclinical training
b) Phase II (3 years) – Practice-based clinical medicine
The philosophy of the curriculum adopted at MAHSA University is to provide early emphasis of clinical
relevance along with teaching of basic sciences in an integrated manner, followed by clinical training
of three years.
The integration is done both vertically and horizontally. Important concepts that are taught in the
preclinical years – Year 1 and 2 and in the clinical years – Year 3, 4 and 5 are revisited in a “spiral
effect” through all phases of the course. The curriculum followed here is one that has been adapted
from the perspectives of the SPICES model. It is aimed to have a student centered, problem based,
integrated, community oriented, evidence based and systematic approach so as to encourage self-
directed learning and strengthen problem-solving skill.
The phase-1 is taught by systems or known as blocks while the phase-2 is taught by the clinical
disciplines. In phase-1, there is a non-clinical elective at the end of year-2 and in phase-2, there is a
clinical-elective at the end of year-4.
MAHSA University 1st revision, 2014 Page 1

MBBS Curriculum Introduction
Vision and Mission of the Faculty of Medicine
VISION
To be internationally recognized as one of the premier institutions for medical education
MISSION
1. To produce competent and caring doctors with a high degree of professionalism
2. To provide state of the art facilities and teaching learning activities of the highest standards in
medical education
3. To enhance a conducive learning environment for students with cultural diversities
4. To promote and enhance opportunities for research and innovation and instil the values of
continuing medical education

MBBS Curriculum Objectives
GENERAL OBJECTIVES of the Medical Degree Programme (PEO)
The general objective of the programme is aimed at producing a competent and caring doctor with a
high degree of professionalism and with a holistic approach to the practice of medicine and:
PEO1 Be equipped with current knowledge and skills in the practice of medicine so
as to become safe and caring doctors to fulfill the needs of the nation.
PEO2 Function independently as part of the healthcare team to carry out curative as
well as preventive programme in urban and rural settings.
PEO3 A competent practitioner with leadership skills and with high ethical and moral
values.
PEO4 Apply critical thinking, problem solving and evidence based practice and with
interest in medical research and innovation.
Programme Learning Outcomes (PLO)
The graduates of the medical school should:
PLO1 Be competent to make a diagnosis and institute management on common

medical and health conditions based on history, physical examinations
and relevant investigations.
PLO2 Be able to practice preventive, promotive and rehabilitative medicine at

all levels of society.
PLO3 Be responsible for maintaining the highest standards of medical practice

through continuing lifelong medical education
PLO4 Possess appropriate attitudes, demonstrate empathy and have ability to

communicate effectively with patients and other health professionals.
PLO5 Be able to conduct the practice of medicine with the highest ethical and
moral values.
PLO6 Be able to work in a team and collaborate with other health care
professionals and exhibit leadership and managerial skills in any
situation of the profession.
PLO7 Be able to embark on research and innovative aspect of medicine in

areas of interest.

leadership/group working
1 Knowledge in specific
3 Social responsibilities
6 Problem solving and
7 Info management &
8 Management and
4 Values, Ethics &
5 Communication/
entrepreneurship
lifelong learning
2 Practical skills
Professionalism
scientific skills
area-content
skills
PEO1: Be equipped
with current
knowledge and skills
in the practice of
medicine so as to √ √ √ √ √ √ √ √
become safe and
caring doctors to fulfil
the needs of the nation.
PEO2:Function
independently as part
of the healthcare team
to carry out curative as √ √ √ √ √ √
well as preventive
programme in urban
and rural settings
PEO3: A competent
practitioner with
leadership skills and √ √ √ √ √ √
with high ethical and
moral values.
.
PEO4
Apply critical
thinking, problem
solving and evidence
√ √ √ √ √
based practice and
with interest in
medical research and
innovation

6 Professional ethics and

1 Communication skill
3 Info management &

Problem solving skills
2 Critical thinking &
7. Leadership skills
5 Entrepreneurship
lifelong learning
4 Team work
moral
PLO1: Be competent to make a
diagnosis and institute management on
common medical and health conditions √ √ √ √
based on history , physical examinations
and relevant investigations
PLO2: Be able to practice preventive,
promotive and rehabilitative medicine at √ √ √ √ √ √
all levels of society
PLO3: Be responsible for maintaining

the highest standards of medical practice
√ √ √ √
through continuing life long medical
education
.
PLO4: Possess appropriate attitude ,
demonstrate empathy and have ability to
communicate effectively with patients √ √ √ √
and other health professionals
PLO5: Be able to conduct the practice of

medicine with the highest ethical and
√ √ √
moral values
PLO6: Be able to work in a team and

collaborate with other health care
professionals and exhibit leadership and
√ √ √ √ √ √ √
managerial skills in any situation of the
profession
PLO7: Be able to embark on research

and innovations with respect to areas of
√ √ √ √ √ √
interest in medicine

MBBS Curriculum Programme Structure
Structure of the MBBS Programme
I. PRECLINICAL PHASE (PHASE-I)

STRUCTURE
BMS Basic Medical GIN Gastrointestinal system & PBL Problem-based

Science Nutrition learning
BMD Basic Mechanism of MSK Musculoskeletal System ECE Early Clinical
Disease Exposure
GIM Genetics, URI Urinary system PPD Personal &
Immunology & Professional
Molecular Medicine development
CVS Cardiovascular NVS Nervous System RMB Research

System Methodology &
Biostatistics
HEM Hematopoietic RPD Reproductive System ESX End Semester
System Examination
RSP Respiratory System EDM Endocrine system REV Revision

ASSESSMENT FOR PHASE 1
Assessment strategy includes both formative and summative. Students are assessed and monitored
throughout the block by tutorials and assignments to check their understanding and improvement during
each block. At the end of the block, there is an end of block test (EBX) as continuous assessment.
This revised assessment methods will be implemented beginning of 2014-2015 session.
The Frist Professional Exam will be divided into Part-1 (Pro-1 Part-1) at the end of year-1 and Part-2
(Pro-1 Part-2) at the end of year-2. These Pro-1 Part-1 and Pro-1 Part-2 will serve as the final summative
assessment in the respective year.
The summative assessment includes EBX as continuous assessment and the Professional examination
as the final assessment.
The revised summative assessment scheme for year-1 is described in the following table:
Sr. Assessment Exam Type of questions

1 Continuous Assessment End of Block Exam 1. MCQ (MTF) 30%
(40%) (EBX) for 6 blocks 2. MCQ (SRA) 30%
(36%) 3. SEQ 25%
4. MEQ 15%
OSCE (2%) 1. OSCE (4 stations)
OSPE (2%)
2 Final Assessment (60%) First Professional 1. MCQ (MTF) 25%

Exam Part-1 2. MCQ (SRA) 25%
(Pro-1 Part-1) 3. MEQ 20%
4. OSPE 20%
5. OSCE 10%
The revised summative assessment scheme for year-2 is described in the following table:

1 Continuous Assessment End of Block Exam 1. MCQ (MTF) 30%
(40%) (EBX) for 6 blocks 2. MCQ (SRA) 30%
(34%) 3. SEQ 25%
4. MEQ 15%
EPI-BIO (2%)
OSCE (2%) 1. OSCE (4 stations)
OSPE (2%)
2 Final Assessment (60%) First Professional 1. MCQ (MTF) 25%

Exam Part-2 2. MCQ (SRA) 25%
(Pro-1 Part-2) 3. MEQ 20%
4. OSPE 20%
5. OSCE 10%

First Professional Examination Part-1 and Part-2
The following grading system is approved by the Faculty Academic Board and the Senate.
MARKS GRADE GRADE POINT STATUS
80 – 100 A 4.00 Excellent*

75 – 79 A– 3.67 Very Good*
70 – 74 B+ 3.33 Good
65 – 69 B 3.00 Good
60 – 64 B– 2.67 Satisfactory
55 – 59 C+ 2.33 Pass
50 – 54 C 2.00 Pass
Borderline Fail
45 – 49 C– 1.67
(called for via voce)
40 – 44 D 1.33 Fail
35 – 39 E 1.00 Fail
<34 F 0.00 Poor
• For the First Professional Exam (Part-1 and Part-2), students with a score of (45-49%) fall into
the redeembale category.
• The redeemable category Borderline–failed candidates with a score of 45-49% will attend a
viva voce (2-panels, at least 2/3 examiners in each) and they should pass both panels.
• Those who fail the viva voce and those with a score below 45% will appear for the
supplementary exam.

II. CLINICAL PHASE (PHASE-II)

STRUCTURE
Year 3 : Community Medicine & Clinical Specialty
Rural Health
Medicine Surgery Pediatrics Obstetrics & (4 weeks)
Gynaecology Psychiatry
(4 weeks)
8 weeks 8 weeks 8 weeks 8 weeks 8 weeks
Emergency Ophthal- Psychiatry

Medicine mology
Medicine Surgery Ortho- Primary (4 weeks)

pedics Care Anaesthe- ENT
Medicine siology Otolaryn-
gology Urban
Health
Critical & Forensic
Palliative medicine (2 weeks)
Care
6 weeks 6 weeks 6 weeks 6 weeks 6 weeks 6 weeks 6 weeks
Psychiatry
Medicine Surgery Pediatrics & Obstetrics & (2 weeks)
Neonatology Gynaecology Primary care
(2 weeks)
Orthopedics
(4 weeks)
8 weeks 8 weeks 8 weeks 8 weeks 8 weeks

ASSESSMENT FOR PHASE 2
throughout the posting by bedside teaching and tutorials to check their understanding and improvement
during each posting. At the end of the posting, there is an end of posting examination (EPX).
The Final Professional Exam which is conducted at the end of year-5 serves as the final summative
assessment the phase-2.
The summative assessment includes EPX as continuous assessment and the Final Professional
examination as the final assessment.
The summative assessment scheme for phase-2 is described in the following table:

1 Continuous Assessment for 5 1. Continuous assessment
Assessment (30%) rotations (6- during the posting (30%)
postings) in year-3 2. End of Posting Exam Theory Exam (35%)
(10%) (70%) Clinical Exam (35%)
Assessment for 7
rotations (12-
postings) in year-4
(10%)
Assessment for 5
rotations (7-
postings) in year-5
(10%)
2 Final Assessment Final Professional 1. THEORY - MCQ 1. Medicine and allied

(70%) Exam 20% subjects 10%
(Final Pro) (45 MTF + 15 SRA) x
2 hr
THEORY – 35% 2. Surgery and allied
subjects 10%
CLINICAL – 35% (45 MTF + 15 SRA) x
2 hr
2. THEORY - MEQ 1. Medicine and allied
10% subjects 5%
(3 MEQ x 20 min)
2. Surgery and allied
subjects 5%
(3 MEQ x 20 min)
3. THEORY - SEQ 1. Medicine and allied
5% subjects 2.5%
(4 SEQ x 15 min)
2. Surgery and allied
subjects 2.5%
(4 SEQ x 15 min)

1. CLINICAL – OSCE 8 + 2 Stations

10%
2. CLINICAL – Short 3 short cases x 10 min
Case
15%
3. CLINICAL – Long 1 – long case x 1 hour
Case
10%

MBBS Curriculum
PHASE 1
( YEAR 1 & 2 )

MBBS Curriculum Phase-1
Phase I: Preclinical Phase
The Preclinical subjects are taught for two years in four semesters in a systematic fashion with each
block dedicated to one system. Twelve [12] blocks run throughout the two years in specific semesters,
each block extending from 4 weeks to 8 weeks, depending on the depth of the content. The phase aims
to introduce the students to basic sciences and to develop the ability to apply these in the clinical setting.
The program is taught in an integrated manner so as to bring together normal and abnormal structures
and functions of every system along with the appropriate therapeutic interventions. This system- based
approach with an introduction to general principles of Anatomy, Physiology, Biochemistry, Pathology,
Microbiology, Parasitology and Pharmacology prepares the student to take on the clinical subjects as
they proceed to Phase II of the course.
Early clinical exposure is incorporated within each block so that the students gain knowledge, basic
clinical skills and are able to perform in the clinical years.
The phase also includes modules on personal and professional development, epidemiology, research
methodology and biostatistics.

Objectives of the Phase-1
During Phase 1, the students will
Cognitive 1. be taught the principles of basic medical sciences and how to apply
them in the clinical context.
2. be taught about the pathophysiology of common diseases,
classification of therapeutic agents, basic principles of
pharmacokinetics and pharmacodynamics, drug action and
interaction
3. be taught about the normal values of important biochemical and
physiological parameters
Psychomotor 1. be taught to take basic history

2. be taught to perform a general and systemic physical examination
3. be exposed to basic clinical procedures using mannequins.
Affective 1. develop the ability to interact with colleagues and others in a

professional, ethical, and respectful manner
2. be trained to be a lifelong learner
3. be taught to manage their own needs in professional and personal
development
Desired Learning Outcomes of the Phase-1
By the end of Phase 1, the student will be able to:
1) apply knowledge of basic medical sciences to be able to explain pathophysiology of

diseases
2) take proper history from patients
3) perform proper physical examination on patient
4) perform basic clinical procedures on patients
5) relate principles of therapeutics to state the rationale of usage of different drugs
6) request for relevant diagnostic investigations.& interpret the findings of laboratory
investigations
7) interact with colleagues and patients in a professional, ethical, and respectful manner
8) manage their own needs in professional development and personal aspects
9) search and manage information and be a self directed learner

CODE BLOCK/MODULE
SEMESTER 1 (year 1)
Old New
BMS MDP1101 BMS 6119 Bio Medical Science
BMD MDP1102 BMD 6117 Basic Mechanisms of Disease
GIM MDP 1103 GIM 6114 Genetics, Immunology & Molecular Medicine
ECE 1 Early Clinical Exposure 1
PPD 1 Personal & Professional Development
Learning and Coping Skills
ENG English
SEMESTER 2 (Year 1)
CVS MDP1201 CVS 6127 Cardiovascular System

HEM MDP1202 HEM6126 Hematopoietic System
RSP MDP1203 RSP6125 Respiratory System
ECE2 Early Clinical Exposure 2
PPD 2 Personal & Professional Development
Ethics & Professionalism
MQA 1 Agama Islam OR Moral Studies
EPI-BIO1 Epidemiology-Biostatistics
SEMESTER 3 (year 2)
GIN MDP2301 GIN6239 Gastro-intestinal Tract & Nutrition

MSK MDP2401 MSK6238 Musculoskeletal System
URI MDP2302 URI6235 Urinary System
ECE 3 Early Clinical Exposure 3
EPI-BIO2 Epidemiology/ biostatistics-2
MQA2 Malaysian Studies
ELV Elective (2 weeks - during End-year Break)
SEMESTER 4 (Year 2)
NVS MDP2401 NVS6279 Nervous System

RPD MDP2303 RPD6244 Reproductive system
EDM MDP2403 EDM6247 Endocrine System and Metabolism
ECE4 Early Clinical Exposure 4

RMB Research Methodology & Biostatistics

New Codes for Subjects
SEMESTER 1 (year 1)
Sr. Code Name
1 MBMS 6119 Basic Medical Sciences
2 MBMD 6117 Basic Mechanisms of Disease
3 MGIM 6114 Genetics, Immunology & Molecular Medicine
4 MPPD 6116 Personal & Professional Development Module (Year-1)
5 MECE 611- Early Clinical Exposure
6 MOSP 6YS4 OSPE Question Paper for ESX-1
SEMESTER 2 (Year 1)
Sr. Code Name
1 MCVS 6127 Cardiovascular System
2 MHEM 6126 Hematopoietic System
3 MRSP 6125 Respiratory System
6 MOSP 6124 OSPE Question Paper for ESX-2
7 MOSC 6125 OSCE Question Paper for ESX-2
8 MERB 612- Epi-Bio Module Part1
SEMESTER 3 (year 2)
Sr. Code Name
1 MGIN 6239 Gastro-intestinal System & Nutrition
2 MMSK 6238 Musculoskeletal System
3 MURI 6235 Urinary System
8 MERB 623- Epi-Bio Module Part2
SEMESTER 4 (Year 2)
Sr. Code Name
1 MNVS 6247 Nervous System
2 MRPD 6244 Reproductive system
3 MEDM 6247 Endocrine System and Metabolism
First Professional Exam
MCQ-1: MMED 6241

MCQ-2: MMED 6242
MEQ & SEQ: MMED 6243
OSPE: MMED 6244

MBBS Curriculum Year-1
MBBS PROGRAM
YEAR-1

MBBS Curriculum BMS/Sem-1/Year-1
Biomedical Science Block – BMS
Course Information
1. Name of Course/Module: Biomedical Science (BMS) Block
2. Course Code: BMS 6119
3. Name(s) of academic staff :
Anatomy
1. Prof.Dr Subramaniam
2. Prof.Dr Khin Myo Thu
3. Prof Bale Swamy Kaki
4. A/P Yeong Soh Onn
5. A/P Dr B.Venugopala Rao
6. Dr Anudeep Singh
Physiology
7. Prof Dr Sarmishtha Ghosh
8. A/P.Dr.Sharad B Kole
9. A/P Dr J Prasanna Kumar
10. Dr Soon Siew Choo
11. Dr. Myomin Khaing
12. Dr. Mona Mohamad
Biochemistry
13. Prof Balabaskaran
14. Prof Kwan Teck Kim
15. Prof Wang Chee Woon
16. A/P Dr Maung Maung Aye.
17. Dr Sathivel A
18. Dr Jaiprakash M
Pharmacology
19. A/P Dr. Chitra Govindaraja
20. A/P Dr. Madhu
21. Dr. Heethal
22. Miss Vjaya
23. Dr. Sunil Kale
24. Dr. Ameeta Pateel
4. Rationale for the inclusion of the course/module in the programme:
Knowledge of basic principles of anatomy, physiology, biochemistry and pharmacology are

essential to build up the basis of studying the abnormal structure and function of human body
organ-systems. These form the building blocks of study of medicine. This block of 8 weeks
duration is taught in the beginning of the first semester of year 1. A general introduction to the
anatomy, physiology, biochemistry and pharmacology of the human body is given. Students
acquire basic knowledge of the structure and function of organ systems along with their

biochemical composition. Handling of delicate and sensitive instruments, data analysis, report
writing and team work are also important for medical professionals. A comprehensive basic
biomedical science knowledge provided in this course is intended to form a strong foundation for
learning in other blocks.
5. Semester and Year offered: Semester 1, Year 1
6. Total Student Face To Face Total Guided and

Learning Time (SLT) Independent Learning
L=Lecture L T P O E
T=Tutorial
P=Practical 62 30 38 3 133 hours
O=Others +
(PBL, review discussions) 124 60 38 15 237 hours
E= exams = 370
7. Credit value:
370/40 = 9.2 ~ 9.0
8. Prerequisite:
9. Objectives:
KNOWLEDGE
The student will have knowledge of :
 the terminologies used in the study of the human body.
 the basic concepts related to the structure and function of the human body at the
molecular, cellular, organ-system level.
 Embryonic development of human body.
 the major biochemical molecules and respective functions in health..
 the role of enzymes in cellular biochemical reactions and their use in clinical diagnosis.
 the metabolic processes and functioning of the body at the cellular and molecular levels
 biopotentials and their clinical applications.
 the factors affecting the pharmacokinetics, theories of drug actions
 pharmacodynamics of drugs, principles of toxicology and adverse effects of drugs
SKILLS
The student will be taught to develop skills to :
 identify and locate different structures of the body
 interpret effects of different stimuli on the properties of skeletal muscles
ATTITUDE
The student will be trained so as to
 develop effective communication and etiquette with sense of self learning responsibility
 develop ability to do team work
Integration
Since this is a basic block, no integration happens here, only basic information are disseminated
to prepare the students to be able to understand the following systemic modules.

10. Learning Outcomes:
At the end of this block, students should be able to
1. explain the terminologies used in the study of the human body.

2. explain the basic concepts related to the structure and function of the human body.
3. explain how deviations in structure can occur in the process of fetal development.
4. identify and describe structures and their functions at the cellular levels.
5. describe the major biochemical molecules and correlate their respective functions.
6. explain the role of enzymes in cellular biochemical reactions and their use in
clinical diagnosis.
7. explain the metabolic processes and functioning of the body at the cellular and
molecular level
8. explain the genesis of biopotentials and their clinical applications.
9. explain the pharmacokinetic and pharmacodynamic processes involved in drug action
11. Transferable Skills:
Transferable skills developed within this course include:
 Interpersonal & Communication Skills

(a) Writing clear and concise records and reports
(b) Presenting technical information to a large group of people
(c) Ability to understand and treat an audience accordingly
(d) Listening attentively
(e) Effectively explaining highly technical information
 Use of general information technology.
12. Teaching-learning and assessment strategy:
Teaching – learning strategy includes

1. Large group lectures
2. Small group tutorials
3. Laboratory demonstrations and hands on practicals
4. Computer aided learning sessions/ video aided learning sessions
5. Directed self learning
6. Self directed learning to support independent reading
7. Integrated teaching.
throughout the block by tutorials and assignments to check their understanding and improvement.
At the end of the block, there is an end of block test (EBX) as continuous assessment.
The First Professional Exam Part-1 (Pro-1 Part-1) which will be conducted at the end of year-1
will serve as the final summative assessment. It will test the knowledge and skill which students
acquire in all 6 blocks of the year-1.
The summative assessment includes both EBX as continuous assessment and the First
Professional Part-1 examination (Pro-1 Part-1) as the final assessment.

13. Synopsis:
This is the first block in Semester 1 of the MBBS program and is taught for 8 weeks. The four
core subjects taught are Anatomy, Physiology, Biochemistry and General Pharmacology.
Students will learn about the basic facts of structure-function of organ-systems and understand
the basic principles of regulation of life processes. The biochemical mechanisms of life are also
included in this block. The block also includes the general mechanism of drugs and their general
pharmacokinetic features. The practical component helps to illustrate and reinforce the theoretical
lectures. The block also ensures development of good attitude, behaviour, develop effective
communication skills.
14. Mode of Delivery:
The implementation of the course is via

1. Lectures (LEC),
2. Practicals (PRC) – demonstration & hands on
3. Tutorials (TUT)
4. Computer aided learning (CAL) lab in pharmacology and physiology.
5. Self-directed learning (SDL)
6. Assignments (ASG).
15. Assessment Methods and Types:
2 types of assessment are used in the course.

1) Formative assessment: tutorial, assignment and practicals
2) Summative assessment: –
2.1 Continuous Assessment

1: End of Block Exam –
A: MCQ (T/F, OBA/OCA)
B: SEQ (Short essay questions)
C: MEQ (modified essay questions)
2.2 BMS in the Frist Professional Exam Part-1 (Pro-1 Part-1)

A: MCQ (T/F, OBA/ OCA)
B: MEQ (modified essay questions)
C: OSPE (objective structured practical questions)
16. Mapping of the course/module to the Program Aims
PEO1 Be equipped with current knowledge and skills in the practice of

medicine so as to become safe and caring doctors to fulfill the needs of
the nation.
PEO2 Function independently as part of the healthcare team to carry out

curative as well as preventive programme in urban and rural settings.
PEO3 A competent practitioner with leadership skills and with high ethical and
moral values.
PEO4 Apply critical thinking, problem solving and evidence based practice and
with interest in medical research and innovation.

PEO1 PEO2 PEO3 PEO4
 
17. Mapping of the course/module to the Program Learning Outcomes




moral values.
PLO7 Be able to embark on research and innovative aspect of medicine in areas

of interest.
PLO1 PLO2 PLO3 PLO4 PLO5 PLO6 PLO7
  
18. Content outline of the course/module and the SLT per topic:
Topic Learning Outcomes Face to face SLT TLT
L T P
Introduction to 1) describe the anatomical position 1
Anatomy I 2) describe the anatomical planes and position
(ANA-1) 3) describe the bones of the axial and
appendicular skeleton
4) describe the structure of joints and their
types and classification
5) describe the characteristic features of
synovial joint
6) describe the terminology associated with
movement
7) explain the various joint movements in the
human body.
8) describe the terminology associated with

location and position of structures
Introduction to 1) define the term ‘Anatomy’ 1 2

Anatomy II 2) appreciate the historical contributions to the
(ANA-2) development of Anatomy
3) appreciate the branches and divisions of
Anatomy
4) describe the organization of the human
body
5) describe the essential terminology
The Cell 1) describe the structure of the ell with regard 1 2

(ANA-3) to its cell membrane
2) describe the structure of the ell with regard
to its ytoplasmic organelles and
cytoskeleton.
3) describe the structure of the ell with regard
to its nucleus
4) describe the cell cycle
Epithelium and 1) describe the classification of the epithelial 1 2

Glands tissue
(ANA-4) 2) describe the characteristics, function and
distribution of the epithelial tissue
3) describe the membrane specialization of the
epithelial tissue
4) describe the classification of glands
5) describe the exocrine and exocrine glands
Connective Tissue 1) classify connective tissue 1 2

(ANA-5) 2) describe connective tissue with regard to its
structure and matrix
Skin and 1) describe the layers of the skin 1 2

Appendages 2) describe the epidermal appendages
(ANA-6)
Bone, Cartilage 1) describe the types of bones according to 1 2
and Ossification microscope structure
(ANA-7) 2) describe the types of cartilages
3) describe the histology of cartilage and
bone
4) describe intramembranous ossification
5) describe endochondral ossification
Muscle 1) describe the skeletal muscle with regard to 1 2

(ANA-8) its attachments, arrangement of fibers
2) describe the actions of prime movers,
antagonists, synergists and fixators
3) characterize the form and function of the
three major muscle tissues types: skeletal,
smooth and cardiac
4) describe the organization of skeletal muscle
at gross, histological, and ultrastructure
levels

Nervous Tissue 1) describe the microscopic structure of a 1 2

(ANA-9) neuron
2) describe the microscopic structure of a
nerve fiber/ peripheral nerve bundle
3) describe the microscopic structure and
locations of sensory, and autonomic
neurons
4) describe and classify the supporting cells
(glia)
5) describe and locate the various types of
nerve endings
Introduction to 1) describe the structure, and functions of 1 2

Circulatory systemic and pulmonary circuits
System 2) define arteries, veins, capillaries and arterial
(ANA-10) anastomoses
3) describe the components of the arterial
system: the aorta with its origin, course and
the major branches and their areas of
distributions
4) describe the components of the venous
system
5) name the major tributaries of the superior
and inferior vena cava and the areas of
drainage
6) describe the lymphatic drainage system
7) describe the functions and clinical
importance of the lymphatic drainage
system
8) locate the most commonly palpated groups
of lymph nodes
Introduction to 1) describe the Organisation 1 2

Nervous System 2) describe the components of Central
(CNS, PNS & Nervous System
ANS) 3) describe the Peripheral Nervous System
(ANA-11) 4) describe the Autonomic Nervous System
Gametogenesis 1) describe primordial germ cells 1

(ANA-12) 2) describe mitosis and meiosis
3) describe the maturation of the gametes:
Morphological Changes in oogenesis,
morphological changes in spermatogenesis
and spermiogenesis
First Week of 1) describe Ovarian cycle & ovulation 1

Development: 2) describe Fertilization
Ovulation to 3) describe Cleavage and Blastocyst formation
Implantation 4) describe Implantation
(ANA-13)
Second Week & 1) describe the development of Bilaminar 1
Third Week of germ disc, Primitive yolk sac and
Development: Amniontic cavity
Formation of 2) describe the establishment of the

Germ layers Uteroplacental circulation

(ANA-14) 3) describe the formation of Secondary yolk
sac
4) describe Gastrulation and formation of the
Trilaminar germ disc
5) describe the formation of Notochord
6) describe the establishment of the Body axes
7) describe the further development of the
trophoblast
Third Week to 1) describe the derivatives of the Three germ 1

Eighth Week layers
(Embryonic 2) describe the formation of Somites
period) 3) describe the formation of Neural tube
(ANA-15) 4) describe the Embryonic folding
5) describe the External appearance during the
second month
Fetal Membranes 1) list the Fetal membranes 1

and Placenta 2) describe the changes in the Trophoblast
(ANA-16) 3) describe the development of Chorion
frondosum and Decidua basilis
4) describe the structure, types and functions
of the Placenta
5) describe the development of Amnion and
Umbilical cord
Growth and 1) describe the Developmental periods 1

Development of 2) describe the Characteristic events of the
the Fetus (3rd Fetal period
month to Birth) 3) describe the Highlights of monthly changes
(ANA-17) of the Foetal period
4) describe the Factors for Estimation of
Foetal age
Birth Defects 1) define the terms,Birth Defects and 1

(ANA-18) Teratology
2) describe the Types of Abnormalities
3) describe the Principles of Teratology
4) list the causes of Birth Defects
Tutorial 1) describe structure of basic histological 2

(ANA-19) tissues
2) describe embryonic and foetal development
Homeostasis 1) define homeostasis 1

(PHY-1) 2) explain mechanisms of feedback and feed
forward mechanisms
3) state examples of feedback mechanisms
Body Fluid 1) list the body fluid compartments & state the 1
Compartments – ionic composition of each
composition & 2) state the importance of barriers between

formation compartments
(PHY-2) 3) explain the mechanism of fluid exchange
between body fluid compartments
4) state its importance in health and disease
5) list some common examples of fluid
imbalances
Applied 1) explain homeostasis at the cellular level 1

Homeostasis 2) explain Allostasis
(PHY-3) 3) explain – adaptation, acclimatization,
biological clock, apoptosis
4) state the effects of increased demand or
stress on a normal cell
Cell Volume – 1) explain principles of diffusion of solutes 1

maintenance & and solvents
importance in 2) explain Nernst potential & Gibbs Donnan
health equilibrium
(PHY-4) 3) explain osmolarity and tonicity
4) explain role of Na/K-ATPase in cell
volume & electrical properties of cell.
5) explain cellular communications and cell
signaling
6) list second messengers
Principles of 1) list the functions of skin & state its 2

Thermoregulation importance in homeostasis
& Osmoregulation 2) explain the functions of various organs in
(PHY-5) osmoregulation
3) outline the importance of thermo- and
osmoregulations in health
Tutorial-1 2
Nerve Physiology 1) classify nerves and state their functions 1
(PHY-6) 2) define neurons and neuroglia and state their
functions
3) state the process of degeneration and
regeneration of nerves
Muscle Physiology 1) list the types of muscles in the body and 1

(PHY-7) state their location and functions
2) state briefly the principles of muscle
contraction in the body
3) list types of muscle contraction in the
whole body: isotonic & isometric
Introduction to 1) list the components of blood and lymph and 1

Cardiorespiratory state the functions of each
System 2) name the types of blood vessels – arteries,
(PHY-8) arterioles, veins, venules & capillaries and
state their specific functions in the body
3) briefly describe the functions of heart and
lungs in maintenance of health

Membrane 1) explain the concept of bioelectricity 2

Potential and 2) explain the role of cell membrane in
Bioelectricity causing the membrane resting potential and
(PHY-9) generation of action potential in nerves and
muscles
3) explain the role of various ions in
generation of bioelectricity
4) differentiate between resting membrane
potential, action potential, generator
potential& graded potential
Tutorial-2 2
Synaptic 1) describe a synapse and its various parts 1

Transmission 2) list the major neurotransmitters and the
(PHY-10) steps in neurotransmission
3) list the drugs and diseases which can modify
synaptic transmission
4) list and explain the properties of synaptic
transmission
Tutorial-3 2
Practical-1
Autonomic 1) identify the divisions and subdivisions of 2

Nervous System the peripheral nervous system
Functions 2) list the functions of sympathetic and
(PHY-11) parasympathetic systems
3) compare and contrast the two subdivisions
of ANS
4) list the higher control of ANS
5) outline the role of ANS and endocrines in
stress responses
Practical-2 2
Sensation & 1) identify the sensory systems present in the 1

Perception body
(PHY-12) 2) name the various receptors present in the
body
3) explain the role of a biological transducer –
coding & perception of sensation
4) describe the mechanism of reflexes in the
body
5) differentiate between reflexes and reactions
Cal lab(ANS) 2
Biophysical 1) explain the concepts of physical principles 2

Principles like pressure, work, energy, surface tension,
(PHY-13) in the different organs of the body for the
maintenance of health
2) explain the hemodynamic principles

Review 1) Explain principles of different types of 2

regulations in the body
2) Outline their importance in health and
disease
3) Understand the concept of health in
physiological terms
Plasma 1) describe the biochemical composition and 1

Membrane: properties of cell membrane
Structure and 2) describe the fluid mosaic model of
Function membrane structure
(BIO-1) 3) describe briefly the transport systems
4) identify the role of membrane glycoproteins
as sites for recognition and as receptors
5) explain signal transduction
Buffer Functions 1) define acid, base, pH, buffer and pI 1

of Amino acids and 2) classify amino acids commonly found in
Proteins body proteins according to the charge and
(BIO-2) polarity of their side chains
3) Apply Henden-Hasselbalch equation to
calculate the quantitative relationship
between the pH and concentration of weak
acid (HA) and conjugate base (A)
4) explain briefly the buffer functions of
amino acids
5) draw the titration curve of alanine
Introduction to 1) Define pharmacology 1

Pharmacology 2) Define the terms : a drug and a toxin;
(PHM-1) differentiate the two
3) List the subdivisions of pharmacology
4) Define pharmacokinetics and
pharmacodynamics
5) Define specific terms in pharmacology-
pharmacotherapeutics, pharmacogenetics
6) Explain the meaning of chemical, generic
and proprietary names of drugs
7) List some ways of classifying drugs
8) Explain what are receptors
9) Describe the significance of biological
membranes
Routes of Drug 1) List the various routes of drug 1

Administration administration.
(PHM-2) 2) List the various drug formulations.
3) Define bioavailability and discuss the
factors that influence it.
4) Define bioequivalence and therapeutic
equivalence.
5) Define first pass metabolism and relate its
significance to various routes of drug
administration.

6) Discuss drug administration by enteral

route
7) Discuss drug administration by parenteral
route.
8) Discuss drug administration by other routes
Tutorial-1 2
CAL-1 1) Describe the routes of administration their 3

advantages and disadvantages
2) Understand the first pass metabolism of
drugs
3) Appreciate the significance of protein
binding of drugs, transport of drugs across
biological membranes
4) Explain drug interactions owing to drugs
inducing and inhibiting the enzymes
CYP450
5) List the common dosage forms
(formulations) pertaining to the various
routes of administration of drugs
6) Explain how routes of administration of
drugs influence absorption, bioavailability
and also onset of action
Drug Absorption 1) Describe the various mechanisms of drug 2

and Distribution 1 permeation.
&2 2) Discuss the effect of pH on drug absorption.
(PHM-3) 3) Discuss the various factors influencing drug
absorption from the gastrointestinal tract.
4) Describe the major body compartments of
drug distribution.
5) Discuss binding of drugs to plasma proteins
and their significance.
6) Define volume of distribution of a drug and
its significance
Drug Metabolism 1) Define drug metabolism 1

of drugs 2) Mention the sites of drug metabolism
(PHM-4) 3) Describe the kinetics of metabolism with
examples
4) Describe first pass metabolism of a drug
with examples
5) Describe phase I metabolic reaction with
examples
6) Describe phase II metabolic reaction with
examples
7) Describe the factors effecting drug
metabolism
8) Describe the importance of drug
metabolism
9) Describe enzyme induction with examples
10) Describe enzyme inhibition with examples

Elimination of 1) Define elimination of a drug 1

drugs 2) Mention the different routes of elimination
(PHM-5) of a drug with examples
3) Describe different processes in the renal
elimination of a drug- glomerular filtration,
proximal tubular secretion, distal tubular
reabsorption
4) Describe enterohepatic circulation with
examples
5) Explain the effect of urinary ph on
elimination of drugs
6) Define total body clearance
Tutorial-2 2
CAL2 1) Define pharmacokinetic parameters such as 3

Vd, T1/2, cl, bioavailability (F) and steady
state concentration of a drug
2) Explain the concept of half life
3) Define pharmacokinetic parameters such as
Vd, T1/2, cl, bioavailability (F) and steady
state concentration of a drug
4) Explain the concept of half life
5) List factors influencing the T/2 of drugs
6) Explain steady state concentration of a drug
and the loading dose
7) Calculate T 1/2, Vd bioavailability, steady
state concentration and therapeutic index
Pharmacokinetic 1) Describe the concept of one-compartment 2

Principles and two-compartment body models and to
(PHM-6) distinguish them from anatomical or
physiological compartments
2) Explain the significance of the total amount
of drug in the body and its concentration in
the blood or plasma
3) Differentiate between first order and zero
order kinetics and the concept of dose-
dependent kinetics
4) Define pharmacokinetic parameters such as
vd, k, t1/2, cl and bioavailability (f)
5) Explain the concept of half-life
6) List factors influencing the t ½ of drugs
7) Calculate t1/2, vd and clearance
8) Appreciate the concept of steady state and
factors influencing it
9) Explain the concept of drug accumulation
during repeated dosing
10) Explain the concept of loading dose and
maintenance dose
11) Appreciate that these pharmacokinetic
parameters are altered in certain
physiological, pharmacological
and diseased states

Drug-mediated 1) Define the specific terms essential for the 2

Responses understanding of drug mechanisms
(PHM-7) 2) Explain the four main mechanisms of drug
action: receptors, carriers, ion channels and
enzymes
3) Non-receptor mediated drug action
4) Explain the four main types of receptors
5) Explain the changes which occur after the
formation of drug-receptor complex at
molecular level
6) Explain the two main types of carriers
7) Define specific terms essential for the
understanding of drug dose-response
understanding of drug dose-responses
9) Describe the dose-response curves
10) State whether a drug is an agonist, partial
agonist or an antagonist based on its dose
response curve
understanding of drug dose-response
understanding of drug dose-responses
13) Describe the dose-response curves

14) State whether a drug is an agonist, partial
agonist or an antagonist based on its dose
response curve
15) Explain the clinical implication of
administering a partial agonist following a
full agonist
16) Compare the efficacy and potency of drugs
in terms of clinical significance
17) Therapeutic index of a drug and its
significance
18) Explain the combined effect of drugs like
synergism, antagonism
Tutorial-3 2
CAL-3 1) Describe the drug –receptor interaction 3

2) Describe the hyperbolic curve versus log
dose response curve
3) Explain the competitive and non-
competitive antagonism of drugs
4) Describe the graded dose response curve vs
quantal dose curve
5) Therapeutic index and its importance
6) Classify receptor and explain the role of
second messengers
7) Explain the concept of spare receptors and
desensitization of receptors

Adverse drug 1) Define an adverse drug reaction 1

reactions relationship for that particular drug
(PHM-8) 2) List the factors influencing adverse drug
reactions
3) Explain how the toxicity of several related
drugs can be compared using the LD50
values and the steepness of the dose-
response curve
4) Estimate the LD50 Explain the factors
affecting its value
5) Differentiate between acute and chronic
LD50
6) Define terms related to indicators in
toxicology
7) List the various toxicity tests.
8) State how adverse drug (ADR) reactions are
reported to the Malaysian ADR Advisory
Committee (MADRAC)
9) Define the unwanted effects
10) Describe in a general way the types of the
damage to target organs
Autacoids 1) Define autacoids 1

(PHM-9) 2) List important autacoids
3) Explain at least three important functions of
each autacoid
4) Discuss the therapeutic uses of autocoids
and their antagonists
5) List the important antagonists of histamine
(H1&H2 receptors) and serotonin
6) Explain the pharmacological actions of
bradykinin and angiotensin
7) Describe the vascular and nonvascular
actions of prostaglandins and leukotrienes.
8) List the uses of prostaglandins and
leukotriene antagonists
9) Explain the mechanism of action of nitric
oxide (NO)
Tutorial-4 2
19. Main references supporting the course:
ANATOMY
Text Books, Dictionary and Atlas
1. Drake, R.L., Mitchell A.W.M., Vogl A. W., and Mitchell A.W.M. (2010). Gray’s
Anatomy. 2nd Edition. Churchill Livingstone Elsevier.
2. Sadler T. W. (2010) Langman’s Medical Embryology. 12th Edition. Wolters Kluver.
Lippincott Williams and Wilkins.
3. Young B., Lowe J.S., Stevens A., Heath J.W., and Deakin P.J. (2011). Wheater’s
Functional Histology: A text and Colour Atlas. 5th Edition. Elsevier.
4. Crossman, A.R., and Neary D. (2010). Neuroanatomy. An illustrated Colour Text. 4th

Edition. Churchill Livingstone.

5. Eroschenko V.P. (2008). diFiore’s Atlas of Histology with Functional Correlations. 12th
Edition. Wolters Kluver. Lippincott Williams and Wilkins.
6. Stedman’s Pocket Medical Dictionary. (with free e-version) (2010) First Edition Wolters
Kluver. Lippincott Williams and Wilkins.
7. Abrahams P.H., Boon, J.M. and Spratt J.D.(2008) McMinn’s Clinical Atlas of Human
Anatomy. 6th Edition. Mosby.
OR
Rohen J.W., Yokochi C and Lutjen-Drecoll. (2011). Color Atlas of Anatomy. 7th Edition.
Wolters Kluver. Lippincott Williams and Wilkins.
Additional Anatomy Reference Books
1. Snell R.S. (2008). Clinical Anatomy by Regions. 8th Edition. Lippincott Williams and
Wilkins.
2. Keith Moore and T.V.N. Persaud. (2008). The Developing Human. 8th Edition. Saunders.
3. Gartner, L.P., and Hiatt J.L. (2011). Concise Histology. First Edition. Saunders Elsevier.
4. Abrahams, P., Craven, J and Lumley, J. (2011). Illustrated Clinical Anatomy. 2nd
Edition. Hodder Arnold.
PHYSIOLOGY
Text Book
1. Dee Unglaub Silverthorn, (2010), Human Physiology – An Integrated Approach, 5th
Edition, Pearson-Benjamin Cummings.
Additional References
1. Ganong WF. (2003). Review of Medical Physiology. 21st Ed. Lange Medical Publications,
Simon & Schuster Asia Pte. Ltd., Singapore
2. Guyton AC and Hall JE (1997). Human Physiology and Mechanism of Disease. 6th
Ed. W. B. Saunders & Co., Philadelphia
3. Sherwood L. (2001). Human Physiology - From Cells to System. 4th Ed.Brooks/Cole
4. West JB. (2008) Respiratory Physiology – The Essentials, 8th Ed.Kluwer/Lippincott
Williams & Wilkins.
5. Levy, MN, et al. (2005) Berne & Levy: Principles of Physiology 4th Ed.Elseview-Mosby
Publishers.
6. Rhoades RA & Bell DR, (2008) Medical Physiology - Principles for Clinical Medicine
3rd Ed Kluwer/Lippincott Williams & Wilkins.
BIOCHEMISTRY
Tex Books
1. Basic Medical Biochemistry: A Clinical Approach, Lieberman M & Marks AD (2009).
3rd Edition. Lippincott, Williams and Wilkins Co. Baltimore.
2. Lippincott’s Illustrated Reviews, Biochemistry Champe PC & Harvey RA, (2010). 5th
Edition. Lippincott, Williams and Wilkins Co. Baltimore.
Reference
1. Medical BiochemistrY Baynes JW & Dominiczak MH (2005). 2nd Edition. Elsevier –
Mosby, Philadelphia.

2. Textbook of Biochemistry (For Medical Students) Vasudevan DM and Sreekumari S.

(2011). 6th Edition. Jaypee Medical Publishers (P) Ltd, New Delhi. India.
3. Harper’s Illustrated Biochemistry Murray RK, Granner DK, & Rodwell VW. (2012). 29th
Edition. McGraw Hill, Boston.
4. Biochemistry : A Case-Oriented Approach Montgomery R, Conway TW, Spector AA &
Chappell (1996), 6th Edition, Mosby. St. Louis. USA
PHARMAOCLOGY
Text Books
1. Basic and Clinical Pharmacology,
Katzung BG: (Eds.). 11th Edition, International edition 2004. McGraw Hill, Education
(Asia)
2. Pharmacology – Lippincott’s Illustrated Review, RA Harvey & Champe PC . 5th Edition,
Lippincott Williams & Wilkins, Philadelphia.
1. Rang and Dale’s Pharmacology H.P.Rang, M.M.Dale, J.M.Ritter, R.J.Flower . 7th Edition,
Churchill Livingstone.
2. The Pharmacological Basis of Therapeutics: A Goodman & Gilman. (Ed.) 12th International
Edition, Hardman & Limbird, McGraw Hill, New York.
20. Other additional information:

MBBS Curriculum BMD/Sem-1/Year-1
Basic Mechanisms of Disease Block – BMD
Course Information
1. Name of Course/Module: Basic Mechanisms of Disease (BMD) Block
2. Course Code: BMD 6117
Pathology
1. Prof Dr Mehboob Khan
2. A/P Dr Manjit Singh
3. Dr Vaishali Jain
4. Dr Chandrasekeran S
Microbiology/Parasitology
5. Prof. Dr. Myint Aung
6. A/P Dr. Chan Boon Tek Eugene
7. A/P. Dr. Haresh Kumar Kantilal
8. A/P Dr. S. Jayakumar
9. Dr. Selvi Palasubramaniam
10. Dr. Saad Musbah Naji Alasil
Pharmacology
12. A/P.Dr. Madhu
13. Dr. Heethal
14. Miss Vjaya
15. Dr. Sunil Kale
16. Dr. Ameeta Patil
Community Medicine
17. Prof.Dr. Than Winn (TW)
18. Dr. Lilli Jacob (LJ)
19. Dr. Than Tun Aung (TTA)
20. Dr. Wan Azman Wan Adnan (WAA)
21. Dr. Aung Ko Ko Min (AKK)
This block is of 6 weeks duration and is the second block of the first semester of year 1. This is
a general introduction to the pharmacology, pathology and microbiology-parasitology with
reference to the diseases producing factors in the human body. At the end of this block, the
student acquires knowledge of the basic causes and mechanisms of diseases of organ systems
along with their biochemical explanations which is a prerequisite for studying the systems which
start in the second semester onwards.


L=Lecture L T P O E
T=Tutorial/CAL
P=Practical/PBL 58 20 12 0 2 270 hours
O=Others
(Review discussion) 116 40 12 10
E = Exam
7. Credit value:
270/40 = 6.75 (~7credit)
8. Prerequisite:
9. Objectives:
KNOWLEDGE
Students will have knowledge of:
 Mechanisms of diseases affecting various systems in human body.
 Difference between normal and diseased states / conditions (‘diseases’).
 Comparison between similar disease states and processes.
 the general causes, or agents, of disease and correlate the virulence factors with the
mechanism of disease.
 the basic mechanisms involved in the causation of disease.
 the macroscopic and microscopic features of diseased tissues/organs.
 the actions, uses and adverse effects of drugs acting on the autonomic nervous systems.
 the mechanism of actions, indications of use and adverse effects and drug interactions of
the bacterial cell wall synthesis inhibitors, common antimicrobial agents against various
infections.
SKILLS
Students will have skills to:
 identify laboratory characteristics, virulence factors of the various biological agents of
disease (bacteria, viruses, fungi and parasites)
 identify pathological changes and processes both macroscopically and microscopically
ATTITUDE
Students will
 develop effective communication and etiquette with ability to undertake self learning
responsibility
 develop ability to do team work
Integration
Since this is a basic module, no integration happens here, only basic information are disseminated
to prepare the students to be able to understand the following systematic modules.

By the end of the block, you should have the knowledge, skills and attitude to be able to:
1. define the terms used in the study of diseases.

2. differentiate between normal and diseased states / conditions (‘diseases’).
3. compare and contrast similar disease states and processes.
4. conceptualize and classify the general causes, or agents, of disease.
5. identify the agents of disease and correlate the virulence factors with the mechanism of
disease.
6. explain the basic mechanisms involved in the causation of disease.
7. explain the responses of the body to exposure to the various agents of disease, and their
sequelae or complications.
8. identify and describe the macroscopic and microscopic features of diseased tissues/organs.
9. explain the factors affecting the pharmacokinetics, theories of drug action – the
pharmacodynamics of drugs, principles of toxicology and adverse effects of drugs.
10. discuss the mechanism of actions, indications of use and adverse effects and drug interactions
of the bacterial cell wall synthesis inhibitors, common antimicrobial agents against various
infections.

(f) Writing clear and concise records and reports
(g) Presenting technical information to a large group of people
(h) Ability to understand and treat an audience accordingly
(i) Listening attentively
(j) Effectively explaining highly technical information

Assessment strategy includes both formative and summative. Students are assessed and
monitored throughout the block by tutorials and assignments to check their understanding and
improvement. At the end of the block, there is an end of block test (EBX) as continuous
assessment.

13. Synopsis:
The block runs for six weeks and covers the relevant aspects of the basic mechanisms of diseases.
In this block, students learn the pathological changes and processes both macroscopically and
microscopically involved in the causation of diseases and their correlation to the clinical
manifestations of the disease, the laboratory characteristics, virulence factors of the various
biological agents of diseases] and mechanisms of microbial pathogenesis. The pharmacokinetics
and pharmacodynamics of drugs, principles of toxicology and adverse effects are also discussed
with respect to their mechanisms of action, indications and contraindications to treatment, side-
effects and the mechanisms of bacterial resistance. Lectures on the introduction to Public Health
and Natural History of Diseases are also be included in this block.

1. Lectures (LEC),
2. Practicals (PRC) – demonstration & hands on
3. Tutorials (TUT)
4. Computer aided learning (CAL) lab in pharmacology and physiology.
There are generally 2 types of assessment used in the course.

3) Formative assessment: tutorial, assignment and practical
4) Summative –
2.1) Continuous Assessment

A: MCQ (T/F)
B: MCQ (OBA/OCA)
C: SEQ (Short essay questions)
D: MEQ (modified essay questions)
2.2) BMD in the First Pro Part-1 Exam

A: MCQ (T/F)
B: MCQ (OBA/OCA)
E: OSPE (objective structured practical examination questions)

the nation.

moral values.

PEO4 Apply critical thinking, problem solving and evidence based practice
and with interest in medical research and innovation.
PEO1 PEO2 PEO3 PEO4
 
PLO1 Be competent to make a diagnosis and institute management on

common medical and health conditions based on history, physical
examinations and relevant investigations.



moral values.

areas of interest.
  
L T P
Introduction: 1) Describe the various causes of cell 1
Reversible cell injury injury
(PAT-1) 2) Explain the mechanism and effects of
cell injury
3) Explain the stages of cellular response
to injury
4) Discuss morphology of cell injury
with emphasis on patterns of
reversible cell injury

Irreversible cell 1) Explain the types of irreversible cell 1

injury (PAT-2) injury
2) Define necrosis and discuss the
patterns of necrosis giving examples
of each
3) Define apoptosis and discuss its
mechanism along with biochemical
and morphologic features
4) Discuss difference between necrosis
and apoptosis
5) Define and differentiate dystrophic
and metastatic calcification’ and give
examples
Acute inflammation 1) List the steps of inflammatory 2

(PAT-3) response
2) Compare features of acute and chronic
inflammation
3) State the components of inflammatory
response and their actions
4) Define acute inflammation, give its
causes
5) Explain the vascular and cellular
events in acute inflammation
6) Discuss in brief about morphologic
patterns, cardinal signs and outcome of
acute inflammation
7) Briefly describe role of chemical
mediators in inflammation
Chronic 1) Define chronic inflammation. List its 1

inflammation causes
(PAT-4) 2) Describe briefly the role of different
cells in chronic inflammation
3) Discuss patterns of chronic
inflammation
4) Define granulomatous inflammation.
Briefly discuss examples of it
5) Understand systemic effects of chronic
inflammation
Tissue repair 1) Briefly describe process of tissue 1

(PAT-5) repair comprising regeneration and
scar formation
2) Understand mechanism of cell
proliferation
3) Discuss role of growth factors and
cytokines involved in tissue repair
4) Mention role of extracellular matrix in
tissue repair
5) Understand the process of
regeneration and scar formation
6) Discuss clinical examples of tissue
repair: skin wound healing

7) Differentiate between healing by

primary intention and healing by
secondary intention
8) Mention factors affecting tissue repair
9) State pathologic aspects of repair
Pigment disorders 1) Describe and discuss the significance 1

(PAT-6) of pigments and metals found in
physiologic and disease states
2) Identify pigment disorders in tissue by
special techniques
Growth disorders & 1) Define with examples terms related to 1

differentiation cells with different regenerative
(PAT-7) capacity
2) Explain the role of growth factors in
differentiation and regeneration
3) Define ‘necrosis’ and ‘apoptosis’
4) Compare and contrast between
necrosis and apoptosis
5) Define and describe with examples
terms related to adaptations to
physiological and pathological stimuli
Carcinogenesis & 1) Define carcinogenesis and the types of 2

neoplasia (PAT-8) carcinogenesis
2) List the causes of carcinogenesis.
3) Discuss briefly the role of
carcinogenic agents in the
development of cancer
4) Discuss host factors in carcinogenesis
5) List the cellular and molecular events
in carcinogenesis
6) Define neoplasia
7) Compare and contrast the
characteristics of benign and
malignant tumours
8) Describe the nomenclature for benign
and malignant tumours
9) Describe tumour-on-host and host-on-
tumour interactions
10) Discuss briefly the underlying
mechanisms of metastasis in
malignant tumour cells
11) Define paraneoplastic syndrome with
examples
Amyloidosis (PAT-9) 1) Define amyloid and explain briefly the 1

physical nature of amyloid
2) Describe briefly the chemical
behaviour of amyloid on special stains
3) Compare and contrast the features of
primary versus secondary amyloidosis
with examples

4) Discuss the complications of

amyloidosis
Shock (PAT-9) 1) Define ‘shock’ 1

2) Explain the causes of shock
3) List the major characteristics of the
different types of shock
4) Explain compensatory mechanisms
activated in shock.
5) Describe the complications of shock
related to the lung, kidney
gastrointestinal tract and blood
clotting
6) Define multiple organ dysfunction
syndrome and explain its significance
Practical 6
Tutorials 3
Bacterial Cell: 1) differentiate between prokaryotic and 1 1 2

Structure and eukaryotic cells
Classification 2) describe the bacterial cell, its structure,
(MIC-1) and functions
3) describe the basic structure of Gram-
positive and Gram-negative bacterial
cell wall
4) describe the structure of bacterial
spore and functions
5) classify bacteria using simple
phenotypic characteristics
Mechanism of 1) define terms relevant to bacterial 1 1 0

bacterial pathogenicity
pathogenesis 2) list and explain Koch’s postulates
(MIC-2) 3) explain how transmission of infection
occurs
4) explain how infectious processes
occur
5) describe virulence factors and
mechanisms of action
Bacterial genetics 1) Define the term bacterial genome 1 1 0

(MIC-3) 2) Describe bacterial chromosome,
plasmids, transposons, and insertion
sequence
3) Discuss genetic variation in bacteria
4) Explain the different mechanisms of
gene transfer in microbes
5) Describe the important types of
plasmids
6) Describe the role of plasmids in the
spread of antibiotic resistance and in

genetic engineering
Gram-positive 1) Classify Gram-positive bacteria of 2 2 2

Bacteria of Medical medical importance
Importance (MIC-4) 2) List a few species of medical
importance from each group according
to the simplified classification
3) Describe briefly the microbiological
characteristics of these bacteria
4) List the virulence factors produced by
these organisms that contribute to the
pathogenicity and mode of
transmission of these organisms
5) List a few diseases caused by these
organisms and the antibiotics used in
the treatment
Gram-negative 1) Classify Gram-negative bacteria of 2 2 2

bacteria of medical medical importance
importance (MIC-5) 2) List a few species of medical
importance from each group
according to simplified classification
3) Describe briefly the microbiological
characteristics of these bacteria
4) List virulence factors produced by
these organisms that contribute to
their pathogenicity and the mode of
transmission
5) List a few diseases caused by these
organisms and antibiotics used in the
treatment
Anaerobes (MIC-6) 1) Define ‘anaerobe’. 1 1 0

2) Classify anaerobes of medical
importance
3) List the clinically important anaerobes
4) Describe the microbiological
characteristics, commonly occurring
sites in the human body and infections
caused by anaerobes of medical
importance
5) Describe the predisposing factors of
anaerobic infections
Mycobacterium and 1) List the Mycobacterium spp. and 1 1 0

Nocardia (MIC-7) Nocardia spp. of medical importance
2) Describe the laboratory characteristics
of these organisms
3) Describe the diseases, laboratory
diagnosis and outline their treatment
Spirochaetes 1) Describe the characteristics of a 1 1 0

(MIC-8) spirochaete. morphology, antigenic
structure and culture

2) List the species of Treponema,

Leptospira and Borrelia of medical
importance and the diseases they
cause.
3) Describe the epidemiology, modes of
transmission, pathogenesis, clinical
manifestations of spirochaetal
diseases.
4) Describe the laboratory diagnosis,
outline of treatment and preventive
measures of spirochaetal diseases
Chlamydia, 1) Describe briefly the microbiological 1 1 0

Mycoplasma and characteristics of the following genera:
Ureaplasma (MIC-9) i: Mycoplasma,
ii: Ureaplasma,
iii:Chlamydia
2) Differentiate Mycoplasma from other
cell wall defective forms
3) List a few species of medical
importance from each genus
4) Describe briefly the diseases and list a
few antibiotics used in the treatment
Rickettsia, Orientia, 1) describe briefly the microbiological 1 1 0

Ehrlichia and characteristics of the following genera:
Coxiella (MIC-10) i: Rickettsia,
ii: Orientia,
iii: Erhlichia,
iv: Coxiella
2) list a few species of medical
importance from each genus
3) describe briefly the diseases and list a
few antibiotics used in the treatment
Introduction to 1) describe the laboratory characteristics 2

Mycology and of fungi
Mechanism of 2) list the examples of fungi of medical
Fungal importance
Pathogenesis 3) describe the effects of fungi on
(MIC-11) humans
4) explain the mechanisms of fungal
pathogenesis
Laboratory 1) discuss the proper collection and 2

Diagnosis of transport of appropriate specimens
Bacterial and Fungal according to the sites of infections
Infections (MIC-12) 2) describe the various methods used in
the diagnosis of bacterial infections
3) describe the various methods used in
the diagnosis of fungal infections
Viral structure, 1) define virus 1 1 0
classification 2) describe the properties of RNA and
and replication DNA viruses

(MIC-13) 3) classify viruses of medical importance

4) describe the basic structure of viruses
and their chemical structure
5) describe briefly the steps involved in
viral replication
RNA viruses of 1) List the RNA viruses of medical 1 1 0

medical importance importance
(MIC-14) 2) Describe briefly the epidemiology,
pathogenesis, clinical presentation,
laboratory diagnosis of infections
caused by medically important RNA
viruses
DNA viruses of 1) list the medically important DNA 1 1 2

medical viruses
importance and 2) explain the epidemiology,
oncogenic viruses pathogenesis, clinical presentation,
(MIC-15) laboratory diagnosis of the infections
caused by medically important DNA
viruses
3) list the oncogenic viruses and tumors
associated with them
Mechanism of 1) describe the common routes of entry in 1 1 0

viral viral infections
pathogenesis 2) explain the mechanism of spread of
(MIC-16) viruses in the body
3) describe the outcome of viral infection
and cytopathogenesis
4) describe the host defenses against viral
infection and the immunopathology
Sterilization and 1) define sterilization and disinfection 1 1 0

disinfection 2) describe the various techniques of
(MIC-17) sterilization
3) list the factors which influence the
process of sterilization
4) list the various modalities used in
determining the efficacy of the
sterilizing process (e.g., autoclave)
5) define disinfectant and antiseptic
6) list the various groups of disinfectants,
their characteristics and their use in the
hospital setting
7) list the factors which influence the
efficacy of disinfectants
8) define pasteurization and state its uses
9) discuss briefly the functions of Central
Supplies and Sterilizing Department
(CSSD) in hospital
Normal flora 1) define ‘normal flora’ 1 1 0
(MIC-18) 2) state the origin of normal flora
3) differentiate between resident normal

flora, transient normal flora and carrier

state
4) discuss factors determining the nature
of the normal flora
5) describe briefly the normal flora of the
different sites of human body
6) discuss the role of normal flora in
disease
7) describe the beneficial effects of
normal flora
Antibiotic resistance 1) describe the origin of antibiotic 1 1 2

(MIC-19) resistance and cross-resistance
2) describe the mechanism of antibiotic
resistance
3) explain briefly the principles of the
different types of antibiotic
susceptibility tests and their
interpretations
4) describe the possible ways of
combating antibiotic resistance
5) discuss the clinical implications of
antibiotic resistance
Overview of 1) appreciate the global picture of 1 1

Parasitology parasitic problems afflicting the world
(PARA-1) 2) appreciate major landmarks in the
history of parasitology
Host-parasite 1) explain the various terms in 1 1

relationship parasitology
(PARA-2) 2) discuss concepts of host-parasite
relationship
Parasite groups 1) classify parasites into groups and 1 1

(PARA-3) subgroups (by common names)
2) list the morphological features and
functions of each group and
subgroups
3) explain the types of lifecycles of
parasites
4) identify a given parasite by its group
or subgroup
Arthropods of 1) classify arthropods into groups and 1 1

Medical Importance common subgroups (by common
(PARA-4) names)
2) explain the medical importance of
common arthropods
3) identify a given arthropod by its
group or subgroup

Parasitic 1) explain the pathogenicity of parasites 1 1

Mechanisms of 2) explain the various modes of disease
Disease (PARA-5) transmission
3) explain the various mechanism by
which they cause disease in humans
Basis of 1) explain principles in the diagnosis of 1 1
Parasitologic parasitic infections
Diagnosis (PARA-6) 2) outline the problem solving steps of
suspected parasitic infections
3) outline the main laboratory
investigations for parasitic infections
Cholinergic drugs 1) explain what are cholinomimetic drugs 1

(PHM-1) 2) classify cholinergic drugs into groups
that act directly and indirectly
3) list the important cholinergic drugs
e.g. acetylcholine, bethanecol,
pilocarpine, nicotine, neostigmine
4) explain the mechanism of action of
directly acting and indirectly acting
cholinergic drugs
5) list the second messengers involved
and the effects of acetylcholine on the
major organs
6) list the clinical applications,
contraindications and the side effects
of cholinergic drugs
Anticholinesterases 1) classify anticholinesterase drugs into 1

(PHM-2) reversible and irreversible groups
anticholinesterase drugs from each
group
3) explain the pharmacological effects of
these drugs on organs
4) compare the actions of neostigmine
and physostigmine on skeletal muscle
and other organs
5) explain the treatment of
anticholinesterase poisoning
6) explain why atropine and pralidoxime
are used in the treatment of
organophosphate poisoning besides
supportive treatment
7) explain cholinergic crisis and
myasthenic crisis
Anticholinergic 1) list the clinically important muscarinic 1

drugs (muscarinic antagonists e.g. atropine, hyoscine,
blockers) ipratropium
(PHM-3) 2) explain the mechanism of action of
these drugs

3) explain in detail the pharmacology of

atropine
4) explain the effect of these drugs on
neuro-effector organs
5) list the clinical uses and side effects of
these drugs
6) list the signs, symptoms and treatment
of atropine overdose
Tutorial-1 2
Adrenergic agonists 1) mention the drugs acting on steps in 3
and the synthesis and release of
Sympathomimetic noradrenaline
drugs 2) name the receptors acting on the
(PHM-4) adrenergic nervous system, their
location and actions
3) name the catecholamines and describe
their action with respect to the
receptors on which they act, their
adverse effects and uses
4) classify sympathomimetics drugs and
give examples for each class e.g.
directly acting – clonidine, dopamine,
epinephrine, isoprenaline,
phenylephrine, salbutamol; indirectly
acting – amphetamine, cocaine,
tyramine, ephedrine
5) mechanism of action of directly and
indirectly acting sympathomimetics
6) describe the pharmacological actions
of directly and indirectly acting
sympathomimetics
7) describe the adverse effects, important
drug interactions and
pharmacokinetics features of directly
and indirectly acting
sympathomimetics
8) mention the uses of directly and
indirectly acting sympathomimetics
Tutorial-2 2
Beta-adrenergic 1) classify beta-adrenergic receptor 1
receptor blockers blockers with examples i.e., non-
(PHM-5) selective – propranolol; selective –
atenolol, metoprolol
2) describe the mechanism of action of
beta-adrenergic receptor blockers
of beta-adrenergic receptor blockers
4) describe the important
pharmacokinetic features, adverse
effects, contraindications and
important drug interactions of beta-
adrenergic receptor blockers

5) describe why propranolol is

contraindicated in bronchial asthma
and diabetes mellitus
6) describe the clinical uses of beta-
adrenergic receptor blockers with
respect to angina and hypertension
Alpha-adrenergic 1) classify alpha-adrenergic receptor 1

receptor blockers blockers with examples i.e., non-
(PHM-6) selective – phenoxybenzamine,
phentolamine; selective – prazosin
alpha-adrenergic receptor blockers
of alpha-adrenergic receptor blockers
4) describe the important
pharmacokinetic features, adverse
effects, contraindications and
important drug interactions of alpha-
adrenergic receptor blockers
5) describe first-dose effect
6) describe the clinical uses of alpha-
adrenergic receptor blockers with
respect to hypertension,
pheochromocytoma, benign prostatic
hypertrophy
Tutorial-3 2
Antiviral drugs 1) classify antiviral drugs based upon 1
(PHM-7) their site of inhibition in the viral
replication cycle
- agents to treat Herpes Simplex
Virus (HSV) infections
- agents to treat Varicella-Zoster
Virus (VZV) infections
- agents to treat Cytomegalovirus
(CMV) infections
- agents to treat Hepatitis B Virus
(HBV) infection
2) explain their mechanisms of action
3) describe their major therapeutic
indications
4) compare their pharmacokinetic
properties
5) list their adverse side effects and
potential drug interactions
6) explain the factors that regulate
antiviral drug resistance
7) important antiviral drugs:
- anti HSV & VZV: acyclovir,
valacyclovir
- anti CMV: ganciclovir,
valganciclovir, foscarnet

- anti HBV: interferon α-2b,

entecavir, lamivudine
Principles of 1) define chemotherapy and give 1

Antimicrobial examples of major classes of
therapy (PHM-8) antimicrobial agents
2) list “selective toxicity” with reference
to antimicrobial therapy
3) list the 4 important mechanisms of
action of antimicrobials
4) discuss factors that can influence
action of antimicrobials
5) discuss host factors that can influence
effectiveness of antimicrobials
6) differentiate between bactericidal
drugs and bacteriostatic drugs
7) explain the general principles that
guide the selection of antimicrobial
agents for therapeutic purposes
8) explain why drug combinations are
used
9) explain chemoprophylaxis
Penicillin, 1) list the beta-lactam antibiotics

cephalosporins and 2) explain the mechanism of action of
beta-lactam penicillin in Gram-positive and Gram-
antibiotics (PHM-9) negative organisms
3) classify penicillins – natural penicillin,
antistaphylococcal penicillin, beta-
lactamase inhibitors, extended
spectrum penicillin, antipseudomonal
penicillin
4) explain what are beta-lactamase
5) explain what are beta-lactamase such
as clavulanic acid and sulbactam
6) discuss the indications for use and
outline the adverse effects of penicillin
7) list the important drug interactions
8) explain the mechanisms of resistance
to penicillin
9) list other drugs affecting bacterial cell
wall synthesis
Tutorial-4 2
CAL on Cholinergic 1) observe and describe the effects of 2
drugs acetylcholine on heart rate and blood
(PHM-10) pressure
2) observe and describe the effects of
atropine on heart rate and blood
pressure
ringer on the esophageal motility
ACh on the esophageal motility


Physostigmine on the esophageal
motility
Atropine on the esophageal motility
Atropine + ACh on the esophageal
motility
Atropine + Physostigmine on the
esophageal motility
CAL on Adrenergic 1) explain the effects of catecholamines, 2

drugs (PHM-11) alpha adrenergic and beta blockers on
heart rate and blood pressure in an
animal preparation
CAL on Effects of 1) observe and describe the effect of 2

drugs on rabbit eye saline on pupillary size, light reflex
(PHM-12) and intraocular tension.
2) observe and describe the effect of
epinephrine on pupillary size, light
reflex and intraocular tension.
atropine on pupillary size, light reflex
and intraocular tension.
ephedrine on pupillary size, light
reflex and intraocular tension
physostigmine on pupillary size, light
lignocaine on pupillary size, light
Introduction to 1) define Health, Public health and other 1

Public Health related terms
(CMD-1) 2) describe characteristics of public
health, the scope of public health
3) identify geographical locations of
WHO main office and six Regional
Offices
4) explain the role of World Health
Organization (WHO) in International
Health
5) enumerate 28 Countries in the WHO
Western Pacific Region (WPRO)
6) describe the role, objectives and core
functions of WHO
7) describe the structure and function of
Ministry of Health Malaysia as a
member country of WHO, WPRO

Natural History of 1) define health, illness and diseases, 1

Diseases (CMD-2) epidemiology, incubation period,
latent period, host, agent, contact
2) list the stages of natural history of
diseases
3) describe the natural history of diseases
4) discuss briefly the stages of natural
history of diseases
PATHOLOGY
Text Books
1. Vinay Kumar, MBBS, MD, FRCPath, Abul K. Abbas, MBBS and Jon Aster, MD (2013).
Robbins Basic Pathology. (9th Edition) Elsevier Health.
2. Text book of Pathology. 6th Edition. Harsh Mohan. Jaypee.
1. Walter and Israel (1996) General Pathology. (7th Edition) Churchill Livingstone.
2. Marshall W. J. (1992) Illustrated Textbook of Clinical Chemistry. (3rd Edition) Mosby.
3. Underwood J.C.E (2009) General & Systemic Pathology (5th Edition) Churchill
Livingstone.
4. Chandrasoma P. and Taylor C.R. (2001) Concise Pathology (3rd Edition) McGraw Hill
International Edition
MICROBIOLOGY
Textbooks
1. Brooks G.F., Carroll, K.C., Butel J.S., Morse S.A. & Mietzner T.A. (2010). Jawetz
Melnick & Adelberg’s Medical Microbiology 25th edition. Lange medical books/
McGraw Hill
2. Goering R.V., Dockrell H.M., Zuckerman, M., Roitt I.M. & and Chiodini P.L.
(2013).Mim’s Medical Microbiology. 5th edition. Elsevier Saunders
Reference
1. Murray, P.R., Rosenthal, K.S., Kobayashi, G.S. and Pfaller M.A. (2008). Medical
Microbiology. 4th ed. St. Louis: Mosby.
PARASITOLOGY
Textbooks
1. Franklin A, Neva and Harold W. Brown. Basic Clinical Parasitology.6th Edition
(1994).Appleton and Lange Publisher.
2. Zaman, V., and Keong, L.A. Handbook of Medical Parasitology.3rd Edition. K.C.Ang
Publishing Private Ltd, Singapore.
3. Jayaram Paniker, CK.Textbook of Medical Parasitology.6th Edition (2007). Jaypee
Brothers Medical Publisher (P) Ltd, News Delhi
PHARMACOLOGY

Text Books
1. Basic and Clinical Pharmacology, Katzung BG: (Eds.). 11th Edition, International edition
2004. McGraw Hill, Education (Asia)
2. Pharmacology – Lippincott’s Illustrated Review, RA Harvey & Champe PC . 5th Edition,
Lippincott Williams & Wilkins, Philadelphia.
1. Rang and Dale’s Pharmacology, H.P.Rang, M.M.Dale, J.M.Ritter, R.J.Flower . 7th Edition,
Churchill Livingstone.
2. The Pharmacological Basis of Therapeutics: A Goodman & Gilman. (Ed.) 12th International
Edition, Hardman & Limbird, McGraw Hill, New York.

MBBS Curriculum GIM/Sem-1/Year-1
Genetics, Immunology & Molecular Medicine Block – GIM
Course Information
1. Name of Course/Module: Genetics, Immunology and Molecular Medicine (GIM)
2. Course Code: GIM 6114
Microbiology/ Parasitology:

Biochemistry
1. Associate Professor Dr Maung Maung Aye.
2. Dr Sathivel A
3. Dr Jaiprakash M
Physiology
Pathology
7. Assoc Prof Dr Manjit Singh
Pharmacology
8. Associate Prof.Dr. Chitra Govindaraja
9. Associate Prof.Dr. Madhu
10. Dr. Heethal
11. Miss Vjaya
12. Dr. Sunil Kale
Community Medicine
14. Prof.Dr. Than Winn
15. Dr. Aung Ko Ko Min
Medical Genetics is one of the most advanced fields of medicine and Molecular Genetics is now
an integral to all aspects of biomedical science. Physicians of the 21st century are expected to
have an in-depth knowledge of the principles of human genetics and their application to a wide
variety of clinical problems. A general introduction to the basic principles of medical genetics

and also to the biochemical basis of heredity is necessary to be taught to medical students.
This module also teaches principles and mechanisms of immunology and the usage of antibiotics
and immunomodulators as preventive measures for infectious diseases.

L=Lecture L T P O E
T=Tutorial 39 10 2 2
P=Practical 53hours
O=Others 78 20 2 10 +
(review discussions) 110 hours
= 163 hours
7. Credit value:
163/40 = 4.0
8. Prerequisite:
9. Objectives:
KNOWLEDGE
By the end of the block, students should be able to:
 Explain the nature of heredity at the level of the individual and the population.
 Explain the biochemical and molecular basis of genetic disorders.
 Apply the knowledge of genetics in diagnosis and risk assessment.
 Describe the organization and the cells of the immune system.
 Describe the characteristics and phases of various immune reactions in the body
 Explain the immunopathogenesis of autoimmune and immunodeficiency diseases and
outline the principles of treatment.
 Explain the mechanism of graft rejection and immune responses to tumours.
 Appreciate the role of genetics in preventive medicine.
 Explain the mechanism of action of anticancer drugs.
 Apply knowledge of genetics, immunology & molecular biology in the practice of
medicine.
SKILLS
At the end of the module the student shall be able to :
 Apply knowledge of genetics, immunology & molecular biology in the practice of
medicine
 Read karyotyping and identify genetic disorders
 Identify and interpret antigen-antibody reactions
ATTITUDE
At the end of the module the student shall be able to
 Appreciate role of genetics and environment in preventive medicine
 develop interest in conducting genetic research in identifying causes and remedies of
various diseases.
Integration
Since this is a basic module, no integration happens here, only basic information are disseminated
to prepare the students to be able to understand the following systematic modules.

By the end of this posting, students should be able to
1. Explain the nature of heredity at the level of the individual and the population.
2. Explain the biochemical and molecular basis of genetic disorders
3. Apply the knowledge of genetics in diagnosis and risk assessment
4. Describe the organization and the cells of the immune system
5. describe the characteristics and phases of various immune reactions in the body
6. Explain the immunopathogenesis of auto immune and immunodeficiency diseases and
outline the principles of treatment
7. Explain the mechanism of graft rejection and immune responses to tumours.
8. Appreciate the role of genetics in preventive medicine
9. Explain the mechanism of action of anti cancer drugs
10. Apply knowledge of genetics, immunology & molecular biology in the practice of medicine

1. Writing clear and concise records and reports
2. Presenting technical information to a large group of people
3. Ability to understand and treat an audience accordingly
4. Listening attentively
5. Effectively explaining highly technical information

assessment.

13. Synopsis:
This block is of 4 week duration covering the basic principles of genetics and immunology. The
basic chemistry of DNA and RNA along with the processes of mutation & repair, transcription
and translation and mechanisms of formation of proteins are taught to understand genetic
aberrations are taught. It also covers the mechanisms involved in types of the host’s susceptibility
to infection in immunodeficiency and hypersensitivity reactions that may result in autoimmunity
and autoimmune diseases.
This block enables students to learn about the details of genetics and immunology and diseases
associated with them and their occurrence in the population, together with antibiotics and
immunomodulators.

1. Lectures (LEC),
2. Practicals (PRC) – demonstration
3. Tutorials (TUT)
5. Fixed Learning Resources (FLR)

2) Summative –
2.1 Continuous Assessment 40%

A: MCQ (T/F)
B: MCQ (OBA/OBA)
2.2 GIM in the First Professional Part-1 Exam 60%

A: MCQ (T/F)
B: MCQ (OBA)
E: OSPE (objective structured practical questions)

the nation.

moral values.

PEO1 PEO2 PEO3 PEO4
 




moral values.

areas of interest.
  
L T P
Metabolism of 1) list the purine and pyrimidine bases 1 1 0
purine and 2) briefly describe the synthesis of purine and
pyrimidine pyrimidine bases
nucleotides 3) briefly describe the catabolism of purine
and pyrimidine bases
4) explain the metabolic process underlying
the blood uric acid level
5) predict what would happen in small joints
if blood uric acid level increases

Structure and 1) list the components of nucleotides in DNA 1

function of Nucleic & RNA structure
Acid: (DNA & 2) explain the formation of phosphodiester
RNA) bonds.
3) describe the structure of DNA & RNA
4) explain the functions of DNA in terms of:
- Gene
- Storage of Genetic Characteristics
- Gene Expression
- Replication
- Transcription
5) explain the various types of RNA and their
functions
Cell cycle & DNA 1) Describe different phases of cell cycle. 1 1 0

replication 2) Explain the regulation of cell cycle
3) List the enzymes involved in DNA
replication
4) Describe the stages of DNA replication
Gene mutation & 1) Describe the process of Genetic mutation 1

DNA repair 2) List the different type of mutations
3) Explain the consequences of genetic
mutation
4) List the types of damage to DNA
5) Describe various mechanism of DNA
repair
Transcription - 1) describe the stages of transcription -RNA 1 1

RNA synthesis synthesis
2) list the different enzymes in RNA
synthesis
3) explain post transcriptional modification
Translation – 1) Define and characterize genetic code 1

Protein / RNA 2) List out the components required for
synthesis translation
3) Describe the steps in protein synthesis
4) Explain co- & posttranslational
modifications
Regulation of gene 1) explain the types of Gene regulation 1

expression 2) explain the regulation of gene expression
in prokaryotes with lac operon model
3) explain the regulation gene expression in
eukaryotes
Genetic 1) list the most common techniques used in 1

Techniques / PCR genetics.
Recombinant DNA 2) list the importance of molecular
Technology diagnostics in clinical practice.
3) briefly describe the basic principle,
procedure and uses of the following
techniques;

- Blotting techniques
- Polymerase Chain reaction
- Recombinant DNA technology
- DNA profiling
Clinical 1) define clinical cytogenetics 2

cytogenetic 1 & 2 2) describe various chromosomal anomalies
3) discuss the principles of molecular
cytogenetics and its applications
Genetic and 1) to know the importance of cytogenetics 1

cancer in the pathogenesis of cancer.
2) chromosomal analysis.
3) applications of molecular cytogenetics
4) Oncogenes and antioncogenes
Protein synthesis 1) explain antibiotics exert their 1

inhibitors 1 2) protein synthesis inhibitors
Aminoglycosides& 3) explain how aminoglycosides
Tetracyclines 4) have selective toxicity
5) explain the concept of concentration-
dependent killing
6) describe “post-antibiotic” effect
7) explain how bacterial resistance develops
to aminoglycosides
8) list the different drugs and their clinical
uses
9) explain the concept of protein synthesis
inhibition at the ribosomal level as the
mechanism of action
10) explain what is meant by a “broad
spectrum” antibiotic
11) describe the pharmacokinetics of
tetracyclines
12) Enumerate the adverse effect and clinical
uses
13) Mention some contraindications to the use
of tetracylines
Protein synthesis 1) List three macrolide antibiotics 1

inhibitors 2 2) Discuss the mechanism of action ,
Macrolides & pharmacokinetics, antibacterial spectrum
Chloramphenicol and adverse effects of Macrolides
3) Explain the modes of drug resistance to
Macrolides
4) Discuss the mechanism of action, clinical
uses, pharmacokinetics and adverse
effects of chloramphenicol
5) Discuss the mechanism of drug resistance
of chloramphenicol
Tutorial 2

Quinolones, folate 1) describe the mechanism of action of 2

antagonists & Sulfonamides and Trimethoprim
metronidazole 2) explain the advantages of combining
Sulfonamides with Trimethoprim
3) explain the pharmacokinetics of
Sulfonamides and Trimethorpim
4) explain the mechanism of resistance to
sulfonamides and Trimethoprim
5) list the adverse effects and drug
interactions of Sulfonamides and
Trimethoprim
6) list the antibacterial spectrum and uses of
Sulfonamides and Trimethorpim
Metronidazole
8) list the adverse effects of Metronidazole
Metronidazole
10) classify quinolones
quinolones
12) describe the mechanism of resistance to
quinolones
13) list the adverse effects of quinolones
quinolones
Immuno- 1) define immune modulating drugs 2

modulators 2) briefly explain the role of these drugs on
certain immune disease processes
3) classify immunomodulating drugs discuss
the general action of immunosuppressive
drugs
4) explain in detail the MOA,
pharmacological actions of
glucocorticoids
5) explain briefly the MOA and actions and
uses of cyclosporine
6) explain briefly the MOA and actions of
tacrolimus
7) list immunosuppressive antimetabolites
that are generally used in combination with
corticosteroids
8) Briefly discuss the general MOA of
monoclonal antibodies
Tutorials 2
GENETICS
Textbooks
1. Emery's Elements of Medical Genetics by Mueller and Young (10th. edition, Churchill
and Livingstone 1998).

2. Jorde, L.B. et al (2003) “Medical Genetics” Mosby 3rd edition. ISBN 0-323-02025
Reference
1. Genetics, Health Care and Public Policy: An Introduction to Public Health Genetics
Alison Stewart, Philippa Brice, Hilary Burton, Paul Pharoah, Simon Sanderson, Ron
Zimmern. 1st edition (2007). Cambridge University Press
PATHOLOGY
Text Books
2. Textbook of Pathology. 6th edition Harsh Mohan. Jaypee Brothers.
2. Marshall W. J. (1992) Illustrated Textbook of Clinical Chemistry. (3rd Edition) Mosby.
Livingstone.
International Edition.
PHARMACOLOGY
Text Books
1. Basic and Clinical Pharmacology,
Katzung BG: (Eds.). 11th Edition, International edition 2004. McGraw Hill, Education
(Asia)
2. Pharmacology – Lippincott’s Illustrated Review,
RA Harvey & Champe PC . 5th Edition, Lippincott Williams & Wilkins, Philadelphia.
1. Rang and Dale’s Pharmacology
H.P.Rang, M.M.Dale, J.M.Ritter, R.J.Flower . 7th Edition, Churchill Livingstone
2. The Pharmacological Basis of Therapeutics:
A Goodman & Gilman. (Ed.) 12th International Edition, Hardman & Limbird, McGraw Hill,
New York.

MBBS Curriculum CVS/Sem-2/Year-1
Cardiovascualr System Block – CVS
Course Information
1. Name of Course/Module: Cardiovascular System Block (CVS) Block
2. Course Code: CVS 6127
Anatomy
1. Prof.Dr Subramaniam (SK)
2. Prof.Dr Khin Myo Thu (KMT)
3. Prof Bale Swamy Kaki (BSK)
4. A/P Yeong Soh Onn (YSO)
5. A/P Dr B.Venugopala Rao (BVR)
6. Dr Anudeep Singh (AS)
Physiology
8. A/P Dr.Sharad B Kole
9. A/P Dr J Prasanna Kumar
Biochemistry
15. Prof Wong Chee Woon
16. A/P Dr Maung Maung Aye.
17. Dr Sathivel A
18. Dr Jaiprakash M
Pathology
20. A/P Dr Manjit Singh
21. Dr Vaishali Jain
Pharmacology

30. A/P Dr. Madhu

31. Dr. Heethal
32. Miss Vjaya
33. Dr. Sunil Kale
35.
Community Medicine
Cardiovascular diseases are commonly encountered all around the globe and are considered to
be an important cause of global mortality. Hence, the in-depth knowledge regarding the basic
structure, physiological functions and biochemical changes seen in this system plays a significant
role in the medical curriculum. The students also need to know the etiopathogenesis of
cardiovascular diseases and their treatment and preventative strategies. With this knowledge the
students will be able to correlate with the clinical cases, as they move on the clinical years which
in turn will help them in patient management.
6. Total Student Face To Face Total Guided and Independent

Learning Time Learning
(SLT)
L=Lecture L T P O E Total guided learning time: 99

T=Tutorial 45 40 11 3 hours
P=Practical 90 84 11 15 Total independent learning time:
O=Others 200 hours
(PBL, review
discussions) = 299 hours
7. Credit value:299/40=7.4≈7
8. Prerequisite:
9. Objectives:
KNOWLEDGE
By the end of the block, students will have the knowledge :
 of the gross anatomy and histology of the heart along with its blood and nerve supply.
 regarding embryology of the heart and the fetal circulation.
 of the transmission of impulses in the heart and the contractility of the heart.
 of the electrical and mechanical events that occur during the cardiac cycle.
 on blood pressure control under various conditions.
 of the metabolism in the heart.
 of etiopathogenesis of cardiovascular diseases, particularly those of importance in
Malaysia.
 regarding the common clinical manifestations of these diseases.

 of the use of common therapeutic agents for these diseases and the rationale behind
their use.
 of preventive and control strategies of these diseases.
 to request for relevant investigations to diagnose these diseases.
SILLS
At the end of the block the student have the skill to :
 interpret the findings of laboratory investigations.
 identify and analyse problems and draw appropriate conclusions
 measure blood pressure and other important cardiovascular parameters and comment
on normal and abnormal findings
ATTITUDE
At the end of the block the student develop the attitude to:
 identify your own learning needs and seek relevant information
 work as a team and communicate with patients and the campus community.
Integration
This is the first system which is taught in an integrated manner. All pre clinical subjects course
content are selected in such a manner that after completion of the block, students acquire a view
of the whole system where the normal structure- function is followed by abnormal structure-
function.Thereafter the rationale of using various drugs and preventive and control strategies for
prevention and control of cardiovascular diseases are understood.
By the end of the Cardiovascular Block, the students should have the knowledge, skills and
attitude to be able to:
1. Describe the gross anatomy and the histology of the heart including its blood and nerve
supply.
2. Describe the embryology of the heart and the fetal circulation.
3. Explain the transmission of impulses in the heart and the contractility of the heart.
4. Explain the electrical and mechanical events that occur during the cardiac cycle.
5. Explain how blood pressure is controlled under various conditions.
6. Explain the metabolism in the heart.
7. Explain the etiology of cardiovascular diseases, particularly those of importance in
Malaysia.
8. Explain the pathogenesis involved in the common manifestations of these diseases.
9. Request relevant investigations to diagnose these diseases
10. Interpret the findings of laboratory investigations
11. Explain the rationale for the use of common therapeutic agents for these diseases
12. Explain the preventive and control strategies of these diseases
13. Identify and analyse problems and draw appropriate conclusions
14. Identify your own learning needs and seek relevant information
15. Work as a team and communicate with patients and the campus community

 Problem Solving Skills
1. Breaking down complex problems into more manageable ones
2. Identifying problems
3. Tracing problems to their causes

4. Identifying cause and effect relationships

5. Formulating procedures to solve problems
6. Integrating knowledge from a number of disciplines to solve a problem

(k) Writing clear and concise records and reports
(l) Presenting technical information to a large group of people
(m) Ability to understand and treat an audience accordingly
(n) Listening attentively
(o) Effectively explaining highly technical information

assessment.
acquire during all 6 blocks of the year-1.
13. Synopsis:
This block is conducted as the first block in semester 2 and it runs for 8 weeks .In this block the
anatomy lectures and practical will help the student understand the structure and development of
the heart. Physiology will help the students to understand the function of the heart as a pump, the
relationship between blood flow, pressure and resistance and regulation of cardiovascular
functioning in health and disease. Biochemistry has lectures on the metabolism of cholesterol and
lipoproteins to understand how disturbances in metabolism of lipid can cause damage to the heart
and blood vessels.
Pathology focuses on the various cardiovascular diseases which are inherited and acquired and
how they bring about changes in the hemodynamic mechanisms leading to complications like
cardiac failure. Microbiology emphasizes on how infections can affect the cardiovascular system,
especially the heart in infective endocarditis leading to severe valvular diseases that can affect
and even cripple the normal function of this organ. Bacteremia and other sepsis-related disorders
is also covered. Together with diseases comes the treatment, which is taught in Pharmacology.

1. lectures (LEC),
2. practicals (PRC),
3. tutorials (TUT)
4. computer aided learning (CAL) lab in physiology & pharmacology.
6. Directed self learning (DSL)

2) Summative –
2.1) Continuous Assessment 40%

A: MCQ (T/F)
B: MCQ (OBA/OCA)
2.2) CVS in the First Professional Part-1 Exam 60%

A: MCQ (T/F)
B: MCQ (OBA)
D: OSPE (objective structured practical examination questions)

the nation.

moral values.
PEO1 PEO2 PEO3 PEO4
 





moral values.

of interest.
  
L T P
Anatomy of the 1) describe the anatomy of the heart. 2 2 2
Heart I & II 2) describe the nerve supply to the heart.
(ANA-1) 3) describe the conducting system of the 4 4 2
heart.
4) describe the blood supply of the heart
Embryology of the 1) describe the development of the heart 1

Heart 2) describe some common anomalies of
(ANA-2) the heart
Fetal Circulation 1) describe the fetal blood circulation 1

(ANA-3) 2) describe events in the fetal and
postnatal blood circulation
Histology of the 1) describe the histology of the heart 1 2

Heart and Blood 2) describe the histology of the blood
Vessels vessels
(ANA-4)

Origin of heart 1) explain the characteristics of the 1

beat and its pacemaker (SAN) and the conductive
conduction tissues
(PHY-1) 2) explain automaticity, rhythmicity,
conductivity and contractility of
cardiac tissues
3) explain the role of autonomic
innervation of the heart
Electrical activity 1) explain the principles and use of the 1

of the Heart – ECG
Electrocardiogra 2) define unipolar and bipolar electrode
m recording
(PHY-2) 3) interpret normal ECG tracings
4) explain effects of blood ionic changes
on ECG
5) explain cardiac arrhythmias
Mechanical 1) explain the cardiac cycle and its 1

Activity of the relationship to the ECG
Heart – Cardiac 2) discuss the pressure and volume
Cycle changes in the atrium, ventricle and
(PHY-3) aorta during a cardiac cycle
3) explain the occurrence and importance
of arterial pulse
4) 4.explain the formation and the
characteristic of heart sounds during a
cardiac cycle
5) state the causes of abnormal heart
sounds
Tutorial-1(L1-3) 2
Cardiac Output & 1) define cardiac output and state the 1

Venous Return & normal values
Regulation 2) state the effects of various conditions
(PHY-4) on cardiac output
3) discuss the various factors controlling
cardiac output
4) discuss the various factors controlling
and influencing venous return
5) explain the relationship between
cardiac output and venous return
Hemodynamics & 1) discuss the physical factors and 1

Microcirculation characteristics of blood vessels that
(PHY-5) govern blood flow
2) describe arterial and arteriolar
circulation
3) explain the role of capillary circulation
in formation of tissue fluids [Recall
from BMS Physiology]

4) explain the role of lymphatic

circulation in health
5) explain physiological regulation of
coronary circulation
Practical-I 2
Cardiovascular 1) explain local regulation of peripheral 1

Regulatory circulation
Mechanisms - I: 2) explain systemic regulation of blood
Regulation of flow
Peripheral
Circulation
(PHY-6)
Cardiovascular 1) explain the importance of blood 1
Regulatory pressure in health and disease
Mechanisms II: 2) state the principles of measurement of
Regulation of blood pressure in a clinical setting
Blood Pressure [Details to be covered in Human
(PHY-7) Physiology Lab @ Level 5]
3) discuss the factors determining blood
pressure
4) discuss factors affecting blood pressure
5) Explain the regulation of blood
pressure
Cardiovascular 1) explain the cardiovascular changes 1

Homeostasis I: following changes in gravity and body
Posture Gravity posture
and Exercise 2) explain the cardiovascular changes
(PHY-8) during exercise
3) explain the effects of physical training
and conditioning on cardiovascular
functioning
Tutorial-2(L4-8) 2
Cardiovascular 1) describe the changes in cardiovascular 1

Homeostasis II: parameters with blood loss
Hemorrhage 2) explain the compensatory mechanisms
(PHY-9) to protect against blood loss
3) explain the effects of various
decompensatory mechanisms that can
intensify the effects of blood loss
Practical-2 2
Tutorial-3 (L1-9) 2
Cardiovascular
Physiology: At a
glance (Review)
(PHY-10)

Structure & 1) classify lipoproteins 1

function of 2) describe the composition of the
lipoproteins various types of lipoproteins
(BIO-1) 3) describe the assembly of lipoprotein in
the intestinal epithelial cells and
hepatocytes
4) outline the functions of the various
types of lipoproteins
Lipid transport & 1) describe the transport of dietary lipids 1

atherosclerosis from the intestinal epithelial cells to
(BIO-2) the other tissues
2) describe the transport of
triacylglycerol synthesized in the liver
to the other peripheral tissues
3) describe the transport of cholesterol to
the tissues and the reverse cholesterol
transport
4) outline the formation of the
atherosclerotic plaque
Cholesterol 1) outline the biosynthesis of cholesterol 1

metabolism 2) explain the regulation of cholesterol
(BIO-3) biosynthesis
3) describe the transport of cholesterol in
the blood stream
4) correlate between plasma cholesterol,
atherosclerosis and coronary heart
disease
5) name the drugs used to lower blood
cholesterol
Biosynthesis of 1) describe the formation of malonyl- 1 1

fatty acids CoA
(BIO-4) 2) outline the synthesis of palmitate
3) explain the biosynthesis of unsaturated
and polyunsaturated fatty acids
4) discuss the mechanism of regulating
the synthesis of fatty acids
Metabolism of 1) outline the biosynthesis of 1

acylglycerol and triacylglycerol and phospholipids
phospholipids 2) explain the role of the different types
(BIO-5) of lipases
3) explain how fatty liver can develop
Regulation of fat 1) explain the factors that regulate the 1 1

metabolism & mobilization of fat from adipose tissue
ketogenesis 2) name the various types of ketone
(BIO-6) bodies
3) outline the synthesis and utilization of
ketone bodies

Clinical 1) compartmentalize enzymes 1

enzymology 2) define isoenzymes
(BIO-7) 3) identify serum enzymes used in
clinical diagnosis
Hyperlipidemia 1) classify plasma lipids and 1 1

(BIO-8) lipoproteins
2) describe lipoprotein metabolism
3) define hyperlipidemia
4) classify hyperlipidemia
5) describe the type and cause of
primary and secondary
hyperlipidemia
6) describe effects and complications
of hyperlipidemia
Practical: 1) explain the principles of cholesterol 2

Estimation of estimation
cholesterol 2) list the normal blood cholesterol level
3) explain the W.H.O classification of
hypercholesterolemia
Hypertension 1) define hypertension 1

(PAT-1) 2) classify hypertension into primary
hypertension (essential) and secondary
3) explain causes and pathogenesis of
secondary hypertension
4) describe the effects and complications
of arterial systemic hypertension
Atherosclerosis 1) define atherosclerosis/ atheroma 1

(PAT-2) 2) list the predisposing factors of
atherosclerosis
3) explain briefly the pathogenesis of
atherosclerosis
of atherosclerosis
Aneurysm 1) describe aneurysm in terms of 1

(PAT-3) definition, types, risk factors and
pathogenesis
2) explain aortic dissection in reference to
types, etiopathogenesis, clinical
features and complications
Thrombo- 1) define thrombus, types of thrombi and 1

embolism and morphology
infarcts 2) describe the pathogenesis of
(PAT-4) thrombogenesis
3) explain the fate of the thrombus
4) explain the clinical significance of the
thrombi

5) define embolism, types of embolism

and morphology
6) explain the clinical significance of
embolism
7) define infarct, types and morphology
Ischaemic Heart 1) define ischemia and infarction 1

disease 2) explain the causes of ischemia and
(PAT-5) infarction
3) explain the factors that influence the
effect of ischemia
of infarctions in relation to specific
organs
Infective 1) list the common etiologic agents and 1

endocarditis predisposing factors of infective
(PAT-6) endocarditis
2) describe the pathogenesis, clinical
features and complications of infective
endocarditis
Rheumatic fever 1) define rheumatic fever 1

and RHD 2) enumerate risk factors
(PAT-7) 3) discuss pathogenesis of acute
rheumatic fever
4) explain acute rheumatic carditis
5) describe in brief chronic rheumatic
heart disease
6) comment on clinical manifestations in
acute rheumatic fever
7) write a note on diagnosis of rheumatic
fever (jones criteria)
8) mention complications in rheumatic
fever
Heart Failure and 1) define heart failure 1

oedema 2) classify heart failure and explain the
(PAT-8) causes for each type
3) explain the compensatory mechanisms
of heart failure
4) describe the pathogenesis and features
of left and right heart failure
5) distinguish between high output and
low output heart failure
6) list signs and symptoms of heart
failure and discuss their pathogenesis
7) define edema
8) classify edema into local and
generalized
9) explain the mechanisms of formation
of edema
10) list the causes of edema

Congenital Heart 1) define congenital heart disease 1

diseases 2) classify congenital heart disease
(PAT-9) 3) explain the mechanism of cyanosis
4) explain the factors that influence the
effect of ischemia
of infarctions in relation to specific
organs
Practical-2 1) The gross and microscopic pathology 4

of:
i. Hypertension
ii. Atherosclerosis
iii. Aneurysm and its various
types based on etiology
iv. Thromboembolism, infarction
Ischemic heart disease
v. Infective endocarditis
vi. Rheumatic heart disease
2) Microscopic pathology of heart failure
3) Gross pathology of congenital heart
diseases
Tutorials x 3 3
Drugs used in 1) classify drugs used in the treatment of 1

Hyperlipidemia hyperlipidemia
(PHM-1) 2) describe the mechanisms of action of
HMG Co-A reductase inhibitors,
fibrates, bile aced binding resins,
niacin and intestinal sterol absorption
inhibitors like ezetimibe
3) explain the side effects of the different
classes of drugs
4) list the indications for use of drugs in
hyperlipidemia
Diuretics I & II 1) explain the physiology of renal tubule 2

(PHM-2) transport mechanism
diuretics
3) classify the diuretic drugs.
4) explain the mechanisms of action,
pharmacokinetics, potential adverse
effects and possible drug interactions
Tutorial-1 2
CAL – 1 1) explain the pharmacologic effect of 2

Langendorff heart drugs (sympathomimetic and their
(PHM-3) antagonist drugs,
parasympathomimetic and their
antagonist drugs) on the isolated

perfused mammalian heart using the

software
drugs on the heart.
3) collect data and interpret the results
based on the experiments
Drugs Used in 1) explain the normal regulation of blood 2

Hypertension I & pressure
II 2) classify the antihypertensive agents
(PHM-4) 3) explain their mechanisms of actions,
pharmacokinetics, potential adverse
effects and drug interactions
Drugs Used in 1) discuss the factors that contribute to 1

Angina angina pectoris
(PHM-5) 2) describe the pharmacological
approaches to the management of
angina pectoris
3) list groups of drugs used in the
treatment of angina with examples
from each group
4) explain the mechanisms of action,
pharmacokinetics, major side effects
and major drug interactions
Drug treatment of 1) know definition, prevalence and risk 1

Acute Myocardial factors of AMI
Infarction 2) explain in brief pathophysiology and
(PHM-6) natural history of AMI
3) enumerate important signs and
symptoms associated with AMI
4) treatment: To be able to explain the
basis of use of following
- oxygen therapy
- pain control
- antiplatelet drugs
- beta- blockers
- heparin
- nitrates
- fibrinolytics
- long-term medications
Tutorial -2 2
CAL -2 Identify the following: 2
Langendorff heart 1) The effects of cardiac glycoside drugs
(PHM-7) on the heart
2) The vasodilator effects of drugs on the
heart
3) The effects of ions on the heart
4) Explain what Starling’s Law is

Drugs Used in 1) describe the pathophysiology of 2

Congestive congestive cardiac failure
Cardiac Failure I 2) classify the drugs used in congestive
& cardiac failure
II 3) describe the mechanism of action,
(PHM-8) pharmacokinetics adverse effects and
interactions of drugs used in congestive
cardiac failure
Principles of Drug 1) describe the electrophysiology of 1

Treatment in normal cardiac rhythm
Arrhythmia 2) describe mechanisms of arrhythmias
(PHM-9) 3) list the 4 classes of antiarrhythmic
drugs on the basis of mechanism of
action
4) describe the mechanism of actions,
pharmacokinetics, therapeutic use and
adverse effects
Tutorial -3 2
Assignment : Drug 1) list the cardiac conditions in which
Treatment of antimicrobial prophylaxis is
Infective recommended
Endocarditis 2) explain the general principles of drug
(PHM-10) therapy in IE
3) explain the prophylactic regimens
4) discuss the selection of antimicrobial
agents in the pharmacotherapy of IE
with its therapeutic rationale
5) discuss in brief, the pharmacology of
antimicrobial agents used in the
management of IE
Bacteremia, 1) define the terms used in relation to 1 1

Sepsis and related bacteremia and sepsis
disorders 2) list the predisposing conditions of
(MIC-1) bacteremia and sepsis
3) list the causative agents commonly
implicated in bacteremia and sepsis in
relation to the predisposing conditions
4) describe the pathogenesis and clinical
manifestations of bacteremia, sepsis
and related disorders
5) describe the laboratory diagnosis of
bacteremia, sepsis and related
disorders
6) outline the management of bacteremia,
sepsis and related disorders
Infective 1) list the etiological agents of infective 1 1

Endocarditis endocarditis
(MIC-2) 2) list the predisposing factors of infective
endocarditis

3) explain the pathogenesis, and clinical

manifestations of infective endocarditis
infective endocarditis
5) describe the principles of antimicrobial
treatment in infective endocarditis
6) describe the prevention of infective
endocarditis
Infections of 1) describe proper collection and 1

cardiovascular forwarding of blood specimen
system 2) describe the blood culturing
(MIC-3) procedures in the laboratory
3) describe the mechanism of antibiotic
sensitivity testing
Epidemiology of 1) define chronic non-communicable 1

Cardiovascular diseases
Diseases 2) describe the classification of diseases
(CMD-1) 3) outline the epidemiological methods in
the study of chronic diseases
4) describe the natural history of chronic
non-communicable diseases
5) describe the epidemiology of
cardiovascular diseases
ANATOMY
Text Books
1. Moore, K.L. & Dalley, A.F. and Agur A.M.R. (2010). Clinically Oriented Anatomy
(6th Edition), Wolters Kluwer - Lippincott Williams & Wilkins: Baltimore.
2. Langman, J. (2003). Langman’s Medical Embryology (12th Edition), Jan Langman:
Williams & Wilkins: Baltimore.
3. Snell, R.S. (2005). Clinical NeuroAnatomy for Medical Students (6th Edition), Little
& Brown: Boston.
4. Junqueira L.C. & Carneiro J. (2005), Basic Histology: Text & Atlas (11th Edition),
McGraw-Hill Medical: New York
5. Drake, R.L., Mitchell A.W.M., Vogl W., and Gray H. (2010). Gray’s Anatomy (2nd
Edition). Churchill Livingstone Elsevier.
6. Eroschenko V.P. (2008) diFiore’s Atlas of Histology with functional correlations.
Lippincott Williams & Wilkins: Philadelphia. (12th Edition).
1. Snell, R.S. (2008). Clinical Anatomy for Medical Students (8th Edition), Brown:
Boston
2. Ross M.H. and Wojeiech P. (2006). A Text and Atlas: With correlated cell and
Molecular Biology (5th Edition), Lippincott Williams & Wilkins: Philadelphia.
3. Moore K.L., Torchia M.G. and Persaud T.V.N. (2007) The Developing Human:
Clinically Oriented Embryology, (8th Edition). W.B. Saunders: Philadelphia.

PHYSIOLOGY
Text Book
1) Dee Unglaub Silverthorn, (2010), Human Physiology – An Integrated Approach, 5th
1) Ganong WF. (2003). Review of Medical Physiology. 21st Ed. Lange Medical
Publications, Simon & Schuster Asia Pte. Ltd., Singapore
2. Guyton AC and Hall JE (1997). Human Physiology and Mechanism of
Disease. 6th Ed. W. B. Saunders & Co., Philadelphia
3. Sherwood L. (2001). Human Physiology - From Cells to System. 4thEd.Brooks/Cole
4. West JB. (2008) Respiratory Physiology – The Essentials, 8thEd.Kluwer/Lippincott
Williams & Wilkins.
5. Levy, MN, et al. (2005) Berne & Levy: Principles of Physiology 4thEd.Elseview-
Mosby Publishers.
6. Rhoades RA & Bell DR, (2008) Medical Physiology - Principles for Clinical
Medicine 3rd Ed Kluwer/Lippincott Williams & Wilkins
BIOCHEMISTRY
Textbooks
1. Champe, P.C. and Harvey, RA. (2010). Lippincott’s Illustrated Reviews, Biochemistry
(5th Edition), Lippincott Williams and Wilkins Co. Baltimore
Reference
1. Smith, C.M, Marks D.B and Marks, A.D.(2009) Basic Medical Biochemistry:
2. A Clinical Approach (3rd Edition) Lippincott Williams and Wilkins Co. Baltimore.
3. Baynes JW & Dominiczak MH(2005), Medical Biochemistry 2nd Edition, Elsevier-Mosby,
Philadelphia
4. Murray, R.K., Granner D.K. & Rodwell V.W. (2012). Harper’s Illustrated Biochemistry
(29th Edition), McGraw Hill, Boston.
5. Vasudevan DM and Sreekumari S. (2011) Textbook of Biochemistry (for Medical
students) (6th Edition), Jaypee Medical Publishers (P) Ltd, New, India.
6. Montgomery R., Conway T.W., Spector A.A. and Chappell (1996), Biochemistry: A
Case-Orientated Approach (6th Edition), Mosby, St. Louis USA.
PATHOLOGY
Text Books
2. Marshall W. J. (1992) Illustrated Textbook of Clinical Chemistry. (3rd Edition) Mosby
Livingstone

MICROBIOLOGY
Textbooks
Melnick & Adelberg’s Medical Microbiology 25th edition. Lange medical
books/McGraw Hill
Reference
PHARMACOLOGY
Text Books
1. Mycek MJ, RA Harvey, PC Champe (2011) Lippincott’s Illustrated Reviews:
Pharmacology, (Eds.) RA Harvey & PC Champe, 5th Edition, Lippincott Williams &
Wilkins, Philadelphia
Additional Reference
1. Katzung BG (2010). Basic and Clinical Pharmacology, (Eds) Katzung BG, 12th Edition,
International Edition McGraw Hill Education (Asia).
2. Rang HP, Dale & Ritter (2012) 7th Edition Pharmacology. Churchill Livingstone,
Edinburgh.
3. KD Tripathi, (2010). Essentials of Medical Pharmacology, 6th edition, Jaypee.
4. Goodman Gilman A (2011): Goodman & Gilman’s The Pharmacological Basis of
Therapeutics, (Eds.) Hardman & Limbird, 12th Edition, International Edition McGraw
Hill, New York.

MBBS Curriculum HEM/Sem-2/Year-1
Haemopoietic System Block – HEM
Course Information
1. Name of Course/Module: Haemopoietic System Block (HEM) Block
2. Course Code: HEM 6126
Anatomy
5. A/P Dr Mohamed Noorulla (MN)
Physiology
9. Asso. Prof.Dr.Sharad B Cole
10. Assoc. Prof Dr J Prasanna Kumar
Biochemistry
15. Associate professor Dr Maung Maung Aye.
16. Dr Sathivel A
17. Dr Jaiprakash M
Pathology
23. Assoc Prof. Dr. Haresh Kumar Kantilal
24. Assoc. Prof. Dr. S. Jayakumar
Pharmacology
27. Associate Prof.Dr. Chitra Govindaraja (CG)
28. Associate Prof.Dr. Madhu (BMK)
29. Miss Vjaya (VLR)

30. Dr. Heethal (HJ)

31. Dr. Sunil (KS)
32. Dr. Ameeta(AP)
Blood forms the most important component of the body. The knowledge on the components
of blood , its functions and the diseases associated with it will help the students to correlate
with the clinical cases as they move on to the clinical years . Hematopoietic system deals with
some of the life threatening disorders like leukaemia and lymphoma .Basic Knowledge of
these diseases will help the student to pick up the clinical features early in the disease so as to
reduce mortality and morbidity .The understanding of the drugs acting on the hemopoeitic
system forms the basis for treatment of cardiovascular conditions as well.

L T P O E Total guided learning time: 90

L=Lecture 41 29 18 2 hrs
T=Tutorial
P=Practical 82 58 18 10 Total independent learning time
O=Others : 168 hrs
(PBL, review
discussions) Total learning time : 258 hrs
7. Credit value: 258/40=6.4≈6
8. Prerequisite:
9. Objectives:
KNOWLEDGE
By the end of the block, students will have the knowledge :
 to explain terminologies and basic concepts relating to the structure and functions of
the blood and lymphoid system
 regarding formation and breakdown of red blood cells
 to identify and explain structures and functions of the blood and lymphoid organs
 on the role of glycolysis in erythrocytes
 to discuss the role of nutritional and hormonal factors in hemopoiesis and
hemostasis
 to explain the etiology of diseases of the hematopoietic & lymphoid system,
particularly those of importance to Malaysia
 to describe the pathogenesis involved in the common clinical manifestations of these
diseases
 about commonly used therapeutic agents for these diseases and the rationale behind
using them.
 to explain the preventive and control strategies of these diseases.

SKILLS
At the end of the block the student shall have the skill to :
 request for relevant investigations to diagnose these diseases
 interpret the findings of the laboratory investigations
 perform the various basic clinical skills in hematology
 identify and analyze problems and draw appropriate conclusions (PBL)
ATTITUDE
At the end of the block the student develop the attitude to:
 identify his/her own learning needs and seek relevant information (SDL).
 work as a team and communicate with the campus community.
Integration
Integration is done between anatomy, physiology, biochemistry, pathology, microbiology/

parasitology and pharmacology. The problem based learning session is a way of ensuring
integrated training for the students. The students are expected to be able to comprehend the
anatomy, physiology and biochemistry knowledge with the etiologypathogensis and
therapeutics of diseases of the hematopoietic system.
By the end of the Haematopoietic System Block, you should be able to:
1. explain terminologies and basic concepts related to the structure and function of
the blood constituents and the lymphoid system
2. explain the formation and breakdown of red blood cells
3. explain the role of glycolysis in erythrocytes
4. explain the role of nutritional and hormonal factors in haemopoiesis and
haemostasis
5. explain the etiology of diseases of the haematopoietic & lymphoid system
6. explain the pathogenesis involved in the common clinical manifestations of these
diseases
7. request relevant investigations to diagnose these diseases
8. interpret the findings of the laboratory investigations
9. explain the mechanism of action, pharmacokinetics, adverse effects of the drugs
used for these diseases, along with their indications for use.
10. identify and analyze problems and draw appropriate conclusions (PBL)
11. identify your own learning needs and seek relevant information (SDL)
12. work as a team and communicate with the community (PPD)
13. perform the various basic clinical skills in haematology (ECE)




assessment.
The First Professional Exam Part-1 (Pro-1 Part-1) which will be conducted at the end of year-
1 will serve as the final summative assessment. It will test the knowledge and skill which
students acquire in all 6 blocks of the year-1.
13. Synopsis:
Haematopoietic System block is the second of 3 blocks in Semester 2, which runs for 5 weeks.
It introduces the students to the basic facts on the synthesis, structure and function of the blood
elements, which are mainly covered in Anatomy, Physiology and Biochemistry. Disorders of
constituents of blood i.e. diseases of red blood cells, white blood cells, platelets are dealt in
Pathology. Overview of the blood groups and transfusion medicine along with blood
transfusion risks and reactions is discussed in Physiology and Pathology.
In Microbiology, the lymph node syndrome, dengue and other viral hemorrhagic fevers are
discussed. Infections by haemoparasites like malaria and filaria and principles in its
management is covered in Parasitology. Pharmacology sessions will entail topics on
hematinics, anticoagulants, fibrinolytic and antiplatelet drugs along with basic principles of
chemotherapy. Common clinical presentations in haematologic disorders will be studied in
Early Clinical Exposure, which will also cover haematological system examination.

The implementation of the course is via lectures (LEC), practicals (PRC), tutorials (TUT)
and other innovative methods example computer aided learning (CAL) lab in
pharmacology. Self-directed learning (SDL) slots in the schedule are discretionary period
for students to reflect upon the lectures and optimize for further reading and perform other
assignments (ASG).

2) Summative –

1: End of Block Exam
A: MCQ (T/F)
B: MCQ (OBA)
2.2) HEM in the First Professional Part-1 Exam 60%

A: MCQ (T/F)
B: MCQ (OBA)

medicine so as to become safe and caring doctors to fulfill the needs
of the nation.

PEO3 A competent practitioner with leadership skills and with high ethical
and moral values.
PEO1 PEO2 PEO3 PEO4
 


PLO2 Be able to practice preventive, promotive and rehabilitative medicine

at all levels of society.
PLO3 Be responsible for maintaining the highest standards of medical

practice through continuing lifelong medical education
PLO4 Possess appropriate attitudes, demonstrate empathy and have ability

to communicate effectively with patients and other health
professionals.
PLO5 Be able to conduct the practice of medicine with the highest ethical
and moral values.

areas of interest.
  
L T P
Histology of 1) Describe the microscopic 1 2
lymphoid tissue anatomy of the primary (bone
(ANA-1) marrow and thmus) and
secondary lymphoid organs.
(lymph nodes, spleen and tonsils)
2) Describe the microscopic
anatomy of the mucosal
associated lymphoid tissue
(MALT)
3) Diffuse lymphoid tissue or
aggregates of lymphocytes and
antigen presenting cells APCs in
the lung and the mucosa of
digestive tract (Peyer’s patches)
Erythrocytes 1) 1.explain the functional 1

(Red Blood Cells) importance of shape of
(PHY-1) erythrocytes
2) 2.explain the functions of
haemoglobin

3) 3.discuss erythropoiesis and

cellular stages of RBC
production
4) 4.discuss the role of
erythropoietin in the control of
erythropoiesis
5) 5.discuss the dietary
requirements for RBC production
and
6) 6.state the factors that can cause
an alteration of the RBC count.
Leucocytes 1) discuss the functions of WBCs 1

(White Blood 2) explain the role of WBCs in
Cells) immunity of the body
(PHY-2) 3) explain leucopoiesis and factors
regulating the process
4) list the physiological and
pathological factors affecting the
white cell count
Platelets; 1) discuss the structure of
Haemostasis and thrombocytes and their role in
Fibrinolysis forming platelet plugs
(PHY-3) 2) discuss the different mechanisms
of haemostasis
3) describe the functional
significance of the cascade of
activation in the formation
of fibrin
4) describe the extrinsic, intrinsic
and final common pathway for
coagulation
5) describe the lytic pathway and
mechanism of its activation
6) describe physiological basis of
the clotting disorder
Platelets; 1) discuss the structure of 3

Haemostasis and thrombocytes and their role in
Fibrinolysis forming platelet plugs
(PHY-4) 2) discuss the different mechanisms
of haemostasis
3) describe the functional
significance of the cascade of
activation in the formation
of fibrin
4) describe the extrinsic, intrinsic
and final common pathway for
coagulation
5) describe the lytic pathway and
mechanism of its activation
6) describe physiological basis of
the clotting disorders

Tutorial-1 2
Blood Groups & 1) explain the origin and importance 1

their Clinical of blood groups
Significance 2) list the types of blood groups
(PHY-5) important clinically and
otherwise
3) explain the process of cross
matching – major and minor
4) describe the physiology of
mismatched blood transfusion
reactions
Tutorial-2 2
Practical 1) identify cells in the peripheral 4
blood smear
2) understand the significance of
experimental parameters
pertaining to blood (CBC)and red
cell indices such as Erthrocyte
Sedimentation Rate (ESR) and
Packed Cell Volume (PCV),
hematocrit, etc
3) relate to the information derived
from a blood test to physiological
changes in the body.
Review 2
Haemoglobin 1) describe the stages of -like and 1

synthesis& -like globin genes expression
metabolism 2) explain the genetic alteration that
(BIO-1) results in abnormal haemoglobin
and thalassemias
3) explain the molecular basis of
sickle cell anaemia
Metabolism of 1) discuss the role of glycolysis in 1

Red Blood Cell & erythrocytes & hexose
membrane monophosphate pathway
stability 2) explain the role of NADPH in
(BIO-2) glutathione metabolism
3) explain the role of ATP and
glutathione in the maintenance of
erythrocyte membrane stability
4) explain the molecular basis of
haemolytic anaemias
Plasma proteins 1) explain the basis of classification 1 1

(BIO-3) of plasma proteins
2) name the major types of
3) proteins
4) list the major roles of plasma
proteins

Anaemia- 1) discuss anaemia in terms of 1

nutritional 2) definition, approach to
deficiency diagnosis, morphological and
anaemias 3) etiological classification with
4) major examples
5) review iron metabolism and its
utility in diagnosis of anaemia
6) explain iron deficiency anaemia
with emphasis on aetiology,
clinical features and
investigations
7) differentiate between iron
8) deficiency anaemia and other
microcytic hypochromic anaemia
9) enumerate causes of macrocytic
anaemia
10) describe vitamin B12 deficiency
and folate deficiency anaemia
covering aetiology, morphologic
changes in blood and bone
marrow
11) Review vitamin B12 absorption
from the GI tract
12) Compare and contrast
megaloblastic states associated
with B12 and folate deficiency
Anaemia- 1) state causes of pancytopenia 1

pancytopenia and 2) discuss aplastic anaemia in
aplastic anaemia terms of aetiopathogenesis,
clinical features, investigations
and complications
3) outline the diagnostic approach
for normocytic anaemia
anaemia- 1) Discuss pathogenesis of 2

haemolytic hereditary spherocytosis and
anaemias G6PD deficiency anaemia
X 2hrs 2) Explain thalassemia in terms of
pathogenesis, types, clinical
features and investigations
3) Describe sickle cell anaemia with
emphasis on pathogenesis,
investigations
4) Explain aetiopathogenesis and
lab investigations for PNH.
Leukaemias 1) 1.Define leukaemia 2

X 2hrs 2) Discuss the classification of
leukaemia

3) Discuss the incidence, aetiology,

pathogenesis, prognostic factors
and complications of leukaemia.
4) Explain the difference between
leukaemia, leucocytosis and
leukaemoid reaction
Myelodysplastic 1) Define MDS. 1

syndrome (mds) 2) State WHO Classification of
MDS
3) Briefly describe
aetiopathogenesis of MDS.
4) Explain lab investigation and
Clinical features of MDS.
5) Enumerate complications and
discuss prognosis of MDS.
Lymphadenopat 1) List the causes of 2

lymphadenopathy
hy and 2) Discuss the classification of
lymphomas x lymphoma: non-Hodgkin’s
lymphoma and Hodgkin’s
2hrs 3) Lymphoma:
a. List the complications of
lymphomas.
b. Describe the main
characteristic features of
lymphomas.
c. Explain the staging of
lymphomas and its
significance
Bleeding 1) Define and classify bleeding 1

disorders disorders.
2) Discuss briefly platelet disorders.
3) Describe immune
thrombocytopenic purpura (ITP)
4) Enlist platelet function disorders.
5) Classify coagulation disorders.
6) Describe inheritance, clinical
features, complications and
investigations of Haemophilia.
7) Describe aetiopathogenesis,
investigations of Disseminated
Intravascular Coagulation (DIC)
8) Evaluate patient with
haemorrhagic disorders
Polycythaemia 1) Define polycythaemia. 1

2) Explain the difference between
absolute and relative
polycythaemia.

3) Classify polycythaemia: primary

and secondary
4) List the causes of secondary
polycythaemia
5) Discuss the effects and
complication of polycythaemia
rubra vera (primary).
Blood transfusion 1) Understand concept of whole 1

reactions blood and blood components
2) State indications of blood
transfusion
3) Enlist tests to be performed prior
to blood transfusion
4) Understand transfusion reactions
in brief
Paraproteinae- 1) Define paraprotein and 1

mias paraproteinaemia.
2) List the causes of
paraproteinemia.
3) Explain the effects and
complications of
paraproteinemia.
4) Define multiple myeloma
5) Describe clinical features of
multiple myeloma
6) Explain the effects and
complications of multiple
myeloma
Tutorial 1 1
Tutorial 2 1
Practicals 1 1) Examine peripheral blood film 2
and bone marrow of the
common anaemia
Contents
1.Iron deficiency anaemia
2.Megaloblastic anaemia
3.Aplastic anemia
4. Hereditary Spherocytosis
5. G6PD deficiency anaemia
6. Thalassemia
7. Sickle cell anaemia
Practical 2 1) Examine peripheral blood films 2

and bone marrow for leukaemia,
lymphoma
Contents
1. Myeloblast
2. Lymphoblast
3. Chronic myeloid leukaemia

4. Chronic lymphoid leukemia

5. Hairy cell leukaemia
6. Burkitt lymphoma
7. Hodgkin lymphoma
8. Multiple myeloma
9. Immune thrombocytopenic
purpura (ITP)
Practical 3 1) Examine peripheral blood films 2

and bone marrow for ITP and
multiple myeloma
Viral 1) List the causative agents of viral 1 1

hemorrhagic hemorrhagic fevers (VHF).
fevers 2) Describe the epidemiological,
pathogenesis, clinical
manifestation, laboratory
diagnosis, treatment, prevention
of dengue and other viral
hemorrhagic fevers
Lymph Node 1) List the diseases which are 1

Syndromes classified as lymph node
syndromes
2) Describe the epidemiology,
pathogenesis, clinical
presentation, laboratory
diagnosis, treatment and
prevention of lymph node
syndromes.
Haematinics 1) discuss the role of folic acids in 1

anaemia.
2) discuss the role of vitamin B12
in anaemia.
3) discuss the pharmacology of
iron, folic acid and vitamin B12.
4) discuss the therapeutic
application of iron, folic acid and
vitamin B12
in the treatment of anaemia
Antiplatelet 1) classify anti-platelet drugs 1

drugs 2) discuss the mechanisms of action
and pharmacology of aspirin
3) discuss the mechanism of action
and pharmacology of clopidogrel
and ticlopidine
and pharmacology of abciximab
Tutorial 1 2

Anticoagulants 1) classify anticoagulant drugs 1

of heparin
3) discuss the pharmacology and
side effects of heparin
4) list the conditions in which
heparin is contraindicated
of warfarin
warfarin
7) discuss the adverse effects of
warfarin and antidotes used
Fibrinolytic 1) classify the fibrinolytic agents 1

Drugs 2) discuss the mechanism of action
of fibrinolytic drugs eg
streptokinase, alteplase
3) discuss briefly the pharmacology
of streptokinase and alteplase
4) discuss briefly the clinical uses
of fibrinolytic drugs
Principles of 1) define cancer 2

drug therapy in 2) list various causes of cancer
cancer 3) list various cancer therapeutic
(Chemotherapy) modalities
4) explain the significance of
combination chemotherapy
5) explain the general toxicities of
anticancer drugs
6) describe the importance of
neoplastic cell burden and explain
the log-kill hypothesis in cancer
therapy
7) describe the importance of cell
cycle kinetics and its relationship
to cell cycle-specific and cell
cycle-nonspecific drugs
8) briefly describe resistance to
cytotoxic drugs
Tutorial 2 2
ANATOMY
Text Books
1. Moore, K.L. & Dalley, A.F. and Agur A.M.R. (2010). Clinically Oriented
Anatomy (6th Edition), Wolters Kluwer - Lippincott Williams & Wilkins: Baltimore.
2. Langman, J. (2003). Langman’s Medical Embryology (12th Edition), Jan
Langman: Williams & Wilkins: Baltimore.
3. Snell, R.S. (2005). Clinical NeuroAnatomy for Medical Students (6th Edition),
Little & Brown: Boston.

Boston
PHYSIOLOGY
Text Book
1. Dee Unglaub Silverthorn, (2010), Human Physiology – An Integrated Approach,
5th Edition, Pearson-Benjamin Cummings.
1. Ganong WF. (2003). Review of Medical Physiology. 21st Ed. Lange Medical
3. Sherwood L. (2001). Human Physiology - From Cells to
System. 4thEd.Brooks/Cole
4. West JB. (2008) Respiratory Physiology – The Essentials,
8thEd.Kluwer/Lippincott Williams & Wilkins.
Mosby Publishers.
BIOCHEMISTRY
Textbooks
1. Champe, P.C. and Harvey, RA. (2010). Lippincott’s Illustrated Reviews,
Biochemistry (5th Edition), Lippincott Williams and Wilkins Co. Baltimore
Reference
3. Baynes JW & Dominiczak MH(2005), Medical Biochemistry 2nd Edition, Elsevier-
Mosby, Philadelphia
4. Murray, R.K., Granner D.K. & Rodwell V.W. (2012). Harper’s Illustrated
Biochemistry (29th Edition), McGraw Hill, Boston.

6. Montgomery R., Conway T.W., Spector A.A. and Chappell (1996), Biochemistry:
A Case-Orientated Approach (6th Edition), Mosby, St. Louis USA.
PATHOLOGY
Text Books
1. Vinay Kumar, MBBS, MD, FRCPath, Abul K. Abbas, MBBS and Jon Aster, MD
(2013). Robbins Basic Pathology. (9th Edition) Elsevier Health.
2. Marshall W. J. (1992) Illustrated Textbook of Clinical Chemistry. (3rd Edition)
Mosby
Livingstone
4. Chandrasoma P. and Taylor C.R. (2001) Concise Pathology (3rd Edition) McGraw
Hill International Edition
MICROBIOLOGY
Textbooks
1. Brooks G.F., Carroll, K.C., Butel J.S., Morse S.A. & Mietzner T.A. (2010).
Jawetz Melnick & Adelberg’s Medical Microbiology 25th edition. Lange
medical books/McGraw Hill
Reference
PHARMACOLOGY
Text Books
Pharmacology, (Eds.) RA Harvey & PC Champe, 5th Edition, Lippincott Williams
& Wilkins, Philadelphia
1. Katzung BG (2010). Basic and Clinical Pharmacology, (Eds) Katzung BG, 12th
Edition, International Edition McGraw Hill Education (Asia).
Edinburgh.


Therapeutics, (Eds.) Hardman & Limbird, 12th Edition, International Edition
McGraw Hill, New York.

MBBS Curriculum RSP/Sem-2/Year-1
Respiratory System Block – RSP
Course Information
1. Name of Course/Module: Respiratory System Block (RSP) Block
2. Course Code:
Anatomy
Physiology
9. Asso. Prof.Dr.Sharad B Kole
Biochemistry
18. Dr Sathivel A
19. Dr Jaiprakash M
Pathology
25. A/P Chan Boon Tek Eugene

Pharmacology
30. A/P Dr. Chitra Govindaraja (CG)
31. A/P Dr. Madhu (BMK)
32. Dr. Heethal
33. Miss Vjaya
34. Dr. Sunil Kale
Community Medicine
36. Prof.Dr. Than Winn
37. Dr. Lilli Jacob
38. Dr. Than Tun Aung
39. Dr. Wan Azman Wan Adnan
Respiratory diseases are one of the most common cause of morbidity and mortality
worldwide. Hence the understanding of the respiratory system and the diseases associated
with it forms one of the key aspects in the medical curriculum. The students are given a basic
understanding of the anatomical, physiological and biochemical basis of the respiratory
system. It also introduces the student to the pathological changes seen and the organism
associated with it, and also the treatment for these pathological conditions.

Learning Time Independent Learning
(SLT)
L=Lecture L T P O E Total guided time:

T=Tutorial 34 25 12 1 2 74 hours
P=Practical 68 50 12 10
O=Others Independent learning
(PBL, review 140 hours
discussions)
7. Credit value:
214/40= 5.3 ≈ 5
8. Prerequisite:
9. Objectives:
KNOWLEDGE
By the end of the block students will have the knowledge:
 of the gross anatomy and the histology of the lungs and the airway.
 of the functions of the respiratory tract and the control mechanisms regulating
breathing under various conditions.
 of the transportation of oxygen and carbon dioxide by hemoglobin
 of the etiopathogenesis of respiratory diseases.
 regarding the macroscopic and microscopic pathological features of respiratory
diseases.
 so as to correlate the pathological processes with the clinical features and the
associated complications of respiratory diseases.

 to request for relevant investigations to help in the diagnosis of these diseases.

 regarding the common therapeutic agents for these diseases.
 to explain the preventive and control strategies for respiratory diseases and the
rationale behind using them.
 regarding parasites invading the respiratory system and their impact on respiratory
health.
SKILLS
At the end of the block the student will have the skill to :
 demonstrate the basic clinical and procedural skills in the examination of the
respiratory system.
 interpret the findings of the laboratory investigations.
 identify and analyze problems and draw appropriate conclusions (PBL).
ATTITUDE
At the end of the block the student will develop the attitude to:
 work as a team and communicate with patients and the campus community
INTEGRATION
The structure and function of the lungs and respiratory tract are taught in integration with the
the pathological changes in structure of parts of the respiratory system. The regulation and
adjustments of respiration in various environmental condition and pathological states are
integrated. Respiratory infections, laboratory diagnosis as well as the drugs used in the
treatment of respiratory diseases are discussed in this Block. The preventive measures to be
taken for common respiratory problems is also included.
By the end of this block, you should be able to:
1. describe the gross anatomy and the histology of the lungs and the
airway.
2. explain the functions of the respiratory tract and the control mechanisms at the
physiological and biochemical levels.
3. explain the transportation of oxygen and carbon dioxide by hemoglobin
4. explain the etiology and pathogenesis of respiratory diseases.
5. describe the pathological features both macroscopically and microscopically of
respiratory diseases.
6. correlate the pathological processes with the clinical features and explain the
associated complications of respiratory diseases.
7. request for relevant investigations to help in the diagnosis of these diseases.
8. interpret the findings of the laboratory investigations.
9. explain the rationale for the use of common therapeutic agents for these
diseases.
10. demonstrate awareness of the parasites invading the respiratory system and their
impact on respiratory health.
11. demonstrate the basic clinical and procedural skills in the examination
12. explain the preventive and control strategies of respiratory diseases of
13. the respiratory system.
14. identify and analyze problems and draw appropriate conclusions

15. identify your own learning needs and seek relevant information



assessment.
The First Professional Exam Part-1 (Pro-1 Part-1) which will be conducted at the end of year-
1 will serve as the final summative assessment. It will test the knowledge and skill which
students acquire in all 6 blocks of the year-1.
13. Synopsis:
The respiratory block is the third block in the second semester. The block runs for five weeks.
The students learn the structure of the respiratory tract and the functions of the respiratory
system . The mechanisms and control of respiration in normal individuals and newborn and
also the effect of exercise on ventilation along with respiratory adjustments in deep sea diving
and high altitude are taught. The transport of gases in the body and the role of surfactants in
breathing is covered. Pathological changes in structure (both macroscopic and microscopic)

and functions and infections of the respiratory system are also taught in this Block. Overview
of the parasites involved in lung infections and pharmacological treatment modalities
respiratory diseases alongwith preventive measures are taught. The impact of smoking on lung
cancer is also covered in this block.

1. lectures (LEC),
3. tutorials (TUT)
4. computer aided learning (CAL) lab in pharmacology.
6. Directed self learning [DSL]
7. assignments (ASG).
There are generally 2 types of assessment used in the course:

1. Formative assessment: tutorial, assignment and practical
2. Summative –

A: MCQ (T/F)
B: MCQ (OBA/ OCA)
2.2) RSP in the First Professional Part-1 Exam 60%

A: MCQ (T/F)
B: MCQ (OBA/OCA)
D: OSPE (objective structured practical examination questions)

medicine so as to become safe and caring doctors to fulfil the needs
of the nation.

and moral values.
PEO1 PEO2 PEO3 PEO4
 





professionals.
and moral values.

areas of interest.
  
L T P
Gross Anatomy 1) describe the gross anatomy 1 2
of Upper 2) of the upper respiratory tract
Respiratory 3) with regard to the external
Tract 4) nose and nasal cavities
5) 2.describe the anatomy of the
nasopharynx
6) 3.describe the anatomy of the larynx
7) 4.describe the anatomy of the Trachea
Gross Anatomy 1) describe the anatomy of the lower 1 2

of Lower respiratory tract with regard to the
Respiratory pleurae
Tract 2) describe the anatomy of the bronchial
tree
3) describe the anatomy of the lungs
Development of 1) describe briefly the branchial arches 1

Respiratory 2) describe the formation of lung buds

System 3) describe the formation of the trachea,

bronchi and lungs
4) describe the maturation of the lungs
Histology of 1) 1.describe the microscopic structure of 1 2

Respiratory the nasal mucosa
Tract 2) describe the microscopic structure of the
larynx
3) describe the microscopic structure of the
trachea
bronchial tree
lungs
Anatomy of the 1) describe the anatomy of the primary 1 2

Diaphragm and muscles of respiration: diaphragm and
the other intercostal muscles
muscles 2) describe the nerves & blood vessels
associated with supplying the diaphragm and intercostal
respiration muscles
3) describe the anatomy of the accessory
muscles of respiration
4) describe the nerves and blood vessels
supplying the accessory muscles of
respiration
5) list and locate the muscles involved in
quiet and deep respiration
Mechanism of 1) explain the general functions of the 1

Respiration 1 respiratory system
2) explain the functions of upper respiratory
tract
3) discuss the mechanics of respiration
Mechanism of 1) explain pulmonary compliance and 1

Respiration 2 factors influencing it
2) explain the role of lung surfactants and
factors influencing them
3) discuss the work of breathing and
changes during abnormal condition
4) explain the alteration of airway resistance
and its significance in health and disease
Pulmonary 1) pressures, resistance to blood flow, and 1

Circulation response to hypoxia.
2) describe the zonal differences in
pulmonary blood flow in an upright
person
3) describe the consequence of hypoxic
pulmonary vasoconstriction on the
distribution of pulmonary blood flow.

4) explain the development of pulmonary

edema by increased hydrostatic pressure
b) increased permeability
5) describe bronchial circulation
Diffusion of 1) explain the diffusion of gases and the 2

Gases, factors influencing them
Ventilation & 2) explain partial pressure of gases, dead
Perfusion space and alveolar ventilation
3) explain different types of dead space and
factors affecting them
4) identify the average ventilation
perfusion (V/Q) ratio in a normal lung
and explain how V/Q is affected by the
various factors
5) explain V/Q imbalance
6) define the following terms and name
their causes:
Hypoventilation, hyperventilation,
hypercapnea, eupnea, hypopnea, and
hyperpnea, hypoxemia
Regulation of 1) discuss the neural and chemical control 2

Respiration of respiration
2) discuss the non-chemical influence on
the activities of the respiratory centre
Tutorial-1 2
Respiratory 1) discuss the effect of exercise on 1

Adjustment 1 ventilation
2) explain the concept of O2 debt
3) define respiratory acidosis and alkalosis
giving clinical examples of each
4) describe the mechanism and function of
respiratory acid base compensations
Respiratory 1) explain the effects of hypobaric 1

conditions on respiration - high altitude
Adjustment 2 2) explain the effects of hyperbaric
conditions on respiration – deep sea
diving
Pulmonary 1) draw a normal spirogram, labeling the 2

Function Tests – four lung volumes and four lung
Spirometry, capacities.
PEFR, 2) list the volumes that comprise each of
Breathing the four lung capacities.
movement 3) identify which volume and capacities
cannot be measured by spirometry
4) draw a spirogram resulting from a
maximal expiratory effort.
5) label the forced vital capacity (FVC),
timed forced expiratory volumes

(FEV1), and the maximal expiratory

flow rate between 25-75% of FVC
(FEF25-75)
6) identify types of respiratory disorders
based on FEV1/FVC ratio
Tutorial-2 2
Biochemical 1) explain the molecular basis for the 1 1

Basis of Gas sigmoid shape of the hemoglobin-
Transport oxygen saturation curve
2) explain how it is affected by changes in
blood temperature, pH, pCO2, and 2,3-
DPG
3) describe situations where such changes
have important physiological
consequences
4) explain the role of hemoglobin in the
transport of CO2
5) define acidosis and alkalosis
6) list the buffer systems in ICF and ECF
7) explain the role of respiratory system in
the maintenance of acid base balance
Buffers & Acid- 1) define buffers 1

Base Balance 2) explain the types of buffers in the blood
3) explain metabolic and respiratory
acidosis and alkalosis
Biochemical 1) name the cell type that synthesizes

Basis of surfactants
Surfactants 2) list the types of surfactants
3) describe the metabolism of
phospholipids
Bronchial 1) Define asthma 1

asthma 2) Describe the differences between
bronchial asthma and cardiac asthma
3) Classify bronchial asthma based on the
etiological factors
4) Explain the pathogenesis of bronchial
asthma
5) Discuss the role of different types of
hypersensitivity reactions in asthma
6) 6.Describe the pathological features –
both macroscopic and microscopic
changes
7) Describe the clinicopathological
correlation of asthma
Chronic 1) Define chronic obstructive pulmonary 1

obstructive disease
pulmonary 2) Discuss emphysema, chronic bronchitis

diseases (COPD) and small airway diseases in terms of

definition, risk factors, pathogenesis,
clinical features, lab investigations and
complications
Pulmonary 1) Discuss pneumonia in general based on 1

infections aetiology, morphological features and
predisposing factors
2) Discuss lobar pneumonia and
bronchopneumonia based on aetiology,
pathological changes and complications
3) Discuss the aetiology, pathological
changes of interstitial pneumonia caused
by virus, Mycoplasma and fungus
4) List the causes of pneumonia in
immunocompromised patients
5) Discuss the aetiology and complications
of lung abscess
Tuberculosis & 1) Classify tuberculosis 1

atypical 2) Describe the differences between the
tuberculosis primary and secondary tuberculosis
3) Describe the pathogenesis and clinical
features of tuberculosis and atypical
mycobacterial infections
4) Describe the macroscopic and
microscopic features of tuberculosis of
the lungs
5) Discuss its association with HIV and
other emerging infections
6) Describe the process of healing in
primary and secondary tuberculosis
7) Describe the complications of
tuberculosis
8) Differentiate amyloidosis from
tuberculosis
Pulmonary 1) define pulmonary oedema explain the 1

vascular pathophysiology and effects on lung
diseases function
2) define pulmonary infarction
3) explain the causes, pathogenesis and
describe pathological changes
4) define pulmonary hypertension
5) explain the causes, pathogenesis and the
effects on the right ventricle of the heart
6) define pulmonary embolism
7) explain the causes, pathogenesis,
predisposing factors, effects and
complications
Pulmonary 1) Classify briefly pulmonary neoplasms 1

neoplasms into primary and secondary neoplasms
2) Explain risk factors, pathogenesis and

describe pathological features, clinical

manifestations and complications of
pulmonary carcinomas
3) Explain the aetiology, pathological
features, spread, clinical manifestations
and principles of treatment of
nasopharyngeal carcinoma (NPC)
4) Classify the pleural tumors and describe
their aetiology, gross and microscopic
features and clinical manifestations
Pulmonary 1) list the common causes of diffuse 1

interstitial infiltrative lung diseases
diseases 2) define adult respiratory distress
syndrome (ARDS)
3) explain the causes, pathogenesis, effects
and complications
4) describe briefly the pathological features
of pneumoconiosis
5) list the systemic collagen-vascular
diseases which can cause lung fibrosis
6) explain in general the effects of
restrictive lung disease on lung functions
Practical 1 – 1) Identify gross and histopathological 2

chronic features of bronchial asthma, chronic
obstructive lung bronchitis, bronchiectasis and
disease emphysema
2) Identify, gross and histopathological
features of different types of pneumonia
and tuberculosis
Practical 2 – 1. Identify and describe the gross pathology 2

pulmonary of various lung tumors especially
neoplasms squamous cell carcinoma and
adenocarcinoma
2. Identify and describe microscopic
features of the various types of lung
tumors
Tutorials x 2 2
X 2hrs
Autacoids 1) define and classify autacoids 1

2) explain the physiological role and
functions of autacoids
3) list the important H1 & H2 receptor
antagonists, drugs modulating the action
of prostaglandins & leukotrienes
4) explain the role of autacoids in the
pathophysiology of respiratory diseases
5) discuss therapeutic role of autacoids and
related drugs

6) apply the knowledge of autacoids &

related drugs to various disease states &
their pharmacotherapy
Treatment of 1) explain the rationale for the use of drugs 2

Bronchial in the treatment of bronchial asthma
Asthma 2) explain the mechanisms by which these
drugs act and their potential adverse
effects
3) describe the relevant pharmacokinetic
factors influencing the therapeutic uses
of these drugs
Treatment of 1) list the commonly used drugs in the 1

relief of allergic rhinitis and cough
Allergic Rhinitis 2) explain the common medical terms of
and Cough drugs used in the treatment of cough
3) explain the mechanisms by which these
drugs act and their potential adverse
effects
Drugs used in 1) list the first line drugs currently used in 1

the Treatment the treatment of TB
of Tuberculosis 2) describe the mechanism of action,
pharmacokinetics and adverse effects of
the first line drugs
3) list the alternative second line drugs and
briefly discuss their mechanisms of
action and toxicities
4) discuss the rationale for combining these
drugs in the treatment of pulmonary TB
5) explain the need for enforcing DOTS
Tutorial 1 2
Epidemiology of 1) describe the contents of cigarettes

cigarette 2) describe the epidemiological
smoking and characteristics of lung cancer
cancer 3) describe the prevention of lung
cancer – anti-smoking campaigns
ANATOMY
Text Books
1. Moore, K.L. & Dalley, A.F. and Agur A.M.R. (2010). Clinically Oriented
Anatomy (6th Edition), Wolters Kluwer - Lippincott Williams & Wilkins: Baltimore.
2. Langman, J. (2003). Langman’s Medical Embryology (12th Edition), Jan
Langman: Williams & Wilkins: Baltimore.
3. Snell, R.S. (2005). Clinical NeuroAnatomy for Medical Students (6th Edition),
Little & Brown: Boston.

Boston
PHYSIOLOGY
Text Book
1. Dee Unglaub Silverthorn, (2010), Human Physiology – An Integrated Approach,
3. Sherwood L. (2001). Human Physiology - From Cells to
System. 4thEd.Brooks/Cole
4. West JB. (2008) Respiratory Physiology – The Essentials,
8thEd.Kluwer/Lippincott Williams & Wilkins.
Mosby Publishers.
BIOCHEMISTRY
Textbooks
Reference
Mosby, Philadelphia

PATHOLOGY
Text Books
Mosby
Livingstone
MICROBIOLOGY
Textbooks
Jawetz Melnick & Adelberg’s Medical Microbiology 25th edition. Lange medical
books/McGraw Hill
Reference
PHARMACOLOGY
Text Books
Pharmacology, (Eds.) RA Harvey & PC Champe, 5th Edition, Lippincott Williams
& Wilkins, Philadelphia
1. Katzung BG (2010). Basic and Clinical Pharmacology, (Eds) Katzung BG, 12th
Edition, International Edition McGraw Hill Education (Asia).
Edinburgh.
Therapeutics, (Eds.) Hardman & Limbird, 12th Edition, International Edition
McGraw Hill, New York.

MBBS PROGRAM
YEAR-2

MBBS Curriculum GIN/Sem-3/Year-2
Gastrointestinal System & Nutrition Block – GIN
Course Information
1. Name of Course/Module: Gastrointestinal System & Nutrition Block (GIN) Block
2. Course Code: GIN6239
Anatomy
Physiology
12. Dr Mona Mohamad
Biochemistry
16. Dr Sathivel A
17. Dr Jaiprakash M
Pathology
23. A/P Dr Chan Boon Tek Eugene

Pharmacology
32. Dr. Sunil (KS)
33. Dr. Ameeta(AP)
Community Medicine
The inclusion of this block in the medical curriculum will give the students an in-depth knowledge
of the anatomical, physiological and biochemical basis of gastrointestinal disorders. This block
also gives an understanding on the pathological basis of the disorders related to the gastrointestinal
tract along with the organisms causing these disorders. It also describes the rationale for the use of
drugs used in these disorders and their preventive measures. Hence, the knowledge gained in this
block will be helpful for the students to correlate to the clinical settings when they move on to the
clinical years.
6. Total Student Face To Face Total Guided and Independent

Learning Time (SLT) Learning
L T P O E Total guided learning

L=Lecture 65 34 19 2 3 123 Hours
T=Tutorial 130 68 19
P=Practical 15 Independent learning
O=Others 232 Hours
(PBL, review
discussions)
7. Credit value:
355/40= 8.8 ≈ 9
8. Prerequisite: Successful completion of year 1 upon passing cumulative ESX1+ESX2
9. Objectives:
KNOWLEDGE
By the end of the block, the students will have the knowledge:
 of the gross anatomy, histology and embryology of the components of the gastrointestinal
tract, liver, pancreas and the gallbladder.
 regarding the functions of the gastrointestinal tract, liver , pancreas and gall bladder and
the mechanisms regulating them.
 on the role of the liver in the biosynthesis of bile salts and their metabolism.
 of the importance of macro and micro nutrients in metabolism and development.

 of the etiopathogenesis, clinical manifestations and complications of common diseases of

the gastrointestinal system and the hepatobiliary system.
 on the use of pharmacological drugs in the treatment of common diseases of the
gastrointestinal system.
 so as to appreciate the relevance of nutrition in the medical field
SKILLS
the students will develop the skill to :
 locate the surface anatomy of the gastrointestinal system
 demonstrate the basic clinical skills in the examination of the gastrointestinal tract.
 identify and analyze problems and draw appropriate conclusions (PBL)
 interpret the liver function test.
 identify the common organisms causing infection of the gastrointestinal tract
ATTITUDE
the students will develop the attitude to:

 identify his/her learning needs and seek relevant information (SDL)
 develop group dynamic skills and lifelong learning habits.
Integration
The structure and functions of the gastrointestinal tract are integrated in this block. The pathological
changes in structure (both macroscopic and microscopic) and functions with infections of the
digestive system are also integrated, with the basic science knowledge, the basic Laboratory
diagnostic procedures as well as the drugs used in the treatment of GI diseases and their rationale
for use are focussed in this Block. The relevance of nutrition in health is integrated with the other
subjects involved in this block.
By the end of this block, the student will be able to:

1. describe the gross anatomy, histology and embryology of the components of the
gastrointestinal tract, liver, pancreas and the gallbladder.
2. discuss the functions of the gastrointestinal tract, liver , pancreas and gall bladder and
their regulatory mechanisms.
3. describe the role of the liver in the biosynthesis of bile salts and their metabolism.
4. discuss the importance of macro and micro nutrients in metabolism and development.
5. describe the etiopathogenesis, clinical manifestations and complications of common
diseases of the gastrointestinal system.
6. describe the mechanism of action, pharmacokinetics and adverse effects of drugs used
in the treatment of common diseases of the gastrointestinal system.
7. appreciate the relevance of nutrition in medicine.
8. identify and analyze problems and draw appropriate conclusions (PBL)
9. identify your their own learning needs and seek relevant information (SDL)

(a) Breaking down complex problems into more manageable ones
(b) Identifying problems

(c) Tracing problems to their causes

(d) Identifying cause and effect relationships
(e) Formulating procedures to solve problems
(f) Integrating knowledge from a number of disciplines to solve a problem


The First Professional Exam Part-2 (Pro-1 Part-2) which will be conducted at the end of year-2 will
serve as the final summative assessment. It will test the knowledge and skill which students acquire
in all 6 blocks of the year-2.
The summative assessment includes both EBX as continuous assessment and the First Professional
Part-2 examination (Pro-1 Part-2) as the final assessment.
13. Synopsis:
This is the first block in semester 3 which spreads over 8 weeks. The block begins by giving you in-
depth knowledge about the embryology, histology and gross anatomy of the gastrointestinal system.
This will allow the student to appreciate the functional aspects of the gastrointestinal tract which
will be covered in physiology. In biochemistry, metabolism of vitamins and minerals along with
digestion and absorption of important macromolecules is emphasized. With this basic knowledge
the student is able to understand and appreciate the pathogenesis, clinical manifestations and
complications in pathology. This block gives the student an understanding of the viruses, bacteria
and parasites involved in the diseases of the gastrointestinal tract which is dealt in microbiology and
parasitology. Eventually, a wide array of drugs used in the diseases of the GI system is dealt in
pharmacology. PBL helps the student to identify and analyze problems and draw appropriate
conclusions. Clinical skills includes history taking and examination technique in the GI system.

1. lectures (LEC),

3. tutorials (TUT)
4. computer aided learning (CAL)
5. self-directed learning (SDL)
6. directed self learning [ DSL]
7. student seminars.

2) Summative –

A: MCQ (T/F)
B: MCQ (OBA/OCA)
2.2) GIN in the First Professional Part-2 Exam 60%

A: MCQ (T/F)
B: MCQ (OBA/OCA)
D: OSPE (objective structured practical exam questions)
PEO1 Be equipped with current knowledge and skills in the practice of medicine
so as to become safe and caring doctors to fulfill the needs of the nation.
PEO2 Function independently as part of the healthcare team to carry out curative
as well as preventive programme in urban and rural settings.
moral values.
PEO1 PEO2 PEO3 PEO4
 

medical and health conditions based on history, physical examinations and
relevant investigations.
PLO2 Be able to practice preventive, promotive and rehabilitative medicine at all

levels of society.


moral values.
professionals and exhibit leadership and managerial skills in any situation
of the profession.

of interest.
  

L T P
Gross anatomy of 1) Describe the tongue with regard to its 1 2
the oral cavity, i. External features
pharynx and ii. Extrinsic and intrinsic muscles
oesophagus iii. Innervation
(ANA-1) iv. Blood supply
v. Lymphatic drainage
2) Describe the location, relations and
innervations of the salivary glands
3) Describe the structures and relations within
the nasopharynx, oropharynx and
laryngopharynx
4) Describe the muscles of pharynx and their
innervation
5) Describe the esophagus with regard to its
i. Gross features
ii. Relations
iii. Innervation
iv. Blood supply
Gross Anatomy of 1) Describe the stomach with regard to its: 1 2

the stomach, liver i. Location and gross features
and biliary tract ii. Peritoneal coverings and its
(ANA-2) attachments
iii. Relations
iv. Innervation

v. Blood supply
vi. Lymphatic drainage
2) Describe the liver with regard to its
i. Gross features
ii. Peritoneal coverings and attachments
iii. Location
iv. Surface anatomy
v. Relations
vi. Innervation
vii. Blood supply
3) Describe the gross anatomy of the
gallbladder and the biliary tract
Histology of 1) Describe the microscopic structure of the 1 2

tongue and tongue
salivary glands 2) Describe the microscopic structure of the
(ANA-3) salivary glands
3) Differentiate the structural differences of
parotid, submandibular and sublingual
salivary glands
Gross anatomy of 1) Describe the duodenum, jejunum and ileum 1 2

small Intestine & with regard to their:
Pancreas i. Location and gross features
(ANA-4) ii. Morphological differences
iii. Relations
iv. Innervation
v. Blood supply
2) Describe the pancreas with regard to its:
i. Gross features and parts
ii. Relations
iii. Innervation
iv. Blood supply
Histology of 1) Describe the microscopic structure of 1 2

oesophagus, GE oesophagus
junction, Stomach, 2) Describe the structural changes at the
PD junction Gastroesophageal junction
(ANA-5) 3) Describe the structure of stomach and the
structural differences of:
i. Cardiac part of stomach
ii. Fundus of stomach
iii. Pylorus of stomach
4) Describe the structural differences at the
Pyloroduodenal junction
Gross anatomy of 1) Describe the colon (large intestine) with 1 2

large intestine, regard to its
rectum and anal i. Gross features and parts
canal ii. Peritoneal relations
(ANA-6) iii. Innervation
iv. Blood supply
2) Describe the caecum and vermiform
appendix with regard to:

i. Location and gross features

ii. Innervation
iii. Blood supply
3) Describe the rectum with regard to its:
i. Gross features
ii. Location
iii. Relations
iv. Innervation
v. Blood supply
4) Describe the anal canal with regard to its:
i. Gross features
ii. Sphincters
iii. Relations
iv. Innervation
v. Blood supply
vi. Lymphatic drainage
Histology of liver, 1) Describe the microscopic structure of the 1 2

biliary tract, liver
pancreas and 2) Describe the microscopic structure of the
appendix gallbladder 3.Describe the microscopic
(ANA-7) structure of the pancreas
3) Describe the microscopic structure of the
appendix
Histology of the 1) Describe the microscopic structure of the 1 2

small intestine, small intestine
large intestine and 2) Describe the microscopic structural
anorectal junction differences of the duodenum, jejunum and
(ANA-8) ileum
colon
anorectal junction
Peritoneum and 1) Outline the general disposition of the 1 2 2

Peritoneal Cavity peritoneum & peritoneal folds
(ANA-9) 2) Comprehend the following structures:
i. Greater sac
ii. Lesser sac
iii. Greater omentum
iv. Lesser omentum
v. Mesentery / mesocolon
3) Subdivision of the peritoneal cavity
4) Retroperitoneal and intraperitoneal organs
Blood supply of 1) Describe the blood supply to GIT 1

gastrointestinal 2) Define the portal circulation
tract 3) Describe the formation, course and
(ANA-10) termination of the portal vein
4) Describe the portal-systemic anastomoses
Gastrointestinal 1) Describe the development of the 2

Embryology – I & gastrointestinal tract

II 2) Describe the development of liver and the

(ANA-11) biliary tract
3) Describe the common anomalies in
gastrointestinal tract
General principles 1) describe major functions of the GI tract 1

of GI physiology 2) describe electrical activity in GI smooth
(PHY-1) muscles
3) describe the characteristic types of GI
motility
4) explain the neural and hormonal regulation
of GI functions in health and disease
Mastication and 1) discuss the process of mastication and its 1

deglutition regulation
(PHY-2) 2) describe the process of salivary secretion
including composition and regulation
3) discuss the phases of swallowing and their
regulation
4) state the role of upper and lower esophageal
sphincters in health and disease- esophageal
reflux and achalasia
Tutorial-1 1
Physiology of 1) discuss the function of stomach, 1

stomach mechanisms of secretion and function of
(PHY-3) gastric acid;
2) state the phases of acid secretion and
respective regulations;
3) describe the mechanism and control of
gastric motility;
4) explain the control of the process of emesis
Physiology of 1) describe the small intestinal motility 1

small intestine 2) list the factors regulating intestinal motility
(PHY-4) 3) explain the role of autonomic nervous
system and local reflexes in regulating
intestinal functions
4) state briefly the intestinal secretions and
functions
5) state the function of ileocecal valve
Physiology of 1) describe the functions of exocrine pancreas, 1

exocrine pancreas 2) discuss pancreatic exocrine function,
(PHY-5) 3) describe phases of pancreatic secretion and
regulation
Tutorial-2 1
Physiology of 1) describe the functions of liver and gall 1

hepatobiliary bladder
system 2) describe production and concentration of

(PHY-6) bile
3) list bile constituents and state their function
4) state the factors regulating formation and
secretion of bile
Tutorial-3 1
Physiology of 1) describe the major functions of colon; 1

colon and describe the motility and its regulation
defecation 2) discuss the process of defecation;
(PHY-7) 3) explain the role of ANS and higher control
on defecation; 4.state the bacterial action in
large intestine
Tutorial-4 1
Review 1) explain the functions of gastrointestinal 2

tract
2) explain the neural and hormonal regulation
of GI functions in health and disease
3) understand the applied knowledge of
gastrointestinal physiology in clinical
setting
Body composition 1) define body composition 2

analysis – 2) state the components and their respective
importance proportion in healthy body
(PHY-8) 3) understand the importance of BMI, Body
fat% and Lean Body Mass in health and
disease
4) list the methods of body composition
analysis and know their respective
advantages and disadvantages
5) be able to understand and explain the
importance of body composition in health
and disease
Biochemistry of 1) explain the components of dietary 1

digestion & carbohydrates.
absorption of 2) explain the digestion of carbohydrates in
carbohydrates & the mouth stomach and intestine.
proteins 3) list the names of enzymes involved in
(BIO-1) digestion and their location.
4) describe metabolism of indigestible
carbohydrates and fibres by colonic
bacteria
5) explain the mechanisms of transport of
monosaccharides in intestinal epithelium.
6) explain protein digestion and absorption of
amino acids in intestinal epithelium
Biochemistry of 1) outline the types of dietary lipids 1

digestion and

absorption of 2) explain lipid digestion in the mouth,

lipids & vitamins stomach and small intestine
3) discuss the role of lingual lipase, gastric
lipase and pancreatic lipase.
4) explain the absorption of digested lipids at
the mucosal level.
5) explain the need for bile salts in the
absorption of fat and fat soluble vitamins
Metabolism of bile 1) explain the composition of bile 1 1

acids 2) explain synthesis of primary bile acids
from cholesterol
3) explain synthesis of secondary bile acids
4) explain the significance of bile salts in gall
stone formation
5) explain the significance of enterohepatic
circulation of bile salts
6) explain the role of drugs that inhibit the
uptake of bile salts
Mineral 1) explain body’s requirement of 1

metabolism macrominerals and microminerals
2) discuss the requirement of calcium, iron,
magnesium and manganese
3) explain the requirement of cobalt ,Zinc,
Selenium, Chromium and Vanadium
Water-soluble 1) distinguish between water soluble and fat 1

vitamins soluble vitamins
2) explain the significance of vitamin B
complex in normal metabolism and in
energy transduction
3) discuss the importance of vitamin C
4) discuss the importance of folic acid
5) discuss the importance of cyanocobalamine
in metabolism
6) explain avitaminosis
Fat-soluble 1) explain the source of vitamin A & D in 1

vitamins A and D diets
2) explain the synthesis of vitamin A from β-
carotene
3) explain the synthesis of retinol, retinal and
retinoic acid
4) explain the role of 11,cis-retinal in vision.
5) explain the role of vitamin D in calcium
homeostasis
6) discuss the relationship between vitamin D
calcium and osteoporosis
Fat-soluble 1) explain the various forms of vitamin K 1

vitamins E and K 2) discuss its role as a coenzyme in the
carboxylation of glutamic acid residues in
various blood clotting factors

3) explain the inhibition by dicumarol and

warfarin
4) name the function of vitamin E and the
underlying mechanism of that function
5) list the functions of tocopherol
Liver function 1) categorize the liver function tests listing a 1 1

tests few examples
2) define and list some important causes for
jaundice
3) explain the clinical importance of
measuring billirubin
4) list and explain the clinical relevance of
certain important markers used to assess
synthetic function of liver
certain important markers used to assess
metabolic function of the liver
certain important enzymatic markers used
in the diagnosis of liver disease
Inflammatory 1) Define esophagitis and gastritis. 1

disorders of the 2) Classify gastritis (acute and chronic).
oesophagus & 3) Explain the pathogenesis of esophagitis
gastritis and gastritis.
4) Have knowledge of the aetiology of
esophagitis and gastritis.
5) Know the complications associated with
esophagitis and gastritis.
6) Describe Barrett’s oesophagus inclusive
of aetiology and its complications.
7) Describe gastrinoma and Zollinger Ellison
syndrome
Peptic ulcer 1) Define dyspepsia, peptic ulcer, gastric 1

disease erosion and gastropathies.
2) Describe the epidemiology and etio-
pathogenesis of gastric erosion, peptic
ulcer disease.
3) Explain the role of Helicobacter pylori
and Zollinger-Ellison syndrome
4) Know the complications of peptic ulcer
disease.
Pancreatic 1) List the common disorders of pancreas. 1

diseases 2) Discuss the aetiology of acute
pancreatitis, morphology, pathogenesis,
clinical feature, laboratory finding and
outcomes.
3) Discuss chronic pancreatitis in terms of its
etiology, pathogenesis, morphology,
complications and outcomes.

4) Discuss the pancreatic tumours in terms of

etiology, gross, microscopic features,
clinical manifestations, diagnosis and
treatment
Tumours of upper 1) Describe the epidemiology and aetiology 1

GIT of upper GIT neoplasms.
2) Classify the types of epithelial and
stromal malignancies.
3) Describe the clinico-pathological features
and complications
4) Understand the pathogenesis of upper GIT
malignancies
Inflammatory 1) Define inflammatory bowel diseases. 2

bowel diseases 2) Describe the pathophysiology of IBD.
3) Describe Crohn’s disease with respect to-
pathology, clinical features, investigations,
complications and management.
4) Describe ulcerative colitis with respect to-
pathology, clinical features, investigations,
complications and management.
5) Describe extra-intestinal manifestations of
IBD
6) Describe appendicitis
Tumours of lower 1) Describe malignant and premalignant 1

GIT lesions of colon.
2) Describe non neoplastic and neoplastic
polyps of colon.
3) Describe pathophysiology of the above
lesions.
4) Describe colorectal carcinomas.
5) Describe anal carcinoma.
6) Describe carcinoid tumours
Gall bladder 1) List the common disorders of gall bladder. 1

disorders 2) Discuss the risk factors of cholelithiasis
describe the differences between
cholesterol stone and pigment stone,
complications of cholelithiasis.
3) Discuss acute and chronic cholecystitis in
terms of their aetiology, pathogenesis,
morphology, complications and outcomes.
4) Discuss the gall bladder tumours in terms
of aetiology, gross microscopic features,
clinical manifestations, diagnosis and
treatment
Hepatitis 1) Classify hepatitis. 1

2) Discuss hepatitis B in terms of aetiology,
pathogenesis, clinical features,
morphology, serological diagnosis and
clinic pathologic syndrome.

3) Discuss hepatitis C in terms of aetiology,

pathogenesis, clinical features,
morphology, and serological diagnosis
Cirrhosis of liver 1) Classify cirrhosis 1

2) Discuss cirrhosis in terms of aetiology,
pathogenesis, morphology, clinical features
and outcomes
Hepatic neoplasms 1) List the hepatic neoplasms. 1

2) Explain HCC in term of aetiology,
pathogenesis, risk factors, morphology,
clinical features and outcomes
Practical 1 : GIT 1) Identify the following: 2

Non Neoplastic i. Oesophagus- Barrett’s oesophagus
disorders and varices
ii. Stomach- benign peptic ulcer
iii. Intestine- crohn’s disease, ulcerative
colitis, appendicitis.
iv. Liver- cirrhosis, hepatitis
v. Gall bladder- cholecystitis,
cholelithiasis
Practical 2: GIT 1) Identify the following: 2

hepatobiliary i. Oesophagus- carcinoma.
Neoplastic ii. Stomach- ca stomach.
disorders iii. Intestine- polyps, carcinoma colon, ca
rectum and carcinoid tumour.
iv. Liver- hepatocellular carcinoma
(HCC).
v. Gall bladder- carcinoma gall bladder.
Tutorial 2
Food poisoning 1) define food poisoning and food-associated 1 1 2

infections
2) list the causative agents of food poisoning
manifestations of food poisoning
4) discuss the proper collection of specimens
and laboratory diagnosis of food poisoning
5) outline the principles of treatment of food
poisoning
6) discuss the prevention of food poisoning
Infections of 1) name the causative agents of enteric fevers, 1 1 2

Gastrointestinal cholera and related infections
tract 1- 2) describe the epidemiology the enteric
Enteric fever, fevers, cholera and related infections
Cholera 3) describe the pathogenesis and clinical
manifestations of the enteric fevers, cholera
and related infections

4) discuss the laboratory diagnosis of enteric

fevers, cholera and related infections
5) outline the principles of treatment of enteric
fevers, cholera and related infections
6) the control of enteric fevers, cholera and
related infections
Infections of 1) list the bacterial causes of gastrointestinal 1 1 2

Gastrointestinal infections
tract 2- other 2) describe the epidemiology of bacterial
bacteria gastrointestinal infections
manifestations of bacterial gastrointestinal
infections
bacterial gastrointestinal infections
5) outline the principles of treatment of
bacterial gastrointestinal infections
6) describe the prevention of bacterial
gastrointestinal infections
Infections of 1) list the viral causes of gastrointestinal 1 1 2

Gastrointestinal infections
tract -3 ( virus) 2) describe the epidemiology of viral
manifestations of viral gastrointestinal
infections
4) describe the laboratory diagnosis of viral
5) outline the principles of treatment of the
viral gastrointestinal infections
6) describe the prevention of viral
Viral hepatitis 1) describe the virology of hepatitis viruses 1 1 2

2) describe the epidemiology of viral hepatitis
manifestations of viral hepatitis
4) discuss the laboratory diagnosis of viral
hepatitis
5) outline the treatment and prevention of
viral hepatitis
Hepatobiliary 1) lis the common causative agents of 1 1 2

Infections hepatobiliary infections
2) describe the pathogenesis of hepatobiliary
infections
3) describe the clinical manifestations of
hepatobiliary infections

Infections of the 1) explain the type of clinical specimen 2

gastrointestinal involved in the diagnosis of gastrointestinal
system infections
2) explain the different types of laboratory
(Fixed-Learning tests involved in the diagnosis of
Resources FLR) gastrointestinal infections
3) explain the type of antimicrobials involved
in the treatment of gastrointestinal
infections
Giardiasis 1) define ‘giardiasis’ 1

2) explain the life-cycle of Giardia lamblia
3) explain the pathogenesis and clinical
manifestations of the infection
4) explain the methods of diagnosis and
interpret the laboratory findings
5) explain the principles of treatment
6) explain the epidemiology, prevention and
control
Ascariasis 1) define ‘ascariasis ‘ 1

2) explain the life-cycle of Ascaris
lumbricoides
manifestations
6) describe the epidemiology, prevention and
control
Hook worm & A.HOOK WORM 1

Strongyloidiasis 1) define ‘hookworm infection.
2) explain the life-cycle of hookworms
4) explain the methods of diagnosis.
control
B.STRONGYLOIDIASIS
1) explain the life-cycle of Strongloides
stercoralis
3) define ‘strongyloidiasis’
4) explain the methods of diagnosis
control

Amoebiasis 1) define ‘amoebiasis’ 1

2) explain the life-cycle of Entamoeba
histolytica
manifestations of intestinal and
extraintestinal amebiasis
control
Trichuriasis 1) define ‘trichuriasis’ 1

2) explain the life-cycle of Trichuris trichiura
manifestations
control
Amoebic liver 1) define ‘liver abscesses’

abscess 2) list the major causative agents
(SLP) 3) explain the pathogenesis and clinical
Enterobiasis 1) define ‘enterobiasis’ 1

2) explain the life-cycle of Enterobius
vermicularis
4) explain clinical and laboratory diagnosis –
scotch tape technique
control
Intestinal 1) define ‘intestinal schistosomiasis’ 1

schistosomiasis 2) explain the general life-cycle of
Schistosoma sp
identify the diagnostic stages
control
Trematode 1) list the common trematodes infecting the

Infections of the gastrointestinal and hepatobiliary tracts

Alimentary 2) explain their modes of transmission

System 3) explain the general clinical manifestations
(SLP) of these infections (generally as a group)
4) list the diagnostic methods and identify the
diagnostic stages (as organ-based groups)
5) name the commonly used drugs for
treatment
6) outline the geographical distribution,
prevention and control
Drugs used in the 1) classify drugs used in the treatment of acid 2

treatment of Acid peptic disease
Peptic Disease 2) describe the role of H+, K+ - ATPase in
gastric acid production
3) explain site and mechanism of H+, K+-
ATPase inhibitor actions
4) list the side effects of proton pump
inhibitors
5) explain mechanisms by which H2
antagonists inhibit acid production
6) describe absorption, metabolism, excretion
and duration of action of H2 antagonists
7) explain mechanisms by which cimetidine
alters responses to other drugs (drug-drug
Interactions)
8) list important adverse effects of H2
antagonists
muscarinic antagonists as gastric
antisecretory agents
10) explain the adverse and / or side effects
associated with anticholinergic therapy
11) describe special concerns about the use of
anticholinergic drugs in elderly patients
12) describe the mechanisms of gastric
antisecretory and mucosal protective
effects of Prostaglandins E (prototype –
Misoprostol)
13) describe the major side effects associated
with misoprostol
14) explain the rationale for use of misoprostol
in peptic ulcers associated with anti
inflammatory drugs
15) list common antacids
antacids
17) explain the rationale for the use of antacids
in the treatment of peptic ulcer,
gastroesophageal reflux disease, and
dyspepsia
18) list the major adverse reactions of antacids
19) provide the rationale for mixtures of
antacids

20) list the agents which protect the gastric

mucosa and list the side effects of the same
Anti-emetic Drugs 1) briefly describe the pathophysiology of 1

and Prokinetic vomiting
Drugs 2) classify drugs which are important anti-
emetic agents
3) describe the MOA, actions, side effects and
clinical uses of Serotonin 5HT3 antagonists
eg ondansetron
4) discuss the MOA, actions, side effects of
Neurokinin receptor antagonists eg
aprepitant
5) describe the MOA, actions, side-effects
and uses of Corticosteroids eg.
Dexamethasone
6) describe the MOA, actions , side-effects of
phenothiazines and buryrophenones eg.
Promethazine, and droperidol
7) describe briefly the MOA of other drugs
such as metoclopramide, H1 antihistamines
eg diphenhydramine and meclizine, and
anticholinergic drug such as hyoscine,
benzodiazepines eg. Diazepam, and
cannabinoids eg nabilone
Prokinetic drugs:
1) describe the physiology of the enteric
nervous system
2) discuss the MOA, actions and side effects
of cholinomimetics (eg bethanechol &
neostigmine), metoclopramide &
domperidone
Antidiarrhoeals 1) mention 129astrointestinal motility 1

and laxatives disorders
2) define functional constipation
3) define laxatives and purgatives
4) classify purgatives
5) describe the mechanism of action of bran,
methyl cellulose, biscodyl, senna
6) define diarrhoea
7) discuss treatments of diarrhoea
i. Adsorbants
ii. Agents that modify fluid and
electrolyte transport
iii. Antimotility agents
Tutorials 2
Introduction to 1) Define community nutrition. 1

Community 2) Describe the way to assess the level of
Nutrition community nutrition.
(NUT-1)

3) Describe how to improve and maintain the

optimal level of nutritional status in the
community
Functional foods 1) Define the following terms and discuss

and food groups/ their importance and uses:
RDA i. Dietary reference intake
ii. Recommended daily allowances
2) Describe the four food groups with regard
to:
i. Nutrient content
ii. Meeting nutritional requirement
iii. Daily dietary intake and servings
iv. Dietary guidelines
Public health 1) Understand the public health issues related

issues in to breast feeding
breastfeeding in 2) Describe the WHO policies on breast
the Malaysian feeding
3) Describe ministry of health Malaysia
Policies on breast feeding
Malnutrition I: 1) Describe malnutrition with regard to:

Under-nutrition i. Causes
ii. Effect
iii. Prevention
Malnutrition II: 1. Describe obesity with regard to:

Obesity  Causes.
 Effect.
 Prevention.
Assessment of 1) Know the different methods for assessing

nutritional status the nutritional status
2) Understand the basic anthropometric
techniques, applications, and reference
standards.
Food Policies and 1) Discuss applied food and nutrition

Malaysian Dietary programs in Malaysia with regard to:
Guidelines i. Food and Nutrition Policy
ii. Success and Failures
iii. Current Needs
2) Discuss the nutritional status of various
groups in Malaysia
i. Conduct Dietary Recall
ii. Calculate energy values in daily diet

Nutritional 1) Enter nutrition data into the software

Assessment of 2) Use the software and perform
Under Fives using i. Calculation of nutritional indices of a
WHO child < 5
Anthropometry ii. Follow-up the nutritional status of
Software children (growth monitoring)
iii. Use a nutrition survey data and
estimate nutritional status of children
in a community from which the data
came
3) Interpret the anthropometric indices
4) Imply this knowledge:
i. in a clinic to identify the nutritional
status of a child at first visit
ii. in growth-monitoring of children
especially who have growth
problems
iii. in conducting a nutritional survey
ANATOMY
Text Books
7. Moore, K.L. & Dalley, A.F. and Agur A.M.R. (2010). Clinically Oriented Anatomy (6th
Edition), Wolters Kluwer - Lippincott Williams & Wilkins: Baltimore.
9. Snell, R.S. (2005). Clinical NeuroAnatomy for Medical Students (6th Edition), Little &
Brown: Boston.
4. Snell, R.S. (2008). Clinical Anatomy for Medical Students (8th Edition), Brown: Boston
PHYSIOLOGY
Text Book

Williams & Wilkins.
10. Levy, MN, et al. (2005) Berne & Levy: Principles of Physiology 4thEd.Elseview-Mosby
Publishers.
3rd Ed Kluwer/Lippincott Williams & Wilkins
BIOCHEMISTRY
Textbooks
2. Champe, P.C. and Harvey, RA. (2010). Lippincott’s Illustrated Reviews, Biochemistry (5th
Edition), Lippincott Williams and Wilkins Co. Baltimore
Reference
Philadelphia
11. Vasudevan DM and Sreekumari S. (2011) Textbook of Biochemistry (for Medical students)
(6th Edition), Jaypee Medical Publishers (P) Ltd, New, India.
12. Montgomery R., Conway T.W., Spector A.A. and Chappell (1996), Biochemistry: A Case-
Orientated Approach (6th Edition), Mosby, St. Louis USA.
PATHOLOGY
Text Books
Livingstone
MICROBIOLOGY
Textbooks
Melnick & Adelberg’s Medical Microbiology 25th edition. Lange medical books/McGraw
Hill

Reference
PHARMACOLOGY
Text Books
6. Rang HP, Dale & Ritter (2012) 7th Edition Pharmacology. Churchill Livingstone, Edinburgh.
Therapeutics, (Eds.) Hardman & Limbird, 12th Edition, International Edition McGraw Hill,
New York.
NUTRITION
References :
1. Nutrition in public health Principles, Policies and Practice
Arlene Spark, 1st edition (2007). CRC Press, USA.
2. Understanding nutrition Ellie Whitney & Sharon Rady Rolfes, 11th edition (2008).
Thomson Higher Education, USA.

MBBS Curriculum MSK/Sem-3/Year-2
Musculoskeletal System Block – MSK
Course Information
1. Name of Course/Module: Musculoskeletal System (MSK) Block
2. Course Code: MSK 6248
Anatomy
Physiology
12. Dr Mona Mohamad
Biochemistry
16. Dr Sathivel A
17. Dr Jaiprakash M
Pathology

Pharmacology
32. Dr. Sunil (KS)
33. Dr. Ameeta(AP)
Community Medicine
Diseases of the musculoskeletal system like gout, rheumatoid arthritis etc are very common in
clinical setting. Hence the basic facts of the normal structure and function of the skeletal muscles
and bones need to be taught in the Preclinical phase. The goal is to cover the normal structure and
function and the processes leading to diseases of the musculoskeletal system. The aetiology,
pathogenesis and biological agents of diseases of muscle and bones are covered here along with
the principles of their treatment protocols.

L=Lecture L T P O E Total guided learning

T=Tutorial 112 Hours
(PBL, review discussions) 128 58 18 15 219 Hours
7. Credit value: 331/40 = 8.3≈8
8. Prerequisite:
9. Objectives:
KNOWLEDGE
 of the structure and functions of the bones and muscles of the body along with the nerve
and blood supply and lymphatic drainage of the musculoskeletal structures
 of the metabolic processes involved in muscle contraction and physical exercise
 of the etiopathogenesis of musculoskeletal diseases, particularly those of importance in
Malaysia and consequences of fracture and nerve injury.
 to identify and interpret basic relevant investigations to diagnose the diseases of the
musculoskeletal system.
 to understand the mechanism of action, pharmacokintiecs , adverse effects and indications
for the use of drugs used in the diseases of the musculoskeletal system.

 to understand the rationale for the use of common therapeutic agents for these diseases
 to understand the preventive and control strategies of these diseases
SKILLS
 demonstrate basic history taking and systemic examination of musculoskeletal system
 identify and analyse problems and draw appropriate conclusions (PBL/PS)
 interpret basic investigations relevant to musculoskeletal diseases
ATTITUDE
 work as a team and communicate with patients and the campus community
 identify your own learning needs and seek relevant information (SDL)
Integration
The structure and functions of the musculoskeletal system are integrated in this block. The
pathological changes in structure (both macroscopic and microscopic) and functions with
infections of the musculoskeletal system are also integrated, with the basic science knowledge.
The basic Laboratory diagnostic procedures as well as the drugs used in the treatment of
musculoskeletal diseases and their rationale for use are focussed in this block.
1. describe the structure and functions of the bones and muscles of the body
2. describe the nerve supply, blood supply and lymphatic drainage of the musculoskeletal
structures
3. describe the pathophysiology of paralysis as a consequent of fracture and nerve injury.
4. explain the mechanism and metabolic processes involved in muscle contraction
5. explain the aetiology pathogenesis of musculoskeletal diseases, particularly those of
importance in Malaysia
6. identify basic relevant laboratory investigations for the diagnosis of musculoskeletal
diseases
7. describe the mechanism of action, pharmacokinetics , adverse effects and indications for
the use of drugs used in the diseases of the musculoskeletal system
8. explain the rationale for the use of common therapeutic agents for these diseases
9. explain the preventive and control strategies of these diseases
10. identify and analyse problems and draw appropriate conclusions (PBL)
11. identify their own learning needs and seek relevant information (SDL)


Breaking down complex problems into more manageable ones
Identifying problems
Tracing problems to their causes
Identifying cause and effect relationships
Formulating procedures to solve problems
Integrating knowledge from a number of disciplines to solve a problem

Writing clear and concise records and reports
Presenting technical information to a large group of people
Ability to understand and treat an audience accordingly
Listening attentively
Effectively explaining highly technical information

13. Synopsis:
The block is introduced as the second block in the third semester and runs for six weeks .It covers
the normal structure and functions of the musculoskeletal system .The mechanisms of muscle
contraction and the energetics are covered. It also involves the processes leading to diseases of the
musculoskeletal system. The block also includes the etiopathogenesis and biological agents of
diseases of muscle, bone and skin along with the principles and rationale of treatment of common
musculoskeletal diseases.


1. lectures (LEC),
3. tutorials (TUT)
4. computer aided learning (CAL) lab in physiology and pharmacology.

4) Summative –

A: MCQ (T/F)
B: MCQ (OBA/OCA)
2.2) MSK in the First Professional Part-2 Exam 60%

A: MCQ (T/F)
B: MCQ (OBA/OCA)
PEO1 Be equipped with current knowledge and skills in the practice of medicine so as to
become safe and caring doctors to fulfill the needs of the nation
PEO2 Function independently as part of the healthcare team to carry out curative as
well as preventive programme in urban and rural settings
values
interest in medical research and innovation
PEO1 PEO2 PEO3 PEO4
 

PLO1 Be competent to make a diagnosis and institute management on common medical

and health conditions based on history, physical examinations and relevant
investigations
PLO2 Be able to practice preventive, promotive and rehabilitative

medicine at all levels of society
PLO3 Be responsible for maintaining the highest standards of medical practice through
continuing lifelong medical education

communicate effectively with patients and other health professionals
PLO5 Be able to conduct the practice of medicine with the highest ethical and moral values
PLO6 Be able to work in a team and collaborate with other health care professionals and
exhibit leadership and managerial skills in any situation of the profession
PLO7 Be able to embark on research and innovative aspect of medicine in areas of interest
  
L T P
Development of the 1) describe the development of the skeletal 1
Musculoskeletal system
System 2) describe the development of the muscular
system
3) describe the development of the limbs
4) mention some common anomalies of the
musculoskeletal system
Bones, Joints and 1) describe the following bones of the upper 1 2

Muscles of Upper limb: scapula, clavicle and humerus
Limb I 2) describe the sternoclavicular and
(Shoulder & Arm) acromioclavicular joints
3) describe the movements of the scapula
4) describe the attachments and actions of the
muscles that move the scapula
5) describe the shoulder joint
muscles producing the movement of the
shoulder joint
7) describe the factors that contribute to the
stability of the shoulder joint and the
clinical aspect of fracture and dislocation

8) describe the boundaries of the axilla and

list its contents
Bones, joints and 1) describe the following bones of the upper 1 2

muscles of Upper limb: the radius, ulna.
Limb II 2) describe the following joints (with
(Forearm, Elbow) emphasis on bony configuration, ligaments,
movements and stability):
i. Elbow joint
ii. Proximal and distal Radioulnar joints
muscles that move the joints stated above.
4) describe the boundaries and contents and
clinical significant of the cubital fossa
Bones, joints and 1) describe the following bones of the upper 1 2

muscles of Upper limb: carpal & metacarpal bones and
Limb III phalanges.
(Wrist & Hand) 2) describe the following joints (with
emphasis on bony configuration, ligaments,
movements and stability):
i. Wrist (radiocarpal) joint
ii. Joints of the hand including digits
muscles that move the joints stated above.
4) describe the carpal tunnel and list the
structures that pass through it. State the
clinical significance.
Innervation and 1) describe the formation and branches of the 2 2

Nerve injuries of brachial plexus.
the Upper Limb I & 2) describe the nerves arising from the roots,
II trunks, and cords.
3) describe the course of the long thoracic
nerve, suprascapular, musculocutaneous,
axillary, radial, median and ulnar nerves.
4) discuss the causes and effects of injuries of
the peripheral nerves mentioned above
Blood Vessels and 1) describe the arteries of the upper limb 1 2

Lymphatics of 2) describe the arterial anastomosis around
Upper Limb the shoulder joint and its clinical
significance
3) describe the veins of the upper limb
4) describe the clinical importance / use of the
blood vessels
5) describe the lymphatic drainage of the
upper limb
Anterior and 1) describe the anterior abdominal wall with 1 2 3

Posterior regard to the surface anatomy of the
Abdominal Walls quadrants

2) describe the attachments, nerve supply and

actions of the muscles in the anterior
abdominal wall
3) describe the formation and contents of the
rectus sheath
4) describe the inguinal canal
5) describe the posterior abdominal wall
6) describe the actions of the muscles of the
posterior abdominal wall
7) describe the thoracolumbar fascia
Pelvis 1) describe the pelvic region

2) describe the boundaries of the pelvic inlet
and outlet
3) describe the pelvic fascia
4) describe the pelvic diaphragm and its
functions
Bones, Joints and 1) describe the gluteal region and state the 1 2
Muscles of the and clinical significance of this region
Lower Limb I 2) describe the bones of the pelvic girdle
(Gluteal region, (pelvic bone and femur)
Pelvic Girdle and 3) describe the hip joint (with emphasis on the
Hip Joint) bony configuration, ligaments and
movements that can occur at the joint)
4) list and describe the attachments and
actions of the muscles that move the hip
joint
stability of the hip joint and the clinical
aspect of fracture and dislocation
Bones, Muscles and 1) describe the following bones of the leg: 1 2

Joints of the Lower patella, tibia & fibula
Limb II 2) describe the knee joint and with emphasis
(Knee & Leg) on the bony configuration, ligaments, and
movements that occur at the joint
3) list and describe the attachments and
actions of the muscles producing the
movements of the knee joint
stability of the knee joint
5) describe the boundaries, contents and
clinical significance of the: a) femoral
triangle; b) adductor canal, c) popliteal
fossa
Bones, Muscles and 1) describe the following bones of the foot: 1 2

Joints of the Lower tarsal & metatarsal bones, & phalanges)
Limb III 2) describe the ankle joint with emphasis on
(Ankle and Foot) the bony configuration, ligaments and
movement that can occur at the joint


muscles that produce the movements of the
ankle joint
stability of the ankle joint
5) describe the tarsal joints with emphasis on
the bony configuration, ligaments and
movement that can occur at the joint
muscles that produce the movements of the
tarsal joints
7) describe the formation of arches of the foot
and state their functions
8) describe the factors that maintain the
medial, longitudinal and transverse arches
of the foot
Innervation and 1) locate the lumbar and sacral plexuses and 1 2

Nerve Injuries of name the branches that supply the lower
the Lower Limb limb
2) describe the origin, root value, branches
and distribution of the following nerves:
femoral, sciatic, obturator, common
peroneal, tibial and medial and lateral
plantar nerves that supply the lower limb
3) describe the causes and effects of injuries
to the nerves mentioned above
Blood Vessels and 1) describe the arteries and their branches that 1 2 2
Lymphatic of the supply the lower limb
Lower Limb 2) describe the veins and their tributaries that
drain the lower limb
3) describe the clinical importance / used of
the blood vessels
4) discuss the mechanisms which ensure the
upward flow of venous blood against the
pull of gravity
5) describe the lymphatic drainage of the
lower limb
The Neck I & II 1) describe the neck with regard to the 2 2

triangles, their boundaries and contents
2) describe the cervical vertebrae
3) describe the cervical fasciae and its
arrangement
4) describe the formation and distribution of
the cervical plexus
5) describe the major blood vessels and
nerves of the head and neck
6) describe the lymphatic drainage of the head
and neck
The Neck III 1) describe the attachment of the various 1 2 2

(Larynx and muscles of the pharynx with their nerve

Pharynx) supply and explain the diverticula that can

occur here and surgical spaces related to
the pharynx
2) describe the main features of the laryngeal
cartilages and the intrinsic muscles,
innervation and cavity of larynx
3) explain the differences between the true
and false vocal cords and direct and
indirect laryngoscopy and about the
recurrent laryngeal nerve
The Head I & II 1) describe the general features and principal 2 2

foramina of the skull
2) describe the of muscles of facial
expression
3) describe the muscles of mastication
4) describe the scalp
5) describe the temporo-mandibular joint
6) describe the orbit and extrinsic eye muscles
Development of the 1) describe the development of the pharyngeal 1

Head and Neck arches
Structures I 2) describe the development of the pharyngeal
clefts and pouches
3) describe development of tongue
4) describe development of thyroid gland
Development of the 1) describe the development of face 1

Head and Neck 2) describe the development of nose
Structures II 3) describe common developmental
anomalies of face
Neuromuscular- 1) describe transmission of impulses at the 1

Transmission neuromuscular junction [NMJ]
2) discuss effects of different neuromuscular
blockers on transmission of impulses
Skeletal Muscle 1) explain the molecular basis of muscle 1

Contraction-1 contraction & relaxation
2) explain the characteristics of muscle
contraction-muscle twitch, graded response,
summation, clonus, tetanus & fatigue and
associate them to real conditions in health &
disease
3) explain the length- tension relationship in
whole muscle
4) list the types of muscle contraction in the
body- isotonic, isometric, eccentric
&concentric, isokinetic etc.
5) describe remodelling of muscle to match
function

Skeletal Muscle 1) 1.list the types of skeletal muscle fibers in 1

Contraction-II the body and state their characteristics
2) explain motor unit & its importance
3) explain the role of muscle spindles on
muscle tone
4) define atrophy, dystrophy, hypertrophy,
hyperplasia, hypotonia, hypertonia
5) explainfatigue,rigor mortis, denervation
hypersensitivity, tetanus & tetany
Practical-1 2
Exercise 1) explain effects of physical exercise on 2
Physiology-I & II skeletal muscles
2) list the effects of training on muscles
3) list the effects of aging on muscles
4) list the exercise- associated changes in
cardiovascular and respiratory system
Practical-2 2
Cal lab 2
Bone Physiology 1) list the type of bone cells in osteogenesis 1
2) explain the physiological process of bone
formation& resorption
3) list the hormones and minerals involved in
the process
4) state the effects of exercise and aging on
bone
Tutorial 2
Review 2
Proteins involved in 1) list the various types of structural 1 1

Muscle Contraction proteins in muscle.
2) explain the structure and function of
myosin, actin, troponins, and other
relevant proteins.
3) explain the selected disorders caused by
muscular protein abnormalities.
Energy Production 1) list the various sources of energy. 1

for Muscle 2) discuss glycogen metabolism in liver and
Function muscle.
3) explain the production of acetyl CoA from
lipid, carbohydrate and protein.
4) explain the generation of ATP by glycolysis
and TCA cycle.
5) explain hormonal regulation of Glycogen
metabolism
Structure and 1) discuss the synthesis and types of Collagen

Function of fibres.
Collagen and 2) explain cross linking of the fibres to
Elastin improve strength.
3) discuss the role of elastin in lung function

Proteoglycans and 1) understand Proteoglycans as

Glycoproteins heteropolysaccharide chains
2) with repeating disaccharide units.
3) glycoproteins as short chain carbohydrate
attachments for cell recognition..
4) appreciate the differences between
proteoglycans and glycoproteins.
5) explain the reasons for their role
1.Bone tumours 1 1) Benign bone forming tumours 2

&2 i. osteoma
ii. osteoblastoma
iii. osteoid osteoma
2) Malignant bone forming tumours.
Osteoscarcoma – pathogenesis,
morphology, clinical course and diagnosis.
3) Benign cartilage forming tumours
i. osteochondroma
ii. chondroblastoma
4) Malignant cartilage forming tumours.
Chondrosarcoma
5) Miscellaneous tumours -
i. fibrous dysplasia
ii. Ewing’s sarcoma
iii. Osteoclastoma
6) Metastatic bone tumours
2.Joint disorders 1) Define osteoarthritis (OA) 1

2) Explain pathogenesis of and discuss the
morphology of osteoarthritis
3) Discuss the clinical course and
complications of OA
4) Define rheumatoid arthritis (RA)
morphology of RA
complications of RA
7) define and classify gout
morphology of gout (tophi)
complications of gout
Connective tissue 1) Define systemic lupus erythematous & 1

disorders scleroderma.
2) Explain briefly the aetiology and
pathogenesis of SLE and scleroderma.
3) Discuss the morphological features of these
diseases.
complications of these diseases.

Miscellaneous 1) Describe osteoporosis 1

disorders of bone 2) Describe paget’s disease of bone
3) Morphological features and complication
of these diseases
Tutorial x 2 2
Practicals x 2 1) Osteogenic sarcoma – Gross and 4
microscopic features
2) Chondrosarcoma – Gross and microscopic
features
3) Fibrous dysplasia – Gross and microscopic
features
4) Ewing’s sarcoma – Gross and microscopic
features
5) Ostosarcoma – Gross and microscopic
features
6) Metastasis – Gross and microscopic
features
7) Osteoarthritis – Gross and microscopic
features
8) Rheumatoid arthritis – Gross and
microscopic features
9) Gout – Gross and microscopic features
Viral Exanthems 1) list the common viral exanthems and their 1 1

causative agents
manifestations of viral exanthems
3) describe the laboratory diagnosis of viral
exanthems
4) outline the principles of treatment of viral
exanthems
5) describe the prevention of viral exanthems
Bacterial Skin and 1) list the common skin and soft tissue 1 1
Soft Tissue infections and their causative agents
Infections 2) describe the pathogenesis and clinical
manifestations of skin and soft tissue
infections
3) describe the laboratory diagnosis of skin
and soft tissue infections
4) outline the principles of treatment of skin
and soft tissue infections
5) describe the prevention of skin and soft
tissue infections
Bone and Joint 1) list the causative agents of bone and joint 1 1
Infections infections
manifestations of bone and joint infections
3) describe the laboratory diagnosis of bone
and joint infections
4) outline the principles of treatment of bone

and joint infections

5) describe the prevention of bone and joint
infections
Superficial and 1) define and list the common types of 1 1

Cutaneous Mycoses superficial and cutaneous mycoses
2) list the causative agents of superficial and
cutaneous mycoses and describe their
microbiological characteristics
manifestations of superficial and cutaneous
mycoses
superficial and cutaneous mycoses
superficial and cutaneous mycoses
Subcutaneous 1) define and list the common types of 1 1

Mycoses subcutaneous mycoses
2) list the causative agents of subcutaneous and
describe their microbiological
characteristics
manifestations of subcutaneous mycoses
subcutaneous mycoses
subcutaneous mycoses
Microbiological Fixed Learning Resource/Practical 2

practicals
1) Infections of skin, soft tissues, bone and
joints: Case scenarios
2) Fungi of medical importance
Pediculosis 1) define ‘pediculosis’ and 'pthiriasis'. 1 1

2) explain the life-cycle of lice.
manifestations of the infestation
5) identify the diagnostic stages of lice
6) outline the principles of treatment
control
Larva migrans 1) define ‘larva migrans’ and ‘Visceral larva 1 1

migrans’
2) list the causative agents
3) explain the mode of transmission


control
Myiasis 1) define ‘myiasis.’ 1 1

2) name the important flies causing human
myiasis in Malaysia.
3) explain the types of myiasis.
4) recognize cases of myiasis.
5) explain the pathogenesis, clinical signs &
diagnosis.
6) outline the principles of treatment.
7) outline methods of prevention and control.
8) importance of maggots in medicine/
mechanism in maggot therapy
Hazardous 1) list important venomous arthropods of 1 1

arthropods Malaysia.
2) recognize venomous arthropods and their
poison appendages.
3) state the type of venom and their effects
and clinical manifestations.
4) outline the principles of management of
cases of envenomation
Snake Bites 1) list the important venomous land & sea 1 1

snakes of Malaysia
2) identify venomous snakes in Malaysia.
3) explain the group, types and effects of
snake venom.
4) explain the clinical manifestations of
venomous snake bites.
5) outline the principles of management of
snake bite victims
6) explain the control measures to prevent
snake bites
Scabies 1) define ‘scabies’. 1 1

2) explain the life-cycle of Sarcoptes scabiei.
manifestations of the infection.
interpret the lab findings.
5) outline the principles of treatment.
control
Trichinosis 1) define ‘Trichinosis’ 1 1

2) explain the life-cycle of Trichinella
spiralis.
manifestations and symptom of the
infection
interpret the lab findings


control
Neuromuscular 1) classify neuromuscular blocking drugs 1

Blocking Drugs 2) explain the mechanism of action of
nondepolarizing (competitive) blockers
eg.Tubocurarine
3) describe their pharmacology (both
pharmacodynamic and pharmacokinetic)
4) list their important adverse effects and their
clinical uses
5) list their common drug interactions
depolarising neuromuscular blocking drugs
eg. Succinylcholine
7) describe the pharmacology of
succinylcholine
8) list their important adverse effects and their
clinical uses
Non-Steroidal Anti- 1) recapitulate the actions of 2

Inflammatory prostaglandins as local mediators
Drugs I & II (taught in the BMD block)
(NSAIDs & 2) recollect the cyclooxygenase pathway –
Paracetamol) contrast the functions of COX1 and
COX2(taught in the BMD block)
3) classify NSAIDs
NSAIDs
5) describe the pharmacological actions of
NSAIDs –with special mention about
aspirin
6) explain the pharmacokinetics of aspirin
7) list the adverse effects and clinical uses
of aspirin
8) explain the role of other NSAIDs
paracetamol
10) describe the pharmacological actions of
paracetamol
11) describe the important pharmacokinetic
features of paracetamol
12) list the adverse effects and uses of
paracetamol
13) describe the mechanism, clinical features
and management of paracetamol poisoning
14) list the difference between aspirin and
paracetamol
Tutorial 2

Drugs Used in Gout 1) list the drugs used in gout 2

& Rheumatoid 2) describe the mechanism of action of
Arthritis I & II colchicine , NSAIDs, probenecid,
sufinpyrazone, allopurinol, febuxostat and
glucocorticoids in relation to gout
3) describe the important pharmacokinetic
features of the above drugs
4) describe the adverse effects and important
drug interactions of the above drugs
5) outline and understand the rationale for
drugs used for the management of acute
and chronic gout the
6) list DMARDs (Disease Modifying Anti-
Rheumatoid Drugs) and BRMs (Biological
Response Modifiers) in the treatment of
rheumatoid arthritis
7) describe the mechanism of action, PK and
adverse effects of DMARDs (gold salts,
azathioprine, methotrexate, leflunomide,
penicillamine, sulfasalazine) & BRMs
(infliximab, adalimumab, etanercept)
Tutorial 2
CAL on 1) explain and interpret the effects of 2

neuromuscular depolarizing and competitive blocking
blockers drugs on neuromuscular transmission.
ANATOMY
Text Books
1.Moore, K.L. & Dalley, A.F. and Agur A.M.R. (2010). Clinically Oriented Anatomy
2) Langman, J. (2003). Langman’s Medical Embryology (12th Edition), Jan Langman:
3) Snell, R.S. (2005). Clinical NeuroAnatomy for Medical Students (6th Edition), Little
& Brown: Boston.
4) Junqueira L.C. & Carneiro J. (2005), Basic Histology: Text & Atlas (11th Edition),
5) Drake, R.L., Mitchell A.W.M., Vogl W., and Gray H. (2010). Gray’s Anatomy (2nd
6) Eroschenko V.P. (2008) diFiore’s Atlas of Histology with functional correlations.
7) Snell, R.S. (2008). Clinical Anatomy for Medical Students (8th Edition), Brown:
Boston
8) Ross M.H. and Wojeiech P. (2006). A Text and Atlas: With correlated cell and
9) Moore K.L., Torchia M.G. and Persaud T.V.N. (2007) The Developing Human:

PHYSIOLOGY
Text Book
1. Dee Unglaub Silverthorn, (2010), Human Physiology – An Integrated
Approach, 5th Edition, Pearson-Benjamin Cummings.
1. Ganong WF. (2003). Review of Medical Physiology. 21st Ed. Lange
Medical Publications, Simon & Schuster Asia Pte. Ltd., Singapore
Williams & Wilkins.
Mosby Publishers.
BIOCHEMISTRY
Textbooks
Reference
Philadelphia
PATHOLOGY
Text Books
Livingstone

MICROBIOLOGY
Textbooks
books/McGraw Hill
Reference
PHARMACOLOGY
Text Books
Edinburgh.
New York.

MBBS Curriculum URI/Sem-3/Year-2
Urinary System Block – URI
Course Information
1. Name of Course/Module: Urinary System (URI) Block
2. Course Code: URI 6235
Anatomy
Physiology
12. Dr Mona Mohamad
Biochemistry
16. Dr Sathivel A
17. Dr Jaiprakash M
Pathology

Pharmacology
32. Dr. Sunil (KS)
33. Dr. Ameeta(AP)
Community Medicine
The renal system plays a key role in the normal functioning of the human body. The incorporation
of this system in the program, intends to introduce the students with the gross anatomy, histology
and functions of the urinary system and also the role of kidney in homeostasis. This block also aims
to teach the students on the composition of normal & abnormal urine and renal function tests. The
understanding of the etiopathogensis and clinical features of the disorders related to the urinary
system and the drugs used in their treatment are also emphasized in this block.

L T P O E Total guided learning time

L=Lecture 34 30 5 2 71 Hours
P=Practical Independent learning time
O=Others 143 Hours
(PBL, review discussions)
7. Credit value:
214/40=5.3≈5
8. Prerequisite:
9. Objectives:
KNOWLEDGE
 of the gross anatomy, histology ,blood supply and anatomical relations of the urinary
system.
 of the physiological functions of urinary system.
 on the role of kidney in electrolyte & acid base balance and water homeostasis.
 to list the constituents of normal and abnormal urine
 on the etiopathogenesis, clinical features and morphology of the common disorders of the
urinary system.
 to list the causative agents of urinary tract infection and its laboratory diagnosis.

 to classify diuretics, explain their mechanism of action, pharmacokinetics, adverse effects

,clinical uses and also to explain the rationale for the use of drugs in urinary tract
infections.
 to list the drugs which are toxic to kidneys
SKILLS
 identify and analyze problems and draw appropriate conclusions (PBL).
 Interpret the renal function test.
 Identify common organisms responsible for infections related to the urinary system
ATTITUDE
 identify his/her own learning needs and seek relevant information
Integration
The structure and function of the urinary system its regulation and adjustments in various
environmental condition are integrated with the pathological changes in structure (both
macroscopic and microscopic) and its functions, and also the infections of the urinary system .The
basic relevant diagnostic procedures as well as the drugs used in the treatment of disorders of the
urinary tract are integrated with the knowledge of the disease process.

1. describe the the gross anatomy, histology ,blood supply and anatomical relations of the
urinary system.
2. describe the physiological functions of the urinary system.
3. describe the role of kidney in electrolyte & acid base balance and water homeostasis.
4. list the constituents of normal and abnormal urine
5. discuss etiopathogenesis, clinical features and morphology of the common disorders of
the urinary system..
6. discuss and define the causative agents of urinary tract infection and its laboratory
diagnosis.
7. classify diuretics, explain their mechanism of action, pharmacokinetics, adverse effects
,clinical uses and also to explain the rationale for the use of drugs in urinary tract
infections.
8. list the drugs which are toxic to kidneys
9. identify and analyze problems and draw appropriate conclusions (PBL).
10. identify their own learning needs and seek relevant information (SDL).

a. Breaking down complex problems into more manageable ones
b. Identifying problems
c. Tracing problems to their causes
d. Identifying cause and effect relationships

e. Formulating procedures to solve problems

f. Integrating knowledge from a number of disciplines to solve a problem

a. Writing clear and concise records and reports
b. Presenting technical information to a large group of people
c. Ability to understand and treat an audience accordingly
d. Listening attentively
e. Effectively explaining highly technical information

13. Synopsis:
This block is the third block in semester 3. It will be conducted in 5 weeks. It introduces the students
with the anatomy and physiology of the urinary system and also the role of kidney in homeostasis
which is the input from physiology. This block teaches the students on the compositions of normal
urine & abnormal urine and biochemical functions of the kidney.With this prerequisite knowledge,
the students learn about the etiopathogenesis, clinical features, morphology and diagnosis of the
disorders in the urinary system which is dealt in pathology. Microbiology and parasitology teaches
how infections can affect the urinary system. Alongside the diseases, the students also learn about
the drugs related to the urinary system and also the effect of drugs on the kidney.
The implementation of the course is via lectures (LEC), practicals (PRC), tutorials (TUT) and
other innovative methods example computer aided learning (CAL) lab in pharmacology. Self-
directed learning (SDL) slots in the schedule are discretionary period for students to reflect upon
the lectures and optimize for further reading and perform other assignments (ASG).


2) Summative –

A: MCQ (T/F)
B: MCQ (OBA/OCA)
2.2) URI in the First Professional Exam

A: MCQ (T/F)
B: MCQ (OBA/OCA)
PEO1 Be equipped with current knowledge and skills in the practice of medicine so as to become
safe and caring doctors to fulfill the needs of the nation.
PEO2 Function independently as part of the healthcare team to carry out curative as well as
preventive programme in urban and rural settings
PEO3 A competent practitioner with leadership skills and with high ethical and moral values.
PEO4 Apply critical thinking, problem solving and evidence based practice and with interest in
medical research and innovation.
PEO1 PEO2 PEO3 PEO4
 

investigations.
PLO2 Be able to practice preventive, promotive and rehabilitative medicine at all levels of
society
PLO4 Possess appropriate attitudes, demonstrate empathy and have ability to communicate
effectively with patients and other health professionals.

PLO5 Be able to conduct the practice of medicine with the highest ethical and moral values.
exhibit leadership and managerial skills in any situation of the profession.
PLO7 Be able to embark on research and innovative aspect of medicine in areas of interest.
  
L T P
Gross Anatomy of 1) describe the gross anatomy of the 1
the Kidney & kidneys.
Ureter 2) describe the gross anatomy of the ureters.
3) describe the important relations of the
right and left kidneys.
4) describe the blood supply, innervation
and lymphatic drainage of the kidneys
and ureters.
Histology of the 1) describe the microscopic structure of the 1

urinary tract I kidney.
ureter.
Gross Anatomy of 1) describe the location of the urinary 1 2 2

the Bladder & bladder.
Urethra 2) describe the gross anatomy of the urinary
bladder.
3) describe the important relations of the
urinary bladder in male and female
subjects
4) describe the blood,supply, innervation
and lymphatic drainage of the urinary
bladder.
5) describe the gross anatomy of the male &
female urethra
Histology of the 1) describe the histology of the bladder in 1 2

Urinary System II normal & distended state
2) describe the histology of the male &
female urethra
Development of the 1) describe the development of the 1

urinary system metanephric kidneys
2) describe the development of the urinary
bladder

3) describe the development of the male and

female urethra
4) mention the common defects of the
kidneys and the ureters
5) mention the common anomalies of the
male and female urethra
Glomerular 1) describe the general functions of renal 1

filtration and renal system
circulation 2) describe renal circulation and define RBF
3) describe the filtration process at the
glomerulus and the characteristics of the
glomerular filtrate
4) define glomerular filtration rate (GFR)
and describe the various factors affecting
glomerular filtration
Regulation of GFR, 1) explain the regulation of renal blood flow 1

RBF and glomerular filtration rate.
2) discuss the alteration of glomerular
filtration in disease.
Renal clearance 1) define renal clearance and explain how 1

renal clearance is determined.
2) explain the significance of inulin,
creatinine and para-aminohippuric acid
clearance
Tubular function I 1) list the substances reabsorbed at Proximal 1

– Proximal tubule tubule.
2) explain the reabsorption and secretion of
substances in proximal tubule.
3) define tubular maximum (Tm) and
explain its importance in renal
reabsorption and secretion of substances
Tubular function II 1) list the substances secreted and 1

– Distal tubule reabsorbed at distal tubule.
2) describe the reabsorption and secretion of
substances along the distal tubule.
3) explain the regulation of tubular
reabsorption/secretion of substances
4) explain the alteration of tubular functions
in health disease
Tubular function 1) list the substances secreted and 1

III –Collecting reabsorbed at collecting tubule.
tubule and 2) describe the reabsorption and secretion of
collecting duct substances along the collecting tubule and
collecting duct
3) explain the regulation of tubular
reabsorption/secretion of substances
4) explain the alteration of tubular functions

in health disease
Tutorial-1(L1-6) 2
Renal function test 1) Define renal function tests and enlist 2

various tests
2) Explain the importance of each test in the
light of clinical importance
3) Name the test that is to be performed to
screen a patient for renal disease
4) Explain the factors that can raise BUN
and creatinine other than renal damage
Micturition 1) explain the functions of nerve supply to 1

urinary bladder and sphincters
2) explain the response of urinary bladder to
filling
3) describe the micturition reflex and its
higher centre control
4) outline the mechanisms leading to
abnormalities in the micturition reflex
Role of kidney in 1) explain the renal mechanism for the 1

water homeostasis excretion of dilute urine
2) explain the ‘counter current multiplier’
and ‘counter current exchanger’
mechanism – role of Loop of Henle and
vasa recta
3) explain the mechanism of production of
concentrated urine
4) outline the causes for the disorders of
urine concentrating/diluting ability of the
kidney 5.differentiate osmotic diuresis
and water diuresis
Role of kidney in 1) describe the role of kidney in the 2

electrolyte and acid regulation of sodium
base balance 2) explain the renal regulation of potassium,
calcium and phosphate
3) explain the renal regulation of acid base
balance
Tutorial-2(L5-7) 2
Review 2
Biochemical 1) List the various organic constituents of 1 1

composition of normal urine
normal urine 2) List the inorganic constituents of normal
urine
3) Explain the clinical significance of
measuring the constituents of the normal
urine

Biochemical 1) List the various abnormal constituents in 1

composition of urine
abnormal urine 2) Explain certain clinical conditions for the
presence of abnormal constituents in the
urine
3) Describe the biochemical processes
involved in the presence of the certain
abnormal constituents
Biochemical 1) Discuss the role of kidney in vitamin d 1

function of kidney activation.
2) Discuss the role of kidney in acid - base
balance.
3) Explain the compensation mechanism
involved in the maintenance of acid base
balance.
4) Discuss the renin-angiotensin system
associated with water- electrolyte
metabolism
Glomerular 1) Classify the various glomerular diseases 2

diseases and describe the histopathological
changes in the kidneys.
2) Define glomerular syndromes.
3) Understand the aetiopathogenesis and
clinical manifestations of the glomerular
diseases
Renal tubular 1) Acute and chronic pyelonephritis- 1

diseases aetiology, pathogenesis, clinical features,
morphology and complications.
2) Tubulo-interstitial diseases induced by
drugs and toxins
Tumours of 1) List the common tumours of urinary tract. 1

urinary tract 2) Discuss renal cell carcinoma,
nephroblastoma- etiopathogenesis,
oncogenes, morphology and course.
3) Understand the urinary bladder tumours-
morphology, aetiology and complications
Urolithiasis 1) Define and explain the aetiology, 1

morphology, clinical features and
complications of the urinary stones.
2) Pathophysiology of hydronephrosis
Practical 1) Glomerular and tubulointerstitial 4

diseases.
2) Urolithiasis and Urinary bladder tumours
Tutorial 2

Urinary tract 1) define the terms used in urinary tract 1 1 2

infections (UTI) infections
2) list the organisms commonly associated
with urinary tract infections
manifestations of urinary tract infections
urinary tract infections
5) outline the principles of treatment in
urinary tract infections
6) discuss the prevention of urinary tract
infections
Male genital 1) define the terms used in male genital 1 1 2

infections infections
2) list the organisms commonly associated
with male genital infections
manifestations of male genital infections
4) describe the laboratory diagnosis of male
genital infections
5) outline the principles of treatment in
male genital infections
Infections of the 1) explain the type of clinical specimen 2

urinary system involved in the diagnosis of urinary
diseases.
2) explain the different types of laboratory
tests involved in the diagnosis of urinary
infection.
3) explain the type of antimicrobials
involved in the treatment of urinary tract
infections
Principles in the 1) explain what is significant bacteruria and 1

pharmacological list the common pathogens causing UTI
treatment of 2) explain the general principles in the
urinary tract treatment UTI - acute cases, chronic
infections cases, dose, pH of urine, fluid intake
3) classify drugs used in the treatment of
UTI
4) describe what are urinary antiseptics
5) explain conditions when antibacterial
prophylaxis is indicated
Diuretics & the 1) classify diuretics and relate them to their 2

kidneys sites of action
2) name two drugs that reduce potassium
loss during natriuresis
3) list the major applications and the
toxicities of loop diuretics, thiazides and
potassium-sparing diuretics

4) describe a therapy that will reduce

calcium excretion in patients with
recurrent renal stones
5) suggest a therapy for severe
hypercalcemia in a patient with advanced
carcinoma
6) describe the treatment to help reduce urine
volme in nephrogenic diabetes insipidus
Drug 1) define drug toxicity 1

Nephrotoxicity 2) explain why the kidneys are prone to
toxicity to many groups of drugs
3) discuss the functions of the various
components of the nephrons
4) describe the various mechanisms by
which drugs become toxic to the kidneys
5) describe how drugs can cause acute or
chronic renal failure
6) explain the mechanism by which
analgesic nephropathy is caused
7) describe nephrotic syndrome caused by
drugs
8) list the various other mechanisms by
which drug nephrotoxicity occurs
Tutorial 2
ANATOMY
Text Books
1. Moore, K.L. & Dalley, A.F. and Agur A.M.R. (2010). Clinically Oriented Anatomy
Brown: Boston.
Boston

PHYSIOLOGY
Text Book
Williams & Wilkins.
Publishers.
BIOCHEMISTRY
Textbooks
1. Champe, P.C. and Harvey, RA. (2010). Lippincott’s Illustrated Reviews, Biochemistry (5th
Edition), Lippincott Williams and Wilkins Co. Baltimore
Reference
Mosby, Philadelphia
PATHOLOGY
Text Books
Livingstone

MICROBIOLOGY
Textbooks
books/McGraw Hill
Reference
PHARMACOLOGY
Text Books
Edinburgh.
Hill, New York.

MBBS Curriculum NVS/Sem-4/Year-2
Nervous System Block – NVS
Course Information
1. Name of Course/Module: Nervous System (NSV) Block
2. Course Code: NVS 6247
Anatomy
Physiology
12. Dr Mona Mohamad
Biochemistry
16. Dr Sathivel A
17. Dr Jaiprakash M
Pathology
Pharmacology


32. Dr. Sunil (KS)
33. Dr. Ameeta(AP)
Community Medicine
Diseases of the central nervous System particularly stroke, head injury, cerebrovascular accidents
and tumors are major causes of morbidity and mortality globally. Hence, the course content is
aimed to cover normal structure and function, development, biochemistry of the nervous system.
It also emphasizes on the the processes leading to diseases of the nervous system and the drugs
used in the treatment of such diseases. Subjects are generally synchronized through their similarity
in topic coverage.


T=Tutorial 50 32 15 3 100 Hours
P=Practical
O=Others 100 64 15 15 Independent learning
(PBL, review discussions) 194Hours
7. Credit value: 294/40 = 7.35≈7
8. Prerequisite:
9. Objectives:
KNOWLEDGE
 of the general organization of the brain and spinal cord, the ascending and descending
tracts, the cerebrum and cerebellum, the deep gray masses, blood supply of the brain, the
ventricular system, the special senses as well as the limbic system.
 of the development of the nervous system and role of complex lipids in the integrity of
the system
 of the role of nervous system in the co-ordination and regulation of the activities of all
other organ systems.
 of the role of pathogens and other factors in the disease processes of the nervous system.
 of the molecular and cellular mechanisms involved in drugs acting on the nervous
system.
 to identify and interpret basic relevant investigations to diagnose these diseases
 to explain the preventive and control strategies of these diseases

SKILLS
 interpret the findings of basic relevant laboratory investigations
 demonstrate history taking and basic clinical examination of the nervous
system
 identify and analyse problems and draw appropriate conclusions
ATTITUDE
 Work as a team and communicate with fellow colleagues and seniors.
 identify your own learning needs and seek relevant information (SDL)
Integration
The block integrates the preclinical subjects to make the students understand normal structure and
function with the etiopathogensis and therapeutic aspects of the diseases of the nervous system.
1. describe the general organization of the brain and spinal cord, the ascending and
descending tracts, the cerebrum and cerebellum, the deep gray masses, blood supply of
the brain, the ventricular system, the special senses as well as the limbic system.
2. describe the components of the nervous system.
3. describe the development of the nervous system.
4. explain the role of nervous system in the co-ordination and regulation of the activities of
all other organ systems.
5. explain how complex lipids play a role in the structural components and functional
integrity of the nervous system.
6. describe the role of viruses, bacteria, other pathogens in the disease process of the
nervous system.
7. describe the molecular and cellular mechanisms involved in drugs acting on the nervous
system.
8. describe the consequence of brain tissue damage due to a raise in intracranial pressure,
tumours and intracranial haemorrhage.
9. identify basic relevant investigations to diagnose these diseases
10. interpret the findings of basic laboratory investigations
11. explain the preventive and control strategies of these diseases
12. identify and analyze problems and draw appropriate conclusions
13. identify your their learning needs and seek relevant information




 Use of general information technology..

13. Synopsis:
This block is included as the first block in semester four and extends for seven weeks. It covers
the normal structure, function, development, biochemistry of the nervous system .It involves the
processes leading to diseases of the nervous system. Subjects are generally synchronized through
their similarity in topic coverage in the medical sciences. The general organization of the brain,
spinal cord, the ascending and descending tracts and component parts of neural circuits and the
basal ganglia are discussed. The role of nervous system in the co-ordination and regulation of the
activities of all other organ systems, transmission of impulses in an orderly manner to the brain
and spinal cord, to bring about the appropriate motor changes in order to maintain homeostasis is
taught. Etiopathogenesis and involvement of pathogens and their role in the disease process of the
nervous system along with the rationale of the drugs used in diseases of nervous system, including
their action and side-effects are taught.


2) Summative –

A: MCQ (T/F)
B: MCQ (OBA/OCA)
2.2) NVS in End-Semester Exam

A: MCQ (T/F)
B: MCQ (OBA/OCA)
PEO1 Be equipped with current knowledge and skills in the practice of medicine so as
to become safe and caring doctors to fulfill the needs of the nation.
PEO2 Function independently as part of the healthcare team to carry out curative as well
as preventive programme in urban and rural settings.
values.
interest in medical research and innovation
PEO1 PEO2 PEO3 PEO4
 

investigations
PLO2 Be able to practice preventive, promotive and rehabilitative medicine at all levels
of society.


PLO5 Be able to conduct the practice of medicine with the highest ethical and moral
values.
  
L T P
1) Understand the components and 1
Development& organisation of the nervous system
General 2) Describe the formation of the neural tube
Topography of 3) Describe the formation of the primary and
CNS secondary brain vesicles
4) Have an overview of the basic organisation
of the brain and associated terminologies
Spinal Cord 1) Describe the gross anatomy of the spinal 1 2

cord
2) Describe the spinal meninges and its
clinical significance
3) Describe the external features of the spinal
cord
4) Describe the formation of a spinal nerve
5) Describe the internal organization of the
spinal cord
Brainstem and 1) State the location of the brainstem 1

Cranial Nerve 2) Name the parts of the brainstem
Nuclei I 3) Describe the external features of the
medulla, pons and midbrain
medulla, pons and midbrain:
5) Locate the cranial nerve nuclei.
6) State the functional components of the
cranial nerve nuclei
Brainstem and 1) State the location of the brainstem. 1 2 2

Cranial Nerve 2) Name the parts of the brainstem.
Nuclei II

3) Describe the external features of the

medulla, pons and midbrain.
medulla, pons and midbrain.
5) Locate the cranial nerve nuclei state the
functional components of the cranial nerve
nuclei.
Cerebellum 1) Describe and identify the cerebellum with 1

regard to its
i. location
ii. external features
iii. subdivisions
iv. relations
v. important neural connections
vi. deep cerebellar nuclei
Cerebral 1) Describe the gyri, sulci and lobes of the 1 2 2

Hemisphere and cerebral hemisphere
Cerebral Cortex 2) Describe the principal landmarks that
indicate the divisions
3) Describe the major functional areas of the
cortex
4) Discuss the clinical and functional
importance of the sensory and motor
homunculus
5) Discuss lesions involving the frontal,
parietal, temporal and occipital lobes
6) Overview of white matter of the cerebral
hemisphere
Diencephalon, 1) Describe the boundaries and components 2

Corpus striatum of the diencephalon
and limbic System 2) Describe and identify the anatomy of the
I and II thalamus with regards to its:
i. external features
ii. internal organization
iii. functional organization of the nuclei
3) Describe the topographical anatomy of the
corpus striatum.
4) Describe the components of the corpus
striatum.
5) Describe the connection and functions of
the corpus striatum.
6) Describe the topographical anatomy of the
hypothalamus.
7) Describe the hypothalamic nuclei with its
connections and functions.
8) Describe the components of the limbic
system.
9) Describe the connection and functions of
the limbic system

Ventricles, 1) Describe the ventricular system with regard 1

CSFand Dural to: topographical anatomy & key relations
Sinuses 2) Describe the cerebrospinal fluid (CSF)
with regard to the site of formation,
circulation, absorption & functions
3) Describe the dural venous Sinuses:
i. Inferior & Superior sagittal Sinuses,
ii. Cavernous sinus,
iii. Superior & Inferior petrosal sinuses,
iv. Transverse sinus and
v. Sigmoid sinus
Blood Supply of 1) Describe the arterial supply of the spinal 1

the C.N.S. cord
2) Describe the venous drainage of the spinal
cord
3) Describe the arterial supply of the brain.
4) Describe the cortical distribution of the
cerebral arteries
5) Describe the circle of willis and its
anatomical relationships.
General Sensory 1) Describe the major sensory pathways for 1

Systems the modalities of touch, pressure, pain,
temperature, as well as pathways for
awareness of posture and movement
2) Understand the anatomical basis for
common clinical lesions associated with
the sensory systems
Special Sensory 1) Describe the olfactory receptors and the 1

Systems olfactory pathway to the primary olfactory
and olfactory association areas.
2) Describe the structure of the eye in general
and the cellular organization of the retina.
3) Describe the central visual pathway from
retina to the visual cortex.
4) Describe the visual field on the retina and
visual field defects.
5) Comprehend the anatomical arrangement
of the cochlea and its internal structure.
6) Comprehend the anatomical arrangement
of the semicircular canals and its internal
arrangement.
7) Describe the auditory pathway.
8) Describe the vestibular pathway.
9) Understand the anatomical basis for
vestibular and auditory disorders
10) Describe the receptors and pathway for
taste.
Motor Systems 1) Understand the concept of lower and upper 1 2 2

motor neurones
2) Describe the corticospinal and

corticobulbar tracts.
3) Comprehend the general disposition and
function of the reticulospinal, tectospinal
and vestibulospinal and rubrospinal tracts.
Spinal Cord – 1) describe the functions of major ascending 2

sensory and motor tracts
function 1 & 2 2) explain the physiology of pain and outline
endogenous analgesic system of body
3) explain reflex, reflex arc, classification of
reflexes, reflexes in health and diseases
4) distinguish between upper and lower motor
neuron disorders
5) describe the effect of spinal cord injury
Tutorial-1(L1&2) 1
Functions of brain 1) explain the functions of ascending and 1

stem descending reticular system
2) explain the types of sleep and the
electroencephalogram waves associated
with it
3) list the important brain stem reflexes (recall
from CVS physiology & respiratory
physiology)
Physiology of 1) describe the functions of basal ganglia in 2

Subcortical areas movement control and its applied aspects
1&2 2) explain the functions of hypothalamus
3) explain the functions of thalamus
4) define/explain the terms: rigidity,
dyskinesia, akinesia, tremor, chorea,
hemiballismus and athetosis
Physiology of 1) describe the role of cerebellum in motor 1

Cerebellum control and its applied aspects
Tutorial-2 (L1-6) 2
Cerebral Cortex 1 1) State the functions of the lobes of cerebral 2

&2 cortex.
2) Describe the functions of prefrontal
association cortex.
3) Describe higher cortical functions:
language, learning, memory and speech.
4) Describe electroencephalogram (eeg) and
its clinical application
Review-I 2
Limbic system 1) State the parts of limbic system. 1

2) Describe the functions of limbic system

Cerebrospinal 1) Describe the functions of cerebrospinal 1

fluid, formation, fluid (CSF).
circulation & 2) Describe the normal pressure, volume and
regulation composition of CSF.
3) Explain blood-brain barrier and its
importance
Functions of eye 1 1) List the functions of cornea, conjunctiva, 2

&2 sclera, iris, ciliary body, crystalline lens,
choroid and vitreous humor.
2) Describe the formation of aqueous humor
and its functions.
3) Explain accommodation and describe the
various errors of refraction.
4) Describe light and dark adaptation.
5) Explaincolor vision.
6) Trace visual pathway and defects in vision
due to lesions at various levels.
7) Describe pupillary reflexes and their
importance.
8) Describe accommodation , trace the
pathway for accommodation reflex and its
importance.
Practical-I 2
Function of Ear 1) Describe the functions of external, middle 1

and internal ear.
2) Trace the auditory pathway.
3) Explain the types of deafness.
14. Physiology of 1) Explain the mechanism of stimulation of 1

taste and smell taste buds and olfactory receptors.
2) Describe the taste and olfactory pathway.
Review-II 2
Practical-II 1
Metabolism of 1) list the types of sphingolipids and their 2 1

Complex Lipids 1 functions
&2 2) describe the synthesis and catabolism of
sphingolipids
3) explain the cause of sphingolipidoses and
associated disorders.
Neuro-transmitter 1) list the classes or types of 2 1

I& II neurotransmitters.
2) describe the synthesis and catabolism of
neurotransmitters.
3) describe how alteration in signalling may
cause diseases.

Increased 1) Brain parenchymal injury- concussion and 1

intracranial laceration.
pressure and 2) Traumatic vascular injury- epidural and
cerebral trauma subdural hematomas, their causes,
morphology, clinical features and sequelae.
3) Raised ICP- causes and complications.
4) Cerebral oedema- causes, morphology,
clinical features and complications
Cerebrovascular 1) Transient ischemic attack. 1

diseases 2) Stroke.
3) Haemorrhages in brain-
i. Intracranial haemorrhage
ii. Subarachnoid haemorrhage
iii. Vascular malformations
CNS tumours 1) Gliomas- types, morphology, pathogenesis 2

and clinical features.
2) Neuronal tumors- types, morphology and
clinical features.
3) Medulloblastomas- morphology and
clinical features.
4) CNS Lymphomas- morphology and
clinical features.
5) Meningiomas- types, morphology,
pathogenesis and clinical features.
6) Peripheral nerve sheath tumours
morphology and clinical features
Tutorial X 2 2
Practicals 1 & 2 X 1) Gliomas- types and morphology 4

2) Medulloblastoma- morphology
2 3) Meningiomas- morphology
4) Schwannoma- morphology
5) Brain metastatic tumours- morphology
6) Neurofibroma- morphology
7) Cerebral oedema- gross morphology
8) Cerebral infarct (necrosis)- gross
morphology
Infections of the 1) List the bacterial and fungal causes of 1 1

nervous system infections.
nervous system 2) Explain the pathogenesis of bacterial and
(bacteria and fungal nervous system infections.
3) Describe the clinical manifestations of
fungi) bacterial and fungal nervous system
infections.
4) Describe the laboratory diagnosis of
bacterial and fungal nervous system
infections

5) Outline the principles of treatment of

bacterial and fungal nervous system
infections.
6) Describe the prevention of bacterial and
fungal nervous system infections.
Infections of the 1) Define prion. 1

2) List prion diseases in humans.
Nervous System 3) List the viral causes of nervous system
(Viruses and infections.
4) Describe the epidemiology of viral nervous
prion) system infections and prion diseases.
5) Describe the pathogenesis and clinical
manifestations of viral nervous system
infections and prion diseases.
6) Describe laboratory diagnosis of viral
nervous system infections and prion
diseases.
7) Outline the treatment viral nervous system
infections and prion diseases.
8) Discuss the prevention of viral nervous
system infections and prion diseases.
Infections of the 1) List the bacterial, fungal, viral and prion 2

causes of nervous system infections.
nervous system 2) Explain the pathogenesis of bacterial,
(case scenario) fungal, viral and prion nervous system
infections.
3) Describe the clinical manifestations of
bacterial, fungal, viral and prion nervous
system infections.
4) Describe the laboratory diagnosis of
system infections
5) Outline the principles of treatment of
system infections.
6) Describe the prevention of bacterial,
fungal, viral and prion nervous system
infections.
Toxoplasmosis 1) Define ‘toxoplasmosis’. 1

2) Explain the life-cycle of toxoplasma
gondii.
3) Explain the pathogenesis and clinical
4) Explain the methods of diagnosis and
5) Explain the principles of treatment.
6) Describe prevention and control methods
Opportunistic 1) Define ‘opportunistic parasites'. 1

Parasitic 2) List these parasites.

Infections 3) Explain briefly their morphology and life-

cycles.
4) Explain the predisposing factors to these
infections.
5) Explain the effects of infection on man.
Free living 1) Define primary amoebic 1

amoebic infection meningoencephalitis (pam) and
granulomatous amoebic encephalitis (gae).
2) Explain the life-cycle of naegleria fowleri
and acanthamoeba spp.
3) Explain the pathogenesis and clinical
6) Describe prevention and control methods.
Anti-epileptic 1) Classify anti-epileptic drugs 2

Drugs 2) Describe the various types of epilepsy ( as
shown in the video session earlier)
3) Describe the mechanisms of action of the
commonly used antiepileptic drugs
4) Describe the pharmacology of
diphenylhydantoin (phenytoin) in detail
carbamazepine
ethosuximide
7) Describe the pharmacology of valproic
acid
8) Discuss the role of benzodiazepines in
treating seizures
9) Explain the limitations of the use of
barbiturates
10) Describe briefly the other drugs eg.
vigabatrin, lamotrigine, gabapentin
11) Discuss the drugs used in status epilepticus
General 1) discuss the types of general anaesthesia 1

Anaesthesia 2) describe the Signs and Stages of
Anaesthesia
3) discuss the general mechanisms of action
of general anaesthetics
4) discuss the general pharmacokinetics of
inhaled anesthetics
5) discuss the general pharmacokinetics of
intravenous anaesthetics
6) discuss the effects of the general
anaesthetics on organ systems

7) list the side-effects associated with the use

of these agents
Local Anaesthesia 1) classify the various local anaesthetics (LA) 1

2) discuss the mechanisms of action of local
anaesthetics.
3) discuss the structure-activity characteristics
of local anaesthetics.
4) discuss the actions of LA on nerves.
5) discuss the pharmacokinetics of local
anaesthetics.
6) list the side-effects commonly encountered
with the use of LA.
7) list the clinical uses of LA.
Tutorial 1 2
Sedative-Hypnotic 1) list four examples of sedative-hypnotic 1

drugs
Drugs 2) explain the mechanism by which they cause
sedation
3) describe the adverse effects of the sedative-
hypnotic drugs
4) list the clinical uses of these agents
5) explain why benzodiazepines are preferred
over barbiturates for the treatment of
insomnia
Opioid analgesics 1) classify the opioid drugs. 2

and antagonists 2) describe the pharmacologic responses
associated with the stimulation of the mu- ,
kappa-, delta-opioid receptor subtypes.
3) describe the distribution of opioid receptors
in relation to the types of pain and pain
perception and how morphine interferes
with these processes
4) describe the pharmacological effects and
sites of action of the prototype opioid
agonist, morphine and its utility in relieving
the different types of pain.
5) describe the pharmacokinetic processes
affecting morphine and its absorption,
distribution, metabolism, excretion .
6) describe the distribution of opioids in the
body, including their ability to cross the
blood-brain barrier and the placenta.
7) discuss the salient differences in
pharmacology between morphine and each
of the following full agonists: meperidine,
fentanyl and methadone.
Tutorial -2 2

Drugs used in the 1) describe the major anatomical pathways and 1

treatment of neurotransmitter systems involved in the
Parkinsonism control of motor function
2) discuss the current hypotheses about the
aetiology and pathophysiology of
Parkinson’s disease
3) describe the rationale for the use of
levodopa in Parkinson’s disease and the
rationale for its use in combination with
peripheral L-amino acid decarboxylase
inhibitor
4) discuss how the drug combination alters
levodopa’s therapeutic and adverse effects
5) differentiate the two major classes of direct
DA receptor agonists and indicate how they
are used therapeutically and also indicate
any significant differences in their adverse
effects
6) discuss the use of other classes of drugs in
the treatment of Parkinson’s disease:
anticholinergics, MAO inhibitors, COMT
inhibitors, amantadine
7) discuss drugs that can induce
Parkinson’s disease
Antidepressant 1) explain the amine hypothesis for the 1

Agents pathogenesis of major depression
2) classify antidepressant agents
3) explain the mechanisms of action of the
different classes of antidepressants
4) describe the adverse effects and important
drug interactions of these agents
5) list the clinical indications for these agents
Tutorial - 3 2
Seminar - Drug 1) Define drug dependence & enumerate drugs 1
Abuse of abuse.
2) Problems related to abuse of chemical
substances acutely (e.g., respiratory arrest
from using heroin) or after some length of
time (e.g., dependence or withdrawal from
continued use of an opiate).
3) The treatment approach: Pharmacotherapy
of substance-related disorders is most often
adjunctive to other modes of therapy such as
counseling and intense psychotherapy.
4) Substance-related disorders with alcohol,
nicotine etc
Anti-Psychotic 1) classify antipsychotic agents. 1

Agents and 2) describe the mechanisms of action of
Lithium individual agents.
3) list the adverse effects of individual agents
giving rationale for occurrence.

4) list the psychiatric and non-psychiatric

indications for individual agents.
5) describe the mechanism of action of lithium
6) explain the adverse effects of lithium
7) give the therapeutic indications for lithium
ANATOMY
Text Books
1) Moore, K.L. & Dalley, A.F. and Agur A.M.R. (2010). Clinically Oriented Anatomy
& Brown: Boston.
Boston
PHYSIOLOGY
Text Book
2. Publications, Simon & Schuster Asia Pte. Ltd., Singapore
Williams & Wilkins.
Mosby Publishers.

BIOCHEMISTRY
Textbooks
Reference
3. A Clinical Approach (3rd Edition) Lippincott Williams and Wilkins Co.
Baltimore.
Mosby, Philadelphia
PATHOLOGY
Text Books
1. Vinay Kumar, MBBS, MD, FRCPath, Abul K. Abbas, MBBS and Jon Aster,
MD (2013). Robbins Basic Pathology. (9th Edition) Elsevier Health.
2. Walter and Israel (1996) General Pathology. (7th Edition) Churchill
Livingstone.
3. Marshall W. J. (1992) Illustrated Textbook of Clinical Chemistry. (3rd
Edition) Mosby
4. Underwood J.C.E (2009) General & Systemic Pathology (5th Edition)
Churchill Livingstone
5. Chandrasoma P. and Taylor C.R. (2001) Concise Pathology (3rd Edition)
McGraw Hill International Edition
MICROBIOLOGY
Textbooks
Jawetz Melnick & Adelberg’s Medical Microbiology 25th edition. Lange
medical books/McGraw Hill
Reference
1. Murray, P.R., Rosenthal, K.S., Kobayashi, G.S. and Pfaller M.A. (2008).
Medical Microbiology. 4th ed. St. Louis: Mosby.

PHARMACOLOGY
Text Books
1..Mycek MJ, RA Harvey, PC Champe (2011) Lippincott’s Illustrated Reviews: Pharmacology,
(Eds.) RA Harvey & PC Champe, 5th Edition, Lippincott Williams & Wilkins, Philadelphia
2.Katzung BG (2010). Basic and Clinical Pharmacology, (Eds) Katzung BG, 12th Edition,
3.Rang HP, Dale & Ritter (2012) 7th Edition Pharmacology. Churchill Livingstone, Edinburgh.
3.KD Tripathi, (2010). Essentials of Medical Pharmacology, 6th edition, Jaypee.
4.Goodman Gilman A (2011): Goodman & Gilman’s The Pharmacological Basis of
Therapeutics, (Eds.) Hardman & Limbird, 12th Edition, International Edition McGraw Hill, New
York.

MBBS Curriculum RPD/Sem-4/Year-2
Reproductive System Block – RPD
Course Information
1. Name of Course/Module: Reproductive System (RPD) Block
2. Course Code: RPD6234
Anatomy
Physiology
12. Dr Mona Mohamad
Biochemistry
16. Dr Sathivel A
17. Dr Jaiprakash M
Pathology
Pharmacology


32. Dr. Sunil (KS)
33. Dr. Ameeta(AP)
Community Medicine
Diseases related to the reproductive system are among the common diseases encountered in medical
practice. Hence, the knowledge of the reproductive system helps the student to have a basis for the
obstetrics and gynaecology posting they will undergo during their clinical years. This block teaches
the students about the anatomical and physiological aspects of the male and female reproductive
systems and gain knowledge which will ensure understanding of the pathological conditions of the
reproductive systems of both sexes and subsequent measures to control them therapeutically and by
lifestyle changes.

L T P O E Total guided learning time

L=Lecture 31 16 10 1 2 60 Hours
P=Practical Independent guided learning
O=Others 114 Hours
(PBL, review discussions)
7. Credit value:
174/40=4.3≈4
8. Prerequisite:
9. Objectives:
KNOWLEDGE
 on the gross anatomy and the histology of the male and female reproductive systems
including its blood and nerve supply.
 of the functions of the male and female reproductive systems.
 of the physiology of spermatogenesis.
 on the mechanism of ovulation and menstruation.
 of the physiology of pregnancy and parturition.
 on the biochemical and physiological aspects of lactation.
 on the biochemistry of male and female sex hormones.
 regarding the etiopathogenesis, clinical manifestation, laboratory diagnosis of
sexually transmitted diseases along with other obstetric and perinatal infections.

 of the basic relevant investigations to diagnose the diseases of the reproductive

system.
 on the mechanism of action, pharmacokinetics, adverse effects and indication for the
use of drugs in the diseases of the reproductive system
 on the rationale for the use of common therapeutic agents for the diseases of the
reproductive system .
 on the preventive and control strategies of these diseases.
SKILLS
 perform history taking and examination of gynaecological and obstetrics patient.
 identify and analyse problems and draw appropriate conclusions (PBL).
 interpret the findings of basic laboratory investigations
ATTITUDE
 identify his/her learning needs and seek relevant information (SDL)
Integration
The structure of the reproductive system and the normal functions of its parts and the regulation and
adjustments in various environmental condition are integrated with the pathological changes in
structure (both macroscopic and microscopic) and functions and infections of the reproductive
system .Laboratory diagnosis as well as the drugs used in the treatment of disorders of the
reproductive system are also discussed in this Block.

1. discuss the gross anatomy and the histology of the male and female reproductive
systems including its blood and nerve supply.
2. explain the functions of the male and female reproductive systems.
3. explain the physiology of spermatogenesis.
4. explain the mechanism of ovulation and menstruation.
5. explain the physiology of pregnancy and parturition.
6. explain the biochemical and physiological aspects of lactation.
7. explain the biochemistry of male and female sex hormones.
8. explain the etiopathogenesis involved in the common manifestations of the diseases of
the reproductive system.
9. explain the pathogenesis, clinical manifestation, laboratory diagnosis of sexually
transmitted diseases along with other obstetric and perinatal infections.
10. identify basic relevant investigations to diagnose these diseases.
11. interpret the findings of basic laboratory investigations related to the reproductive
system.
12. explain the mechanism of action, pharmacokinetics, adverse effects and indication for
the use of drugs in the diseases of the reproductive system
13. explain the rationale for the use of common therapeutic agents for the diseases of the
reproductive system .
14. describe the preventive and control strategies of these diseases.




13. Synopsis:
This block is taken up as the second block in Semester 4 over a period of 5 weeks. The approach to
teaching this block is basically the same as with the previous blocks. In anatomy the students are
taught embryology, gross anatomy and histology of the reproductive system. In physiology and
biochemistry, the functional aspects, including topics such as pregnancy, parturition and lactation
are covered. The causative agents, pathogenesis, clinical manifestations, laboratory diagnosis of
the sexually transmitted diseases is discussed under pathology and Microbiology. The drugs used
in the reproductive system which includes androgens, oestrogens, and oral contraceptive are dealt
in Pharmacology.


2) Summative –

A: MCQ (T/F)
B: MCQ (OBA/OCA)
2.2) RPD in the First Professional Part-2 Exam

A: MCQ (T/F)
B: MCQ (OBA/OCA)
PEO1 Be equipped with current knowledge and skills in the practice of medicine so as to become
safe and caring doctors to fulfill the needs of the nation.
PEO2 Function independently as part of the healthcare team to carry out curative as well as
preventive programme in urban and rural settings.
PEO3 A competent practitioner with leadership skills and with high ethical and moral values.
PEO4 Apply critical thinking, problem solving and evidence based practice and with interest in
medical research and innovation
PEO1 PEO2 PEO3 PEO4
 
PLO1 Be competent to make a diagnosis and institute management on common medical and
health conditions based on history, physical examinations and relevant investigations.
PLO2 Be able to practice preventive, promotive and rehabilitative medicine at all levels of
society.

PLO4 Possess appropriate attitudes, demonstrate empathy and have ability to communicate
effectively with patients and other health professionals.
PLO5 Be able to conduct the practice of medicine with the highest ethical and moral values.
  

L T P
Anatomy of the male 1) describe the gross anatomy, innervations 1 2
reproductive system and blood supply of the following male
reproductive organs:
i. Testis, epididymis, ductus deferens,
ejaculatory ducts and seminal
vesicles.
ii. Prostate gland External genitalia
Histology of the Male 1) Describe the microscopic structure of the 1 2

Reproductive System following organs of the male reproductive
system:
i. Testis.
ii. Epididymis.
iii. Ductus deferens
iv. Prostate gland.
v. Seminal vesicles.
vi. Penis
Anatomy of the 1) describe the gross anatomy, innervations 1 2 2

Female Reproductive and blood supply of the following female
System reproductive organs:
i. Ovary.
ii. Uterine tubes.
iii. Uterus.
iv. Cervix.
v. Vagina.
vi. External genitalia
vii. Mammary glands

Histology of the 1) Describe the microscopic structure of the 1 2

Female Reproductive following organs of the female
System reproductive system:
i. Ovary.
ii. Uterine tubes.
iii. Uterus and cervix.
iv. Vagina.
v. Mammary glands.
Embryology of the 1) Describe the development of the gonads.

reproductive system 2) Describe the development of the genital
ducts.
3) Describe the development of external
genitalia.
4) Describe the development of the
mammary glands
5) Mention some common anomalies and
understand its applied relevance
Introduction to 1) explain the phenotypic development of the 1

reproductive male and female reproductive tracts.
physiology 2) explain the process of puberty in males
and females.
3) explain the hormonal basis of puberty.
4) describe the changes in the body at
puberty
5) list some abnormalities and crisis in
puberty
6) state the age-related changes and the
mechanisms in male and female
reproductive system; in utero, puberty
and senescence
Physiology of the 1) explain the function of the major 1

Male Reproductive components of the male reproductive tract
System 2) explain the regulation of secretion of
testosterone and its actions.
3) explain spermatogenesis and its
regulation.
4) state the composition of semen and its
abnormalities.
5) explain the neural, vascular and endocrine
roles in erection and ejaculation.
Physiology of Female 1) explain the hormonal, ovarian and uterine 1

Reproductive System changes during the menstrual cycle
1 - Menstruation and 2) explain the mechanism of ovulation
Ovulation 3) explain the actions of GnRH, FSH, LH,
relaxin, oestrogen and progesterone
Physiology of Female 1) explain the process of fertilization and 1

Reproductive System implantation.
2 - Pregnancy and

Parturition 2) explain the hormonal and physiological

changes during pregnancy.
3) explain the roles of placenta and the
human chorionic gonadotropin (hCG) in
maintaining pregnancy during early post-
implantation.
4) explain the physiology of parturition.
Tutorial-1 (L1-4) 1
Physiology of 1) explain the hormonal control of breast 1

Lactation and development.
Galactogenesis 2) explain the regulation of milk secretion
and the milk letdown process.
3) explain the basis of the inhibition of milk
secretion during pregnancy and the
initiation of lactation after parturition.
Tutorial-2 (L1-5) 2
Menopause and 1) 1.define menopause and andropause. 1

Andropause 2) 2.explain the physiological basis of
(SLP) menopause and andropause.list the effects
of menopause and andropause on
individuals
Metabolism of male 1) define androgens. 1 1

sex hormone 2) describe the biosynthesis of testosterone
in the testis.
3) describe the transport and the mechanism
of action of testosterone.
4) explain the regulation of testosterone
biosynthesis.
5) list the selected biochemical functions of
testosterone.
6) briefly describe the functions of synthetic
androgens
Metabolism of female 1) define estrogens 1

sex hormone 2) describe the biosynthesis of estrogen and
progestrone in the ovary.
3) describe the transport and the mechanism
of action of estrogen.
4) explain the regulation of estrogen
biosynthesis.
5) list the selected biochemical functions of
estrogen and progesterone.
6) briefly describe the functions of synthetic
estrogens.
7) State the causes of congenital adrenal
hyperplasia.
Biochemical 1) Carbohydrate – lactose 1
composition of milk 2) Protein – Casein

3) Amino acid – phenylalanine, methionine,

cystine and taurine
4) Lipids – cholesterol, linolic acid, carnitine
and lipases
5) Minerals
6) Vitamins
7) Anti infectious factors – bifidus factor,
lactobifidus factor, immunoglobulins,
lactoferrin, lysozome, lactoperoxidases
Disorders of male 1) Congenital malformations of penis 1

genital tract-penis 2) Tumors of penis
and prostate 3) Prostate- inflammatory disorders
4) Prostate- Nodular hyperplasia
5) Prostate- Tumors
Disorders of testis 1) cryptorchidism 1

2) ectopic testis
3) tumors of testis- Germ cell tumors (GCT)
and Non- germ cell tumors (NGCT)
Ovarian disorders 1) Classify ovarian tumors according to 1

WHO classification.
2) Discuss the benign ovarian tumors in
terms of aetiology, pathogenesis,
morphology, clinical features, laboratory
findings and complications.
3) Discuss the malignant ovarian tumors in
terms of aetiology, pathogenesis,
morphology, clinical features, spread,
laboratory findings and complications.
Gestational 1) Define gestational trophoblastic disorders. 1

trophoblastic (GTD)
diseases (GTD) 2) Types of GTD
3) Discuss hydatidiform mole in terms of
aetiology, pathogenesis, morphology,
clinical features, laboratory findings and
complications
4) Discuss the invasive mole
5) Discuss the Choriocarcinoma in terms of
aetiology, pathogenesis, morphology,
clinical features, laboratory findings and
complications
Diseases of cervix and 1) Acute and chronic cervicitis 1

vagina 2) What is CIN (Cervical intraepithelial
Neoplasia).
3) Discuss the carcinoma of cervix in terms
of aetiology, pathogenesis, precancerous
lesion, morphology, clinical features,
spread, staging, laboratory findings and
prognosis.

4) Discuss the tumors of vulva and vagina
Diseases of the uterus 1) Understand what the common causes of 1

abnormal uterine bleeding are.
2) Discuss dysfunctional uterine bleeding.
3) Define Endometriosis and types of
endometriosis.
4) Discuss endometriosis in terms of
pathogenesis, morphology, complications
and clinical features.
5) Define endometrial hyperplasia and
discuss about it in term of types.
6) Describe the tumors of uterus.
7) Discuss carcinoma of endometrium in
term of pathogenesis, morphology,
grading, spread, clinical features,
diagnosis and prognosis.
8) Discuss the tumors of myometrium in
terms of morphology, clinical features,
and effect or complications.
Breast- benign 1) Classify benign disorders of the breast: 1

disorders i. Inflammatory diseases
ii. Benign disorders
2) Describe the aetiology of:
i. Acute mastitis
ii. Duct ectasia (Plasma cell
mastitis)
iii. Fat necrosis
iv. Galactocele.
v. Fibrocystic changes
vi. Sclerosing adenosis
vii. Gynecomastia
viii. Breast abscess
ix. Granulomatous mastitis
3) Differentiate fibrocystic change and
sclerosing adenosis from infiltrating duct
carcinomas.
4) Aetiology and pathogenesis of
i. Fibroadenoma
ii. Benign Phylloides tumour.
5) Describe the signs and symptoms of
benign disorders and differentiate these
from malignant tumours.
6) Types of benign epithelial lesions
i. Non-proliferative lesions
ii. Proliferative lesions
(1) Proliferative lesions without
atypia
(a) Epithelial hyperplasia
(b) Sclerosing adenosis
(c) Papilloma
(d) Fibroadenoma
(e) Fibrocystic change

(2) Proliferative lesions with

atypia
(a) Atypical duct hyperplasia
(b) Atypical lobular
hyperplasia
Breast- malignant 1) Classify malignant disorders of the breast

disorders (WHO classification).
i. Non-invasive (in-situ)
a) Intra-ductal carcinoma
b) Lobular carcinoma in situ
ii. Invasive carcinomas:
a) Infiltrating duct carcinoma
(NOS)
b) Medullary carcinoma
c) Tubular carcinoma
d) Invasive comedo-carcinoma
e) Infiltrating lobular carcinoma
f) Malignant Phylloides Tumour
g) Colloid carcinoma
h) Papillary carcinoma
i) Paget’s Disease of the nipple
2) Aetiology and pathogenesis of In situ
carcinomas of breast and Invasive
carcinomas.
3) Role of BRCA1 and BRCA2 genes.
4) Microscopic grading
i. Richardson and Bloom’s grading
system
5) Role of ER and PR receptors and
HER/neu (erb B2) tests. in diagnosis
1. HER2 /neu over-expression
a. Negative: 0
b. moderate:2+
c. Marked: 3+
2. complications and metastasis of
breast cancers
Practical 1 & 2 Male 4

Genital Tract &
Female genital tract
Tutorial 2
Genital Infections / 1) list sexually transmitted diseases/genital 1 1

Sexually transmitted infections which are characterized by
diseases urethritis or mucopurulent cervicitis and
(Bacteria & Yeasts) state the causative agents
2) list the sexually transmitted
diseases/genital infections which are
characterized by genital ulcers and state
the causative agents
3) list the sexually transmitted

diseases/genital infections characterized

by vaginal discharge and state the
causative agents
4) describe the pathogenesis of sexually
transmitted disease/genital infections
5) describe the clinical manifestations of
sexually transmitted disease/genital
infections
6) describe laboratory diagnosis of sexually
transmitted disease/genital infections
sexually transmitted disease/genital
infections
Genital Infections / 1) list the viral causes of sexually- 1 1

Sexually transmitted transmitted diseases
diseases (Virus) 2) describe the pathogenesis and clinical
manifestations of viral sexually-
transmitted diseases
3) discuss the laboratory diagnosis viral
sexually-transmitted diseases
viral sexually-transmitted diseases
5) describe the prevention of viral sexually-
transmitted diseases.
HIV infection and 1) describe the structure of Human 1 1

AIDS immunodeficiency virus (HIV)
2) describe the epidemiology of HIV
infection and AIDS
3) discuss the pathogenesis of HIV infection
and AIDS
4) describe the clinical manifestation of HIV
infection and AIDS
5) describe the laboratory clinical diagnosis
of HIV infection and AIDS
6) outline the principles of treatment of HIV
infection and AIDS
7) discuss the prevention of HIV infection
and AID
Estrogens 1) describe the physiological functions of 1 2

estrogen
2) mechanism of action, pharmacokinetics
and adverse effects of estrogen
3) list the estrogen receptor modulators
4) describe the mechanism and adverse
effects of estrogen receptor modulators
5) describe the role of estrogen in hormone
replacement therapy
Progesterone & 1) Describe the physiological functions of 1 2

Drugs acting on progesterone
uterus

2) Mechanism of action , pharmacokinetics

and adverse effects of progesterone
3) Describe the role of progesterone in
hormone replacement therapy
DRUGS ACTING ON UTERUS:
1) Describe the pharmacological actions,

mechanism and adverse effects of
oxytocin
2) List the uterine stimulants, their
mechanism of action and adverse effects
3) List the uterine tocolytics, their
mechanism of action and adverse effects
Tutorial 1 2 3
Contraceptives 1) list the various types of contraception 1 2

available: oral & others
2) discuss the types of oral contraceptives
(OCs) commonly used..
combination OCs.
4) discuss the mechanism of action of
progestin-only OCs.
5) discuss in detail the effects of OCs on the
ovary, uterus and on the breasts.
6) explain the other important effects of the
OCs – on the cardiovascular system and
on the skin
7) list the mild, moderate and severe adverse
a. effects of the OCs.
b. list the contraindications and precautions
in the use of OCs.
8) discuss other contraceptives and those
used in emergency contraception
Androgens ,anabolic 1) Describe the synthesis, secretion and 1 2

steroids and regulation of androgens
antiandrogens 2) Explain the pharmacological actions of
androgens
3) Explain the Pharmacokinetics
4) Discuss the therapeutic uses
5) List the adverse effects
6) Explain how anabolic steroids differ from
androgens
7) List the therapeutic uses and adverse
effects of anabolic steroids
8) List the antiandrogens and the indications
of their use
Tutorials 1 2

ANATOMY
Text Books
1. Moore, K.L. & Dalley, A.F. and Agur A.M.R. (2010). Clinically Oriented Anatomy (6th
Edition), Wolters Kluwer - Lippincott Williams & Wilkins: Baltimore.
Brown: Boston.
1. Snell, R.S. (2008). Clinical Anatomy for Medical Students (8th Edition), Brown: Boston
PHYSIOLOGY
Text Book
Williams & Wilkins.
Publishers.
BIOCHEMISTRY
Textbooks

Reference
Mosby, Philadelphia
PATHOLOGY
Text Books
Livingstone
MICROBIOLOGY
Textbooks
books/McGraw Hill
Reference
PHARMACOLOGY
Text Books
Edinburgh


New York.

MBBS Curriculum EDM/Sem-4/Year-2
Endocrine System and Metabolism Block – EDM
Course Information
1. Name of Course/Module: Endocrine System and Metabolism (EDM) Block
2. Course Code: EDM6247
Anatomy
Physiology
12. Dr Mona Mohamad
Biochemistry
16. Dr Sathivel A
17. Dr Jaiprakash M
Pathology

Pharmacology
32. Dr. Sunil (KS)
33. Dr. Ameeta(AP)
Community Medicine

The diseases of the endocrine system, like thyroid dysfunction is commonly encountered in
routine practice. Hence, the knowledge of the normal anatomical structure, the physiological and
biochemical functions of the endocrine system, as well as the disease aspects of the system,
treatment , prevention and control of these diseases is an essential aspect of the program. This
block also aims to teach the students on how the endocrine system maintains the homeostasis of
the internal environment by releasing hormones, and how hormonal imbalance can affect the
normal functioning of the body.


T=Tutorial 44 32 29 2 107 Hours
(PBL, review discussions) 191Hours
7. Credit value: 298/40 = 7.4 ~ 7
8. Prerequisite:
9. Objectives:
KNOWLEDGE
 of the gross anatomy, histology of the endocrine glands along with the functions of
the endocrine glands and the control mechanisms at the physiological and
biochemical levels.
 of the etiopathogensis of the endocrine disorders.
 of the macroscopic and microscopic pathological features of the endocrine diseases.
 of correlation of the pathological processes with the clinical features explaining the
associated complications of endocrine diseases.

 to identify basic relevant investigations helping in the diagnosis of these diseases.

 to interpret the findings of the basic relevant laboratory investigations.
 to explain the rationale for the use of common therapeutic agents in endocrine related
diseases and
 of the preventive and control strategies of endocrine diseases.
SKILLS
 interpret the findings of basic relevant laboratory investigations

 demonstrate basic history taking and clinical examination of the endocrine
system
 identify and analyze problems and draw appropriate conclusions
ATTITUDE
the students will have the attitude to:
 be a team worker and a good communicator
 identifying their own learning needs and seek relevant information
Integration
Students are taught to integrate normal structure and function with the etiopathogenesis and
therapeutic aspects of the diseases of the endocrine system.
1. describe and identify the gross anatomy and the histology of the endocrine glands.
2. explain the functions of the endocrine glands and the control mechanisms at the
physiological and biochemical levels.
3. explain the etiopathogenesis of endocrine disorders.
4. describe the macroscopic and microscopic pathological features of endocrine diseases.
5. correlate the pathological processes with the clinical features explaining the associated
complications of endocrine diseases.
6. identify basic relevant investigations helping in the diagnosis of these diseases.
7. interpret the findings of the basic relevant laboratory and investigations of endocrine
disorders.
8. explain the rationale for the using of common therapeutic agents in related diseases.
9. explain the preventive and control strategies of endocrine diseases.




13. Synopsis:
The Endocrine System and Metabolism Block is incorporated as the last block of the phase one
program. It is in the fourth semester and extends for five weeks. In this block the students will
study the normal anatomical structure, the physiological and biochemical functions of the
endocrine system. It also covers the etiopathogenesis of the diseases of the endocrine systems and
also the treatment and the prevention of these diseases.

2) Summative –


A: MCQ (T/F)
B: MCQ (OBA/OCA)
2.2) EDM in the First Professional Part-2 Exam

A: MCQ (T/F)
B: MCQ (OBA/OCA)

the nation.

moral values.
PEO1 PEO2 PEO3 PEO4
 




moral values.


of interest.
  
L T P
Gross anatomy of 1) Identify and describe the gross 1 2 2
pituitary, thyroid, anatomy of the major endocrine
parathyroid & adrenal glands
glands and pancreas
Histology of the Pituitary 1) Describe the histology of the 1

and Thyroid Gland hypothalamus, pituitary gland,
thyroid gland and parathyroid
gland
Development of endocrine 1) Describe the development of the 1

glands major endocrine glands
Histology of the 1) Describe the histology of the 1

Parathyroid, Adrenal adrenal gland and pancreas (both
gland and Endocrine endocrine and exocrine)
Pancreas
Pituitary hormones 1 1) define hormone, classify hormones 1

& state their mechanism of action
2) describe the relation between
neural and endocrine physiology as
it pertains to the hypothalamus and
pituitary
3) define neuron-neuron interactions,
hypophysiotropic hormones, and
the concepts of feedback and feed
forward loops
4) list the characteristics and actions
of the hypophysiotropic hormones:
thyrotropin releasing hormone
(TRH); gonadotropic releasing
hormone (GRH); somatostatin;
corticotropin releasing hormone
(CRH); growth hormone releasing
hormoneGHRH); prolactin

inhibitingfactor (PIF) and releasing

factor (PRF)
5) describe the effects of these various
hormones of pituitary gland:
Antidiuretic hormone.
ACTH, TSH,
Prolactin, Oxytocin, Gonadotropin
s [ recall RPD Block]
Pituitary hormones 2 1) describe the actions of growth 1

hormone
2) explain the regulation of secretion
of growth hormone
3) describe the effects of hypo and
hyper secretion of growth hormone
Thyroid hormones and 1) describe the physiological actions 2

thermoregulation and mechanisms of action of
thyroid hormone
2) explain how circulating levels of
thyroid hormones are regulated.
3) evaluate thyroid function in health
and disease and physiological
variables affecting pituitary-
thyroid function.
4) describe the effects of various drugs
on thyroid function.
5) recognize the role of thyroid
hormones and the hypothalamus in
thermoregulation
Tutorial-1(L1-3) 2
Physiology of hormones 1) explain the role of parathyroid 1

involved in calcium hormone, calcitonin and 1, 25
homeostasis dihydroxycholecalciferol in the
calcium homeostasis
2) describe regulation of secretion of
parathyroid hormone, calcitonin
and 1, 25 dihydroxycholecalciferol
3) describe the effects of hypo and
hyper secretion of parathyroid
hormone, calcitonin and 1, 25
dihydroxycholecalciferol
4) describe the signs used to detect the
early tetany
Physiology of endocrine 1) describe control of insulin secretion 2

pancreas & recognize intracellular events
associated with insulin action.
2) identify tissue-specific sites of
insulin action.
3) describe the action of somatostatin.
4) identify the neuronal control of

pancreatic hormones.
5) recognize the role of various
hormones in metabolic regulation
during starvation
Tutorial-2 (L4&5) 2
Review(L1-6) 2
Adrenal hormones 1 and 2 1) identify the molecular mechanisms 1

and physiological actions of each
class of steroid hormone
(mineralocorticoids
glucocorticoids, and sex
hormones).
2) recall the physiology of adrenergic
axon terminals and chromaffin
cells, biological effect of
catecholamines, and the biological
roles of epinephrine and
norepinephrine as hormones and
neurotransmitters.
3) identify effects of hyper and hypo
secretion of adrenal hormones
Tutorial-3(L6-8) 2
Hormones of pineal gland, 1) describe the functions of pineal 2

heart, kidney and hormone (melatonin)
gastrointestinal tract 2) explain the functions of hormones
of the kidney and heart
3) explain the functions of gastro-
intestinal tract hormones
Review(L7&8) 2
Biochemistry of Protein 1) define hormone and differentiate it 1 1

and Steroid Hormones from enzyme.
2) discuss the classification of
hormones based on its chemical
structure.
3) discuss different hormones based
on biosynthesis, storage, secretion ,
transportation.
4) explain the feedback mechanism
that regulates hormone
biosynthesis.
5) describe the role of receptors in
hormone action.
that produce metabolic or
physiological responses.

Metabolism of thyroid 1) name the hormones produced by 1

hormones thyroid gland
2) describe the biosynthesis, storage,
secretion and transportation,
mechanism of action and
subsequent catabolism and
excretion of thyroid hormones
3) explain the effects of thyroid
hormones on intermediary
metabolism, thermogenesis, and on
growth
4) describe briefly the effects of T3
and T4 on cardiovascular system
and digestive tract
5) describe the regulation of thyroid
hormones synthesis
6) describe the principles of various
biochemical test used for the
determination of thyroid function
test
Biochemistry of insulin 1) name the hormones secreted by

and glucagon GIT and the islets of Langerhans in
pancreas
2) discuss the biosynthesis with
emphasis of structural changes
during activation
3) discuss secretion and subsequent
action on target tissues
4) explain the function of insulin and
glucagon in the homeostasis of
glucose
5) explain the biochemical disorder in
the homeostasis of glucose in
diabetes mellitus
6) explain the path-physiology of the
symptoms such as polyuria,
glycosuria and ketoacidosis
commonly exhibited by
uncontrolled diabetic patients
7) explain the principles of laboratory
tests used for the diagnosis and
monitoring diabetes mellitus
Blood glucose homeostasis 1) outline the role of insulin and

glucagon in the homeostasis of
glucose
2) explain the metabolic changes in
maintaining glucose homeostasis
fasting and postprandial states
3) explain the biochemical disorder in
the homeostasis of glucose in
diabetes mellitus

4) explain the path-physiology of the

symptoms such as polyuria,
glycosuria and ketoacidosis
commonly
5) exhibited by uncontrolled diabetic
patients
6) characterize type 1 and type 2
diabetes mellitus
7) explain the principles of laboratory
tests relevant for the diagnosis and
monitoring of diabetes mellitus
Metabolism of adrenal 1) name the hormones synthesized by 1 1

hormones adrenal glands
2) describe the biosynthesis, secretion
and transportation in blood of
above hormones
3) explain the mechanism of action
and the biochemical effects of
glucocorticoids on carbohydrate,
lipid and protein metabolism
4) describe the role of glucocorticoids
that opposes the effects that are
produced by various stress stimuli
5) describe the excessive effect of
glucocorticoids such as
immunosuppressive, anti-
inflammatory and anti-allergic
reaction
6) describe other effect of
glucocorticoids on bone, calcium
and water excretion
7) describe the effect of
mineralocorticoids homeostasis of
sodium, potassium and water
8) discuss the effect of
mineralocorticoids on acid base
balance
non-neoplastic disoders of 1) Describe the hypo and 1

thyroid hyperthyroidism
2) Describe the causes of goitre
3) Classify thyroiditis and explain the
aetiopathogenesis of the various
types of thyroiditis
neoplastic disorders of 1) Classify the various thyroid 1

thyroid neoplasms-
i. Benign tumours of thyroid
ii. Malignant tumours.
2) Describe the various benign and
malignant thyroid neoplasm.

3) Discuss the aetiology, clinical

manifestations and complications
of thyroid neoplasm.
4) Describe the histological feature of
i. Adenomas- types
ii. Papillary carcinoma
iii. Follicular carcinoma
iv. Medullary carcinoma
v. Anaplastic carcinoma
disorders of endocrine 1) Describe the classification, 1

pathogenesis, clinical features and
complication of diabetes mellitus.
2) Diagnose diabetes mellitus type
two and differentiate it from type
one diabetes mellitus.
disorders of adrenals 1) Describe the common disorders 1

that affect the adrenal medulla.
2) Describe the disorders that cause
hypo and hyper function of adrenal
cortex.
3) Gross and histological feature of
pheochromocytoma
Practical -1 & 2 1) Identify the disorders of thyroid. 4

Endocrine disorders 2) Identify the types of pancreatitic
neoplasm.
3) Identify the disorders of adrenal
glands.
Tutorials x 2 2
Immunization 1) differentiate active and passive 1 1

immunization
2) describe the different types of
vaccines and routes of
administration
3) describe the immune response
following the different types of
immunization
4) describe the childhood
immunization program in Malaysia
5) describe the recommended adult
immunization program in Malaysia
6) list the contraindications of
immunization
Systemic mycoses 1) define systemic mycoses. 1 1

2) list the types of systemic mycoses.
3) list the causative agents of systemic
mycoses.

4) describe briefly the

microbiological characteristics of
the causative agents of systemic
mycoses.
5) describe the pathogenesis and
clinical manifestation of systemic
mycoses.
6) describe laboratory diagnosis of
systemic mycoses.
of systemic mycoses.
Infections in the immuno- 1) classify infections in the 1 1

compromised host immunocompromised host
2) describe infections in febrile
neutropenics, outline of treatment
and preventions
3) list the opportunistic infections in T
cell defect and hypogamma-
globulinemia
4) describe the infections associated
with comple- ment deficiency
5) describe the infections in asplenic
patients, outline of treatment and
preventions
6) describe infections in transplant
patients
Hospital infections 1) define hospital infection 1 1

2) list the common pathogens and the
sources (endogenous and
exogenous) of hospital infections
3) explain the modes of transmission
of hospital infections
4) discuss factors which predispose
patients to hospital infections
5) describe common types of hospital
infections
6) describe the control and prevention
of hospital infections
Thyroxine and anti- 1) outline the regulation and the key 1

thyroid drugs steps in thyroid hormone synthesis
and peripheral conversion
2) explain the mechanism by which
thyroid hormones regulate cellular
function
3) describe the pharmacological
effects of these hormones
thyroid hormones
5) list the commonly used antithyroid
drugs and describe their

mechanisms of action, kinetics and

side effects
6) provide the rationale for the use of
propranolol in the treatment of
hyperthyroidism.
Drugs Acting on Calcium 1) describe the homeostasis of body 2

Homeostasis calcium, phosphate magnesium
2) list the pharmacological agents
used in hypocalcaemia
3) list the pharmacological agents that
increase calcium levels
4) discuss the mechanism of action,
uses and adverse effects of the
following:
i. pharmacological agents
ii. bisphophonates
iii. plicamycin
iv. calcitonin,
v. estrogen & raloxifen
vi. calcium
vii. vitamin D
Tutorial 1 2
Pharmacology of Insulin 1) list the various insulin preparations 1

and Glucagon 2) discuss the onset of action and
duration of action for each
principle type of insulin
preparations
insulin
4) discuss the important actions on
target organs e.g. liver, muscle and
adipose tissue
5) discuss the adverse effects and
complications of insulin therapy
glucagon
7) describe the relative roles of
insulin and oral hypoglycemics in
the treatment of type I and type II
diabetes mellitus
Oral hypoglycaemic drugs 1) distinguish between Type I and 1

Type II diabetes mellitus (DM)
2) classify the clinically useful oral
hypoglycaemic drugs
sulphonylureas
4) discuss the pharmacokinetics and
side-effects of sulphonylureas
5) discuss the drug interactions seen
with sulphonylureas

6) discuss the pharmacokinetics and

side-effects of biguanides
meglitinide, glucosidase inhibitors
and thiazolidinediones and list their
clinical uses and adverse effects.
Tutorial 2 2
Glucorticoids & 1) list the commonly used 2

Mineralocorticoids glucocorticoids and
mineralocorticoids
the glucocorticoids and
mineralocorticoids
3) discuss the actions of these steroids
on carbohydrate, protein and fat
metabolism
4) describe their regulatory effects: on
the hypothalamus and pituitary, on
the blood vessels, and on
cellular events
glucocorticoids
6) explain the important side-effects
of the glucocorticoids and
mineralocorticoids
7) list the common clinical uses of
these drugs
Tutorial 3 2
ANATOMY
Text Books
1) Moore, K.L. & Dalley, A.F. and Agur A.M.R. (2010). Clinically Oriented Anatomy
& Brown: Boston.
Boston


PHYSIOLOGY
Text Book
1) Dee Unglaub Silverthorn, (2010), Human Physiology – An Integrated Approach,
Williams & Wilkins.
Publishers.
BIOCHEMISTRY
Textbooks
Reference
Mosby, Philadelphia
PATHOLOGY
Text Books

Mosby
Livingstone
MICROBIOLOGY
Textbooks
books/McGraw Hill
Reference
PHARMACOLOGY
Text Books
Edinburgh.
Hill, New York.

MBBS PROGRAM
Non-block modules
Phase-1
(Year-1 and Year-2)

MBBS Curriculum ECE/Phase-1
Early Clinical Skills Module – ECE
Course Information
1. Name of Course/Module: Early Clinical Exposure Module
2. Course Code:
25. Assoc. Prof. Dr. Htin Aung

26. Dr. Lee
27. Dr. Celine
35. Dr Jaiprakash M
38. Dr. Sunil (KS)
39. Dr. Ameeta(AP)
41. Dr. Lilli Jacob
This module is implemented in all 4 semesters of the phase-1 of the MBBS curriculum. It
includes the introduction to history taking, physical examination and basic clinical
procedures. Students are exposed to the basic principles and techniques in history taking and
physical examination of a system in a respective block so that they have an opportunity to
integrate and apply their theoretical knowledge in clinical history and examination.
5. Semester and Year offered:

Semester 1, Year 1
Semester 2, Year 1
Semester 3, Year 2
Semester 4, Year 2


L=Lecture L T P O E Total Guided

T=Tutorial 27 27 54 1.5 109.5 hrs
P=Practical
O=Others 54 54 54 7.5 Independent Learning
(PBL, review discussions) 169.5 hrs
7. Credit value:
279/40 = 6.97 ~ 7
8. Prerequisite:
9. Objectives:
KNOWLEDGE
Students will be trained during this module to
1. Know the basic principles in clinical history taking
2. Know the techniques in physical examination
3. Apply the theoretical knowledge in history taking
4. Apply their basic medical knowledge in physical examination
5. Know the basic principles of some bedside clinical procedures
SKILLS
Students will be trained during this module to
1. Perform the clinical history taking according to each system in phase-1
2. Perform the physical examination
3. Demonstrate the bedside clinical procedures on the manikin
ATTITUDE
At the end of the module, students will be able to
1. develop an idea of the importance of history taking and physical examination in the
medical practice
2. develop effective communication and etiquette
3. show the respect on the profession and patients
At the end of this module, students will be able to
1. demonstrate the hand-washing techniques

2. take the clinical history taking in terms of cardiovascular, haematology, respiratory,
gastrointestinal, urinary, reproductive, musculoskeletal, nervous and endocrine
systems
3. conduct the focused history taking in the above systems
4. perform the physical examination in the above systems
5. demonstrate some bedside procedures of the above systems



 Understand the economics and principles of management in the health industries
 Awareness by health care professionals to improve healthy individuals, normal

pregnancy outcomes and providing healthier babies.
Teaching will be in lecture and demonstration modes followed by practical sessions on the
history taking, physical examination and bedside procedures.
At the end of the semester, students are given an opportunity to evaluate the course and the
lecturer. Assessment is through formative and summative strategy. Throughout each block,
students are assessed and monitored by assignments and during the practical to check their
understanding and improvement.
13. Synopsis:
The implementation of the course is via lectures (LEC), demonstration and practical
(PRC). Self-directed learning (SDL) slots in the schedule are discretionary period for
students to reflect upon the lectures and optimize for further reading and perform
assignments (ASG).
Ther are generally 2 types of assessment used in the course.

1) Formative assessment: assignment and practical
2) Summative –
2.1) Continuous Assessment - 40%
2.2) OSCE at the end of each semester (starting from semester-2) - 60%


medicine so as to become safe and caring doctors to fulfill the needs
of the nation.

and moral values.
PEO1 PEO2 PEO3 PEO4
 




professionals.
and moral values.

areas of interest.
  


L T P
Hand washing 1. explain the importance of routine 1 1 2
technique hand washing
2. explain the three different kinds of
hand washing
3. list the steps of routine hand washing
4. perform a proper hand washing
General history 1. explain the process of history 1 1 2

taking taking and physical examination
2. take a systematic detailed history
from the patient
3. take a proper history from patients
presenting with pain
4. build rapport with the patient
5. communicate effectively with the
patient
Vital signs 1. assess the vital signs of the patient 1 1 2

by accurately measuring and
interpreting:
- the blood pressure (using the
sphygmomanometer)
- pulse rate, respiration rate, and
temperature.
Basic physical 1. perform basic physical examination 1 1 2

examination skills which includes inspection,
palpation, percussion and
auscultation
History taking in 1. utilise a systematic and holistic 1 1 2

cardiovascular approach to history taking.
system 2. elicit and record an appropriate
clinical history from patients
presenting with a cardiovascular
problem.
3. obtain appropriate background
information: past medical history,
drug history, allergy, family history
and social information.
4. apply critical reasoning skills to
identify differential diagnoses.
5. identify the risk factors for coronary
heart diseases.
6. list the various causes of chest pain.
7. explain the pathophysiology of
coronary heart disease.
patient, relatives and others by being
able to:
- empathise via active listening

skills and recognition of the

nuances of non-verbal
communication.
- build rapport and trust with the
patient.
- explain to the patient of
confidentiality of information.
- obtain appropriate valid consent,
defining associated
underpinning medical/legal and
ethical principles.
- communicate information to
others
Physical 1. explain to the patient of 1 1 2

examination in confidentiality of information.
cardiovascular 2. gain appropriate valid consent,
system defining associated underpinning
medical/legal and ethical principles.
3. determine the peripheral pulses,
measure the rate and describe
characteristics of the pulses
4. measure the blood pressure.
5. observe for raise in the jugular
venous pressure.
6. conduct a complete cardiovascular
system examination in a proper and
acceptable manner.
7. describe the component of
cardiovascular system examination.
8. explain and share with the patient,
using simple language, the findings
of the examination
Procedural skill: 1. prepare the patient for a 12-lead 1 1 2

Performing a 12- electrocardiography.
lead 2. prepare the equipments and
electrocardiography materials required for performing a
(ECG) & interpra- 12-lead electrocardiography.
tations 3. explain to the patient / family on the
technique and purpose of
performing an electrocardiography.
4. obtain appropriate valid consent,
defining associated underpinning
medical / legal and ethical
principles.
5. explain to the patient of
confidentiality of information
6. systematically interpret a basic
electrocardiogram
Focused history 1. utilise a systematic and holistic 1 1 2

taking in Haemato- approach to history taking.

logy system 2. elicit and record an appropriate

clinical history from patients with
hematological problems.
identify differential diagnosis.
patient by being able to:
communication
patient
- obtain appropriate valid
consent, defining associated
ethical principles
others
6. list the possible causes of anemia
and enlarged lymph nodes
Focused physical 1. describe the components of 1 1 2

examination in hematopoietic system examination.
haematology system 2. explain to the patient of
3. conduct a complete hematopoietic
system examination in a proper and
acceptable manner.
4. examine the axillary, cervical and
supraclavicular lymph nodes.
5. perform Hess test.
6. gain appropriate valid consent,
medical/legal and ethical
principles.
of the examination
Procedural skills: 1. prepare the patient for intravenous 1 1 2

Intravenous blood blood sampling
sampling 2. prepare the equipments and
(Venepuncture) materials required for intravenous
blood sampling and for dispatch of
the collected specimen to the lab
3. explain to the patient about the
purpose, technique, complications
of intravenous blood sampling

4. explain to the patient with regard to

his / her rights as a patient e.g. to
refuse the procedure as well as to the
5. practise proper aseptic technique
6. position the patient in the ideal
position for intravenous blood
sampling
7. choose a suitable site for obtaining
an intravenous blood sample
8. perform safely proper intravenous
blood sampling
9. request and dispatch the specimen to
the laboratory

respiratory system approach to history taking
2. elicit and record an appropriate
respiratory symptoms
and social information
4. identify differential diagnoses by
applying critical reasoning skills
6. empathise via active listening skills
and recognition of the nuances of
non-verbal communication
7. build rapport and trust with the
patient
medical/legal and ethical principles
10. communicate information to others
Focused physical 1. describe the components of 1 1 2

examination in respiratory system examination
respiratory system 2. explain to the patient on the
3. conduct a respiratory system
examination in a proper and
acceptable manner
of the examination

Procedural skills: 1. identify the various parts of a 1 1 2

Nebulizer inhalation nebulizer machine
technique and peak 2. assemble a nebulizer machine
expiratory flow rate 3. explain to the patient / family on the
measurement technique and purpose of
administering medicated air using a
nebulizer
4. administer medicated air using a
nebulizer machine
5. fill up patient’s medication kardex
and progress note
6. explain to the patient / family on the

technique and purpose of measuring
a peak expiratory flow rate
7. perform a peak expiratory flow
measurement

Gastrointestinal approach to history taking
system 2. elicit and record an appropriate
gastrointestinal problems
identify differential diagnosis
nuances of non- verbal
communication
patient
consent, defining
associated underpinning
principles
others
Physical 1. describe the components of 1 1 2

examination in abdominal examination
gastrointestinal 2. explain to the patient of
system confidentiality of information.
3. conduct a systematic examination of
the abdomen in a proper and

acceptable manner.
4. identify the nine regions of the
abdomen.
5. identify and describe the surface
marking of the gastrointestinal
system.
6. describe common causes of common
palpable abdominal masses.
7. describe in detail the characteristics
of a palpable mass.
using simple language, the
findings of the examination
Procedural skills: 1. discuss nasogastric tube insertion 1 1 2

nasogastric (NG) 2. describe the various types of NG
tube insertion tubes used in the procedure
3. insert Ryle’s NG tube in a proper
manner
4. describe the various methods
assessing the position of the tube
after insertion.
5. assess the proper placement of the
tube after insertion by injecting air
and listening for the air flow over the
epigastrium
6. properly document relevant
information related to the procedure
in the patient’s progress note.
History taking in 1. utilize a systematic and holistic 1 1 2

reproductive system approach to history taking
gynecological problems
3. obtain appropriate menstrual history
4. obtain appropriate past
gynecological and past obstetrics
history
drug history (including
contraception), allergy, family
history and social information
6. formulate differential diagnosis by
a. empathise via active listening

communication
b. build rapport and trust with the
patient
c. explain to the patient about the
d. obtain appropriate valid
consent, defining associated
ethical principles
e. communicate information to
others
Physical 1. perform a safe and systematic pelvic 1 1 2

examination: Pelvic examination
Examination – 2. explain to the patient the methods
speculum and and equipments used in performing
bimanual a pelvic examination
examination 3. explain to the patient the indications
for a pelvic examination
4. obtain appropriate valid consent
from the patient
confidentiality of information and
her right in refusing the procedure
without losing her rights to treatment
6. prepare the appropriate equipment
for performing a pelvic examination
7. position the patient for a pelvic
examination
8. perform a speculum examination on
female pelvic trainer
9. perform a bimanual examination on
a female pelvic trainer
Procedural skills: 1. to perform a traditional single slide 1 1 2

taking a cervical based cervical smear (traditional
smear (papanicolau Pap smear)
smear) 2. explain to the patient on the methods
and equipment used for performing
a Pap smear
3. explain to the patient the indications
and contraindications of Pap smear
4. explain to the patient the
recommended frequency of testing
5. explain the various classification
schemes of Pap smear
6. obtain appropriate valid consent
from the patient
her right in refusing the procedure
without losing her rights of
treatment
8. prepare proper equipments and

materials for performing a Pap

smear
9. position the patient for a Pap smear
10. perform a traditional single slide
based Pap smear; including
collection of cervical samples,
smearing on a slide, fixing and
labeling
11. fill up a request form.
of the examination.
13. dispatch the collected samples to the
laboratory
History taking in 1. effectively take a focused history 1 1 2

Urinary system from a patient presenting with
urinary tract disease
2. utilize a systematic and holistic
approach to history taking
urological problems
a. empathise via active listening
communication
b. build rapport and trust with the
patient
c. explain to the patient about the
d. obtain appropriate valid consent,
e. communicate information to others
Physical 1. perform a digital rectal examination 1 1 2

examination in and proctoscopy
urinary system: 2. explain to the patient on the
digital rectal methods, equipment used, and the
examination indications for performing a digital
technique & rectal examination and proctoscopy
proctoscopy 3. obtain appropriate valid consent
from the patient


his or her right in refusing the
procedure without losing his / her
rights of treatment
materials for performing a digital
rectal examination and proctoscopy
6. position the patient for a rectal
examination
7. perform a digital rectal examination
8. evaluate the clinical findings of the
prostate gland
9. perform a proctoscopy examination
of the examination
Procedural skills: 1. Able to safely insert a urinary 1 1 2

Male and female catheter into the urinary bladder of
urinary a male and female adult patient
catheterization 2. describe the various types and sizes
technique of urinary catheter
3. discuss the indications for urinary
catheterizatio
4. discuss the complications of urinary
catheterization
5. explain to the patient on the
methods, equipment used,
indications and complications of
urinary catheterization
6. gain appropriate valid consent from
the patient
materials for urinary catheterization
8. insert a Foley urinary catheter in an
adult male
9. insert a Foley urinary catheter in an
adult female
10. properly documented relevant
information related to the procedure
in the patient’s progress note
History taking in 1. to effectively take a focused history 1 1 2

Musculoskeletal from a patient presenting with
system musculoskeletal disease
musculoskeletal problems


nuances of non- verbal
communication
patient
- explain to the patient about the
consent, defining
associated underpinning
principles
others
Physical 1. able to systematically perform a 1 1 2

examination in GALS screening examination
Musculoskeletal 2. describe the components of GALS
system screening examination.
5. assess the integrity of the
musculoskeletal system
6. conduct a systematic GALS
screening examination
of the examination
Procedural skills: 1. prepare the patient for intramuscular 1 1 2

safe injection injection
techniques – 2. prepare the appropriate equipments
intramuscular required for intramuscular injection.
injection 3. explain to the patient on the purpose,
technique and complications of the
procedure.
4. choose an appropriate intramuscular
injection site.
5. perform the procedure safely.
6. fill out the patient drug chart
Procedural skills: 1. prepare the patient for subcutaneous 1 1 2

subcutaneous required for subcutaneous injection

injections 3. explain to the patient on the

purpose, technique and
complications of the procedure.
4. choose an appropriate subcutaneous
injection site
5. perform the procedure safely
6. fill out the patient medication chart
Procedural skills: 1. prepare the patient for intradermal 1 1 2

intradermal required for intradermal injection
injections 3. explain to the patient on the purpose,
technique and complications of the
procedure.
4. choose an appropriate intradermal
injection site
6. fill out the patient medication chart
Focused history 1. to effectively take a focused history 1 1 2

taking in Nervous from a patient presenting with
System neurological disease
approach to history taking.
neurological problems
applying critical reasoning skills.
non- verbal communication.
patient.
10. obtain appropriate valid
consent, defining associate
ethical principles
Physical 1. to systematically perform an 1 1 2

examination: examination of the cranial nerves
Neurological and motor and sensory system
Examination examination of the upper limbs

2. describe the components of cranial

nerves examination
3. describe the components of motor
and sensory examination of the
upper limbs
medical/legal and ethical principles.
the cranial nerves
7. conduct as systematic examination
of the motor and sensory system of
the upper limbs
of the examination
Procedural skills: 1. Perform the ophthalmoscopic 1 1 2

Nervous System examination of the fundus
2. Be able to handle an
ophthalmoscope
3. Describe the purpose and function
of the instrument.
4. Conduct a direct ophthalmoscopic
examination of the fundus.
5. Be able to follow a system for
identifying the optic disc, the retina
and retinal vessels
Focused history 1. history taking in a patient 1 1 2

taking in Endocrine presenting with an endocrine
system disorder (hypo / hyperthyroidism)
2. utilise a systematic and holistic
clinical history from patient
presenting with a swelling in the
neck and gather enough information
to established clinical evidence of
hypo or hyperthyroidism
5. identify differential diagnosis by
non-verbal communication.


patient.
9. explain about confidentiality of
information to the patient
Focused Physical 1. To do a proper technique of 1 1 2

Examination examination of the neck
2. list the possible causes of neck
swellings
3. explain to the patient about
4. gain appropriate valid consent prior
to performing the examination
the neck
6. determine the site of the thyroid
glands
7. examine a thyroid gland in a
systematic manner
8. differentiate a thyroid gland
swelling from other swellings in the
neck.
9. properly describe a swelling in terms
of: site, size, shape, margin
Procedural skills: 1. conduct peripheral intravenous 1 1 2

Initiation of an cannulation
intravenous infusion 2. comply with infection control
procedure
3. explain the indications for
intravenous cannulation and
infusion
4. choose the size/type of device to be
used.
5. choose an appropriate insertion site.
6. prepare the appropriate equipment.
7. practise proper aseptic technique.
9. explain the complications of the
procedure
1. International Federation of Infection Control : Hand Hygiene

http://www.theific.org/oldsite/Manual/Hands.htm
2. How to wash your hand
http://www.infectioncontrolservices.co.uk/hand_hygiene_instructions.htm

REFERENCES
1. Douglas et al. (2009) Macleod’s Clinical Examination, 12th Edition, Elsevier Churchill
Livingstone.
2. Michael Swash, Michael Glynn (2007) Hutchinson’s Clinical Methods, 22nd Edition,
Saunders Elsevier.Niall Cox and T.A Roper. (2005) Clinical Skills, 1st Edition, Oxford
University Press.
3. Nicholas J Talley and Simon O’ Connor. (2006), Clinical Examination: A Systemic
Guide to Physical Diagnosis, 5th Edition, Elsevier Churchill Livingstone.
4. Kumar & Clark (2005). Clinical Medicine, 6th Edition, Elsevier Saunders.
5. The auscultation assistant http://www.med.ucla.edu/wilkes/Physiology.htm
6. Cardiac Examination Module, University of Virginia
7. http://www.med-ed.virginia.edu/courses/pom1/pexams/CardioExam/

MBBS Curriculum EPI-BIO/Year-2
Epidemiology and Biostatistics - EPI-BIO
Course Information
1. Name of Course/Module: Introduction to Public Health & Epidemiology and Biostatistics
2. Course Code: MERB 6236
1. Prof. Dr. Than Winn (TW)

2. 2. Dato’ Prof. Dr. Marzukhi Isa (MI)
5. Dr. Aung KoKo Min (AKK)
It is an integrated Module where Epidemiologic principles and practices are intertwined with
supporting applications of basic descriptive and inferential statistical methods. As the
epidemiology helps students understand the overview of health-related problems, biostatistics
plays an important role in describing and analysing the burden of diseases and inferencing
causes and risks of diseases. This module also acts as a basic stepping stone for evidence-based
medicine which becomes more and more important in the clinical medicine. Students will be
equipped with basic necessities for the research in public health.
The major thrust of this Module would be to enable students to apply principles and methods of
epidemiology and statistics in routine health care vis-à-vis research and disease prevention and
control. In addition, students will be applying the knowledge imparted here in their latter part
of the curriculum while profiling, diagnosing community health status and intervention
thereafter.
They will be more confident and competent in confronting with outbreak of diseases such as
dengue fever, cholera, typhoid etc. which are still rampant in some parts of Malaysia. This
Module will make students think analytically in linking basic medical sciences to clinical
practices in the context of agent, host and environment interaction in natural history of diseases.
It would be of some benefits for students during PBL sessions while making learning hypotheses
relating patient’s clinical acumen and diagnosis of the disease. This Module will partially equip
the students with knowledge and skill in the design, conduct, analysis and report of research to
be delivered in depth during the clinical years. The knowledge and practice skills that the
students have learned in this Module will be field-tested in Rural and Urban Health postings as
part of Years 3 and 4 curriculums.
5. Semester and Year offered: Semester-3, Year-2


L T P O E Guided learning =
L=Lecture 48 21 18 4 5 96 hr
T=Tutorial
P=Practical Independent learning =
O=Others 138 hr
(PBL, review discussions) 96 42 0 0 15
Total = 234 hrs
7. Credit value: 234/40 = 5.85 ~ 6
8. Prerequisite:
9. Objectives:
1. Understand and describe the concept, principles and methods of Epidemiology, various
uses of epidemiological studies and their application in research.
2. Discuss the identification, mode of transmission, prevention and control of
communicable diseases that spread via vectors, direct contact, air and food/water
particularly those of public health importance in Malaysia
3. Describe the process of epidemiological investigation during a disease outbreak
4. Compute and interpret epidemiologic measures disease frequency, risks and
associations and apply this knowledge in investigation of outbreak and research and
intervention studies.
5. Describe the epidemiology of non-communicable diseases and occupational health
6. Define and describe disease surveillance, its types and components and is application
in disease control and prevention of outbreak
Upon completion of this posting , the student will be able to
1. Describe the role of public health and epidemiology in prevention and control of
diseases (health problems)
2. Compare between epidemiologic practice and clinical practice
3. Understand and compute measures of morbidity; apply this knowledge in
epidemiologic research
4. Identify associations between exposure and outcome variables
5. Apply appropriate epidemiologic research methods in the estimation of association
between exposure and outcome variables
6. Describe modes of disease transmission, agent factors, host factors, prevention of
communicable disease
7. Explain the levels of prevention and apply them to various types of diseases and
conditions
8. Define and describe disease surveillance, its types and components
9. Discuss epidemiology and prevention of Food and Waterborne, air-borne, vector-
borne diseases, close contact diseases
10. Define, describe and compute parameters related to epidemiologic screening
11. Describe the epidemiology of non-communicable diseases
12. Describe the epidemiology and prevention of Emerging & re-emerging diseases
13. Describe the epidemiology and prevention of occupational diseases
14. Describe the types of immunity, herd immunity immunization program in Malaysia

15. Describe and differentiate between association and causation, describe criteria for
causation
 Theories and Concepts of Public Health and Epidemiology.

 History of Public Health interventions and their contemporary implications.
 Multi-factorial model of association between disease and factors in which students will
appreciate risk factors don’t act alone but they interact or confound each other; some
factors are modifiable some are not.
 The multilateral collaboration among many disciplines be they therapeutic or
preventive; the ultimate goals being elimination of rampant diseases which hempen
socio-economic development.
 Research methodologies vary depending upon the research questions to be answered,
goals to achieve and available manpower, technological and financial resources.
 In this digital era, many learning resources are e-based and epidemiology is no
exception.
At the end of the course, students are given an opportunity to evaluate the course and the
lecturer. Assessment is through summative and formative strategy.

6. Self directed learning to support independent reading.
monitored throughout the module by tutorials and assignments to check their understanding and
improvement. At the end of the module, there is an end of module test (EMX) as continuous
assessment.
The summative assessment includes both EMX as continuous assessment and the First
13. Synopsis:
This Module provides the student with an introduction of public health approach to prevention
and control of diseases which are prevalent in Malaysia. It begins with general basic principles
and methods of epidemiology which are relevant to conduct community-based diagnosis
(example: investigation of disease outbreak) and treatment (control of outbreaks). Design,
conduct and analysis of various types of research will help appreciate the role of epidemiology
in identifying causes of diseases which are useful for programs geared toward primary
prevention. Screening of diseases is a tool used for secondary prevention.


1. lectures (LEC),
3. tutorials (TUT)
4. computer aided learning (CAL)
6. directed self-learning [ DSL].

2) Summative –
A. Continuous assessment –
1. End-lecture assessment (MCQs/PBQs)
2. Test on DSL (emerging & re-emerging diseases) 20%
3. Two tests (CTX1 & CTX2) (MCQs, ETQs and PBQs) 20%
B. End-module exam (Theory paper (MCQs, ETQs and PBQs) 60%
Total: 100%
The Department will adopt the attendance rule as mandated by the Faculty of Medicine,
MAHSA University. Passing grade will be awarded if the students attain 50% or more of the
total scores.

the nation.

PEO3 To become a competent practitioner with leadership skills and with

high ethical and moral values.
PEO1 PEO2 PEO3 PEO4
  





moral values.

areas of interest.
   
L T P
Introduction to EPI- 1) Conceive the importance of learning 1
BIO module Epidemiology and Biostatistics hand-
in-hand
2) Appreciate extraordinary advances in
scientific knowledge and methods,
epidemiology and biostatistics
provide essential tools for
understanding disease etiology and
for identifying effective and efficient
approaches to prevention and
treatment
Introduction to 1) Define and describe 1

Epidemiology in the i. Types of epidemiology
Context of ii. Principles, practice and uses
Community of epidemiology
Medicine

2) Describe the role of public health and

epidemiology in prevention and
control of diseases (health problems)
3) Compare between epidemiologic
practice and clinical practice
Introduction to 1) Define the term `statistics’
Medical Statistics 2) Understand basic concepts of
statistics
3) Describe the difference between
descriptive statistics and inferential
statistics
4) Understand why medical students /
doctors need to learn statistics
5) Comprehend statistical
measurements and their scales
6) Appreciate the role of computing in
teaching and learning of statistics
Descriptive Statistics 1) define the following terms/concepts:

I & II a. Variable
b. Frequency distribution, Relative
frequency, Cumulative
frequency
2) distinguish between discrete and
continuous variable
3) distinguish between quantitative and
quantitative data
4) distinguish between different scales
of measurement
5) transform data set into information in
the form of tables, graphs and
diagrams
6) define, explain, calculate and
interpret the following:
Mean, median, mode
7) explain when it is appropriate to use
mean, median or mode to describe the
`middle’ of the distribution for a
continuous variable
8) define, explain, calculate and
interpret the following indices:
Range, Quartiles, Percentiles,
Standard deviation,
Coefficient of variation
Introduction to SPSS 1) understand the nature of statistical

& Data Entry software (SPSS)
2) do the data entry
3) perform basic data management
4) present the summary of different
types of variables properly
5) create a data template in SPSS
6) understand the following data
attributes:

Variable name. type, decimal, labels,

value, missing value
Measures of Disease 1) Understand and compute measures of

Frequency: morbidity
Morbidity & 2) Understand and compute measures of
Mortality mortality
3) Apply this knowledge in
epidemiologic research
Vital Statistics 1) Describe vital statistics and its

importance
2) Describe the various types of
mortality statistics
3) Identify the source of vital statistics
4) Describe the method of measuring
and uses of birth rates
5) Describe the method of measuring
and uses of death rates
6) understand uses and limitation of
vital statistics
Measures of Risks & 1) Define and estimate various types of

Associations and risk measurements
Applied 2) Identify associations between
Epidemiological exposure and outcome variables
3) Apply appropriate epidemiologic
Methods 1 and 2 research methods in the estimation of
association between exposure and
outcome variables
4) Discuss the implications of
association in epidemiologic and
medical practices
Epidemiological 1) Define communicable disease and

Concepts of other related terms
Communicable 2) Describe modes of disease
Diseases transmission
3) Describe agent factors
4) Describe host factors
5) Describe prevention of
communicable disease
6) Describe linkages in the prevention
and control during a disease outbreak
7) Appreciate the integrate approach to
communicable diseases in the
context of Epidemiology and its
related disciplines such as Statistics,
Microbiology and Pharmacology.
8) Understand dynamics of
communicable diseases and ways to
break the chain of infection to
control CD

9) Apply knowledge of epidemiology in

prevention of communicable diseases
Principles of Disease 1) Explain the levels of prevention

2) Explain the components in each level
Prevention of prevention
Epidemiology of 1) Describe foodborne and waterborne

Food and diseases
Waterborne Diseases 2) Describe the epidemiology of:
i. typhoid
ii. cholera
iii. hepatitis A
iv. food poisoning
Small Group
Discussion (1)
Investigation of an 1) Understand how to set up and

Epidemic conduct epidemiological studies and
analysis in populations at risk of or
experiencing outbreaks of
disease/disorders
2) Define specific terms commonly
used in the investigation of
epidemics (Epidemic, pandemic,
endemic and outbreak)
3) Describe the steps involved in the
investigation and control of an
epidemic
4) Apply the principles and practices of
epidemiology in investigation and
confirmation of a disease outbreak
Epidemiology of 1) Describe the epidemiology of Nipah

Emerging and Re- Virus, Ebola Virus, Plague, Avian
emerging Diseases in Flu, SARS, H1N1 Swine Flu
Malaysia
Small Group
Discussion (2) for
Food-borne outbreak
Introduction to 1) define and explain the following
Probability terms/concepts:
a. Probability
b. Mutually exclusive
b. events
c. Independent events
d. Normal distribution
2) apply the operation of additive and
multiplicative laws of probability in
medicine
3) apply standard normal distribution

table to find the probability

4) comprehend basic probability
concepts
5) describe elementary properties of
probability
6) calculate the probability of events
7) apply the probability concepts in
descriptive and inferential statistics;
(descriptive and analytical
epidemiology)
Probability 1) understand the meaning of probability 2

Distributions & distributions
sampling 2) describe various types of Probability
distributions Distributions
3) apply Probability Distributions in
various types of statistical analyses
Estimation 1) define/explain the following

statistical terms/concepts:
a. Target and study population
b. Sampling distribution
c. Standard error of mean
d. Point estimate
e. Confidence interval
2) Construct a confidence interval for
sample mean and proportion
3) explain the purpose of using
confidence intervals
4) apply and interpret confidence
interval as and when required
Sample Size 1) rationalize the role of sample size
Calculation calculation in medical research
2) to describe various parameters and
assumptions required for sample size
calculations
3) to conceive sample size formulas as
they are fitted into the sample-size
calculating software
4) to determine sample size using
software for various types of research
designs
Sampling Methods 1) describe four non-probabilistic

sampling methods
2) describe four probabilistic sampling
methods
3) define population, samples, sampling
frames and sampling units
4) discuss advantages and disadvantages
of sampling methods
5) conduct simple random sampling
from a given sampling frames

Small Group
Discussion (3)
Epidemiology of 1) Describe the occurrence of non

communicable diseases
Non-Communicable 2) Explain the importance of non
Diseases communicable diseases
3) Compare between communicable
and non communicable diseases
4) Describe risk factors in non
communicable diseases
5) Describe the epidemiology and
prevention of coronary heart disease
Epidemiology of 1) Discuss epidemiology, prevention

Airborne Diseases and control of airborne diseases
i. Diptheria,
ii. Pertussis,
iii. Measles,
iv. German measles,
v. Tuberculosis,
vi. Chicken pox,
vii. Flu
Epidemiology of 1) Describe the epidemiology of STD

Close Contact and close contact diseases:
Diseases i. Syphilis
ii. Gonorrhoea
iii. HIV
iv. Hepatitis B
v. MRSA
Research 1) define research

Methodology: 2) classify research methodology
Preview 3) review incidence rates, prevalence
rates, risk ratios and odds ratio
4) give the definition of observational,
experimental, descriptive and
analytical studies
5) give the definition of dependent
variables and independent variables
6) outline steps involved in a research
proposal
7) outline steps involved in a research
report
Research 1) describe concept and types of Cross-

Methodology 1 sectional studies
Cross-sectional study 2) explain design, conduct and analysis
of cross sectional studies
Research 1) define and conceptualize Case-

Methodology 2 Case- control studies

control study 2) understand how CCS are designed,

conducted and analyzed
3) compute and interpret odds ratios
from CCS
4) appreciate advantages and
disadvantages of CCS compared with
other research designs
Research 1) discuss the data gathering approaches

Methodology 3 2) discuss methods of sampling
Cohort 3) define and describe prospective
studies
4) define and describe cohort studies
Research 1) define and describe RCT

Methodology 4 RCT 2) discuss its concept
i. Randomization
ii. Blinding
iii. Use of placebos
3) design, conduct and analyze
randomized control trials
Review on Research 1) calculate the measures of risks and

Methods association from each study
2) to calculate the 95% CI of the values
by using Epi-Info software
3) to interpret the results from the output
4) to differentiate the pros and cons of
above study designs
Introduction to 1) Understand diseases that fall under

Occupational Health the category of occupational diseases
and Prevention & 2) Understand the basic principles in
control of occupational disease prevention and
occupational diseses control
Introduction to 1) define/explain the following

Statistical inference/ statistical terms/concepts:
Hypothesis testing a. Null hypothesis
b. Alternate hypothesis
c. Test of significance
d. Significance level
e. Test statistic
f. p- value
g. Statistical inference
h. Type I and II errors
2) explain when and why a test of
significance needs to be carried out
3) discuss the misinterpretations and
limitations of p-value in assessing the
evidence from a study
Statistical tests for 1) understand the t distribution

quantitative data I: t 2) explain when t-tests are applicable

3) recognize different types of t test
tests 4) carry out t-test and construct CI for
mean difference when required
5) know assumption underlying the use
of t-test
6) interpret the finding of the outcome of
such test and significance of
confidence interval
Statistical tests for 1) explain when ANOVA is applicable

quantitative data II: 2) explain the assumptions underlying
ANOVA use of ANOVA
3) carry out ANOVA and post-hoc tests
4) interpret the findings from the
outcome of ANOVA
Statistical tests for 1) explain the basis for the use of Chi
qualitative data: Chi square tests on qualitative data
square test 2) explain the limitations of the Chi
square tests
3) carry out the Chi square tests
4) interpret the findings from the Chi
square tests of significance
5) interpret degrees of freedom and
critical values of Chi square statistics
from Chi square table
Small Group
Discussion
Immunization in 1) Explain the importance of

Malaysia immunization
2) Differentiate between active and
passive immunization
3) Describe the types of immunity
4) Describe herd immunity
5) Describe the immunization program
in Malaysia
Causation in 1) Describe types of association

Epidemiology 2) Describe criteria for causation
3) Infer association to causation
Surveillance of 1) Define and describe disease

surveillance
Diseases 2) List the purposes and uses of
surveillance
3) Describe the types of surveillance
4) List the components of surveillance
system
5) Describe environmental control
6) Describe host related control and
prevention

7) Describe notifiable disease reporting

8) Appreciate characteristic and
limitations of surveillance system
Screening of Diseases 1) Understand the usefulness of

screening
2) Understand how to plan a screening
program for the population
3) Understand tests of validity and their
results
4) Give some examples of screening
tests
Statistical tests for 1) interpret the nature of relationship of

quantitative data: data presented in a scatter plot
Correlation & 2) explain the concept and application of
Regression linear regression
3) distinguish between correlation and
linear regression
4) interpret the findings from correlation
and regression analysis
Review on Medical 1) do a proper data entry, data

Statistics Lab management and data analysis
Exercises 2) present the data in appropriate ways
3) do the hypothesis testing in SPSS: t-
test, one way ANOVA, correlation &
regression, chi-square
4) perform the checking for assumptions
of tests described above
5) interpret the results from the output of
SPSS
6) differentiate between statistical
significance and clinical significance
7) describe the use of p-value and 95%
CI
Small Group
Discussion
Textbooks
1. Epidemiology, Gordis, Leon. (2009) 4th edition Elsevier Saunders, Philadelphia, PA.
USA.
2. Biostatistics: A Foundation for Analysis in the Health Sciences, Wayne W Daniel:
(2010) 9th Ed (International Student Version), John Wiley & Sons, INC.
Reference
rd
1. Foundations of Epidemiology David E. Lilienfeld, Paul D. Stolley: (1994) 3 Edition,
Oxford University Press, Oxford.
nd
2. Epidemiology Kept Simple Gertsman BB. (2003) 2 Edition. Wiley-Less, Inc.,

Hoboken, NJ. USA.

th
3. A Dictionary of Epidemiology Last JM. (2009) 5 Edition. Oxford University Press,
New York, Oxford, Toronto.
4. Infectious Diseases Epidemiology. E, Nelson, et el. 2001 Kenrard WC100/b4026
th
Benenson A S., 1995. 16 Edition. American Public Health Association
5. Epidemiology for the Uninitiated, 5th Edition David Coggon, David Barker, Geoffrey
Rose (2003) BMJ Books, Wiley :
6. An Introduction to Medical Statistics, Martin Bland: (2000) 3rd Edition, Oxford
University Press, Oxford.
7. Statistical Procedures Companion (SPSS 14.0), Norusis, MJ. (2005) Prentice Hall Inc.
 This module is called non-block standalone module. It is delivered at the beginning of

year 2 Sem3.
 It is independent from the block topics in teaching, learning and assessment. Its
contribution to the final scores for the ESX is 2%.
 Students are required to keep the teaching and learning materials for this Module so that
they will better understand this Module by cross-referencing with what they learn in
PBL, ECE and other block contents.
 This Module will be reviewed again during Years 3 and 4 RHP and UHP postings
respectively when they will be developing research proposal and conducting research
and reporting the findings.

MBBS Curriculum
PHASE 2
YEAR 3
YEAR 4
YEAR 5

Subject Codes
YEAR – 3
Sr. Code Name

1 MMED 6355 Medicine
2 MSUR 6355 Surgery
3 MOBG 6355 Obstetrics and Gynecology
4 MPED 6355 Pediatrics
5 MPSY 6354 Psychiatry
6 MRHP 6354 Rural Health Posting
7 MCOL 6352 Common lectures
YEAR – 4
Sr. Code Name

2 MSUR 6474 Surgery
3 MORT 6473 Orthopedics
4 MPCM 6475 Primary Care Medicine
5 MANE 6472 Anesthesiology
6 MCPC 6472 Critical and Palliative Care
7 MEMM 6472 Emergency Medicine
8 MOPT 6472 Ophthalmology
9 MENT 6472 Otorhinolaryngology
10 MFMS 6472 Forensic Medicine
12 MUHP 6473 Urban Health
13 MMJP 648- Medical Jurisprudence
14 MCOL 6472 Common lecture
YEAR – 5
Sr. Code Name

2 MSUR 6595 Surgery
3 MOBG 6596 Obstetrics and Gynecology
4 MPED 6595 Pediatrics
5 MORT 6593 Orthopedics
6 MPCM 6593 Primary Care Medicine

FINAL PRO
Med MCQ-1: MMED 6591

Med MEQ & SEQ: MMED 6592
Sur MCQ-2: MMED 6593
Sur MEQ & SEQ: MMED 6594
OSCE: (Digital/INTERACTIVE) MMED 6595
Short case: MMED 6596
Long Case:

MBBS PROGRAM
YEAR-3

MBBS Curriculum Medicine/Year-3
Medicine (Year-3)
Course Information
1. Name of Course/Module: MBBS year 3 Medicine
2. Course Code: MED 6355
1. Prof. Dr. Mohammed Abul Bashar

2. Associate Prof. Dr. Muhammad Ihtishamul Haque
3. Dr. Wint Wint Thu Nyunt
4. Dr. Sharmila Vedhavathy Sornam
In MAHSA MBBS year 3 Medicine posting, primary emphasis is for preparing students to take
care of patients and families in a humanistic and professional manner.
In MAHSA competency-based curriculum, this course provides opportunities for learning and
evaluation in the following competencies:
 Medical knowledge
 Clinical skills and patient care
 Interpersonal and communication skills
 Professionalism and ethnical judgement
 Lifelong learning, problem solving and continuous professional development
 Social and community context of health care
5. Semester and Year offered: Year 3

L S P O E Guided learning :
L= Lecture (2) 18 26 5 150 4 251hours
S=Seminars(6)/Case 3
discussion(5)/Debate(5) Independent learning :
P=Clinical Skill Labs (2) 36 78 20 134 hours
O=Others/SDL
(OT/Clinics/ON Call). Total : 385 hours
E=exam
7. Credit value: 385/80=5
8. Prerequisite: Pass the first professional examination

9. Objectives:
A. Medical Knowledge of
1. basic and clinical science principles that underlie the practice of internal medicine.
2. basic medical history and examination techniques.
3. basic investigations and their interpretation.
4. principles of management of common medical problems.
B. Skills in
1. obtaining basic medical history.
2. performing physical examination.
3. basic interpretation of ECG.
4. basic interpretation of chest x-ray.
5. effective communication with patients, families, and others on the health care team.
C. Attitude regarding
1. treating patients, their families, and health care providers with respect and dignity
while acting with honesty and integrity.
2. commitment to caring for patients regardless of race, socioeconomic status, sexual
orientation, age, religion, culture or disability.
At the end of training, each student must be able to:

1. Obtain a good history taking
2. Perform a thorough physical examination including mental status examination and
examination of an unconscious patient.
3. Correlate the clinical symptoms and physical signs to make the provisional diagnosis.
4. Suggest and Interpret reasonably the relevant investigations.
5. Present and discuss principles involved in the management of the patient.
6. Initiate first-line management and outline short-term and long-term management.
7. Identify the various manifestations of infectious and non-infectious diseases.
8. perform basic procedures under supervision, e.g. IV (intravenous) cannulation,
nasogastric tube, urinary bladder catheterisation, use of peak flow meter.

 Problem solving skill
(d) Identifying cause and effect relationship
(f) Integrating knowledge from a number of disciplines to solve the problem
 Interpersonal and communication skill
(c) Ability to understand and treat the audience accordingly
 Awareness of social, ethical and environmental issues in relation to Medicine
 Professionalism: motivation, dress, grooming, honesty, patient privacy and respect to
patient autonomy

 demonstrating a proficiency in the access of literature via online and library resources.
 initiate personal life long learning.
Teaching-learning activities are in theory and clinical format, supported by independent reading
and private study for examinations.
Assessment is through summative and formative strategy.
At the end of the course, students are given an opportunity to evaluate the course and lecturers.
13. Synopsis:
MAHSA MBBS year 3 Medicine posting is an eight-week course, that serves as the beginning
of the students clinical years. It is one of the first opportunities for patient contact as well as
introduction to application of knowledge and skills acquired in early clinical exposure.
Communication and clinical skills are necessary to becoming a good physician. This posting
incorporates interactive learning opportunities to foster a ‘hands-on’ approach to learning. We
also encourage self-directed learning in the curriculum.
The core medicine clerkship will serve primarily as an inpatient service experience in which
students will apply concept of diagnosis and management to hospitalized and ambulatory
patients. Students’ experience will focus on areas traditionally identified and related to
Medicine, for example, pathophysiology of non-surgical diseases and application of non-
surgical diagnostic and therapeutic techniques. Clinical experience (Medicine) will take place
primarily on general medical wards, Medicine clinics, Dermatology clinic and accident and
emergency department. Any outpatient experience will be designed to provide students with
understanding of routine care performed in the physician’s office/clinic, and will be at the
discretion of the attending physician.
Students will clerk and examine patients on their own and observe diagnostic/ therapeutic
procedures in the medical wards allotted to them. During ward placement, students will clerk
patients (history taking, physical examination), outline management plan, observe or perform
relevant procedures for the patient under supervision. Students will present the case to the
respective attending consultant during ward rounds. Students will continue to monitor the
progress of their respective patients.
Students will observe and learn about the patient education, how to communicate with the
patients, especially about the disease progress, management plan, life-style modification, health-
related quality of life, psychosocial issues which are related to medical problems.
Theory sessions: lectures, interpretative skill sessions, radiology and imaging tutorials,
tutorials, seminar, small group discussion
Clinical sessions: bed-side teaching, clinical skill, procedure, clinical question case
conference, ward round, ward work, clinic, oncall.
CONTINUOUS ASSESSMENT
Attitude 5%
Logbook 15%
Case-write up 10%

END-OF-POSTING EXAMINATION
THEORY
1. Multiple choice question (true/false questions & single response questions) 15%
2. Short essay question 10%
3. Modified essay question 10%
CLINICAL
1. Long case 15%
2. Short cases 10%
3. Objective structured clinical examination (OSCE) 10%
Total 100%

the nation.

and moral values.
PEO1 PEO2 PEO3 PEO4
   




moral values.


areas of interest.
     
L T P
Problem-based 1) analyse the following symptoms
discussion with their pathophysiology, causes
(Symptom analysis) and importance
1. chest paing
2. Palpitation
3. Oedema
4. Dyspnoea
5. Cough
6. Haemoptysis
7. Wheeze
8. Abdominal pain
9. Jaundice
10. Hematemesis/Melena
11. Ascites
12. Diarrhoea
13. Weight loss
14. Abdominal mass
15. Vomiting
16. Dysphagia
17. Constipation
18. Haematuria
19. Anaemia
20. Bleeding and bruises
21. Unilateral leg swelling
22. Lymphadenopathy
23. Fits
24. Acute neurological deficit
25. Loss of consciousness
26. Headache/ facial pain
27. Involuntary movements
28. Joint pain
29. Fever
30. Skin rash
Cardiovascular Acute coronary syndrome/ Coronary

system (long case/ artery disease
short case) Cardiac failure
Hypertension
 Uncontrolled hypertension

 Hypertensive emergency/
urgency
Infective endocarditis
Valvular heart disease
 Mitral stenosis/ Mirtal
regurgitation
 Aortic stenosis/ Aortic
regurgitation
 Tricuspid regurgitation
 Valve replacment (on Warfarin)
Congenital heart disease
 VSD
 ASD
 TOF
Arrhythmias
 Atrial fibrillation
Pulmonary hypertension
Respiratory system Bronchial asthma

(long case/ short Chronic obstructive Pulmonary disease
case) (COPD)
Pneumonia
Tuberculosis
Pleural effusion
Bronchiectasis
Interstitial lung disease/ pulmonary
fibrosis
Bronchogenic carcinoma
Obstructive sleep apnoea
Central nervous Stroke

system (long case/ Cranial nerve palsy
short case) Meningitis/ Encephalitis
Parkinsonism
Myasthenia gravis
GBS
Multiple sclerosis
Motor neurone disease
Epilepsy
Myopathy
Peripheral neuropathy
Gastrointestinal Chronic liver disease

tract (git) (long case/ Mass in abdomen/ hepatomegaly/
short case) splenomegaly
Acute hepatitis
Peptic ulcer disease (PUD)
Gastroesophageal reflux disease
(GERD)
Inflammatory bowel disease
Acute gastrointestinal haemorrhage
Acute diarrhoea/ Chronic diarrhoea
RENAL SYSTEM Chronic kidney disease/ Chronic renal

(long case/ short failure

case)  End-stage renal failure
 Fluid overload
 Line-related infection
 Renal replacement therapy:
haemodialysis/ peritoneal
dialysis/ kidney transplant
Acute renal failure
Nephrotic syndrome
Glomerulonephritis
Adult polycystic kidney disease
Urinary tract infection
Electrolyte disorders/ Acid-base
imbalance
Haematology (long Anaemia

case/ short case)  Hemolytic anaemia/ β
Thalassaemia major
 Aplastic anaemia
 Sickle cell anaemia
Leukaemia/ Lymphoma
Multiple myeloma
Thrombocytopenia
 Immune thrombocytopenic
purpura (ITP)
Haemophilia
Deep vein thrombosis
Infectious disease Dengue fever

(long case/ short Cellulitis
case) Leptospirosis
HIV/ AIDS
Human Herpes virus infection
Sexually transmitted infections/ diseases
Malaria
Enteric fever
Endocrine system Diabetes Mellitus

(long case/ short  Uncontrolled daibetes mellitus
case)  Diabetic Ketoacidosis (DKA)
 Hyperosmolar hyperglycaemic
state (HHS)
 Diabetic foot ulcer
 Peripheral neuropathy
 Hypoglycaemia
Hyperthyroidism
 Graves’ disease
 Toxic multinodular goitre
 Toxic solitary thyroid nodule
Hypothyroidism
Cushing’s syndrome
Acromegaly
Addison’s disease

Rheumatology Rheumatoid arthritis (RA)

(long case/ short Systemic Lupus erythematosus (SLE)
case) Gout
Osteoarthritis (OA)
Seronegative spondyloarthropathies
 Psoriatic arthritis
 Ankylosing spondylitis
 Reiter’s syndrome
Systemic sclerosis
Polymyositis/ Dermatomyositis
Mixed connective tissue disease
(MCTD)
Vasculitides
Adult Still’s disease
Dermatology (long Psoriasis

case/ short case) Eczema
Acne
Infections of skin
Skin rashes
Drug reaction
Cutaneous manifestations of systemic
diseases
Textbooks
1. Graham Douglas, Fiona Nicol, Colin Robertson. ‘Macleod’s Clinical Examination’. 13th
Edition. 2013. Elsievier Churchill Livingstone.
2. Brian R. Walker, Nicki R. Colledge, Stuart H. Ralston, Ian Penman. ‘Davidson’s Principles
and Practice of Medicine’. 22nd Edition. 2014. Churchill Livingstone.
CONSOLIDATED CURRICULUM CONTENTS
GENERAL
THE ‘ART’ AND ‘SCIENCE’ OF MEDICINE

- Principles of medical ethics
- Clinical diagnostic reasoning
- Principles of prevention of disease
- Clinical genetics – common types, clinical presentation, investigation and prevention of
genetic diseases and genetic counseling
CLINICAL PHARMACOLOGY
- Principles of drug therapy
- Adverse drug reactions
- Drug interactions
- Monitoring drug therapy
- Writing a drug prescription
NUTRITIONAL AND METABOLIC DISORDERS

- Nutritional assessment and needs

- Nutritional and metabolic disorders
- Protein energy malnutrition
- Obesity
WATER, ELECTROLYTE AND ACID-BASE IMBALANCE

- Water and electrolyte physiology
CRITICAL CARE MEDICINE

- Physiology of the critically ill patient
- Major manifestations of critical illness
- Circulatory failure: shock
PAIN MANAGEMENT AND PALLIATIVE CARE

- General principles of pain
POISONING
- General approach to the poisoned patient
- Poisoning by specific pharmaceutical agents
SPECIFIC ENVIRONMENTAL AND OCCUPATIONAL HAZARDS

- Heatstroke and hypothermia
- Drowning and near-drowning
- Electrical injuries
IMMUNE RESPONSE AND INFECTIONS
- Basic considerations
- Patterns of infection
- Laboratory diagnosis of infections
- Principles of immunization and vaccine use
- Clinical syndromes
- The febrile patient
- Fever and rash
- Fever of unknown origin
SPECIFIC INFECTIONS
EPIDEMIOLOGY, CLINICAL FEATURES, LABORATORY DIAGNOSIS, TREATMENT
AND PREVENTION OF :
- Protozoal infections
- Amoebiasis
- Malaria
- Leishmaniasis
- Toxoplasmosis
- Giardiasis
CARDIOVASCULAR SYSTEM
- Clinical examination of the cardiovascular system
- Functional anatomy, physiology and investigations
- Major manifestations of cardiovascular disease
- Chest pain
- Breathlessness
- Palpitation
- Acute circulatory failure (cardiogenic shock)
- Heart failure
- Hypertension

- Presyncope and syncope

- Cardiac arrest and sudden cardiac death
- Abnormal heart sounds and murmurs
- Atrial fibrillation
- Disorders of heart rate, rhythm and conduction
- Congestive cardiac failure
- Rheumatic fever
- Valvular heart disease
- Ischemic heart disease
- Congenital heart disease in the adult
- Cor pulmonale
- Hypertension
RESPIRATORY SYSTEM
- Clinical examination of the respiratory system
- Major manifestations of lung disease
- Cough
- Dyspnea
- Chest pain
- Hemoptysis
- The solitary radiographic pulmonary lesion
- Respiratory failure
- Upper and lower respiratory infections
- Bronchial asthma
KIDNEY AND GENITOURINARY SYSTEM

- Clinical examination of the kidney and genitourinary system
- Major manifestations of renal and urinary tract disease
- Dysuria, pyuria, urethral symptoms
- Disorders of urine volume
- Hematuria
- Proteinuria
- Oedema
- Obstruction of the urinary tract
- Incontinence
GASTROINTESTINAL TRACT
- clinical examination of the abdomen
- functional anatomy, physiology and investigations particularly role of imaging,
endoscopy and tests of function
- major manifestations of gastrointestinal disease
- abdominal pain (acute and chronic)
- dysphagia
- dyspepsia
- vomiting
- constipation
- diarrhea
- abdominal lump
- weight loss
LIVER AND BILIARY TRACT DISEASE

- clinical examination of the abdomen for liver and biliary disease
- functional anatomy, physiology and investigations of hepatobiliary disease

- major manifestations of liver disease

- ‘asymptomatic’ abnormal liver function tests
- Jaundice
- Acute (fulminant) hepatic failure
- Portal hypertension and ascites
ENDOCRINOLOGY AND METABOLISM
DIABETES MELLITUS
THYROID GLAND
- Clinical examination of thyroid disease
- Major manifestations of thyroid disease
THE REPRODUCTIVE SYSTEM
- Major manifestations of reproductive disease
- Male hypogonadism
- Gynaecomastia
- Impotence
THE PARATHYROID GLANDS
- Major manifestations of diseases of the parathyroid glands
THE ADRENAL GLANDS
- Major manifestations of adrenal disease
THE ENDOCRINE PANCREAS AND GASTROINTESTINAL TRACT
- Major manifestations of disease of the endocrine pancreas
THE HYPOTHALAMUS AND THE PITUITARY GLAND
- Major manifestations of hypothalamic and pituitary disease
- Hypopituitarism
- Visual field defects
- Galactorrhoea
HAEMATOLOGICAL DISORDERS
- Clinical examination in blood disorders
- Major manifestations of hematological diseases
- Anemia
- Polycythemia
- Leucopenia
- Leukocytosis
- Thrombocytopenia
- Thrombocytosis
- Pancytopenia
- Lymphadenopathy
- Splenomegaly
DISORDERS OF THE IMMUNE SYSTEM, CONNECTIVE TISSUE AND JOINTS

- Introduction to the immune system and autoimmunity
- Primary immune deficiency diseases
- HIV, AIDS and related disorders
- Major manifestations of musculoskeletal disease
- Joint pains
- Bone pain
- Muscle pain and weakness
- Regional periarticular pain
- Back and neck pain
- Approach to articular and musculoskeletal disorders
SKIN DISEASES

- Clinical examination of skin diseases

- Major manifestations of skin diseases
- Various types of rash
NEUROLOGICAL DISEASES
- Clinical examination of nervous system
- Major manifestations of nervous system disease
- Headache and facial pain
- Raised intracranial tension
- Faintness, dizziness, syncope and vertigo
- Neurological manifestations of systemic diseases

MBBS Curriculum Surgery/Year-3
Surgery (Year-3)
Course Information
1. Name of Course/Module: Surgery (Year-3)
2. Course Code: SUR 6355
1. Dato’ Prof Dr Syed Noori

2. Professor Dr U.Kyaw Tin Hla
3. Associate Professor Dr Kumar
4. Prof Venkatesh
5. Associate Prof Dr Ernest Yeoh
6. AssocProf.Ravi
7. Dr Chandra
This is an important core topic in the MBBS curriculum.The student will be introduced formally
to the main subspecialties of general surgery including urology, hepatobiliary surgery,
paediatric surgery and neurosurgery. At the end of this posting the students are expected to have
a more complete understanding of all the systems of the human body through the surgical
perspectives. The period of posting is 8 weeks in Hospital Sg. Buloh.
5. Semester and Year offered: Year-3

L T P O E Guided learning = 170 hr

L= Lecture (2) 18 66 58 24 4
S=Seminars(6)/Case Independent learning =
discussion(5)/Debate(5) 254 hr
P=Clinical Skill Labs (2) 36 198 0 0 20
O=Others/SDL Total = 424 hr
(OT/Clinics/ON Call).
E=exam
7. Credit value:
424/80=5
8. Prerequisite:
9. Objectives:
1. Understand scientific basis of surgery including pathogenesis, and pathophysiology,

and clinical manifestations, of common surgical conditions.
2. Improve communication skills in history taking.

3. Understand the behavior of patient and the health care providers as well as psychosocial
aspects of patients
4. Knowledge of performing physical examination and formulating an appropriate
diagnosis.
5. Knowledge of the principles of management of surgical patients.
6. Knowledge of surgical management including preoperative, intraoperative and
postoperative management.
7. skills in History taking and physical examination basic and abdominal examination
thoroughly
8. skills in breast and axilla examination
9. skills in neck exam especially thyroid pathology and swellings
10. skills in Inguino-scrotal examination hernias and testicular pathology
11. skills in perrectal exam proctoscopy
By the end of this posting, the student will be able to

1. Describe the pathogenesis, and pathophysiology, and clinical manifestations, of
common surgical conditions.
2. Obtain basic surgical history.
3. Describe the psychosocial aspects of surgical illness
4. Perform physical examination and formulate an appropriate diagnosis.
5. Discuss the principles of management of surgical patients.
6. Describe the types of surgical management including preoperative, intraoperative and
postoperative management.

 Understand the economics and principles of management in the health industries.
 Awareness of social, safety, ethical and environmental issues in relation to application
of medical imaging.
Teaching will be in lecture and tutorial format supported by independent reading and private
study for examinations.

The teaching learning activities during the posting will be carried out in the ward, clinics, A&E,
operation theatre and in various learning facilities with close supervision in HSB (Hospital
Sungai Buloh) surgical wards and affiliated facilities with active participation of the students.
Assessment of the students throughout this posting will be done continuously and an end of
posting written and clinical examination involving long cases, short cases and OSCE including
added exposures to anatomical and pathological specimens and dissected bodies will be carried
out.
13. Synopsis:
Produce a keen learner with strong basic knowledge enable him to perform clinical history
taking and do physical examinations to establish a working diagnosis ;observe and plan a
strategy to investigate further to wards a management plan based on srtrong understanding of
pathological disease process the patient presents with.
1. Lecture
2. Seminar
3. Case presentation
4. Tutorial
5. Bed side teaching
6. Ward rounds
7. Case write up( Two) and discussions
8. Clinical skills lab sessions, workshops on sutures, tying knots, instruments, truecut,
chest tubes and underwater sealed drainage system drain tubes and etc.
9. SDL (self-directed learning) sessions
10. Clinics, procedures, dressings, FNACS,ENDOSCOPY SESSIONS,OT,SRUBBING
11. Integrated sessions (Anaesthesiology and Surgical Radiology)
12. CPC (Clinico-pathological conferences)
13. On call sessions; discussion of on call at nights
14. Examinations of post mortem.
Continuous Assessment 30 %
Mid Posting Exam 10%
MCQ 5%
SEQ 10%
Log Book 5%
Case write up 10 %
End of Posting Examination (70%)
a) Theory (35%)
b) Clinical (35%)
 Clinical Long Case25%
 OSCE20%
 MCQ15%
 SEQ10%
Total : 100%


the nation.

and moral values.
PEO1 PEO2 PEO3 PEO4
   




moral values.

areas of interest.
     


L T P
General Surgery Common acute surgical
emergencies
1.HISTORY TAKING AND
PHYSICAL EXAMINATION
2. ANATOMY OF GIT
Topographic arrangement
3.Acute abdomen
4.Peptic ulcer disease
5.Epigastric pain
GIT physiology
6.Dysphagia
Upper GIT tumors
7. Anorectal conditions
8. abdominal wal and hernias
/Inguino scrotal conditions
9.Intestinal obstructions
10.SHOCK
11GIT bleedings
12.Breast Mass /cancer
Surgical Pathology
13.Thyroid problema
Goitres/neck masses
14.Infections in Surgery
15.Nutrition in Surgery
16.PH ,Fluids and electrolytes
17Peripheral vascular disease
18Inflammatory Bowels and
Ulcerative colits
19Lumps and Bumps
20Abdominal swellings
21Wound Healing
23Skin swellings and tumors
24Surgical Radiology
25Advances in surgery
26Per rectal exam , proctoscopy
27Suture and knot tying
28IV fluids lines , CV catheters
29Chest drainage
Biopsy technique/Truecute
Aaesthesia-principle complications
perioperative care
Shock.\, haemorrhage
Coagulation problems in
surgeryand blood transfusion
acute abdominal conditions
Appendicitis
Peptic ulcer perforations
Acute pancreatitis
Gynaecolocal acute abdomen-
ectopic rupture, pelvic

inflammatory diseases, torsions etc

Injury abdomen
Chest injury
30 perioperative care
31 lower git tumors
Accident Emergency 1) Early management of trauma

2) Disaster management
Texbooks
1. Introduction to the Symptoms & Signs of Surgical Disease; Norman L Browse: Hodder
Arnold, 4"' Ed.
2. Bailey & Love's Short Practice of Surgery; Revised by RCG Russell, Norman S William
Christopher JK Bulstrode, 24th Ed, Arnold Publishers, 2004
Reference
1. Essential Surgical Practice, edited by A. Cuschieri, R.J.C. Steele, A.R. Moosa, 41, Ed,
Oxford: Butterworth Heinemann, 2000
2. Essential Clinical Anatomy; Moore KL, Agur AMR, , 2n' Ed, Lippincott Williams &
Wilkins 2002
3. Clinically Oriented Anatomy; Moore KL and Dailey, 5th Edition, Lippincott Williams &
Wilkins 2006
4. Review of Medical Physiology; W.F. Ganong, Lange Medical Publication, 2004
5. Current surgical diagnosis & treatment: edited by Lawrence'vV. Way; illustrated by
Laurel V. Schubert, 10th Ed, East Norwalk, Conn., Appleton & Lange, 2002

MBBS Curriculum O&G/Year-3
Obstetrics & Gynaecology (Year-3)
Course Information
1. Name of Course/Module: Obstetrics and Gynaecology (Year-3)
2. Course Code: OBG 6355
1. Professor Dr. Siva Achanna

2. Associate Professor Dr. Ganesh Ramachandran
3. Associate Professor Dr. Renu Gopinath
The purpose of this module is to provide the students with a basic exposure to the discipline in
year 3. The module is designed to provide the students with unique educational experience
which allows the students to incorporate themselves into the teams that provide care to the
patients admitted into the obstetrics and gynaecology wards in Hospital Sungai Buloh. This
module thus is an educational experience that aims to bring together the theory and practice of
medicine in the setting of the wards.
The module aims to integrate the basic science learnt in phase 1 to the practice of medicine
which is the thrust of phase 2. The module also aims to introduce and reinforce concepts of self-
learning and continuous learning which are integral parts of medical education today.
5. Semester and Year offered: Year 3

L S P O E Guided learning: 258

L= Lecture (2) hours
S=Seminars(6)/Case 21 28 72 133 4
discussion(5)/Debate(5) Independent learning :
P=Clinical Skill Labs (2) 42 72 0 0 20 134 hours
O=Others/SDL
(OT/Clinics/ON Call). Total : 392hours
E=exam
7. Credit value: 392/80 = 5
8. Prerequisite:
9. Objectives:
Knowledge :
1. Common obstetric and gynaecological problems in clinical practice.
2. Health care screening for all women.

3. The principles involved in the diagnosis and management of common obstetric and
gynaecological conditions.
4. The common procedures performed in an obstetric and gynaecology setting.
Skills:
1. Problem based obstetric and gynaecological history
2. Performing an obstetric and gynaecological physical examination.
3. Interpersonal communication
Attitude:
1. professional attributes required for the practice of medicine
This posting is designed to train students to apply their knowledge and skills in a holistic and
professional manner expected of a doctor. It prepares them to be leaders in the field of medicine
in both the local and global context. At the end of the posting the students will have built a basic
foundation in the discipline and are expected to:
1. apply basic science knowledge learnt in phase 1 and relate them to the pathogenesis of
obstetric and gynaecological conditions in the clinical setting.
2. obtain a competent history and perform an examination relevant to the discipline.
3. formulate a sensible provisional and differential diagnosis of common conditions in
obstetrics and gynaecology.
4. formulate and justify a rational investigations list.
2. interpret the investigations.
3. apply basic principles in the management of common obstetric and gynaecological
conditions.
4. describe the common pharmacological agents used in obstetrics and gynaecology.
5. practice aseptic techniques and universal precautions.
6. describe and assist in common obstetric and gynaecological procedures.
7. demonstrate effective communication skills expected of a junior doctor in the health care
team.

(a) Identify problems and prioritize them.
(b) Identify causes for these problems.
(c) Develop problem solving skills that are founded on sound and rational principles of
reasoning.
(d) Develop skills in problem solving that demonstrate ability to integrate knowledge
derived from a number of disciplines.

(a) Listening effectively and establishing rapport with patients (clients).
(b) Building trust and cooperation of patients. Demonstrating sensitivity to contextual
factors in patient care. (Examples being cultural, ethnic and religious sensitivities, socio
economic circumstances).
(c) Developing the ability to work as part of a team to deliver the best outcomes.
(d) Developing rapport with peers.
(e) Writing and maintaining focused, precise and concise reports. (Examples being
patient progress notes, discharge summaries and referrals).
(f) Presentation skills. (The ability to tailor presentations to the needs of different

audiences).
 Professional attributes
(a) Projecting a professional image. (demeanour, attire, punctuality)
(b) Ability to work as a team as well as independently according to needs.
(c) Demonstrating responsibility and dependability in patient care. (Integrity).
(d) Recognition of one’s own strengths and weaknesses.
 Developing an ability in understanding and using information technology
 Understand the economics of health care
The program has clearly defined goals. These are met initially via didactic lectures delivered to
the whole cohort. As the course progresses the strategy incorporates strategies that encourage
group study and self-learning. Assessment is through summative and formative strategy.
13. Synopsis:
This is an 8 week module. It is hospital based. It is designed to introduce the students to the
basic principles of obstetrics and gynaecology, aiming to develop the ability of the cohort to
apply knowledge from phase 1 to the clinical setting in phase 2. Its main thrust is to enable
students to develop the ability to apply didactic knowledge in the practical setting, and develop
an initial understanding of the place of the junior doctor in the functioning of the health care
team.
 Lectures (intra departmental and common).

 Practical skills workshop (episiotomy repair, programs and CTGs, pelvic examination).
 Bed side teaching
 Student led seminars.
 Debate
Attendance at outpatient antenatal/gynaecology, labour room and operating theatre

sessions/ward rounds/on call.
Formative (30%)
(a) Attitudes 5%
(b) Case write up/essays/ partograms 10%
(c) Log book 15%
Summative (70%)
(a) Theory 35% - MCQ and SBA (30 questions in total) 15% MEQ and SEQ (2 each) 20%
(b) Clinical 35% - Clinical long case 30% OSCE 5%
Total 100%


the nation.

and moral values.
PEO1 PEO2 PEO3 PEO4
   




moral values.

areas of interest.
     

L T P
History taking in 1) Introduce history taking and 1
obstetrics and examination outline for obstetrics and
gynaecology gynaecology patients
2) develop a template to use on the wards
with real patients
Physiological 1) Describe the physiological changes in 1

changes in pregnancy to the major organ systems
pregnancy 2) Describe the physiology of the
placenta
3) Apply knowledge to explain the
mechanism of physiological changes
in normal pregnancy
4) Apply knowledge to explain the
pathophysiological changes in
pregnancy complicated by disorders
such as hypertension, diabetes mellitus
Obstetric anatomy 1) Describe the anatomy of the maternal 1

(L3) pelvis.
2) Describe the anatomy of the foetal
skull
3) Define the following obstetric terms
i. lie,
ii. presentation,
iii. attitude,
iv. denominator,
v. position,
vi. engagement.
4) Demonstrate the ability to use the
above in the clinical situation, i.e. the
bony landmarks traditionally assessed
during clinical pelvimetry,
measurements for pelvic adequacy and
description of mechanism of normal
labour
Ante natal and post 1) Understand the aims of normal ante 1

natal care (L4) natal and post natal care
2) Enumerate the components of ante
natal and post natal care
3) Apply these in the screening of
abnormal pregnancies
Medical disorders in 1) Demonstrate an understanding of the

pregnancy (L5) relationship of medical diseases and
pregnancy i.e. how pregnancy effects
the disease and vice versa
2) Understand the pathophysiological
basis of these diseases in pregnancy
3) Describe the principles of management

of these diseases in pregnancy

(diseases covered in year 3 are heart
diseases, asthma, thyroid disease,
urinary tract infections, chronic renal
disease, DVT and obesity)
Normal labour and 1) Describe the mechanism of normal 1

management (L6) labour
2) Understand and describe the diagnosis
of established labour
- The principles of management of
normal labour
- (abdominal examination and FHR
monitoring, vaginal examination
and amniotomy, appropriate
intervals for vaginal examination,
maternal vital signs monitoring)
3) Demonstrate an understanding of the
rate of labour progress, significance of
clear and meconium stained liquor, and
foetal monitoring in normal labour
4) List the pharmacological agents used
in normal labour, and their mode of
action and adverse effects
5) Demonstrate understanding of their
appropriate use
Bleeding in early 1) List the causes of bleeding in early 1

pregnancy (L7) pregnancy (i.e. miscarriage/ectopic
pregnancy/molar pregnancy/other
incidental causes)
2) Describe the clinical features of the
above
3) Demonstrate an understanding of
appropriate investigations for the
above
Abdominal pain in 1) List the common causes of abdominal 1

pregnancy (L8) pain in pregnancy.
2) Demonstrate the ability to distinguish
causes of pain according to aetiology
(i.e. obstetric/ gynaecological/
surgical/ medical) trimester of onset.
3) Demonstrate the ability of diagnosing
normal labour pain.
4) Appropriately investigate abdominal
pain in pregnancy
5) Describe principles of management
Abnormal uterine 1) Describe the normal menstrual cycle 1

bleeding (L 9) 2) Define the terms Heavy menstrual
bleeding, abnormal menstrual
bleeding, intermenstrual bleeding, and

post coital bleeding

3) Classify bleeding using the PALM
COIEN system
4) Appropriately diagnose the causes of
abnormal uterine bleeding
5) Investigate appropriately cases of
abnormal uterine bleeding
6) Describe principles of management
Abnormal lie and 1) Define normal lie and presentation of 1

presentations (L 10) pregnancy
2) Describe the type’s abnormal lie and
presentation seen in pregnancy.
3) Describe the clinical findings in each
of the abnormal lie and presentation.
4) Demonstrate an ability to relate
abnormal lie and presentation to other
obstetric abnormalities.
5) Describe the appropriate investigations
to diagnose and monitor these cases.
in these cases
Fetal monitoring (L 1) List methods of fetal monitoring 1

11) 2) Demonstrate the ability to
appropriately utilize these methods
according to the clinical circumstances
Multiple pregnancy 1) Define multiple pregnancy, 1

(L12) monozygotic twins, dizygotic twins,
monochorionic twins, dichorionic
twins
2) Explain the occurrence of mono and
dichorionicity
3) List the predisposing factors for
multiple pregnancy
4) Describe the clinical features of
multiple pregnancy
in monitoring a multiple pregnancy
need to diagnose chorionicity in a
multiple pregnancy (i.e. why is
chorionicity important, how it is ante
natally diagnosed and when should this
investigation be done
7) Describe the complications of multiple
pregnancy
8) Understand the principles of TTTS
9) Appropriate monitoring of a multiple
pregnancy and principles of
management
10) List complications associated with
multiple pregnancy

Gynecological 1) List the common gynecological

malignancy (L13) malignancies
2) Describe the risk factors for
development of these malignancies
3) Describe the presentation of these
malignancies
and principles of FIGO staging
importance of FIGO staging
6) Describe principles of management of
these malignancies
7) Describe screening and preventative
strategies to reduce the incidence of
these malignancies
Endometriosis 1) Define these conditions 1

adenomyosis and PID 2) Describe their clinical presentations
(L 14) 3) Describe appropriate investigations for
these conditions and differential
diagnosis
of these conditions
5) Recognize the underlying
commonality in these conditions in
relation to presentation and sequalae
Infertility (L 15) 1) Define infertility, differentiate primary 1

and secondary infertility
2) Describe broadly the categories of
infertility and list common causes in
each category
3) List and describe the investigation of
an infertile couple
an infertile couple, with particular
emphasis to the use of ovulatory
induction agents. (clomiphene)
Puerperal pyrexia and 1) Define puerperal pyrexia 1

postpartum 2) Describe the appropriate investigations
complications (L16) and principles of management in a case
of puerperal pyrexia
3) List other common postpartum
complications and their management
Contraception (L 17) 1) Define contraception

2) Define the ideal contraceptive
3) Categorize the various contraceptive
methods
4) Describe the mode of action of the
different contraceptive methods
5) Describe the adverse effects and
contraindications to contraceptive use

6) Define the Pearl index

7) List the failure rates of each method of
contraception
8) List non contraceptive benefits of
contraceptive use particularly in
relation to the COCP
Fibroids and benign 1) Define fibroids

adnaxeal masses (L 2) Classify benign adnexal masses
18) clinically
3) Describe the presenting features and
complications of fibroids and benign
adnexal masses
4) Develop a template to differentiate
between the different causes of
adnexal masses
5) Describe the differential diagnosis of
fibroids
and principles of management of
fibroids and adnexal masses
Maternal and Perinatal 1) Define maternal mortality and

Mortality (L 19) perinatal mortality
2) List the chief causes of maternal and
perinatal mortality and the current
rates in Malaysia
3) Describe strategies to reduce the
maternal and perinatal mortality rates
in our country
Obstetric analgesia (L 1) Describe the various methods of

20) obstetric analgesia
2) Describe the common
pharmacological agents used
3) Describe the advantages and
disadvantages of each method and
recognize the adverse effects of the
pharmacological agents used
Episiotomy workshop This workshop aims to familiarize the 2

(CST 1) students with the types of episiotomy, the
sutures used and the method of episiotomy
repair. Students are expected to be able to
recall the anatomy of the perineum in terms
of vascular and nerve supply as well as the
muscles of the perineum.
Partogram and CTG This workshop aims to familiarize the 2

workshop (CST 2) student with the partogram and the clinical
information contained therein. The student
is taught to fill in a partogram and
recognize the normal labour partograms
and the abnormal labour partogram.

The student is expected to be able to chart

a partogram, recognize normal and
abnormal labour patterns as well as
appreciate the advantage of recording
labour progress on a partogram.
The student is expected to recognize a
normal and abnormal CTG. The student is
expected to be familiar with early, late and
variable decelerations and be able to
recognize them on a CTG.
Pelvic examination The pelvic examination is a skill that is an 2

(CST 3) essential part of gynecological
examination. Apart from completing the
CST- clinical skills examination and helping with diagnosis, it
teaching is a skill that is required when performing
gynecological procedures (pap smear,
vaginal swabs, and endometrial biopsy).
Students are provided with pelvic models
with different pathology and are taught the
fundamentals of a pelvic examination and
performing a pap smear.
Diabetes in pregnancy 1) Describe the changes in carbohydrate 2

(S1) metabolism in pregnancy
2) List the hormones that are responsible
for the changes in carbohydrate
metabolism in pregnancy
3) Recognize the risk factors for diabetes
in pregnancy
differences in the diagnosis of
diabetes in pregnancy from the non-
pregnant state
5) Describe the test used in the diagnosis
of diabetes in pregnancy and
demonstrate the ability to interpret
this test
6) List and understand the principles of
management of a diabetic pregnancy,
(recognize that this is a high risk
pregnancy, incidence and magnitude
of the problem, pre conception
management, blood sugar profile,
HbA1c, diet control, insulin therapy,
optimal glycaemic control
,recognition of microvascular
complications, foetal monitoring and
complications timing and mode of
delivery, postpartum management,
contraceptive options)
Postdates and 1) Define the terms: 2

induction of labour i. Term pregnancy

(S2) ii. Post term pregnancy

iii. Post-dated pregnancy
iv. Prolonged preg nancy
risks associated with a post-dated
pregnancy.
3) Describe the monitoring of a post-
dated pregnancy.
4) Describe the methods of induction of
labour.
5) List and describe the clinically relevant
pharmacological properties of agents
used in induction.
6) Understand and describe the principles
of management of a post-dated
pregnancy.
7) Recognize the complications of
induction and demonstrate an
understanding of the strategies
employed in preventing these.
Hypertension in 1) Classify hypertensive diseases in 2

pregnancy.(S 3) pregnancy
2) Define gestational hypertension, pre
eclampsia and eclampsia.
3) Describe the incidence of pre
eclampsia and eclampsia.
4) List the risk factors for pre eclampsia.
5) Describe the pathophysiology and
clinical manifestations of these
conditions. Demonstrate the ability to
clinically correlate the two.
6) Describe the clinical course of these
conditions and demonstrate an
understanding of monitoring the
mother and foetus with pre eclampsia.
(Maternal and foetal monitoring,
medical management of hypertension,
maternal and foetal complications.
Timing and mode of delivery)
of eclampsia.
8) List and describe the common
medications used in the management
of hypertension in pre eclampsia.
9) List the anti convulsant of choice in the
management of eclampsia, it’s mode of
administration and mode of action
10) Describe the parameters monitored in
these patient explain why this is done.
of pre-existing hypertension in
pregnancy and post-partum
management of pre eclampsia
12) List the screening and prophylactic

measures available for these diseases,

explain their rationale and indications
for their use
Premature labour 1) Define premature labour, PROM and 2

PROM and PPROM PPROM.
(S 4) 2) List the risk factors for the above.
3) List the incidence of these conditions
4) Describe the clinical features of these
conditions.
5) List the diagnostic methods used in the
management of these conditions and
demonstrate an understanding of their
use.
6) Describe the principles of
management.
7) List the drugs used in the management
of these conditions, and describe their
indications and possible adverse
reactions (tocolytics, antibiotics and
steroids)
8) Understand the long term burden of the
sequalae of prematurity, PROM and
PPROM
Assisted delivery and 1) List the types of assisted delivery and

caesarean section. (S caesarean sections.
5) 2) Identify the different types of forceps
and ventouse apparatus.
3) List the types of instrumental
deliveries, and demonstrate an
understanding of the need to use
different instruments.
4) List the indications for an instrumental
delivery.
5) List the prerequisites for an
instrumental delivery.
6) List the complications of instrumental
deliveries.
7) Understand the limitations of this
modality of management. (Recognize
scenarios associated with difficult
instrumental delivery, recognize the
features of a failed instrumental
delivery, and understand the concept of
trial of instrumental delivery).
8) List the types and indications of
caesarean section.
9) Preoperative and postoperative care.
10) Vaginal birth after caesarean section,
demonstrate an understanding of how
these situations are assessed and risks
associated with spontaneous versus
induced or augmented labour

Amenorrhea (S 6) 1) Define primary and secondary

amenorrhea.
2) List the common causes of primary and
secondary amenorrhea.
3) Develop a diagnostic pathway for the
assessment of amenorrhea.
of amenorrhea
Infections in 1) Discuss the aetiopathogenesis of the

Obstetrics and following in relation to pregnancy:
Gynaecology ( S 7) i. Rubella
ii. Hepatitis B
iii. HIV
iv. Syphilis
2) Discuss the aetiopathogenesis of gp B
streptococcal infection in pregnancy.
3) Discuss the aetiopathogenesis of PID
in gynaecology.
4) Outline the principles of management
of the above
Ante partum 1) Define ante partum haemorrhage and

haemorrhage (S 8) list the causes.
2) Describe the causes, and the typical
clinical differences between placenta
praevia and abruption placenta.
3) List maternal and foetal complications
of the above and describe the
principles of maternal and foetal
monitoring in APH.
4) Outline the principles of management
of placenta praevia and abruption
placenta.
5) Describe the pathogenesis of DIVC
and list the blood products used in
these cases with clinical justifications
Discrepancies in 1) List the causes of a “uterus

uterine size (S 9) larger/smaller than dates.
for these conditions.
3) Demonstrate an ability to work up
these cases clinically
Menopause – health 1) Define menopause, premature

issues and HRT(S 10) menopause and early menopause.
2) Describe the hormonal changes during
menopause.
3) List the clinical features of menopause
and explain the pathogenesis.
4) Describe the management of a
menopausal patient.
5) Demonstrate an understanding of long

term health problems associated with

the menopause and its management.
(cardiovascular disease, cancers,
osteoporosis and dementia)
6) List broadly the management
modalities of the menopause and its
sequalae, demonstrate an
understanding of the rationale of using
the different HRT preparations
All breeches should be 1) Discuss the pros and cons of vaginal vs

delivered by LSCS LSCS birth in breech presentations.
(Debate) 2) Discuss the place of ECV in the
management of breech presentations
Acute pelvic pain (CD 1) Use an illustrative case to develop a

1) management plan for a woman with
acute pelvic pain
2) Describe the gynecological and non-
gynecological causes of acute pelvic
pain and outline the principles
involved in investigation and
treatment of these conditions
Grand multiparity 1) Use an illustrative case to describe the

(CD 2) issues associated with the
management of a grand multiparous
mother
Obstetric emergencies 1) Use an illustrative case to describe the

(CD 3) management of post-partum
hemorrhage/cord prolapse/shoulder
dystocia
(ectopic pregnancy, miscarriage,
torsion and ovarian cyst accidents, PID
and tubo ovarian abscess, acute
appendicitis)
Tumour markers in 1) List commonly used tumor markers in

gynaecology (CL 1) gynecological practice.
2) Understand the place of tumor markers
in different gynecological
malignancies
3) Demonstrate an ability to use this
knowledge in the management of GTD
and ovarian cancer
Imaging in obstetrics 1) List the imaging modalities in

and gynaecology (CL obstetrics and gynecology.
2) 2) Describe the appropriate use of these
modalities in clinical practice

Textbooks
1. Obstetrics Illustrated 7th edition Hanretty. Churchill Livingstone
2. Gynaecology Illustrated 6th edition Bain, Burton and Mcgavigan. Churchill Livingstone
3. Obstetrics and Gynaecology 4th edition Impey and Child. Wiley Blackwell
4. Oxford Handbook Of Obstetrics and Gynaecology 2nd/3rd edition Collins, Arulkumaran et al
Oxford Publications
Reference
1. Journal Of Paediatrics’ Obstetrics and Gynaecology
2. GP Online
3. Green top Guidelines of the RCOG London

MBBS Curriculum Paediatrics/Year-3
Paediatrics (Year-3)
Course Information
1. Name of Course/Module: Paediatrics (Year-3)
2. Course Code: PED 6555
1. Prof Prameela Kannan Kutty

2. Prof Shinde SV
3. Prof Usha Singh
4. Dr. Ismail Mohammed Elghuwael
5. Assoc Prof Ali Hadi
This module will provide students with the knowledge Paediatrics. They will learn to recognise
normal health indices of neonates, infants, toddlers, children and adolescence. The student will
recognise normal developmental and physiological changes in children. They will detect
pathology, common clinical conditions by taking a paediatric history, conducting a physical
examination and arriving at relevant diagnoses. Basic management including investigations,
treatment and parental counselling will be taught. Emergency management of important
paediatric conditions are introduced.
At the end of both modules, the student will be able to handle the basic medical problems of
children as a houseman and junior medical officer.

L S P O E Guided learning = 180 hr

L= Lecture (2) 12 46 90 28 4 Independent learning =
S=Seminars(6)/Case 182 hr
discussion(5)/Debate(5)
P=Clinical Skill Labs (2) 24 13 0 0 20 Total = 362 hrs
O=Others/SDL 8
E=exam
7. Credit value: 362/80=5
8. Prerequisite:

9. Objectives:
Knowledge of
1. the rights of children.
2. normal growth parameters in children.
3. the normal developmental milestones in children and important variances form the
norm.
4. common paediatric problems seen in a clinical setting.
5. common paediatric emergencies.
6. Malaysian immunisation schedule for children.
7. the common causes of breathlessness at different ages
8. signs of upper and lower respiratory infection
9. WHO classification of Acute Respiratory Infections(ARI)
10. clinical signs of respiratory distress with relation to pathophysiology
11. Treatment, prevention and counselling in febrile fits
Skills in
1. obtaining a complete paediatric history, including taking history from the mother or the
caregiver
2. obtaining a history from an older child by appropriate questioning of the child and
his/her parents.
3. obtaining a history from an adolescent with or without the parent/s or carer.
4. performing a systemic examination of neonates, infants and children, appreciating and
putting into practice the important variations in the paediatric approach to the clinical
examination of children.
5. plotting growth parameters accurately on age and gender appropriate growth charts.
6. performing core procedures in paediatric settings.
Attitude regarding
1. interaction with patients (and their families) with regards to respect,
compassion and empathy.
2. Politeness and respect for other health care professionals.
3. punctuality, reliability and the ability to take initiative and responsibility where
appropriate.
4. ability to work effectively as part of a team.
5. motivation towards patient assessment, self-directed study and maximising clinical
experience.

1. amalgamate data from the history and physical examination and request basic relevant
investigations and interpret their results
2. formulate a provisional diagnosis in a problem oriented manner.
3. recognize the critically ill child
4. recognize special ethical Paediatric problems that could be encountered in paediatric
practise.
5. make a developmental assessment of the neonate, the infant and the toddler
6. recognise the normal and abnormal patterns of infantile, childhood and pubertal growth
7. examine a child for strabismus
8. identify normal nutritional requirements at varying ages of childhood and adolescence.
9. carry out appropriate parental counselling on nutritional needs in childhood
10. explain to parents the necessity of immunisation with scientific basis.

11. give advice to parents about injury prevention

12. participate in health education available to children
13. apply the general principles of screening in paediatrics
14. perform the routine examination of a newborn and identify the normal variations.

(c) Tracing clinical problems to their causes and diagnosis
 Use of general information technology and investigative tools
of patient care
Teaching will be in clinical bedside, lecture and seminars with case discussions and hospital
ward rounds, supported by independent reading and private study for examinations.
13. Synopsis:
This course provides the student understanding of the pathophysiological changes in the
paediatric patient and to arrive at a differential diagnosis through clinical history taking and
physical examination. They are trained by various TLA methods to have the knowledge and
values to empower them skills and attitudes required of good housemen and junior MOs.
Bedside teachings, case discussions, lectures, seminars, short case, long case, OSCE and
theory assessment.
Continuous Assessment 30%

End Posting Exam 70%
MCQ, MEQ, SAQ

Total written 35%

Clinical
Long Case, Short Case, OSCE
Total Clinical 35%
Total : 100%

the nation.

and moral values.
PEO1 PEO2 PEO3 PEO4
   




moral values.

areas of interest.

    
L T P
1) History taking and physical
examination skills
2) Normal child growth & development
3) Vaccinations
4) Feeding including breastfeeding
5) Respiratory
6) Cardiovascular
7) Renal
8) Hematology
9) Musculoskeletal
PRESCRIBED TEXT BOOK

1. Nelson:Essentials Of Paediatrics Behrman, Richard E, Kliegman, Robert M 6th edition
2. Hutchinson’s clinical methods Illustrated Textbook of Paediatrics.
3. Macleods Clinical Methods
4. 4Illustrated Textbook of Paediatrics. Tom Lissauer & Graham Clayden 4th edition 2007
Mosby International Limited
RECOMMENDED TEXTBOOKS
1. Nelson Textbook Of Pediatrics,Kliegman , Robert M,Arvin A,Behrman,R latest edition
2. Hospital paediatrics - A. D. Milner, David Hull
Suggested further reading:

1. Breast milk immunoprotection and the common mucosal immune system Mal J nutrition
2010 Prameela KK, Adel al Kadi
2. HIV transmission through breastmilk: the science behind the understanding of current
trends and future research. MJM 2010 Prameela KKutty
3. Breastfeeding and the Influenza viral pandemic 2009 MJM PrameelaKK
4. Rotavirus diarrhea and breastfeeding Prameela KK, Vijaya MalJ nutrition 2010
Extra case discussions , ward rounds , teaching in the clinic or outpatient settings and extra
teaching for the weaker students or the motivated students are teaching activities done ad hoc
and on student request as per midcourse feedback.

MBBS Curriculum Psychiatry/Year-3
Psychological and Behavioural Medicine (Year-3)
Course Information
1. Name of Course/Module: Psychiatry (Year-3)
2. Course Code: PSY 6354
1. Assoc. Prof Dr Selvam Karuppiah
1. To Improve the knowledge, skills and attitudes in the field of psychological and
behavioural aspects of medical and health care practice
2. To help medical students understand the psychological and behavioural aspects of
medicine and use them effectively in patient care

L S P O E Guided learning = 82.5 hr

L= Lecture (2) 15.5 50 12 5 Independent learning =
S=Seminars(6)/Case 206 hr
discussion(5)/Debate(5)
P=Clinical Skill Labs (2) 31 150 0 25 Total = 288.5 hrs
O=Others/SDL
E=exam
7. Credit value: 288.5/80 = 4
8. Prerequisite:
9. Objectives:
A. Knowledge of
1. scientific basis of psychiatry and its application to patient care.
2. the relationship of psychological, social and physical factors that contribute to
emotional and behavioural signs, symptoms in all diseases in various settings.
3. common mental signs and symptoms.
4. diagnosis of common psychiatric conditions and psychotic disorders at
primary care level.
5. common reasons for psychiatric referrals from non-psychiatric settings.
B. Essential skills of
1. history taking.

2. physical examination.
2. politeness and respect for other health care professionals.
3. punctuality, reliability and the ability to take initiative and responsibility
where appropriate.
4. ability to work effectively as part of a team
5. motivation towards patient assessment, self-directed study and maximising
clinical experience.
1. carry out a clinical interview of a patient with emotional distress in any setting,
adequately.
2. clerk a patient with emotional distress using a psychiatric clerking format.
3. arrive at a preliminary understanding of the main psychological and social
problems faced by the patient and generate a provisional diagnosis.
4. discuss common investigations used in psychiatry, their indications and their
significance
A. Problem Solving Skills of

1. Recognizing clinical problems/diseases and sorting them according to their
importance.
2. Recognizing and treating sources of these clinical problems in the
environment of the ward or clinic.
3. Build up problem solving/ clinical reasoning skills by linking the history and
physical examination skills to the clinical knowledge.
B. Interpersonal & Communication Skills of

1. establishing an understanding relationship with patients.
2. gaining trust of the patient.
3. teamwork.
4. effective and concise patient clerking
5. case reporting.
C. Professional attributes of
1. professional image (demeanour, attire, punctuality)
2. self-dependence
3. teamwork
4. leadership
The course teaching learning activities are designed to facilitate the students to achieve the
learning outcomes of the course; meanwhile, the assessment is aimed to evaluate the degree of
students’ achievement of learning outcomes.

13. Synopsis:
During this 4 weeks posting will be rotating, on a daily basis, at psychiatric out patient clinic,
methadone clinic, medical ward liaison & on call, and rehabilitation.
Students will be exposed to the Psychiatric patients at out patient clinic. During the clinical
attachment, students are required to attend the outpatients department to observe, clerk and
discuss management of psychiatric problems. Applied clinical teaching takes place here.
Subsequently these clinical episodes are discussed at clinical case discussion sessions and every
aspect of the case is discussed ranging from history taking technique to identifying the illness
based on the Bio Psychosocial Model. Management and therapy aspects are also discussed.
Student are also exposed to other services such as addiction clinic (methadone clinic) as well as
Rehabilitation clinic.
Teaching is also done in several formats. Such as lectures small group discussions in seminars,
Problem Based Learning, Case conferences, Tutorials and Journal Club discussions.
During this 3rd year students also do’ tag calls’ at least a total of twice in the tenure of 4 weeks
and they would be able to appreciate interdisciplinary team work in the assessment of new cases
presenting after office hours. During this ‘tag-calls’ students are supervised by Mahsa staff as
well as Hospital staff.
1. Lectures (common lectures).

2. Case presentations and discussions
3. Problem Based Learining
4. Student led seminars.
5. Case conferences.
6. Clinical attachment (Outpatients, Methadone Clinic, Rehabilitation,
“Tag”On-call)
7. Case write-ups.
Continuous (30%)
(a) Attitudes 5%
(b) Case write-up 5%
(c) Log book (Presentations (10%), Seminar (5%), and Case discussion (5%))
Final (End of Posting) (70%)

(a) Theory 30% - MCQ and SBA (10 questions in total)
(b) Clinical 40% - OSCE (3 OSCEs in total)
Total 100%

the nation.


and moral values.
PEO1 PEO2 PEO3 PEO4
   




moral values.

areas of interest.
    

L T P
1. Scientific basis of Psychiatry
History of Psychiatry
The evolution of concepts in
psychiatry and scientific reasons to
consider it as as a science and not a
belief
Introduction to Psychiatry and safety
issues briefing.
2. BioPsychoSocial Model of
psychiatry
The student is made to understand
the core components of psychiatry is
to be viewed from a holistic point of
considering biological, psychological
and social reasons for the illness.
To deliver a comprehensive
management plan, it is important to
realise the multifactorial concept of
the illness. Formulating and using the
3Ps..Predisposing,precipitating and
perpetuating reasons
3. The Psychiatric Interview

The proper history taking using the
Maudsley Model.
Including the art of phrasing
questions which are open ended and
close ended.
Mental State examination.
Diagnosis and use of DSMIV and
ICD 10
4. Psychopathology
Knowing the terminology and
specific meanings, their use and
importance as diagnostic markers
5. Anxiety Disorder
6. Depression
7. Bipolar Mood Disorder
8. Schizophrenia
9. Deliberate Self Harm
10. Suicide
11. Delirium

12. Dementia
13. Childhood disorders
14. Alcohol related disorders
Child psychiatry- 1) Name and identify the common

overview childhood disorders
2) A brief idea of management
Eating disorders 1) Identify eating disorder problems

and its different presentations.
2) Identify underlying reasons for the
disorder
3) Understand treatment concept
Culture bound 1) Identify the different culture bound

syndrome syndrome seen in Asian community
2) Understand the concept behind these
syndromes
3) Know the management principles
Emergency 1) Understand the range of problems

psychiatry that may present as an emergency
2) Know the basic principles of
management of a psychiatric
emergency
Post natalblues and 1) recognize and differentiate post

post partum
depression partum blues and post partum
depression.
2) Have a basic idea of management
Textbooks
1) Oxford Textbook of Psychiatry, Gelder M., Gath D., Mayou R Oxford University Press.
2) Synopsis of Psychiatry Behavioural Sciences/ clinical psychiatry, Kaplan H.,I.,Saddock
B., J., Williams & Wilkins, Baltimore

MBBS Curriculum Rural Health/Year-3
Rural Health (Year-3)
Course Information
1. Name of Course/Module: Rural Health Posting (Year-3)
2. Course Code: RHP 6354
1. Prof. Dr. Than Winn (TW)

5. Dr. Aung KoKo Min (AKK)
RATIONALE
1. To understand and describe the organizational structure and functions of the

health delivery system in the rural area
2. To study the types of illnesses, common socio-psychological and
occupational problems faced by the rural community
3. To understand the linkages between the rural and the urban health delivery systems
4. To design, organize, conduct, analyze and report on a community research project in
the district
SPECIFICALLY
1. To study the health delivery system of the rural areas

2. To study the role of Medical Officer of Health (MOH) and the role of
Medical and Health Officer (MNHO) in a district
3. To study the programs and activities of various units that provide health care
i.e. administration, finance, disease control, sanitation, food and water
quality, vector control, maternal and child health, health education,
occupational and environmental health and other health related programs
4. To identify the different agencies which contribute towards health activities
in the district; District Council and understand linkages between different
health agencies and health related agencies in the rural set-up
5. To identify the causal web for common health problems in the district by
clinic-social case-clerking of the hospital patients who will be followed up to
their homes and working environments.
6. To study the organization and management of a district hospital
a. The organization of a secondary care hospital
b. The roles of director of hospital, medical officers and support staff in the
hospital
c. To understand the activities of a secondary care hospital
7. To plan and conduct a study on an important public health problem identified
by clerking a case from the health clinics' and conducting home visits to

discover the psychological, occupational, social and environmental impact on

the patient's health and its implications tohimself/herself, the family and the
community
8. To study the (rural) occupational activities which include factory risk
assessment (HIRARC)

L S P O E Guided learning =
L= Lecture (2) 52 18 8 56 2.5 136.5 hr
S=Seminars(6)/Case
discussion(5)/Debate(5) Independent learning =
P=Clinical Skill Labs (2) 170.5 hr
O=Others/SDL 104 54 0 0 12.5
(OT/Clinics/ON Call). Total = 307 hrs
E=exam
8. Prerequisite:
9. Objectives:
1. Overview of the health organization in the rural setting

2. Understand the rural health care system and the public health care progra
3. Apply knowledge of Epidemiology, Research methodology & Biostatistics in
conducting community research.
4. To expose students to district field and factory visits, so that the student gains
knowledge of environmental and occupational issues in the rural area.
1. Understand and describe the health delivery system in the rural area.
2. List all the programs conducted by the health department and to understand the
programs and activities of the different units that contribute towards the health of the
population in a district -
i. Vector Borne diseases prevention and control
ii. Food Quality control
iii. Water Quality control
iv. Health Quality control and surveillance
v. Health Education
vi. Occupational Safety .and Health activities
vii. School Health activities
viii. Maternal Child Health activities
3. Describe the environmental and occupational health issue in the rural area.
4. Be able to plan a prevention and health education module to address the health issues
of that district
5. Be able to communicate effectively with healthcare personnel and other individuals

involved in delivery care to the community.

6. To organize, planned and conduct a community based research project.

importance.

3. teamwork.
5. case reporting.
2. self-dependence
3. teamwork
4. leadership
Teaching will be in lecture, demonstrations and practicals hands on, supported by independent
reading and private study for examinations.
lecturer. Assessment is through summative and formative strategy
13. Synopsis:
This course provides the student with an overview of the major elements of rural healthcare
activities. This includes all the environmental activities carried out by the health department of
that district. Activities such as health education, maternal and childhealth clinics, vaccination
programs, school health and dental care are introduced to the student during this posting.
The students also conduct a community based research project during this posting. They are also
exposed to an industry visits to understand the occupational issues.
Lectures, tutorials, practicals, field visits, Industry visit, Case clerking and presentation
demonstrations, Research, Literature review, District hospital and Health clinic visits, Home
visits.

Continuous Assessment
(a) Literature Review: 5%
(b) Proposal Assignment : 15%
(c) Presentation of Field& Industry Visits : 10%
(d) Clinical Social Case : 10%
(e) Community Research : 15%
(f) Attendance & Attitude : 5%
Final Exam EPX : 40%

Total : 100%
EPX consist of: MTF, OBA, SEQ, PBQ, OSPE
The Department will adopt the attendance rule as mandated by the Faculty of Medicine,
MAHSA University. Passing grade will be awarded if the students attain 50% or more
of the total scores.

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Basic Concepts of 1) Define management 1
Management 2) Decide which principles of
management apply in a variety of
situations
3) Explain which management
decisions are required in a variety of
situations
4) Name the three broad functions of
management and show how they
relate to one another
Health Informatin, 1) Define health education, information,

communication
Education 2) Describe the qualities of a health
&Communication educator
3) Describe the process of a health
education program
4) Define health promotion
5) Describe the importance of the
technology and media in the health
education process
Managing Health in 1) Describe health problems and issues

in the district of Gombak
a District 2) Describe programs and objectives of
health program in Gombak
3) Describe the achievements in the
implementation of the programs
4) Identify limitations and constraints in
the implementation of the program

5) Discuss possible solutions and

recommendation in managing health
problems in the district
Environmental 1) Understand the Sources and Health

Effects of Water, Air and Land
Pollution and Pollution
Control 2) Understand the Principles of
Pollution Control
3) Understand the Environmental
Quality and Related Laws in
Malaysia
Role of Medical and 1) Understand the organization

structure of the district health office
Health Officer and clinics
2) Understand the nature of the work of
a doctor in health clinics at the
district level
3) Understand the duties of the medical
and health officers at the district
health clinics
4) Understand the roles of the medical
and health officers in managing
health problems in the district
Family Health 1) Understand the organisation in a

Health Centre
Services & Expanded 2) Know the services given at maternal
Scope Programme and child health
3) Know the services via the expanded
scope programme
4) Understand how the services is
linked to the secondary or tertiary
care
5) Understand the involvement of the
community and the family in the
services provided
Prevention and 1) Understand definition and examples

of common non-communicable
control of NCD diseases in Malaysia
2) Know in general the national
strategic plan for NCD
3) Know the basic statistics on these
NCDs
4) Understand the basic principles of
prevention and control of diseases
5) Know the current prevention and
control programs for NCDs at the
district level
6) Examples of NCD programs in
Gombak

7) Know the changes in implementing

prevention and control programs for
NCDs at the district level
Communicable 1) Elaborate the objectives and

programmes of communicable
Diseases diseases
2) Understand the concept, theory and
problems of communicable diseases
at district level
3) Elaborate the achievements attained
in the implementation of the
programmes
Prevention and 1) To give a direct understanding on

various aspects of prevention and
control of VBD control of Dengue fever and Malaria
to the students
2) To deliver a direct experience on
how and the techniques of
maintenance on equipments and
pesticides
3) To give first-hand exposure on
legislative enforcement according to
the SOP (Standard Operating
Procedure)
4) To explain the limitations of the
programmes that being deployed
Food Quality 1) Understand the food safety and

quality control
Control 2) Causes of food poisoning
3) Identify the health hazards along
the food chain and food processing at
various stages from the public health
point of view
4) Understand the sanitary control
of food, and food legislations
Water supply 1 1) Understand the water-related 1

infections, water chemistry and
diseases
2) Identify the uses and various sources
of water supplies
3) Understand the measurement of
Drinking Water Quality and
guidelines in Malaysia
Water supply II 1) Understand water supplies in the 1

rural and urban areas
2) Understand the purification of
water in urban areas
3) Understand the drinking water
quality surveillance in Malaysia

Waste water 1) Understand the public health

importance of excreta
2) Understand the excreta and waste
water disposal systems in rural
and urban areas of Malaysia
Solid Waste Disposal 1) Describe the various types of

solid waste
2) Understand the health aspects of
solid waste
3) Be familiar with the methods of
refuse disposals
4) Understand the community
participation and law enforcement
Rural Occupational 1) Define the scope of occupational

health
Health 2) Outline a brief history
3) Know the importance of legislation
for workers in occupational health
4) Describe the most common work
related diseases
5) Understand the relationship
occupational health with
development of the country
6) Describe the prevention for
occupational hazards
Occupational and 1) Elaborate the objectives and the

related programmes of occupational
Environment Health diseases and environmental health
2) Understand the problems, concept
and theory of occupational diseases
at district level
3) Describe the achievements of these
programmes
4) Explain the limitations of these
programmes
Disaster 1) Definitions
Management in 2) Causations
Health District 3) Preventive and control measures
Clinic Visit/ Rural 1) Understand the functions and

clinic (klinikdesa) structure of Health Clinic.
and home visits 2) Work process and the needs of home
visits
3) Understand the community health
problems in Rawang
4) Communicate well with clinic
customers and patients
5) Understand the work processes of
outpatient and maternal and child
health units

Food premise 1) To know procedure of food premise

inspection inspection
2) To know the related acts
Larva survey, 1) SOP for Aedes breeding surveillance

Fogging, BFMP 2) Search and action taken for places
found as mosquito‘s breeding
grounds
3) The right procedure to capture larvae
and the subsequent follow-ups
4) Identify larvae species and the
legislative action/s
5) Take blood slide sample (BFMP) for
MBS/ACD as a means to control
Malaria
6) Techniques of measurement, mixing
of pesticides and to dye the mosquito
net
7) The correct procedure for wearing
various PPEs
8) Procedures for use and maintenance
of machines and equipments
Health Clinic Visit 1) Understand the community health

Rawang (Practical problems in Rawang.
session) 2) Communicate well with clinic
customers and patients.
3) Understand the work processes of
outpatient and maternal and child
health units
Literature Review 1) know how to do literature review

2) apply the knowledge of study designs
and medical statistics from year 2
3) discuss the findings of the study
Proposal writing and 1) know who to write a proposal

2) develop a proposal for study
research report 3) do the referencing
4) conduct a study
5) do the analysis of the data by using
SPSS ver 19.0
6) write a research report
7) present the research findings
References
1. On Being in Charge: A guide for middle-level management in primary health care,
WHO, 1980. (A guide to Rural Health Services Management
2. Epidemiology* Gordis, Leon. 4th edition (2009). Elsevier Saunders, Philadelphia,
PA. USA.
3. Biostatistics: A Foundation for Analysis in the Health Sciences: Wayne W
Daniel: (2010) 9th Ed (International Student Version), John Wiley & Sons, INC.

4. Oxford Textbook of Public health: Roger Detels, 4th Edition, Oxford University
Press, New York, 2003.
5. Guidelines for Hazard Identification, Risk Assessment and Risk
Control(HIRARC): Department of Occupational Safety and Health 2008

MBBS PROGRAM
YEAR-4

Medicine (Year-4)
Course Information
1. Name of Course/Module: Medicine (Year-4)
2. Course Code: MMED 6474
1. Prof. Tan Sri Dato’ Seri Dr. Haji Mohd Ismail Merican
3. Prof. Dr. Nandakumar Singaram
4. Prof. Dr. Ajai Pratap Singh
5. Prof. Dr. Har Mohan Pal Singh
6. Associate Prof. Dr. Tarek Mohammed Elshaarawy Mohammed Nassar
In MBBS year 4 Medicine posting, emphasis is for preparing students to take care of patients
and families in a competent and professional manner. Medicine posting’s students are allocated
to various discipline based wards (Cardiology, Pulmonology, gastroenterology, nephrology,
rheumatology, Neurology), to expose them to common problems seen in these discipline and
their principles of management.
In MAHSA knowledge and skill based curriculum, this course provides opportunities for
learning and evaluation in the following competencies:
5. Semester and Year offered: Year-4 (6-week posting)

L= Lecture (2) 12 29 37 127 6 211 hr
S=Seminars(6)/Case
P=Clinical Skill Labs (2) 141 hr
O=Others/SDL 24 87 0 0 30
E=exam
7. Credit value: 352/80 = 4.4

8. Prerequisite:
9. Objectives:
Knowledge of
1. comprehensive approach to the evaluation and care of the adult medical patient
suffering from cardiac, pulmonary, Gastro, Renal, Rheumatic and Neurological disese.
Skills in
1. obtaining, recording, analyzing and communicating clinical information.
Attitude in
1. continuing lifelong study
2. communicate patients with professionalism, ethics and empathy
1. to obtain an accurate, comprehensive history from the patient

2. to perform a rational, thorough physical exam
3. to, when appropriate, focus the history and physical exam to the patient's active issues
4. to order basic laboratory and radiologic studies as appropriate and to know how to
interpret the results of these studies
5. to use information from the history, physical examination and initial laboratory data to
create a problem list
6. to recognize and prioritize the issues in the problem list that need attention and to
generate a differential diagnosis for each active problem
7. to use information from the history, physical examination and initial laboratory data,
along with the problem list and differential diagnoses, to generate a patient-oriented
assessment that includes a diagnostic and therapeutic plan for each of the patient's active
problems
8. to record in writing, and present orally, the results of the complete history and physical
examination (including assessment and plan) in a systematic, concise and coherent
manner
9. to use the medical literature to understand the natural history of diseases and to help
plan therapy that addresses the pathophysiology of these diseases
10. to integrate clinical reasoning skills with an ever increasing knowledge base
11. to continue to develop and use the skills of self-directed learning



of medical imaging.
13. Synopsis:
This course provides the student with an overview of the major elements of high technology
entrepreneurial activities including evaluating and planning of new business, financing, team
building, typical marketing and operational management issues, alternatives models for revenue
and growth, and exist strategies. It will also introduce the student with the theory and nature of
electronic commerce, particularly those based with internet technologies.
Lectures, tutorials, practicals

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Acute coronary
syndrome
Peripheral vascular
disease
Infections of the
respiratory system
Pulmonary vascular
disease
Infections of the
nervous system
Intracranial mass
lesion

Inflammatory joint
disease
Systemic connective
tissue disease
Acute glomerular
disease
Systemic renal
disease
Malabsorption
Inflammatory bowel
disease
Heart failure
(Seminar-1)
Respiratory failure
(Seminar-2)
Chronic renal
failure/ Renal
replacement therapy
(Seminar-3)
Chronic liver disease

(Seminar-4)
Osteoporosis,
Osteomalacia and
Ricket
(Seminar-5)
Movement disorders
of CNS / Paraparesis
(Seminar-6)
CVS Investigation
CNS Investigations
HEAMTOLOGICAL
diseases-
INVESTIGATIONS
Rheumatology –
INVESTIGATIONS
GIT
INVESTIGATIONS

Liver/Renal
Function Tests
Revision
Patient with chest pain

on exertion
Patient with cough,

chest pain and
haemoptysis
Patient with fever and

rash
Patient with acute

breathlessness
Patient with acute

neurological deficit
Patient with joint pain
CAD(Coronary artery
disease)
Cardiac failure
Pneumonia
COPD/Asthma
Chronic Renal failure
Malabsoption
GIT Neoplasm
Bed side teaching
Ward work/ward
round
Textbooks
1. Graham Douglas, Fiona Nicol, Colin Robertson. ‘Macleod’s Clinical Examination’. 13th
Edition. 2013. Elsievier Churchill Livingstone.
2. Brian R. Walker, Nicki R. Colledge, Stuart H. Ralston, Ian Penman. ‘Davidson’s Principles
and Practice of Medicine’. 22nd Edition. 2014. Churchill Livingstone.

MBBS Curriculum SurgeryYear-4
Surgery (Year-4)
Course Information
1. Prof Dr C.S.Venkatesh
2. Dr Chandramohan V.
3. Datuk Prof Dr Syed Noori
4. Assoc Prof Kumar Hari Rajah
5. Prof Dr O.Ravindran
6. Assoc Prof Ernest yeoh
7. Prof U Kyaw Tin Hla
8. Prof Saad
Adjunct lecturer
1. Dr Muralisundram
2. Prof Dr Zainal arrifin
3. Datuk Dr Safari
4. Dr Kantarasalingam
5. Dr Azmi
This is an important core topic in the MBBS curriculum. The student will be introduced formally
to the main subspecialities of general surgery including urology, hepatobiliary surgery,
paediatric surgery and neurosurgery.At the end of this posting the students are expected to have
a more complete understanding of all the systems of the human body, and understand the
principles of care of patients in the disciplines above. They will have an oppourtunity to build
upon the foundations provided by the year 3 posting with emphasis on investigation and
management of a surgical patient.The period of posting is 6 weeks in GH-KL. A sub speciality
posting such as this is needed as these disciplines have become increasingly complex and are
seen only occasionally in general surgical units.
5. Semester and Year offered: Year-4 (6-weeks posting)

L= Lecture (2) 16 22 60 102 4 204 hr
S=Seminars(6)/Case
E=exam

8. Prerequisite:
9. Objectives:
1. Knowledge of the principles of management of patients in the various surgical sub-

specialities with experience hands-on exposure and daily activities.
2. Skill of presenting the data acquired by history taking and clinical examination in the
various surgical sub-specialities.
3. Knowledge of the approach to resolve patient’s problems including generating
differential diagnoses, using investigations to gather more information and formulating
a provisional diagnosis.
At the end of the posting, the student will be able to

1. obtain a history and perform an examination which will allow the student to arrive at
a list of provisional diagnosis
2. generate a list of relevant investigations to allow evidence based management of the
surgical patient.
3. describe the principles of management of common conditions seen in these sub
specialities.
4. describe the basic principles of surgery in the sub specialities above. this includes the
principles of pre operative intra operative and post operative care.
5. recognize common surgical emergencies and be able to assist in their management
6. function in the capacity of a junior doctor in the health care team in a surgical unit

1. A capacity to break problems down into smaller potions and apply sound scientific and
evidence based principles to solve them.
2. The ability to work in a team with the capacity to recognize ones strengths and
limitations. This includes the recognition of the need to ask for assistance when needed
and working independently when required.
3. The ability to recognise the need for continous professional development in their chosen
carrear paths.
4. The development of empathy when caring for patients.
The teaching learning activities during the posting will be carried out in the wards, clinics, A &
E department, operation theatre and in various learning facilities.The students will be divided
into 2 groups and all groups will be posted to the general surgical wards,the subspeciality wards
and be rotated accordingly.Attempt to gain exposure to clinical conditions prescribed in the
logbook.Also ,students should take the opportunity to study whatever patients that happen to be
in the ward.
Lectures and seminars of each subspeciality will be carried out as the students go through this
posting.The topics which have not been covered in the lecturers will be done as tutorials.Added
to this are anaesthesia and radiological sessions.

Components of curriculum of the surgical posting will be covered through

1. Experiential learning through exposure to clinical practice
2. lecture
3. seminar
4. tutorial
5. bedside teaching
6. case presentation
7. SDL
8. OT sessions
9. Clinics
10. ward rounds
11. case write up(two)
12. Integrated sessions(anaesthesiology and radiology)
13. Synopsis:
This posting exposes the year 4 students to areas not usually seen in general surgical wards
today. These have become highly subspecialised and this posting recognizes and meets this
need. However the common thread that runs through this posting is the emphasis on application
of the basic science from phase 1 to the clinical situation in the wards. This allows the
development of a logical reasoning process that will result in a sound understanding of the
principles involved in the management of the patient.
Lectures, tutorials, seminars, and practical
(a)Attitude 5%
(b)Case write up(2) 10 %
(c)Progress record books: 15 %
Final Exam
Theory (mcq,meq,seq) 35%
Clinical(long case,short case,osce) 35%
Total 100%

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Neurosurgery 1) head injuries 5 8 12
2) space occupying lesions of the brain
3) congenital neurological abnormalities
4) radiology session
5) vascular lesions of the CNS
6) management of hydrocephalus
7) management of raised intra cranial
pressure
8) spinal tumors

9) intervertebral disc disease
Paediatric surgery 1) principles of paediatric surgery 4 8 12

2) biliary atresia and management
3) inguino-scrotal condition and other
miscellaneous condition in childhood
4) intussusception,hirschsprung and
toxic megacolon condition
5) Transport of neonates
6) hydrocephalus and spinal dysraphism
anorectal anomalies
7) urethral valves and hypospadias
8) surgical congenital conditions
Urology 1) urinary tract stones,pathology , 4 12 12

manifestations and investigations
2) enlarged prostate, pathology,
manifestations and investigations
3) neoplasms of kidney and bladder,
pathology, management and
investigations
4) robotics in urology:indications and
management renal transplant
5) minimally invasive surgery including
ESWL
6) malignant urogenital condition
7) stones and benign prostatic
hyperplasia
8) testicular masses and tortion
9) trauma to the urogenital structure
Hepatobiliary 1) portal hypertension and esophageal 4 10 16

varices
2) hepato biliary tract infection and
management
3) biliary stones
4) liver transplant
5) obstructive jaundice
6) pathology and management of
pancreatic disease
7) liver and pancreatic trauma
8) hepatocellular carcinoma;clinical
features and management
9) acute pancreatitis
Texbooks
1. Introduction to the symptoms and signs of surgical disease;Norman L Browse;hodder
Arnold,4th ed,2005
2. Bailey & Love’s Short Practice of surgery;revised by RCG Russel,Norman S,William
Christopher JK Bulstrode,24th ed,Arnold ,2004
3. Current surgical diagnosis and treatment,edited by Lawrence W Way,10th edi,2002

Reference
1. Clinical surgery:Cushieri,Henessey,Rowley and Grace,Blackwell Science,2nd edi,2005
2. Principles and practice of surgery:O,J Garden ,Churchile Livingstone,4th edi,2002
3. Essential surgical practice:Cushieri,R,J,Steele:4th edi oxford,butterworth
Heinemann,2000
4. An aid to clinical surgery:Scott R Peter:Churchill Livingstone,6th edi,2003
5. Textbook of surgery:edited by Joe J Tjandra,Gordon,2nd edi,London,Blackwell science
LTD,2001
6. Essential surgery:problems,diagnosis and management:Burkitt H.George H,George
Burkitt:2nd edi,Churchill livinststone,1996
7. General Surgery:H Ellis,Watson:Blackwell Science,10th edi,progress record book,2002
8. Surgery of the liver and biliary tract;blumgart,L.H.and Fong,3rd
edition,2000,W.B.Saunders,Philadelphia
9. Paediatric surgery;Ashcraft,K.W,Murphy,3rd edition,2000 W.B Saunders
10. Compresensive urology ;Weiss G,Weiss,R,M,2001,Elservier,Amsterdam

MBBS Curriculum Orthopaedics/Year-4
Orthopaedics (Year-4)
Course Information
1. Name of Course/Module: Orthopaedics (Year-4)
2. Course Code: ORT 6473
1. Professor Dato Dr Abdul Hamid bin Abdul Kadir

2. Dr Pooya Moslemzadeh Tehrany
3. Dr Fredy Arianto
4. Dr Talluri Venu Gopala Krishna
5. A/Prof Khaled El Sayed Mohamed Ebid
Orthopaedics, which includes traumatology, is a major discipline and is one of the six rotations,
of 4 months each, during the 2-year houseman training in Malaysia, prior to full registration.
Road Traffic Accidents is the fourth major cause of death in Malaysia, after Coronary Heart
Disease, Stroke and Influenza & Pneumonia. The average bed occupancy of patients with
trauma and trauma-related disease in orthopaedic wards in major hospitals in the country is 60-
70%.

L= Lecture (2) 15 20 132 18 3 188 hr
S=Seminars(6)/Case
E=exam
8. Prerequisite:
9. Objectives:
Knowledge of
1. basic principles of orthopaedics and traumatology
2. common diseases of the musculo-skeletal system in association/relation with other
disciplines like internal medicine, paediatrics, rehabilitation medicine, geriatrics, etc.
3. applied anatomy, clinical physiology and clinical pathology of the musculo-skeletal

system with the objective of reinforcing the fundamentals in relation to learning and
understanding orthopaedics and traumatology.
4. essential investigations in orthopaedics and traumatology
5. The principles of management of orthopaedic and trauma conditions are introduced in
stages.
Skills in
1. obtaining orthopaedic history
2. performing focused orthopaedic physical examination appropriate to arrive at
provisional and differential diagnoses, and ultimately in the definitive diagnosis.
3. basic orthopaedic procedures.
Attitude regarding
1. interaction with patients (and their families) with regards to respect, compassion
and empathy.
appropriate.
5. motivation towards patient assessment, self-directed study and maximizing clinical
experience

1. discuss the aetio-pathogenesis, pathophysiology and clinical manifestations of
common musculo-skeletal diseases, deformities and disorders.
2. describe the scientific basis of management in both general orthopaedic diseases
and in musculo-skeletal trauma.
3. demonstrate communication skills
4. take a focused orthopaedic history
5. describe the behavioural background of the patient and the healthcare providers
as well as psychosocial aspects of healthcare.
6. perform thorough orthopaedic physical examination.
7. apply the relevant imaging investigations to arrive at an appropriate diagnosis.
8. plan a management strategy for common orthopaedic problems
9. discuss the psychosocial background of the patient and its impact on the
management
The students will graduate as medical practitioners, appropriately and specifically trained in
skills to undertake healthcare delivery as General (Family) Practitioners. They will after
graduation undergo houseman training in Orthopaedics for 4 months, in addition to Medicine,
Surgery, Obstetrics & Gynaecology, Paediatrics and A&E, each for 4 months.
The teaching-learning strategy adopted is to inculcate in the students the concept of life-long
practice as medical practitioners, with episodes of continuing medical education input, both in
knowledge and skills, from time to time.
The formative and summative assessments of the students are tailored to achieve the target of

graduating young doctors who will possess the required knowledge and skills to undergo
houseman training in public healthcare facilities, and primarily and initially to be able to
function as general (family) practitioners.
13. Synopsis:
The details of the course are covered in various sections above in this document. The primary
objective is to train the students in knowledge and skills over the 5 years, through structured
teaching-learning schedules which are disease and patient-oriented, with over-riding emphasis
on ethics, professionalism and good standard of doctor-patient and doctor-colleague-healthcare
personnel relationship. They are also trained to appreciate socio-cultural-ethnic and economic
values of our people.
The curriculum is delivered through tutorials, lectures, seminars, skills workshops and hands-
on experience during ward-work and treatment areas (operation theatres, POP rooms,
dressings) and bedside teaching (with direct patient contact) in Hospital Kuala Lumpur (HKL),
which is the teaching hospital accredited for clinical phase of the curriculum. Students are
impressed upon the need for practical training in orthopaedic procedures and they are
supervised in this engagement.
Continuous (30%)
(a) Attitudes 5%
(b) Case write up 10%
(c) Log book 15%
End of posting (70%)

(a) Theory
 35% - MCQ and SBA 15%
 MEQ and SEQ 20%
(b) Clinical 35%
 Clinical long case 15%
 Short case 10%
 OSCE 10%
Total 100%

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Orthopaedic diseases 1) Understand aetio-pathogenesis and 10 6 3
in childhood, adults modes of presentation of diseases
and in old age, through and the principles of management in
the five categories: each category
congenital,
developmental,
degenerative,

neoplastic, and
infection
Skeletal trauma: 1) Understand all aspects of trauma of 10 6 3

fracture healing, types bone, joints and soft tissue, including
of fractures, principles cartilage. Able to diagnose and
of treatment, early and understand the principles of
late complications; management
dislocation of joints;
infections; open
fractures.
Soft-tissue trauma ; 1) Understand all aspects of trauma of 10 6 3

Sports injuries, bone, joints and soft tissue, including
ligament, muscle and cartilage. Able to diagnose and
tendons, cartilage understand the principles of
injuries management
Textbooks
1. Solomon L, Warwick D, Selvadurai N. Apley’s Syste of Orthopaedics and Fractures
2001 (8th Edition) London: Butterworth-Heinemann
2. Ronald McRae. Pocketbook of Orthopaedics and Fractures 2006 (2nd Edition).
Chuchill Livingstone
3. Hamblen D., Simpson H. Adams. Outline of Orthopaedics (14th Edition) Churchill
Livingstone
4. Hamblen D., Simpson H. Adams Outline of Fractures, including Joint Injuries (12th
Edition) Harcourt.
Reference books
1. Campbell’s Opertive Orthopaedics (Terry Canale) 9th edition
2. Spivak JM, Zukerman JD. Orthopaedics – A Comprehensive Study Guide.
3. Benson, Fixen, Macnicol and Parsch. Children’s Orthopaedics and Fractures. (3rd
Edition) Springer-Verlag 2010.

MBBS Curriculum Primary Care Medicine/Year-4
Primary Care Medicine (Year-4)
Course Information
1. Name of Course/Module: Primary Care Medicine (Year-4)
2. Course Code: PCM 6475
1. Associate Prof. Dr. Gauri Krishnaswamy

2. Prof. Datuk Dr. Daniel Mahendran Thuraiappah
3. Associate Prof. Dr. Aminah Abd. Rahman
4. Dr. Ng Yee Tze
Primary Care Medicine is that component of the health care system, which provides initial,
continuing, comprehensive and coordinated medical care that is evidence-based for all
individuals, families and communities and which integrates current biomedical, psychological
and social understandings of health. It involves the ability to take appropriate responsible action
on any problem the patient presents and therefore is now recognized as an essential subject in
the teaching of undergraduates.

L= Lecture (2) 20 55 106 56 2.5 188 hr
S=Seminars(6)/Case
O=Others/SDL 40 165 0 0 12.5
E=exam
8. Prerequisite:
9. Objectives:
Knowledge:
 basic clinical skills required to provide effective and efficient primary care.
 the spectrum of medical problems that occur in primary care and understand
how to provide continuous, comprehensive care to patients and their families.
 principles and the clinical application of health promotion, risk factor
assessment, disease prevention and patient education interventions.

 the relevance of biopsychosocial, familial, socioeconomic and community

factors in providing patient – cantered care.
 the personal, economic, ethical and legal issues that influence the patient and
physician in the primary care setting.
 evidence based medical care in the management of common primary care
ailments.
 10the role of primary care within the healthcare delivery system.
Skill:
 effective communication skills with patients, families and other health care
providers.
 teamwork, develop leadership qualities and managerial skills.
Attitude:
 leadership qualities and managerial skills.
At the end of the posting, the student should be able to:
1. identify common signs and symptoms of diseases in Primary care

2. communicate effectively with patients to gather relevant medical history and educating
them
3. identify the patients concerns and expectorations in management of his/her condition.
4. draw up an investigation and management plan for the patient’s current disease and
undifferentiated illness, plan for the patient’s continuity of care, promoting health and
improving the health seeking behaviour.
5. Make decisions that are evidence based.
6. describe the role of disease screening and prevention in relation to patient care in the
Primary care setting.
7. differentiate the illness patterns between patients in the primary care clinic and hospital
setting.
8. identify and appropriately refer patients requiring secondary or tertiary care
9. describe the role of the primary care physician and primary health care workers in the
health care delivery system.
10. discuss the principles of evaluating the validity and applicability of diagnostic tests and
therapies in Primary Care practice



of medical imaging.
Teaching will be in lecture, student led seminars, health clinic clerkships, role pay sessions and
groups discussions format supported by independent reading and private study for examinations.
Formative assessment will include case write up and log book.
13. Synopsis:
This course provides the student opportunity to develop a firm foundation of knowledge, attitude
and skill about the holistic approach of patients in the community setting, as stated in the
learning outcomes of this subject.
Lectures, health clinic clerkships, student led seminars and groups discussions role paly and
common lectures
a) Attitude : 5%
b) Case write up : 20 %
c) Log book : 5%
Final Exam
a) Long case : 20%
a) Short case : 15%
b) Theory – MTF/SBA/SEQ/MEQ: 35%
Total :100%

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Briefing on Primary Comprehensive care of Primary Care
Care clerkship (I) patients
1) Assess the undifferentiated
presentation, separating those
problem that are acute / serious and
require immediate evaluation and
consultation from those that do not
2) Exposure to extended care centers
including community clinics and
hospice.

3) Prepare holistic management plans

for common medical problems and
chronic diseases in Primary Care
4) Translate clinical practice guidelines
into daily clinical practice
 Diagnosis
 Management plan
 Medication – its indication,
side-effects, drug interactions
and concordance
 Risks, benefits and
complications of common
procedures
 Advice on preventive
measures, health promotion
and lifestyle modification
5) Observe and assist under observation

basic technical procedures common
in Primary Care
Delivery of nebuliser therapy
 ECG
 Subcutaneous and
Intramuscular injections
 Suturing & Dressing
 Venepuncture
Vaccinations
Briefing on Primary 1) Consistently demonstrate

Care clerkship (II) compassion and understanding
toward patients and their families
towards patients’ needs regardless
of their age, gender, race,
disabilities or problem presented
2) Treats patients and their families
with respect and dignity at all time
3) Practices the spirit of professional
team work in providing care in
the best interest of the patients
4) Demonstrate consistent
responsibility for one’s own
learning through timeliness,
preparation, initiative in patient
care and information gathering
and response to feedback
Introduction to 1) Describe the primary health care

Primary Care and the organizational structure in the
Primary Health Care Ministry of Health, the roles of
System in Malaysia NGO’s and private practitioners in
the provision of primary health care
in Malaysia

The importance of the 1) Accurately identify and discuss the

Family Unit in family, support system, community,
Primary Care cultural, ethnic, occupational and
Medicine economic factors influencing patient
management and outcomes
2) Demonstrate increasing integration of
this above biopsychosocial
information into patient care in a
manner which will improve patient
outcomes
Holistic approach to 1) Demonstrate progressive integration

of health promotion and disease
management prevention strategies into all patient
visits.
2) Consistently identify health risk
factors and demonstrate use of
motivational interviewing techniques
to identify and develop strategies for
change.
3) Consistently identify appropriate
patient education materials and
activities, and demonstrate
integration of these into patient care
4) Demonstrate a sound knowledge
regarding management of common
health problems and chronic diseases
in Primary Care with emphasis on
prevention and health promotion.
5) Make appropriate referral according
to the continuity of care model
problems that are acute / serious and
hospice
Clinical decision 1) Develop a sound knowledge of

disease and illness behaviour in order
making skills to make a deferential / working /
definitive diagnosis
2) Diagnostic decision making –
formulate a differential diagnosis
based on the key findings from the
history and physical examination.

3) Recognize the environmental,

psychological and social impact of
diseases on illness behaviour
Prescribing 1) Recognize the importance of rational,

medication and evidence-based and cost-effective
achieving prescribing.
concordance 2) Economic – practice management
including managed care (techniques
intended to reduce the cost of
providing health benefits and improve
the quality of care), billing, insurance,
and reimbursement.
3) Ethical – advanced directives and
informed consent in the office,
inappropriate requests for treatment,
refusal of treatment, genetic testing,
preventive medicine, confidentiality,
suspected abuse and neglect, treating
minors, pain control and managed
care
4) Legal – risk management, including
communicating with difficult patients
and proper documentation
Consultation models 1) Develop effective communication

skills with patient and their family
and skills, counselling 2) Demonstrate empathy gain trust and
and communication confidence of the patients.
3) Develop and attain a high level of
skills in Primary Care humane, optimistic and positive
Medicine attitude towards the elderly.
4) Identify hidden agenda
5) Recognize psychosocial issues
6) Demonstrate listening skills with
probing and clarifying
7) Work with patients experiencing
multidisciplinary problems, angry
patients and somatisizing patients
8) Make concise, accurate and well –
organized clinical notes and oral
presentations; dictate and write
prescriptions.
9) With colleagues and other allied
health professionals on issues
regarding patients’ care
10) Interact effectively with and discuss
patient care with appropriate health
professionals.
11) Demonstrate correct method of
dealing with special circumstances
such as breaking bad news.
12) Educate and counsel patients and their
families so that they comprehend the
diagnosis,management plan,

medication – its indication, side-

effects, drug interactions and
concordance, risks, benefits and
complications of common procedures
and advice on preventive measures,
health promotion and lifestyle
modification
13) Consistently demonstrate compassion
and understanding toward patients
and their families towards patients’
needs regardless of their age, gender,
race, disabilities or problem
presented.
14) Treats patients and their families with
respect and dignity at all time.
team work in providing care in the
best interest of the patients
1) Demonstrate consistent responsibility

for one’s own learning through
timeliness, preparation, initiative in
patient care, initiative in information
gathering and response to feedback
Travel and tropical 1) Develop a sound knowledge of travel

medicine and tropical diseases and illness
behavior in order to make a
deferential / working / definitive
diagnosis
Chronic disease 1) Define and describe common chronic

management in disease presentations in Primary Care.
Primary Care 2) Demonstrate a sound knowledge
Medicine regarding management of chronic
diseases in Primary Care with
emphasis on prevention and health
promotion.
Skills
Well developed and refined basic clinical
skills required to provide effective and
efficient management for common health
problems seen in Primary Care
History and physical examination – obtain

a patient's history and physical exam in a
logical, organized and thorough manner
while adapting to the urgency of the
medical situation and the time available.

Therapeutic decision making –

understand risks, benefits, and
compliance issues in choosing a
treatment.
Everyday problems in 1) Demonstrate increasing knowledge of

childhood problems commonly seen
childhood in Primary Care.
2) Develop a sound knowledge of
disease and illness behaviour in order
to make a deferential / working /
3) Define and describe common
presentations in Primary Care
those with acute illness
those with ‘hidden agendas’
the worried well
those with chronic illness and
disabilities
the terminally ill
5) Develop reasonable diagnoses and
management plans for both
undifferentiated and common health
problems
6) Consistently demonstrate intuitive
reasoning supporting diagnoses and
management decisions.
7) Recognize serious and life-
threatening presentations which
require immediate intervention and
demonstrate appropriate clinical
response
Complementary and 1) Demonstrate knowledge of

Alternative Medicine complementary and alternative
medicine practices available in
Malaysia
2) Demonstrate consistent application of
relevant current, evidence-based
literature when possible, at the “point
of care” to determine patient
management.
Group discussion 1) Develop a sound knowledge of

and role play disease and illness behavior in order
‘Red Flags’ ‘Yellow to make a deferential / working /
Flags’ ‘Alarm definitive diagnosis
symptoms’ and 2) Define and describe common
‘Pitfalls’ presentations in Primary Care
Abdominal pain those with ‘hidden agendas’

the worried well

Cough and dyspnoea those with chronic illness and
disabilities
Constipation the terminally ill
Deafness and hearing psychological and social impact of
loss diseases on illness behaviour
Disturbed patient
Dyspepsia
Dizziness
Fits, faints and funny

turns
Jaundice
Headache
Lower back pain
Nausea and vomiting
Painful ear
Painful arm and hand
Painful knee and pain

in the leg
Palpitations
Red and tender eye

and visual failure
Sleep disorders
Sore throat
Tiredness
Urinary disorders
Seminars 1) Develop a sound knowledge of

Screening in Primary disease and illness behavior in order
Care to make a deferential / working /
Prevention in Primary 2) Define and describe common
Care presentations in Primary Care
Pain management in a those with ‘hidden agendas’
Primary Care setting the worried well

those with chronic illness and

Family planning and disabilities
Hormone the terminally ill
Replacement Therapy 3) Recognize the environmental,
(HRT) psychological and social impact of
Chronic Disorders –
Hypertension:
Diagnosis and
Management in a
Primary Care setting
Diabetes Mellitus:
Diagnosis and
Management in a
Asthma & COPD:
Diagnosis and
Management in a
Prevention &
Management of TB
and HIV in the
Community
Coronary Heart
Disease & Stroke
Hyperlipidaemia,
Obesity & Metabolic
Syndrome
Clinical sessions 1) Develop effective communication

2) Demonstrate empathy gain trust and
confidence of the patients.
humane, optimistic and positive
attitude towards the elderly.
patients and somaticizing patients


prescriptions.
professionals
Texbooks
1. Murtagh J. General Practice. McGraw-Hill, 5th Edition, 2010
2. Swash M. Hutchinson’s Clinical Methods. Saunders, 22nd Edition, 2007
Reference
1. Rakel. Textbook of Family Medicine. Saunders, 8th Edition
2. Simon C et al. Oxford Handbook of General Practice. Oxford University Press, 3rd
Edition, 2010
3. Jones R et al. Oxford Textbook of Primary Medical Care (Vol. 1 & 2). Oxford
University Press, 2005
4. Goroll A.H. et. al. Primary Care Medicine: Office Evaluation and Management of
Adult Patient. Lippincott, William & Wilkins, 6th Edition 2009
INTERNET RESOURCES: WEBSITES

National Institute of Clinical Excellence (NICE), UK: www.nice.org.uk
Medscape Family Medicine: www.medscape.com
Ministry of Health Malaysia: www.moh.gov.my
Academy of Family Physicians of Malaysia: www.afpm.org.my
INTERNET RESOURCES: JOURNALS

Official Journal of Malaysian Family Physicians: http://www.e-mfp.org/
American Family Physician: www.aaf.org/afp
Australian Family Physician: www.afp.racgp.org.au/aspindex.shtml
INTERNET RESOURCES: DATABASE

PubMed: www.ncbi.nlm.nih.gov
Ovid: ovidsp.ovid.com
The Cochrane Collaboration: www.cochrane.org
SCOPUS: www.scopus.com

MBBS Curriculum Anaesthesia/Year-4
Anaesthesia (Year-4)
Course Information
1. Name of Course/Module: Anaesthesia (Year-4)
2. Course Code: ANE 6472
1. Assoc. Prof Dr Mustafa Ahmed Jirjees MBChB, FIBMS/ Anaesthesia
The aim of this course is to introduce the student to the essential skills and concepts of
perioperative anaesthesia care and pain management within the environment of the operating
room, anaesthesia and pain clinics.
During the posting the student will gain the required knowledge and skill to manage the surgical
patient preoperatively and postoperatively, meanwhile, the intraoperative experience will give
the students the opportunity to gain the skills of airway, ventilation and fluid management. The
latter skills will be an asset to the future clinical practice of any student.

L= Lecture (2) 1 30 4 54 1 90 hr
S=Seminars(6)/Case
P=Clinical Skill Labs (2) 2 90 0 0 5 97 hr
O=Others/SDL
E=exam
8. Prerequisite:
9. Objectives:
A. Knowledge of
1. pre-anaesthetic patient evaluation and risk stratification with special focus on:
a) The effects of patient’s co-morbidities on anaesthetic management.
b) The potential anaesthetic options for a given surgical procedure.
2. postoperative management including the most common postoperative
complications and their potential aetiologies.

3. commonly used local anaesthetic agents and different modalities of regional

anaesthesia.
4. different modalities for postoperative pain management.
5. the standard patient monitors in an operation theatre and their advantages and
disadvantages.
6. basic perioperative fluid management
B. Essential skills of/on

1. airway evaluation and management.
2. resuscitative and life-saving procedures practiced in an operation theatre.
3. history taking.
4. physical examination
3. punctuality, reliability and the ability to take initiatives and responsibilities
where appropriate.
1. make basic preoperative assessment and risk stratification.

2. apply the standard intra-operative monitoring modalities on a life and simulated
patient.
3. perform airway management including mask ventilation, laryngeal mask airway
placement, and endotracheal intubation in simulation.
4. make a basic intra-operative fluid management plan.
5. manage various shock scenarios in simulated patient
6. plan a basic postoperative pain management strategy

importance.

3. teamwork.
5. case reporting.

1. professional image. (demeanour, attire, punctuality)
2. self-dependence
3. teamwork
4. leadership
13. Synopsis:
During this two weeks posting, students will be rotating; on a daily basis; in the main operation
theatre (OT), subspecialty OTs and their attached Preoperative (Preop) clinics and Post
Anaesthesia Care Units (PACU). Moreover, students will be exposed to the Pain clinic. During
the clinical attachment, each student will be assigned to an individual OT where the student will
observe and assist the daily clinical activities. Students will be in the operating room every day
(except when they have other teaching-learning activities) and They will observe and assist (if
possible) the specialist or medical officer (MO) in the anaesthetic care of the patient pre-
operatively, intra-operatively and post-operatively. The course offers a great opportunity for the
medical students to gain valuable experience and knowledge of the operating room setting
within a teaching general hospital of Kuala Lumpur, where, they will be exposed to the daily
challenges faced by anesthesiologists.

2. Clinical skills and simulation Labs (basic and advanced airway evaluation
and management)
5. Group discussions and debates.
6. Clinical attachment (anaesthesia clinic, waiting bay, operating theatre and
PACU and on calls)
7. Case write-ups.
Continuous (30%)
(a) Attitudes 5%
(c) Log book (Procedures (10%), Seminar (5%), and Case discussion (5%))
Final (70%)
Total 100%


the nation.


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L T P
Preoperative A. Preanesthetic assessments including:
1) History taking with a special focus
anaesthesia care on the following :
 Factors influencing perioperative
anaesthesia plan:
 Drug history:
2) Physically assess airway,
cardiovascular system, respiratory
system
3) Review and interpret laboratory data
4) Assign appropriate ASA
classification
B. Premedication including:
1) Indication of preanesthetic drug
administrations
2) Classes of premedication drugs and
examples from each class
3) NPO guidelines.
C. Basic anaesthetic management plan.
Intraoperative A. Induction of anesthesia

B. Maintenance of anesthesia
anesthesia care C. Emergence and PACU
Perioperative A. Hypoxia
B. Hypercapnia
problems C. Hypertension
D. Difficult and failed endotracheal
intubation
E. Endobronchial intubation
F. Esophageal intubation
G. Position related injuries
Regional Anesthesia A. Pharmacology of commonly used

local anesthetics.
B. Advantages and Disadvantages of
different types of regional anesthesia
Symptoms and Signs of impending
local anesthetic toxicity
Postoperative Pain A. Assessment of postoperative pain

including:
Management - Pain scales
- Visual analogue scales
B. Advantages and disadvantages of
different types of pain management
Obstetrical A. Physiological changes of pregnancy

and their implications for anaesthesia

Anaesthesia B. Physiology of labour pain.

C. Advantages and disadvantages of
general anaesthesia and regional
anesthesia in the obstetrics.
2. Paediatric Anesthesia
A. Anatomical differences between
pediatric and adult patients.
B. Physiological differences between
pediatric and adult patients.
C. Preop assessment, investigation and
premedication of Paediatric patient
Preoperative 1) explain the pathophysiology of CAD 2 10

Assessment And 2) identify the patient at risk of
Preparation Of developing CAD (risk stratification)
Patients With 3) explain and rationalize the
Coronary Artery management of CAD patient.
Disease (CAD)/ 4) assess any patient with CAD
Hypertension (HT) coming for elective surgery
(severity, control, type of control and
complications).
5) explain and assess CAD patient
METs.
6) describe a working plan to assess
and manage a patient with CAD
scheduled for surgery.
7) list and rationalize the preoperative
orders for patients with CAD.
8) identify the patient at risk of
developing HT coming for elective
surgery (risk stratification)
9) classify hypertensive patient
according to severity and describe
the management of each class
according to Malaysian CPG.
10) assess any patient with hypertension
complications).
orders for patients with hypertension
12) describe briefly the postop. care of
CAD and HT
Preoperative 1) explain (compare and contrast) the

assessment and pathophysiology of asthma and
preparation of COPD.
patients with asthma/ 2) identify the patient at risk of
COPD developing asthma and COPD (risk
stratification)
3) classify asthma patients according to
severity and describe the
management of each class according
to Malaysian CPG.
4) assess any patient with asthma
coming for elective surgery


complications).
orders for patients with asthma.
asthma.
7) classify COPD patients according to
severity and describe the
management of each class according
to Malaysian CPG.
8) assess any patient with COPD
complications).
orders for patients with COPD
COPD patient
Preoperative 1) explain (compare and contrast) 2 10

assessment and the pathophysiology of type1 and
preparation of type2 DM.
patients with dm 2) identify the patient at risk of
developing type1 and type2 DM
coming for elective surgery (risk
stratification)
3) classify DM type2 patients
according to severity and describe
the management of each class
according to Malaysian CPG.
4) assess any patient with DM
(severity, control, type of control
and complications).
5) describe a working plan to assess
and manage a patient with DM
scheduled for elective surgery.
6) list and rationalize the
preoperative orders for patients
with DM
7) describe briefly the postop. care
of DM patient
SPECIAL 1) discuss the effects of 2 10

physiological changes of
PERIOPERATIVE pregnancy on anesthetic
CONSIDERATIO management.
NSFOR 2) describe the pain pathway for the
1st and 2nd stages of labor.
OBSTETRIC
3) discuss briefly the modalities of
PATIENT Obstetric analgesia
4) list the complications of Obstetric

analgesia
5) compare and contrast GA and RA
for Cesarean section.
6) assess pregnant patient coming
for CS or normal vaginal labour
preoperative orders for a pregnant
patient
LOCAL 1) compare and contrast RA and GA 2 10

2) discuss the factors affecting the
ANESTHETIC onset, strength and duration of
AGENTS AND regional block.
REGIONAL 3) compare and contrast the
commonly used local anesthetic
ANESTHESIA
agents used in clinical practice.
(onset, duration, risk and type of
toxicity).
4) describe briefly common
modalities of Regional
anesthesia.
5) compare and contrast Spinal,
Epidural and combined spinal-
epidural anesthesia.
6) List and rationalize absolute and
relative contra-indications for RA
7) List and rationalize complication
of RA
8) Discuss the types of toxicity and
their management
SPECIAL 1) discuss the effects of anatomical 2 10

and physiological differences on
PERIOPERATIVE paediatric patient anesthetic
CONSIDERATIO management.
NS:PEDIATRIC 2) assess paediatric patient coming
for elective surgery.
PATIENT
preoperative orders for a
pregnant patient
4) discuss the different modalities
of postop. analgesia for a
paediatric patient
Textbooks
1. Oxford Handbook of Anesthesia. Keith G. Allman; Oxford University Press,
3rd edition, 2011.
2. Essential Clinical Anesthesia. Charles A. Vacanti, Pankaj K. Sikka, Richard

D. Urman, Mark Dershwitz, B. Scott Segal; Cambridge University Press, 1st

edition, 2011.
Reference
1. http://openanesthesia.org/. Go to Wiki Section- Anesthesia Text, Sponsored
by International Anesthesia Research Society-IARS.
2. http://update.anaesthesiologists.org/ . Sponsored by Would Federation of
Societies of Anesthesiologists.

MBBS Curriculum Critical & Palliative Care/Year-4
Criticl and Palliative Care (Year-4)
Course Information
1. Name of Course/Module: Critical and Palliative Care Posting (Year-3)
2. Course Code: CPC 6472
1. Assoc. Prof Dr Mustafa Ahmed Jirjees MBChB, FIBMS/ Anaesthesia
This course is aimed to improve the early detection, management and referral of
critically ill/ pre-arrest patients in medical and surgical wards, resulting in an
enhancement of houseman role in the prevention of intra-hospital critical/ arrest
incidents.
This course is to introduce the students to the essential skills and concepts related to the
pathophysiological derangements; confronted in intensive care and high dependency
care units; along with the comprehensive evaluation and management of critically ill
patients. Moreover, this posting will help the students to understand the role of palliative
care to relieve suffering and improve the quality of life of patients with end stage
diseases.

L= Lecture (2) 1 30 4 54 1 90 hr
S=Seminars(6)/Case
E=exam
8. Prerequisite:

9. Objectives:
A. Knowledge of
1. prioritizing resuscitative measures (A,B,C,D,E), procedures and tests in
critically ill patients, understanding the tempo required for resuscitation
and stabilization.
2. the relationship between treatment intensity and clinical benefits.
3. different types of acute respiratory failure and their management
4. basic management plan of patients on mechanical ventilatory support
5. interpretation of simple acid-base disorders and their management.
6. classification of shock according to pathophysiology, hemodynamic
profiles.
7. management of all types of shock, utilizing a goal directed therapy.
8. basic management of patients with altered mental status
9. dengue fever, the warning signs and its management.
10. basic care of critically ill patient.
11. the ethical and legal aspects of withdrawal and withholding of life
support and the appropriate application of the DNR (Do Not
Resuscitate) order.
12. end-of-life care
B. Skills of/on
1. advanced life support and cardiopulmonary resuscitation.
2. airway management
3. peripheral venous access
4. central venous line insertion
5. arterial line insertion and sampling
6. interpretation of hemodynamic monitoring data obtained from CVL and
arterial line
7. basic setting of mechanical ventilator
8. Communicating Bad News
3. punctuality, reliability and the ability to take initiative and responsibility
where appropriate.
5. motivation towards patient assessment, self-directed study and
maximizing clinical experience

1. take a history, perform a physical examination and initiate a diagnostic
work-up on patients with critical illness.
2. state the indications for various diagnostic modalities commonly used in
ICU including
 arterial blood gases

 thoracentesis
 plain radiography and CT scan of the chest
 bronchoscopy
3. interpret arterial blood gases results.
4. interpret plain radiographs of the chest and formulate differential
diagnoses for the relevant findings.
5. interpret the results of pleural fluid analysis
6. list the indications for invasive and non-invasive mechanical ventilation.
7. list the indications for the CPAP (continuous positive airway pressure).
8. choose appropriate initial ventilator settings for a patient with critical
illness.
9. initiate and maintain the proper resuscitative measures for common
critical illnesses.
10. perform effectively all common emergency techniques.
11. identify psychosocial consequences of critical illnesses
12. interact proficiently with the patients, doctors, nursing staff and
colleagues

1. Recognizing critical ill patients and sorting them according to their
severity.
2. Recognizing and treating sources of these critical illnesses in the
environment of the ward.
3. Build up problem solving/ clinical reasoning skills by linking the
history and physical examination skills to the clinical knowledge.

1. establishing an understanding relationship with patients and their
families.
2. gaining trust of the patients and their families.
3. effective communication and teamwork with peers, superiors and
subordinates .
4. effective and concise patient clerking.
5. case reporting.
2. self-dependence.
3. teamwork.
4. leadership
The course teaching learning activities are designed to facilitate the students to achieve
the learning outcomes of the course; meanwhile, the assessment is aimed to evaluate
the degree of students’ achievement of learning outcomes.

13. Synopsis:
During this two weeks posting, students will be observing closely the specialists and
medical officers in intensive and high dependency care units, and attend didactic
conferences and daily case discussions. Furthermore, the students will be exposed to the
bioethical and end-of-life issues that are faced so often in the critical care setting.
During this posting, students will be provided with resources to acquire the essential
knowledge and skill to interpret arterial blood gases, pulmonary function tests, chest x-
rays, and pleural fluid studies as well as resources to help you learn more about
mechanical ventilation and other essential skills and concepts in critical and palliative
care. Teaching venues will be in the intensive care department of General Hospital
Kuala Lumpur.

2. Clinical skills and simulation Labs (ECG interpretation and Central
venous line insertion)
6. Clinical attachment (pain clinic, ICU and on calls)
7. Case write-ups.
Continuous (30%)
(a) Attitudes 5%
Final (70%)
Total 100%

the nation.



PEO1 PEO2 PEO3 PEO4
   




moral values.

areas of interest.

    
L T P
1. Basic resuscitative manoeuvres for
 airway control
 cardiac arrest/peri-arrest
 shock
 comatose patient
2. Acute respiratory failure including
:
 Principles of oxygen therapy

 Differential diagnosis and

treatment of acute hypoxemic
respiratory failure
 Differential diagnosis and
treatment of ventilatory failure
3. Mechanical Ventilatory support
including:
 Non-invasive ventilation
 Indications for (and risks of)
CPAP/PEEP
 Relationship between ventilator
settings and hemodynamic
 Relationship between ventilator
settings and arterial blood gases
 Complications of mechanical
ventilation
4. Interpretation of simple and mixed
acid-base disorders with
appropriate changes in mechanical
ventilation as needed.
5. Fluid and electrolytes
 Basic principles of fluid
administration
 Dehydration
6. SIRS, sepsis, severe sepsis, septic
shock including
 pathophysiology
 hemodynamic profiles
 Management of septic shock
7. Patient with altered mental status
including:
 use of the Glasgow Coma Scale
 identification of metabolic and
anoxic encephalopathy
 criteria for brain death
 criteria for persistent vegetative state
and coma
8. Glucose control in ICU.
9. Infectious diseases
 Endemics infectious diseases
(Dengue fever)
10. Dengue Fever in the intensive care
unit including
 Latest WHO classification
 Management of each type of
presentation
 Management of compensated and
decompensated shock
11. Stress ulcer prophylaxis in ICU
12. Venous thromboembolism
prevention in the ICU
13. Scoring system for critically ill
patients including:

 GCS
 Ricker’s
 Mews
14. Ethical and legal aspects of
withdrawal and withholding of life
support and the appropriate use of
the DNR (Do Not Resuscitate) order.
15. End-of-life care
16. Brain death testing
APPROACH TO 1) apply MEWS score on any patient to 2 10

CRITICALLY ILL identify the patients at risk of
PATIENT developing critical illness.
2) assess critically ill patient using
ABCDE system.
3) explain and rationalize the categories
of patients who are indicated for
ICU admission.
4) explain and rationalize the use of
scoring systems.
5) describe the clinical application of
Riker’s and GCS.
6) discuss and rationalize the basic care
of critically ill patient
7) discuss and rationalize the use of
pulse oximeter, capnograph, ECG &
invasive BP:
8) parameters measured by these
monitors
9) conditions that are detected by each
monitor
10) conditions that lead to inaccurate
readings of these monitors
11) alarm setting for these monitors
APPROACH TO 1) explain the pathophysiology of type

RESPIRATORY 1 RF and relate it to the patient‘s
FAILURE (RF) symptoms and signs.
2) discuss the properties of each type of
O2 therapy.
of patients who are indicated for O2
therapy.
4) manage each pathophysiological
problem of type 1 RF with proper
type of O2 therapy
5) explain the use of CPAP/PEEP in
the treatment of type 1 RF
6) explain and rationalize the other uses
of CPAP/PEEP
7) explain the pathophysiology of type
2 RF and relate it to the patient‘s
symptoms and signs

of patients who are indicated for

mechanical ventilation
9) compare and contrast invasive and
non-invasive ventilation (indications,
contra-indications and
complications)
10) explain briefly the pathophysiology
of ALI/ARDS and relate it to the
patient‘s symptoms and signs
11) explain briefly the pathophysiology
of Gullian Barre syndrome and relate
it to the patient‘s symptoms and
signs
APPROACH TO 1) compare and contrast SIRS, Sepsis,

SIRS, SEPSIS, Severe sepsis Septic shock, MOD
SEPTIC SHOCK, and MOF.
MOD AND MOF 2) explain the pathophysiology of
SIRS, Sepsis, Severe sepsis Septic
shock, MOD and MOF and relate it
to the patient‘s symptoms and signs
(presentation)
3) explain the use of MEWS to identify
patients at risk of developing SIRS
4) manage and justify the management
of a patient with SIRS, Sepsis,
Septic shock
5) manage and justify the management
of a patient with severe Sepsis,
MOD
APPROACH TO 1) discuss the identification and

ALTERED diagnosis of AMS
MENTAL STATUS 2) explain the early management of
(AMS) PATIENT AMS
3) list the common causes of AMS
4) discuss the pathophysiology of
anoxic encephalopathy
5) compare and contrast different levels
of AMS
6) discuss the inclusion and exclusion
criteria for brain death testing
7) describe and rationalize brain death
testing
8) discuss the indications for End of
life care
9) discuss the principles of End of life
care
APPROACH TO 1) explain body PH homeostasis

ACID-BASE 2) interpret ABG readings
DERANGEMENT, 3) discuss respiratory acidosis and
FLUID THERAPY alkalosis and give real life examples
AND PRINCIPLES 4) discuss respiratory acidosis and

OF BLOOD alkalosis and give real life examples

TRANSFUSION 5) describe and rationalize fluid therapy
6) list the daily requirement of Na, K,
Cl, Energy
7) list and rationalize fluids used for
each part of fluid therapy
8) compare and contrast colloids and
crystalloids
9) discuss massive blood transfusion
10) list and rationalize the complications
of massive blood transfusion
11) discuss and rationalize the concept
of allowable blood loss
12) calculate allowable blood loss
APPROACH TO 1) discuss Dengue fever risk factors

2) classify dengue fever according to
DENGUE FEVER the new WHO classifications
3) discuss the diagnosis, differential
diagnosis of dengue fever
4) discuss and justify the admission
criteria for dengue fever patient
5) describe and rationalize the
management of all classes of dengue
fever
Textbooks
1. Oxford American Handbook of Critical Care Medicine. John A. Kellum, Scott
R. Gunn, Mervyn Singer, Andrew R. Webb. Oxford University Press, 1st edition,
2008.
2. Critical Care Handbook of the Massachusetts General Hospital. Luca M.
Bigatello, Hasan B. Alam, Rae M. Allain, Edward A. Bittner, Dean R. Hess,
Richard M. Pino, Ulrich Schmidt. LIPPINCOTT WILLIAMS & WILKINS, a
WOLTERS KLUWER business, 5th edition, 2010.
3. Core Topic in Critical Care. Fang Gao Smith, Joyce Yeung. CAMBRIDGE
UNIVERSITY PRESS, 1st edition, 2010
4. Manual of Intensive Care Medicine (Lippincott Manual Series). Richard S.
Irwin, James M. Rippe. LIPPINCOTT WILLIAMS & WILKINS, 5th edition,
2010.
Reference
1) http://www.ccmtutorials.com/index.htm. helpful site to understand diagnosis and
management of critical care illnesses.
2) http://www.medscape.org/criticalcare. online full journals and textbooks.
3) http://www.uptodate.com/home/clinicians/specialties/pulmonary.html. up to
date in critical care medicine by Wolters Kluwer.
4) http://www.mdcalc.com/. Website with medical equations, scores, calculators.
5) http://www.hospicecare.com/. Website with full information about palliative care
services.

6) http://www.pallcare.info/. Website with full information about palliative care

services, drugs and guidelines.

MBBS Curriculum Emergency Medicine/Year-4
Emergency Medicine (Year-4)
Course Information
1. Name of Course/Module: Emergency Medicine (Year-4)
2. Course Code: EMM 6472
1. Assoc. Prof Dr Ernest Yeoh M.B.Ch.B, FRCS(Ed)

2. Assoc. Prof Dr Mustafa Ahmed Jirjees M.B.Ch.B, FIBMS/ Anesthesia
The purpose of emergency medicine positing is to provide students with a valuable opportunity
of clinical exposure in a setting; where they will be evaluating undifferentiated and undiagnosed
patients; which will involve clinical conditions from virtually all medical and surgical
specialties. Additionally, being in the scene of emergency department (ED) will create chances
for the students to apply clinical skills they have learned in class to a real life situation in a well
supervised environment as well as they will be introduced to new skills that they should observe
and practice later on manikin. Furthermore, they will appreciate the team work between the
emergency physicians with other ED staff and the interaction between emergency department
team and other departments’ teams.
In this posting students will learn the skill to differentiate seriously ill patients; who need an
immediate treatment; from those needing less urgent treatment. Moreover, students' knowledge
and mind will be challenged by the idea of doing immediate management of patients who they
have a very limited knowledge about their illnesses’ background.

L= Lecture (2) 1 30 4 54 1 90 hr
S=Seminars(6)/Case
E=exam
8. Prerequisite:

9. Objectives:
A. Knowledge of
1. principles of triage of patients coming to emergency department according to
the severity of their illnesses.
2. common emergency conditions and their priorities of treatment.
3. the ABCDE concept of emergency management.
4. how to performing primary and secondary surveys for emergency trauma
patient.
5. the leading symptoms and signs of common emergency illnesses and their
appropriate investigations.
6. life-threatening illness or injury and the basic principles of early management
of these entities.
7. diagnosis and treatment of shock
8. management of common emergency conditions.
9. the principles of trauma management.
10. the psychosocial consequences of emergency illnesses and how to manage
these consequences.
11. the role emergency department as a key link between the general population
and the health care system.
B. Essential skills of
1. assessment of the undifferentiated patient.
2. performing primary and secondary surveys for emergency trauma patient
3. basic life support and cardiopulmonary resuscitation.
4. airway management.
5. performing essential resuscitative and therapeutic measures for common
emergency conditions.
6. establishment of intravenous access and fluid/blood administration.
7. the communication with the patients, doctors, nursing staff and colleagues in
the emergency department.
8. establishing appropriate consultative and referral letters.
9. the use of defibrillator.
10. basic wound care techniques.
11. basic emergency room procedures, such as venous access cervical spine
immobilization
C. Attitude of
appropriate.
5. motivation towards patient assessment, self-directed study and maximizing
clinical experience

1. triage all patients coming to Emergency department according to the urgency
of their illnesses.
2. diagnose all common emergency illnesses by the appropriate utilization of
primary survey, secondary survey and relevant investigations.

3. initiate and maintain the proper resuscitative measures for all common
emergency patients.
4. perform effectively all common techniques used in Emergency department.
5. write a proper consultation request and referral letter for an emergency patient.
6. deal with psychosocial consequences of emergency illnesses
7. interact proficiently with the patients, doctors, nursing staff and his colleagues
in Emergency Department.

1. recognizing life threatening conditions and prioritize them according to their
severity.
2. recognizing and treating sources of these life threatening conditions in the
environment of the ward and emergency medicine department.
3. build up problem solving/ clinical reasoning skills by linking the history and

1. establishing an understanding relationship with patients and their families.
subordinates .
5. case reporting.
2. self-dependence.
3. Teamwork
4. Leadership
13. Synopsis:
During this two weeks posting during year 4, students will be rotating; on a daily basis; in the
ED zones that will introduce them to the essential skills and concepts within the environment of
the emergency department. Teaching venues will be in the emergency department of General
Hospital Kuala Lumpur.

2. Clinical skills and simulation Labs (basic and advanced airway evaluation
and management)


6. Clinical attachment (anesthesia clinic, waiting bay, operating theatre and
PACU and on calls)
7. Case write-ups.
Continuous (30%)
(a) Attitudes 5%
Final (70%)
Total 100%

the nation.


PEO1 PEO2 PEO3 PEO4
  





moral values.

areas of interest.
  
L T P
1. Major incident management
a) Concepts and application
of triage
b) Concepts of disaster
management
2. Basic resuscitation of
a) airway
b) cardiac arrest/peri-arrest
c) shock
d) coma
2. Multiple trauma patient
a) Major trauma
b) Head injury
c) Chest trauma
d) Abdominal trauma
e) Spinal injury
f) Burns
3. Vascular emergencies
a) Deep venous thrombosis
(DVT)
b) Pulmonary Embolism
4. Cardiology
a) Basic
electrocardiographic
analysis
b) Recognition and initial
treatment of acute
myocardial infarction

c) Recognition and initial

treatment of life-
threatening arrhythmia
5. Respiratory medicine
a) Airway obstruction
b) Asthma and Chronic
obstructive pulmonary
disease
c) Acute pneumothorax
6. Toxicology
a) Treatment of acute
ingestions
b) Identification of basic
toxins
7. Diabetes and endocrinology
a) Acute Diabetic Keto-
Acidosis DKA coma
b) hyperosmolar non-ketotic
coma (HONC)
c) Hypoglycemia
d) Thyroid storm
e) Myxedema coma
8. Immunology
a) Anaphylaxis
APPROACH TO 1) discuss the initial assessment and 2 10

triage of trauma patient
POLYTRAUMA 2) explain the steps of primary survey
PATIENT / part 1 of trauma patient
3) list the most common causes of
airway obstruction in trauma patient
4) explain and rationalize airway
management during the A of primary
survey
5) list the adjuncts of airway
resuscitation
6) list the most common chest injuries
7) explain and rationalize breathing
assessment and resuscitation during
the B of primary survey
8) list the adjuncts of breathing
resuscitation
9) list the most common causes of
shock in polytrauma patient
10) list the types of shock and give
examples
11) classify and rationalize the classes of
hypovolemic shock
12) explain and rationalize circulatory
assessment and resuscitation during
the C of primary survey
13) list the adjuncts of circulatory
resuscitation
14) explain assessment of disability
during the D of primary survey

15) explain exposure during the E of

primary survey
16) list the adjuncts of exposure
APPROACH TO 1) describe briefly the factors 2 10

affecting the intracranial pressure
POLYTRAUMA (ICP)
PATIENT / part 2 2) discuss the pathophysiology and
presentation of raised ICP
3) explain and rationalize the
methods of reducing ICP
4) compare and contrast epidural
and subdural hematomas
5) describe briefly different types of
burn
6) classify and rationalize the
classes of burn
7) explain and rationalize the
assessment and resuscitation of
burn patient
8) explain the criteria for admission
of burn patient
APPROACH TO 1) explain the pathophysiology of

ACS
CARDIAC 2) generate a general differential
DYSPNEA AND diagnosis for chest pain
CHEST PAIN 3) arrange the differential diagnosis
starting from the most common
and down to the least common.
4) generate a rational plan to
diagnose and manage STEMI
5) compare and contrast NSTEMI
and Unstable Angina (with
regards to clinical presentation,
diagnosis and management)
6) name and discuss the
management of the most serious
complications of ACS.
7) compare and contrast the pain of
ACS, Aortic dissection,
pericarditis, GERD and
musculoskeletal origin
DIABETIC AND 1) compare and contrast the

pathophysiology and clinical
ENDOCRAINE presentation of DKA and HHNS
EMERGENCIES 2) state the specific investigations to
diagnose DKA
3) Generate a plan for emergency

management of DKA
4) state the specific investigations to
diagnose HHNS
5) generate a plan for emergency
management of HHNS
6) compare and contrast thyroid
storm and myxedema coma (with
regards to pathophysiology,
presentation and management)
APPROACH TO 1) compare and contrast the

NON-CARDIAC pathophysiology and presentation
DYSPNEA AND of severe exacerbation of asthma
SHORTNESS OF and COPD.
BREATH 2) generate a differential diagnosis
of acute shortness of breath.
3) generate a plan for emergency
management of severe
exacerbation of asthma and
COPD
SPECIAL 1) generate a general management

plan of poisoning
PERIOPERATIVE 2) describe the typical presentation
CONSIDERATIO of organophosphate poisoning
NS:PEDIATRIC 3) discuss the emergency
management of organophosphate
PATIENT
poisoning
4) describe the typical presentation
of paracetamol poisoning
5) discuss the emergency
management of paracetamol
poisoning
of salicylate poisoning
management of salicylate
poisoning
of opioids/sedatives poisoning
management of opioids/sedatives
poisoning
Textbooks
1) Oxford Handbook of emergency medicine. Jonathan P. Wyatt; Oxford
University Press, 3rd edition, 2012.
2) Sarawak Handbook of Medical Emergencies. Hua Huat Soo et al; Sarawak
: C.E. Publishing, 3rd edition, 2011.

3) Emergency Medicine Diagnosis and Management: Anthony Brown, Michael

Cadogan; Hodder Arnold, an imprint of Hodder Education, a division of
Hachette UK, 6th edition,2011.
Reference
1) http://www.trauma.org/. everything about trauma.
2) http://www.emedicine.com/emerg/. online EM textbooks.
3) http://www.medscape.com/emergencymedicine. online full journals and textbooks.
4) http://www.uptodate.com/home/clinicians/specialties/emergency_medicine.html up to
date in emergency medicine by Wolters Kluwer.
5) http://www.mdcalc.com/. website with medical equations, scores, calculators, made by
an EM physician

MBBS Curriculum Ophthalmology/Year-4
Ophthalmology (Year-4)
Course Information
1. Name of Course/Module: Ophthalmology (Year-4)
2. Course Code: OPT 6472
1. AP. Dr. Mohd. Mustafizur Rahman

2. Consultant & specialist from GHKL(adjunc)
To acquire basic theoretical knowledge of common ophthalmological diseases & skill, for
caring of patients with eye problems in undergraduate level

L= Lecture (2) 10 20 40 30 1 30 hr
S=Seminars(6)/Case
E=exam
8. Prerequisite:
9. Objectives:
Knowledge of
1. the disorders of the visual system in terms of Anatomy, physiology and pathology of the
eye
2. common ophthalmological diseases.
Skills in
1. basic clinical clerking skills (history taking & physical examination) on patients with
various problems.
2. eye examination
Attitude regarding
1. good practice and appropriate attitudes in handling ophthalmic patients

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

1. Take good clinical history related to ophthalmology
2. Perform complete clinical examination of the eyes
3. Use an ophthalmoscope
4. Asses clinically important parameters of visual functions, field of vision and colour
vision
5. Identify common eye disease
6. Describe ophthalmic presentation of systemic diseases
7. Describe common ophthalmic imaging procedures
A. Interpersonal & Communication Skills of

1. establishing an understanding relationship with patients and their
families.
subordinates .
5. case reporting.
B. Professional attributes of
2. self-dependence.
3. Teamwork
4. leadership
13. Synopsis:
By these two weeks posting student will elaborate their year 1-2 anatomy & physiology
knowledge in relation to eye. Through good relevant history taking and proper examination,
including use of ophthalmoscope, be able to identify common eye problems.
1.Lectures
2. Tutorials
3. Bedside teaching
4. Clinics teaching
6. Operation theater session

Continuous (30%)
(a) Attitudes 5%
(b) Case write up/essays/partograms 10%
(c) Log book 15%
End of Posting (70%)

15% MEQ and SEQ (2 each) 20%
(b) Clinical 35% - Clinical long case 30% OSCE 5%
Total 100%

the nation.


PEO1 PEO2 PEO3 PEO4
  





moral values.

areas of interest.
  
L T P
Anatomy &
physiology of eye
Common eye diseases

and systemic diseases
related with eye
manifestation
Textbooks List :
1. Oxford hand book of ophthalmology
2. The wills Eye Manual
3. Opthalmology –Principals & concept – Frank W Newell
4. Kansky –clinical Ophthalmology
5. Opthalmology at a glance – Oliver j & casedy- Blackwell science 2004
6. Lecture notes on ophthalmology- Blackwell science-2003
7. M Natterrury.B Bowling 2005,ophthalmology , an illustrated color atlas
8. Baic ophthalmology for medical student
9. primary care residence – American Academy of ophthalmology

MBBS Curriculum ENT/Year-4
Otorhynolaryngology (Year-4)
Course Information
1. Name of Course/Module: Otorhinolaryngology (Year-4)
2. Course Code: ENT 6472
1. Dr. Shailesh Khode . Senior Lecturer

2. Dr. Saleh Khaled . Lecturer
3. Consultant & specialist from GHKL(adjunct)
To acquire basic theoretical knowledge of common Otolaryngeal diseases & skill for caring of
patients with ENT problems in undergraduate level

L= Lecture (2) 10 20 40 30 1 101 hr
S=Seminars(6)/Case
E=exam
8. Prerequisite:
9. Objectives:
Knowledge of
1. the disorders of Otorhinolaryngology in terms of Anatomy, physiology and pathology of
the ear, nose & throat.
2. basic theoretical knowledge of common disorders in Otorhinolaryngology
3. commonly used investigations in ENT specialty
4. the management of common ENT problems
Skills in
1. basic clinical clerking (history taking & physical examination) of patients with various
ENT problems

Attitude regarding
1. good practice and appropriate attitudes in handling patients with ENT disorders
At the end of posting, student should be able to

1. good clinical history related to otorhinolaryngology
2. Perform competent clinical examination of patient otorhinolaryngology problem
3. Use an otoscope
4. identify main manifestation of otorhinolaryngology diseases
5. identify common otorhinolaryngology diseases.
6. Describe otorhinolaryngology associated systemic diseases
7. Justify for and interpret common used imaging procedures in otorhinolaryngology
A. Interpersonal & Communication Skills of

3. teamwork.
5. case reporting.
B. Professional attributes of
2. self-dependence
3. teamwork
4. leadership
The assessment format consists of a) Continuous Assessment (30%), and b) End of Posting
Examination (70%).
13. Synopsis:
By this two weeks posting student will elaborate their year 1-2 anatomy & physiology
knowledge in relation to Ear, Nose and Throat. Through good relevant history taking and proper
examination, including use of General ENT instruments and otoscope, be able to identify
common ENT and Head-Neck related diseases.
1. Lectures
2. Tutorials
3. Bedside teaching
4. Clinics teaching
6. Operation theatre session
Continuous (30%)
(a) Attitudes 5%

(b) Case write up and its presentation 10%

(c) Log book 15%

(a) Theory 40% - MTF ( 10% questions ) and SBA (20% questions), and 10% MEQ
(b) Clinical 30% - OSCE 30%
Total 100%

the nation.


PEO1 PEO2 PEO3 PEO4
   




moral values.


areas of interest.

    
L T P
A. Clinical exposure to patients in
emergency room, outpatient
department, the
Otorhinolaryngology ward, and
operating theatre.
B. The topics covered will be :
C. Anatomy & physiology of Ear,
Nose and Throat, and Head-Neck
D. Clinical examination techniques
E. Common diseases of Ear, Nose and
Throat
a. Ear diseases
1. Diseases of external ear
2. Diseases of middle ear
(ASOM and CSOM)
and its complications
3. Evaluation of Hearing
loss and rehabilitation (
Hearing Aids)
4. Disease of inner ear (
BPPV, Meniere’s
disease and vertigo)
b. Nose disease
1. Diseases of external
nose ( congenital
anomalies and
trauma)
2. Disease of internal
nose ( Deviated
septum, epistaxis,
mass in nasal cavity
and septal
abscesses, rhinitis)
3. Diseases of
paranasal sinuses (
acute or chronic
sinusitis and its
complications)
4. Foreign body nose
and its management

c. Throat disease
1. Tonsillitis
2. Pharyngitis
3. Lesions of tongue
and oral cavity
4. Carcinoma of throat
d. Head-Neck diseases
1. Tracheostomy and
its management
2. Laryngitis
3. Carcinoma of larynx
and hypopharynx
4. Benign disease of
larynx
5. Neck trauma
6. Pediatric condition
e.g. thyroglossal
cyst and branchial
cyst
7. Cleft palate and lip
Anatomy&physiolog
yof Ear ,Nose,
,Throat & Head &
Neck
Common ENT
diseases and systemic
diseases related with
ENT manifestation
Prescribed Textbooks List :
1. PL Dhingra, Diseases of Ear,Nose and Throat, 5th Edition, Elisvers Publications.

2. Mohan bansal. Diseases of ear niose and thorat, 1st edition, Jaypee brothers publications.
B: Recommended
3. PL Dhingra, Diseases of Ear,Nose and Throat, 5th Edition, Elisvers Publications.
C: Reference
1. Glisson M., Scott brown's otorhinolaryngology, head and neck surgery, 7th edition
,Hodder Arnold,2008.
2. Ludman H, Bradley PJ. ABC of ear nose and throat 6th Edition, Wiley -Blackwell ,2013.
3. c.Lee KJ. Essential Otolaryngolgy: Head and Neck Surgery. 9th Edition.Mcgraw Hill
Medical, 2008.
4. Ellis H, Mahadevan V. Clinical Anatomy: Applied Anatomy for students and Junior
Doctors, 12th Edtion, Wiley-blackwell, 2010. ( 2 COpies)
5. Dhillon RS, East CA. Ear, Nose, Thorat Head and Neck Surgery: AN Illustrated Colour
Text 3rd Edition. Churchill Livingstone, 2006.
6. Rogan Carbridge, Nicholas S. Oxford handbook of ENT and Head and Neck Surgery, 2nd
edition.


MBBS Curriculum Forensic Medicine/Year-4
Forensic Medicine (Year-4)
Course Information
1. Name of Course/Module: Forensic Medicine (Year-4)
2. Course Code: FMS 6472

3. Dr Chandrasekaeran S
1. Apply their knowledge and skills in the medico-legal aspect of any case
2. Able to identify and interpret the medical evidence to assist the prosecution

L= Lecture (2) 10 3 20 0 1 34 hr
S=Seminars(6)/Case
E=exam
8. Prerequisite:
9. Objectives:
1. the principles of a post mortem examination

2. preparation of reports in medico-legal cases in accordance with the country’s laws
3. the principles of preserving and dispatching specimens.
4. relevant legal/court procedures applicable to the medico-legal cases
5. common poisons and environmental, occupational and preventive aspects of
toxicology

By the end of this posting, a student should be able to:

1. Identify, examine and prepare report or certificate in of medico-legal cases/situations in
accordance with the existing laws in Malaysia.
2. Describe medico-legal post-mortem examination and interpret autopsy findings and
results of other relevant investigations to logically conclude the cause, manner and time
since death.
3. Describe relevant legal/court procedures applicable to the medico-legal cases.
4. Describe the procedure of preserving and dispatching specimens and other concerned
materials in medico-legal/post-mortem cases to the appropriate Government agencies
for necessary examination.
5. Provide a list of common poisons and environmental, occupational and preventive
aspects of toxicology

(b) Listening attentively
(c) Effectively explaining highly technical information
(d) Use of general information technology and importance of team work
13. Synopsis:
1. The curriculum provides a proper orientation of the student towards recognizing cases of
foul play, and the various forms of suspicious or unnatural deaths
2. A reasonable idea of how to go about proving this through a post-mortem examination,
or clinical examination and reporting when these living cases are presented for medico-
legal documentation will be imparted to the undergraduate student as part of the training
Lectures, tutorials, autopsies, case write-ups
(a) Components of Continuous Assessment:

1) Attitude: 5%

2) case write-ups: 5%
3) Log Book: 20%
(b)End Posting Exams :70%

Total : 100%

the nation.


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moral values.

areas of interest.

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Identification 1) Establishment of identity of living
persons
2) Identification of accused, unknown
persons, dead bodies from the
remains
3) Superimposition
Lecture Contents:
1. Definition of Corpus Delicti

2. Race, sex, religion, complexion,
stature, age determination using
morphology, teeth-eruption,
decay, bite marks, bones
ossification centres, medicolegal
aspects of age
3. Hairs, fibers, teeth,
anthropometry, dactylography,
foot prints, scars, tattoos, and
poroscopy
4. Superimposition
5. DNA printing
Medicolegal Autopsy 1) Definition of Medico-legal autopsy

2) The autopsy Protocol
3) External Examination of the body
4) Internal Examination of Organs
5) Exhumation
Lecture Contents:
1. Rules for medico-legal autopsies

2. External Examination
3. Skin incisions
4. Internal Examination of the
viscera
5. Test for pneumothorax
6. Examination of the brain
7. Fixation of the brain
8. Collection of samples/specimen
for investigation
9. Preservation of viscera in cases of
suspected poisoning

10. Examination of mutilated bodies

or fragments
11. Exhumation- authorization and
procedure
12. Second autopsy
13. Type of Police forms
14. Confidentiality
15. Collection of viscera and
preservatives used.
Post Motrtem 1) Definition of death

2) Types of death
Changes 3) Post-mortem changes after death
Lecture Contents:
1. Somatic/Clinical /Cellular,
Molecular and Brain death
2. Cortical death and Brainstem
death, Coma and Syncope
3. Natural and Unnatural death
4. Suspended animation
5. Signs of death
6. Post Mortem changes- cooling of
dead body, postmortem lividity,
rigor mortis, cadaveric spasm,
heat and cold stiffening,
putrefaction, mummification,
adipocere formation, maceration
and preservation of dead bodies
7. Estimation of time since death on
postmortem examination
8. Entomology of the cadaver,
gastrointestinal tract and body
fluids
9. Examination of mutilated bodies
or fragments, bundle of bones and
exhumation
Mechanical Injuries 1) Definition and classification of

injuries
2) Vehicular injuries (MVA)
3) Coup and contrecoup injuries (Head
injuries)
Lecture Contents:
1. Identification and medico-legal

aspects of various types of
injuries- Abrasion, bruise,
laceration, stab wound, incised
wound, chop wound, defense
wound, self inflicted/fabricated
wounds and their medico-legal
aspects

2. Description of regional injuries to

head (Scalp wounds, fracture
skull, Intracranial hemorrhages)
3. Vehicular injuries – Primary and
Secondary impact, Secondary
injuries and crush syndrome
4. Diffentiate between injuries,
assault and hurt
5. Differentiate between Accidental,
Suicidal and Homicidal injuries
6. Grading of injuries – Simple,
Grievous and Dangerous
7. Ante-mortem and Post-mortem
Injuries and their Medico-legal
implications
FIREARM 1) Firearm injuries

2) Classification of fire-arms
INJURIES 3) Structure and components of various
firearms
4) Blast injuries
5) Distance fired
6) Identification of bullets
Lecture Contents:
1. Various terminology in relation

of firearm – calibre, range and
choking
2. Description of different types of
cartridges and bullets
3. Preservation and dispatch of trace
evidences in cases of firearm and
blast injuries
4. Various test related to
confirmation of use of firearms
5. Knowledge of the principles of
projectile firing from a weapon
6. Knowledge of the types of
commonly used firearms
 Revolver
 Automatic
 Rifle
 Shotgun
7. Types of firearm injures
 Laceration
 Bruise
 Cavitation
 Shock waves
 Modern bullet
8. Knowledge of forensic science
applied to identification of
recovered bullet
9. Distance of fire

ASPHYXIAL 1) Definition and classification of 1 2

asphyxia
DEATHS 2) Definition and types of
hanging and strangulation
3) Medico-legal interpretation of
post-mortem findings in
asphyxial deaths
Lecture Contents:
1. Description of clinical findings

causes of death, postmortem
findings and medico-legal
aspects of death due to hanging
and strangulation
2. Examination and dispatch of
ligature material
3. Definition, pathophysiology,
clinical features, postmortem
findings and medicolegal
aspects of traumatic asphyxia,
obstruction of nose & mouth,
suffocation and sexual
asphyxia
4. Definition, types,
pathophysiology, clinical
features, postmortem findings
and medicolegal aspects of
drowning, diatom test and
Gettler test
SEXUAL 1) Definition and types of sexual

offences
OFFENCES 2) Definition of rape
3) Examination of victim of alleged case
of rape
4) Unnatural sexual offences
Lecture Contents:
1. Preservation and dispatch of trace

evidence in cases of rape
2. Adultery
3. Unnatural sexual offences-
Sodomy, incest, lesbianism,
buccal coitus (oral sex), bestiality
and indecent assault
4. Sexual perversions- fetichism,
transvestism, voyeurism, sadism,
necrophagia, masochism,
exhibitionism, frotteurism and
necrophilia

5. Examination of the accused and

victim, preservation of report and
giving opinion, collection and
preservation and dispatch of trace
evidence to relevant authorities
6. Bite marks- dental identification
7. Nail clippings of accused and
victim
8. Confidentiality
INFANTICIDE 1) Infanticide
2) Foeticide, and Abortions
3) Stillbirth
4) Intra uterine death
5) SIDS (Cot Death/Crib Death)
Lecture Contents:
1. Signs of live birth

2. Signs of viability of the fetus
3. Age determination of the fetus
4. Demonstration of ossification
centres
5. Hasse’s rule
6. Hydrostatic test
7. Maceration
8. Sudden infant death syndrome
(SIDS)
9. Munchausen’s syndrome by
proxy
10. Abortion and types
CHILD ABUSE 1) shaken baby syndrome

2) eye injuries
3) visceral injuries
4) whiplash injuries
5) battered Baby Syndrome
6) retrieved foreign objects
Lecture Contents:
1. Distinguish between accidental

from inflicted trauma on the child
2. Physical abuse on the child
3. Discrepancy in accounts by
parents or maid
4. General condition of the child
5. Psychomotor abilities of the child
6. Symptoms and signs of trauma
7. Radiological findings
8. Blood findings
9. Lesions on skin and mucous
membrane

10. Signs of chocking and strangle

11. Signs of injuries-Bite marks,
pinch marks
12. Violent grasping
13. Soft tissue injuries- bruises, scars
(old scars)
14. External genitalia trauma
1. Imprint marks
2. Hair loss
3. Burn marks
4. Fractures
5. Head injuries
6. Brain injuries
DOCTOR IN 1) Inquest 1
2) Medical evidence
COURT 3) Witnesses
4) Perjury
5) Contempt of court
Lecture Contents:
1. Definition of inquest and types of

inquests- coroner’s inquest
2. Define and types of medical
evidences-documentary (dying
declaration) and oral evidences
3. Define witnesses and types of
witnesses
4. Define perjury
5. Conduct and duties of Doctor in the
Witness box
6. Subpoena- types
7. Role of Prosecution
8. Role of defense counsel
9. Attire in Court
10. Attendance in court
11. Failure of attendance in court
AUTOPSIES 10
TUTORIALS 3
Recommended Reading
1. Keith Simpson’s – Forensic Medicine.
2. The Essentials of Forensic Medicine and Toxicology - Dr KS Narayan Reddy, 13th
Edition 2011.
3. Text Book of Medical Jurisprudence and Toxicology: Dr Ck Parikh CBS Publications.

1. Modi’s Medical Jurisprudence and Toxicology, 23rd Edition, Edited by K.

Mathiharan & A.K. Patnaik, Eastern Book Company, Lucknow
2. Knight’s Forensic Pathology, 3rd Edition, Edited by Pekka Saukko and Bernard
Knight, Arnold Publication, London, Co-published by Oxford Publications,
USA

Course Information
1. Name of Course/Module: Psychological and Behavioural Medicine (Year-4)
1. Assoc. Prof Dr Azhar Salleh

2. Assc. Prof. Dr. Selvam Karupiah
Adjunct Lecturers:
HKL-
3. Prof Dr Salina Abdul Aziz
4. Dr. Chee Kok Yoon
5. Dr. Norliza Chemi
6. Dr. Riana Abdul Rahim
Hospital Sg Buloh-
7. Prof Dr Zulkifli Ghaus
8. Dr. Razak
The aim of this course is to introduce the student to the essential skills and concepts of
Psychological and behavioural components of medical care. Despite the recognition in recent
decades that the place of psychiatry in medicine is far more than the false belief that all mental
illness is only related to psychoses, neither the place of psychiatry nor its practice has shown
much change. The World Health Report of 2001 of the World Health Organization, stressed the
importance of treating mental illnesses in primary care and referred to the recognition that more
than 25% of the primary care workload needed mental help. Be that as it may there is little
evidence that these reports have changed the place of psychiatry in health care. This state of the
art in neglect of the psychosocial in medicine may be related to the very long and entrenched
concepts of medicine itself. The belief that medicine is all physical is widespread and the place
of psychiatry relegated to mental asylums that to most doctors are outside the mainstream of
medical care. Teaching of Medicine has been mainly of physical medicine, and psychosocial
factors in disease when forced on reality of a non- accountable symptom or feature, quietly
labeled, psycho, supra-tentorial, psy or referred to a social worker or simply referred with no
history to the psychiatrist.
During the posting the student will gain the required knowledge and skill to recognize, diagnose
and initially manage patients with psychiatric manifestations of illness. These skills will be an
asset to the future clinical practice of all students.
5. Semester and Year offered: Year-4 (4-weeks)


L= Lecture (2) 4 33 25 65 4 131 hr
S=Seminars(6)/Case
E=exam
8. Prerequisite:
9. Objectives:
A. Knowledge of
1. various mental signs and symptoms in patients in clinical practice.
2. common presentations of psychiatric conditions, namely: anxiety, depressive
and psychotic disorders
3. emotional illnesses in medical and surgical disciplines.
4. common child and adolescent psychiatric problems in clinical practice.
5. pharmacological and non-pharmacological interventions in psychiatry.
B. Essential skills of/on

1. clinical interviewing patients with emotional distress and significant others in
his life adequately.
2. basic counselling and behavioural techniques of treatment in the context of
emotional distress in any patient at primary care level
1. interaction with psychiatric patients (and their families) with regards to
respect, compassion and empathy.
2. politeness and respect for other health care professionals, including
psychologists, social workers and doctors.
3. punctuality, taking initiative, reliability and be responsible where appropriate.
Upon completion of the posting, the students should be able to:

1. carry out a full mental state examination and cognitive screen.
2. determine a provisional diagnosis and several differential diagnoses of the
condition the patient is suffering from.
3. recognize the mental signs and symptoms in common physical diseases, in
internal medicine, physical symptoms and signs of mental illnesses and
psychological reactions to physical illnesses.
4. determine the common groups of medications used in treatment of psychiatric
conditions, know a few in each group well, including their uses, side effects,
doses, method of usage and dangers.

5. observe and recognise the need of basic counselling and behavioural

techniques of treatment in the context of emotional distress in any patient at
primary care level
6. explain the role of allied professional in mental health such as psychologists,
psychiatric nurses, social workers, counsellors and occupational therapists in
the evaluation and management of persons with emotional distress and mental
illnesses.

1. Recognizing common psychiatric conditions/diseases and sorting them
according to their importance.
2. Recognizing and initiating treatment of common psychiatric problems in the
ward or clinic.

3. teamwork.
4. effective and concise patient history taking and doing a mental state
examination.
5. case reporting.
2. self-dependence.
3. teamwork.
4. leadership.
13. Synopsis:
By the end of the four week posting, the student should be skilled in knowledge and skills in the
aetiology, symptomatology, diagnoses and management including rehabilitation of common
mental illnesses, common liaison psychiatry cases, child and adolescent psychiatry, community
mental health patients, psychological and behavioural disorders at a primary care level and have
developed an attitude of compassion and caring for patients consonant with the highest ethical
standards of medical practice.
1. Lectures
4. Group discussions.

5. Clinical attachment (psychiatry clinics, ward, methadone clinics)

6. Case write-ups.
7. Case summaries.
8. Psychiatric Simulation
Continuous Assessment (30%)

(a) Attitudes 5%
(b) Case write-up (10%)
(c) Case Summaries (5%)
(d) Case Presentation (10%)

(a) Theory 35% - MCQ15% and SAQs 20%
(b) Clinical 35% - Long Case
Total 100%

the nation.


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L T P
Scientific basis of 1) give an overview on various
psychiatry etiological models relevant to
psychiatry,
2) explain the methodological issues in
understanding etiology of mental
illness, discuss treatment issues
related to evidence based medicine in
psychiatry
Basic 1) give an overview of the terms used in

Psychopathology psychopathology and their diagnostic
significance in relation to various
mental disorders
2) describe the conduct of mental status
examination
Delirium and 1) elaborate on the clinical features,

Dementia investigations and assessment for
delirium and dementia
2) outline the principles of
pharmacological and non-
pharmacological management for
Substance Related 1) give an overview about the

Disorders epidemiology of alcohol and drug
dependence

2) discuss the etiology,

pathophysiology and natural course
of drug dependence
3) describe the psychiatric morbidity
associated with substance abuse
4) outline the screening procedures and
treatment goals for alcohol and drugs
of abuse
Schizophrenia and 1) be aware of the aetiology of

related Disorders schizophrenia and other acute and
chronic delusional disorders
2) describe the clinical manifestations
and phenomenology of
schizophrenia, state the differential
diagnosis of schizophrenia
3) outline the treatment of an acute
psychotic episode
4) describe the principles of long-term
management of schizophrenia and
Mood Disorders 1) explain the epidemiology and

etiology of depression and mania
2) discuss the clinical presentation of
depression and mania
3) describe the differential diagnosis
and management of depression and
mania
4) outline the clinical presentation of
bipolar affective disorder and explain
its management
Anxiety Disorders 1) explain how to recognize disorders

of anxiety like phobia, panic,
obsession and compulsive,
generalized anxiety disorder
2) discuss the etiology, clinical features
and differential diagnosis of various
anxiety disorders
3) outline the treatment of
uncomplicated anxiety and
obsessional disorders
Personality 1) explain the concepts of personality

Disorders and personality disorders
2) describe the influence of personality
disorders on physical and mental
illnesses
personality disorders
4) describe the clinical features of
various personality disorders and

outline the options available for

management of personality disorders
Psychiatrtic 1) give an overview of the main groups

Medications & ECT of psychotropic medications
(Antipsychotics, antidepressants,
mood stabilizers, anxiolytics)
2) explain the pharmacokinetics and
pharmacodynamics of each group,
describe the indications and
contraindications for each of the
main groups of psychotropic drugs
3) describe the major side effects of
each of the main groups of
psychotropic drugs
4) state the interactions, toxic effects
and other adverse effects of each of
the main groups of psychotropic
drugs
5) describe problems of compliance
with psychiatric medications and
possible interventions
6) discuss the indications for
electroconvulsive therapy (ECT),
describe the procedure and
evaluation of a patient undergoing
ECT
7) describe post-ECT management,
explain the adverse effects of ECT
and frequency of treatment
Suicide and 1) give an overview of the epidemiology

Deliberate Self harm of suicide and deliberate self-harm
2) describe the assessment and risk
factors for suicide
3) discuss the relation between suicide
and various mental illnesses
4) outline the management of potentially
suicidal patients and of those
recovering from self-harm
Emergency 1) discuss the assessment and

Psychiatry interviewing techniques of aggressive
patients
2) outline the principles of management
of acutely violent patients in the
emergency department
3) give an overview of the psychiatric
emergency conditions (stupor, drug
overdose etc)
4) outline the initial management plan,
and identify the other common
emergency situations in psychiatry
and know their acute management

Community Mental 1) be aware of sources of treatment,

Health management and support for patients
with psychiatric disorder in non-
hospital settings, including
community- based care
2) understand the role of community
mental health services available in
Malaysia
3) be aware of the principles of relapse
prevention, social treatment and
rehabilitation
Main References:
1. Kaplan H. I., Sadock B. J. (2005). Synopsis of Psychiatry, Behavioral Sciences/Clinical
Psychiatry (eds. Kaplan H. I., Sadock B. J.). 10th Edition. Williams & Wilkins,
Baltimore.
2. Gelder M., Gath D., Mayou R., Cowen P. (2005). Oxford Textbook of Psychiatry. 5th
Edition. Oxford University Press.
3. Johnstone E.C., Freeman C. P. L., Zealley A. K. (2004). Companion To Psychiatric
Studies. 7th edition. Churchill Livingstone, Edinburgh.
Topics
1. Introduction to 4th Yr Clerkship in psychiatry (L)
2. Introduction to department, ward, clinic, day center (Visit)
3. Classification of psychiatric disorders (L)
4. Relationships, love, marriage , families and medical problems (L)
5. Schizophrenias: signs and symptoms, history, onset (L)
6. Community team and care services (Seminar)
7. Anxiety Disorders (Seminar)
8. Mood Disorders (Seminar)
9. Substance Abuse & Addiction (Seminar)
10. Parasuicides and Suicides, and prevention (Seminar)
11. Childhood mental illnesses, learning disorders (Seminar)
12. Mental illnesses of the elderly, dementias (Seminar)
13. Organic mental illnesses (Seminar)
14. Counseling, psychotherapy and behaviour modification (Seminar)
15. Medication and ECT in Psychiatry (Seminar)
16. Community Psychiatry (Seminar)
17. Psychiatric emergencies and management (Seminar)
18. Personality Disorders (Seminar)
19. Neurocognitive Assessment (L)

MBBS Curriculum Urban Health/Year-4
Urban Health (Year-4)
Course Information
1. Name of Course/Module: Urban Health (Year-4)
2. Course Code: UHP 6473
1. Prof. Dr. Than Winn

2. Dr. Lilli Jacob
A majority of the world's population live in urban areas nowadays. Urbanization refers to a
change in size, density and heterogeneity of cities. Urban city refers to impact of living in urban
areas at a given time. Urbanization affects health positively and negatively. Urbanization brings
about lifestyle diseases hence our future doctors should be aware of this and play an active role
in the prevention, screening & detection, treatment of these urban hazards.
A large proportion of medical graduates will spend at least part or most of their professional
career in urban health/medical practice. In view of this, it is important for medical
undergraduates to be exposed to the urban health problems and go through a learning experience
from qualified health and medical personnel in the urban areas.
Hopefully, this will act as guidance and instil confidence in them before they are entrusted with
the burden of managing or practicing health in an urban area. The students will also be
introduced to the organization and management of the government for urban health care
services. They will learn about their future role as a manager and as a medical/ health officer in
the urban health care system.
During this 2-week posting, the students will also have the opportunity to visit and present their
reports on important health problems and needs in the urban areas. This posting will give them
an insight to the impact of urbanization on the life of patients.

L= Lecture (2) 21 20 6 20 4 71 hr
S=Seminars(6)/Case
O=Others/SDL 42 60 18 0 20


E=exam
8. Prerequisite:
9. Objectives:
Knowledge of
1. Demographic distribution of the population
2. Malaysian primary health care concept
3. Population dynamics
4. Social determinants & urban health issues
5. Environmental health issues in urban areas
6. Physical health issues in urban areas
7. Psychological health issues in urban areas.
8. International health
9. Group dynamics in leaning public health
10. Concepts of healthy living
11. Introduction to health care financing
Skill in
1. performing critical appraisal
Attitude regarding
1. interaction with psychiatric patients (and their families) with regards to respect,
2. politeness and respect for other health care professionals, including psychologists,
social workers and doctors.
3. punctuality, taking initiative, reliability and be responsible where appropriate.
5. motivation towards patient assessment, self-directed study and maximising clinical
experience.
1. describe the organization structure and functions of the health delivery system in the
urban area of Malaysia
2. discuss the current health problems (especially physical, psychological and social)
common in the urban community
3. demonstrate the ability to critically appraise scientific articles published journals
4. explain the health system and health care expenditure



of medical imaging.
study for examinations and seminar preparation and presentation.
13. Synopsis:
This Module provides the student with an introduction of urban health and approach to
prevention and control of diseases which are prevalent in the Urban sector of Malaysia. It begins
with demography, healthy cities and environmental and occupational issues in the urban sector.
It is complimented with field visits to Majlis Bandaraya Petaling Jaya, Pejabat Kesihatan
PJ,Care & Cure Service Centre at Taman Medan and finally to Befrienders Malaysia. The visit
to MBPJ is for exposure to environmental issues of urban health. The PKD Petaling visit
provides exposure to HIV and Aids status followed by CCSC where the community based
rehabilitation is conducted.
At Klinik Kesihatan Taman Jaya the students are exposed to Methadone replacement therapy
for drug addicts.
The visit to Befrienders is with the intention to expose the students with the mental health status
associated with urbanization.
Lectures, tutorials, seminars, field visits and practical

(a)Test
(b) Assignment
(c) Presentation of Business Plan
Final Exam (End of posting) 70%
Total : 100%


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moral values.

areas of interest.
  

L T P
Healthy City 1) Understand the concept of Healthy 1
City
2) Understand an overview of Healthy
Cities projects
3) Discuss an action plan for a Healthy
Cities project
Demography 1) Define demography 1

2) Discuss the use and its importance of
demographic data in public health
3) Discuss the effect of components of
population growth and population
momentum to the population size
4) Understand Malthus and Transition
Theories in relation to population
growth
5) Understand the concept of population
census
6) Interpret population census and
population composition
7) Discuss the population profile based
on population growth and
composition
8) Understand the concepts of
population estimates and projections
Environmental 1) Understand the environmental 2

Issues in Urban problems in urban setting
Setting 2) Understand the climate issues in
urban settings
3) Discuss the environmental pollutions
of urban areas
4) Overview of population issues and
urbanization
5) Describe transport issues in urban
areas
6) 6. Explain housing issues in urban
settings
Critical Appraisal 1) Answer the following questions 2

i. What is critical appraisal
(CA)?
ii. Why CA?
iii. How CA?
2) Describe key steps in undertaking a
CA?
3) Perform a hands-on CA of some
articles published in peer-reviewed
medical journals
4) Write reports on their findings

5) Grade and recommend on further

improvements on the article
Socio-Cultural 1) Understand the concept of health, 1.5

Concepts and illness and wellbeing.
Determinants of 2) Discuss the determinants of health,
Health illness and wellbeing.
3) Understand the relationship between
sociological factors and diseases
Healthcare 1) Define healthcare funding 2

Financing 2) Understand the various funding
models
3) Understand the role of health
insurance and managed care
organization
4) Discuss the healthcare funding
models in Malaysia
5) Understand the private healthcare
facilities act 2008
6) Discuss future challenges in
healthcare financing
International Health 1) Understand the meaning of 1

International Health
2) Understand the changing trends of
International Health
3) Overview the various models of
international health system
4) Discuss the causes of rising
healthcare cost
Occupational Health 1) Describe the occupational exposures 1

in urban setting & hazards in urban setting
2) Elaborate the various
exposures/hazards and their
outcomes.
3) Understand & discuss their
preventive and control measures
Introduction to 1) Understand the organizational 1

Health Services at structure and function of MBPJ
MBPJ 2) describe the functions of the health
department of MBPJ
3) understand how law enforcement is
carried out by MBPJ for health care
activities
4) describe the practical procedures
carried out by MBPJ for food
sanitation
Integrated Solid 1) describe the current practice of 1 3

Waste Management integrated solid waste management
by MBPJ system by MBPJ

2) describe the structure and functions of

the sanitary landfill
Environmental 1) describe the programme carried out 1 2

Health and Issues at by MBPJ for the environmental health
MBPJ issues
2) understand the environmental
pollution issues in urban setting
HIV/Aids health 1) understand the current health 1

Program in Malaysia programs for the prevention of
HIV/AIDS in Malaysia
2) describe the national strategic plan on
HIV/AIDS
3) discuss the effectiveness of the health
program with health statistics
Drug Rehabilitation 1) understand the harm reduction 1

Program in Malaysia strategies carried out in Malaysia
2) understand the drug laws and
legislation of Malaysia
3) describe the methadone maintenance
therapy and national policy on it
Rehabilitation 1) Understand the Role of CCSC as an 1

program(Cure and institution that provides services to
Care Service Centre) the target groups through programs
provided in an effort to help address
the drug problem.
2) Understand that CCSC caters for
clients who want to lead their Drug
Rehabilitation voluntarily
Urban Settings and 1) Understand the mental health issues 1.5 1

Impact of of the Urban community
Psychological 2) Understand the psychological impact
Problems in the urban setting
3) Is awareness of the causes of suicide
and how to prevent it
4) Evaluate the effectiveness of the
suicide prevention resource centre
Mental health & 1) Discuss the emotional support needed 1.5

Statistics of by those under distress and suicidal.
Psychological 2) Able to impart emotional support
Problems skills to the community.
3) Able to instil coping skills for better
mental health.
4) Discuss the statistics of
psychological and mental health
issues in the urban setting

Textbooks
1. Park’s textbook of Preventive and Social Medicine (2009), 20th ED, Banarsidas
Bhanot publishers, Jabalpur, India.
2. Gordis, Leon. 4th ED (2009). Elsevier Saunders, Philadelphia, PA. USA.

MBBS PROGRAM
YEAR-5

Medicine (Year-5)
Course Information
1. Name of Course/Module: Medicine (Year-5)
2. Course Code: MED 6595
1. Prof. Tan Sri Dato’ Seri Dr. Haji Mohd Ismail Merican
3. Prof. Dr. Nandakumar Singaram
4. Prof. Dr. Ajai Pratap Singh
5. Prof. Dr. Har Mohan Pal Singh
6. Associate Prof. Dr. Tarek Mohammed Elshaarawy Mohammed Nassar
8. Dr. Wint Wint Thu Nyunt
9. Dr. Sharmila Vedhavathy Sornam
In MAHSA MBBS year 5 Medicine posting, primary emphasis is for preparing students to take
care of patients and families in a humanistic and professional manner to take over responsibility
as a houseman and tomorrows doctors in Malaysia
In MAHSA problem based , competency oriented, knowledge focused- curriculum, provides
opportunities for learning and evaluation in the following competencies:

L= Lecture (2) 8 34 35 189 4.5 270.5 hr
S=Seminars(6)/Case
O=Others/SDL 16 102 0 0 12.5
E=exam

8. Prerequisite:
9. Objectives:
KNOWLEDGE:
During the posting the students will acquire knowledge of the medical problems seen in adults.
1. pathophysiology
2. epidemiology
3. clinical decision making
4. use and interpretation of diagnostic tests
5. pharmacology
6. medical ethics and
7. medicolegal issues.
CLINICAL SKILLS:
1. Obtain from a patient an accurate focused medical history.

2. Perform a complete physical examination.
3. will be taught to properly document findings from the history, physical
examination, progress notes, procedure notes, physician’s orders, and
prescriptions for medications
4. acquire the skill to communicate with the patient, their families and members
of the health care team and
5. acquire skills on routine procedures commonly conducted for the evaluation
and care of patients, including venipuncture, bladder catheterization, arterial
puncture, insertion of peripheral intravenous catheters, fecal occult blood tests,
electrocardiograms, insertion of nasogastric tubes, use of sterile technique, and
use of universal precautions.
PROFESSIONAL BEHAVIOR:
Students must understand and be able to demonstrate the attitudes and behaviors necessary to
provide patient evaluation and care. Specifically, students must understand the importance of
and display the following attitudes and behaviors.
1. Independent, self-directed learning
2. Reliability
3. Integrity, honesty, altruism
4. Compassion, tolerance
5. Respect for patient privacy and confidentiality
6. Respect for the patient’s rights
7. A professional image in manner, dress and grooming
8. Recognition of personal limitations in knowledge and skills and willingness to
improve them
9. Provision of patient care without interference by personal biases
10. Advocacy for improving care of under-served populations
11. Respect for the roles of other health care professionals
1. 1.Carry out a consultation with a patient, comprising of:

• taking a history and assess the patient's mental state
• conducting a physical examination and requesting for appropriate investigations
• make a diagnosis based on the above

• explain the diagnosis and management to the patient

• provide reassurance and support if required
2. Be able to recognize and manage medical emergencies
3. 3. Be able provide basic life support and cardio-pulmonary resuscitation
4. be able to apply the basic principles on advanced life support
5. Be able to recognize and manage chronic and lifestyle illness
6. Able to appropriately prescribe drugs and other therapies for clinical condition and be
able evaluate potential benefits and risks of such therapies
7. Carry out common procedures;
• taking blood pressure
• venepuncture
• cannulation of veins
• use infusion devices
• administering blood transfusion
• administer subcutaneous and intramuscular injection
• administer oxygen
• safe transport of patients
• bladder catheterisation
• urinalysis
• electrocardiography
• basic respiratory function tests

a) Breaking down complex problems into more manageable ones
b) Identifying problems
c) Tracing problems to their causes
d) Identifying cause and effect relationships
e) Formulating procedures to solve problems
a. Integrating knowledge from a number of disciplines to solve a problem
a) Writing clear and concise records and reports
b) Presenting technical information to a large group of people
c) Ability to understand and treat an audience accordingly
d) Listening attentively
e) Effectively explaining highly technical information
of medical imaging.
 Altruism, honesty, ethical commitment
a) Empathy
b) Creativity
c) Initiative
d) interpersonal skills

13. Synopsis:
This is the final phase of training in Internal Medicine for the MBBS program. Students work
under the supervision of faculty and consultants. It is eight week hospital based training in the
Internal Medicine department of HKL. During this posing concepts introduced over the
previous 2 years are reemphasized and further training is provided so that the students will be
able to take on the responsibility of a house officer in the health care team.
Lectures, tutorials, practicals, hands on training
CONTINUOUS ASSESSMENT
Attitude 5%
Log Book Assessments 15%
Case write 10%
END-OF-POSTING EXAMINATION
Theory
Multiple choice question (true/false questions & single response questions) 15%
Short essay question 10%
Modified essay question 10%
CLINICAL
Long case 15%
Short cases 10%
Objective structured clinical examination (OSCE) 10%
Total 100%

the nation.


PEO1 PEO2 PEO3 PEO4
   





moral values.

areas of interest.
     
L T P
Acute in patient care
Nutritional support
hospitalized patient
Shock
Hypertensive
Emergency
Unconscious patient/
DKA/ HONK
Acute poisoning/Drug
over dose
Hepatic
Encephalopathy

General Management
Fluid and Electrolytes
Status epilepticus
Acute pulmonary
oedema/Cardiac
tamponade/cardiogeni
c shock
Acute severe
Bronchial asthma/
ARDS
Cardiovasuclar Clinical examination

System
Respiratory System Clinical examination
Abdomen Clinical examination

(Gastrintestinal Tract,
Renal,
Haematological
System)
Central Nervous Clinical examination

System (Higher
Cerebral Function,
Cranial Nerves)
Central Nervous Clinical examination

System (Motor, Co-
Ordination, Sensory)
Endocrine System Clinical examination
Musculoskeletal Clinical examination

System
CAD(Coronary artery 2
disease)
Cardiac failure
Pneumonia
COPD/Asthma
Chronic Renal failure
Fever with rash
HIV/AIDS
Malabsoption
GIT Neoplasm
Viral Hepatitis
Leakemia/Lymphoma
ITP/Hemophilia
Diabetes Mellitus
Pituitary/Adrenal/Thy

roid disorder
SLE/Dermatomyositis
/Systemic sclerosis
Cerebrovascular
disorders/MND/Parap
aresis
Acute in patient care
Nutritional support
hospitalized patient
Shock
Hypertensive
Emergency
Unconscious patient
Hepatic
Encephalopathy
General Management
Fluid and Electrolytes
A man with crushing
chest pain for ......
A smoker with
persistent cough......
An women with
pruritus and
jaundice............
A girl with facial rash
and joint pain....
An young man with
recent onset of fever,
gum bleeding and
lymphadenopathy
Travellers with
persistent fever......
A man with
progressive wasting of
distal limb
muscles........
A diabetic man with
blackening of
toes........
Cardiomyopathy
Pulmonary
thromboembolism
Metabolic bone
disease
Inflammatory Bowel
disease
Oncologic emergency
Palliative and End life
care
CNS Infections
HIV/AIDS
ECG- CAD,
Arrythmias,
Hypertrophy. Heart

Block
X-RAY-Heart, Lung,
Bone, Metabolic
disease
CT SCAN- Chest,
Abdomen, Brain and
spine
Ultrasonogram-
Abdomen ,Chest,
thyroid and joint
disease
Endoscopy UGT,
Colonoscopy, MRCP
Bronchoscopy
MRI- Brain and spine
Echocardiography
EEG,EMG, Evoke
potential
Blood,Hormone
Urine analysis
Fecal analysis
Serology,PCR
Medical Data
Image/Pictures
Pericardial diseases
Interstitial lung
disease
Malabsorption
Adrenal gland
disorders
Renal replacement
therapy
Metabolic bone
disease
Dementia
Bed side teaching
Ward work/ward
round
Textbooks
1. Graham Douglas, Fiona Nicol, Colin Robertson. ‘Macleod’s Clinical Examination’.
13th Edition. 2013. Elsievier Churchill Livingstone.
2. Brian R. Walker, Nicki R. Colledge, Stuart H. Ralston, Ian Penman. ‘Davidson’s
Principles and Practice of Medicine’. 22nd Edition. 2014. Churchill Livingstone.
3. Clinical Medicine- Kumar and clerk
4. Hutchisons clinical method-22nd Edition
Reference:
1. Cecil Text Book of Medicine

Surgery (Year-5)
Course Information
1. Prof Dr .O.Ravindran
2. Prof Dr Saad
3. Assoc Prof Dr Kumar Hari Rajah
4. Datuk prof Syed Noori(HOD)
5. Prof C.S.Venkatesh
6. Prof U Kyaw Tin Hla
7. Dr Chandra Mohan
8. Asso Prof Dr Ernest yeoh
adjunct lecturers:
1. Prof Dr Zainal
2. Dr Hanif
3. Dr Guru
4. Dr Mohan
5. Dr Hakim
This is an important core topic in the MBBS programme. It is to have a consolidated teaching-
learning for all surgery items with stress on management options. The student will be thoroughly
exposed to items of the history, physical examination, investigations and the specific
management of the relevant surgical diseases. The period of posting is 8 weeks in GH-KL.

L= Lecture (2) 32 44 80 60.5 4 220.5 hr
S=Seminars(6)/Case
O=Others/SDL 64 132 0 0 20
(OT/Clinics/ON Call). Total = 436.5 hrs
E=exam
7. Credit value: 436.5/80 = 5

8. Prerequisite:
9. Objectives:
Knowledge of
1. the relation between the pathophysiology and manifestation of surgical diseases.
2. the rationale for used of investigation in surgical clinical practise.
3. the basic principles of vascular surgery
4. the pathogenesis and clinical manifestations of the common vascular conditions that is
seen in the outpatient and inpatient setting and emergency room.
5. the management of the common cases in vascular diseases.
6. the basic principles of vascular surgery and their effects on the patients.
7. the principles of pre, intra, and post-operative surgical knowledge and the basis of
scientific foundation in vascular surgery.
Skill in
1. obtaining comprehensive surgical history
2. performing focused surgically oriented physical examination
3. competent presentation of history and physical examination
4. performing urinary catheterization and per rectal examination
Attitude regarding
1. enhance humanistic values including good communication skills in their clinical
experiences.
2. interaction with patients (and their families) with regards to respect, compassion
and empathy.
appropriate.
6. motivation towards patient assessment, self-directed study and maximizing clinical
experience.
At the end of the posting, the student will be able to

1. present surgical history and clinical examination in an effective and professional way.
2. consolidate and correlate the pathophysiology of surgical disease manifestations to
arrive at a surgical diagnosis.
3. make a provisional diagnosis through the effective utilization of history taking, physical
examination skills.
4. thoroughly present a rationale for choice of investigations in patient management.
5. describe the definitive surgical intervention and postoperative management of
different surgical diseases.
6. discuss the role of multi disciplines teamwork and good intra-hospital networking in
the management of complicated surgical patients.
7. describe the pathogenesis and clinical manifestations of the common vascular
conditions that is seen in the outpatient and inpatient setting and emergency room.
8. outline the management of the common cases in vascular diseases.
9. recognize the basic principles of vascular surgery and their effects on the patients
10. discuss the principles of pre, intra, and post-operative surgical knowledge and the basis
of scientific foundation in vascular surgery


of medical imaging.
Teaching learning activities during the posting will be carried out in the wards,clinics, accident
and emergency ,operation theatre and in various learning facilities.There will also be radiology
sessions.
Components of the curriculum of the surgical posting will be covered through:
1)Experiential learning through exposure to clinical practice
2)Lecture
3)Seminar
4)Tutorial
5)Case presentations
6)Clinics
7)Ward rounds
8)on calls
9)Bedside teaching
10)Hands on sessions
11)Case write up.
And the assessment strategy will be

1)progress of record book
2)attendance
13. Synopsis:
To produce a competent and highly skilled healthcare professional through qualified,dedicated

and experienced teachers and to provide state of the heart facilities to ensure the desired
standards in education
Lectures, tutorials, seminars and practical.

(a)attitude:5 %
(b)case write-up :10 %
(c)Progress record book :15 %
End of posting Exam

1)theory-mcq,meq and seq :35%
2)clinical-long case,short case and osce:35%
Total :100%

the nation.


PEO1 PEO2 PEO3 PEO4
   




moral values.



areas of interest.
     
L T P
General surgery 1) take a proper history
2) do a general and specific physical
examinatioin
3) analyse the differential diagnosis
4) discuss the investigative findings
5) outline the management of the
following surgical conditions:
i. abdominal trauma and chest
trauma
ii. peptic ulcer disease
iii. infections in surgery
iv. dysphagia
v. medical conditions in surgery
vi. acute abdomen
vii. acid base balance and fluid
and electrolyte balance
viii. intestinal obstruction
ix. burns
x. hernias and abdominal wall
anatomy
xi. GIT tumors
xii. upper and lower GIT bleed
xiii. anorectal disorders
xiv. shock
xv. perioperative care
xvi. abdominal mass
xvii. acute peritonitis
xviii. minimally invasive surgery
breast and endocrine 1) take a proper history

surgery 2) do a general and specific physical
examinatioin
i. breast lumps

ii. breast cancer

iii. neck swellings
iv. thyroid problems
vascular surgery 1) take a proper history

examinatioin
i. peripheral vascular disease
hepatobiliary 1) take a proper history

surgery 2) do a general and specific physical
examinatioin
i. portal hypertension and
esophageal varices
ii. biliary stones
iii. obstructive jaundice
iv. pancreatic cancer
v. liver and pancreatic trauma
vi. acute pancreatitis
urology 1) take a proper history

examinatioin
i. urinary tract stones
ii. prostatic conditions(BPH)
iii. obstructive uropathy
iv. urological malignancies
v. testicular tortion and masses
vi. trauma to the urinary system
paediatric surgery 1) take a proper history

examinatioin
i. trachea-esophageal
fistula/cleft lip and palate
ii. biliary atresia
iii. abdominal pain and vomiting
iv. intestinal obstruction in

neonates and children

v. anorectal anomalies
vi. inguinoscrotal conditions
neurosurgery 1) take a proper history

examinatioin
i. head and spine injuries
ii. craniosyantosis
iii. raised intracranial pressure
iv. space occupying lesions of
the brain and
spineintravertebral disc
disease
v. hydrocephalus
cardiothoracic 1) take a proper history

surgery/plastic 2) do a general and specific physical
surgery examinatioin
i. cardiac surgery
ii. thoracotomy(indications and
technique
iii. flaps (classification and
techniques
Texbooks
1. Introduction to the symptoms and signs of surgical disease;Norman L Browse;hodder
Arnold,4th ed,2005
2. Bailey & Love’s Short Practice of surgery;revised by RCG Russel,NormanS,William
Christopher JK Bulstrode,24thed,Arnold ,2004
3. Current surgical diagnosis and treatment,edited by Lawrence W Way,10th edi,2002
Reference
1. Clinical surgery:Cushieri,Henessey,Rowley and Grace,Blackwell Science,2nd edi, 2005
2. Principles and practice of surgery:O,J Garden ,Churchile Livingstone,4th edi,2002
3. Essential surgical practice: Cushieri, R, J, Steele: 4th edi oxford, butterworth
Heinemann, 2000
4. An aid to clinical surgery:Scott R Peter:Churchill Livingstone,6th edi,2003
5. Textbook of surgery: edited by Joe J Tjandra, Gordon, 2nd edi, London, Blackwell
science LTD,2001
6. Essentialsurgery: problems, diagnosis and management: Burkitt H. George H, George
Burkitt: 2nd edi, Churchill livinststone,1996
7. General Surgery: H Ellis, Watson: Blackwell Science, 10th edi, progress record book,
2002


MBBS Curriculum ObGy/Year-5
Obstetrics and Gynaecology (Year-5)
Course Information
1. Name of Course/Module: Obstetrics and Gynaecology (Year-5)
2. Course Code: OBG 6596
1. Professor Dr. Siva Achanna

2. Associate Professor Dr. Ganesh Ramachandran
3. 3. Associate Professor Dr. Renu Gopinath
This module picks up from the obstetrics and gynaecology posting in year 3. While the year 3
module emphasizes history and examination, in year 5 the student is required to enhance their
skills so that they will be able to take a targeted history and perform a focused examination of
the female patient. In this posting students are expected to further their knowledge so that they
they incorporate principles of management of common obstetrics and gynaecology problems
seen in clinical practice. The students are expected to shadow the doctors in the unit so that they
will obtain firsthand experience of patient management in the obstetrics and gynaecology
department in HKL.
5. Semester and Year offered: Year-5 (8-weeks posting)

L= Lecture (2) 8 66 31 147 4.5 256.5 hr
S=Seminars(6)/Case
O=Others/SDL 16 198 0 0 22.5
E=exam
8. Prerequisite:

9. Objectives:
1. The student is taught to take a targeted history and perform a focused clinical
examination.
2. The student will be able to identify the relevant investigtions and intepret them.
3. The student must be able to generate a list of differential diagnoses and outline
principles of management of common clinical situations.
4. The student must observe and assist in the management of normal labour and delivery.
5. The student must observe common gynaecological procedures.
6. Develop communication skills and apply these in their interaction with patients and
their relatives, colleagues and medical staff.
7. Inculcate positives attitudes in obstetrics and gynaecology, emphasizing on being
caring, respectful and sensitive to the patient’s needs.
8. Incorporate values with regard to patient’s privacy, dignity, confidentiality and ethics
in the management of obstetrics and gynaecology problems
At the end of the course, students should be able to:
1. Use their knowledge to competently clerk and develop a management plan for an
obstetrics/gynaecology patient.
2. Recognize patterns of normal and abnormal labour and appropriate manage them.
3. Describe the principles of episiotomy repair
4. Perform cardiotocography (CTG) and recognize normal and abnormal patterns and their
intervention.
5. Document all information regarding progress of labour in the partogram and interpret
the findings.
6. Recognize the patient’s problem and prioritize according to patient’s individual needs
particularly in obstetrics.
7. Request and interpret the relevant investigations and evaluate the usefulness of tests
according to clinical presentations.
8. Formulate the diagnosis, prioritize the problem and discuss the management options.
9. Function as a house officer in the healthcare team.

• Problem Solving Skills
a. Identify problems and prioritize them.
b. Identify causes for these problems.
c. Develop problem solving skills that are found on sound and rational principles of
reasoning.
d. Develop skills in problem solving that demonstrate ability to integrate knowledge
derived from a number of disciplines.
• Interpersonal & Communication Skills

a. Listening effectively and establishing rapport with patients (clients).
b. Building trust and cooperation of patients. Demonstrating sensitivity to
contextual factors in patient care. (Examples being cultural, ethnic and religious
sensitivities, socio economic circumstances).
a. Developing the ability to work as part of a team to deliver the best outcomes.

b. Developing rapport with peers.

c. Writing and maintaining focused, precise and concise reports. (Examples being
patient progress notes, discharge summaries and referrals).
d. Presentation skills. (The ability to tailor presentations to the needs of different
audiences).
• Professional attributes
a. Projecting a professional image. (demeanour, attire, punctuality)
b. Ability to work as a team as well as independently according to needs.
c. Demonstrating responsibility and dependability in patient care. (Integrity).
d. Recognition of one’s own strengths and weaknesses.
• Developing an ability in understanding and using information technology
• Understand the economics of health care
The program has clearly defined goals. These are met initially via didactic lectures delivered to
the whole cohort. As the course progresses the strategy incorporates strategies that encourage
group study and self-learning. Assessment is through summative and formative strategy.
13. Synopsis:
This Year 5 obstetrics & Gynaecology curriculum is designed to train the final year medical
students (Year 5) as a “junior house officer” aimed at more clinical exposure to prepare them
for the first year of working in medical service. The design is such that the students can gain the
basic principles of the theory and practical in O&G. It will provide them with the initial needs
for sound grasp of the subject enabling further development as required later. During the
stipulated period in the training, student will be facilitated in the relevant process of knowledge,
acquisition, developing practical and procedural competence and attaining the desire attitude
required from them. Moral and ethical perspectives are blended and imbued in consonance with
MASHA University College and Faculty philosophy throughout the training and learning. Eight
weeks clinical O&G posting in Year 5 is mainly consolidation of the foundation laid in Year 3,
emphasizing more in the management aspect. By the end of the course the student will have
acquired competency in history taking, performing basic examination techniques, making
differential diagnoses, formulating basic investigations, and planning for patient management.
 Lectures.
 Practical skills workshop (episiotomy repair, programs and CTGs, Instrumental
delivery, contraception, pelvic examination).
 Bed side teaching
 Student led seminars.
 Study Circles and group discussion.
 Once a Week discussion on MEQ,SAQ, OSCE, MCQ
 Attendance at outpatient antenatal/gynaecology, labour room and operating theatre
sessions/ward rounds/on call.

(a) Attitudes 5%

(b) Case write up15%

(c) Log book 10%
End of Posting (70%)

(a) Theory 35% - MCQ and SBA (30 questions in total) 15% MEQ and SEQ (2 each) 20%
(b) Clinical 35% - Clinical long case 20%, short case 10%, OSCE 5%
Total 100%

the nation.


PEO1 PEO2 PEO3 PEO4
   




moral values.


areas of interest.
     
L T P
History taking in 1) Introduce history taking and
obstetrics and examination outline for obstetrics and
gynaecology gynaecology patients
2) Develop a template to use on the
wards with real patients
Medical disorders in 1) Demonstrate an understanding of the

pregnancy relationship of medical diseases and
pregnancy i.e. how pregnancy effects
the disease and vice versa.
2) Understand the pathophysiological
basis of these diseases in pregnancy.
management of these diseases in
pregnancy
Assisted 1) Able to define infertility, examine

reproductive and identify the causes of it
technology 2) How to investigate an infertile
couple
3) An overview of the management
options
Role of Ultrasound in 1) Able to describe the Physics in

obstetrics & Ultrasound imaging
Gynecology 2) Students should know the use of
ultrasound in the diagnosis of normal
and abnormal pregnancies
3) To detect the Gynaecological
abnormalities using scans
4) Procedures that can be done using
scan
Prenatal Diagnosis 1) Normal and abnormal fetus

2) Genetic and structural abnormalities
of the fetus
3) Procedures to detect the above
abnormalities
4) Blood tests
5) Treatment modalities

Gynecological 1) List the common gynaecological

malignancies malignancies.
2) Describe the risk factors for
development of these malignancies
3) Describe the presentation of these
malignancies
4) Describe the appropriate
investigations and principles of FIGO
staging.
importance of FIGO staging.
these malignancies.
7) Describe screening and preventative
strategies to reduce the incidence of
these malignancies
Normal and 1) Describe the mechanism of normal 1

abnormal labour labour
2) Understand and describe the
diagnosis of established labour.
3) The principles of management of
normal labour.(abdominal
examination and FHR monitoring,
vaginal examination and amniotomy,
appropriate intervals for vaginal
examination, maternal vital signs
monitoring)
rate of labour progress, significance
of clear and meconium stained liquor,
and foetal monitoring in normal
labour.
5) List the pharmacological agents used
in normal labour, and their mode of
action and adverse effects.
6) Demonstrate understanding of their
appropriate use.
Abnormal lie and 1) .Define normal lie and presentation of

malpresentation pregnancy
2) Describe the type’s abnormal lie and
presentation seen in pregnancy.
3) Describe the clinical findings in each
of the abnormal lie and presentation.
4) Demonstrate an ability to relate
abnormal lie and presentation to other
obstetric abnormalities.
investigations to diagnose and
monitor these cases.
management in these cases

Adnexal masses 1) Classify benign adnexal masses

clinically.
2) Describe the presenting features and
complications of fibroids and benign
adnexal masses.
3) Develop a template to differentiate
between the different causes of
adnexal masses.
4) Describe the differential diagnosis of
fibroids
investigations and principles of
management of fibroids and adnexal
masses.
Caesarean section 1) Definition, different types of

caesarean section and indications
2) Able to define VBAC and selection
criteria
3) Monitoring of previous scar in labour
and monitoring the scar integrity
4) Symptoms and signs of scar rupture
5) How to prepare a patient for
caesarean section and postpartum
monitoring
Preterm labour and 1) Define preterm labour, causes, and

premature rupture of differential diagnosis
membranes 2) Physical examination, investigations
3) Management options
4) Problems of prematurity
PIH, PE and 1) Definition, risk factors

Eclampsia 2) causes, and differential diagnosis,
Physical examination, investigations
4) Indications for early delivery in these
cases
5) Commonly used antihypertensive
drugs
6) Use of Magnesium sulphate in PE and
Eclampsia
Fetal distress 1) Definition, causes

2) Clinical examination
3) Diagnosis of foetal distress
4) Management
Pelvic inflammatory 1) Define these conditions.

disease and tubo 2) Describe their clinical presentations.
ovarian mass 3) Describe appropriate investigations
for these conditions and differential
diagnosis

management of these conditions.

5) Long term complications and
management options
Anaemia in 1) Define, clinical presentations

pregnancy 2) describe the appropriate
management
3) List other common antenatal
complications of it.
4) Medical management
5) Intrapartum and post-partum
management
Induction of 1) Define Induction of labour.

labour(IOL) 2) Categorize the various methods of
IOL.
3) Describe the mode of action of the
above.
4) Describe the adverse effects and
contraindications for the use of the
above.
5) Selection criteria for the patient
6) 5.Observations during IOL, problems
of IOL
7) Monitoring of both mother and the
foetus and further management if
labour progresses
Menstrual disorders 1) Definition of menorrhagia and how to

quantify menorrhagia
2) Classify different types of menstrual
disorders.
3) Describe the presenting features
4) 4.Clinical examination findings
5) Describe the differential diagnosis
management of menstrual disorders
depending on the diagnosis
Post date 1) Verifying patient’s LMP and

confirming the EDD
2) What is postdate and clinical
implications
3) Fetal surveillances
4) Complications and management
options
Amenorrhoea 1) Define primary and secondary

amenorrhoea
2) Clinical examination findings
3) Describe the investigations to be done
4) Management options depending on

the cause
Multiple pregnancy 1) Able to describe the definition,

clinical findings, antenatal
complications, investigations.
Post-partum 1) Describe what is primary and

haemorrhage secondary post-partum haemorrhage
2) Should describe the physical
examination findings and
investigations
3) Medical and surgical management of
PPH
Shoulder dystocia 1) Antenatal predictions of these

and Cord prolapse conditions
2) Definitions, importence of team work
in managing this condition
3) Manuevours used and surgical
options
4) Maternal and fetal complications of
the conditions
Eclampsia 1) Definition of eclampsia

2) Resuscitation of the patient
3) Clinical examination, blood
investigation
4) Treatment modalities using drugs
5) Should be able to decide on mode of
delivery
6) Postpartum management
Uterine inversion 1) Risk factors of Uterine inversion

2) Definition, physical examinations
3) Importance of team work in managing
this case
4) O’Sullivan’s method of management
5) Contraception and Counselling for
future pregnancy
Episiotomy 1) familiarize the students with the types

(Workshop-1) of episiotomy, the sutures used and
the method of episiotomy repair
2) recall the anatomy of the perineum in
terms of vascular and nerve supply as
well as the muscles of the perineum
Partograph 1) fill in the partogram

2) analyse the clinical information
contained therein
3) differentiate between normal labour
partogram and the abnormal labour
partogram

Contraception 1) Different types of contraception

2) Medical and surgical methods
3) Indications and contraindications
4) Side effects
5) Define Pearl index
6) Male contraceptive methods
CTG 1) Describe components of a normal

CTG
2) Interpreting CTG
3) Able to recognize Abnormal CTG
Amniotomy, Breech 1) Describe how to perform amniotomy,

delivery and advantages of it
Instrumental 2) List and describe types of breech,
delivery causes of breech presentation,
Clinical findings and Management
options
Study circle and Students are given 7 topics of interest for

group discussion group discussion as student directed
learning.
Bed side teaching 1) Student will clerk 2 long cases and

present to the lecturer where the
clinical examination techniques and
application of the knowledge in
managing the case will be analysed
Labour room 1) Student will be exposed to labour

teaching room management of the patients
2) May assist in deliveries
3) Learn to plot partogram
4) Observe instrumental deliveries and
caesarean section
Clinics Students will clerk cases and present

to the lecturer
Obstetric ward Clerk cases and learn the management 21

work in totality and understand the team
work in
the management of a patient
Gyne ward work Clerk cases and learn the management
in totality and understand the team
work in the management of a patient
PAC & clinic See the new cases, screen them , assess
the necessity of admission and further
management
Labour room Clerk patients who are in active phase

of labour, understand the fluid

requirement and analgesia in labour.

Learn all the steps in the management
of a normal and abnormal labour
Textbooks
1. Obstetrics Illustrated 7th edition Hanretty. Churchill Livingstone
2. Gynaecology Illustrated 6th edition Bain, Burton and Mcgavigan. Churchill
Livingstone
3. Obstetrics and Gynaecology 4th edition Impey and Child. Wiley Blackwell
4. Oxford Handbook Of Obstetrics and Gynaecology 2nd/3rd edition Collins,
Arulkumaran et al Oxford Publications
5. Essentials of Obstetrics- Arulkumaran, Sivanesaratnam , Chattergee, Kumar
6. Essentials of Gynecology- Arulkumaran, Sivanesaratnam , Chattergee, Kumar
Reference
1. Journal Of Paediatrics’ Obstetrics and Gynaecology
2. GP Online
3. Green top Guidelines of the RCOG London

Paediatrics (Year-5)
Course Information
1. Name of Course/Module: Paediatrics (Year-5)
2. Course Code: PED 6595
1. Prof Prameela Kannan Kutty

2. Prof Shinde SV
3. Prof Usha Singh
4. Dr. Ismail Mohammed Elghuwael
5. Assoc Prof Ali Hadi
This module is an extension of the introductory module to paediatrics conducted in Year 3. It

seeks to reinforce the basic concepts of child care introduced in year 3. In this module the student
will be exposed to the principals of management of common paediatric problems seen in the
community. Recognition of paediatric emergencies and their management will be covered
during the posting. Basic management including investigations, treatment and parental
counselling will be reemphasized.
At the end of both modules, the student is expected have the necessary competencies required
to function as a house officer in a paediatric unit.

L= Lecture (2) 8 41 50 114 4 217 hr
S=Seminars(6)/Case
O=Others/SDL 16 123 0 0 20
E=exam
8. Prerequisite:
9. Objectives:
Knowledge of
1. common paediatric emergencies and the principles of their management

2. abnormal growth and developmental patterns in the paediatric patient cohort

3. early features of nutritional deficiencies and manage them.
4. the benefits of exclusive breastfeeding of the infant till six months of age.
5. common infective disease patterns and their appropriate preventive measures
6. common congenital and non-congenital heart diseases in neonates, infants and
children with correlation to the pathophysiological changes
7. common laboratory investigation used in paediatric patient cohort and their
significance
8. initial management for common paediatric disorders.
Skills in
1. obtaining focused paediatric history
2. performing thorough paediatric examination
3. common procedures in paediatric clinical practice.
Attitude regarding
8. punctuality, reliability and the ability to take initiatives and responsibilities
where appropriate.
clinical experience
At the end of this posting the student will be able to

1. take a focused paediatric history, perform an adequate examination and
institute initial management for common paediatric disorders.
2. diagnose common paediatric emergencies and manage them as part of the
paediatric team.
3. diagnose abnormal growth and developmental patterns in the paediatric
patient cohort and appropriately refer them in a timely manner.
4. recognize early features of nutritional deficiencies and manage them.
5. counsel parents on the benefits of breast feeding.
6. list the nonspecific symptoms of infections in children
7. institute preventive measures for infectious diseases
8. diagnose and treat infections in children
9. manage paediatric patients in a professional and ethical manner.
10. recognize manifestations of heart disease and correlate them to the
pathophysiological changes
11. identify the main manifestations of congestive cardiac failure in infancy and
childhood.
12. List the principle modalities used to investigate heart disease
13. utilize the concept of high index of suspicion in generating any provisional
diagnosis.

(c) Tracing clinical problems to their causes and diagnosis


 Use of general information technology and investigative tools
of patient care
Teaching will be in clinical bedside, lecture and seminars with case discussions and hospital
ward rounds, supported by independent reading and private study for examinations.
Assessment is through summative and formative strategy
13. Synopsis:
This course provides the student understanding of the pathophysiological changes in the
paediatric patient and to arrive at a differential diagnosis through clinical history taking and
physical examination. They are trained by various TLA methods to have the knowledge and
values to empower them skills and attitudes required of good housemen and junior MOs.
Bedside teachings, case discussions, lectures , seminars , short case, long case, OSCE and
theory assessment.

End Posting Exam 70%
MCQ
MEQ
SAQ
Total written 35%
Clinical
Long Case
Short Case
Osce
Total Clinical 35%
Total : 100%


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moral values.

areas of interest.
     

L T P
Childhood
malignancies
Approach to a sick
neonate
Diabetes Mellitus
Prematurity and low
birth weight
Spina bifida and
hydrocephalus
Congenital infections
Adolescent
development and
Psychiatry
Respiratory distress
in term baby
Anaemia
Common endocrine
disorders
Jaundice and liver
disease
Common
Respiratory
Problems
HIE
ARF and CRF
Antibiotics and iv
fluids in children
Neuromuscular
diseases
CCF
NNJ
Autoimmune
Disorders
bronchial asthma
Thalassemia
PRESCRIBED TEXT BOOK

1. Nelson:Essentials Of Paediatrics Behrman, Richard E, Kliegman, Robert M 6th edition
2. Hutchinson’s clinical methods Illustrated Textbook of Paediatrics.
3. Macleods Clinical Methods
4. 4Illustrated Textbook of Paediatrics. Tom Lissauer & Graham Clayden 4th edition 2007
Mosby International Limited
RECOMMENDED TEXTBOOKS
1. Nelson Textbook Of Pediatrics,Kliegman , Robert M,Arvin A,Behrman,R latest edition
2. Hospital paediatrics - A. D. Milner, David Hull
Suggested further reading:

1. Breast milk immunoprotection and the common mucosal immune system Mal J nutrition
2010 Prameela KK, Adel al Kadi

2. HIV transmission through breastmilk: the science behind the understanding of current
trends and future research. MJM 2010 Prameela KKutty
3. Breastfeeding and the Influenza viral pandemic 2009 MJM PrameelaKK
4. Rotavirus diarrhea and breastfeeding Prameela KK, Vijaya MalJ nutrition 2010
Extra case discussions , ward rounds , teaching in the clinic or outpatient settings and extra
teaching for the weaker students or the motivated students are teaching activities done ad hoc
and on student request as per midcourse feedback.
These are difficult to account for in terms of number of hours of teaching but are ongoing in the
paediatric department for year 5 teaching.

Orthopaedics (Year-5)
Course Information
1. Name of Course/Module: Orthopaedics (Year-5)
2. Course Code: ORT 6593
1. Professor Dato Dr Abdul Hamid bin Abdul Kadir

2. Dr Pooya Moslemzadeh Tehrany
3. Dr Fredy Arianto
4. Dr Talluri Venu Gopala Krishna
5. A/Prof Khaled El Sayed Mohamed Ebid
 Orthopaedics, which includes traumatology, is a major discipline and is one of the six
rotations, of 4 months each, during the 2-year houseman training in Malaysia, prior to
full registration.
 Road Traffic Accidents is the fourth major cause of death in Malaysia, after Coronary
Heart Disease, Stroke and Influenza & Pneumonia.
 The average bed occupancy of patients with trauma and trauma-related disease in
orthopaedic wards in major hospitals in the country is 60-70%.
5. Semester and Year offered: Year-5 (4-weekposting)

L= Lecture (2) 17 23.5 30.5 47.5 5 123.5 hr
S=Seminars(6)/Case
O=Others/SDL 34 70.5 0 0 25
E=exam
8. Prerequisite:
9. Objectives:
1. The broad objective is to prepare the students to undergo houseman training for 4 months
in orthopaedics.
2. The topics covered in Year 5 are re-visited through tutorials with greater emphasis on
principles of management.

3. Practical skills (applying POP, wound dressing and suturing wounds) are emphasised and
students are required to observe/assist in the wards, treatment areas and clinics.
By the end of this posting, the student will be able to:
1. outline the principles of management of common orthopaedic and trauma patients

2. apply basic principles of orthopaedic surgery, including pre-, intra- and post-operative
management , including rehabilitation of orthopaedic patients.
The students will graduate as medical practitioners, appropriately and specifically trained in
skills to undertake healthcare delivery as General (Family) Practitioners. They will after
graduation undergo houseman training in Orthopaedics for 4 months, in addition to Medicine,
Surgery, Obstetrics & Gynaecology, Paediatrics and A&E, each for 4 months.
The teaching-learning strategy adopted is to inculcate in the students the concept of life-long
practice as medical practitioners, with episodes of continuing medical education input, both in
knowledge and skills, from time to time.
The formative and summative assessments of the students are tailored to achieve the target of
graduating young doctors who will possess the required knowledge and skills to undergo
houseman training in public healthcare facilities, and primarily and initially to be able to
function as general (family) practitioners.
13. Synopsis:
The details of the course are covered in various sections in this document. The primary objective
is to train the students in knowledge and skills over the 5 years, through structured teaching-
learning schedules which are disease- and patient-oriented, with over-riding emphasis on ethics,
professionalism and good standard of doctor-patient and doctor-colleague-healthcare personnel
relationship. They are also trained to appreciate socio-cultural-ethnic and economic values of
our people.
The curriculum is delivered through tutorials, lectures, seminars, skills workshops and hands-
on experience during ward-work and treatment areas (operation theatres, POP rooms, dressings)
and bedside teaching (with direct patient contact) in Hospital Kuala Lumpur (HKL), which is
the teaching hospital accredited for clinical phase of the curriculum. Students are impressed
upon the need for practical training in orthopaedic procedures and they are supervised in this
engagement.

(a) Attitudes 5%
(c) Log book 15%

End of Posting Assessment (70%)

(c) Theory 35%
 MCQ and SBA 15%
 MEQ and SEQ 20%
(d) Clinical 35%
 Clinical long case 15%
 Short case 10%
 OSCE 10%
Total 100%

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areas of interest.
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L T P
Orthopaedic diseases 1) Understand aetio-pathogenesis and
in childhood, adults modes of presentation of diseases
and in old age, through and the principles of management in
the five categories: each category
congenital,
developmental,
degenerative,
neoplastic, and
infection
Skeletal trauma: 1) Understand all aspects of trauma of

fracture healing, types bone, joints and soft tissue, including
of fractures, principles cartilage. Able to diagnose and
of treatment, early and understand the principles of
late complications; management
dislocation of joints;
infections; open
fractures.
Soft-tissue trauma ; 1) Understand all aspects of trauma of

Sports injuries, bone, joints and soft tissue, including
ligament, muscle and cartilage. Able to diagnose and
tendons, cartilage understand the principles of
injuries management
Textbooks
1. Solomon L, Warwick D, Selvadurai N. Apley’s Syste of Orthopaedics and
Fractures 2001 (8th Edition) London: Butterworth-Heinemann
2. Ronald McRae. Pocketbook of Orthopaedics and Fractures 2006 (2nd Edition).
Chuchill Livingstone
3. Hamblen D., Simpson H. Adams. Outline of Orthopaedics (14th Edition)
Churchill Livingstone
4. Hamblen D., Simpson H. Adams Outline of Fractures, including Joint Injuries
(12th Edition) Harcourt.

Reference books
1. Campbell’s Opertive Orthopaedics (Terry Canale) 9th edition
2. Spivak JM, Zukerman JD. Orthopaedics – A Comprehensive Study Guide.
3. Benson, Fixen, Macnicol and Parsch. Children’s Orthopaedics and Fractures.
(3rd Edition) Springer-Verlag 2010.

Primary Care Medicine (Year-5)
Course Information
1. Name of Course/Module: Primary Care Medicine (Year-5)
2. Course Code: PCM 6593
1. Associate Prof. Dr. Gauri Krishnaswamy

2. Prof. Datuk Dr. Daniel Mahendran Thuraiappah
3. Associate Prof. Dr. Aminah Abd. Rahman
Primary Care Medicine is that component of the health care system, which provides initial,
continuing, comprehensive and coordinated medical care that is evidence-based for all
individuals, families and communities and which integrates current biomedical, psychological
and social understandings of health. This posting in year 5 emphasises It involves the ability to
take appropriate responsible action on any problem the patient presents and therefore is now
recognized as an essential subject in the teaching of undergraduates.

L= Lecture (2) 6 36 31 - 3 135 hr
S=Seminars(6)/Case
O=Others/SDL 12 108 0 0 15
E=exam
8. Prerequisite:
9. Objectives:
Knowledge of
1. the spectrum of medical problems that occur in primary care and understand how to
provide continuous, comprehensive care to patients and their families.
2. the clinical application of health promotion, risk factor assessment, disease prevention
and patient education interventions.
3. the relevance of biopsychosocial, familial, socioeconomic and community factors to
providing patient – cantered care.

4. the personal, economic, ethical and legal issues that influence the patient and
physician in the primary care setting.
5. evidence – based approach and clinical practice guidelines to the diagnosis and
management of problems commonly seen in a primary care setting.
6. an understanding of the specialty of primary care medicine and its role within the
healthcare delivery system.
Skills in
1. applying basic clinical skills required to provide effective and efficient primary care
2. performing clinical audits to improve quality of care rendered to patients, family and
community
Attitude regarding
1. effective teamwork
2. leadership qualities and managerial skills.
3. effective communication with patients, families and other health care providers
At the end of the posting the student will be able to
1. communicate effectively with patients to gather relevant medical history and in

educating them.
2. diagnose using efficient diagnostic strategy and the whole person approach.
3. draw up a management plan for the patient’s current disease, plan for the patient’s
continuity of care, promoting health and improving the health seeking behaviour.
4. differentiate the illness patterns between patients in the primary care clinic and hospital
setting.
5. identify those patients requiring a referral for secondary or tertiary care.
6. describe the roles of the Primary Care Physician and primary health care workers in the
health care delivery system.
7. apply the principles of evaluating the validity and applicability of diagnostic tests and
therapies in Primary Care practice.



of medical imaging.
Teaching will be in lecture, student led seminars, health clinic clerkships, role pay sessions and
groups discussions format supported by independent reading and private study for examinations.
Formative assessment will include case write up and log book.
13. Synopsis:
This course provides the student opportunity to develop a firm foundation of knowledge, attitude
and skill about the holistic approach of patients in the community setting, as stated in the
learning outcomes of this subject.
Lectures, health clinic clerkships, student led seminars and groups discussions and common
lectures
(a) Attitude 5%
(c) Audit presentation and write up 10%
(d) Log book 5%
Final Exam
b) Long case 20%
c) Short case 15%
d) Theory – MTF/SBA/SEQ/MEQ 35%
Total :100%

the nation.



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moral values.

areas of interest.
     
L T P
Elderly and disease
Importance of
fostering a good
doctor-patient
relationship
Assessment of the
elderly patient
Audit cycle and how 1) Define and describe the ‘Audit Cycle’
to conduct a clinical and the role of Clinical Audit as an
audit ongoing tool to improve the quality of

health care provision
Abuse in the elderly 1) Demonstrate thorough understanding

of the Care of the Elderly
2) Demographic and social changes in
the aging society and factors affecting
these changes in Malaysia.
3) Age-related changes in the elderly.
4) Delayed, atypical and non-specific
presentation of illnesses in the
elderly.
Comprehensive geriatric assessment.
5) Evaluate the impact of “giants of
geriatric medicine” on the elderly
and their carers
6) Diagnose and manage common
health problems in the frail elderly
7) Problems and danger of
polypharmacy
8) Outline the principles and
responsibilities for continuing care
for the elderly with irremediable
disabilities and of terminal care of
the dying patients.
Dementia versus 1) Demonstrate thorough understanding

depression of the Care of the Elderly
elderly.
and their carers
polypharmacy
the dying patients.
Behavioural changes 1) Demonstrate thorough understanding

in the elderly of the Care of the Elderly


elderly.
and their carers
polypharmacy
the dying patients.
Medication and the 1) Demonstrate thorough understanding

elderly of the Care of the Elderly
elderly.
and their carers
polypharmacy
the dying patients.
Fall in the elderly 1) Demonstrate thorough understanding

of the Care of the Elderly
elderly.
and their carers


polypharmacy
the dying patients.
Depression 1) Develop a sound knowledge of

disease and illness behavior in order
3) those with acute illness
4) those with ‘hidden agendas’
5) the worried well
6) those with chronic illness and
disabilities
7) the terminally ill
Drugs problems 1) Develop a sound knowledge of

among the elderly disease and illness behavior in order
5) the worried well
disabilities
Anemia in the elderly 1) Develop a sound knowledge of

5) the worried well
disabilities

Endocrine disorders 1) Develop a sound knowledge of

in the elderly disease and illness behavior in order
5) the worried well
disabilities
Spinal dysfunction 1) Develop a sound knowledge of

5) the worried well
disabilities
Urinary tract 1) Develop a sound knowledge of

infections disease and illness behavior in order
5) the worried well
disabilities
Malignancies and the 1) Develop a sound knowledge of
elderly patient disease and illness behavior in order


5) the worried well
disabilities
Infections in the 1) Develop a sound knowledge of

elderly disease and illness behavior in order
5) the worried well
disabilities
Neurological 1) Develop a sound knowledge of

dilemmas disease and illness behavior in order
5) the worried well
disabilities
Connective tissue 1) Develop a sound knowledge of

diseases and disease and illness behavior in order
vaculitides to make a deferential / working /
5) the worried well
disabilities


Clinic sessions 1) Develop effective communication

2) Demonstrate empathy gain trust and
confidence of the patients.
humane, optimistic and positive
attitude towards the elderly.
patients and somaticizing patients
prescriptions.
professionals.
11) Provide patient-centred whole person
and whole family care.
12) Accurately identify patients’ ideas,
concerns and expectations regarding
their illness.
13) Accurately identify and discuss the
family, support system, community,
cultural, ethnic, occupational and
economic factors influencing patient
management and outcomes.
14) Demonstrate increasing integration of
this above biopsychosocial
information into patient care in a
manner which will improve patient
outcomes.
15) Demonstrate correct method of
dealing with special circumstances
such as breaking bad news
16) Well developed and refined basic
clinical skills required to provide
effective and efficient management
for common health problems seen in
Primary Care
17) History and physical examination –
obtain a patient's history and physical
exam in a logical, organized and

thorough manner while adapting to

the urgency of the medical situation
and the time available.
18) Diagnostic decision making –
formulate a differential diagnosis
based on the key findings from the
history and physical examination.
19) Therapeutic decision making –
understand risks, benefits, and
compliance issues in choosing a
treatment.
20) Comprehensive care of Primary Care
patients
problem that are acute / serious and
hospice.
25) Educate and counsel patients and their
families so that they comprehend the
Diagnosis, Management plan,
Medication – its indication, side-
effects, drug interactions and
concordance
26) Risks, benefits and complications of
common procedures
27) Advice on preventive measures,
health promotion and lifestyle
modification
28) Observe and assist basic technical
procedures common in Primary Care
Delivery of nebuliser therapy
ECG
Subcutaneous and Intramuscular
injections
Suturing & Dressing
Venepuncture
Vaccinations
29) Consistently demonstrate compassion
and understanding toward patients
and their familiestowards patients’
needs regardless of their age, gender,
race, disabilities or problem
presented.
30) Treats patients and their families with
respect and dignity at all time

team work in providing care in the

best interest of the patients
32) Demonstrate consistent responsibility
for one’s own learning through
timeliness, preparation, initiative in
patient care, initiative in information
gathering and response to feedback
Texbooks
a) Murtagh J. General Practice. McGraw-Hill, 5th Edition, 2010
b) Swash M. Hutchinson’s Clinical Methods. Saunders, 22nd Edition, 2007
Reference
a) Rakel. Textbook of Family Medicine. Saunders, 8th Edition
b) Simon C et al. Oxford Handbook of General Practice. Oxford University Press, 3rd
Edition, 2010
c) Jones R et al. Oxford Textbook of Primary Medical Care(Vol. 1 & 2). Oxford
University Press, 2005
d) Goroll A.H. et. al. Primary Care Medicine: Office Evaluation and Management of
Adult Patient. Lippincott, William & Wilkins, 6th Edition 2009
INTERNET RESOURCES: WEBSITES

National Institute of Clinical Excellence (NICE), UK: www.nice.org.uk
Medscape Family Medicine: www.medscape.com
Ministry of Health Malaysia: www.moh.gov.my
Academy of Family Physicians of Malaysia: www.afpm.org.my
INTERNET RESOURCES: JOURNALS

Official Journal of Malaysian Family Physicians: http://www.e-mfp.org/
American Family Physician: www.aaf.org/afp
Australian Family Physician: www.afp.racgp.org.au/aspindex.shtml
INTERNET RESOURCES: DATABASE

PubMed: www.ncbi.nlm.nih.gov
Ovid: ovidsp.ovid.com
The Cochrane Collaboration: www.cochrane.org
SCOPUS: www.scopus.com

Course Information
1. Name of Course/Module: Psychological and Behavioural Medicine (Year-5)
1. Assoc. Prof Dr Azhar Salleh

2. Assc. Prof. Dr. Selvam Karupiah
Adjunct Lecturers-
1. Prof Dr Salina Abdul Aziz

2. Dr. Chee Kok Yoon
3. Dr. Norliza Chemi
4. Dr. Riana Abdul Rahim
Visiting Lecturer-
1. Dr Fadzil Man
The aim of this course is to help the student to revise and practice the essential skills and
concepts of Psychological and Behavioural components of medical care. The World Health
Report of 2001 of the World Health Organization, stressed the importance of treating mental
illnesses in primary care and referred to the recognition that more than 25% of the primary care
workload needed mental help.
The belief that medicine is all physical is widespread, and the place of psychiatry relegated to
mental asylums that to most doctors are outside the mainstream of medical care.
Teaching of Medicine has been mainly of physical medicine, and psychosocial factors in disease
is quietly labelled, psycho, supra-tentorial, psy or referred to a social worker or simply referred
with no history to the psychiatrist.
During the posting the student will again revise and integrate the required knowledge and
skills in psychological and behavioural medicine to recognize, diagnose and initially manage
patients with psychiatric manifestations of illness.


L= Lecture (2) 1 30 4 50 4 89 hr
S=Seminars(6)/Case
E=exam
8. Prerequisite:
9. Objectives:
Knowledge of
1. the psychiatric emergencies that require medical care.
2. community care of persons with longer term mental illnesses.
3. the management of substance abuse in the Malaysian setting.
Essential skills on
1. analysing the risk of self- harm, harm to others, or to property
2. analysing the need of emergency medical, psychological and social measures
required to attenuate risk
Attitude regarding
1. interaction with psychiatric patients (and their families) with regards to
respect, compassion and empathy
2. politeness and respect for other health care professionals, including
psychologists, social workers and doctors
3. punctuality, taking initiative, reliability and be responsible where appropriate
clinical experience
1. carry out a full mental state examination and cognitive screen.

2. recognise the risk of self- harm, harm to others, or to property in patients.
3. determine the emergency medical, psychological and social measures that
need to be instituted to prevent the risk mentioned above.
4. summarize the relevant aspects of history and physical examination of a
patient
5. interpret the information and come to a provisional & differential diagnosis
6. describe briefly a treatment plan with bio-psycho-social aspects of
management


A. Problem Solving Skills
1. The ability to recognize complexity of different problems.
2. The ability to prioritize problems and solve them sequentially.
3. The ability to recognize one’s limitations and request for assistance
when required.

1. establishing an understanding relationship with patients and peers
3. teamwork.
4. effective and concise patient history taking and doing a mental state
examination.
5. case reporting.
2. self-dependence.
3. Teamwork
4. Leadership
13. Synopsis:
By the end of the two week posting, the student should be skilled in developing a proper doctor-
patient interpersonal relationship, in eliciting an accurate and relevant history of the patient's
problems including the ability to incorporate information obtained from other sources, carrying
out a mental state examination and making a provisional diagnosis and differential diagnoses
with the information gathered.
They should also have developed an attitude of compassion and caring for patients consonant
with the highest ethical standards of medical practice.
1. Lectures
4. Group discussions.
5. Clinical attachment (psychiatry clinics, ward, methadone clinics)
6. Case write-ups.
7. Case summaries.
8. Psychiatric Simulation

Continuous assessment (30%)

(a) Attitudes 5%
(d) Case Presentation 10%
Summative (70%)
Theory 35%
(a) MCQ 10%,
(b) SBA 5%
(c) SAQs 20%
Clinical - Long Case 35%
Total 100%

the nation.


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moral values.

areas of interest.
     
L T P
Scientific basis of 1) give an overview on various
psychiatry etiological models relevant to
psychiatry
2) explain the methodological issues in
understanding etiology of mental
illness
3) discuss treatment issues related to
evidence based medicine in
psychiatry
Basic 1) give an overview of the terms used in

Psychopathology psychopathology and their diagnostic
significance in relation to various
mental disorders
2) describe the conduct of mental status
examination
Delirium and 1) elaborate on the clinical features,

Dementia investigations and assessment for
2) outline the principles of
pharmacological and non-
pharmacological management for
Substance Related 1) give an overview about the

Disorders epidemiology of alcohol and drug
dependence
2) discuss the etiology, pathophysiology
and natural course of drug
dependence
3) describe the psychiatric morbidity
associated with substance abuse
4) outline the screening procedures and

treatment goals for alcohol and drugs

of abuse.
Schizophrenia and 1) be aware of the aetiology of

related Disorders schizophrenia and other acute and
2) describe the clinical manifestations
and phenomenology of schizophrenia
3) state the differential diagnosis of
schizophrenia
4) outline the treatment of an acute
psychotic episode
5) describe the principles of long-term
management of schizophrenia and
chronic delusional disorders.
Mood Disorders 1) explain the epidemiology and

etiology of depression and mania
depression and mania
3) describe the differential diagnosis
and management of depression and
mania
4) outline the clinical presentation of
bipolar affective disorder and explain
its management
Anxiety Disorders 1) explain how to recognize disorders

of anxiety like phobia, panic,
obsession and compulsive,
generalized anxiety disorder
2) discuss the etiology, clinical features
and differential diagnosis of various
anxiety disorders
3) outline the treatment of
uncomplicated anxiety and
obsessional disorders
Personality 1) explain the concepts of personality

Disorders and personality disorders
2) describe the influence of personality
disorders on physical and mental
illnesses
personality disorders
4) describe the clinical features of
various personality disorders
5) outline the options available for
management of personality disorders
Psychiatrtic 1) give an overview of the main groups

Medications & ECT of psychotropic medications
(Antipsychotics, antidepressants,
mood stabilizers, anxiolytics)

2) explain the pharmacokinetics and

pharmacodynamics of each group
3) describe the indications and
contraindications for each of the main
groups of psychotropic drugs
4) describe the major side effects of each
of the main groups of psychotropic
drugs
5) state the interactions, toxic effects and
other adverse effects of each of the
main groups of psychotropic drugs
6) describe problems of compliance with
psychiatric medications and possible
interventions
7) discuss the indications for
electroconvulsive therapy (ECT)
8) describe the procedure and evaluation
of a patient undergoing ECT
9) describe post-ECT management
10) explain the adverse effects of ECT
and frequency of treatment
Suicide and 1) give an overview of the epidemiology

Deliberate Self harm of suicide and deliberate self-harm
2) describe the assessment and risk
factors for suicide
3) discuss the relation between suicide
and various mental illnesses
4) outline the management of potentially
suicidal patients and of those
recovering from self-harm.
Emergency 1) discuss the assessment and

Psychiatry interviewing techniques of aggressive
patients
2) outline the principles of management
of acutely violent patients in the
emergency department
3) give an overview of the psychiatric
emergency conditions (stupor, drug
overdose etc)
4) outline the initial management plan
5) identify the other common emergency
situations in psychiatry and know
their acute management
Community Mental 1) be aware of sources of treatment,

Health management and support for patients
with psychiatric disorder in non-
hospital settings, including
community- based care
2) understand the role of community
mental health services available in
Malaysia

3) be aware of the principles of relapse

prevention, social treatment and
rehabilitation
1. Kaplan H. I., Sadock B. J. (2005). Synopsis of Psychiatry, Behavioral Sciences/Clinical

Psychiatry (eds. Kaplan H. I., Sadock B. J.). 10th Edition. Williams & Wilkins, Baltimore.
2. Gelder M., Gath D., Mayou R., Cowen P. (2005). Oxford Textbook of Psychiatry. 5th Edition.
Oxford University Press.
3. Johnstone E.C., Freeman C. P. L., Zealley A. K. (2004). Companion To Psychiatric Studies.

7th edition. Churchill Livingstone, Edinburgh.

MBBS Curriculum Radiology/Phase-2
Radiology (Phase-2)
Course Information
1. Name of Course/Module: Radiology (Phase-2)
2. Course Code: RHP 6354
1) Departement of Surgery academic staff

2) Depatement of Orthopics academic staff
3) Depatement of Medicine academic staff
4) Department of Obstetrics and gynecology academic staff
In the radiology module, the students are introduced to the knowledge and skills of one of the
most routinely used diagnostic tool in the everyday clinical practice. They are prepared to
correctly interpret basic radiological investigations. They will have an understanding of the
applicability and limitations. Upon completion of this module, the students will have the
appropriate basic diagnostic and therapeutic knowledge and skills for radiological
interpretation, practice and application.

L= Lecture (2) 21 26 8 0 0 55 hr
S=Seminars(6)/Case
E=exam
8. Prerequisite:
9. Objectives:
Knowledge of
1. Anatomy of the major organ system
2. the normal and abnormal structure of the body and its radiological imaging.
3. The importance of evidence-based medicine in the choice of radiological imaging,
procedures and its appropriate interpretation.
4. The formulation of differential diagnoses form common radiologic findings.

5. The applications of radiology as a screening modality of diseases and for use in

guiding medical and surgical interventions.
Skills on
1. Developing effective communication with other health care professionals and ability
to work as a team in the best interest of the patient.
Attitude regarding
the highest standards of integrity, service, and professionalism.

1. select and justify the use of radiological imaging for different conditions and diseases.
2. interpret the results of the most frequently used radiological image.
3. develop diagnostic and treatment strategies with regard to radiological technologies
that are cost-effective, sensitive to limited resources, and do not compromise quality
of care.
4. work collaboratively as members of a healthcare team in a variety of settings
5. develop effective communication skills

(a) Identifying problems
(b) Breaking down complex problems into more manageable ones
(c) Recognizing the root cause of the problem
(b) Presenting technical information
(c) Listening attentively ability to understand the anxieties of the patient
of medical imaging.
Teaching will be in the form of lectures and tutorials supported by independent reading study
for examinations. Assessment is through summative and formative strategies.
The teaching learning activities during the posting will be carried out during clinical teaching
sessions various learning facilities such as HSB (Hospital Sungai Buloh) and Hospital Kuala
Lumpur wards. Assessment of the students throughout this module will be done continuously
and an end of posting written and clinical examination involving long cases, short cases and
OSCE is conducted.
lecturer.

13. Synopsis:
The radiology programme is taught during the phase 2 of the medical program. Radiological
procedures and their place in the practice of clinical medicine are introduced so that the
student is able to use this modality rationally.
Interpretation of these findings are taught at the same time such that there is integration of this
module with the other clinical studies.
1. Lecture
2. Seminar
3. Tutorial
4. Bed side teaching
5. Ward rounds
The assessment of the radiology module topics is carried out through the Continuous
Assessment and End of Posting Examination of each of the respective departments.

the nation.


PEO1 PEO2 PEO3 PEO4
  





moral values.

areas of interest.
     
L T P
Plain Radiograph 1) Discuss principles of radiology
2) Identify normal anatomy on PA, AP,
and lateral chest films
3) List risks associated with radiation
exposure
4) Recognize abnormal chest films
including pleural effusion,
pneumothorax, pneumonia, changes
of chronic obstructive pulmonary
disease, atelectasis, pulmonary
nodules and changes of congestive
heart failure,.
5) Identify normal anatomy on
radiological views of the abdomen
6) Recognize abnormal abdominal films
including ileus, small bowel
obstruction, large bowel obstruction,
free air, and calcifications
7) Identify normal anatomy of the spine
and long bones in both adults and
children
8) Recognize abnormal bone
radiographs including fractures,
degenerative joint disease,
osteoporosis (including vertebral
collapse), and primary versus
metastatic bone malignancy

9) Identify normal anatomy on

intravenous pyelogram, barium
enema, and upper gastrointestinal
series
Computed 1) Discuss principles of CT and its

Tomography with/ applications
without contrast 2) Discuss differences between CT,
MRI, plain film, and US.
3) Discuss general indications of when
to use CT as the imaging of choice
4) Identify normal anatomy of the organ
systems using CT scan images.
5) Recognize and understand the use of
CTs in the management of common
clinical conditions seen in the
hospital settings
Magnetic Resonance 1) Discuss the principles of magnetic

resonance imaging.
Imaging 2) Identify normal anatomy of the organ
systems on MRI.
MRI in the management of common
hospital settings
Ultrasound 1) Discuss general principles of the

ultrasound.
place of US as a primary imaging
modality in Obstretics and
Gynaecology
3) List indications and limitations of US
US in the management of common
hospital settings
Mammography 1) Discuss Understand the principles of

mammography and its use in the
screening of breast cancer
Angiography 1) List the main indications for

conducting angiograms
2) Recognize normal anatomy of the
great vessels
Texbooks
1. Introduction to the Symptoms & Signs of Surgical Disease; Norman L Browse: Hodder
Arnold, 4"' Ed,

2.Bailey & Love's Short Practice of Surgery; Revised by RCG Russell, Norman S William
Christopher JK Bulstrode, 24th Ed, Arnold Publishers, 2004
3.Chest X-ray made easy
Year-3 Surgery
Types of imaging
Ultrasound
Contrast studies
CT Scan
MRI
Other modalities of radiography
Year-4 Surgery
Hepatobiliary and GIT radiography
Basic reading of CT scans in neonates and infants
Urology’s radiography, ultrasound, intravenous urography and MRI
Neurosurgical CT scan with/without contrast and MRI
Cardiothoracic/ vascular doppler, arteriography, angiography and MRI
Year-5 Surgery
Interpretation of plain abdominal radiographs
Investigations of the gastrointestinal tract
Investigations of the biliary system
Breast imaging
Gastrografin study and barium enema contrast studies
CT scan
Year-3 Medicine
Imaging of cardiovascular system
Imaging of respiratory system
Imaging of gastrointestinal system
Imaging of musculoskeletal system
Imaging of nervous system
Imaging of endocrine system
Year-5 Medicine
X-RAY-Heart, Lung, Bone, Metabolic disease
CT SCAN- Chest, Abdomen, Brain and spine
Ultrasonogram-Abdomen ,Chest, thyroid and joint disease
MRI- Brain and spine
Year-4 Orthopaedics
X-Ray Census
Year-3 Obstetrics and Gynaecology

Imaging in obstetrics and gynaecology
Year-4
Ultrasonography

MBBS Curriculum Dermatology/Phase-2
Dermatology (Phase-2)
Course Information
1. Name of Course/Module: Dermatology (Year-4)
2. Course Code:
1. Dr. SHARMILA VEDHAVATHY SORNAM
Adjunct Lecturers:
1. DATIN. Dr .ASMAH JOHAR
2. Dr. SUGANTHI THEVARAJAH
3. Dr. NOOR ZALMY AZIZAN
4. Dr. AZURA MOHD AFFANDI
5. Dr. PRIYA GILL
6. DR. AZAZUDDIN
It has been long recognized that there is a deficit in teaching of dermatology in undergraduate
medical education. It is found that they do not have sufficient knowledge and skills to diagnose
and treat the common dermatological complaints which routinely present on a daily basis in
clinical practice.
This curriculum is developed to embody the minimum knowledge and competencies that all
medical graduates should have on the subject of dermatology.
5. Semester and Year offered: Year-3 & Year-5

L= Lecture (2) 12 22 36 2 2 74 hr
S=Seminars(6)/Case
E=exam
7. Credit value: 174/80 = 2.175
8. Prerequisite:

9. Objectives:
1. Acquire sufficient knowledge and understanding of human skin structure and function
and to extend this understanding to the management of health and common skin
diseases.
2. Acquire appropriate skills and attitudes to provide responsible clinical care within
their professional limitations.
3. Apply understanding of population health issues to the health needs of individuals,
families and communities
4. Apply ethical standards of behavior and knowledge of legal responsibilities to
professional practice.
5. Demonstrate the capacity for continuing self directed learning.
6. Essential competencies must be mastered for safe practice
1. obtain a comprehensive history from the patient.

2. perform a rational thorough physical examination.
3. order basic laboratory and skin diagnostic tests (as appropriate) and to know
how to interpret the results of these studies.
4. use information from history, physical examination and initial laboratory tests
to generate a differential diagnosis for each active problem.
5. use information from history, physical examination and initial laboratory data
along with differential diagnosis to generate a patient oriented assessment that
includes a diagnostic and therapeutic plan for each of the patient active
problems.
6. record in writing and present orally the results of complete history and physical
examination (including assessment & plan) in a systemic and coherent manner
7. use medical literature to understand the patho-physiology of common skin
diseases and plan the management
8. integrate clinical reasoning skills with an ever increasing knowledge base.
9. continue to develop and use the skills of self directed learning.

importance.

3. teamwork.


5. case reporting.
2. self-dependence
3. teamwork
4. leadership
There will be a variety of teaching methods including problem based learning, lectures, tutorials,
seminars, clinical skills and direct patient encounters in clinical practice.
Proficiency in clinical dermatology relies extensively on acquisition of visual literacy and so it

need to be ensured that appropriate resources and time are available to support visual literacy
teaching and student evaluation thereof.
13. Synopsis:
The curriculum has been organized around 30 core competencies. The core competencies reflect
common dermatologic conditions encountered either directly or incidentally by most
physicians, regardless of practice focus and also represent the clinical needs of the Malaysians
who deserve timely and proper care of their skin problems.
Dermatology teaching for undergraduate M.B.B.S students is usually for a period of 2 weeks
(80 hours of teaching) during a full M.B.B.S course. This 80 hours of teaching sessions shall be
done separately as 2 weeks rotation postings or can be integrated along with internal medicine
postings.
In addition to studying the fundamentals of skin biology and dermatology, all students should
have a direct clinical contact with dermatological patients.
In MAHSA University, Dermatology posting for M.B.B.S students is integrated vertically along
with Medicine clerkship in year 3 (in Sungai Buloh Hospital) and year 5 M.B.B.S (in Hospital
Kuala Lumpur). Students will attend dermatology clinics in Sungai Buloh hospital in year 3
M.B.B.S and dermatology clinics in Hospital Kuala Lumpur in year 5 M.B.B.S.
In Year 3 MBBS internal medicine postings, students will attend dermatology clinics once a
week for 7 weeks. In Year 5 MBBS internal medicine postings, the students are divided into 3
subgroups. The Dermatology posting will be for a period of 2 weeks (morning session only) for
each subgroup of students. In the afternoon session, students will attend the classes in internal
medicine posting along with other subgroups. Dermatology classes will commence at 7.00 a.m
every day and will continue till 1.00 p.m.
Students should learn to direct their own learning. They must have access to suitable learning
resources including course material, dermatology texts, color atlas of skin diseases and
computer technology.

Lectures, dermatology clinics, tutorials, seminars, daycare procedure, case-based discussions,

ward work, bed-side teaching, slef-directed learning
Continuous Assessment:
Attendance (both clinical theory sessions) and punctuality
Seminars
Knowledge – tutorials ( MCQ, OSPE )
Clinical skills in dermatologic clinics
Log book evaluation
Attitude
Final Assessment:
Class test
End posting exam
For Year 3 MBBS, CLASS TESTS & END POSTING EXAM is conducted integrated along
with internal medicine postings. For Year 5 MBBS, CLASS TESTS comprising of theory
(MCQ), clinical skills (OSCE ), and short case assessment will be conducted during the end of
dermatology posting for each subgroup.
THE END-OF-POSTING EXAMINATION / assessment (comprises of MCQ, OSCE, SEQ)

will be conducted integrated along with internal medicine examination during the last week of
the medicine posting. Dermatology contributes to 10% of total marks in assessment with
medicine posting.

the nation.


PEO1 PEO2 PEO3 PEO4
  





moral values.

areas of interest.
     
L T P
Approach to a 1) Understand the basics of skin
patient with skin anatomy – different layers of skin
disease – 1 and its structure
2) Understand the concept of
keratinization process
3) Be familiar with skin appendages –
pilosebaceous unit and sweat gland
4) Know the important functions of skin
5) Understand the importance of skin
exam – to elicit a complete history,
physically examine a patient in a
systematic approach.
6) Be able to counsel a patient on how
to perform a self skin exam
Morphology of skin 1) Know the different terminologies /

morphologies used to describe the
lesions skin lesions

2) Know to classify the morphologies

as primary, secondary and special
skin lesions
3) Identify and define the primary skin
lesions eg: macule, papule, nodule,
vesicle, bulla, pustule...
4) Identify and define the secondary
skin lesions eg: scale, crust,
lichenification...
5) Identify and define the special skin
lesions eg: comedone, burrow,
telengiectasia
6) Know a few examples of different
morphologies of skin lesions
Bacterial infections 1) discuss the etiology and clinical

presentations of staphylococcal and
of skin streptococcal infections of skin.
2) discuss the etiology and clinical
presentation of other bacterial skin
infections
presentation of toxin-mediated
illness
Fungal infections of 1) discuss the etiology and clinical

presentation of superficial fungal
skin skin infections:
Dermatophytosis
Candidiasis
Tinea versicolar
Viral infections of 1) discuss the clinical presentation of

human papilloma virus infections
skin 2) discuss the clinical presentation of
pox virus infections
human herpes virus infections
presentation of other viral infections
Eczema 1) define and classify eczema /

dermatitis
2) discuss the etiopathogenesis and
clinical feature of different types
of eczema / dermatitis
Acne / Psoriasis 1) discuss the etiopathogenesis,

different types and clinical feature
of acne and acneiform eruptions.
2) Be able to discuss the
etiopathogenesis, different types

and clinical presentation of

psoriasis
Skin manifestations 1) discuss the various skin

of systemic diseases – manifestations of systemic disorders
1  Endocrine disorders
(Year-3) 1. Diabetes mellitus
2. Cushings syndrome
3. Hypothyroidism /
hyperthyroidism
4. Addisons disease
 HIV / AIDS disease
 Hyperlipidemias
 Infective endocarditis
 Meningococcemia
 Henoch-Schonlein purpura
Collagen vascular 1) discuss the clinical presentation,

investigation and management of
diseases (Year-5) lupus erythematosus.
2) discuss the clinical presentation,
scleroderma.
dermatomyositis.
rheumatoid arthritis
Cutaneous 1) discuss the various skin

manifestations of systemic disorders:
manifestations of 1. Metabolic and nutritional
systemic diseases - 2 disorders
 Hyperlipidemias -
review
 Scurvy
 Zinc deficiency
 Pellagra
2. HIV and AIDS – review
3. Endocrine disorders - review
4. Inflammatory bowel disease
5. Puetz – Jegher syndrome
6. Liver & renal disorders
7. Genodermatoses
:Neurofibromatosis and
Tuberous sclerosis
8. Infective endocarditis – review
9. Meningococcemia – review
Bullous disorders of 1) discuss the etiopathogenesis, clinical

presentation, investigation and
skin management of pemphigus.

2) discuss the etiopathogenesis, clinical

management of bullous pemphigoid
management of dermatitis
herpetiformis
Skin manifestations 1) discuss the etiology, clinical skin

of sexually manifestations and management of
transmitted bacterial STI.
infections (STI) 2) Be able to discuss the etiology,
(Year-5) clinical skin manifestations and
management of viral STI
3) Be able to discuss the syndromic
management of STI
Common infections 1) discuss knowledgeably about

& infestations of skin 1. Management of bacterial
infections of skin
(Tutorial) 2. Management of Fungal
infections of skin
3. Management of Viral infections
of skin
4. Management of common skin
infestations
Common Disorders 1) discuss knowledgeably about

of skin 1. The management of different
types of eczema / dermatitis
2. Management of psoriasis
3. Management of acne and
acnieform eruptions
Pigmentary 1) discuss the clinical presentation and

management of the following:
disorders of skin and 1. hypopigmentary disorders of
hair disorders skin
2. hyperpigmentary disorders of
skin
3. hair loss (alopecia)
4. excess hair growth
Adverse cutaneous 1) understand the different clinical

types of adverse cutaneous drug
drug reactions reactions
2) discuss the etiology, clinical
presentation and management of
different types of adverse cutaneous
drug reactions.
presentation and management of
urticaria and angioedema

Benign skin lesions 1) Know the etiology, clinical feature

(Seminar-1) and management of benign skin
lesions
 Cysts- sebaceous cyst, milia
 Vascular lesions – spider
angioma, cherry angioma,
pyogenic granuloma
 Dermal leisons – lipoma,
dermatofibroma, keloids,
skin tag
 Other lesions – syringoma,
seborrheic keratosis,
epidermal nevus
Malignant tumors 1) Know the etiology, clinical

of skin features and management of
malignant tumors of skin:
 Premalignant – actinic
keratosis
 Squamous cell carcinoma
 Basal cell carcinoma
 Malignant melanoma
 Cutaneous T cell
lymphoma

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MAHSA UNIVERSITY

CURRICULUM FOR MBBS PROGRAM

Phase I: Preclinical Phase ........................................................................................................................ 13

Biomedical Science Block – BMS .......................................................................................................... 18

Cardiovascualr System Block – CVS.................................................................................................... 63

Gastrointestinal System & Nutrition Block – GIN .................................................................... 111

Nervous System Block – NVS ............................................................................................................... 166

Early Clinical Skills Module – ECE..................................................................................................... 217

Medicine (Year-3) ...................................................................................................................................... 253

Medicine (Year-5) ...................................................................................................................................... 402

Advisor: Prof. Dr. Abdul Rahim Md Noor (Dean)

Chairman: Assoc. Prof. Dr. Ganesh Ramachandran (Deputy Dean – Academic)

Deputy. Chairman: Prof. Dr. Sarmishtha.Ghosh (Head of the Curriculum Committee)

Members: Assoc. Prof. Dr. Chitra Govindaraja (Head of Assessment Committee)

The MBBS programme is a 5-year course and is conducted in two phases:

b) Phase II (3 years) – Practice-based clinical medicine

MAHSA University 1st revision, 2014 Page 1

Vision and Mission of the Faculty of Medicine

To be internationally recognized as one of the premier institutions for medical education

1. To produce competent and caring doctors with a high degree of professionalism

3. To enhance a conducive learning environment for students with cultural diversities

MAHSA University 1st revision, 2014 Page 2

GENERAL OBJECTIVES of the Medical Degree Programme (PEO)

Programme Learning Outcomes (PLO)

The graduates of the medical school should:

PLO1 Be competent to make a diagnosis and institute management on common

PLO2 Be able to practice preventive, promotive and rehabilitative medicine at

PLO3 Be responsible for maintaining the highest standards of medical practice

PLO4 Possess appropriate attitudes, demonstrate empathy and have ability to

PLO7 Be able to embark on research and innovative aspect of medicine in

MAHSA University 1st revision, 2014 Page 3

6 Problem solving and

7 Info management &

MAHSA University 1st revision, 2014 Page 4

6 Professional ethics and

3 Info management &

PLO3: Be responsible for maintaining

PLO5: Be able to conduct the practice of

PLO6: Be able to work in a team and

PLO7: Be able to embark on research

MAHSA University 1st revision, 2014 Page 5

Structure of the MBBS Programme

I. PRECLINICAL PHASE (PHASE-I)

BMS Basic Medical GIN Gastrointestinal system & PBL Problem-based

CVS Cardiovascular NVS Nervous System RMB Research

MAHSA University 1st revision, 2014 Page 6

ASSESSMENT FOR PHASE 1

This revised assessment methods will be implemented beginning of 2014-2015 session.

Sr. Assessment Exam Type of questions

2 Final Assessment (60%) First Professional 1. MCQ (MTF) 25%

Sr. Assessment Exam Type of questions

2 Final Assessment (60%) First Professional 1. MCQ (MTF) 25%

MAHSA University 1st revision, 2014 Page 7

First Professional Examination Part-1 and Part-2

MARKS GRADE GRADE POINT STATUS

80 – 100 A 4.00 Excellent*

MAHSA University 1st revision, 2014 Page 8

II. CLINICAL PHASE (PHASE-II)

Year 3 : Community Medicine & Clinical Specialty

Year 4 : Community Medicine & Clinical Specialty

Emergency Ophthal- Psychiatry

Medicine Surgery Ortho- Primary (4 weeks)

Year 5 : Community Medicine & Clinical Specialty