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 SMLE CONTENT OUTLINE
This outline provides a common organization of SMLE content. SMLE central committee continually
reviews the outline to ensure content is relevant to the practice of medicine. As practice guidelines
evolve or are introduced, the content on SMLE is reviewed and modified as needed.

The examination will emphasize certain parts of the outline, and no single examination will include
questions on all aspects. Questions may include content that is not included in this outline.

MEDICINE
CARDIOLOGY:
 Coronary Artery Disease
 Heart Failure
 Atrial Fibrillation
 Cardiovascular risk reduction
 Valvular heart diseases
 Pericarditis / myocarditis

PULMONARY:
 Bronchial Asthma
 COPD
 Lung mass
 Pleural effusion
 Pulmonary embolism

GASTROENTEROLOGY:
 Peptic ulcer disease
 GERD
 IBD
 Celiac disease
 Pancreatitis

April 2018 1
 HEPATOLOGY:
 Acute viral hepatitis
 Acute non-viral hepatitis
 Chronic viral hepatitis
 Complications of Liver cirrhosis
 Hepatocellular carcinoma
 Ascending cholangitis

NEPHROLOGY:
 Acute kidney injury
 Chronic Kidney disease
 Diagnosis of nephrotic syndrome
 Hyper and hypokalemia
 Hypo and hyper natremia
 Primary HTN
 Secondary HTN

ENDOCRINE:
 Hypothyroidism
 Hyperthyroidism
 Diabetes (diagnosis)
 Acute diabetic complications
 Chronic diabetic complications
 Prolactinoma
 Adrenal insufficiency
 Osteoporosis

RHEUMATOLOGY:
 Rheumatoid arthritis
 SLE
 Osteoarthritis
 Gout
 Reactive arthritis

April 2018 2
 HEMATOLOGY:
 Iron deficiency anemia
 Megaloblastic anemia
 Hemolysis
 Thrombotic disorders
 Sickle cell disease
 Anticoagulant Rx management
 Thrombocytopenia
 Acute leukemia (recognition)

INFECTIOUS DISEASES:
 Pneumonia
 Urinary tract infections
 Tuberculosis
 Brucellosis
 Meningitis
 Soft tissue / bone / joint infections
 Infective endocarditis
 Line related blood stream infections
 H1N1
 MERS-CoV
 Chickenpox and shingles
 Sexually transmitted infections (including HIV)
 Malaria and dengue fever

NEUROLOGY:
 Ischemic stroke
 Hemorrhagic stroke
 TIA
 Seizure disorders
 Multiple sclerosis
 Spinal cord compression
 Migraine

ONCOLOGY:
 Lung cancer
 Prostate cancer
 Tumor lysis syndrome
 Superior vena cava obstruction
 Febrile neutropenia

April 2018 3
 CRITICAL CARE:
 Respiratory failure
 Sepsis and septic shock
 Hemorrhagic shock
 Cardiac tamponade
 Massive PE
 Cardiogenic Shock

GERIATRICS:
 Acute confusional state
 Dementia
 Falls

PSYCHIATRY:
 Depression
 Side effects of medications
 Substance abuse
 Bipolar disorder
 Scizophrenia

April 2018 4
 PAEDIATRICS
GENERAL PAEDIATRIC:
 Gastroenteritis
 Nephrotic syndrome
 Febrile seizure
 Bronchial asthma
 Iron deficiency anemia
 Bronchiolitis
 Pneumonia
 Otitis media
 Cellulitis
 Upper respiratory tract infections
 Urinary tract infections
 Celiac disease
 Down syndrome
 Acute renal failure
 Henoch schonlein purpura
 Constipation
 Fluids and electrolytes disturbance
 Rickets
 Hypertension
 Infantile colic
 Celiac disease
 Cerebral palsy
 Undescended testis
 Well baby

AMBULATORY:
 Immunization
 Development and behavior
 Growth and growth disorders
 Nutrition and nutritional disorders
 Sequent
 Failure to thrive
 Enuresis

CENTRAL NERVOUS SYSTEM:

 Guillain barre syndrome
 Headaches
 Epilepsy
 Hypotonia
 Ataxia
 Myasthenia gravis

April 2018 5
 CARDIOVASCULAR SYSTEM :
 Congenital heart disease
 Heart failure
 Syncope
 Rheumatic heart disease

RESPIRATORY SYSTEM:
 Sinusitis
 Adenotonsillitis
 Pleural effusion
 Laryngomalacia
 Tracheomalacia
 Cystic fibrosis
 Croup
 Tracheitis

GASTROINTESTINAL SYSTEM:
 Cleft palate
 Gastroesophageal reflux
 Pyloric stenosis
 Congenital Gastrointestinal anomalies
 Foreign body ingestion
 Peptic ulcer disease
 Inflammatory bowel disease
 Appendicitis
 Intussusception
 Chronic liver disease
 Jaundice

MUSCULOSKELETAL SYSTEM:
 Systemic lupus disease
 Kawasaki Disease
 Post infectious arthritis
 Rheumatoid arthritis

INFECTIOUS DISEASES:
 Brucella
 Tuberculosis

April 2018 6
  Osteomyelitis
 Myositis
 Cellulitis
 Scarlet fever
 Pharyngitis
 Meningitis
 Encephalitis
 Malaria, enteric fever, leishmania
 Dengue fever
 CMV, EBV, HSV, HIV, hepatitis
 Measles, mumps and rubella
 Pertussis
 Parasites (Ascaris, pinworms, giardiasis, amoeba)
 Septic arthritis
 Osteomyelitis

NEPHROLOGY:
 Post streptococcal glomerulonephritis
 Chronic kidney Disease
 Congenital anomalies of kidney and genitourinary tract (CAKUT), (polycystic kidney
disease, Vesicourethral reflux, neurogenic bladder)
 Hemolytic uremic syndrome
 Renal tubular acidosis

ACUTE CARE:
 Acute respiratory distress syndrome
 Status asthmaticus
 Status epilepticus
 Shock
 Arrhythmias
 Drug ingestions (e.g. iron, acetaminophen)
 Trauma
 Testicular torsion
 Peritonitis
 Foreign body inhalation

HEMATOLOGY/ONCOLOGY:
 Hemolytic anemias
 Immune thrombocytopenic purpura
 Hemoglobinopathies
 Leukemia
 Lymphoma
 Retinoblastoma

April 2018 7
  Willm’s tumor
 Neuroblastoma
 Nephroblastoma
 Bleeding disorders

NEONATOLOGY:
 Respiratory distress syndrome
 Transient tachypnea of newborn
 Intrauterine growth retardation
 Meconium aspiration
 Hemorrhagic diseases of newborn

ENDOCRINOLOGY:
 Diabetes mellitus
 Thyroid disorders
 Diabetes insipidus
 Panhypopituitarism
 Short stature
 Precious puberty
 Ambiguous genitalia
 Adrenal disorders
 Obesity

GENETIC/METABOLIC:
 Newborn screening
 Hypoglycemia
 Galactosemia
 Phenylketonuria
 Maple syrup disease
 Turner syndrome
 Marfan syndrome

ALLERGY/IMMUNOLOGY:
 Atopic dermatitis
 Allergic rhinitis
 Primary immunodeficiencies

April 2018 8
 OBSTETRICS AND GYNAECOLOGY
 History & Examination
 Ectopic Pregnancy
 Spontaneous Abortion
 Preeclampsia-Eclampsia
 Third Trimester Bleeding
 Preterm Labor
 Preterm Rupture of Membranes
 Postpartum Hemorrhage
 Pap Smear & DNA Probe & Culture
 Sexually Transmitted Infections and Urinary Tract Infections
 Personal Interaction and Communication Skills
 Normal and Abnormal Uterine Bleeding
 Dysmenorrhea
 Uterine Leiomyomas
 Sexual Assault
 Domestic Violence
 Diagnosis and Management Plan
 Maternal-Fetal Physiology
 Preconception Care
 Antepartum Care
 Intrapartum Care
 Immediate Care of the Newborn
 Postpartum Care
 Lactation
 Medical and Surgical Complications of Pregnancy
 Alloimmunization
 Multifetal Gestation
 Fetal Death
 Abnormal Labor
 Intrapartum Fetal Surveillance
 Postpartum Infection
 Anxiety and Depression
 Post-term Pregnancy
 Fetal Growth Abnormalities
 Obstetrics Procedures
 Family Planning
 Induced Abortion
 Vulvar and Vaginal Disease
 Endometriosis
 Chronic Pelvic Pain
 Gynecological Procedures
 Puberty
 Amenorrhea
 Hirsutism and Virilization
 Menopause
 Infertility
 Premenstrual Syndrome and Premenstrual Dysphoric Disorder

April 2018 9
  Legal and Ethics Issues in Obstetrics and Gynecology
 Gestational Trophoblastic Neoplasia
 Cervical Disease and Neoplasia
 Endometrial Hyperlasia and Carcinoma
 Ovarian Neoplasms
 Preventive Care and Health Maintenance
 Pelvic Organ Prolapse and Urinary Incontinence
 Vulvar Neoplasms
 Sexuality and Modes of Sexual Expression

April 2018 10
 SURGERY
BASIC PRINCIPLES:
Surgical infection and antibiotics:
 Systemic inflammatory response
 Surgical infection prevention
 Principles of antibiotics use in surgical patients
 Surgical Site Infections
 Intra-Abdominal Infections
 Infections of the Skin and Soft Tissue

Preoperative assessment:
 Preoperative evaluation
 Risk assessment

Anaesthesia and Pain management:

 Local and regional anaesthesia
 Patient's monitoring
 Pain management

Wound care:
 Phases of wound healing
 Factors affecting wound healing
 Abnormal wound healing
 Wound dressing

Post-operative complications:
 Post-operative care
 Postoperative fever
 DVT
 Complications of common procedures

GENERAL SURGERY:
Breast:
 Mastalgia
 Nipple discharge
 Breast mass approach
 Breast mass in pregnancy
 Benign breast disorders: proliferative and non-proliferative disease, breast abscess,
mastitis
 Breast cancer screening
 Breast cancer

April 2018 11
 Thyroid and parathyroid:
 Neck mass evaluation
 Thyroid nodule approach
 Surgery for hyperthyroidism
 Thyroid cancer
 Complications of thyroidectomy
 Primary hyperparathyroidism
 2ndry hyperparathyroidism
 Tertiary hyperparathyroidism

Adrenal:
 Surgical hypertension
 Incidental adrenal mass

GIT:
 GERD
 Corrosive esophageal injury
 Swallowing foreign body
 Esophageal cancer
 Upper GI bleeding
 Peptic Ulcer Disease
 Surgical management of Obesity
 Lower GI bleeding
 Appendicitis
 Bowel obstruction
 Inflammatory Bowel Disease
 Colon cancer screening
 Colonic polyp
 Colon cancer
 Diverticular disease
 PR bleeding
 Anorectal conditions
 Pilonidal sinus

Hepatobiliary:
 Biliary colic
 Acute cholecystitis
 Obstructive jaundice
 Cholangitis
 Hydatid liver disease
 Liver abscess
 Acute Pancreatitis
 Chronic pancreatitis
 Pancreatic cancer

April 2018 12
 Hernias:
 Inguinal hernia
 Incisional, Umbilical and epigastric hernias
 Obstructed hernia
 Rectus sheet hematoma

Skin and subcutaneous lesions:

 Cellulitis
 Necrotizing fasciitis
 Lipoma
 Tetanus prophylaxis
 Soft tissue sarcoma

Vascular Surgery:

 Diabetic foot
 Peripheral arterial disease PAD
-Acute limb ischemia
-Chronic limb ischemia
-Critical limb ischemia
 Venous Disorders
-Varicose veins
-Venous thromboembolism
 Others
-Compartment syndrome
-Gangrene
-Dialysis vascular access
-Abdominal aortic aneurysms

Paediatric surgery:

 Branchial cysts
 Thyroglossal cyst
 Pyloric stenosis
 Diaphragmatic hernia
 Tracheoesophageal fistula
 Umbilical hernia
 Undefended testicle
 Hirschsprung disease
 Wilms tumor
 Neuroblastoma
 Circumcision

April 2018 13
 Plastic surgery:
 Hand infections
 Fingers injuries and amputations
 Carpal tunnel syndrome
 Upper limb nerve injuries evaluation
 Cutaneous melanoma
 Squamous cell carcinoma
 Burn
 Bed sore

TRAUMA AND ACUTE CARE SURGERY:

Trauma:
 Initial assessment of trauma patient
 Airway management
 Life threatening injuries (Airway obstruction, tension pneumothorax, cardiac tamponade
 Chest trauma
 Shock
 Abdominal trauma
 Pelvic fracture
 Head trauma
 Spinal injuries
 Musculoskeletal trauma
 Trauma in extreme age
 Triaging

Gastrointestinal Bleeding:
 Upper GI bleeding, causes and surgical management
 Lower GI bleeding causes and surgical management
Specific organ trauma:
 liver
 spleen
 kidney and retroperitoneum
 Esophageal, gastric and bowel trauma
 Damage control surgery

Surgical ICU:
 Abdominal compartment syndrome
 Lung protective ventilation
 Early and adequate nutrition
 Restrictive blood transfusion
 DVT and stress gastritis prophylaxis
 Source control in septic patients

Acute surgical condition:

 Acute abdomen
 Peritonitis
 Mesenteric bowel ischemia
 Perforated viscous

April 2018 14
 SUBSPECIALTIES:
Urology:
 Emergencies: Acute Urinary Retention, Testicular Torsion , hematuria, Fournier’s
Gangrene, Priapism
 Infections: Cystitis ,Pyelonephritis , Prostatitis, Epididymo-orchitis
 Lower Urinary Tract Obstruction: Benign Prostatic Hyperplasia, Urethral Stricture
 Upper Urinary Tract Obstruction: Urolithiasis, Retroperitoneal Fibrosis
 Pediatric Urology: Ureteropelvic Junction, Vesicoureteral Reflux, Ureteroceles, Posterior
Urethral Valve

Neurosurgery:
 Raised intracranial pressure
 Cerebrovascular diseases
 Spinal cord compression
 Entrapment neuropathy
 Cranial & spinal infection
 Hydrocephalus
 Degenerative disc disease
 Congenital anomalies
 Brain tumors

Orthopedic:
 Trauma: Open fracture treatment, Compartment syndrome
 Principles of fracture/ dislocation management
 Oncology: Osteosarcoma, Ewing's sarcoma, Chondrosarcoma
 Birth injuries
 Developmental diseases

ENT:
 Epistaxis
 Otitis externa
 Otitis media
 Sinusitis
 Tonsillitis
 Acoustic neuroma
 Foreign body
 Disorders of balance
 Hearing loss

April 2018 15
 Ophthalmology:
 Infectious and inflammatory disorders: blepharitis; conjunctivitis , uveitis
endophthalmitis; iridocyclitis; periorbital cellulitis; uveitis
 Neoplasms: melanoma; retinoblastoma
 Cataract
 Glaucoma
 Lacrimal system disorders
 Refractive disorders
 Disorders of the retina: diabetic retinopathy; papilledema; retinal detachment; retinitis
pigmentosa; retinal hemorrhage, amaurosis fugax,
 Visual impairment/blindness, night blindness, Sudden loss of vision
 Traumatic and mechanical disorders: corneal abrasion, ulcer; dislocated lens; foreign
body in eye, laceration of the eyelid; subconjunctival hemorrhage

April 2018 16
 PATIENT SAFETY, PREVENTIVE MEDICINE, & ETHICS
ETHICS:
 Informed Consent
 DNR/DNI
 Organ Donation
 Abortion
 Breaking Bad News
 DAMA
 Authorship and Plagiarism
 Patient Privacy
 Proper HIM
 Abuse (spouse, child and elderly)
 Conflict of Interest
 Social Media Practices/Technology
 Confidentiality
 Sick Leave
 Second opinions
 Medico-legal Issues/Whistleblowing
 Death Certificate
 Identity Theft
 Fertility Ethics
 Plastic Surgery/Bariatric/Obesity
 Communications with peers' patients
 Bullying and Abuse
 Impaired Physicians

PATIENT SAFETY:
 Clinical Privileges
 Patient /Community Education
 Medications Safety
 Infectious Prevention and Control
 Surgical Safety
 Emergency Preparedness
 Continues Professional development
 Inter-professional communication
 International patient safety goals
 Blood Transfusion safety
 Radiation Safety
 Patient Empowerment
 Communication with patient and family
 Institute of Medicine Quality dimensions
 Diagnostic Errors
 Venous thromboembolism prophylaxis

April 2018 17
 PREVENTIVE:
 Nutrition / Obesity
 Exercise
 Travel medicine
 Risk factors (NCDs) Assessment and modifications
 Smoking
 Environmental
-Temp (hyperthermia, heat stroke)
-Metals (lead)
 Venomous bites and stings
 Reportable diseases
 Outbreaks
 Herd immunity
 Immunization (Child, Adult)
 Disease screening (Cancer, CVD, DM, HTN, AAA)
 Mental Health
 Principles of screening (validity, test parameters, criteria for screening test)
 Sleep Medicine
 Preventive Cardiology
 Adolescent health
 Geriatric medicine
 Women Health

April 2018 18
 Report of the Incidence and Prevalence of Diseases and other Health
Related Issues in Saudi Arabia
A study for the SMLE Blueprint Project

Heba AlManea
Assessment Executive Specialist, SCFHS

Dr Abdulmohsen Al-Zalabani
Associate Professor, Epidemiology & Community Medicine, Taibah University

Dr Fadi Munshi
Executive Director of Assessment, SCFHS

1
November 2017
Overview and Purpose of the Review

Presently, the Saudi Medical Licensure Examination (SMLE) must be passed as part of the
process leading to practice in Saudi Arabia. The intent of the SMLE is to assess the medical
knowledge and clinical decision-making ability of a candidate at an entry-level general
practitioner whom are expected to provide safe and effective patient care for the Saudi Nation.

The primary purpose of this report is to review and summarize the frequency of most
responsible diagnoses as seen in the Saudi context by using existing data. This includes data
from Ministry of Health (MOH) statistical book. The data includes common cases, and
operations witnessed in MOH hospitals during 2015-2016. Another source is a Global Burden of
Disease study that includes lists of the top conditions/diseases with the greatest burden on the
population health in Saudi Arabia reported by the Institute of Health Metrics and Evaluation.
The inclusion of these prevalent conditions in medical licensure examinations would help
ensure that doctors are adequately prepared to treat today’s Saudi population’s major health
concerns.

As a secondary purpose, this report includes a review of certain areas of importance for the
practice of medicine which may not be well represented by patient presentations/diagnoses,
such as population health (in Hajj seasons), Patient Safety issues and Medical Malpractice
issues.

2
November 2017
A Snapshot of Health Care in Saudi Arabia

In 2016, the population of Saudi Arabia was over 31 million individuals, all of whom require
health care services in some capacity. In 2016, children and youth under 15 years of age
represent (30.35%) of the Saudi population; adults 15 to 64 years of age represent 65.46%;
whereas seniors over the age of 65 comprise 4.17% of the population. In 2016, Ministry of
Health Statistical yearbook reported the total number of visits to the primary health care
centers, private, general and polyclinics in 2016 was nearly 138 Million visits; 3451377 cases
represented the total number of inpatients in the hospitals of all health sectors: 49.4% of them
were in MOH hospitals. The statistical yearbook also reported 49,817,811 visits to Health
centers and 64,346,910 visits to Outpatients of MOH hospitals.

In 2016, the MOH published its annual statistical book detailing health activities and services
provided across Saudi Arabia. The report outlines cases related to complications of pregnancy,
children, and gynecology, MOH hospitals, injury cases by type of injury, gynecology operations
in MOH hospitals by type of operations, deliveries in MOH hospitals by type of delivery,
operations in MOH hospitals by hospital sections and cases of malignant tumors registered in
KFSHRC Riyadh & Jeddah. The report, also, includes lists of most common causes of premature
mortality and conditions with the highest burden. Findings from this report will contribute to
our knowledge of incidence and prevalence of disease in Saudi Arabia.

Studying statistics of such cases and conditions will contribute to the drafting of a framework
that outlines what should be included and assessed by establishing the grounds of our
knowledge of incidence and prevalence of disease in Saudi Arabia. SMLE will focus on such
cases and conditions which will be seen frequently by future doctors. (See Tables 1-8 in
Appendix 1).

3
November 2017
Health of the Population (Hajj Season)

Public health refers to a population-health based approach. The public health aims to monitor
health status, promote health, and prevent diseases and injuries through various activities
including population health assessment, health protection, and emergency preparedness.

Health practitioners practicing in Saudi Arabia have great opportunities to be exposed to

public health in the field of Hajj as there is a high chance to be recruited among Hajj healthcare
programs. Thus, physicians must possess a strong knowledge base in the domain of public
health in a way that enables them to meet the needs of hajj public health system.

It is noteworthy that MOH pursues its program “Safe Surgery Saves Lives” (SSSL), which
features providing free specialized healthcare services, including open-heart surgeries, cardiac
catheterization, kidney blood and peritoneal dialysis, alimentary endoscopy, obstetrical cases,
in addition to other specialized services needed by pilgrim patients.

In 2017, More than 29,000 health practitioners - including various medical, technical and
administrative groups - were commissioned under Hajj Manpower Program. Physicians, nurses
and allied health personnel constituted 76% of the assigned manpower. In average, a physician
served 425 pilgrims.

Nevertheless, there are many steps being taken to enhance public health practice in Saudi
Arabia. The future vision is that “all physicians graduating from Saudi medical schools should be
able to practice medicine with the concepts of public health as key elements in their day-to-day
activities, as well as seeing themselves as a key component of the public health system”.

4
November 2017
Patient Safety

To provide safe care to patients, it is important for physicians to have clear understanding of
safety issues and patient safety concepts. The Canadian Patient Safety Institute (CPSI) has
developed a safety competencies framework to help health professionals to improve the health
of their patients. Six overarching competencies have been developed to enhance safe practices:
(1) contribute to a culture of patient safety, (2) work in teams for patient safety, (3)
communicate effectively for patient safety, (4) manage safety risks, (5) optimize human and
environmental factors, and (6) recognize, respond to and disclose adverse events. The
competencies describe the knowledge, skills, and behavior necessary for the safe care of
patients.

Recently, the American College of Physicians has published patient safety strategies which the
authors strongly recommend be adopted. Although these strategies are proposed for an
American patient population, they are in keeping with prior research from the CPSI.

The Saudi Patient Safety Center (SPSC) is a national body that aims to raise awareness and
knowledge of patient, strengthen and improve the culture of best practices in patient safety in
all health institutions, study and research to improve the quality of health facilities.

SPSC will frequently issues patient safety alerts with recommendation action items. SMLE will
include common patient safety issues, as familiarity with published strategies are required to
further improve the health of their patients.

5
November 2017
Medical Malpractice

In an effort to reduce medical malpractice, the General Directorate of Forensic Medicine Centers
at MOH has issued a statistical report about the Medical Malpractice in Saudi Arabia. The report
tackled the specialties of the convicted practitioners concluded by the forensic health centers
during the years 1434 H – 1437 H.

The data manifested that the practitioners specialized in OB/GYN were the most likely to be
convicted of malpractice during the last four years. Following them were practitioners
specialized in general surgery in the years 1434 H - 01436 H. Internal Medical practitioners
came in third place in the years 1434 and 1436.

By shedding light on the most common medical malpractices in Saudi Arabia, the SMLE may
play a vital role in addressing the systemic malfunctions in order to ensure the safe practice of
general practitioners.

Summary

The intent of the SMLE is to assess the medical knowledge and clinical decision-making
ability of a candidate at an entry-level general practitioner. This review outlines the most
common cases and conditions in the Saudi population. It also provides information about other
health related issues that are necessary for the improvement of Saudis’ health and establishing
the SMLE blueprint.

6
November 2017
Appendix 1
Table 1: Cases related to complications of pregnancy and childbirth, MOH Hospitals

Anemia With Pregnancy

Vaginal Bleeding (Antepartum)
Gestational Diabetes Mellitus
Vaginal Bleeding (Post Partum)
Pregnancy with UTI
Gestational Hypertension (Pre-eclampsia)
Diabetes Mellitus (Diagnosed before Pregnancy)
Hypertension (Diagnosed before Pregnancy)
Vaginal Bleeding (Intrapartum)
Pregnancy with Bronchial Asthma
Venous Disorder with Pregnancy
Gestational Hypertension (Eclampsia)
Heart Disease with Pregnancy

0 2000 4000 6000 8000 10000 12000

7
November 2017
Table 2: Total Injury Cases in the Kingdom by type of injury (1436 H)

Type of Injury # Cases

Fracture in lower limbs 21585
Fracture in upper limbs 19976
Bruises 19476
Head injury 16991
Fracture in spine 13272
Chest injury 5536
Deep wounds 2198
Abdominal injury 1964
Asphyxia 467
First degree burn 395
Second degree burn 250
Third degree burn 134

8
November 2017
Table 3: Some Gynecology Operations in MOH Hospitals by Type of Operations (1437 H)

Type of Operation # Cases

Evacuation 20052
D&C 6848
Hysterectomy 628
Removal of Ovarian Tumours 370
Correction of prolapse 135
Anal fistulae 34
Urinary fistulae 34

9
November 2017
Table 4: Deliveries in MOH Hospitals by Type of Delivery

Normal deliveries

Cesarean section

Ventouse

Other

Breech

Forceps

0 50000 100000 150000 200000

10
November 2017
Table 5: Operations in MOH Hospitals by Hospital Sections (1436 H)

Sections # Cases
General 119981
OBS\GYN 116123
Ophthalmology 82345
Orthopedics 55472
ENT 28452
Plastic 20974
Urology 18400
Pediatrics 18291
Others 13768
Faciodental 13085
Cardiac, Chest & vascular 9442
Neurology 7901

11
November 2017
Table 6: Cases of Malignant Tumors Registered in KFSHRC Riyadh & Jeddah

Breast
Thyroid gland
NHL-lymph
Leukemia
Brain & C.N.S
Hodgkin’s
Oral cavity
Liver
Lung
Bladder
Nasopharynx
Soft tissue
Ovary
Esophagus

0 100 200 300 400 500 600 700

12
November 2017
Table 7: Top 10 causes of premature mortality

Rank Disease YLLs per 100,000

1 Ischemic heart disease 2,172.10
2 Road injuries 1,103.40
3 Cerebrovascular disease 964.7
4 Congenital defects 766
5 Lower respiratory infection 560.2
6 Chronic kidney disease 504.2
7 Neonatal preterm birth 461.5
8 Alzheimer disease 394
9 Neonatal sepsis 218.4
10 Diabetes 200.9
* YLL: Years of Life Lost (years lost due to premature mortality).

13
November 2017
Table 8: Top 10 risk factors contributing to DALY*

Dietary risks

High body-mass index

High systolic blood pressure

High fasting plasma glucose

High total cholesterol

Air pollution

Tobacco smoke

Low glomerular filtration rate

Low physical activity

Occupational risks

*DALY (disability-adjusted life year): summary measure used to give an indication of the burden
of disease

14
November 2017
Table 9: Specialties of convicted malpractice practitioners concluded by the Forensic Health
Centers (MOH) during The Years 1434 H – 1437 H

Specialty 1434 H 1435 H 1436 H 1437 H

OB/GYN 167 153 155 189
General Surgery 85 64 73 66
Orthopedic Surgery 32 23 37 34
Neurosurgery 18 8 14 7
Urology 13 14 12 8
ENT 10 4 8 14
Plastic Surgery 3 7 7 7
Ophthalmology 17 12 11 21
Other Surgeries 8 12 12 12
INT Medicine 64 44 72 69
Cardiology 9 3 8 13
Dermatology 6 8 5 1
Anesthesia & critical Care 32 26 27 19
Pediatrics 41 44 59 45
Dental Surgery 30 46 44 71
Oral Maxillofacial Surgery 1 4 0 3
Radiology 12 8 5 5
Hematology 2 2 7 4
Midwifery 51 46 39 77
Other Specialties 43 28 60 32
Total 644 555 655 697

200
180
160
140
120
100
80
60 1437 H
40
20 1436 H
0
Anesthesia &…

Oral Maxillofacial…

1435 H
Cardiology
ENT
Urology

Pediatrics
OB/GYN

Plastic Surgery

Other Surgeries

Midwifery
Radiology

Other Specialties
General Surgery

INT Medicine

Hematology
Dental Surgery
Neurosurgery
Orthopedic Surgery

Ophthalmology

Dermatology

1434 H

15
November 2017