CURRICULUM OF SURGERY - Independent Medical College

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1CURRICULUM IMC

CURRICULUM OF SURGERY MBBS COURSE

Contents

S. No. Subject Page No.

1. Introduction 02

2. Educational Hours 03

3. Learning Outcomes 04

4. Educational Strategies 05

5. Assessment 06

6. Learning Resources 07

7. Contents Modules 08

8. Implimentation 09-12

9. Programme Evaluation 13

10. Table of Specification 14-17

11. Modules 18-25

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2CURRICULUM IMC

INTRODUCTION

Billions of people worldwide lack access even to basic health care. Out of the roughly 250 million operations performed each year, only 3.5% are performed on the poorest third of the world’s population. Healthcare has a crucial role to play in achieving universal health coverage including the United Nations Millennium Development Goals, a set of goals set by the UN in 2000 to be fulfilled by 2015. This is not to say that surgery is any more important than other types of treat-ment, but it is certainly as important as other global health priorities.

The global burden of disease is massive, of which much is un-diagnosed and untreated. All doc-tors need to understand which options are possible and many of the treatments are basic and well-established. The graduating medical student should have an awareness of health services in local environment, including the place of health services in global healthcare.

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3CURRICULUM IMC

SURGERY

Year Theory Practical Total

1st year 20 hours 25 hours 45

2nd year 20 hours 25 hours 45

3rd year 25 50 (Surgery rotation 4 weeks)

50 (Specialities rotation 4 weeks)

75 (Sur)50 (Spe)

4th year 25 (Surgery)25 (Specialities)

50 (Surgery rotation 4 weeks)


75 (Sur)75 (Spe)

5th year 60 (Surgery)75 (Specialities)

300 (Surgery rotation 8 weeks)


360 (Sur)175 (Spe)

Total 250 hours in 36 weeks/year 650 hours 600 (Sur)

300 (Spe)

Strategy

LecturesProblem based learningSmall group discussionCase based discussion

Clinical attachmentEvening duties in wardsClinical skills laboratoryEarly clinical exposure

EDUCATIONAL HOURS

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4CURRICULUM IMC

AT THE END OF CURRICULUM STUDENT WILL BE ABLE TO

• Take a focused history

• Perform physical examination(s) in order to identify specific problems

• Formulate a provisional diagnosis problems, Order appropriate investigations for common

surgical problems

• Formulate management plans in partnership with Using cost-effective best evidence

• Competent graduates require professional values, attitudes and behaviors that embody good

medical practice, that is, life-long learning, altruism, empathy, cultural and religious sensitivi-

ty, honesty, accountability, probity, ethics, communication skills, and working in teams

• Can demonstrate knowledge of basic medical and clinical sciences required for the practice

of surgery.

• Can display the ability to critically evaluate existing knowledge, technology and information,

and to be able to reflect on it, is necessary for solving problems.

• Perform basic procedures with the consent of the patient, ensuring infection control

• Medical and dental graduates must continually acquire new scientific knowledge and skills to

maintain competence, and incorporate it into their day-to-day medical practice.

• Graduates should be able to demonstrate Communication Skills, when dealing with patients

and their families, nurses, other health professionals, community, the general public and the

media.

LEARNING OUTCOMES

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5CURRICULUM IMC

EDUCATION STRATEGIES

The educational strategies in this curriculum are multiple and aligned with domain of learning and according to the desired outcome

Interactive lecturesOne-third of the curriculum will be delivered in a traditional didactic format including PowerPoint presentations and case discussions. Didactic education is considered to be a one-way transmis-sion of material from teacher to learner, we cannot overlook the possibility of meaningful interac-tion between experts and learners during live lectures. This type of interaction, which allows for immediate clarification of concepts and extension of knowledge, may be particularly important for novice learners who have relatively little exposure to the subject matter, such as our study population(4).

Case based DiscussionA lot of emphasis is on case based discussion during ward placement. Problem-based learning (PBL) is complex and heterogeneous. A wide variety of educational methods are referred as PBL. These include Lecture-based case, Case based lecture, Case based discussions, Problem or inquiry based and Closed loop or reiterative. Incorporation of case based discussion in teaching enhances the critical thinking and problem-solving skills. It also helps in developing a broader prospective of clinical case scenarios (5).

Small Group DiscussionSmall group discussion provides a unique environment to achieve high standards in medical edu-cation. Activation of prior knowledge, exchange of ideas, and engagement at a higher cognitive level are assumed to result in deeper learning and better academic achievements by students (6).

Clinical Skills SessionsClinical skills session are important part of curriculum to achieve psychomotor and affective outcomes. Learning manual skills is a fundamental part of health care education, and motor, sensory and cognitive learning processes are essential aspects of professional development. Simulator training has been shown to enhance factors that facilitate motor and cognitive learning. Students learned manual skills, how to perform the procedure, and professional behaviour. They learned by preparing, watching, practising and reflecting. The simulator contributed by providing opportunities for students to prepare for the skills training, to see anatomical structures, to feel resistance, and to become aware of their own performance ability (7).

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6CURRICULUM IMC

ASSESSMENT MCQ’s and SEQ’s Multiple choice question and short essay question test will be used at the end of part of curric-ulum to assess the learning of knowledge. These all assessment exercises will be formative. The written tests like Multiple-Choice Questions (MCQs) and Short-Essay Questions (SEQs) test formats are used for the assessment of cognitive domain. The MCQs are more objective and essentially select type of item response format. MCQs have a cueing effect, which promotes guessing and leads to higher scores. In addition, writing MCQs of higher cognitive level of prob-lem solving is challenging. On the contrary, the SEQs are more subjective and have a supply or construct type item response format, which does not have any cueing effect and can effectively assess problem solving skills(8).

OSCE AND SHORT CASEShort case and OSCE will be used to evaluate clinical skills and procedural skills at the ward end of placement. The OSCE is a method of clinical skill assessment, and it has been reported to be appropriate for assessing learning achievement levels in the psychomotor and emotional domains, which are difficult to evaluate with written examinations(9).

CLINICAL LOG BOOKClinical log book is meant for self directed learning (SDL) and assessment of students. The clini-cal logbook includes reflection which helps the students to set educational goals.

MINI-CEXMini-CEX is used to assess the clinical skills and problem solving skills of medical students. This is the tool used by clinical teachers. This can assess all three domains, Pyschomotor, cognitive and affective. This also used as formative assessment.

INTERNAL ASSESSMENT i. The weightage of internal assessment shall be 10% of totals marks. ii. Continuous internal assessment shall consist of evaluation at the end of each assignments,

e.g. stages/sub-stage, class tests etc., attitudinal assessment from educational supervisors. iii. Assessment of knowledge, Skills and Attitude shall contribute toward internal assessment.

Methods used to assess these domains shall include Multiple Choice Questions of one-best type, Short essay questions, Oral/Viva, and Practical/Clinical axaminations.

iv. The score of internal assessment shall contribute to the score in the final examination, Final university examination of each subject shall contribute 90 to total score, and the candidate shall pass in aggregate.

v. Proper record of continuous internal assessment shall be maintained.

Evaluation plan

Each Module Written test (MCQ and SEQ) Formative

After 12 weeks of ward placement Ward test (OSCE and short case) Formative

At end of 36 weeks Send up exam (MCQ and SEQ)Viva voce Formative

Annual University Professional exam Summative

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7CURRICULUM IMC

LEARNING RESOURCESThe department of Surgery will require following resources for implementation resources:

• Human resource

• Instructors (faculty members 8)

• Curriculum coordinator curriculum secretary

• Infrastructure

• Lecture hall with AV aids

• Tutorial room with AV aids

• Clinical skills Lab with manikins

• Simulated patients and simulated manikins

• Computers

LISTS OF CONTENT RESOURCES• Short Surgical Practice Bailey & Love 28th edition

• Surgical Signs and Symptoms Norman Browse

• ATLS manual 9th edition

• Clinical examination systems by Muhammad Shuja Tahir

• Tell me the Answer Vol 1 and Vol 2 by Muhammad Shuja Tahir

• Trauma by Muhammad Shuja Tahir

• Breast Problem by Muhammad Shuja Tahir

• Thyroid Problems by Muhammad Shuja Tahir

• GIT Problems by Muhammad Shuja Tahir

• Urology by Muhammad Shuja Tahir

• Investigations by Muhammad Shuja Tahir

• Independent Review (H-2000) www.indepreview.com

• History Register

• Clinical Log book

• General Surgery (Lecture Notes Series) by Harold Ellis, Roy Calne, Chris Watson

• An Introduction to the Symptoms and Signs of Surgical Disease by Norman Browse

• Current Surgical Practice: by Norman L. Browse, Alan G. Johnson, and Tom. Vol. 6

• Schwartz’s Principles of Surgery by F. Charles Brunicardi, Dana K.

• Andersen, Timothy R. Billiar, and David L. Dunn 8th edition. 2004

• Online Journals and Reading Materials through HEC Digital Library Facility

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8CURRICULUM IMC

COURSE CONTENTS

3rd Year

1st Term Module 1: Wounds & Surgical infections

2nd Term Module 2: Surgical physiology

3rd Term Module 3: Critical care and Anesthesia

4th Year

1st Term Module 4: Diagnosis and Surgical technology

2nd Term Module 5: Surgical Pathology

3rd Term Module 6: Trauma

Final Year

1st Term

Module 7: Skin and soft tissue lesions

Module 8: Head and neck

Module 9: Breast diseases

Module 10: Upper GIT

2nd Term

Module 11: Small intestine and appendix

Module 12: Abdominal wall and peritonitis

Module 13: Hepato billiary and pancreas

Module 14: Colorectal disease

3rd Term

Module 15: Urology

Module 16: Vascular diseases

Module 17: Pediatric surgery

Module 18: Neurosurgery

CONTENTS MODULES

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9CURRICULUM IMC

IMPLEMENTATIONThe curriculum will be spread over 5 year with 36 working weeks each year. During this period student will be exposed to various education strategies to achieve the learning objectives.

1st Year.In this year student will be exposed to do early clinical exposure to develop understanding of applied aspects of basic sciences.

Theory (Lecture, SGD and PBL) Practical (Early clinical exposure, Skills lab)

20 Hours (36 Weeks) 25 Hours

2nd Year.In this year student will be exposed to do early clinical exposure to develop understanding of applied aspects of basic sciences.

Theory (Lecture, SGD and PBL) Practical (Early clinical exposure, Skills lab)

20 Hours (36 Weeks) 25 Hours

3rd Year.In this year student will be placed on ward attachments and formative assessment of clinical skills will be started.

Theory (Lecture, SGD and PBL) Practical (Ward Placement, Skills lab)

25 Hours (36 Weeks) 100 Hours (8 Weeks)

4th Year.In this year student will be placed on ward attachments and clinical skills lab. formative assess-ment of clinical skills will be started.



Final Year.In this year student will be placed on ward attachments and clinical skilsl lab. All students will be assessed for knowledge and clinical skills during year. This year will have summative assessment as final professional at the end of year.



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10CURRICULUM IMC

THIRD YEAR WARD ROTATION IN SURGERY Duration: 8 weeks (100 hours)Location: ward, OPD, Tutorial roomTutors: Assistant professor, associate Professor, Professor

Ward C P A % age Assessment

Week 1

History takingGeneral physical examinationExamination of ulcerExamination of swelling

C2C2

P1P1

A1A1 15

Ward testMini CEXOSPE

Week 2

Abdominal examinationDigital rectal examinationInguinal examinationScrotal examination

C2C2

P1P1

A1A1 15


Week 3 Chest examinationBreast examination

C2C2

P1P1

A1A1 15


Week 4 Examination of neckThyroid examination

C2C2

P1P1

A1A1 15


Week 5Arterial examinationVenous examinationDiabetic foot examination

C2C2

P1P1

A1A1 10


Week 6CNS examinationExamination of upper limb nervesExamination of lower limb nerves

C2C2

P1P1

A1A1 10


Week 7 Orthopedics Examination of upper limb joint

C2C2C2

P1P1P1

A1A1A1

10Ward testMini CEXOSPE

Week 8 OrthopedicsExamination of lower limb joints

C2C2C2

P1P1P1

A1A1A1


Evaluation:• Attendance of 75% is mandatory• 15 clinical histories must be completed on history register• Every Saturday will be formative assessment for course work of that week• End of course work will be ward test • Ward test will be OSPE and 2 short cases

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11CURRICULUM IMC

FOURTH YEAR WARD ROTATION IN SURGERY Duration: 8 weeks (100 hours)Location: Ward, OPD, Tutorial roomTutors: Assistant Professor, Associate Professor, Professor

Ward C P A % age Assessment

Week 1Examination of ulcerExamination of swellingNeck swelling

C2C2C3

P2P2

A2A2 15


Week 2Abdominal examinationDigital rectal examinationAbdominal Pain

C2C2C3

P2P2

A2A2 15


Week 3

Inguinal examinationScrotal examinationLUTSHematuria

C2C2C3C3

P2P2

A2A2 15


Week 4Chest examinationBreast examinationJaundice

C2C2C3

P2P2

A2A2 15


Week 5Examination of neckThyroid examinationdysphagia

C2C2C3

P2P2

A2A2 10


Week 6

Arterial examinationVenous examinationDiabetic foot examinationIschemic limb

C2C2C3C3

P2P2

A2A2 10



C2C2C2

P2P2P2

A2A2A2



C2C2

P2P2

A2A2 10



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12CURRICULUM IMC

FINAL YEAR WARD ROTATION IN SURGERY Duration: 12 weeks (350 hours)Location: ward, OPD, Tutorial room, Operation theatreTutors: Assistant Professor, Associate Professor, Professor

Small Group Discussion ward % age Assessment

Week 1 WoundsSkin lesions/ulcers

Examination of wound /ulcerExamination of swelling 8 Short case

SEQ, OSPE

Week 2Soft tissue swellingsLateral neck swellingMidline neck swelling

Examination of neckThyroid examination 8 Short case

SEQ, OSPE

Week 3Breast lumpBreast painNipple discharge

Breast examinationmammography 8 Short case

SEQ, OSPE

Week 4 DysphagiaUpper GI bleed Barium studies 8 Short case

SEQ, OSPE

Week 5RIF painRUQ painEpigastric pain

Abdominal examinationGeneral anesthesia 10 Short case

SEQ, OSPE

Week 6Intestinal obstructionLUQ lumpRIF mass

Abdominal x-rayRegional anesthesia 10 Short case

SEQ, OSPE

Week 7 Periumbilical swellingInguinoscrotal swelling

Examination of groinPain management 10 Short case

SEQ, OSPE

Week 8 JaundiceRectal mass ERCP, PTC 10 Short case

SEQ, OSPE

Week 9LUTSUrinary retentionHematuria

IVU 8 Short case SEQ, OSPE

Week 10Renal painRenal massScrotal swelling

Examination of scrotum 8 Short case SEQ, OSPE

Week 11Diabetic foot Varicose veinsIschemic limb

Arterial examinationVenous examination 8 Short case

SEQ, OSPE

Week 12Abdominal traumaHead injuryChest trauma

CT scanCNS examnationExamination of peripheral nerves upper and lower limb

4 Short case SEQ, OSPE


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13CURRICULUM IMC

PROGRAMME EVALUATIONPurpose of Evaluation The major goals of the evaluation are to provide information that the students can use to achieve curricular objectives and that the faculty can use to monitor quality of and improve curriculum.

Design of Evaluation The evaluation design as only posttest.

Users of evaluation: students, curriculum faculty, Principal OfficeResources: Curriculum faculty and departmental secretaries. No additional funding

Evaluation question: • What percentage of students achieved 75% mandatory attendance?• What percentage of students achieved pass marks in university exam?• What are the strengths of the curriculum? What are the weaknesses? How can the curriculum

can be improved?

Because of limited resources, the evaluation was kept simple. Data Collection was integrated into the curriculum schedule. The major goals of the evaluation are to provide information that the students can use to achieve curricular objectives and that the faculty can use to monitor quality of and improve curriculum. The evaluation design as only posttest.

End of curriculum evaluation form:This will be filled by students and faculty members for evaluation of adequacy with each content was covered, whether they would recommend the curriculum to others and written comments on curriculum strengths, weaknesses and suggestions for improvements.

Annual Report:Based on evaluation of the educational programe report will be generated annually and submitted to Medical Educational Department.

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14CURRICULUM IMC

TABLE OF SPECIFICATIONSURGERY 1 (Principles of Surgery)

No Module Subject percentage MCQ SEQ

1 Surgical anatomy 6% 3 1

2Wounds and injuries

Wounds, tissue repair and scars 6% 3

1

3 Accident and Emergency , warfare Injuries 6% 3

4Surgical physiology

Fluid , electrolytes and acid base balance 6% 3

1

5 Blood transfusion and shock 6% 3

6 Nutrition 6% 3 1

7Surgical infections

Wound infection 6% 3

1

8 Special infection, AIDS , sterile precautions 6% 3

9

Skin and soft tissues

Tumors, cyst ulcer and sinuses 6% 3

110 Burns 6% 3

11 Skin lesions, skin grafts and flaps 6% 3

12

Vascular system

Arterial disorders 6% 3

113 Venous disorders 6% 3

14 Lymphatic disorders 6% 3

15 Critical care Principles of anesthesia and pain management 6% 3 1

16 Principles of radiology 6% 3 1

17 Principles of radiotherapy and chemotherapy 4% 2 1

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15CURRICULUM IMC

SURGERY 2 (systemic Surgery)No Module Subject percentage MCQ SEQ

1

Musculoskeletal Disease

Fractures and dislocations-general principles

10%

1

1

2 Fractures and dislocations-upper limb 1

3 Fractures and dislocations-lower limb 1

4 Other diseases of bones, joints and related tissues 2

5 Hand and foot 1

6

Upper GI

Esophagus

24%

3

2

7 Stomach and duodenum 2

8 Liver 2

9 Spleen 2

10 Gall bladder and bile ducts 2

11 pancreas 2

12 Peritoneum. Omentum, mesentry, and retroperitoneal space 2

13

Lower GI

Small and large intestine

20%

2

2

14 Intestinal obstruction 2

15 Vermiform appendix 2

16 Rectum 2

17 Anus and anal canal 2

18 Hernia , umbilicus and abdominal wall 2

19

Urogenital system

Kidney and ureter

16%

2

2

20 Urinary bladder 2

21 Prostate and seminal vesicles 2

22 Urethra and penis 2

23 Testis and scrotum 2

24

Head and neck

Thyroid gland and thyroglossal tract

7%

1

125 Parathyroid and Adrenal Glands 1

26 Salivary Glands 1

27 Others 1

28Thorax

Chest trauma7%

21

29 Others 2

30Breast diseases

Malignant diseases of breast7%

21

31 Benign diseases of breast 2

32Nervous system

Head , spine and nerve injuries3%

11

33 Others 1

34 Heart and great vessels

Heart3%

11

35 Great vessels 1

36orodontal

Maxillofacial injuries3%

1 1

37 Others 1

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16CURRICULUM IMC

TABLE OF SPECIFICATION FOR OSPE

OSPE

TOTAL MARKS 55Total Station 13 (02 Rest Station)05 Marks at Each Station 05 Marks at Each Station

Static Stations

0905 General Surgery 01 of the four sub-speciaties (Anaesthesia, Urology, Neurosurgery, Orthopaedics)

Interactive / Observed Stations 02General Surgery and Trauma only

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17CURRICULUM IMC

FINAL PROFESSIONAL MARKING SCHEME

Theory

SEQ MCQ Int. Ass Sub Total

Surgery 1 50 50

25 250

Surgery 2 65 60

Clinical

Short caseX2 cases

Long caseX1 case OSPE Int. Ass Sub total

100 70 55 25 250

Total: 500

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18CURRICULUM IMC

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19CURRICULUM IMC

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SC/O

SPE

SC SC/O

SPE

SEQ

SEQ

OSP

EM

CQ

SEQ

OSP

ESE

Q

Mod

ule-

4: D

iagn

ostic

s an

d su

rgic

al te

chno

logy

Diag

nost

ic Im

agin

g in

sur

gery

(ide

ntifi

catio

n of

m

orbi

ditie

s , h

igh

risk

patie

nts,

pitf

alls

Endo

scop

y in

sur

gery

Tiss

ue d

iagn

osis

Min

imal

inva

sive

sur

gery

Surg

ical

inci

sion

s

• Co

mpa

re d

iffer

ent r

adio

logi

cal i

nves

tigat

ions

• An

alyz

e va

rious

labo

rato

ry in

vest

igat

ions

•

Desc

ribe

adva

nce

surg

ical

inve

stig

atio

ns

• Ca

tego

rize

path

olog

ical

inve

stig

atio

ns

• Ex

plai

n an

atom

y of

sur

gica

l inc

isio

ns

C3 C3 C3 C3 C3P3

Lect

ure

SGD

lect

ure

SGD

Skills

lab

MCQ

MCQ

/SEQ

MCQ

/SEQ

SEQ

OSP

E

Mod

ule-

5: S

urgi

cal P

atho

logy

Neo

plas

ia a

nd s

urge

ryPr

inci

ples

of C

hem

othe

rapy

Pr

inci

ples

of r

adio

ther

apy

Prin

cipl

es o

f tra

nspl

anta

tion

• Ex

plai

n pr

inci

ples

of o

ncol

ogic

al th

erap

y an

d pa

lliatio

n •

Desc

ribe

prin

cipl

es o

f tra

nspl

anta

tion

• Di

scus

s ph

arm

acol

ogy

of c

hem

othe

rapy

• De

scrib

e ty

pes

of r

adio

ther

apy

C3 C3 C3 C3

Lect

ure

Lect

ure

Lect

ure

SGD

MCQ

MCQ

MCQ

SEQ

ww

w.im

c.ed

u.pk

20CURRICULUM IMC

Con

tent

sO

bjec

tives

Do-

mai

nSt

rate

gyAs

sess

men

t

Mod

ule-

6: T

raum

a

Intro

duct

ion

to tr

aum

a an

d tr

iage

Prim

ary

surv

ey a

nd S

econ

dary

sur

vey

Burn

s an

d its

type

s &

Man

agem

ent o

f bur

nsSp

inal

inju

ryAb

dom

inal

trau

ma

Ches

t tra

uma

• Di

scus

s pa

thop

hysi

olog

y of

Hea

d In

jury

• Re

cogn

ize

sign

s of

Hea

d in

jury

•

Plan

trea

tmen

t of H

ead

inju

ry p

atie

nt

• Pe

rfor

m C

NS

exam

inat

ion

• Ex

plai

n an

atom

y of

spi

nal i

njur

y •

Dem

onst

rate

App

licat

ion

of c

ervi

cal c

olla

r •

Desc

ribe

man

agem

ent o

f abd

omin

al tr

aum

a •

Out

line

man

agem

ent

ches

t inj

urie

s •

Inte

rpre

t che

st x

-ray

C•

Dem

onst

rate

airw

ay m

anag

emen

t sk

ills

• Pe

rfor

m c

linic

al e

xam

inat

ion

of C

hest

•

Carr

y ou

t tria

ge a

nd p

re h

ospi

tal c

are

• Pe

rfor

m p

rimar

y an

d se

cond

ary

surv

ey

C3 C3P3

A3C3

P3A3

C3P3

A3C3 C3

P3A3

C3 C3 C3 C3 C3P3

A3C3

P3A3

C3P3

A3

Lect

ure

beds

ide

SGD

beds

ide

Lect

ure

Skills

Lab

Lect

ure

SGD

SGD

Skills

Lab

beds

ide

Skills

lab

MCQ

OSP

ESE

Q/M

CQSC

/OSP

EM

CQO

SPE

MCQ

MCQ

OSP

EO

SPE

SC/O

SPE

OSP

E

Mod

ule-

7: S

kin

and

soft

tiss

ue le

sion

s

Beni

gn s

oft t

issu

e le

sion

sSq

uam

ous

cell

carc

inom

a an

d Ba

sal c

ell

carc

inom

aSk

in g

rafts

and

flap

sre

trope

riton

eal S

arco

mas

& L

ymph

omas

• De

scrib

e Pr

inci

ples

of s

kin

cove

rage

•

Diffe

rent

iate

bet

wee

n Co

mm

on b

enig

n an

d m

alig

nant

ski

n le

sion

s •

Perf

orm

Clin

ical

exa

min

atio

n of

ulc

er•

Disc

uss

the

com

mon

sur

gica

l ski

n sw

ellin

gs

• Pe

rfor

m e

xam

inat

ion

of s

wel

ling

and

Just

ify

clin

ical

feat

ures

•

Diffe

rent

iate

bet

wee

n di

ffere

nt b

enig

n sk

in

swel

lings

C3 C3P3

C3P3

A3C3 C3

P3A3

C3P3

Lect

ure

SGD

Beds

ide

SGD

Beds

ide

SGD

MCQ

SEQ

/OSP

E

SC/O

SPE

MCQ

/SEQ

SC/O

SPE

SEQ

/MCQ

Mod

ule-

8: H

ead

and

neck

Nec

k sw

ellin

g &

Saliv

ary

glan

d di

seas

es &

Br

anch

ial c

yst,

bran

chia

l sin

us ,

cyst

ic h

ygro

ma

Goi

tre/s

olita

ry n

odul

e of

thyr

oid

& Hy

per

/hy

poth

yroi

dism

Thyr

oid

mal

igna

ncy

Para

thyr

oid

glan

d di

seas

e &

Pheo

chro

moc

ytom

a ,

MEN

1 an

d M

EN 2

• Ex

plai

n Tr

iang

les

and

zone

s of

nec

k •

Desc

ribe

Saliv

ary

glan

d di

seas

es

• Pl

an m

anag

emen

t of

Thy

roid

dis

ease

s •

Expl

ain

Cong

enita

l sw

ellin

gs o

f nec

k •

Asse

ssm

ent o

f nec

k sw

ellin

g •

Clin

ical

exa

min

atio

n of

nec

k an

d th

yroi

d di

seas

e pa

tient

s •

Plan

inve

stig

atio

ns fo

r ne

ck s

wel

ling

• In

terp

ret t

hyro

id fu

nctio

n te

sts

C3 C3 C3P3

C3 C3P3

A3C3

P3A3

C3P3

C3P3

Lect

ure

Lect

ure

SGD

SGD

Beds

ide

Beds

ide

SGD

SGD

MCQ

MCQ

/SEQ

MCQ

/SEQ

MCQ

/SEQ

SC/O

SPE

SC/O

SPE

OSP

ESE

Q

ww

w.im

c.ed

u.pk

21CURRICULUM IMC

Con

tent

sO

bjec

tives

Do-

mai

nSt

rate

gyAs

sess

men

t

Mod

ule-

9: B

reas

t dis

ease

s

Nip

ple

disc

harg

e M

asta

lgia

& B

enig

n br

east

lum

p , G

ynae

com

astia

Carc

inom

a br

east

Brea

st s

urge

ry

• De

scrib

e cl

inic

al fe

atur

es o

f bre

ast l

umps

• Pe

rfor

m c

linic

al e

xam

inat

ion

of b

reas

t •

Expl

ain

trip

le a

sses

smen

t •

Disc

uss

path

olog

y of

bre

ast c

ance

r •

Prep

are

man

agem

ent p

lan

for

mal

igna

nt lu

mps

of

brea

st

• An

alys

e pa

tient

s w

ith n

ippl

e di

scha

rge

• O

utlin

e m

anag

emen

t mas

talg

ia

• Di

scus

s p

rinci

ples

of b

reas

t sur

gery

•

Disc

uss

mal

e br

east

pro

blem

s

C3 C3P3

A3C3

P3C3 C3

A3C3

P3A3

C3 C3 C3

Lect

ure

Beds

ide

SGD

Lect

ure

SGD

SGD

SGD

Lect

ure

lect

ure

MCQ

/SEQ

SC/O

SPE

MCQ

/SEQ

MCQ

SEQ

SEQ

MCQ

MCQ

MCQ

Mod

ule

10: U

pper

GIT

Mot

ility

diso

rder

s of

eso

phag

usG

ERD

dise

ase

Uppe

r G

I ble

edCa

rcin

oma

esop

hagu

sCa

rcin

oma

stom

ach

• An

alys

e pa

tient

with

dys

phag

ia

• Di

ffere

ntia

te M

otilit

y di

sord

ers

of e

soph

agus

•

Prep

are

man

agem

ent p

lan

for

UGI B

leed

•

Disc

uss

man

agem

ent o

f car

cino

ma

esop

hagu

s •

Expl

ain

man

agem

ent o

f gas

troes

opha

geal

reflu

x di

seas

e •

Inte

rpre

t bar

ium

sw

allo

w

• De

term

ine

man

agem

ent p

lan

for

carc

inom

a st

omac

h

C3A3

P3C3 C3

A3C3 C3 C3

A3C3

Beds

ide

SGD

SGD

Lect

ure

Lect

ure

SGD

Lect

ure

OSP

EM

CQ

SEQ

MCQ

/SEQ

MCQ

/SEQ

OSP

EM

CQ/S

EQ

Mod

ule-

11: S

mal

l int

estin

e an

d ap

pend

ix

Inte

stin

al o

bstr

uctio

nIn

test

inal

TB

, typ

hoid

and

am

ebia

sis

Appe

ndic

itis

, app

endi

cula

r m

ass

, app

endi

cula

r ab

sces

sTu

mor

s of

sm

all i

ntes

tine

Mec

kels

div

ertic

ulum

• Di

scus

s m

anag

emen

t of p

atie

nt w

ith r

ight

ilia

c fo

ssa

mas

s •

Perf

orm

abd

omin

al e

xam

inat

ion

• Ev

alua

te p

atie

nt w

ith in

test

inal

obs

truc

tion

• Di

scus

s pa

thol

ogy

of in

test

inal

obs

truc

tion

• As

sess

men

t of a

cute

abd

omin

al p

ain

• In

terp

reta

tion

of a

bdom

inal

x-ra

y

C3 C3P3

A3C3

P3A3

C3 C3P3

A3C3

P3A3

Lect

ure

beds

ide

SGD

Lect

ure

Beds

ide

Skills

Lab

MCQ

SC/O

SPE

SEQ

MCQ

/SEQ

SC/O

SPE

OSP

E

ww

w.im

c.ed

u.pk

22CURRICULUM IMC

Con

tent

sO

bjec

tives

Do-

mai

nSt

rate

gyAs

sess

men

t

Mod

ule-

12: A

bdom

inal

wal

l and

per

itoni

tis

Gro

in h

erni

as

Vent

ral h

erni

asBu

rst a

bdom

en a

nd in

cisi

onal

her

nia

Perit

oniti

s

• De

scrib

e an

atom

y of

ingu

inal

regi

on

• Ex

amin

e pa

tient

with

gro

in s

wel

ling

• Ex

plai

n gr

oin

hern

ia a

nd it

s co

mpl

icat

ions

•

Asse

ss s

wel

lings

in u

mbi

lical

regi

on

• Pl

an m

anag

emen

t pla

n of

ven

tral

her

nias

• Pa

thol

ogy

of p

erito

nitis

• Pl

an m

anag

emen

t of p

erito

nitis

C3 C3P3

A3C3 C3

P3A3

C3 C3 C3A3

Lect

ure

Beds

ide

SGD

Beds

ide

SGD

Lect

ure

SGD

MCQ

SC/O

SPE

SEQ

SC/O

SPE

SEQ

/MCQ

MCQ

SEQ

Mod

ule-

13: H

epat

o bi

lliar

y an

d pa

ncre

as

Chol

elith

iasi

s a

nd C

holid

ocol

ithia

sis

Tum

ors

of b

iliary

trac

tPa

ncre

atiti

s Ca

rcin

oma

panc

reas

Sple

nom

egal

yLi

ver

absc

ess

and

Live

r m

asse

s

• Ev

alua

te p

atie

nts

with

RUQ

mas

s •

Desc

ribe

path

olog

ies

of li

ver

• De

scrib

e m

anag

emen

t of A

cute

cho

lecy

stiti

s an

d en

list i

ts c

ompl

icat

ions

• Di

scus

s pa

tient

s w

ith le

ft hy

poch

ondr

ial m

ass

with

sp

leno

meg

aly

• Ex

plai

n pa

thop

hysi

olog

y fo

r inv

estig

atio

n of

ja

undi

ce

• De

scrib

e m

anag

emen

t of s

urgi

cal j

aund

ice

C3P3

A3C3 C3

A3C3 C3

P3A3

C3 C3A3

beds

ide

lect

ure

SGD

SGD

Lect

ure

SGD

SC/O

SPE

MCQ

SEQ

SEQ

/MCQ

MCQ

SEQ

Mod

ule-

14: C

olor

ecta

l dis

ease

Low

er G

I ble

ed a

nd A

bdom

inal

mas

sIn

flam

mat

ory

bow

el d

isea

seCo

lore

ctal

car

cino

ma

Carc

inom

a an

al c

anal

Blee

ding

PR

and

hem

orrh

oids

Anal

fiss

ure

and

peria

nal a

bsce

ss

Peria

nal fi

stul

aPi

loni

dal s

inus

• As

sess

pat

ient

with

lowe

r GI b

leed

ing

• Ex

plai

n m

anag

emen

t of c

olor

ecta

l car

cino

ma

• De

scrib

e di

verti

cula

r dise

ase

• Di

scus

s m

anag

emen

t of r

ecta

l pro

laps

e •

Desc

ribe

colo

nosc

opy

, bar

ium

ene

ma

and

its

prep

arat

ion

• Ex

plai

n an

atom

y of

col

onic

sur

gery

•

Com

pare

ulc

erat

ive c

oliti

s an

d ch

ron’s

dise

ase

• Ou

tline

man

agem

ent

for h

emor

rhoi

ds

• De

scrib

e an

atom

y of

per

iana

l fist

ula

•

Expl

ain

man

agem

ent o

f per

iana

l con

ditio

ns•

Perfo

rm d

igita

l rec

tal e

xam

inat

ion

• De

scrib

e m

anag

emen

t of p

iloni

dal s

inus

C3 C3P3

A3C3

P3A3

C3P3

A3C3 C3

P3A3

C3 C3 C3 C3 C3P3

A3C3

P3A3

C3P3

A3

Lect

ure

beds

ide

SGD

beds

ide

Lect

ure

Skills

Lab

Lect

ure

SGD

SGD

Skills

Lab

beds

ide

Skills

lab

Skills

lab

MCQ

OSP

ESE

Q/M

CQSC

/OSP

EM

CQ

OSP

EM

CQM

CQO

SPE

OSP

ESC

/OSP

EO

SPE

OSP

E

ww

w.im

c.ed

u.pk

23CURRICULUM IMC

Con

tent

sO

bjec

tives

Do-

mai

nSt

rate

gyAs

sess

men

t

Mod

ule

15: U

rolo

gy

Urin

ary

trac

t sto

ne d

isea

se

Hydr

onep

hros

is a

nd h

ydro

uret

erRe

nal n

eopl

asm

Ca

rcin

oma

bald

der

BPH

and

carc

inom

a pr

osta

teSt

rictu

re u

reth

raSc

rota

l sw

ellin

g Te

stic

ular

tum

our

Rena

l tra

ct in

vest

igat

ion

• De

scrib

e Lo

wer

urin

ary

tract

syp

mto

ms

• As

sess

pat

ient

with

hem

atur

ia•

Disc

uss

pros

tatic

dis

ease

and

iden

tify

plan

of

man

agem

ent

• Ev

alua

te p

atie

nt w

ith re

nal,m

ass

• Pl

an m

anag

emen

t of c

arci

nom

a bl

adde

r •

Inte

rpre

t IVU

and

iden

tify

step

s of

IVU

Exp

lain

ste

ps

of c

ricum

ciss

ion

• As

sess

pat

ient

with

scr

otal

sw

ellin

g •

Man

age

rena

l col

ic p

atie

nt•

Outli

ne m

anag

emen

t of u

rinar

y re

tent

ion

• Pe

rform

ure

thra

l cat

hete

rizat

ion

C3 C3A3

P3C3 C3

A3P3

C3 C3A3

C3 C3P3

A3C3

A3P3

C3 C3A3

P3

Lect

ure

Besi

deSG

D

Beds

ide

SGD

Skills

Lab

SGD

Beds

ide

SGD

Lect

ure

Skills

Lab

SEQ

SC/S

EQM

CQ/S

Eq

SC/O

SPE

MCQ

/SEQ

OSP

EO

SPE

SC MCQ

/SEQ

MCQ

/SEQ

OSP

E

Mod

ule-

16: V

ascu

lar

dise

ases

Arte

rial o

cclu

sive

dis

orde

rs

Aneu

rysm

s G

angr

ene

Varic

ose

vein

s DV

TDi

abet

ic fo

ot

• Di

scus

s ch

roni

c lim

b is

chem

ia

• Ex

plai

n Ra

ynau

d’s

and

Buer

ger’s

dis

ease

•

Dem

onst

rate

eva

luat

ion

of d

iabe

tic fo

ot

• Di

scus

s va

rious

ane

urys

ms

• Ex

plai

n an

atom

ical

des

crip

tion

of v

aric

ose

vein

s•

Out

line

man

agem

ent o

f ven

ous

diso

rder

s •

Perf

orm

exa

min

atio

n of

vas

cula

r s

yste

m

• Ex

plai

n ris

ks a

nd c

ompl

icat

ions

of D

VT

C3 C3 C3P3

A3C3 C3 C3

A3C3

A3P3

C3

Lect

ure

lect

ure

beds

ide

lect

ure

lect

ure

SGD

Beds

ide

SGD

MCQ

/SEQ

MCQ

/SEQ

SC/O

SPE

MCQ

MCQ

DEQ

SC/O

SPE

MCQ

/SEQ

Mod

ule-

17: P

edia

tric

sur

gery

Unde

scen

ded

test

is &

Hyp

ospa

dias

Tes

ticul

ar

tors

ion

Clef

t lip

and

pal

ate

Hirs

ch s

prun

g di

seas

e an

d co

ngen

ital

mal

form

atio

ns o

f anu

sHy

pert

roph

ic p

ylor

ic s

teno

sis

Rect

al p

olyp

and

rect

al b

leed

ing

• De

scrib

e Te

stic

ular

tors

ion

• Ev

alua

te A

cute

abd

omin

al p

ain

in c

hild

ren

• Ex

plai

n ty

pes

of c

left

lip &

pal

ate

• O

utlin

e an

o re

ctal

mal

form

atio

ns•

Disc

uss

caus

es o

f ble

edin

g PR

in c

hild

ren

• Ex

plai

n m

anag

emen

t of U

DT

C3 C3P3

A3C3 C3 C3 C3

A3

Lect

ure

SGD

Lect

ure

Lect

ure

SGD

lect

ure

MCQ

/SEQ

SEQ

MCQ

/SEQ

MCQ

/SEQ

SEQ

SEQ

ww

w.im

c.ed

u.pk

24CURRICULUM IMC

Con

tent

sO

bjec

tives

Do-

mai

nSt

rate

gyAs

sess

men

t

Mod

ule-

18: N

euro

surg

ery

Brai

n tu

mor

Hydr

ocep

halu

sM

enin

goce

leIn

trac

rani

al p

ress

ure

Perip

hera

l ner

ve in

jurie

s

• In

trodu

ctio

n to

intr

acra

nial

tum

ours

• Ex

plai

n an

atom

y of

Per

iphe

ral n

erve

inju

ries

• De

scrib

e co

ngen

ital a

nom

alie

s of

CN

S•

Disc

uss

path

ophy

siol

ogy

of C

SF•

Perf

orm

exa

min

atio

n of

per

iphe

ral n

erve

s•

perf

orm

Exa

min

atio

n of

CN

S

C3 C3 C3 C3 C3P3

A3C3

P3A3

Lect

ure

Lect

ure

Lect

ure

Lect

ure

Beds

ide

beds

ide

MCQ

MCQ

MCQ

/SEQ

MCQ

/SEQ

SC/O

SPE

SC/O

SPE

Mod

ule

19 C

linic

al S

kills

Basi

c su

rgic

al s

kills

Ur

ethe

ral c

athe

triz

atio

n IV

can

nula

tion

Prim

ary

surv

ey

NG

tube

inse

rtio

n Ai

rway

man

agem

ent

Wou

nd d

ress

ing

• De

mon

stra

te s

utur

ing

skills

•

Dem

onst

rate

scr

ubbi

ng te

chni

que

• De

scrib

e st

eps

of u

reth

ral c

athe

teriz

atio

n •

Desc

ribe

step

s of

IV c

annu

latio

n •

Dem

onst

rate

ste

ps o

f prim

ary

surv

ey

• De

mon

stra

te s

kills

for

airw

ay m

anag

emen

t

C3 P

3 A3

C3 P

3 A3

C3 P

3 A3

C3 P

3 A3

C3 P

3 A3

C3 P

3 A3

Skills

lab

Skills

lab

Skills

lab

Skills

lab

Skills

lab

Skills

lab

OSP

E O

SPE

OSP

EO

SPE

OSP

EO

SPE

ww

w.im

c.ed

u.pk

25CURRICULUM IMC

Con

tent

sO

bjec

tives

Do-

mai

nSt

rate

gyAs

sess

men

t

Mod

ule-

20: O

rtho

pedi

cs

Trau

ma

and

Shoc

k.Bo

ne &

sof

t tis

sue.

Biom

echa

nics

of f

ract

ure.

Heal

ing

& re

pair

(bon

e &

soft

tissu

es).

Prin

cipl

es o

f phy

siot

hera

pyO

rtho

tics

– or

thop

aedi

c ap

plia

nces

to

su

ppor

t and

cor

rect

def

orm

ities

Pros

thes

is –

art

ifici

al s

ubst

itute

for

mis

sing

bo

dy p

arts

.Co

ngen

ital

& De

velo

pmen

t Di

seas

es

of

bone

s an

d jo

ints

su

ch

as

Bone

dy

spla

sia

(def

ect

intr

insi

c to

bon

e) D

war

f- Ac

hond

ropl

asia

.Bo

ne a

nd jo

int i

nfec

tions

Acut

e os

teom

yelit

is

and

sept

ic

arth

ritis

, Ch

roni

c os

teom

yelit

is,

Tube

rcul

ous

arth

ritis

/Car

ies

spin

e,

Ost

eoly

sis/

bone

cy

st,

sequ

estr

um,

perio

stea

l rea

ctio

n.M

etab

olic

Bon

e di

seas

es.

Bone

Tum

ours

, Ben

ign

& M

alig

nant

.Pr

inci

ples

, in

dica

tions

, te

chni

ques

an

d or

thot

ics

rela

ted

to a

mpu

tatio

n.N

eck

Pain

, Low

Bac

k Pa

in a

nd S

ciat

ica.

Arth

ritis

an

d M

uscu

losk

elet

al

Pain

ful

Diso

rder

s.So

ft Ti

ssue

Inju

ries,

Fra

ctur

es.

ATLS

Pric

iple

s of

frac

ture

man

agem

ents

Cl

inic

al E

xam

inat

ion

• Ex

plai

n Pa

thop

hysi

olog

y of

trau

ma

and

shoc

k.•

Desc

ribe

the

Mec

hani

cal p

rope

rtie

s of

bon

e &

soft

tissu

e.•

Expl

ain

the

Biom

echa

nics

of f

ract

ure.

• Ex

plai

n th

e st

eps

of H

ealin

g &

repa

ir (b

one

& so

ft tis

sues

).•

Defin

e th

e Pr

inci

ples

of p

hysi

othe

rapy

• De

scrib

e O

rtho

tics

– or

thop

aedi

c ap

plia

nces

to

supp

ort

and

corr

ect d

efor

miti

es•

Desc

ribe

Pros

thes

is –

art

ifici

al s

ubst

itute

for m

issi

ng b

ody

part

s.•

Disc

uss

the

Cong

enita

l & D

evel

opm

ent D

isea

ses

of b

ones

an

d jo

ints

suc

h as

Bon

e dy

spla

sia

(def

ect i

ntrin

sic

to b

one)

Dw

arf-

Acho

ndro

plas

ia.

• Ex

plai

n th

e Bo

ne a

nd jo

int i

nfec

tions

• De

scrib

e Ac

ute

oste

omye

litis

and

sep

tic a

rthr

itis,

Chr

onic

os

teom

yelit

is, T

uber

culo

us a

rthr

itis/

Carie

s sp

ine,

•

Desc

ribe

Ost

eoly

sis/

bone

cys

t, se

ques

trum

, pe

riost

eal

reac

tion.

• Di

scus

s M

etab

olic

Bon

e di

seas

es.

• Ex

plai

n Bo

ne T

umou

rs, B

enig

n &

Mal

igna

nt.

• Di

scus

s Pr

inci

ples

, in

dica

tions

, te

chni

ques

and

ort

hotic

s re

late

d to

am

puta

tion.

• Di

scus

s N

eck

Pain

, Low

Bac

k Pa

in a

nd S

ciat

ica.

• De

scrib

e Ar

thrit

is a

nd M

uscu

losk

elet

al P

ainf

ul D

isor

ders

.•

Expl

ain

the

mec

hani

sm a

nd t

reat

men

t of

Sof

t Ti

ssue

In

jurie

s, F

ract

ures

.•

Dem

onst

rate

Bas

ic a

nd a

dvan

ced

trau

ma

life

supp

ort,

Tria

ge o

f inj

ured

pat

ient

s in

em

erge

ncy

room

.•

Desc

ribe

Prin

cipl

es o

f fra

ctur

e cl

assi

ficat

ion,

Prin

cipl

es o

f fr

actu

re tr

eatm

ent i

n ch

ildre

n, P

rinci

ples

of f

ract

ure

fixat

ion,

M

anag

emen

t of

com

mon

ort

hopa

edic

em

erge

ncie

s, M

al-

unite

d fr

actu

res;

non

-uni

ons.

• Pe

rfor

ms

exam

inat

ion

of J

oint

s (H

ip,

Knee

, Sh

ould

er,

Wris

t, An

kle)

.

C3 C3 C3 C3 C3 C3 C3 C3 C3 C3 C3 C3 C3 C3 C3 C3 C3 C3 P

3

A3 C3

Lect

ure/

SGD

Lect

ure/

SGD

Lect

ure/

SGD

Lect

ure/

SGD

Lect

ure/

SGD

Lect

ure/

SGD

Lect

ure/

SGD

Lect

ure/

SGD

Lect

ure/

SGD

Lect

ure/

SGD

Lect

ure/

SGD

Lect

ure/

SGD

Lect

ure/

SGD

Lect

ure/

SGD

Lect

ure/

SGD

Lect

ure/

SGD

Lect

ure/

SGD

Beds

ide/

SGD

Lect

ure/

SGD

Beds

ide/

Skill

Lab

SEQ

/MCQ

SEQ

/MCQ

SEQ

/MCQ

SEQ

/MCQ

SEQ

/MCQ

SEQ

/MCQ

SEQ

/MCQ

SEQ

/MCQ

SEQ

/MCQ

SEQ

/MCQ

SEQ

/MCQ

SEQ

/MCQ

SEQ

/MCQ

SEQ

/MCQ

SEQ

/MCQ

SEQ

/MCQ

SEQ

/MCQ

OSP

E

SEQ

/MCQ

OSP

E

ww

w.im

c.ed

u.pk

26CURRICULUM IMC

Domain Level

Knowledge

C1 Knowledge C2 Comprehension C3 ApplicationC4 AnalysisC5 SynthesisC6 Evaluation

Psychomotor

P1 Observe P2 Practice P3 Adjust P4 MasterP5 DevelopP6 Construct

Affect

A1 ReceivingA2 RespondingA3 ValuingA4 OrganizationA5 Characterization

CURRICULUM OF SURGERY - Independent Medical College

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Transcript of CURRICULUM OF SURGERY - Independent Medical College