Surgery & Allied Subjects

Departmental Objectives
The aim of this course is to provide community oriented & need based
education so as to produce basic doctors who will be able to:
 elicit a complete clinical history & physical findings and formulate diagnosis of common
surgical problems prevalent in Bangladesh and abroad.
 carry out necessary investigations & interpret the results with proper utilization for
management
 perform minor surgical procedures and treat minor surgical problems
 recognize the major surgical problems needing specialized care, initiate the primary
treatment and refer to the appropriate centers
 diagnose and provide competent primary care in surgical emergencies.
 carry out the responsibility of management in common casualties or natural calamities to
offer and arrange basic life support.
 take necessary preventive & prophylactic measures for surgical problems
 be involved in continued care & rehabilitation of surgical patients.
 deliver health education in the community with emphasis to the preventive aspects of
surgical disorders.
 demonstrate the right attitude in
 Patient Care
 Community health care
 Continuing medical education & research
 Observing the moral & legal codes of medical ethics

List of Competencies to acquire:

1. Clinical –
a. rapport building with patients, relatives, colleagues, health care professionals and
supporting staffs of the hospital
b. take detail relevant history
c. conduct thorough clinical Examination
d. decide on a provisional working diagnosis
e. perform and/or order relevant investigations considering the cost effectiveness
f. interpret common laboratory and imaging investigations
g. calculate fluid and electrolyte requirements
h. evaluate and make initial management of acute trauma patient
i. adopt aseptic techniques and procedures and maintain principles of sterilization
2. Communication-
a. obtain permission before any examination and clinical procedures
b. obtain informed consent for surgical procedures including organ ablation.
c. appreciate right to privacy and information about the disease and its consequence
3. Managerial-
a. provide leadership during team work
b. implement time management skills
c. issue certificates (discharge, death, medical and injury).
d. write notes (case notes, operation notes, referrals)
e. keep detail and systematic records both manual and electronic
f. use computer and IT facilities.
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4. Manipulative and practical skills-
a. adopt universal aseptic techniques in handling surgical patient
b. start IV lines
c. insert NG tubes
d. introduce urethral catheter and perform supra-pubic cystostomy
e. drain superficial abscesses
f. perform per-rectal examination
g. achieve emergency control of revealed hemorrhage
h. carry out initial management of wound
i. repair minor wounds
j. complete primary management of fractures and arrange transfer to appropriate
centers.
k. apply splints, slings, POP casts and slabs, tractions, bandages, sterile dressings

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 Distribution of teaching - learning hours Surgery & Allied Subjects

Small group Clinical/Bedsid

Phase integrated teaching

Departmental integrated

Summative examination
Formative examination
Lecture (in hours) teaching (in e teaching

teaching (in hours)

hours) (in weeks)

Block posting
Total weeks

(in weeks)
(in hours)

(in days)

(in days)
PBL, Practical
Subject demonstration ,

2nd Phase

2nd Phase
3rd Phase

3rd Phase
4th Phase

4th Phase
Instrumental

Total
demonstration,
Skill lab, Tutorial
& etc.
General surgery 35 30 60 125 15 01 07 23
Orthopaedic surgery - 15 45 60 02 04 04 10
Radiology - - 05 05 01 - - 01

Preparatory leave-10 days

Preparatory leave-10 days

Radiotherapy - - 08 08 - 01 - 01

Exam time-15days

Exam time-30days
Anesthesia - 10 - 10 01 - - 01
Neurosurgery - - 05 05 (11 topics ×2 (42 topics × 3 - 01 - 01
134 hours
Pediatric surgery - 05 10 15 hours) = 22 hours) = 126 - - 02 02 04 wks
Urology - 05 10 15 hours hours - - 02 02
Burn & Plastic surgery/ - - 05 05 01 01
Emergency & Casualty - -

Dentistry - - - - 01 01
Ophthalmology - 38 38 - 04 04 08
Otolaryngology - 38 38 - 04 04 08
Total 324 134 22 126 hrs 20 15 24 59 wks 04 wks 25 days 40 days
Grand Total 480 hours 126 hrs 63 weeks 65 days
Time for integrated teaching, examination preparatory leave and formative & summative assessment is common for all subjects of the phase
Preventive aspects of all diseases will be given due importance in teaching learning considering public health context of the country and others parts of the world.
Related behavioral, professional & ethical issues will be discussed in all clinical and other teaching learning sessions

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 Surgery & Allied Subjects: Hours distribution for Clinical/Bedside teaching in 2nd, 3rd & 4th phases in details
Clinical/Bedside & Ambulatory care teaching (in hours)
2nd Phase 3rd Phase 4th Phase
Total weeks
Indoor clinical/ bedside teaching Indoor clinical/ bedside teaching Indoor clinical/ bedside teaching

(in three phases)

& & &

Total hours
{(2nd phase wks
Ambulatory care teaching Ambulatory care teaching Ambulatory care teaching
Subject + 3rd phase wks
Morning Evening Morning Evening Morning Evening + 4th phase wks
= Total three phases wks)
Indoor/ OPD/ Indoor/ Indoor/ OPD/ Indoor/ Indoor/ OPD/ Indoor/
Emergency & Emergency & Emergency & Emergency & Emergency & Emergency & × (6 days × 4 or 2 hours)}
Casualty Casualty Casualty Casualty Casualty Casualty
21 weeks 15 weeks 24 weeks
General surgery 180 h (15w) 180 h (15w) 12 h (1w) 12 h (1w) 84 h (7w) 84 h (7w) 552 h (15+01+07) = 23 w× (6 days × 4 hrs)
Orthopaedic surgery 24 h (2w) 24 h (2w) 48 h (4w) 48 h (4w) 48 h (4w) 48 h (4w) 240 h (2+4+4) = 10 w× (6 days × 4 hrs)
Radiology 12 h (1w) - - - - - 12 h (1+0+0) = 01 w× (6 days × 2 hrs)
Radiotherapy - - 12 h (1w) - - - 12 h (0+1+0) = 01 w× (6 days × 2 hrs)
Anesthesia 12 h (1w) 12 h (1w) - - - - 24 h (1+0+0) = 01 w× (6 days × 4 hrs)
Neurosurgery - - 12 h (1w) 12 h (1w) - - 24 h (0+1+0) = 01 w× (6 days × 4 hrs)
Pediatric surgery - - - - 24 h (2w) 24 h (2w) 48 h (0+0+2) = 02 w× (6 days × 4 hrs)
Urology - - - - 24 h (2w) 24 h (2w) 48 h (0+0+2) = 02 w× (6 days × 4 hrs)
Burn & Plastic surgery/
- - - - 12 h (1w) 12 h (1w) 24 h (0+0+1) = 01 w× (6 days × 4 hrs)
Emergency & Casualty
Dentistry 12 h (1w) - - - - - 12 h (1+0+0) = 01 w× (6 days × 2 hrs)
Ophthalmology - - 48 h (4w) 48 h (4w) 48 h (4w) 48 h (4w) 192 h (0+4+4) = 08 w× (6 days × 4 hrs)
Otolaryngology - - 48 h (4w) 48 h (4w) 48 h (4w) 48 h (4w) 192 h (0+4+4) = 08 w× (6 days × 4 hrs)
Total 240 hrs 216 hrs 180 hrs 168 hrs 288 hrs 288 hrs 1380 hrs 59 weeks

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 Teaching-learning methods, teaching aids and evaluation
Teaching Methods Teaching aids In course
Large Small group Self Others evaluation/
group teaching learning Formative
Tutorials, Computer, Item
Lectures Problem Based Assignment, Integrated Chalk & board, OHP, Examination
Learning, Self study teaching, Multimedia, Card final,
Clinical demonstrations Photographs &Videos, Term
OPD / indoor Visit to Specimens, & Models, Examination
attending & observing radiotherapy Plain & Contrast X-rays Term final
minor operations Attend centers of Upper & lower GIT, (written, oral+
Demonstrations of where I.V.U, Fractures practical +
X-rays specimen, investigations for Skull X-rays clinical)
Observations in hearing Sinogram & Marks
ICU, Postoperative impairment, Fistulogram distribution:
ward, Case Presentation vertigo, Tinnitus Ultrasonogrphy, a) Surgery—
and discussion. are available. Abdomen I. Card final-3
Skill lab practice HBS & Pancreas II. Term Final-2
Urinary tract III. MCQ of
Scans, thyroid scans, Integrated
C.T. Scan, MRI, PET teaching-5
Scan, Bone scan, b) Ophthal- 5
Doppler and duplex c) ENTD-5
imaging.
Immunohistochemistry

Final professional Examinations:

Marks distribution for assessment of surgery
Total marks Surgery and allied Subjects – 500
 Written = 200 (Formative Assessment-20 +(MCQ- SBA & MTF) 40+ (SAQ
+SEQ) 140 =200)
 Structured Oral = 100 (60+20+20)
 Clinical = 100 (60+20+20)
 Practical (OSPE/OSCE) = 100 (60+20+20)
Total in Surgery and allied---500.

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Related Equipments:

General surgery Materials

a. Sets -butterfly needle & cannula, Infusion and g. Special-Lane’s twin gastro jejunostomy clamp,
Transfusion sets proctoscope, metalic urethral dilators,
b. Tubes--Feeding tubes, NG tube, Flatus tube , ‘T’ nephrolithotomy forceps, Bone nibbler,
tube, Chest drain set, Endo-tracheal tube Osteotome, chisel, hammer, amputation saw,
c. Bags- Blood bags, Stoma bags, Fluid bags, SPC set, CV line set, Spinal needle,
Nutrition bags, Urine bags, Drain bags, Bi- h. Orthopedic--Plaster of Paris bandage, crepe
channel bandage, Splints supporting aids- Cervical
d. Sharps- BP blade and handle, surgical scissors, collar, Circle brace, artificial limb,
Needle holder, Surgical suture materials, Gloves, i. Anesthesia- machine, Laryngoscope, airway
gown, mask, caps, surgical goggles tube, Umbo bag, pulse oximetry, Digital
e. Forceps-Sponge holding forceps , towel clip, Thermometer, Oxygen cylinder with devices
Alli’s tissue forceps, artery forceps, Sinus
forceps, dissecting forceps, Kocher’s artery (These equipment may be used in OSPE
forceps, kidney tray, gully pot, intestinal clamps,
procedure stations)
f. Retractors—Deavers, abdominal, Morris
abdominal retractor, Langhanbach’s retractor,
ENTD
Boyle Davis mouth gag,
Thudicum nasal speculum, Luc’s tongue depressor,
Killians self retaining nasal speculum, Draffins bipod metallic stand,
Lichwitz antrum puncture trocar and cannula, Eve’s tonsillar snare,
Higginson’s rubber syringe, Walsham’s forceps, St Clare Thomson Adenoid curette and cage,
Luc’s forceps, Tilleys forceps,
Trousseau’s tracheal dilator,
St Clair Thomson post nasal mirror,
Jobson horne probe and ring curette, Jackson’s metallic tracheostomy tube,
Tuning fork, Direct laryngoscope
Head mirror, Chevalier Jackson’s oesophagoscope,
Negus bronchoscope etc.

Ophthalmology
Trial lens, trial frame, Iris repositor, lens dialer, two way cannula,
Eye speculums (Wire, Universal), chalazion clamp and scoop, corneal forceps,
DCR punch, Tonometer, Ophthalmoscope, Cat’s irrigating vectis, sac guard, sac dissector, lacrimal
paw retractor, BP Blade & handle, Keratome, Squint probe, punctum dialtor etc.
hook

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 Learning Objectives and Course Contents in Surgery
Learning Objectives Contents Teaching
Hours
A. Basic and Principles of Surgery CORE
Phase II
Student should be able to: 1. History, evolution and scope of surgery 20 hours
1. state the history , evolution and scope of Surgery 2. Approach to a surgical patients
2. assess and prepare patient for surgery 3. Surgical diagnostic process and techniques
3. understand the patho-physiology of trauma 4. Surgical Infection (Boil , Furuncle, Abscess,
4. diagnose, treat and manage minor wounds Carbuncle , cellulites)
5. diagnose, treat and manage surgical infections ( boil, abscess, 5. Septicemia ( causes, complications and treatment)
carbuncle & gangrene) . 6. Sinus, Fistula and cysts
6. diagnose and provide basic treatment for shock & haemorrhage. 7. Wounds (classification and management)
7. recognize all external hernias & their complications & initiate 8. Ulcers , pressure sores
primary care for complicated hernias. 9. Groin hernias
8. recognize & differentiate different types of burns and initiate primary 10. Haemorrhage
care &take measure to prevent complications. 11. Shock
9. recognize fluid & electrolytes imbalance states, investigate & initiate
appropriate therapy. Phase III
10. recognize, & investigate different types of skin ulcerations. 12. Metabolic response to injury
11. recognize, investigate & treat superficial skin tumour & cysts 13. Principles of Management of Trauma 10 hours
12. take appropriate measures to prevent hospital infection. 14. Management of a severely injured patient
13. understand and comply with ethical principles in clinical practice 15. Fluid and electrolytes balance
16. Enteral and Parenteral nutrition

10 hours
Phase IV
17. Pre operative assessment and preparation
18. Tumours of skin
19. Lymphadenopathy
( causes, investigations, diagnosis, biopsy )
20. Surgical ethics

ADDITIONAL
Organ transplantation, Robotics in surgery

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 Learning Objectives Contents Teaching
Hours
B. Systemic Surgery CORE
1. Alimentary System Phase II 5 hours
Complications of Peptic ulcer
Student should be able to : (Perforation, Pyloric stenosis)
1. investigate and diagnose the common surgical diseases of Upper G.I. Tract bleeding
alimentary system and suggest management Appendicitis
Intestinal obstruction;
2. diagnose the acute conditions of alimentary system and
initiate primary care Phase III
Abdominal trauma (Diagnostic and Management principles)
Ruptured Spleen
3. identify the patient requiring specialty surgical intervention Ruptured liver 5 hours
& refer to appropriate centre Ruptured intestine

4. take continued care of the operated patients Phase IV

Tongue, Lip & other oral lesions (ulcer, cancer )
Oesophagus
5. recognise post operative complications & take appropriate Carcinoma oesophagus and stricture
measures. Carcinoma stomach
Neoplasm of colon and rectum
Intestinal tuberculosis 5 hours
Anal canal Haemorrhoids, Fistula, Sinus & Fissure,
Carcinoma anus
Colostomy & ileostomy (indications and management)

Abdominal incisions (Tutorial)

ADDITIONAL
Intra abdominal abscess
Diseases of salivary glands
Hiatus hernia.

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 Learning Objectives Contents Teaching
Hours
2. Genito-Urinary System CORE

Student should be able to- Phase III

1. Urinary symptoms & definitions
1. diagnose common congenital G.U. anomalies & advise / 2. Urological investigations and their interpretations,
refer to appropriate centers 2. Developmental genito-urinary anomalies
2. diagnose and manage acute GU conditions like 3. Scrotal swelling 20 hours
 Acute retention of urine  Hydrocele
 Acute epidedymo- orchitis  Scrotal cellulitis
 Torsion testis 4. Acute scrotal conditions
 Paraphimosis  Epididymo- orchitis
 Phimosis  Torsion testis
 Acute ureteric colic Phase IV
 Urosepsis 5 Urolithiasis (Causes ,Diagnosis , Principles and modalities
of treatment)
3. evaluation of scrotal swelling 6 Retention of urine ( acute and chronic
4. evaluate a case of haematuria 7 Hydronephrosis
5. order necessary investigations, and interpret the result of 8 UTI
investigation & suggest principles of management 9 Urinary tract injury.
10 hours
 Renal injury
 Urethral injury
6. recognize a case of retention of urine , find out causes 10. Renal Neoplasm
perform aseptic catheterization  RCC
7. introduce suprapubic catheter  Wilm’s Tumour
8. describe the steps of circumcision 11 Testicular Tumour
12 BPH
13 Stricture urethra

ADDITIONAL

 Male infertility
 Minimal Invasive Surgery in Urology

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 Learning Objectives Contents Teaching Hours
3 Hepatobiliary & Pancreas CORE
Phase II
Student will be able to: Cholelithiasis (causes and complications) 5 hours
1. diagnose, investigate cholecystitis, cholelithiasis & Cholecystitis (acute & chronic)
Choledocholithiasis Pancreatitis (acute pancreatitis)
2. suspect pancreatitis; initiate primary case
management & suggest management Phase IV
3. investigate & interpret the results in case of Obstructive jaundice
obstructive jaundice & suggest appropriate treatment Pancreatic tumours
4. diagnose & investigate suspected case of liver & Liver abscess
sub-phrenic abscess & suggest appropriate 5 hours
treatment. ADDITIONAL
Hepatic neoplasm
Cysts of liver
Neoplasm of Gall Bladder 4 hours

4 Endocrine & Breast

CORE
Phase IV
Students will be able to:
1. assess, investigate & diagnose thyroid swelling & Thyroid 4 hours
thyrotoxicosis and suggest principles of Goitre and Neoplasms of thyroid
management Breast
2. diagnose & manage a case of breast abscess Breast pain, Mastitis and Breast Abscess
3. assess, investigate & interpret the status and Fibro-adenosis and Fibroadenoma 4 hours
diagnose a case of breast lump & suggest principles Carcinoma of breast
of treatment. ADDITIONAL
Diseases of adrenal gland
Diseases of Parathyroid gland 2 hours

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 Learning Objectives Contents Teaching
Hours
5 Chest CORE

Phase IV
Students will be able to: Chest injury (Haemothorax, Pneumothorax) 3 hours
 assess & diagnose traumatic haemopneumo-thorax, associated Chest tumours, Chest drain,
injuries & introduce water seal drain in appropriate case.
ADDITIONAL
Dysphagia
Empyaema thoracis

6. Cardio-vascular System CORE

Phase III
Students will be able to:
Vaso occlusive disorders
1. recognize chronic ischaemic conditions of limbs Atherosclerosis, 5 hours
2. take appropriate preventive measures & refer to Buerger’s disease
specialized centre. Varicose vein
3. take appropriate measure to prevent DVT Thrombophlebitis
4. recognize early cases of DVT Deep vein thrombosis

ADDITIONAL
Pulmonary embolism
Angioplasty, CABG and cardiac surgery
7. Plastic & Reconstructive
Core
Students will be able to Phase IV 5 hours
1. manage Burn patient and minimize their complications Burn (Causes, complications and management)
2. take any major wound care Skin grafting
3. suggest measures for con. External deformity & Skin tumours,
disfiguration Special area burn , Inhalation and electric burn

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 Learning Objectives Contents Teaching
Hours
8. Neuro surgery CORE
Phase IV
Head injury 5 hours
Students will be able to: ICSOL
PLID
1. provide primary care of head injury & Spinal injury cases. Paraplegia/hemiplagia
2. take measures to prevent complications in neuro surgical
patients. ADDITIONAL
3. involve effectively in continued care & rehabilitation of Hydro cephalus
neuro surgical cases. Tumours of brain
Tumours of spinal cord

9. Operative Surgery CORE

Phase III 5 hours
Principles of Asepsis & Antisepsis
Student should be able to perform: Pre-operative assessment & preparation
1. primary & delayed primary & Secondary suture closure of Venus access
wounds Cricumcision
2. Circumcision Operation for hydrocele
3. Vasectomy Repair of D.U perforation
4. drainage of superficial Abscess Wound care
5. Venesection
6. Hydrocele operation Tutorials
7. excision of superficial cysts & tumours Universal precautions (Scrubbing , gloving & gowning) 5 hours
8. dressing of surgical wounds O.T. environment & behavior
Preoperative skin preparation and draping
Suturing materials ,Stitches

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 Learning Objectives Contents Teaching
hours
Phase IV
Student should be able to : Common Abdominal incision 10 hours
Operation for inguinal hernia
 assist in common major operations & take post Drainage of abscesses
operative care Catheterisation , Supra-pubic cystostomy
Anastomosis
Appendicectomy
Cholecystectomy
Gastrojejunostomy
Basic principles of Laparoscopy.
Additional
Thyroidectomy, Nephrectomy, Mastectomy / Prostatectomy
10. Orthopedic Surgery CORE

Student should be able to: Phase III

 apply ATLS protocol to provide resuscitation of a) General Orthopedics
polytrauma patient.  Introduction to orthopaedics
 manage simple and undisplaced factures  Hard tissue trauma :- 5 hours
 demonstrate skill in wound excision of open fractures . - Fracture classification
 demonstrate skill in: - Principal of management of open and closed facture
 application of splints, slings , traction. - Fracture healing –nonuninon, malunion, delayed union.
 application of plaster cast and slab  Infection of bone (Acute and chronic osteomyelitis)
 plaster techniques and design
10 hours
 versatility & possible complications of plaster Phase III
 the art of application of plaster & its’ removal b) Regional orthopedics
 manipulative reduction of common fracture and Upper limb
dislocation. Colles’ fracture Supracondylar fracture
 aseptic technique of joint fluid aspiration. Clavicle fracture
 diagnose and outline treatment for acute Radius Ulna fracture (Shaft)
osteomylities and septic arthritis Humerus fracture (Shaft)
 identify patient for referral to appropriate centre Lower limb
 demonstrate knowledge and understanding of the Fracture of Shaft of femur
basic principle of physiotherapy and Fracture of Tibia fibula
rehabilitation.

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Learning Objectives Contents Teaching
Hours
Phase IV
Regional Orthopaedics 45 hrs
 Upper Limb
Hand injuries and Hand Infection
 Lower Limb
Frac ture of Neck of femur
Fracture of Pelvis
Ankle and foot injuries
Amputations
Additional
Dislocation – Hip, Haemarthosis
 Soft tissue trauma (muscle and tendon injuries,
compartmental syndrome)
.
 Infection of joint including osteoarticular tuberculosis

 Mass Casualty- ATLS, Disaster management.

 Bone tuberculosis
Additional
Dislocation of shoulder and elbow

b) Paediatric orthopedics :
Congenital anomalies-talipes, DDH, Bow legs, Polydactyly, Claw
c) Bone tumors :
Classification of bone tumor
Common benign and malignant bone tumor – osteochondroma, Giant
cell tumor, Osteosarcoma, Metastatic bone tumor.
Vertebral fracture – (primary management, transportation.
Principles of definitive management)
Additional
d) Tendinitis, Tenosynovitis, bursitis.

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 Learning Objectives Contents Teaching
Hours
11. Anaesthesiology Phase III
CORE
a) Anesthesia as a subject: its scope, outline- present & future 10 hours
Student should be able to : b) Anesthesia Pharmacology:
 be aware of the safety in Anaesthesia. Drugs: induction, maintenance, muscle relaxants
 be aware of the possible complications & c) Intra-operative management
management d) Post-operative management and complication
 demonstrate basic knowledge and perform Cardio- e) General GAnes (G.A)
Pulmonary Resuscitation (CPR) f) Local/Regional anesthesia
 describe the scope of Anaesthesia in rural g) Management of Pain (chronic)
environment. h) Intensive Care Unit (ICU)
i) Basic life support.
j) Cardio-Pulmonary Resuscitation (CPR)
Practical Skills
Exposure to practical procedures (Tutorial) :
Student should be able to perform :
 Pre-operative assessment
 pre-operative assessment
 Induction
 induction
 Endo tracheal Intubation
 intubation
 CV line
 I/V line
 Artificial ventilation
 artificial ventilation
 Face mask ventilation.
 post-operative room care
 Recovery room experience

362
 Learning Objectives Contents Teaching Hours

12. Radio Diagnosis & Imaging CORE

6 hours
Phase IV
Student should be able to :
 demonstrate knowledge and understanding of the principles  Introduction of radiology & imaging including
of radiology and imaging CT & MRI
 appreciate the importance of imaging as investigation &  Hazards of radiation and protection for personals,
diagnosis of clinical conditions and patients.
 describe the hazards of radiation  Principles of ultra-sonography & its clinical
 describe the protection measures for personal patient and the application
community.  Plain & contrast X-Rays
 write proper requisition for various x-rays & imaging.  Interventional imaging
 USG
X-RAY Chest

2 hours
Student should be able to :
 differentiate normal anatomical images from those due to
pathological states, CORE:
 diagnose the common conditions like tuberculous  Normal and pathological image
consolidation, pleural effusion, pneumothorax, lung abscess,  Pneumonic and Tuberculous consolidation
collapse, bronchogenic carcinoma.  Pleural effusion
 make radiological diagnosis of mediastinal masses  Pneumo Thorax
Additional
 Lung abscess
 Mediastinal mass

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 Learning Objectives Contents Teaching
Hours
Gastro intestinal system
Core:
Student should be able to :  Plain X-ray findings of Acute abdomen.
 diagnose intestinal obstruction, perforation etc.  Indications & contraindicatious for barium studies.
 recognise indications and contra-indication for barium Hepatobiliary system
studies e.g. meal, swallow, follow-through & enema. Cholangiogram & ERCP
 make differential diagnosis of stones & calcification on plain
X-Ray.  USG of HBS and Pancreas
 diagnose gastric ulcer, duodenal ulcer, growth in the
stomach, oesophageal cancer on barium studies. Additional: MRCP
 interpret the finding of cholangiogram.

Skeletal system CORE

 Diagnosis of common fractures of upper and lower
Student should be able to : limb
 diagnose common fractures, dislocations & bone tumours  skull fractures
bone infections with the help of X-rays
 Spinal fractures and caries spine
 Acute osteomyelitis
 common bone tumours
Excretory System  diseases of joints
Should be able to :  dislocations
 identify renal calculi in plain X-ray CORE
 understand USG & IVU findings in renal stone and other  X-ray KUB & IVU
renal diseases.  USG of Kidney, Ureter , Bladder and prostate

364
 Learning Objectives Contents Teaching Hours

13. Radiotherapy Phase IV

CORE
Introduction to Radiotherapy
Students will be able to: Radiation oncology, basic principles and practices :
 appreciate the role of radiotherapy in the management  Aims of radiation oncology
of cancer  Sources of radiation , Isotopes and their mechanism of action
 demonstrate knowledge of radiation  Curative/Palliative radiotherapy
 identify different sources of radiation  Radiosensitivity, radioresistance, radiocurability and normal 5 hours
 refer the patients to radiotherapy department tissue tolerance.
 recognize common radiation hazards after primary  Common radiation reactions and management.
care
Medical oncology, basic principles and practice :
 Cell cycle and Mechanism of action of cytotoxic drugs
 Clinical aspect of cancer chemotherapy
 Complications of chemotherapy (Infection and bleeding
Students will be able to:
tendency)
 recognise common cytotoxic drugs.
 Chemotherapy of common cancers,
 refer appropriate cases for chemotherapy.
 Common Chemotherapeutic regimes
 recognise common complication & offer primary
care.

365
 Teaching Hours
Learning Objectives Contents

Students will be able to: Prevention of common cancer :

 appreciate the role of doctors in prevention and early diagnosis
of cancer & referral of cancer patients.  Primary prevention, Secondary prevention 1 hour
 Early diagnosis
 take leadership in the community to offer rehabilitative support  Referral to appropriate centre

 offer follow up & terminal care of cancer patients. Palliative support and terminal care :

 recognise clinical condition as which could be diagnosed by  Follow-up of cancer patients and terminal care
radio-isotope & interpret the results. 1 hour
Nuclear Medicine, basic Principles and practice :
 recognise diseases requiring isotope therapy.
 Radio-isotope in diagnosis
 Radio-isotope in therapy 1 hour

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 Teaching
Learning Objectives Contents Hours

14. Paediatric Surgery

CORE
Phase III
Students will be able to:  Examination of a child and neonate (Special 5 hours
considerations)
 identity common paediatric surgical problems including
emergencies.  Infantile Inguino scrotal swellings
 initiate primary care  Acute abdomen in infants & children
 refer the cases to appropriate hospital  Congenital hypertrophic pyloric stenosis

Phase IV
 Neonatal/Infantile intestinal obstruction
 Intussusception
 Anorectal malformations.
 Maldescended Testis
 Torsion Testis
 Haemangioma and other Cutaneous lesions
 Child-hood tumours.
 Rectal bleeding and prolapsed rectum

Tutorials
 Cystic hygroma, Branchial fistula 10 hours
 Phimosis/balanitis
 Paraphimosis
 Phimosis/balanitis
 Paraphimosis

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Appendix-1
COLLEGE
MONOGRAM Photograph of the
student

CLASS PERFORMANCE RECORD CARD

DEPARTMENT OF SURGREY
----------------------------- Medical College
Bangladesh.

Name of the student: ...............................................................................................................

Father’s Name: ………………………………Mother’s Name………………………………
Address: -- Village/road with no……………………………………………………………
m

P.O: ……………………………P.S: ………………………..Dist: ……………………….

Postal Code no…………………….Country: …………………………………………….
Telephone No: ………………………………..Mobile No: ………………………………..
Batch................................... Roll No: ................. Admission Session......................................
Local Address: ............................................................. ……………………………………..
Hostel:-……………………………………………………. Room No: ...........................
Year of admission in 1st year MBBS...................................................................................
Promoted to 3rd year: Jan/ July - Year......................................

2nd Professional examination due in- Jan/ July- Year......................................

2nd professional passed on Jan/July-Year……………………………………
3rd Professional due on Jan/July, Year-----------------------------------------------
3rd Professional Passed on Jan/July-----------------------------------------------------
Final Professional examination due in- Jan/ July- Year......................................

For foreign students

Citizenship: .......................................Passport no………………………………

368
 SURGERY- Card-One

Cl. Reg. No. Card No. 1 (One) :12 wk

Roll No. Year 3rd year

Group Total marks 100

Batch Pass marks 60%

Name of the student

Period of placement From : To : Unit :

Professor / Asso. Professor in charge

Academic Co-ordinator

CLINICAL Satisfactory /
No. Unsatisfactory Marks Signature

1. Rapport development with patient and hospital

supporting stuffs
2. History taking and writing (at least 10 different
cases)
3. General examination and general principle of
examination
4. Examination of swelling, ulcer, sinus, fistula, etc.
(at least 10 different cases)
5. Examination of
a) Inguino-scrotal swelling
b) Vascular system
6. Examination of chronic abdominal conditions. (5
cases)
a) G.I. tract condition
 Lumps in different quadrants.
 Gastric outlet obstruction
b) Hepato biliary conditions
c) Pancreatic conditions
Examination of acute abdominal conditions
 Acute Appendicitis
7.  Perforation of the hollow viscus
 Acute Pancreatitis
 Intestinal obstruction
Short cases in out patient clinics
 Lipoma, Neurofibroma
8.  Cyst, Ganglion, Keloid
 Haemangioma, Umbilical
 Inguinal Hernias ,Hydrocele

369
 PRACTICAL Satisfactory /
No. Unsatisfactory
Marks Signature

1.
5-infusions are to be observed & recorded
2.
10 I.M. injections are to be given & recorded
3.
Observe Ryles tube introduction in 5 cases
4.
10 X-rays are to be seen & findings recorded
5. 6 operations are to attain & observe in OT &
record
6. Specimen-Gallstone, G. Bladder, Appendix,
Urinary stones, Breast lump
7.
Instruments

TUTORIAL
1.
Shock
2.
Fluid electrolyte balance
3.
Sterilization, Tetanus, gas gangrene
4.
Gangrene, Boil, abscess, carbuncle, ulcers
5.
Sepsis and asepsis in surgery
6.
Preoperative & postoperative care

OFFICIAL RECORD
(To be completed by department of Surgery)

Date of issue of Card

Date of return of the Card

Date of entry of the Result

Date of issue of next Card

Card No.
Excellent/Good/ Satisfactory /Unsatisfactory/ to be repeat

Remarks and Counter signature of Registrar

Unit Chief Depa rtment of Surgery

370
 Neurosurgery (1wk)

CLINICAL Satisfactory/
No. Marks Signature
Unsatisfactory

1. Examination of Neurosurgical patients

2. Examination of Hydrocephalus, Meningocele, Brain
tumours, Extradural & Sub dural haemorrhage, Brain
Abscess
5. Examination and assessment of Head injury patients.
6. PLID- Back pain

CARD COMPLETION EXAMINATION

Attendance out of

Total marks obtained in items Percentage

Marks obtained in card Percentage

Completion
Remarks

Registrar
Unit chief of Neuro-Surgery Neuro Surgical Unit

OFFICIAL RECORD
(To be completed by department of Surgery)
Date of issue of Card
Date of return of the Card
Date of entry of the Result
Date of issue of next Card
Card No.

Remarks and Counter signature of Dealing Assistant

Academic Co-ordinator Department of Surgery

371
Cl. Reg. No. Card no. 2 (Two)-A
Roll N0. Year 4th year
Group Total marks 100
Batch Pass marks 60%

ORTHOPAEDIC & TRAUMATOLOGY

Name of the
student
Period of From: To: Unit:
placement
Professor/Associ
ate Professor
Academic
coordinator

. CLINICAL Satisfactory/ Marks Signature

Unsatisfactory
1. General principle of Musculoskeletal 1
history taking
2. General principle of Musculoskeletal 2
examination
3. Clinical examination of Hand & Wrist, 3
Elbow& Shoulder.
4. Clinical examination Hip, Knee, Foot & 4
Ankle.
5. Examination of Bone disorders – Chronic 5
pyogenic osteomyelitis, Bone tumours.
6. Examination of fractures & dislocations 6
7. Examination and assessment of polytrauma 7
patient.
8. Examination of bones & joints deformity, 8
club foot.

372
 No. PRACTICAL Satisfactory Marks Signature
/Unsatisfactory
1 ORTHOPAEDICS
a. Splint, Bandage, technique of
immobilization-Plaster slab & cast.
b. Observation of orthopaedics OT
2 CASUALTY
a. At least five emergency cases to be
received at Emergency Department &
recorded.
b. At least five minor wounds to be
repaired.
c. At least three operations are to be
assisted.
3 X-ray of fractures, dislocations,
tumours and osteomyelitis
Specimens of BoneTumours and
Ostemyelitis
Common Orthopaedic Instruments
TUTORIAL
1 Fracture, Complication
2 Dislocation, Subluxation
3 Open fracture Management

CARD COMPLETION EXAMINATION

Attendance Out of
Total marks obtained in
items Percentage
Marks obtained in card
completion Percentage
Remarks
Excellent/Good/ Satisfactory /Unsatisfactory/ to be repeat

Professor of Orthopeadics/Unit Chief Registrar (Ortho Unit- )

373
 ORTHOPAEDIC & TRAUMATOLOGY

Card No. 2 (Two)-B

Cl. Reg. No. Year 5th year
Roll No. Total Marks 100
Group Pass marks 60%
Batch

Name of the Student

Period of placement From: To: Unit:
Professor/Associate
Professor
Academic
coordinator

N CLINICAL Satisfactory/ Marks Signature

. Unsatisfactory
1 Review on General principle of Musculoskeletal history
taking&examination
2 Clinical examination of upper & lower extremities.
3 Principle of examination of muscles, tendons & joints
instabilities.
4 Examination of muscles, tendons & joints instabilities of
Knee& Shoulder.
Examination of Spine& spinal cord injury.
6 Examination of peripheral nerves.
7 Long cases presentation & discussion.
8 Short cases presentation & discussion.

374
No. PRACTICAL Satisfactory/ Marks Signature
Unsatisfactory
ORTHOPAEDICS
1 a. Use of functional braces, Walking aids, Caliper.
b. Observation of orthopaedics OT & Operations (At
least five)
2 CASUALTY
a. At least five emergency cases to be received at
Emergency Department & recorded.
b. At least five minor wounds to be repaired.
c. At least three operations are to be assisted.
3 X-ray of fractures, dislocations, tumours and osteomyelitis
Specimens of Bone Tumours and Ostemyelitis & others
Common Orthopaedic Instruments

TUTORIAL

1 Bone tumours& Osteomyelitis

2 Children fractures& Compart ment Syndrom

3 Mass casualty & ATLS

CARD COMPLETION EXAMINATION

Attendance Out of
Total marks obtained in Percentage
items
Marks obtained in card Percentage
completion
Remarks

Professor of Orthopaedics/Unit Chief Registrar Ortho unit---

375
 SURGERY-CARD-Three

Cl. Reg. No. Card No. 3 (Three) 10 wk

Roll No. Year 5th year

Group Total marks 100

Batch Pass marks 60%

Name of the student

Period of placement From : To : Unit :

Professor / Associate Professor

Academic Co-ordinator

CLINICAL Satisfactory /
No. Unsatisfactory Marks Signature

1. Examination of neck swelling

 Lymph Nodes
 Thyroid
 Thyro glossal Cyst
2. Examination of extremities for peripheral vascular
conditions
3. Examination of chronic abdominal conditions. (5
cases)
a) G.I. tract condition
 Lumps in different quadrants.
 Gastric outlet obstruction
 Ascitis
b) Hepato biliary conditions
c) Pancreatic conditions
Examination of acute abdominal conditions
 Acute Appendicitis, lump
4.  Perforation of the hollow viscus
 Acute Pancreatitis
 Intestinal obstruction
5. Examination of face & oral cavity, paritid
Examination of breast & axillary's lymph node
6.
(Benign & Malignant tumours)
7. Examination of anorectal condition
UROLOGY(2 Wk)
Examination of Genitor-Urinary system
a. Hydronephrosis, Kidney tumours
b. Bladder tumours
8. c. BEP & Carcinoma Prostate with Retention of
Urine
d. Scrotal Swellings, Epididymo orchitis
e. Hypospedias, Phimosis, Para phimosis

376
 PAEDIATRIC SURGERY (2 WK)

Examination of Paediatric surgical cases

 Anorectal malformation
 Hernias
9.  Urogenital malformations
 Congenital Hypertrophic Pyeloric stenosis
 Cleft lip, palate.
 Haemangioma, Cystic Hygroma, Branchial
cyst
 Neonatal Intestinal obstruction
Short cases in out patient clinics
 Lipoma, Neurofibroma
 Cyst
 Haemangioma
10.
 Inguinal Hernias ,Hydrocele
 Neck swellings
 Breast tumours & abscess

PRACTICAL
1.
Ten complete histories with clinical examination are to
be taken & recorded (2 of pediatric surgery, 2 of
Urology)
2. Three proctoscopic examination are to be done &
recorded
3.
Observe surgical dressings & stitch-usually in 3 cases.
4. Ten X-rays (Including Urological) are to be seen and
findings recorded
5.
Three operations are to be assisted
6.
Observe & introduce urethral Catheter in 5 cases
7. Specimen-Ca-Breast, Prostate, Sequestrum, Stomach,
Thyroid, testis, Gallstones & Urinary stones.

TUTORIAL

1.
Gastro-intestinal bleeding
2.
Acute abdomen
3.
Surgical jaundice
4.
Chronic abdominal condition
5.
Burn, Fluid & electrolytes, Parentral Nutrition
6.
LUTS, Haematuria
7.
Retention of urine

377
 CARD COMPLETION EXAMINATION
out of
Attendance
Percentage
Total marks obtained in items
Percentage
Marks obtained in card Completion

Remarks

Registrar
Unit Chief of Surgery Surgical Unit

OFFICIAL RECORD
(To be completed by department of Surgery)

Date of issue of Card

Date of return of the Card

Date of entry of the Result

Date of issue of next Card

Card No.
Excellent/Good/ Satisfactory /Unsatisfactory/ to be repeat

Remarks and Counter signature of Registrar

Unit Chief of Surgery Department of Surgery

378
 Ophthalmology
Departmental Objectives
The objective of this course is to provide need-based education so as to produce a quality doctor who
will be able to
 deal with common ocular ailments
 identify, give initial management & refer ocular emergency cases appropriately
 provide leadership in the sphere of primary eye care in the country as well as abroad.

To achieve the above mentioned departmental objectives, the following learning objectives will be
required:
List of Competencies to acquire:
1. Measure visual acuity of adult and children, a. unaided b. with pin hole c. with glass;
2. Examine color vision & examination of visual field (confrontation method)
3. Examine ocular movement and alignment; assessment of pupillary light reflex (direct and consensual)
4. Perform direct ophthalmoscopy.
5. Perform digital tonometry.
6. Perform Regurgitation test of lacrimal sac.
7. Perform Fluorescein dye test, irrigation of conjunctival sac & installation of eye drops/ointment.
8. Perform eversion of upper lid & removal of conjunctival foreign body.
9. Diagnose and give treatment of bacterial conjunctivitis, vitamin A deficiency disease (night blindness,
Bittot’s spot, xerophthalmia), initiate treatment of minor trauma, correction of simple presbyopia and
referral of difficult cases.
10. Diagnose and initiate treatment and referral of ocular emergency cases:
a. trauma, b. painful red eye. c. corneal ulcer/keratits, d. corneal foreign body, e. acute dacryocystits.
11. Diagnose and referral for specialist management: cataract, chalazion, pterygium, leucocoria of
children, squint, cases with reduced vision

Fundamentals and principles of ophthalmology

Goal: The students will have the overall understanding of external and internal ocular structures of
the normal human eye and will be able to perform the eye examination in normal and disease
conditions.

Topic Specific objectives:

At the end of the teaching of the course the students will be able to:
 describe normal ocular anatomy.
 obtain detail ocular history.
 measure and record visual acuity in adults and children.
 assess pupillary reflexes.
 evaluate ocular motility.
 use the direct ophthalmoscope for gross assessment of red reflex, the optic disc and fundus
examination.
 perform and evaluate visual fields by confrontation.

379
Specific contents in this subject will include:
A. Ocular Anatomy.
Students should be able to define gross anatomy of the eyeball& adnexa
1. Eyelids.
2. Extraocular muscles.
3. Lacrimal apparatus
4. Conjunctiva.
5. Cornea
6. Sclera.
7. Anterior chamber
8. Iris
9. Pupil.
10. Lens
11. Ciliary body
12. Posterior chamber
13. Vitreous cavity.
14. Retina
15. Optic disc.
16. Macula.
17. Choroid.
18. Optic nerve.

Learning Objectives
A. Knowledge components:
Students will be able to describe:
1. basic ocular anatomy
2. concept of measuring visual acuity without correction ,with pinhole and with correction
3. the importance of assessing ocular motility in the six cardinal positions of gaze and ocular
alignment in primary position
4. the basic function of ophthalmoscope
5. importance of dilatation of pupil for fundus examination
6. abnormal fundal appearance in diabetic and hypertensive retinopathy
7. the concept of measuring intraocular pressure
8. the technique of determining the peripheral visual field by confrontation method
9. referral guideline

B. Skill Components:
At the end of the course, the students will able to demonstrate the skill of:
1. examination of each eye individually.
2. test V/A each eye individually and with pinhole.
3. evaluation of the position of the lids, and inspection of the conjunctiva, sclera, cornea and
iris with a penlight.
4. examination of the pupil and assessment of the pupillary reaction.
5. ocular motility test in six positions and cover test
6. manual sac regurgitation test
7. assessment of intraocular pressure by digital method
8. performing visual field assessment by confrontation method
9. eversion of the upper lid and examine for the presence of foreign bodies
10. fluorescein dye test and its interpretation.
11. performing direct ophthalmoscopy and identify structures eg. optic disc, macula, and major
vessels.
380
C. Attitude component:
Students will show continuous interest in gaining information in the subject and at the end of the
teaching; they will be able to demonstrate the following:
a. A patient-centered role:
b. Scientific Integrity:
c. Ethical medical Professional Behavior:
d. Dedication to Continuous Learning:

Learning will be facilitated by:

Active participation in the
a. Classroom discussion
b. Completion of assignments
c. Formal presentations in tutorials.
d. Self-initiated independent thinking, presentation skill.

Evaluation:
Students will be evaluated by
a. Written examination(Short Essay test and MCQ test)
b. Formal and informal observations by instructor
c. Terms examinations
d. Final assessment together with other topics in the final Professional MBBS examination.
e. Class and ward attendance

Remediation during training:

1. The course coordinator will review the student’s performance and will:
i. Identify any specific deficits
ii. Document all areas requiring remediation or additional concentration.
iii. Provide additional recommendations for remediation of specific lackings.

Method of teaching:
a. Didactic lecture
b. In-class group session
c. Clinical class in the hospital out-patient, in-patient and Operation Theatre settings
d. Problem based discussion.

Materials
Models, power point presentation will be provided and students will get copies of handout whenever
available.

381
 Learning Objectives and Course Contents in ophthalmology
Learning Objectives Contents Teaching
Hours
Student will be able to: Orbit:
1. describe the anatomy of orbit and its contents 1. Gross Anatomy: 2 hrs
2. describe gross anatomy of the extra ocular muscles a. Bones of the orbit constituting walls, roof and floor
b. Contents of the orbit
3. diagnose orbital cellulitis, proptosis, squint /deviation and 2. Clinical examination of orbital disease:
asymmetry and refer to specialist care 3. Orbital diseases:
a. Orbital cellulitis
4. list the conditions for further referral to specialist care b. Proptosis

2 hrs
Students will be able to Eye lids:
1. describe gross anatomy of the lid 1. Gross Anatomy of the eye lid & its disease
2. describe surgical steps of chalazion operation. 2. Clinical Examination procedure
a. Corneal light reflex & palpebral fissure height
3. demonstrate the skill of step wise clinical examination, b. Visual inspection of eyelids and periocular area.
4. describe diagnosis and treatment procedure of the 3. Diseases of Lid
a. Malpositions.(definitions)
followings; Stye, chalazion and blepharitis. i. Trichiasis
5. identify and refer the following: Trichiasis, ptosis, ii. Ptosis
iii. Ectropion
ectropion, entropion, chalazion iv. Entropion.
6. perform eversion of the lid. b. Inflamations.
i. Stye
ii. Chalazion
iii. Blepharitis
iv. Internal hordeolum

382
 Learning objectives Contents Teaching Hours

Students will be able to : Conjunctiva:

1. describe gross anatomy of conjunctiva 1. Gross Anatomy of the Conjunctiva & its 2 hrs
2. name diseases of the conjunctiva diseases:
3. describe surgical steps of pterygium operation. 2. Examination procedure for conjunctiva
4. examine the conjunctiva 3.Disease of conjunctiva:
5. diagnose and manage of viral, bacterial, allergic conjunctivitis a. Conjunctivitis
& ophthalmia Neonatorum - Bacterial
6. diagnose pterygium and refer for surgical management - Viral
7. remove superficial conjunctival foreign body - Allergic
b. Ophthalmia neonatorum
c. Trachoma (Gross idea)
d. Pterygium
4.Precautionary measures:

Students will be able to:

1. describe the anatomy of lacrimal apparatus
Lacrimal Apparatus: 2 hrs
2. describe production, and functions of tear. 1. Gross Anatomy of the Lacrimal Apparatus& its
3. describe steps of sac patency test with interpretation diseases:
4. describe symptoms, signs of lacrimal sac diseases. 2. Physiology:
5. diagnose and manage lacrimal sac diseases. Function of tear.
6. mention indication, contraindication and major complications 3.Examination Technique:
of DCR and DCT
7. perform digital regurgitation test 4. Lacrimal sac disease:
8. perform digital massage in congenital nasolacrimal duct a. Actuate dacryocystitis.
obstruction. b. Lacrimal sac abscess
9. initiate treatment of acute & chronic dacryocystitis, and c. Chronic dacryocystitis.
congenital nasolacrimal duct obstruction, and referred to d. Congenital nasolacrimal duct obstruction
an ophthalmologist

383
 Learning objectives Contents Teaching Hours

Cornea and sclera:

Students will be able to 3 hrs
1. describe gross anatomy of the fibrous coat of the eye 1. Gross anatomy of cornea and sclera
2. describe supply of nutrition to cornea and maintenance of its 2. Physiology:
transparency a. Maintenance of nutrition& transparency of
3. describe steps of performing fluorescein dye test. cornea
4. describe Keratoplasty b. Function of cornea
5. examine cornea c. Tear film
6. perform fluorescein dye test (to detect corneal epithelial 3. Diseases of cornea
defect) a. corneal ulcer
7. remove superficial nonimpacted corneal foreign body b. keratitis
8. diagnose, and initiating treatment of corneal ulcer, keratitis c. Keratoplasty (Gross idea)
and appropriate referral

Student will be able to Uveal tract

1. describe the parts of uveal tract. 2 hrs
2. describe diseases of uveal tract, symptoms, signs and 1. Gross Anatomy
management of acute iritis & endophthalmitis 2. Diseases of uveal tract
3. identify circumcorneal / ciliary congestion
4. perform pupil examination a. Anterior uveitis/uveitis
5. identify ciliary tenderness b. Endophthalmitis
6. diagnose, initiation of treatment of iritis, endophthalmitis and c. Panopthalmitis
appropriate referral.

384
 Learning objectives Contents Teaching
Hours
Students will be able to: Lens and cataract:
1. describe clinical features of age related cataract 1. Gross Anatomy: 3 hrs
2. describe stages of senile cataract 2. Physiology:
3. mention indications of cataract surgery Accommodation
4. mention complications of untreated cataract 3. Disease of the lens
5. perform the preoperative evaluation a. Cataract
6. state ECCE, SICS and phaco surgery. b. Pseudophakia
7. mention Complications of cataract operation c. Aphakia
8. state Advantage of IOL implantation over spectacle 4. Management of cataract:
9. demonstrate the skill of diagnosis of cataract and referral to proper a. Cataract surgery (Gross idea)
ophthalmologist b. Intraocular lens and its advantage (Gross idea)
5. Referral criteria of a cataract case

Glaucoma:
Student will be able to: 1. Gross Anatomy
2. Physiology 4 hrs
1. describe anatomy of the anterior chamber and anterior chamber angle a) Production, circulation and outflow of the
2. describe production circulation and outflow of the aqueous humor aqueous humor.
3. define and classify glaucoma. b) Intra ocular pressure and factors
4. describe Symptoms, signs and management of POAG, PACG and influencing IOP.
congenital glaucoma 3. Classification of glaucoma.
5. demonstrate the skill of: 4. Disease.(gross aspect)
a. taking history of glaucoma patients. a) Primary angle closure glaucoma i) Risk
b. digital tonometry. factors ii) Symptoms iii) Signs iv)
c. conformation test Management
d. direct ophthalmoscopy b) Primary open angle glaucoma: i) Risk
6. diagnose and provide initial management of PACG and early referral. factors ii) Symptoms
7. counseling of all glaucoma patient regarding blinding nature of c) Congenital glaucoma
disease & necessity of life long regular treatment & follow up i) Genetics ii) Symptoms iii) Signs
d) Secondary Glaucoma: Causes
6. Principles of Management:
a. Pharmacological treatment. b. Surgical
Management: c. Laser treatment

385
 Learning objectives Contents covered in this topic Teaching Hours
Retina and vitreous:
Student will be able to: 1. Gross Anatomy: 3 hrs
i. Vitreous
1. describe the gross anatomy of the retina and its function ii. Retina
2. describe the normal fundus. 2. Function of retina.
3. describe the fundal features of diabetic, hypertensive i. Normal vision. (acuity of vision)
retinopathy. ii. Color vision
4. examine normal eye with use of direct ophthalmoscope 3. Symptoms Suggestive of vitro- retinal disorder.
5. identify or suspect vitro retinal disorder and refer patient 4. Examination of normal eye with direct
ophthalmoscope.
5. Fundal features of
a. Diabetic retinopathy.
b. Hypertensive retinopathy.
6. Referral criteria
a. Abnormal red reflex of fundus
b. Visual loss or symptoms
Student will be able to: Refraction, Contact lens, Refractive Surgery
and Low vision (Gross idea):
1. define the common refractive errors eg. myopia, hypermetropia & 3 hrs
astigmatism.
1. Refractive status& management
2. define Aphakia and pseudophakia
a. Emetropia.
3. define presbyopia and describe the rule of thumb for correction
b. Myopia.
of presbyopia
c. Hypermetropia.
4. demonstrate basic knowledge about contact lens and refractive
d. Astigmatism.
surgery.
e. Presbyopia
5. define low vision and mention importance of low vision aid for
f. Aphakia-
rehabilitation.
I. Spectacle correction
6. record visual acuity.
II. Contact lens
7. do prescription of presbyopic glass as per rule of thumb and
III. Intraocular lens and pseudophakia
referring difficult patients to ophthalmologists.
IV. Refractive surgery (Basic idea)
8. refer all cases for final correction by ophthalmologist
6. Low vision.
9. detection of cases with low vision and refer to low vision aid
Definition of low vision. Refer to low vision aid centre
centers

386
 Learning objectives Contents Teaching
Hours
Leucocoria in children
Students will be able to. a. Cataract 1 hrs
1. name tumors affecting the eye and adnexa b. Retinoblastoma
2. name the causes of leucokoria in children. c.. Endophthalmitis
3. describe stages, symptoms, signs and management of retinoblastoma d. Persistent fetal vasculature (PVF/PHPV)
4. diagnosef Leucokoria and mention its importance for early referral
e. Retinopathy of prematurity

Student will be able to: Ocular motility and paediatric

ophthalmology: 2 hrs
1. describe Strabismus. 1. Gross Anatomy.
2. describe the importance of measuring visual acuity of children of two to five
Extra-ocular muscles
years old
3. describe the causes of amblyopia in children 2. Amblyopia.- Definition, cause & impact
4. describe the causes of Leukocoria 3. Strabismus/squint: Definition, cause,
5. demonstrate the skill of:
diagnosis,effects and management
a. recording visual acuity in children
b. ocular motility test principle
c. recognize strabismus, nystagmus and amblyopia for immediate specialist 4. Nystagmus: Definition & identification
referral.

a.

387
 Learning objectives Contents Teaching
Hours
Student will be able to: Optic Nerve and Neuro Ophthalmology:
2 hrs
1. describe visual and pupillary, path ways. A. Gross Anatomy
2. describe manifestations of III, IV & VI cranial nerve palsy. 1. Visual path way.
2. Pupillary Pathway
3. describe Papilloedema
4. record visual acuity. B. Examination procedure:
1. VA
5. perform confrontation visual field testing in four quadrants for 2. Visual field testing (confrontation)
each eye. 3. Pupillary light reflex.
4. Direct Ophthalmoscopy
6. examine pupillary light reflex
7. recognize and diagnose nystagmus.
8. examine the optic disc with the direct ophthalmoscope

Student will be able to: Ocular trauma:

2 hrs
1. describe types of ocular injury 1. Blunt injury (Details)
2. explain the effect of different types of ocular trauma
3. mention criteria for referral of the patients 2. Perforating Injury.
4. demonstrate skill of:
a) examination of the eye to assess the effect of injury 3. Foreign Body:(Extra and intra ocular)
b) removal of superficial conjunctival, sub-tarsal and
superficial corneal foreign body 4. Chemical Injury (details)
c) performing pad-bandage of the eye
d) providing primary management of ocular trauma 5. Thermal injury (Basic idea)
e) referring the patient after primary management to
ophthalmologist /hospital 6. Radiation injury (Basic idea)

388
 Learning objectives Contents Teaching
Hours
Students will be able to:
a. describe fundal change in hypertension Ocular Manifestations of 2 hrs
b. describe fundal change in diabetes mellitus. systemic diseases (Gross idea):
c. describe ocular manifestation of vitamin-A deficiency and management.
d. provide health education regarding importance of yearly eye checkup by 1. Diabetes mellitus
ophthalmologist for prevention of blindness due to diabetes. 2. Hypertension
e. demonstrate the skill of detecting disc oedema on fundus examination with 3. Vitamin A Deficiency
direct ophthalmoscope 4. Auto-immune diseases (Basic idea)
f. recognize Bittot’s spot, xerophthalmia and Kerotomalacia & referal. 5. Tuberculosis
6. AIDS

Student will be able to: Miscellaneous & Community eye

a. describe etiology, magnitude and impact of blindness. care:
b. demonstrate the concept of ‘Primary Eye care’ 1. Etiology and magnitude of blindness
c. describe Ocular hygiene. 2. School sight test.
d. describe diseases and conditions for referral. 3. Primary eye care
e. describe concept of school sight test. 4. Referral guide line 5 hrs
f. define low vision 5. Low vision and rehabilitation
g. demonstrate gross idea about communicable and preventable eye diseases. 6. Outreach activities.
h. perform school sight test 7. Eye donation & eye banking.
i. identify cases of low vision and referral. 8. Vision 2020, The right to sight
j. implement “Primary Eye Care” concept at the place of work (Gross idea)
k. develop awareness about eye donation in the community. 9. Ocular therapeutics
l. diagnose & initiate initial management of ocular emergency 10. Ocular emergency
11. Sudden loss of vision
12. Painful loss of vision
13. Painless loss of vision
14. Gradual dimness of vision
15. Red eye
16. Ocular effects of environmental
change

389
EXAMINATION SKILLS Skills- Assist Observe
Able to Able to Perform
perform under Guidance
Independentl
y
1. Visual Acuity test and Use of pinhole

(including light perception, projection)
2. Colour Vision test 
3. Visual field by confrontation 
4. Examination of ocular movements 
5. Flourescien staining to identify 
corneal abrasion
6. Pupillary size and reaction 
7. Distant direct ophthalmoscopy on

dilatedpupils to diagnose lens opacities
8. Method of Direct ophthalmoscopy 
9. Digital tonometry 
10. Schiotz tonometry 
11. Regurgitation for NLD Block 
12. Syringing 
13. Instillation of eye drops/ ointment 
14. Irrigation of conjunctiva 
15. Applying of patching 
16. Epilation of cilia 
17. Eversion of upper eye lid 
18. Removal of corneal foreign body 
19. Cataract surgery 
20. Glaucoma surgery 
21. Chalazion/Stye 
22. Tarsorraphy 
23. Assessment of Opacity in the media 
24. Lacrimal Sac Surgery 

390
 DEPARTMENT OF OPHTHALMOLOGY
CARD FOR EVALUATION

First clinical Card (4th year) Total Marks = 100

Name of the student

Roll No Class
Session Batch
Period of placement in Eye 4 weeks

From To

No. Items Day of Marks Teacher’s

teaching obtained Signature
1. History taking 1 day
2 Examination of the Eye: Adnexa, Lid, Chalazion, 3 days
Ext.Hordeolum, Int.Hordeolum Visual Acuity
(Adult & children unaided, with pinhole, with
present glass), Ant. Segment. Ocular motility,
Digital tonometry, Confrontation test.(Visual field
test)
3 Methods of application of ocular drugs: Eye 1 day
Bandage, removal of sup. Corneal F.B, Irrigation of
conj. Sac.
4 ‘RED EYES’ - case demonstrations. Including 2 day
fluorescein dye test & cilliary tenderness.
5 Trial box, Snellen’s chart 1 day
6 Regurgitation test, Sac Patency Test and Epiphora 1 day
3 cases
7 Assessment 1 day
8 Total 10 days

Total No. of attendance

Marks obtained
Comment
Signature of the Registrar/RS Signature of Head of the Department

391
 DEPARTMENT OF OPHTHALMOLOGY
CARD FOR EVALUATION
th
Second clinical Card (5 Year) Total Marks = 100
Name of the student
Roll No Class
Session Batch
Period of placement in Eye Ward 4 (four) weeks. ( ward + OPD )

From To

Total No. of attendance

Marks obtained
Comment
Signature of the Registrar/RS
Signature of Head of the Department
Teaching Hours
Methods Total
No. Items Day of Marks Teacher’s
teaching obtained Signature
1. History & Exam (Colour vision, Field of vision, 4 days
pupillary light reflex)
2. Corneal ulcer, Corneal abrasion: Diagnosis and 2 days
management.
3. Uveitis: Diagnosis and management. 2 days
4. Cataract diagnosis and management. 3 days
5. OT, surgical demonstration Chalazion, Stye, DCR, 2 days
Cataract surgery with IOL implantation
(SICS/ECCE/Phaco)
6. Glaucoma. 3 days
7. Ocular Injury, Conjunctival irrigation, Eversion of 2 days
lid, Epilation
8. Ophthalmoscopy, Tonometry, Assessment of 2 days
opacity in media
9. Dacryocystitis: Diagnosis & management. 2 days
10. Xerophathalmia, paediatric cases. 2 days
11. Assessment 2 days
Total 26 days

Lectures 40 hours
Ward Teaching 8 weeks

392
 Otorhinolaryngology & Head-Neck Surgery

Departmental Objectives
The aim is to teach undergraduate medical students so as to produce need based
community oriented doctors who will be capable of :
1. diagnosing and managing common ENT & Head-Neck disorders.
2. referring complicated ENT and head-neck disorders to appropriate centres if and when
necessary
3. managing common emergencies in ENT & head-neck disease
4. giving preventive advice on certain aspects of ENT & head-neck diseases

To achieve above mentioned departmental objectives the following learning objectives

should be achieved:

1. The art of appropriate history taking

2. Should perform primary ENT & head-neck examination procedure
3. Should use the aural speculum, nasal speculum, tongue depressor, laryngeal mirror, tuning
fork and head mirror/light, otoscope & other instruments as listed in the enclosure
4. Should be able to describe the clinical application of basic anatomy & physiology of Ear,
Nose and Throat
5. Should be able to describe the pathology of common ENT disorders & disorders of the Head-
Neck region
6. Should list commonly used drugs and describe their adverse effects
7. Should recommend common investigative procedures and special investigation (CT, MRI,
and sonography, etc)

393
 Learning Objectives and Course Contents in Otorhinolaryngology & Head-Neck Surgery

Learning Objectives Contents Teaching

Hours
Students will be able to: EAR
1. demonstrate the applied Anatomy of ear.
CORE
2. demonstrate the applied Physiology of ear. 1. applied Anatomy of ear
3. take History of ear diseases 2. applied Physiology of ear:- hearing, Balance
4. conduct clinical hearing test and value the significance 3. congenital diseases of ear-Preauricular sinus
of audiometry and caloric test. 4. causes of earache
5. diagnose various ear diseases by clinical examination 5. causes of deafness
(FB, Otitis Exerna, Traumatic Tympanic membrane 6. diseases of ext. ear-Furuncle, Otitis externa ,Otomycosis, Foreign
perforation, ASOM, CSOM, Otosclerosis. body, Trauma,Perichondritis of pinna
6. remove impacted wax, foreign body, Aural toileting 7. diseases of middle ear-ASOM, CSOM, OME, Otosclerosis.
7. diagnose ear diseases and Its complications and refer to 8. diseases of internal Ear-Meniere’s disease, Labyrinthitis.
appropriate hospital when needed. 9. Tuning fork test, Audio metry, Caloric test
e.g.- perichondritis 10. micro ear surgery-Myringotomy Myingoplasty & different types
otosclerosis of mastoidectomies.
extra and intracranial 11. neurootological complications:
complications of middle ear diseases Lateral sinus thrombosis, general idea about intra cranial
8. make D/D of earache complications of ASOM & CSOM.
9. differentiate safe from unsafe variety of CSOM.
Additional:
12. causes of Vertigo &Tinnitus
13. management of deafness.

394
 Teaching Hours
Learning Objectives Contents

NOSE

Student will be able to : CORE:

1. Anatomy of nose
1. describe applied anatomy and applied physiology of 2. Physiology of nose
nose. 3. Epistaxis.
2. manage epistaxis 4. FB nose, Fracture nasal bone
3. remove FB and reduction of Fracture nasal bone. 5. Nasal allergy
4. diagnose nasal diseases by clinical examinations 6. Nasal polyp
5. refer the patient to specialized ENT centre 7. Rhinitis, Sinustitis
6. apply ANS Pack. 8. DNS, septal perforation, septal abscess, septal
7. history taking of disease of Nose and PNS. haematoma
9. Nasal papilloma, rhinosporidiosis.
10. Atrophic rhinitis
11. Nasopharyngeal angiofibroma and naso-pharyngeal
carcinoma.
12. Sino-nasal malignancy

Additional
Headache
Tumours of nose and PNS
Common nasal and sinus Operation:-
Polypectomy
SMR, Septoplasty
Caldwell Luc operation
BAWO

395
 Teaching Hours
Learning Objectives Contents
Mouth cavity, pharynx, larynx and
Student will be able to :
esophagus
CORE
1. Describe anatomy of oral cavity, pharynx, larynx and
1. Anatomy of oral cavity, pharynx, larynx and
oesophagus.
Oesophagus
2. Describe Physiology of deglutition.
2. Physiology of salivation, deglutition and functions of
3. Make D/D of white patches, ulcers in oral cavity,
larynx, pharynx.
Leukoplakia and Sorethroat.
3. Diseases of oral cavity Congenital anomalies like Hare
4. Diagnose Diphtheria and refer it to appropriate hospital
lip, cleft palate White patch-oral cavity, oral
5. Diagnose acute & recurrent tonsillitis, adenoids,
ulceration, Leukoplakia and neoplasm.
6. Describe indications of adenotonsillectomy and principles
4. Acute & recurrent tonsillitis faucial diphtheria.
of post operative management and contraindications.
5. Adenoids
7. Diagnose complications of adenotonsillectomy and its
6. Tonsillectomy and adenoidectomy
management
7. Peritonsillar abscess, retro pharyngeal abscess,
8. List D/D of dysphagia.
parapharyngeal abscess.
9. List D/D of hoarseness of Voice.
10. List D/D of Stridor
Larynx
11. Describe indications of trachestomy & its steps,
postoperative management and complications. Acute Epiglottitis, Acute Laryngo tracheo bronchitis
Acute & chronic laryngitis
Papillomalarynx
Stridor
Causes of hoarseness of voice
Tracheostomy
Carcinoma-larynx.
Foreign Body larynx, trachea, bronchus.

396
Learning Objectives Contents Teaching
Hours

Pharynx
FB
Malignancy of Pharynx
Oesophagus
PV syndrome
Dysphagia
Foreign Body
Benign & malignant lesion of Oesophagus
(strictures, rupture)
Head-Neck

1. Applied anatomy of salivary glands, Thyroid &

Parathyroid glands
2. Physiology of salivary glands, Thyroid & Parathyroid
glands
3. Salivary gland diseases
4. Thyroid and parathyroid diseases
5. Neck mass
6. Congenital sinus & cyst of head neck
(Thyroglossal cyst, Branchial cyst, Branchial sinus)

General Idea about head neck malignancies

397
 Integrated Teaching
Topic Learning Objective Teaching Aids Assessment Department

 Otogenic and Student will be able to: Video cassette film of Performance, ENT & Neuro
Rhinogenic extra-  state the causes of extra-cranial & intra-cranial C.T. Scan, X-ray, Interpretation, Surgery
cranial & intra-cranial complications of ASOM and CSOM Diagram,
complications  describe the symptoms & signs of acute mastoiditis, Otoscope, Short Question,
facial palsy, labyrinthitis lateral sinus thrombosis. Hammer, Cotton, Pin
 Investigate & interpret the results of investigation. & Patients. Modified short
 treat different complications (gross idea) Tongue depressor, Question,
PNS mirror,
 Facio-Maxillary State common causes of maxillary swelling/carcinoma of laryngeal mirror MCQ
Neoplasm Maxilla. Nasal speculum. ENT & Eye
(Nice to know Practical Exam
fundoscopy) OSCE
Ophthalmoscope

Teaching Methods:
 Lecture/ Mini Lecture
 Tutorial/ Demonstration - Video
 Case presentation- Subject – Operation- Programe side Teaching Theatres
 Discussion, Visit to RHC / Specialised Centre (If available)

Teaching Hours for Otorhinolaryngology & Head-Neck Surgery

Methods Total
Lectures 38 hours
Ward Teaching 8 weeks

398
 CARD SYSTEM FOR WARD & OUTDOOR DUTIES
Clinical Card in Otorhinolaryngology & Head-Neck Surgery
(4 weeks in 3rd phase and 4 weeks in 4th phase - Total marks = 100)
Name of the student
Roll No Class
Session Batch
Period of placement in ENT Outdoor /Ward

From To

3rd Phase
No. Item Date of Marks Signature of
teaching & obtained teacher
learning
1. History taking, examination & investigations of
ear diseases
2. History taking, examination & investigations of
diseases of nose & Paranasal Sinuses.
History taking, examination and investigation
of diseases of pharynx, larynx & Oesophagus
3.
4. Examination of Head-Neck & differential
diagnosis of neck swellings.
5. Observe 10 cases of discharging ears and
establish diagnosis
6. Observe 10 cases of deafness and establish
diagnosis
7. Observe 10 cases of nasal obstruction &
establish diagnosis. Learn all about septal
deviation
8. Observe 5 cases of nose bleeding and learn
nasal packing
9. Observe 5 cases of wax in ears and learn
toileting
10. Observe 10 cases of neck swellings and establish
diagnosis

399
4th - phase
No. Items Date of Marks Signature
teaching & obtained of teacher
learning
1. Observe 5 cases of Recurrent tonsillitis
tonsillectomy, also learn pre & postoperative
management.
2. Observe cases of Peritonsillar abscess/
retropharyngeal abscess. Establish diagnosis. Learn
principles of management
3. Observe 10 cases of hoarseness of voice. Establish
diagnosis & learn principles of treatment
4. Observe instruments for laryngoscopy,
oesophagoscopy & bronchoscopy. Learn procedures
of each
5. Observe 5 cases of tracheostomy. Learn technique of
pre & post-operative management
6. Observe 2 antral washout operation. Learn
instruments & principles of operation. See 3 cases of
FB Nose. Learn technique of removal.
7.. Observe 5 cases of dysphagia. Learn management.
Learn all about nasogastric feeding
8. Observe 10 cases of Head & Neck swellings
Establish diagnosis.
9. Observe ENT X-rays. Interpret common findings

Total Number of attendance Out of

Punctuality
Attitude to learning
Relationship with staff & patients
Percentage of marks obtained in items
examination

Date :
Signature of Professor / Associate Professor

400
Instruments
1. Ear speculum
2. Otoscpe
3. Nasal speculum (Thudicum)
4. Antrum puncture trocar and cannula (Lichwitz)
5. Tongue depressor (Luc’s)
6. PNS mirror
7. Laryngeal mirror
8. Boyle Davis mouth gag
9. Adenoid curette with / without cage (St Clare Thomson)
10. Tracheostomy tube-metallic/PVC
11. Laryngoscope
12. Oesophagoscope
13. Bronchoscope
14. Head light/mirror
15. Tuning Fork

Operative Procedures
a. Tonsillectomy
b. Adenoidectomy
c. Septoplasy/SMR
d. Caldwell-Luc operation
e. Myringoplasty
f. Mastoidectomy
g. Thyroidectomy
h. Salivary gland excision
i. Biopsy for diagnosis of carcinoma of tongue, oral lesions etc
j. Direct larygnoscopy
k. Neck node biopsy
l. Antral washout
X-ray
m. X-ray paranasal sinus (occipito-mental view)
n. X-ray nasopharynx – lateral view
o. X-ray mastoid
 Towne’s view
p. X-ray neck
 Lateral view
 Ba swallow x-ray of esophagous
Nice to know
CT scan /MRI
FOL – Fibre Optic Laryngoscopy

401
 CLINICAL PLACEMENT OF STUDENTS DURING PHASE II, III & IV ( for 62 weeks)

WEEKS PHASE II 20 WEEKS WEEKS PHASE III 14 WEEKS WEEKS PHASE IV 12+12 + 04 WEEKS
01-15 Surgery indoor 01-04 Orthopaedics & traumatology 1st term
Surgery OPD
16-17 Orthopaedic surgery 05-08 Ophthalmology 01-04 Orthopedics
18 Radiology 09-12 ENT 05-08 Ophthalmology
19 Anaesthesia 13 Radiotherapy 09-12 ENT
20 Dentistry 14 Neurosurgery 2nd & final term
15 General Surgery
01-07 Surgery
08-09 Urology
10-11 Paediatric Surgery
12 Emergency & Casualty
Card completion exam at the end of rotation & Burn & Plastic Surgery
Term exam at 41st week Term exam at 41st week 04 weeks BLOCK POSTING
Final assessment

Time schedule for the lecture classes (number)

DICIPLINE 2ND PHASE 3RD PHASE 4TH PHASE TOTAL

Gen Surgery 35 30 60 125

Orthosurgery 0 15 45 60
Radiology 0 0 5 5
Radiotherapy 0 0 8 8
Anaesthesia 0 10 0 10
Neurosurgery 0 0 5 5
Paediactric Surgery 0 5 10 15
Urology 0 5 10 15
Burn Plastic Surgery 0 0 5 5
35 65 148 248

402
Large Group Teaching

All lectures should be interactive one.

It should be directed to develop analytical and problem solving attitude.
Student should be encouraged to adopt self-directed learning.
.
Clinical Teaching and tutorials

 Students are to attend the wards as per placements twice in a day in morning and evening
sessions as fixed by the respective college authority.
 They must be well dressed along with apron & nameplate. Shirts, Pants (full length) Shoes
only and Winter apparels are allowed in ward settings. Three quarter pant, T-shirt, Sandals
are not allowed and teacher may disallow those students to continue the class.
 They will carry stethoscope, percussion hammer, pencil torch and measuring tape and other
necessary clinical examination tools.
 During their ward visit, they will examine patients and try to make working diagnosis and
write the history as per prescribed format.
 They will go through hospital documents and look what necessary measures and decision has
been taken to follow the management of the patient in the ward.
 They will observe and practice techniques of IV & IM injection, infusion, dressing of the
wounds. Student will also attend the operation theater and observe the instruments and
equipments used in the operation theater.
 They will observe the techniques of different anaesthesia and the drugs used, techniques of
hand scrubbing, gowning gloving, scrubbing and draping of operation field, making
incisions, haemostasis, saturating technique and wound repair.
 Students performance will be assessed by item examinations, ward and term examinations.

Assessment-
1. Internal assessment: (Marks for formative assessment)
a. Items & Card completion examination ,
b. Year final assessment at the end of Phase-II & III (written)
c. MCQ in Integrated teaching.
d. Final assessment examination (similar to final professional examination)
at the end of block posting. (Medicine, Surgery, Obs & Gynae)
2. Final professional MBBS Examination:
a. Written: (MCQ- 20 (10 SBA and 10 MTF) ; SAQ & SEQ=70) each paper
Time allocation: MCQ- 30 minutes; SAQ+SEQ – 02hrs 30minutes.

i. Paper – I SAQ & SEQ consists of 4 groups.

403
 Group -1:- Principles of surgery, Vascular Diseases, Anaesthesia,
Radiology, Radiotherapy.
Group -2:- GIT, Paediatric surgery, Operative Surgery, Chest disease
Group -3:- HBS & Pancreas, Urology, Breast, Endocrine.
Group -4:- Orthopaedics & Traumatology, Neurosurgery,
There will be 05 questions in each group and out of those 04 are to be
answered carrying 3.5 marks each.
At least two Structured Essay Question (SEQ) will be in each paper.

ii. Paper –II:

Ophthalmology-- MCQ-10 (5 SBA, 5 MTF) & SAQ & SEQ -35;
ENT-- MCQ-10 (5 SBA, 5 MTF) & SAQ & SEQ -35
Group-1and Group 2 = Ophthalmology
Group-3 and Group 4 = ENT
At least two Structured Essay Question (SEQ) will be in each paper.

iii Preferably questions will be of

recall type- 30%,
understanding or data interpretation type- 30% and
problem solving type- 40%
iv Question should cover the whole curriculum .
90% of the questions should preferably be from core content
and 10% from additional content of course.
v. Scripts distribution: Group-1 will be assessed by General surgeon, Group -2
will be assessed by General surgeon, Group-3 will be assessed by a General
surgeon/allied subject expert and Group -4 will be assessed by an Orthopedic
surgeon.

b. OSPE –

i. Stations will be constructed centrally by two experience examiners nominated and

supervised by chairman of the examination committee of the respective university.
ii. Each station will of 5 minutes time and marks will be allocated according to rules
mentioned in the subject concerned.
iii. All the examinee under each university will appear in OSCE/OSPE exam in their
designated centers on a same date and before 9 am scheduled by University for a
particular subject. Failure to arrive at examination center before 9 am is an offense
and examiner may dis qualify the candidate.
iv. OSPE examination of Surgery, Ophthalmology and ENT will be in two different
days.
v. Answer scripts of OSPE will be divided among the examiners for evaluation and
the marks are to be submitted prior to final day of the oral examination scheduled in
the respective centre.

vi. Every examination center should be prepared for testing competencies including
different procedure stations, data analysis, counseling, displaying x-ray, specimens
and instruments. Original materials should be placed at each station.
vii. Station setup
1. Total 20 stations will be made comprising 10 from Surgery,
2. Five (5) Ophthalmology and
3. Five (5) ENT stations.
Out of those, at least two stations from surgery, one from Ophthalmology
and one from ENT will be procedural station.

404
 ix Marks allocation
Surgical stations are- (10 x 6 = 60 marks)
No.

a. Plain x-ray -1
b. Contrast x-ray -1
c. Orthopaedic X-ray -1
d. Specimen -1
e. Instrument/s -1
f. Appliances (Catheter, tubes, stoma or reservoir bags etc) -1
g. Data interpretation -1
h. Procedure stations -2
i. Splint/bandage -1
4. Ophthalmology -5 and ENT-5 stations are- ( 5+5) x4 = 40 marks)
No.
a. Instrument station =1
b. X-ray station/ Specimen =1
c. Clinical photograph/ tracing =1
d. Procedure =1

c. Structured Oral Examination. (SOE)

NB: Oral & Practical Examination Boards of Surgery & Allied Subjects: Eight (8) Examiners in 4
boards in two days.
Day -1:
Board- A- 1 examiner from General Surgery & 1 examiner from Allied subjects
Board-B-1 examiner from General Surgery & 1 examiner from Orthopaedics
Day-2:
Board-A-1 examiner from Ophthalmology & 1 examiner from Ophthalmology
Board-B-1 examiner from ENT & 1 examiner from ENT
NB: In case of unavailability of any concerned examiner of any board the convener of the examiner in
consultation with concerned dean of the faculty of medicine will select the examiner from General
surgery or sub specialty or any allied subject

Paper-1 (General surgery and allied subjects) Marks-30X2=60

a. Two separate boards comprising one internal and one external examiner will assess
written scripts, oral, practical and clinical examination.
b. There are two other reserve examiners in each internal and external pool. One of
the reserve examiner should be from allied subject like urology, pediatric surgery,
plastic surgery or neurosurgery.
c. Out of four examiners two will be from general surgery, one will be an
orthopedician & another one will be from allied subjects of surgery.
d. There will be four boxes covering questions on surgery and allied specialties
assigned for each examiner.
e. Each box will contain at least 20 sets of questions.
f. A set of question will contain 3 small questions of three-difficulty level (Must
Know, Better to Know & Nice to Know)
g. Content of the box-
1. Box-1:- Principles of surgery, Vascular Diseases, Anaesthesia, Radiology,
Radiotherapy.
405
 2. Box-2:- GIT, Paediatric surgery, Operative Surgery, Chest disease
3. Box-3:- HBS & Pancreas, Urology, Breast, Endocrine.
4. Box-4 :- Orthopaedics & Traumatology, Neurosurgery.

Paper –II (Ophthalmology and ENT) Marks 20X 2= 40

i. Two separate boards for each specialty comprising one internal and one external
examiners will assess written scripts, oral, practical and clinical examination.
ii. There will be one reserve examiner in each specialty.
iii. Instruments and x-rays will not be examined in viva board.
iv. Each student will be allocated 15 minutes
v. Problem solving skills / Judgment of knowledge should be examined
vi. The question and answer will be constructed by the examiners in advance
vii. Question is typed in a card and put in box of defined domain
viii. A number of questions from each topic should be constructed covering the
content area.
ix. Content will be changed on alternate days
x. The candidate randomly selects one card from each box and answer.
xi. The candidate should answer selected number of question in the board
xii. The examiner read the question, repeat it if necessary or the candidate reads the
question if allowed.
xiii. When candidate answers the questions, the examiner will put a tick in appropriate
site on a prepared rating scale
d. Clinical examination of surgery
a. Surgery -60
1. Short cases 3 x 10 =30
2. One Long case- 30.
b. Ophthalmology cases -2 x 10=20
c. ENT cases- 2 x 10=20

406
 Mark distribution of oral, clinical and practical examination in surgery in final
professional examination

Subject Oral Practical/OSPE Clinical Total

Surgery + 30+30 60 30+30 180

Allied &

Orthopaedics

Ophthalmology 20 20 20 60

ENT 20 20 20 60

Total 100 100 100 300

ssss

 There will be separate Answer Script for MCQ (SBA & MTF) and written SAQ &SEQ
assessment.
 Pass marks is 60 % in EACH of Written, oral, practical and clinical components.
 Practical Examination will be in 2 days, one day Surgery, One day Eye-ENT
 Oral+Clinical will be in 2 days, One day- Surgery, another day- Ophthalmology + ENT.
 Marks and Written examination scripts must be returned before last day of oral-clinical
examination at respective examination center. Otherwise convener of the center will return
the whole scripts to Dean office for final decision.
 For declaration of results in earliest possible time after compilation of marks quick disposal
of marks to competent authority is desirable.

407
 FINAL PROFESSIONAL EXAMINATION
Assessment of Surgery
(MARKS DISTRIBUTION)

Components Marks Sub total Marks Total Marks

On each component
Written examination
Formative assessment marks
General Surgery & allied subjects 10
Ophthalmology 05 20 20
ENT 05
Written
Paper – 1:
General Surgery + allied & Orthopaedics : MCQ- (20+70) 90 180
(SBA+MTF) +(SAQ + SEQ)

Paper – II:
Ophthalmology: MCQ- (SBA+MTF) +(SAQ + (10+35) 45
SEQ)
ENT : MCQ- (SBA+MTF) +(SAQ + SEQ) (10+35) 45

Oral, Clinical & Practical

General Surgery + allied & Orthopaedics
(Oral+ Clinical+ Practical) (60+60+60) 180
Ophthalmology
(Oral+ Clinical+ Practical)
(20+20+20) 60 300

ENT
(Oral+ Clinical+ Practical) (20+20+20) 60

Oral examination should be structured.

500
Grand Total Marks

408