New Curriculum for MBBS notified by NMC

New Delhi: Following the publication of the Graduate Medical Education Regulations 2023 in the official Gazette on June 02, 2023, the Undergraduate Medical Education Board (UGMEB) of the National Medical Commission (NMC) has now issued the new MBBS curriculum for medical students.

Issuing a circular in this regard on June 12, 2023, the Director of the UGMEB, Shambhu Sharan Kumar informed, "All previously issued Notifications/circulars/clarifications shall now be void and superseded by these new guidelines."

These new guidelines including the new CBME curriculum for the MBBS students "shall be applicable to all the admission made in MBBS course in a medical college in the academic year 2023-24."

In the preamble of the Curriculum, NMC mentioned, "The new Graduate Medical Education Regulations attempts to stand on the shoulder of the contributions and the efforts of resource persons, teachers and students (past and present). It intends to take the leamer to provide health care to the evolving needs of the nation and the world. About 25 years have passed since the existing Regulations on Graduate Medical Education, 1997 were notified, necessitating a relook at all aspects of the various components in the existing regulations and adapt them to the changing demography, socio-economic context, perceptions, values, advancements in medical education and expectations of stakeholders. Emerging health care issues particularly in the context of emerging diseases, impact of advances in science and technology and shorter distances on diseases and their management also need consideration. The strong and forward-looking fundamentals enshrined in the Regulations on Graduate Medical Education, 1997 has made this job easier. A comparison between the 1997 Regulations and proposed Graduate Medical Education Regulations,2019 will reveal that the 2019 Regulations have evolved from several key principles enshrined in the 1997 Regulations."

"The thrust in the new regulations is continuation and evolution of thought in medical education making it more leamer-centric, patient-centric, gender- sensitive, outcome -oriented and environment appropriate. The result is an outcome driven curriculum which conforms to global trends. Emphasis is made on alignment and integration of subjects both horizontally and vertically while respecting the strengths and necessity of subject-based instruction and assessment. This has necessitated a deviation from using "broad competencies"; instead, the reports have written end of phase subject (sub) competencies. These "sub-competencies" can be mapped to the global competencies in the Graduate Medical Education Regulations," the circular mentioned.

"The importance of ethical values, responsiveness to the needs of the patient and acquisition of communication skills is underscored by providing dedicated curriculum time in the form of a longitudinal program based on Attitude, Ethics and Communication (AETCOM) competencies. Great emphasis has been placed on collaborative and inter-disciplinary teamwork, professionalism, altruism and respect in professional relationships with due sensitivity to differences in thought, social and economic position and gender," it added.

The new MBBS curriculum includes objectives of the Indian Graduate Medical Training Programme, National Goals in respect of the Indian Medical Graduates, Institutional Goals, Goals for the Learner, Competency Based Training Programme of the Indian Medical Graduate, Lifelong learner committed to continuous improvement of skills and knowledge.

Apart from these, the Curriculum at length has discussed about the competencies, broad subject specific objectives, skills, integration in respect of 1st professional year subjects including Anatomy, Physiology, Biochemistry, 2nd professional year subjects including Pathology, Microbiology, Pharmacology, 3rd professional year subjects such as Forensic Medicine and Toxicology, Community Medicine, General Medicine, Dermatology, Psychiatry, Respiratory Medicine, Pediatrics, General Surgery, Orthopedics (including Physical Medicine and Rehabilitation), Anaesthesiology, Radiodiagnosis, Oto-rhinolaryngology (ENT), Ophthalmology, Obstetrics and Gynaecology.

Further, the new CBME Curriculum has also discussed about the phase-wise training and time distribution for professional development. It includes training period and time distribution, the distribution of 4.5 years period, phase-wise distribution of teaching hours. It also has discussed about the new teaching/learning elements including the foundation course, early clinical exposure, electives, Professional Development including Attitude, Ethics and Communication Module (AETCOM), Learner-doctor method of clinical training (Clinical Clerkship), Assessment etc.

Regarding the eligibility to appear for Professional examinations, the new CBME curriculum has discussed about attendance, internal assessment, university examinations, appointment of examiners etc. The guidelines also include AETCOM competencies for first, second and third year MBBS. Tables specifying time distribution of MBBS programme & examination schedule, distribution of subjects in each Professional Phase, Foundation Course, Distribution of subject wise teaching hours of MBBS 1st, 2nd and final year MBBS, clinical posting schedules in weeks, learner-doctor programme, marks distribution for various subjects for University annual examinations etc.

Objectives of the Indian Graduate Medical Training Programme:

The undergraduate medical education program is designed with a goal to create an "Indian Medical Graduate" (IMG) possessing requisite knowledge, skills, attitudes, values and responsiveness, so that she or he may function appropriately and effectively as a Physician of first contact of the community while being globally relevant. To achieve this, the following national and institutional goals for the learner of the Indian Medical Graduate training program are hereby prescribed.

National Goals: 

At the end of undergraduate program, the Indian Medical Graduate should be able to

a. Recognize "health for all" as a national goal and health right of all citizens and by undergoing training for medical profession fulfill his social obligations towards realization of this goal.

b. Learn key aspects of National policies on health and devote himself to its practical implementation.

c. Achieve competence in practice of holistic medicine, encompassing promotive, preventive, curative and rehabilitative aspects of common diseases.

d. Develop scientific temper, acquire educational experience for proficiency in profession and promote healthy living.

e. Become exemplary citizen by observance of medical ethics and fulfilling social and professional obligations, so as to respond to national aspirations.

Institutional Goals:

In consonance with the national goals, each medical institution should evolve institutional goals to define the kind of trained manpower (or professionals) they intend to produce. The Indian Medical Graduates coming out of a medical institute should:

a. Be competent in diagnosis and management of common health problems of the individual and the community, commensurate with his/her position as a member of the health team at the primary, secondary or tertiary levels, using his/her clinical skills based on history, physical examination and relevant investigations.

b. Be competent to practice preventive, promotive, curative, palliative and rehabilitative medicine in respect to the commonly encountered health problems.

c. Appreciate rationale for different therapeutic modalities; be familiar with the administration of the "essential drugs" and their common side effects.

d. Appreciate the socio-psychological, cultural, economic and environmental factors affecting health and develop humane attitude towards the patients in discharging one's professional responsibilities.

e. Possess the attitude for continued self-learning and to seek further expertise or to pursue research in any chosen area of medicine, action research and documentation.

f. Be familiar with the basic factors which are essential for the implementation of the National Health Programs including practical aspects of the following:

i) Family Welfare and Maternal and Child Health (MCH);

ii) Sanitation and water supply;

iii) Prevention and control of communicable and non-communicable diseases;

iv) Immunization; v) Health Education and advocacy;

vi) Indian Public Health Standards (IPHS) at various level of service delivery;

vii) Bio-medical waste disposal viii) Organizational and or institutional arrangements.

g. Acquire basic management skills in the area of human resources, materials and resource management related to health care delivery, general and hospital management, principal inventory skills and counseling.

h. Be able to identify community health problems and learn to work to resolve these by designing, instituting corrective steps and evaluating outcome of such measures with max imum community participation.

i. Be able to work as a leading partner in health care teams and acquire proficiency in communication skills.

j. Be competent to work in a variety of health care settings.

k. Have personal characteristics and attitudes required for professional life including personal integrity, sense of responsibility and dependability and ability to relate to or show concern for other individuals.

Goals for the Learner:

In order to fulfill these goals, the Indian Medical Graduate must be able to function in the following ro les appropriately and effectively : -

a. Clinician who understands and provides preventive, promotive, curative, palliative and holistic care with compassion.

b. Leader and member of the health care team and system with capabilities to collect, analyze, synthesize and communicate health data appropriately.

c. Communicator with patients, families, colleagues and community

d. Lifelong learner committed to continuous improvement of skills and knowledge.

e. Professional, who is committed to excellence, is ethical, responsive and accountable to patients, community and profession.

f. Critical thinker who demonstrates problem solving skills in professional practice

g. Researcher who generates and interprets evidence

Competency Based Training Programme of the Indian Medical Graduate:

Competency based learning would include designing and implementing medical education curriculum that focuses on the desired and observable ability in real life situations. In order to effectively fulfrll the roles, the Indian Medical Graduate would have obtained the following set of competencies at the time of graduation:

Clinician, who understands and provides preventive, promotive, curative, palliative and holistic care with compassion

• Demonstrate knowledge of normal human structure, function and development from a molecular, cellular, biologic, clinical, behavioral and social perspective.
• Demonstrate knowledge of abnormal human structure, function and development from a molecular, cellular, biological, clinical, behavioral and social perspective.
• Demonstrate knowledge of medico-legal, societal, ethical and humanitarian principles that influence healthcare.
• Demonstrate knowledge of national and regional health care policies including the National Health Mission that incorporates National Rural Health Mission (NRHM) and National Urban Health Mission (NUHM), frameworks, economics and systems that influence health promotion, health care delivery, disease prevention, effectiveness, responsiveness, quality and patient safety.
• Demonstrate ability to elicit and record from the patient, and other relevant sources including relatives and caregivers, a history that is complete and relevant to disease identification, disease prevention and health promotion.
• Demonstrate ability to elicit and record from the patient, and other relevant sources including relatives and caregivers, a history that is contextual to gender, age, vulnerability, social and economic status, patient preferences, beliefs and values.
• Demonstrate ability to perform a physical examination that is complete and relevant to disease identification, disease prevention and health promotion.
• Demonstrate ability to perform a physical examination that is contextual to gender, social and economic status, patient preferences and values.
• Demonstrate effective clinical problem solving, judgment and ability to interpret and integrate available data in order to address patient problems, generate differential diagnoses and develop individualized management plans that include preventive, promotive and therapeutic goals.
• Maintain accurate, clear and appropriate record of the patient in conformation with legal and administrative frameworks.
• Demonstrate ability to choose the appropriate diagnostic tests and interpret these tests based on scientific validity, cost effectiveness and clinical context.
• Demonstrate ability to prescribe and safely administer appropriate therapies including nutritional interventions, pharmacotherapy and interventions based on the principles of rational drug therapy, scientific validity, evidence and cost that conform to established national and regional health programmers and policies for the following: Disease prevention, Health promotion and cure, Pain and distress alleviation, and Rehabilitation and palliation.
• Demonstrate ability to provide a continuum of care at the primary (including home care) and/or secondary level that addresses chronicity, mental and physical disability.
• Demonstrate ability to appropriately identify and refer patients who may require specialized or advanced tertiary care.
• Demonstrate familiarity with basic, clinical and translational research as it applies to the care of the patient.

Leader and member of the health care team and system:

Work effectively and appropriately with colleagues in an inter-professional health care team respecting diversity of roles, responsibilities and competencies of other professionals.

Recognize and function effectively, responsibly and appropriately as a health care team leader in primary and secondary health care settings.

Educate and motivate other members of the team and work in a collaborative and collegial fashion that will help maximize the health care delivery potential of the team.

Access and utilize components of the health care system and health delivery in a manner that is appropriate, cost effective, fair and in compliance with the national health care priorities and policies, as well as be able to collect, analyze and utilize health data.

Participate appropriately and effectively in measures that will advance quality of health care and patient safety within the health care system.

Recognize and advocate health promotion, disease prevention and health care quality improvement through prevention and early recognition: in a) life style diseases and b) cancer, in collaboration with other members of the health care team.

Communicator with patients, families, colleagues and community: 

Demonstrate ability to communicate adequately, sensitively, effectively and respectfully with patients in a language that the patient understands and in a manner that will improve patient satisfaction and health care outcomes.

Demonstrate ability to establish professional relationships with patients and families that are positive, understanding, humane, ethical, empathetic, and trustworthy

Demonstrate ability to communicate with patients in a manner respectful of patient's preferences, values, prior experience, beliefs, confidentiality and privacy.

Demonstrate ability to communicate with patients, colleagues and families in a manner that encourages participation and shared decision- making.

Lifelong learner committed to continuous improvement of skills and knowledge"

Demonstrate ability to perform an objective self-assessment of knowledge and skills, continue learning, refine existing skills and acquire new skills.

Demonstrate ability to apply newly gained knowledge or skills to the care of the patient. Demonstrate ability to introspect and utilize experiences, to enhance personal and professional growth and learning.

Demonstrate ability to search (including through electronic means), and critically reevaluate the medical literature and apply the information in the care of the patient.

Be able to identify and select an appropriate career pathway that is professionally rewarding and personally fulfilling.

Professional who is committed to excellence, is ethical, responsive and accountable to patients, community and the profession:

Practice selflessness, integrity, responsibility, accountability and respect.

Respect and maintain professional boundaries between patients, colleagues and society.

Demonstrate ability to recognize and manage ethical and professional conflicts.

Abide by prescribed ethical and legal codes ofconduct and practice.

Demonstrate a commitment to the growth of the medical profession as awhile.

A. CURRICULUM: 

1st Professional Year:

1. ANATOMY:

a. Competencies:

The undergraduate must demonstrate:

Understanding of the gross and microscopic structure and development of human body,

Comprehension of the normal regulation and integration of the functions of the organs and systems on basis of the structure and genetic pattern,

Understanding of the clinical correlation of the organs and structures involved and interpret the anatomical basis of the disease presentations.

b. Broad subject specific objectives: 

Knowledge: At the end of the course the student should be able to

Comprehend the normal disposition, clinically relevant interrelationships, functional and cross -sectional Anatomy of the various organs and structures of the body.

Identify the microscopic structure and correlate elementary ultra structure of various organs and tissues with the functions as a prerequisite for understanding the altered state in various disease processes.

Comprehend the basic structure and connections of the central neryous system to analyze the integrative and regulative functions of the organs and systems.

He should be able to locate the site of gross lesions according to the deficits encountered

Demonstrate knowledge of the basic principles and sequential development of the organs and systems; recognize the critical stages of development and the effects of common teratogens, genetic mutations and environmental hazards.

He should be able to explain the developmental basis of the major variations and abnormalities.

c. Skills:

At the end of the course the student should be able to --

Identify and locate all the structures of the body and mark the topography of the Living Anatomy.

Understand clinical basis of some common clinical procedures i.e. intramuscular and intravenous injection, lumbar puncture and kidney biopsy etc.

Identify the organs and tissues under the microscope.

Understand the principles of karyotyping and identify the gross congenital anomalies.

Understand principles of newer imaging techniques and interpretation of CT scan, sonogram, MRI & Angiography.

d. Integration:

The teaching should be aligned and integrated horizontally and vertically in organ systems with clinical correlation that will provide a context for the learner to understand the relationship between structure and function and interpret the anatomical basis of various clinical conditions and procedures.

2. PHYSIOLOGY: 

a. Competencies: The undergraduates must demonstrate:

Understanding of the normal functioning of the organs and organ systems of the body,

Comprehension of the normal structure and organization of the organs and systems on basis of the functions,

Understanding of age-related physiological changes in the organ functions that reflect normal growth and development,

Understand the physiological basis of diseases

b. Broad subject specific objectives: 

Knowledge : At the end of the course, the student will be able to

Describe the normal functions of all the systems, the regulatory mechanisms and interactions of the various systems for well coordinated total body functions.

Understanding the relative contribution of each organ system in the maintenance of the milieu interior (homeostasis)

Explain the physiological aspects of the normal growth and development.

Analyze the physiological responses and adaptation to environmental stress. Comprehend the physiological principles underlying pathogenesis and treatment of disease.

Correlate knowledge of physiology of human reproductive system in relation to National Family welfare program.

c. Skills : At the end of the course the student shall be able to:

Conduct experiments designed for study of physiological phenomenon.

Interpretexperimental/investigativedata.

Distinguish between normal and abnormal data derived as a result of clinical examination and tests, which he has performed and observed in the laboratory.

Recognize and get familiar with newer computerized and advanced instruments like medspiror, semen quality analyzer, EMG and TMT

d. Integration: The teaching should be aligned and integrated horizontally and vertically in organ systems in order to provide a context in which normal function can be correlated both with structure and with the biological basis, its clinical features. diagnosis and therapy.

3. BIOCHEMISTRY: 

a. Competencies: The learner must demonstrate an understanding of:

Biochemical and molecular processes involved in health and disease,

Importance of nutrition in health and disease,

Biochemical basis and rationale of clinical laboratory tests, and demonstrate ability to interpret these in the clinical context.

b. Broad subject specific objectives:

Knowledge: At the end of the course, the student shall be able to

Enlist and describe the cell organelles with their molecular ad functional organization.

Delineate structure, function and interrelationships of various biomolecules and consequences of deviation from the normal.

Understand basic enzymology and emphasize on its clinical applications wherein regulation of enzymatic activity is disturbed.

Describe digestion and assimilation of nutrients and consequences of malnutrition.

Describe and integrate metabolic pathways of various biomolecules with their regulatory mechanisms.

Explain the biochemical basis of inherited disorders with their associated squeal. Describe mechanisms involved in maintenance in water, electrolyte and acid base balance and consequences of their imbalances.

Outline the molecular mechanisms of gene expression and regulation, basic principles of biotechnology and their applications in medicine.

c. Skills : At the end of the course, the student shall be able to

Make use of conventional techniques / instruments to perform biochemical analysis relevant to clinical screening and diagnosis;

Analysis and interpret investigative data;

Demonstrate the skills of solving scientific and clinical problems and decision making.

d. Integration: The teaching/learnirrg programme should be integrated horizontally and vertically, as much as possible. to enable learners to make clinical correlations and to acquire an understanding of the cellular and molecular basis of health and disease.

2ndProfessional Year:

4. PATHOLOGY

a. Competencies: The undergraduate must dernonstrate:

Comprehension of the causes, evolution and mechanisms of diseases,

Knowledge of alterations in gross and cellular morphology of organs in disease states,

Ability to correlate the natural history, structural and functional changes with the clinical manifestations of diseases, their diagnosis and therapy.

b. Broad subject specific objectives

Knowledge: At the end of one and half years, the student shall be able to

Describe the structure and ultra structure of a sick cell, causes and mechanisms of cell Injury, cell death and repair.

Correlate structural and functional alterations in the sick cell.

Explain the path physiological processes, which govern the maintenance of homeostasis, mechanisms of their disturbance and the morphological and clinical manifestation associated with it.

Describe the mechanisms and patterns of tissue response to injury so as to appreciate the path physiology of disease processes and their application to clinical science.

Correlate the gross and microscopic alterations of different organ systems in common disease to the extent needed for understanding disease processes and their clinical significance.

Develop an understanding of steps in neoplastic changes in the body and their effects in order to appreciate need for early diagnosis and fuither management of neoplasia.

Understand mechanisms of common hematological disorders and develop a logical approach in their diagnosis and management.

Develop understanding of the blood banking, blood donors & transfusion of blood & blood products, (components).

Understand pathophysiology of infectious diseases in relation with tissue changes.

Describe the various immunological reactions in understanding the disease process & tissue transplant.

Develop an understanding for genetic disorders. Understand the vital organ function test of Kidney, liver & thyroid.

c. Skills : At the end of one and half years, the student shall be able to:

Describe the rationale and principles of routine technical procedures of the diagnostic laboratory tests & perform it.

Interpret routine diagnostic laboratory tests and correlate with clinical, hematological and morphological changes.

Perform the simple bed-side tests on blood, urine and other biological fluid samples: Draw a rational scheme of investigations aimed at diagnosing and managing the cases of common disorders.

Able to understand the microscopic and macroscopic features of common diseases.

Develop different type of skills such as observation skills, communication skill and presentation skill.

Understand biochemical/physiological disturbances that occur as a result of disease in collaboration with preclinical department.

d. Integration: The teaching should be aligned and integrated horizontally and vertically in organ systems recognizing deviations from normal structure and function and clinically correlated so as to provide an overall understanding of the etiology, mechanisms. laboratory diagnosis, and management of diseases.

5. MICROBIOLOGY: 

a. Competencies: The undergraduate leamer demonstrates:

Understanding of role of microbial agents in health and disease,

Understanding of the immunological mechanisms in health and disease,

Ability to correlate the natural history, mechanisms and clinical manifestations of infectious diseases as they relate to the properties of microbial agents, o Knowledge of the principles and application of infection control measures,

An understanding of the basis of choice of laboratory diagnostic tests and their interpretation, antimicrobial therapy, control and prevention of infectious diseases.

Knowledge of outbreak investigation and its control.

b. Broad subject specific objectives : At the end of the course the student will be able to :

Explain how the different microorganisms can cause human infection.

Understand commercial, opportunistic and pathogenic organisms and describe host parasite relationship.

Describe the characteristics (morphology, cultural characteristics, resistance, virulence factors, incubation period, mode of transmission etc.) of different microorganisms.

Explain the various defense mechanisms of the host against the microorganisms which can cause human infection.

Describe the laboratory diagnosis of microorganisms causing human infections and disease. Describe the prophylaxis for the particular infecting microorganisms

c. Skills : At the end of the course the student shall be able to

Plan the laboratory investigations for the diagnosis of infectious diseases.

Perform laboratory procedures to arrive at the etiological diagnosis of infectious diseases caused by bacteria, fungi, viruses and parasites including the drug sensitivity profile.

Perform and interpret immunological and serological tests.

Operate routine and sophisticated instruments in the laboratory.

Develop microteaching skills and Pedagogy Successfully implement the chosen research methodology

d. Integration: The teaching should be aligned and integrated horizontally and vertically in organ systems with emphasis on host-microbe-environment interactions and their alterations in disease and clinical correlations so as to provide an overall understanding of the etiological agents, their laboratory diagnosis and prevention.

6. PHARMACOLOGY: 

a. Competencies: The undergraduate must demonstrate

Knowledge about essential and commonly used drugs and an understanding of the pharmacologic basis of therapeutics,

Ability to select and prescribe medicines based on clinical condition and the pharmacologic properties, efficacy, safety, suitability and cost of medicines for common clinical conditions of national importance,

Knowledge of pharmacovigilance, essential medicine concept and sources of drug information and industry-doctor relationship,

Ability to counsel patients regarding appropriate use of prescribed drug and drug delivery systems.

b. Broad subject specific objectives :

Knowledge: At the end of the course, the student shall be able to

Describe the Pharmacokinetics and Pharmacodynamics of essential and commonly used drugs.

Enlist the indications, contraindications, interactions and adverse reactions of commonly used drugs.

Tailor the use of appropriate drugs in disease with consideration of its cost, efficacy and safety for individual needs and Mass therapy, under National Health Programs.

Integrate the list of drugs of addiction and recommend the management of drug addiction.

Explain pharmacological basis of prescribing drugs in special medical situations such as pregnancy, lactation, infancy, old age, renal damage, hepatic damage and immunocompromised patients.

Explain the concept of rational drug therapy in clinical pharmacology.

State the principles underlying the concept of 'Essential Drugs'.

Evaluate the ethics and modalities involved in the development and introduction of new drugs.

c. Skills : At the end of the course, the student shall be able to

Prescribe drugs for common ailments.

Identify adverse reactions and drug interactions of commonly used drugs.

Interpret the data obtained from the experiments designed for the study of effect of drugs in various experimental and clinical studies.

Analyze the information regarding common pharmaceutical preparations and critically evaluate drug formulations.

Appraise the Principles of Clinical Pharmacy and Dispense the Medications giving proper lnstructrons.

d. Integration: Practical knowledge of use of drugs in Clinical Practice will be acquired through Integrated Teaching vertically with Preclinical and Clinical subjects and horizontally with other Para clinical subjects.

3rd PROFESSIONAL YEAR

7. FORENSIC MEDICINE AND TOXICOLOGY

a. Competencies : The learner must demonstrate:

Understanding of medico-legal responsibilities of Physicians in primary and secondary care seftings,

Understanding of the rational approach to the investigation of crime, based on scientific and legal principles,

Ability to manage medical and legal issues in cases of poisoning /overdose,

Understanding the medico-legal framework of medical practice and medical negligence,

Understanding of codes of conduct and medical ethics

b. Broad subject specific objectives:

Knowledge: At the end of the course, the student shall be able to

Identify the basic Medico-legal aspects of hospital and general practice.

Define the Medico-legal responsibilities of a general Physician while rendering community service either in a rural primary health centre or an urban health centre.

Appreciate the Physician's responsibilities in criminal matters and respect for the codes of Medical ethics.

Diagnose, manage and identify legal aspect of common acute and chronic poisonings.

Describe the Medico-legal aspects and findings of post-mortem examination in cases of death due to common unnatural conditions and poisonings.

Detect occupational and environmental poisoning, prevention and epidemiology of common poisoning and their legal aspects particularly pertaining to Workmen's Compensation Act.

Describe the general principles of analyical toxicology.

c. Skills : At the end of the course, the student shall be able to :

As recommended by Medical Council of India Regulation, 1997 desirable for Bachelor of Medicine and Bachelor of Surgery (MBBS) Graduate for Forensic Medicine and Toxicology.

Make observations and draw logical inferences in order to initiate enquiries in criminal matters and Medico-legal problems and be able to - Carry on proper Medico-legal examination and documentation/Reporting of Injury and Age.

Conduct examination for sexual offences and intoxication.

Preserve relevant ancillary materials for medico-legal examination.

Identify important post-mortem findings in common unnatural deaths.

Diagnose and treat common emergencies in poisoning and chronic toxicity.

Make observations and interpret findings at post-mortem examination.

Observe the principles of medical ethics in the practice of his profession.

d. Integration: The teaching should be aligned and integrated horizontally and vertically recognizing the importance of medico-legal. ethical and toxicological issues as they relate to the practice of medicine.

8. COMMUNITY MEDICINE

a. Competencies: The undergraduate must demonstrate :

Understanding of the concept of health and disease,

Understanding of demography, population dynamics and disease burden in National and global context,

Comprehension of principles of health economics and hospital management,

Understanding of interventions to promote health and prevent diseases as envisioned in National and State Health Programmes.

Understanding of physical, social, psychological, economic and environmental determinants of health and disease,

Ability to recognize and manage common health problems including physical, emotional and social aspects at individual family and community level in the context of National Health Programmes,

Ability to Implement and monitor National Health Programmes in the primary care setting,

Knowledge of maternal and child wellness as they apply to national health care priorities and programmes,

Ability to recognize, investigate, report. plan and manage community health problems including malnutrition and emergencies.

b. Broad subject specific objectives:

Knowledge: At the end of the course the student shall be able Explain the principles of sociology including demographic population dynamics. Identifu social factors related to health, disease and disability in the context of urban and rural societies.

Appreciate the impact of urbanization on health and disease.

Observe and interpret the dynamic of community behaviors.

Describe the elements of normal psychology and social psychology.

Observe the principles of practice of medicine in hospital and community settings.

Describe the health care deliveiy systems including rehabilitation of the disabled in the country.

Describe the National Health Programmes with particular emphasis on maternal and child health programmes, family welfare planning and population control.

Describe the epidemiological methods and techniques.

Outline the demographic pattern of the country and appreciate the roles of the individuals, family, community and socio-cultural milieu in health and disease.

Describe the health information systems.

Acquire, understand, integrate, apply and manage information in context to health care problems and health care delivery system in various communities, health care settings and hospitals.

Describe the principles and components of primary health care, National Rural Health Mission and the national health policies to achieve the goal of "Health for all" with regards to identify the environmental, bio-waste and occupational hazards and their control.

Describe the importance of water and sanitation in human health.

Describe the principles of health economies, health administration, health education in relation to community.

Critically analyze the problem (s) and apply his/trer knowledge to solve the problem in holistic manner.

Describe and apply principles of prevention, promotion and maintenance of health.

c. Skills : At the end of the course. the student shall be able to

Use the principles and practice of medicine in hospital and community settings and familiarization with elementary practices.

Use the Art of communication with patients including history taking and medico social work.

Use epidemiology as a scientific tool to make rational decisions relevant to community and individual patient intervention.

Organize health care services for lulnerable and disadvantages groups.

Organize health care services in case of calamities. Collect, analyze, interpret and present simple community and hospital base data.

Diagnose and manage common health problems (including communicable and noncommunicable diseases) and emergencies at the individual, family and community levels keeping in mind the existing health care resources and in the context of the prevailing socio-culture beliefs. 

Diagnose and manage corlmon nutritional problems at the individual and community level.

Plan, implement and evaluate a health education Programme with skill to use simple audio-visual aids. Interact with other members of the health care team and participate in the organization of health care services, health advocacy and implementation of national health programmes.

Perform Administrative functions at health centers Observe the principles of medical ethics in the practice of his profession.

d. Integration: Department shall adopt an integrated approach towards other clinical disciplines, public health services, NGOs, environmental sciences, social sciences, management, hospital administration, research, etc. to impart training to enable the graduate to work at all levels of health care. The teaching should be aligned and integrated horizontally and vertically in order to allow the learner to understand the impact of environrnent, society and national health priorities as they relate to the promotion of health and prevention and cure of disease.

9. GENERAL MEDICINE

a. Competencies: The student must demonstrate ability to do the following in relation to common medical problems of the adult in the community:

Demonstrate understanding of the pathophysiologic basis, epidemiological profile. signs and symptoms of disease and their investigation and management. Competently interview and examine an adult patient and make a clinical diagnosis.

Appropriately order and interpret laboratory tests.

Initiate appropriate cost-effective treatment based on an understanding of the rational drug prescriptions. medical interventions required and preventive measures.

Follow up of patients with medical problems and ref-er whenever required.

Communicate effectively, educate and counsel the patient and family,

Manage common medical emergencies and refer when required.

Independently perfonn common medical procedures safely and understand patient safety issues.

b. Broad subject specific objectives:

Knowledge: At the end of the course, the student shall be able to:

Diagnose common clinical disorders with special reference to infectious diseases. nutritional disorders. tropical and errvironmental diseases:

Outline various modes of management including drug therapeutics especially dosage, side effects, toxic ity. interactions, indications and contra-indications;

Propose diagnostic and investigative procedures and ability to interpret them;

Provide first level management of acute emergencies promptly and efficiently and decide the timing and level of referral, if required:

Recognize geriatric disorders and their management.

c. Skills : At the end of the course, the student shall be able to

Develop clinical skills (history taking. clinical examination and other instruments of examination) to diagnose various common medical disorders and emergencies;

Refer a patient to secondary and/or tertiary level of health care after having instituted primary care;

Perform simple routine investigations like hemogram. stool. urine. sputum and biological fluid examinations;

Assist the common bedside investigative procedure like pleural tap. Lumbar puncture. bone marrow aspiration/biopsy and liver biopsy.

d. Integration: The teaching should be aligned and integrated horizontally and vertically in order to provide sound biologic basis and incorporating the principles of general medicine into a holistic and comprehensive approach to the care of the patient. With other relevant academic inputs which provide scientific basis of clinical medicine e.g. anatomy, physiology, biochemistry, microbiology, pathology and pharmacology.

10. DERMATOLOGY:

a. Competencies: The undergraduate student must demonstrate:

Understanding of the principles of diagnosis of diseases of the skin. hair. nail and mucosa,

Ability to recognize, diagnose, order appropriate investigations and treat common diseases of the skin including leprosy in the primary care setting and refer as appropriate.

A syndromic approach to the recognition. diagnosis. prevention. counseling, testing and management of common sexually transmitted diseases including HIV based on national health priorities,

Ability to recognize and treat emergencies including drug reactions and refer as appropriate.

b. Broad subject specific objectives:

Knowledge: At the end of the course of Dermatology the student shall be able to

Demonstrate sound knowledge of common diseases, their clinical manifestations. including emergent situations and of investigative procedures to confirm their diagnosis

Demonstrate comprehensive knowledge of various modes of therapy used in treatment of cutaneous. sexually transmitted diseases and leprosy

Describe the mode of action of commonly used drugs. their doses, side ef fects/toxicity. indications and contra-indications and interactions

Describe commonly used modes of management including the medical and surgical procedures available for the treatment of various diseases and to offer a comprehensive plan of management for a given disorder

c. Skills: The student shall be able to

Interview the patient, elicit relevant and correct information and describe the history in a chronological order;

Conduct clinical examination. elicit and interpret physical findings and diagnose common disorders and emergencies.

Demonstrate simple, routine investigative and laboratory procedures required for making the bed-side diagnosis, especially the examination of scrapings for fungus, preparation of slit smears and staining for AFB for leprosy patients and for STD cases and take a skin biopsy for diagnostic purposes.

Manage common diseases and recognizing the need for referral for specialized care. in case of inappropriateness of therapeutic response.

d. Integration: The teaching should be aligned and integrated horizontally and vertically in order to emphasize the biologic basis of diseases of the skin, sexually transmitted diseases and leprosy

11. PSYCHIATRY

a. Competencies: The student must demonstrate:

Ability to promote mental health and mental hygiene,

Knowledge of etiology (bio-psycho-social-environmental interactions), clinical features, diagnosis and management of common psychiatric disorders across all ages,

Ability to recognize and manage common psychological and psychiatric disorders in a primary care setting. institute preliminary treatment in disorders difficult to manage. and refer appropriately.

Ability to recognize alcohol/ substance abuse disorders and refer them to appropriate centers.

Ability to assess risk for suicide and refer appropriately.

Ability to recognize temperamental difficulties and personality disorders,

Assess mental disability and rehabilitate appropriately.

Understanding of National and State programmes that address mental health and welfare of patients and community.

b. Broad subject specific objectives:

Knowledge: At the end of the course the student shall be able to:

Understand the comprehensive nature & development of different aspects of normal human behavior like learning. memory. motivation, personality & intelligence

Recognize differences between normal & abnormal behavior Classify psychiatric disorders

Recognize clinical manifestations of the following common syndromes & plan their appropriate management of organic psychosis. functional psychosis. schizophrenia, affective disorders, neurotic disorders, personality disorders. psycho physiological disorders, drug & alcohol dependence. psychiatric disorders of childhood & adolescence

Describe rational use of different mode of therapy in psychiatric disorders.

c. Skills: The student shall be able to:

Interview the patient & understand different methods of communications in patient-doctor relationship

Elicit detailed psychiatric case history & conduct clinical examination for assessment of mental status

Define, elicit & interpret psychopathological symptoms & signs

Diagnose & manage common psychiatric disorders

Identify & manage common psychological reactions & psychiatric disorders in medical & surgical patients in clinical practice & in community setting

d. Integration: The teaching should be aligned and integrated horizontally and vertically in order to allow the student to understand bio-psycho-social-environmental interactions that lead to diseases/ disorders for preventive, promotive, curative. rehabilitative services and medico-legal implications in the care of patients both in family and community.

12. RESPIRATORY MEDICINE

a. Competencies: The student must demonstrate:

Knowledge of common chest diseases: their clinical manifestations, diagnosis and management,

Ability to recognize. diagnose and manage pulmonary tuberculosis as contemplated in National Tuberculosis Elimination programme.

Ability to manage common respiratory emergencies in primary care setting and refer appropriately.

b. Broad subject specific objectives:

Knowledge: At the end of the course of Pulmonary Medicine, the student shall be able to:

Demonstrate sound knowledge of common chest diseases, their manifestations. including emergency situations and of investigative procedures to confirm their diagnosis.

Demonstrate comprehensive knowledge of various modes of therapy used in treatment of respiratory di seases.

Describe the modes of action of commonly used drugs, their doses, side effects/ toxicity. indications and contra indications and interactions.

Describe commonly used modes of management including medical and surgical procedures available for treatment of various diseases and to offer a comprehensive plan of management inclusive of Revised National Tuberculosis Control programme.

c. Skills : The student shall be able to

Interview the patient, elicit relevant and correct information and describe the history in chronological order;

Conduct clinical examination, elicit and interpret clinical findings and diagnose common respiratory disorders and emergencies;

Perform simple, routine investigative and office procedures required for making the bed side diagnosis especially sputum collection and examination for etiologic organisms especially Acid fast Bacilli (AFB). interpretation of the chest x-rays and respiratory function tests;

Interpret and manage various blood gases and PH abnormalities in various respiratory diseases;

Manage common diseases recognizing need for referral for specialized care, in case of inappropriateness of therapeutic responses;

Assist in the performance of common procedures. like laryngoscopic examination, pleural aspiration, respiratory physiotherapy, laryngeal intubation and pneumothoracic drainage/asp iration

d. Integration: The teaching should be aligned and integrated horizontally and vertically in order to allow the student to recognize diagnose and treat TB and other lung diseases in the context of the society. national health priorities. drug resistance and co-morbid conditions like HIV

13. PEDIATRICS

a. Competencies: The student must demonstrate:

Ability to assess and promote optimal groMh, development and nutrition of children and adolescents and identify deviations from normal,

Ability to recognize and provide emergency and routine ambulatory and First Level Referral Unit care for neonates, infants, children and adolescents and refer as may be appropriate.

Ability to perform procedures as indicated for children of all ages in the primary care setting,

Ability to recognize children with special needs and refer appropriately,

Ability to promote health and prevent diseases in children,

Ability to participate in National Programmes related to child health and in conformation with the Integrated Management of Neonatal and Childhood Illnesses (l MNC I) Strategy, Ability to communicate appropriately and effectively

b. Broad subject specilic objectives:

Knowledge:-At the end of the course, the students shall be able to:-

Describe the normal GroMh and Development during fetal life, Neonatal period. Childhood and Adolescence and the deviations thereof.

Describe the common Pediatric disorders and emergencies in terms of Epidemiology, Etiopathogenesis. Clinical manifestations.

Diagnosis and also describe the rational therapy and rehabilitation services.

Workout age related requirements of calories, nutrients, fluids. dosages of drugs etc. in health and disease.

Describe preventive strategies for common infectious disorders, Malnutrition, Genetic and Metabolic disorders, Poisonings, Accidents and Child abuse

Outline national programs related to child health including Immunization programs

c. Skills : At the end of the course, the students shall be able to:

Take detailed Pediatric and Neonatal history and conduct an appropriate physical examination of children and neonates. make clinical diagnosis, conduct common bedside investigative procedures, interpret common laboratory investigations, plan and institute therapy.

Take anthropometric measurements. resuscitate newbom, prepare oral rehydration solution, perform tuberculin test, administer vaccines available under current National programs. perform venesection, start intravenous fluids and provide nasogastric feeding.

Conduct diagnostic procedures such as lumbar puncture. liver and kidney biopsy. bone marrow aspiration. pleural and ascitic tap.

Distinguish between normal Newborn babies and those requiring special care and institute early care to all newborn babies including care of preterm and low birth weight babies, provide correct guidance and counseling about breastfeeding and Complementary feeding.

Provide ambulatory care to all not so sick children. identify indications for specialized/ inpatient care and ensure timely referral to those who require hospitalization.

d. Integration: The teaching should be aligned and integrated horizontally and vertically in order to provide comprehensive care for neonates. infants, children and adolescents based on a sound knowledge of groMh, development. disease and their clinical, social" emotional. psychological correlates in the context of national health priorities.

14. GENERAL SURGERY

a. Competencies: The student must demonstrate:

Understanding of the structural and functional basis, principles of diagnosis and management of common surgical problems in adults and children

Ability to choose. calculate and administer appropriately intravenous fluids. electrolytes, blood and blood products based on the clinical condition

Ability to apply the principles of asepsis. sterilization, disinfection, rational use of prophylaxis. therapeutic utilities of antibiotics and universal precautions in surgical practice

Knowledge of common malignancies in India and their prevention. early detection and therapy

Ability to perform common diagnostic and surgical procedures at the primary care level

Ability to recognize. resuscitate, stabilize and provide Basic & Advanced Litb Support to patients following trauma

Ability to administer informed consent and counsel patient prior to sr.rrgical procedures, Commitment to advancement of quality and patient safety in surgical practice

b. Broad subject specific objectives.

Knowledge: At the end of course, the student should be able to:

Describeaetiology, pathophysiology. principles of diagnosis and management of common surgical problems including emergencies in adult and children.

Define indications and methods for fluid and electrolytes replacement therapy including blood transfusion.

Define asepsis. disinfection and sterilization and recommend judicious use of antibiotics.

Describe common malignancies in the country and their management including prevention.

Enumerate different types of anaesthetic agents. their indications. contraindications. mode of administration, and side effects

c. Skills : At the end of the course, the student should be able to :

Diagnose common surgical conditions both acute and chronic. in adults and children.

Plan various laboratory tests for surgical conditions and interpret the results. Identify and manage patients of hemorrhagic, septicanemia and other types of shock.

Be able to maintain patent air-way and resuscitate.

Monitor patient of head. chest, spinal and abdominal injuries. both in adults and children.

Provide primary care for a patient of burns.

Acquire principles of operative surgery including preoperative, operative and post operative care and monitoring.

Treat open wound including preventive measures against tetanus and gas gangrene.

Diagnose neonatal and pediatric surgical emergencies and provide sound primary care before referring the patient to secondary/tertiary centres.

Identify congenital anomalies and refer them for appropriate management.

d. Integration: The teaching should be aligned and integrated horizontally and vertically in order to provide a sound biologic basis and a holistic approach to the care of the surgical patient.

Apply knowledge of basic medical sciences and other relevant subjects to support understanding of various pathologies, facilitate examination of and intervention for the patients.

To apply the principles of quality of health care. legal and ethical principles and regulations as recommended by Medical Council of India and WHO.

15. ORTHOPAEDICS (INCLUDING PHYSICAL MEDICINE & REHABILITATION)

a. Competencies: The student must demonstrate:

Ability to recognize and assess bone injuries, dislocation and poly-trauma and provide first contact care prior to appropriate referral,

Knowledge of the medico-legal aspects of trauma, Ability to recognize and manage common infections of bone and joints in the primary care setting.

Recognize common congenital. metabolic, neoplastic, degenerative and inflammatory bone diseases and refer appropriately.

Ability to perfbrm simple orthopedic techniques as applicable to a primary care setting,

Ability to recommend rehabilitative services for common orthopaedic problerns across all ages.

b. Broad subject specific objectives

Knowledge: The student shall be able to understand:

The principles, diagnosis and primary management and be able to give appropriate referral for further definitive management of bones and joint injuries.

Osteogenesis, manifestation and diagnosis, primary management and give their referral for appropriate correction or rehabilitation of common musculoskeletal disorders including infections of bones and joints; congenital skeletal anomalies, metabolic bone diseases and neoplasm affecting bones.

c. Skills : At the end of the course, the student shall be able to:

Detect soft tissue injuries such as sprains and strains.

Detect common fractures of extremities. Deliver first aid measures for common fractures and sprains

Deliver emergency measures to poly trauma patients.

Manage uncomplicated fractures of clavicle. forearm, phalanges etc.

Use techniques of splinting such as application of Thomas splint, plaster slab and casts, immobilization by skin tractions etc.

Learn indications for closed reductions, open reductions. internal fixation and external fixations of fracture.

Manage common bone infection; learn indications for sequestration, amputation and corrective measures for bone deformities.

Advice and counsel patient for rehabilitation for post traumatic, poliomyelitis, cerebral palsy and amputation.

Be able to perform certain orthopedic skills. provide sound advice of skeletal and related conditions at primary or secondary health care level.

d. Integration: The teaching should be aligned and integrated horizontally and vertically in order to allow the student to understand the structural basis of orthopedic problems, their management and correlation with function, rehabilitation and quality of life.

16. ANAESTHESIOLOGY

a. Competencies: The student must demonstrate ability to:

Describe and discuss the pre-operative evaluation. assessing fitness for surgery and the modifications in medications in relation to anesthesia /surgery,

Describe and discuss the roles of Anesthesiologist as a peri-operative Physician including pre-medication, endotracheal intubation, general anesthesia and recovery (including variations in recovery from anesthesia and anaesthetic complications),

Describe and discuss the management of acute and chronic pain, including labour analgesia,

Demonstrate awareness about the maintenance of airway in children and adults in various situations.

Demonstrate the awareness about the indications. selection of cases and execution of cardio- pulmonary

Resuscitation in emergencies and in the intensive care and high dependency units,

Choose cases for local / regional anesthesia and demonstrate the ability to administer the same.

Discuss the implications and obtain informed consent for various procedures and to maintain the documents.

b. Broad subject specific objectives:

Knowledge: At the end of the course, the student shall be able to

Know of simple nerve block and pain relief

Awareness of the principles of administration of general, regional and local anesthesia.

Know importance of hypoglycemialhyperglycemia, hypotension/hypertension, lHD, Myocardial infarction. Know ventilators.

c. Skills : At the end of the training, the students should be able to

Perform cardio-pulmonary resuscitation with the available resources and transfer the patients to a bigger hospital for advanced life support.

Set up intravenous infusion and manage fluid therapy

Clear and maintain airway in unconscious patient. Administer oxygen correctly

d. Integration: The teaching should be aligned and integrated horizontally and vertically in order to provide comprehensive care for patients undergoing various surgeries, in patients with pain. in intensive care and in cardio respiratory emergencies. Integration with the preclinical department of Anatomy, para- clinical department of Pharmacology and horizontal integration with anylall surgical specialties is proposed.

17. RADIODIAGNOSIS

a. Competencies: The student must demonstrate

Understanding of indications for various radiological investigations in common clinical practice.

Awareness of the ill effects of radiation and various radiation protective measures to be employed,

Ability to identify abnormalities in common radiological investigations.

b. Broad subject specific objectives:

Knowledge: At the end of the course, the student shall be able to:

Enlist and describe the various diagnostic modalities Delineate normal and abnormal radiological findings Understand basic radiology and emphasize on its clinical applications Describe radiographic, ultra sonographic, CT, MRI features of common pathologies. Describe and integrate radiological findings in CNS. GIT, RS, CVS. MSK, GUT

c. Skills: At the end of the course, the student shall be able to

Make use of Imaging findings to reach to a diagnosis;

Analysis and interpret radiological data;

Demonstrate the skills of solving clinical problems by illustrative evidences and decision making.

d. Integration: Horizontal and vertical integration to understand the fundamental principles of radiologic imaging, anatomic correlation and their application in diagnosis and therapy

18. OTO-RHTNOLARYNGOLOGY(ENT)

a. Competencies: The learner must demonstrate:

Knowledge of the common Otorhinolaryngological (ENT) emergencies and problems,

Ability to recognize, diagnose and manage common ENT emergencies and problems in primary care setting

Ability to perform simple ENT procedures as applicable in a primary care setting,

Ability to recognize hearing impairment and refer to the appropriate hearing impairment rehabilitation programme.

b. Broad subject specific objectives:

Knowledge: At the end of the course, the student shall be able to

Describe the basic pathophysiology of common Ear, Nose & Throat (ENT) diseases &emergencies.

Adopt the rational use of commonly used drugs keeping in mind their adverse reactions.

Suggest common investigative procedures & their interpretation.

c. Skills: At the end of the course the student shall be able to :

Examination & Diagnose common ENT problems including pre-malignant & Malignant disorders of the Head & Neck.

Manage ENT problems at f,rrst level of care & be able to refer whenever necessary.

Assist I carry out minor ENT procedures like ear syringing, ear dressing, nasal packing. Assist in certain procedures such as tracheotomy, endoscopy & removal of foreign bodies.

d. Integration: The teaching should be aligned and integrated horizontally and vertically in order to allow the learner to understand the structural basis of ENT problems. their management and correlation with function. rehabilitation and quality of life. The undergraduate training ENT will provide an integrated approach towards other disciplines especially, neurosciences, ophthalmology & general surgery

19. OPHTHALMOLOGY:

a. Competencies: The student must demonstrate

Knowledge of common eye problems in the community Recognize, diagnose and manage common eye problems and identify indications for referral,

Ability to recognize visual impairment and blindness in the community and implement national programmes as applicable in the primary care setting.

b. Broad subject specific objectives

Knowledge: At the end of the course, student shall have the knowledge of

Common problems affecting the eye.

Principles of management of major ophthalmic emergencies.

Main systemic disease aflfbcting the eye.

Effects of local and systemic diseases on patient's vision and the necessary action required minimizing the sequelae of such diseases.

Adverse drug reaction with special reference to ophthalmic manifestations.

Magnitude of blindness in India and its main causes.

National programme for control of blindness and its implementation at various levels.

Eye care education for prevention of eye problems.

Role of primary health center in organization of eye camps.

Organization of primary health care and the functioning of the ophthalmic assistant.

Integration of the national programme for control of blindness with the other national health programmes. Eye bank organization.

c. Skills:

Elicit a history pertinent to general health and ocular status

Assist in diagnostic procedures such as visual acuity testing, examination of eye, Schiotztonometry.

Staining of Corneal pathol6gy, confrontation, perimetry, Subjective refraction including correction of Presbyopia and aphakia, direct ophthalmoscopy and conjunctival smear examination and Cover test.

Diagnose and treat common problems affecting the eye.

Interpret ophthalmic signs in relation to common systemic disorders.

Assist/observe therapeutic procedures such as Subconjunctival injection. corneal conjunctival foreign body rernoval, carbolic cautery for corneal ulcers, Nasolacrimal duct syringing and tarsorrhaphy

Provide first aid in rnajor ophthalmic emergencies.

Assist to organize community surveys for visual check-up.

Assist to organize primary eye care service through primary health centers.

Use effective means of communication with the public and individual to motivate for surgery in cataract and for eye donation.

Establish rapport with his seniors, colleagues and paramedical workers so as to effectively function as a member of the eye care team.

d. Integration: The teaching should be aligned and integrated horizontally and vertically in order to allow the student to understand the structural basis of ophthalmologic problems. their management and correlation with function. rehabilitation and quality of life

20. OBSTETRICS AND GYNAECOLOGY

a. Competencies: The student must demonstrate ability to:

Provide peri-conceptional counseling and ante natal care, Identify high-risk pregnancies and refer appropriately,

Conduct normal deliveries, using safe delivery practices in the primary and secondary care settings,

Prescribe drugs safely and appropriately in pregnancy and lactation,

Diagnose complications of labor, institute primary care and refer in a timely manner,

Perform early neonatal resuscitation,

Provide postnatal care, including education in breast-feeding,

Counsel and support couples in the correct choice ofcontraception,

Interpret test results of laboratory and radiological investigations as they apply to the care of the obstetric patient,

Apply medico-legal principles as they apply to tubectomy, Medical Termination of Pregnancy (MTP), Pre-conception and Prenatal Diagnostic Techniques (PC PNDT Act) and other related Acts.

Elicit a gynecologic history, perform appropriate physical and pelvic examinations and PAP smear in the primary care setting,

Recognize, diagnose and manage common reproductive tract infections in the primary care setting,

Recognize and diagnose cofllmon genital cancers and refer them appropriately.

b. Broad subject specific objectives

Knowledge : At the end of the course, the student shall be able to:

Outline the anatomy, physiology and pathophysiology of the reproductive system and the common conditions affecting it.

Diagnose normal pregnancy, labour, puerperium and manage the problems he is likely to encounter therein.

List of leading causes of maternal and perinatal morbidity and mortality.

Understand the principles of contraception and various techniques employed, methods of medical termination of pregnancy, sterilization and their complications. o Identify the use, abuse and side effects of drugs in pregnancy, peri- menopausal and post-menopausal periods.

Describe the national programme of maternal and child health and family welfare and their implementation at various levels.

Identify common gynecological diseases and management.

State the indications, techniques and complications of surgeries like Caesarian section, laparotomy, abdominal and vaginal hysterectomy, Fothergill's operation and vacuum

Aspiration for Medical Termination of pregnancy (MTP) and minor surgeries like EB, D and C, Cervical Biopsy and Cervical encirclage.

c. Skills : At the end of the course, the student should be able to

Take proper history and writing a good case sheet

Writing a good discharge summary, proper referral letter

Examination of patient and arrival at a diagnosis

Planning for investigation and treatment

Community orientation, participation in community health promoting and preventing programmes

Examine a pregnant woman, recognize high- risk pregnancies and make appropriate referrals.

Conduct a normal delivery, plot and inter pretepartogram .

Recognize complications and decision of referral, provide postnatal care,

Resuscitate the newborn and recognize the congenital anomalies.

Advise a couple on the use of various available contraceptive devices (student should see at least 5 Cu-Tinsertions and 5 cases of female sterilization operations.)

Perform pelvic examination, diagnose and manage common. gynecological problems including early detection of genital malignancies.

Make a vaginal cytological smear, perform a post coital test and wet vaginal smear examination for Trichomonas vaginalis, Moniliasis and gram stain for gonorrhea, catheterization of urinary bladder .

Interpretation of data of investigations like biochemical, histopathological, radiological ultrasound etc.

d. Integration: The teaching should be aligned and integrated horizontally and vertically in order to provide comprehensive care for women in their reproductive years and beyond. based on a sound knowledge of structure. functions and disease and tl-reir clinical. social, emotional. psychological correlates in the context of national health priorities. The student shall be able to integrate clinical skills with other disciplines and bring about coordination of family welfare programme for the national goal of population control.

B. PHASE WISE TRAINING AND TIME DISTRIBUTION FOR PROFESSIONAL DEVELOPMENT

The Competency based Undergraduate Curriculum and Attitude, Ethics and Communication (AETCOM) course, as published by the Medical Council of India and also made available on the Council's website, shall be the cumiculum for the batches admitted in MBBS from the academic year 2019-20 onwards.

In order to ensure that training is in alignment with the goals and competencies required for a medical graduate, there shall be a Foundation Course to orient medical leamers to MBBS programme. and provide thern with requisite knowledge, communication (including electronic), technical and language skills.

I. Training period and time distribution:

Universities shall organize admission timing and admission process in such a way that teaching in the first Professional year commences with induction through the Foundation Course by the 1st of August of each year. There shall be no admission of students in respect of any academic session beyond 30th August under any circumstance. The Universities shall not register any student admitted beyond the said date.

The National Medical Commission may direct, that any student identified as having Obtained admission after the last date for closure of admission be discharged from the Course of study, or any medical qualification granted to such a student shall not be a recognized qualification by National Medical Commission.

The institution which grants admission to any student after the last date specified from the same shall also be liable to face such action as may be prescribed by National Medical Commission.

Every learner shall undergo a period of certified study extending over 4 1/2 academic years. divided into four professional years from the date of commencement of course to the date of completion of examination which shall be followed by one year of compulsory rotating internship.

Each academic year will have at least 39 teaching weeks with a minimum of eight hours of working on each day including one hour as lunch break.

Didactic lectures shall not exceed one third of the schedule; two third of the schedule shall include interactive sessions, practicals, clinical or/and group discussions. The learning process should include clinical experiences, problem- oriented approach. case studies and community health care activities

Teaching and learning shall be aligned and integrated across specialties both vertically and horizontally for better leamer comprehension. Learner centered learning methods should include Early Clinical Exposure. problem-oriented learning, case studies. community- oriented learning. self- directed, experiential learning& Electives.

AETCOM Competencies for First MBBS

Apart from the CBME Curriculum, the guidelines issued by the UGMEB also includes issues including Manpower requirement for research facilities in a medical college, Family Adoption Program, Admission of students under "Disability Category" in MBBS course, Format for submission of information regarding admission of in a medical college.

To view the guidelines, click on the link below:

Also Read: NMC releases final Graduate Medical Education Regulations 2023, check out details