BSMMU MD Residency Syllabus : Medicine and Allied Phase – A

Medicine and Allied Phase – A Residency Syllabus- BSMMU

BSMMU MD Medicine Syllabus Index:

  1. cardiovascular System
  2. Endocrine & Metabolic Disorder
  3. Gastroenterology & Hepatology
  4. Haematology
  5. Infectious Diseases & Tropical Medicine
  6. Renal & Genitourinary System
  7. Neurology
  8. Respiratory Medicine
  9. Musculoskeletal System

The aim of the syllabus for Phase A training is to guide the Residents to acquire broad based knowledge on Medicine before entering the Phase B specialty-specific training. Patients present themselves with problems and it is the problem that needs solving. A specialist who has broad based knowledge of Medicine will be able to solve the problem in a better way. So the ultimate objective of Phase A training is to produce a knowledgeable, competent, altruistic specialist with up to date background knowledge of Medicine. Emphasis has been laid on common diseases frequently encountered in this part of the world.

By the end of Phase A Training (Core Medical Training) the Resident should be able to:

a. Assess presenting symptoms and signs
b. Formulate appropriate investigations and accurately interpret
investigation reports
c. Communicate the diagnosis and prognosis
d. Institute appropriate treatment recognizing indications,
contraindications and side effects of common clinical conditions:
On this background, it is expected that Residents will be able to:
(i) acquire knowledge lof common medical conditions,emergencies, & rehabilitations].
(1) acquire skills (diagnostic,clinical and decision making) and (iii) develop attitude (caring,learning, & ethical).

11.1. Learning Objectives:

A. CLINICAL SKILLS

1. Elicit the history and obtain other relevant data
2. Conduct an appropriate physical examination
3. Synthesize findings from history and physical examination to
develop differential diagnoses, identify problems, make
problem list and formulate management plan
4. Plan and arrange investigations appropriately

B. PATIENT CARE AND THERAPEUTICS

1. Manage general care in the unwell patient
2. Prescribe appropriate and safe pharmacotherapy
3. Incorporate health and wellness promotion in clinical practice
4. Manage patients with surgical problems
5. Facilitate ongoing care planning
6. Know his limitations and seeks appropriate consultation

C. PROCEDURAL SKILLS

1. Prepare patient for procedure
2. Competently perform procedures relevant to General Internal
Medicine
3. Provide care following procedure

D. MANAGEMENT OF ACUTE MEDICAL PROBLEMS

1. Recognize and manage the critically ill patient
2. Manage specific acute medical problems
3. Communicate with patients and their families in an
emergency situation

E. MANAGE PATIENTS WITH UNDIFFERENTIATED PRESENTATIONS

1. Manage patients with undifferentiated presentations (eg,
Chest pain, cough, weight loss, etc)

F. MANAGE PATIENTS WITH COMMON DISORDERS OF ORGANS

1. Disorders of the cardiovascular system
2. Endocrine and metabolic disorders
3. Disorders of the gastrointestinal system
4. Disorders of the haemopoetic system.
5. Mental health disorders
6. Disorders of the musculoskeletal system
7. Disorders of the neurological system
8. Disorders of the renal and genitourinary systems
9. Disorders of the respiratory system
10. Skin disorders

G. MANAGE PATIENTS WITH DEFINED DISEASE PROCESSES

1. Manage patients with neoplastic diseases
2. Manage patients with genetic disorders
3. Manage patients with infectious diseases
4. Manage patients with electrolytes and acid base disorders

H. MEDICINE THROUGHOUT THE LIFESPAN
GROWTH AND DEVELOPMENT
1. Manage common presentations in adolescents
2. Manage common presentations in pregnancy
3. Manage common problems associated with the menopause
4. Manage problems in the older patient
5. Manage patients at the end of life

11.2. Outline of Core Syllabus:

BSMMU Core Syllabus in which the Resident should acquire good
knowledge, clinical competence including appropriate
technical abilities is outlined below.
Respective applied basic sciences will be integrated with the
clinical science content 

1. Disorders of CVS

HeadlinesImportant Topics
Applied Basic scienceAnatomy 
Fetal circulation
Principle of 
Blood vessel 
Coronary anatomy
Coronary circulation 
Conducting System
Cardiac cycle
Cardiac performance 
Core Clinical KnowledgeSymptoms and Sign of Cardiovascular Disease
IHD
Angina
ACS
Arrhythmia 
Conduction defect
Heart failure
Cardiogenic shock
Valvular  Heart disease 
HTN
Dyslipidaemia
Infective endocarditis
Myocarditis
Cardiac myopathy
Pericardial effusion 
Congenital heart disease 
Peripheral Vascular Diseases 
Systemic disease of heart
Emergency Management Unstable Angina
Arrhythmia 
MI
LVF
Malignant HTN
Cardiac temponode
DVT with Pericardial effusion 
Critical limb ischemia 
CPR
Common Presentation 
Scenario
Chest pain syndrome 
Shock state
Cyanosis
Acute Pulmonary Oedema
Breathlessness 
Palpitition
Oedema
Investigation, procedure, interpretationECG
Echocardiography
Ambulatory 
Cardiac catherization
Cardiac pacing
ETT
CT venous cannulation 
CT angiography
Cardiology Question BankHere

2. Endocrine Disorder

HeadlinesImportant Topics
Applied Basic scienceClassification, mechanism, and action of Hormone 
Hypothalamic regulatory hormone 
Pituitary Hormone
Adrenal cortex
Adrenal Medulla 
Pancreas 
Thyroid 
Physiologic responce in pregnancy
Core Clinical KnowledgeSymptoms and sign of endocrine Disorder,
DM,
Hyperglycemia & hypoglycemia 
Hypercalcemia & Hypocalcemia 
Thyroid nodule and cancer,
Autoimmune thyroiditis,
Hypothyroidism & hyperthyroidism,
Hypopituitarysm,
Pituitary tumor,
Multiple endocrine neoplasia, 
Polycystic ovarian syndrome, 
Obesity,
Hypogonadism,
Male sexual dysfunction, 
Hyper and hypoadrenalism,
Pheochromocytoma,
Hypo and Hyper aldostrenism,
Emergency Management DKA,
HONK,
 Hypoglycemia, 
Tetanus,
Addison crisis,
Thyrotoxic crisis,
Myxedoma coma,
Common Presentation 
Scenario
Thurst,
Polyurea, 
Hyperpigmentation,
Fatigue, 
Weekness,
Weight gain,
Weight loss,
Appetite, 
Hirsutism,
Investigation, procedure, interpretationCT scan,
MRI,
Radioiodine scan of thyroid, 
USG of Thyroid, 
Short synactin test,
X ray skull, 
OGTT,RBS,HbA1C,FBS
FNAC,
Thyroid function test,
Thyroid autoantibody, 

3. Disorder Of Gastrointestinal and Hepatopancreatic system

HeadlinesImportant Topics
Applied
Basic science
Regional anatomy: Surface Marking, Diaphragm,
Thoracic duct, esophagus,
stomach,
Duodenum, liver.

Physiology of stomach, pancreas, biliary tract,liver,small intestine and Large intestine.

Core Clinical KnowledgeSign and Symptoms of Gastrointestinal Disorder, 
Oral memedicine, 
Esophagitis,
esophageal motility disorder,
dysphagia and esophageal cancer.
PUD,
Celiac disease, 
Gallbladder Diseases,
Alcoholic liver diseases, 
Acute viral hepatitis and chronic viral hepatitis, 
CCirrhosis with Portal HTN,
Emergency Management Upper Gastrointestinal hammorrhage,
Acute pancreatitis,
Acute abdomen,
Acute hepatic failure.
Common Presentation 
Scenario
Diarrhoea : acute, Chronic & dysentery, 
Abdominal pain,
Dyspepsia, 
Jaundice, 
Abdominal distension including ascites & mass,
Anorexia & weight loss.
Investigation, procedure, interpretationUpper GI Endoscopy, 
Intestinal Biopsy,
ERCP & MRCP,
Sigmoidoscopy & Colonoscopy,
Liver biopsy,
Abdominal paracenthesis,
Plain Radiology, 
USG of HBS,
Abdominal CT & MRI.

4. Disorder of Haemopooetic system

HeadlinesImportant Topics
Applied Basic scienceHematopoesis and hematopoietic factor,
Hemostasis 
Core Clinical KnowledgeBlood Cell 
Emergency Management  Acute severe Blood loss,
Neutropenic fever with sepsis,
Severe anaemia,
DIC,
Hemophilia & ITP
Common Presentation 
Scenario
Anaemia, Pancytopenia,
Polycythemia,
Purpura, echymosis, Bruise, Bleeding, Hepatomegaly & Splenomegaly
Investigation procedure, interpretationCBC,
PBF,
Bone Marrow aspirations & Biopsy,
BT,CT,PT,APTT.

5. Infectious Diseases & Tropical Medicine

HeadlinesImportant Topics
Applied Basic scienceClassification of Microorganisms, 
Bacterial characteristics, reservoir of infection,
Endotoxin,
Exotoxin,
Antibacterial, 
Structures of viruses,
Antiviral, 
Slow virus, 
Parasite & antiparasitic chemotherapy, 
Opportunistic pathogen, Incubation periods, 
Vaccine & immunization, 
Sterilization and disinfection, 
Immunology – cell involved inbthe immune response to infection,
Clostridium difficile,
Giardiasis,
SIRS & sepsis,
Amebiasis, 
Kalagazar & PKDL
Core Clinical Knowledge
Emergency Management Septicemia & septic shock,
Bacterial meningitis, 
Severe typhoid, 
Severe malaria,
Infection inbthe immunocompromised.
Common Presentation 
Scenario
Fever,
PUO,
Rash,
Lymphedenopathy,
Abnormal WBC count.
Investigation, procedure, interpretation 
LP,
Bone marrow, 
Splenic aspirations, 
Serology, 
Gram stain d AFB stain,
Culture sensitivity, 
Sputum examination, 
Radiology investigation, 
FNAC,
Blood slide preparation. 

6. Disorder of Genitourinary System

HeadlinesImportant Topics
Applied Basic scienceAnatomy and physiology of Urinary and reproductive system,
Acid Base & Fluid Balance,
Kidneys Function, 
Renal sodium transport, 
Salt water balance, 
Renal transport to others solutes, 
Renal transport of water.
Core Clinical KnowledgeSign & Symptoms of kidney diseases,
Acid base balance, 
UTI,
CKD/CRF,
Dialysis, 
Renal transplantation, 
Glomerulonephritis,
Over active bladder, 
RTA,
Haematuria,
Nephroitic syndrome, Renal stone,
Congenital urinary tract abnormality, 
Urinary tract obstruction, 
BEP,
PKD.
Emergency Management  AKI,
Acute retention of urine
Common Presentation 
Scenario
 Edema,
Polyuria,
Polydipsia,
Oliguria,
Renal & ureteric colic,
Proteinuria,
Haematuria,
Dysuria.
Investigation, procedure, interpretation Renal imaging :X-ray KUB,US,CT,IVU
Uroflowmetry.
Interpretations of acid base disorder & electrolyte imbalance, 
Urine RU & CS.

 7. Disorder of Nervous System

HeadlinesImportant Topics
Applied Basic scienceRegional Anatomy and physiology of: Dermatome,Spinal nerves,Central d automomic Nervous system
Core Clinical KnowledgeSign & symptom pf neurological diseases, 
Stroke & TIA,
Itracranial hahaemorrhage,
Cerebral tumors,
Meningitis & encephalitis, 
Basal ganglia disease,
Movement disorder, 
Epilepsy, 
Degenerative disease, 
Neuropathy, 
Myopathy,
Myasthenia gravis,
Motor Neuron Disease, 
Spinal Cord diseases, 
Multiple sclerosis & Demylinating diseases,
Cranial nerve disease, 
Brain death,
Headache syndrome,
Paraneuplastic syndrome.
Emergency Management  Coma,
Meningitis, 
Encephalitis, 
Raised intracranial pressure,
Status epilepticus,
Subarachonoid hamorrhage,
GBS, 
Stroke. 
Common Presentation 
Scenario
 headache, 
Confusion, 
Loss of or alter consciousness, 
Dizziness, 
Vertigo,
Paresthesia,
Hemiplegia,
Lower limb weakness, 
Abnormal movement, 
Ptosis,
Facial Palsy,
Visual Disturbance.
Investigation procedure interpretationLumber Puncture,
Nerve conduction studies, 
EMG, EEG, CT, MRI,
Angiography, Radionuclide scanning, 
Muscle & nerve biopsy.

8. Respiratory System

HeadlinesImportant Topics
Applied Basic scienceRegional Anatomy and physiology of: Cricoid cartilage, larynx, thorax, Surface marking,  bronchus Division, Plural space,
Lung volume and capacity, mechanism of breathing,  Pulmonary gas, exchange blood gas transport, 
Pulmonary circulation, 
Control of breathing, 
Response to chronic hypoxia.
Core Clinical KnowledgeSign & Symptoms of Respiratory diseases, 
Asthma,COPD,
Community acquired pneumonia, 
Hospital acquired pneumonia, 
Bronchial CA,
Bronchiectesis, bronchitis, 
Mediastinal diseases,
Chest wall diseases, 
Lung abscess, 
Pleural diseases, 
Cystic fibrosis,
Pneumothorax,
Sarcoidosis,
Fungal lung diseases,
Slepp apnea, 
Pulmonary HTN,
DPLD,
Pulmonary involvement of Systemic diseases, 
Occupational lung diseases, 
Diseases due to cigarette smoking,
Respiratory failure,
Assisted ventilation, 
ARDS,
Pulmonary thrombo-embolic diseases, 
Uppert RTI,
Pulmonary TB.
Emergency Management acute severe astham,
Pneumonia, 
Pulmonary embolism, 
Respiratory failure,
ARDS,
TeTension pneumothotax,
Acute exacerbation of COPD
common Presentation 
Scenario
Hemoptysis, 
Breathlessness, 
Cough,
Wheeze, stridor,
Acute pneumonia syndrome & Pulmonary ininfiltrate.
investigation procedure, interpretation Chest Radiology,
Lung Function Test,
Bronchoscopy,
Arterial bloodbgas & interpretation, 
IT Placement & Management, 
Pleural fluid study & aspirations. 

9. Disorder of Masculosceletal system

HeadlinesImportant Topics
Applied Basic scienceStructure of synovial joint,
Synovial fluid, 
Role of T cell and B cel in Pathogenesis of RA,
COX 1 & COX 2.
Core Clinical KnowledgeOsteoarthritis,
Rheumatoid arthritis, 
The seronegative spondyloarthropathy, 
Ankylosing spondylitis,
Reactive arthritis,
Psoriatic arthritis, 
Enteropathic arthritis, 
Gout,
Systemic lupus erythrmotous,
Systemic sclerosis,
Detmatomyositis and polyomyositis,
Infectious arthritis, 
Osteoporosis, 
Osteomalacia,
Fibromylgia,
Loe back pain,
Systemi vasculitis,
Common periarticular disorder. 
Emergency Management Acute LBP,
Septic arthritis, 
Acute Gouty arthritis, 
Infection in immunocompromised  conditions 
Common Presentation 
Scenario
Joint pain,
Low Back pain,
Bodyache,
Rash.
Investigation, procedure, interpretationJoint Fluid aspiration, 
Intra-articular injection, 
Interpretation of radiological,  immunological, and serologic test.
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