Medicine and Allied Phase – A Residency Syllabus- BSMMU
BSMMU MD Medicine Syllabus Index:
- cardiovascular System
- Endocrine & Metabolic Disorder
- Gastroenterology & Hepatology
- Haematology
- Infectious Diseases & Tropical Medicine
- Renal & Genitourinary System
- Neurology
- Respiratory Medicine
- 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
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
| Headlines | Important Topics |
|---|---|
| Applied Basic science | Anatomy Fetal circulation Principle of Blood vessel Coronary anatomy Coronary circulation Conducting System Cardiac cycle Cardiac performance |
| Core Clinical Knowledge | Symptoms 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, interpretation | ECG Echocardiography Ambulatory Cardiac catherization Cardiac pacing ETT CT venous cannulation CT angiography |
| Cardiology Question Bank | Here |
2. Endocrine Disorder
| Headlines | Important Topics |
|---|---|
| Applied Basic science | Classification, mechanism, and action of Hormone Hypothalamic regulatory hormone Pituitary Hormone Adrenal cortex Adrenal Medulla Pancreas Thyroid Physiologic responce in pregnancy |
| Core Clinical Knowledge | Symptoms 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, interpretation | CT 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
| Headlines | Important 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 Knowledge | Sign 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, interpretation | Upper 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
| Headlines | Important Topics |
|---|---|
| Applied Basic science | Hematopoesis and hematopoietic factor, Hemostasis |
| Core Clinical Knowledge | Blood 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, interpretation | CBC, PBF, Bone Marrow aspirations & Biopsy, BT,CT,PT,APTT. |
5. Infectious Diseases & Tropical Medicine
| Headlines | Important Topics |
|---|---|
| Applied Basic science | Classification 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
| Headlines | Important Topics |
|---|---|
| Applied Basic science | Anatomy 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 Knowledge | Sign & 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
| Headlines | Important Topics |
|---|---|
| Applied Basic science | Regional Anatomy and physiology of: Dermatome,Spinal nerves,Central d automomic Nervous system |
| Core Clinical Knowledge | Sign & 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 interpretation | Lumber Puncture, Nerve conduction studies, EMG, EEG, CT, MRI, Angiography, Radionuclide scanning, Muscle & nerve biopsy. |
8. Respiratory System
| Headlines | Important Topics |
|---|---|
| Applied Basic science | Regional 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 Knowledge | Sign & 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
| Headlines | Important Topics |
|---|---|
| Applied Basic science | Structure of synovial joint, Synovial fluid, Role of T cell and B cel in Pathogenesis of RA, COX 1 & COX 2. |
| Core Clinical Knowledge | Osteoarthritis, 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, interpretation | Joint Fluid aspiration, Intra-articular injection, Interpretation of radiological, immunological, and serologic test. |
