3RD YEAR MBBS FOUNDATION-II

MODULE
3RDYEAR STUDY
GUIDE

This study guide of the module /course outlines the key

components and areas for the facilitation of the students.

Department of Medical Education.

KMU (IHPER)- Central Curriculum Committee 0

 Vision and Mission of KGMC
Khyber Medical University: Vision
Khyber Medical University will be the global leader in health sciences
academics and research for efficient and compassionate health care.

Khyber Girls Medical College: Vision

“Excellence in health care, research ,teaching and training in the service of

Humanity”

Khyber Girls Medical College: Mission

The mission of KGMC is to promote compassionate and professional health care leaders
Who are knowledgeable, skillful, and community oriented lifelong learners serving humanity through
evidence based practice
Curriculum Committee KGMC
Chair:
Professor Dr. Zahid Aman Dean KGMC.
Co-Chair:
Dr. Amin ul Haq, Associate Dean KGMC.

Clinical Sciences:
 Dr. Mohammad Noor Wazir ,Department of Medicine KGMC/HMC
 Dr. Bushra Rauf Department of Gynae KGMC/HMC.
 Dr. Sofia Iqbal, Department of Ophthalmology KGMC/HMC.
 Dr. Said Amin Department of Medicine KGMC/HMC.
 Dr. Ghareeb Nawaz Department of ENT KGMC/HMC.
 Dr. Jamshed Alam Department of Surgery KGMC/HMC.
 Dr. Ambreen Ahmad, Department of Pediatrics KGMC/HMC.
 Dr. Ain-ul-Hadi Department of Surgery KGMC/HMC.
 Dr. Fawad Rahim Department of Medicine KGMC/HMC.
Behavioral Sciences:
 Dr. Ameer Abbas Department of Psychiatry KGMC/HMC.
Medical Education
 Dr. Naheed Mahsood, Department of Medical Education, KGMC.
  Dr. Naveed Afzal Khan, Department of Medical Education, KGMC.
 Dr Onaiza Nasim , Department of Medical Education, KGMC

Basic Sciences:
 Dr. Amin-ul-Haq Department of Biochemistry, KGMC.
 Dr. Khalid Javed Department of Pathology, KGMC.
 Dr. Raheela Amin Department of Community Medicine, KGMC.
 Dr. Zubia Shah Department of Physiology, KGMC.
 Dr. Naheed Siddique Department of Forensic Medicine, KGMC.
 Dr. Shams Suleman Department of Pharmacology, KGMC.
 Dr. Shahab-ud-Din, Department of Anatomy, KGMC.
Module Committee for Foundation II

Foundation Module:
 Prof. Dr. Abdul Hameed Department of Pharmacology….Member
 Prof. Dr. Sabina Aziz Department of Community Medicine……Member
 Associate Prof. Dr. Shams Suleman Department of Pharmacology….Member
 Prof. Dr. Bushra Rauf Department of Gynae…………….Member
 Prof. Dr. Samia Tabassum Department of Gynae…………….Member
 Dr. Saeed-ur-Rehman Professor Department of Pathology…………….Member
 Dr. Anwar-ul-Haq Associate Professor Department of Forensic Medicine…………….Member
 Dr. Jahanzeb Khan Associate Professor Department of Pediatric A…………….Member
 Dr. Muhammad Shah Assistant Professor Department of Surgery C…………….Member
 Dr. Fawad Rahim Assistant Professor Department of Medicine…………….Member
 Dr. Salma Akbar Senior Lecturer Department of Community Medicine……Member
 Dr Naheed Mahsoud Director Department of Medical Education………..Member
Integrated curriculum:

An integrated curriculum is all about making connections, whether to real life or across the disciplines, about skills or about knowledge. An

integrated curriculum fuses subject areas, experiences, and real-life knowledge together to make a more fulfilling and tangible learning

environment for students. Integrated teaching means that subjects are presented as a meaningful whole. Students will be able to have better

understanding of basic sciences when they repeatedly learn in relation to clinical examples. Case based discussions, computer-based assignments,

early exposure to clinics, wards, and skills acquisition in skills lab are characteristics of integrated teaching program.

Outcomes of the curriculum:

The outcomes of the curriculum of MBBS According to the PMDC are as follows:

 Knowledge
 Skillful
 Community Health Promoter
 Problem-Solver
 Professional
 Researcher
 Leader and Role Model
KNOWLEDGE
By the end of five year MBBS program the KGMC student should be able to;

1. Acquire a high level of clinical proficiency in history taking, physical examination, differential diagnosis, and the effective use of

medicine’s evolving diagnostic and procedural capabilities including therapeutic and palliative modalities

2. Manage the common prevalent diseases in community

3. Identify the common medical emergencies

4. Develop plan for prevention of common community diseases

5. Formulate a referral plan

6. Compose a prescription plan

PSYCHOMOTOR
By the end of five year MBBS program the KGMC student should be able to;

1. Demonstrate the ability to perform the disease specific relevant examination

2. Respond to common medical emergencies

3. Master the skill of first aid

4. Perform BLS

5. Apply the best evidenced practices for local health problems

AFFECTIVE
By the end of five year MBBS program the KGMC student should be able to

1. Relate to patient and careers vulnerability

2. Demonstrate ethical self-management

3. Counsel and educate patients and their families to empower them to participate in their care and enable shared decision-making.

4. Display compassion with patient and colleagues

5. Demonstrate in cli`nical care an understanding of the impact of psychological, social, and economic factors on human health and disease
 Teaching Hours Allocation
Table 1 Hours Allocation
S. No Subject Hours needed
1 Pharmacology 32

2 Pathology 25

3 Forensic medicine 12

4 Community medicine 8

5 Family medicine 1

6 PRIME and Research 4+3

7 Eye 3

8 ENT 1

Total 86
 List of Themes
Theme Duration

Molecules, bacteria and cell injury 3 weeks

Ageing and death 2 weeks

 Learning Objectives
By the end of Foundation-2 Module, 3rd year MBBS students will be able to:

1) Define pathology, its different branches and enumerate clinically important bacteria.
2) Describe the structure of bacterial cell and mechanisms by which they cause the disease.
3) Describe methods used to identify different microbes in laboratory and explain the interventions employed to prevent
infections including vaccines.
4) Describe cell injury, its different mechanisms and sub cellular responses to cell injury.
5) Describe necrosis, apoptosis and adaptive changes seen in clinical settings and its identification in surgical specimens.
6) Define common terms related to Pharmacology.
7) Describe the basic principles of pharmacokinetics and pharmacodynamics and apply these principles to clinical practice
as they relate to drug absorption, distribution, metabolism, excretion, mechanism of action, clinical action and toxicity.
8) Describe the cellular and biochemical sites where drugs bind to act.
9) Describe the general principles of drug interactions in relation to clinical practice.
10) Describe the process of new drug development.
11) Identify different dosage forms of drugs.
12) Demonstrate searching accurate information quickly in a formulary.
13) Demonstrate administration of a drug through intramuscular and intravenous routes.
14) Write down the basic format of drug prescription and describe the general principles of prescribing drugs.
15) Write correctly medical abbreviations used in clinical practice.
16) Identify commonly used equipments in pharmacy.
17) Describe Forensic medicine, its different branches and importance.
18) Describe law and its various components.
19) Explain medicolegal system and legal procedure for a doctor.
20) Describe the contents of medical jurisprudence.
21) Describe the diagnosis of death and WHO death certificate.
22) Describe different refractive errors and its management.
23) Explain causes of watery eyes in both infants and elders and its management.
24) Describe the basic concept of health, disease and primary health care.
25) Demonstrate different pathological laboratory procedures and identify gross and microscopic features in the given
specimens.
26) Demonstrate professionalism, respect, honesty and compassion by behaving in a courteous manner with colleagues and
teachers during course activities like long lectures, SGDs and Practicals.
27) Describe the PMC code of Ethics
28) Describe the steps of process of developing a research protocol
 Specific Learning Objectives
Theme-1 (Molecules and Bacteria)
Subject Topic Hours Learning objectives

Pharmacology Introduction 1 Define basic terms like Pharmacology, Clinical Pharmacology,

to the subject Therapeutics, drug, medicine, pro-drugs, prototype drugs, Materia
medica, pharmacopoeia, formulary, national formulary, poisons, toxins,
pharmacokinetics, pharmacodynamics, excipient, compounding and
dispensing.
Describe the branches of Pharmacology like Pharmacy, Pharmacognosy,
pharmacogenetics, pharmacogenomics, toxicology and posology.
Define prescription drugs, OTC drugs, WHO essential drugs and Orphan
drugs with examples.
Nomenclature 1 Describe how drugs are named, i.e. chemical, generic, approved, official
of drugs and trade names of drugs with examples.
Sources of 1 Enlist various sources of drugs.
drugs Give examples of drugs obtained from plants, animals, mineral and
synthetic sources.
Describe the genetic engineering source of drugs with examples.
Active Enlist important principles of crude drugs with examples.
principles of
crude drugs
Routes of drug 2 Enlist various routes of drug administration.
administration Describe the merits and demerits of oral, sublingual, rectal,
intramuscular, subcutaneous, intravenous, intra-arterial, inhalational,
spinal, topical and transdermal routes of drug administration.
Give examples of drugs given through oral, sublingual, rectal,
intramuscular, subcutaneous, intradermal, intravenous, intra-arterial,
inhalational, spinal, topical and transdermal routes of drug
administration.
Describe the difference between topical and transdermal routes of drug
administration.
Describe the difference between subcutaneous and intradermal routes of
drug administration.
Absorption of 1 Define drug absorption.
drugs Describe various mechanisms of drug absorption like simple diffusion,
facilitated diffusion, active transport, ion-pair transport, endocytosis and
filtration with examples.
Describe the concept of ionization of drug molecules and clinical
significance of ion trapping.
 Describe factors affecting drug absorption.
Bioavailability 1 Define bioavailability, bioequivalence and pharmaceutical equivalence.
and Explain Time-Concentration curve.
Bioequivalenc Describe AUC (Area Under the Curve).
e Describe the factors affecting bioavailability.
Hepatic first- 1 Describe hepatic first-pass effect (Pre-systemic elimination) and its
pass effect clinical significance.
(Pre-systemic
elimination)
Enterohepatic Define enterohepatic circulation.
circulation
Describe enterohepatic circulation with examples and its clinical
significance.
Distribution of 1 Define distribution of drugs.
drugs Define redistribution of drugs with example.
Describe plasma protein binding and its clinical significance in diseased
conditions.
Describe factors affecting drug distribution.
Volume of Define volume of distribution.
distribution Enlist drugs with small volume of distribution.
Enlist drugs with large volume of distribution.
 Apply formula for calculating volume of distribution.
Describe volume of distribution with reference to its clinical significance.
Loading dose Define loading dose of a drug.
Enlist some drugs whereby loading dose is administered.
Apply formula for calculating loading dose.
Physiological 1 Enlist important physiological barriers to transport of drugs.
barriers to Describe important physiological barriers to transport of drugs like blood-
transport of brain barrier and placental barrier with reference to their clinical
drugs significance.
Biotransforma 1 Define biotransformation.
tion Define xenobiotics.
(metabolism) Describe the objectives of biotransformation and fate of drugs after
of drugs biotransformation.
Name major sites of biotransformation.
Describe major drug metabolizing enzymes i.e. microsomal (P450) and
non-microsomal enzymes.
Describe the phases and reactions of biotransformation.
Describe the factors affecting drug biotransformation.
Genetic 1 Define pharmacogenetics and pharmacogenomics.
influence on Define idiosyncrasy with examples.
biotransforma Describe the genetic factors influencing biotransformation of drugs with
tion of drugs examples.
Enzyme Define enzyme induction.
induction Enlist enzyme inducers.
Describe enzyme induction and its clinical significance.
Enzyme Define enzyme inhibition.
inhibition Enlist enzyme inhibitors.
Describe enzyme inhibition and its clinical significance.
Describe suicide inhibition (mechanism-based inhibition) with examples of
drugs.
Excretion of 1 Define drug excretion and drug clearance.
drugs and Enlist major and minor routes of drug excretion.
drug clearance Differentiate between excretion, elimination and clearance.
Apply the formula for calculating drug clearance.
Maintenance Define maintenance dose of a drug.
dose Apply the formula for calculating the maintenance dose.
Apply Young’s formula, Dilling’s formula and Clark’s formula for
calculating doses of drugs.
Plasma half Define plasma half-life.
life Enlist drugs with short half-life.
Enlist drugs with long half-life.
 Apply the formula for calculating plasma half life.
Explain the clinical significance of half life.
Steady-state 1 Define steady-state concentration of drugs.
concentration Describe the time to reach steady-state concentration of drugs.
of drugs Describes the importance of steady-state concentration in clinical
practice.
First- and Define first- and zero-order kinetics.
zero-order Differentiate between first- and zero-order kinetics with examples.
kinetics Explain the clinical significance of first- and zero-order kinetics
Bioassay and Define bioassay and standardization.
standardizatio Describe the relative importance of bioassay compared with physical or
n chemical assays.
Describe the most common type of bioassay, i.e. three-point assay.
Pharmacodyna 2 Define pharmacodynamics.
mics Define agonist, antagonist, partial agonist and inverse agonist with
examples.
Describe receptors.
Define orphan receptors, serpentine receptors and spare receptors.
Describe the biochemical and cellular sites of drug targets.
Describe intracellular Second-messenger system and enlist some important
Second-messengers.
 Describe up regulation and down regulation of receptors with examples.
Define drug selectivity and specificity.
Dose-response 1 Define dose response curve, graded dose-response curve and quantal dose-
curves response curve.
(Graded and Describe graded dose-response curve and quantal dose-response curve.
Quantal) Describe the limitations of graded dose-response curve and its remedy in a
quantal dose-response curve.
Describe the significance of constructing dose-response curves.
Explain the advantages of taking log dose values on the dose axis.
Therapeutic 1 Define therapeutic index.
index Describe therapeutic index with reference to its clinical importance.
Apply formula for calculating therapeutic index
Define median lethal dose, median toxic dose and median effective dose.
Enlist some drugs with narrow therapeutic index.
Enlist some drugs with broad therapeutic index.
Protective Define protective index.
index Differentiate between therapeutic index and protective index.
Therapeutic 1 Define therapeutic window.
window Describe therapeutic window with reference to its clinical importance.
Potency and Define potency and efficacy.
efficacy Describe potency and efficacy with examples.
 Describe the clinical importance of efficacy compared to potency.
Drug Define drug antagonism.
antagonism Enlist types of antagonism.
Describe chemical, physiological (functional) and pharmacological
(competitive/surmountable and non-competitive) antagonisms with
examples.
Drug 1 Define drug interaction.
interactions Define drug incompatibilities with examples.
Describe pharmacokinetic drug interactions with examples and its clinical
significance.
Describe pharmacodynamics drug interactions with examples and its
clinical significance.
Describe drug-food interactions and drug-disease interactions with
examples.
Define summation, synergism and potentiation with examples.
Tolerance and 1 Define Tolerance, cross tolerance, reverse tolerance (sensitization),
Tachyphylaxis innate tolerance, tachyphylaxis and drug resistance.
Describe the mechanisms of development of tolerance and tachyphylaxis.
Define drug holidays with example.
Adverse drug 1 Define adverse drug effect, secondary effect and intolerance to a drug.
reactions Classify adverse drug reactions.
 Describe dose-related adverse effects (side effects and toxic effects) with
examples.
Describe non-dose-related adverse effects (idiosyncrasy and drug allergy)
with examples.
Describe causes of adverse drug reactions.
Enlist some drugs causing hepatotoxicity.
Enlist some drugs causing renal toxicity.
Enlist some cardio toxic drugs.
Enlist some drugs causing adverse effects on reproduction.
New drug 1 Describe the processes involved in drug discovery and development.
development Define lead compound and drug screening.
Describe pre-clinical and clinical studies.
Define placebo, placebo response and nocebo response.
Define no-effect dose and minimum lethal dose.
Describe 04 phases of clinical trials.
Define post-marketing surveillance.
Define single-blind, double-blind, crossover and ADME studies.
Describe the role of Food and Drug Administration (FDA) in the drug
development process.
Differentiate between IND (Investigational New Drug) and NDA (New Drug
Application).
Pathology Introduction 1 Define pathology, microbiology and list its major branches
to the subject Describe essential characteristics of five major groups of microorganisms
Differentiate between prokaryotes and eukaryotic cells based on their
structure and complexity of their organization
Introduction 1 Define cell
to cell Describe structure of cell membrane
Describe cell organelles
Classification 1 Describe classification of bacteria based on oxygen requirement as
of Bacteria aerobes and anaerobes with examples.
Describe classification of bacteria based on staining characteristics,
nature of cell wall, ability to grow in the presence of oxygen and ability to
form spores.
Structure of 1 Describe structure and function of each of various parts of the bacterial
bacterial cell cell including cell wall, cytoplasmic membrane, Mesosome, ribosomes,
granules and nucleoid
Describe specialized structures outside the cell wall including capsule,
flagella, pilli and glycocalyx
List the differences between cell wall characteristics of Gram Positive and
Gram Negative Bacteria
Describe classification and important functions of plasmids.
 Describe functions and arrangement of transposons.
Describe structure, functions and medical importance of bacterial spores
with examples.
Bacterial 1 Describe various phases of bacterial growth curve
growth curve
Normal Flora Describe medically important members of normal flora and their anatomic
location
Bacterial 1 Define mutation
genetics Describe the classification of various types of mutations and their common
causes.
Describe methods of transfer of DNA within bacterial cells including
process of conjugation, transduction, recombination and transformation.
Lab diagnosis 1 Describe the bacteriologic approach to diagnosis of bacterial infections
of including blood, throat, stool, sputum, spinal fluid, urine, genital tract
bacterial and wound cultures.
infections Describe general principals of various immunologic and nucleic acid based
methods for identification of an organism.
Bacterial 1 Define the term pathogen, infection, virulence, communicable, endemic,
pathogenesis epidemic and pandemic diseases, carrier, pathogens, opportunists,
commensals and colonizers.
Describe stages/determinants of bacterial pathogenesis.
 Describe colonization, invasion, toxins, immune-pathogenesis.
Differentiate between exotoxins and endotoxins.
Describe the various modes of action of endotoxins and endotoxins
produced by gram positive and gram-negative bacteria.
Describe the four stages of a typical infectious disease and Koch’s
postulates for establishing the causal role of an organism in the disease.
Antibacterial 1 Define immunization and vaccination.
Vaccines Describe role of immunization in inducing active and passive acquired
immunity.
Enlist the current bacterial vaccines and their indications.
Describe various types of bacterial vaccines in terms of
composition, preparation, indications, route of administration and
common side effects.
Forensic Introduction 1 Describe forensic medicine and its various branches
medicine
to the subject Describe pillars of forensic medicine
of Forensic Describe the various terminologies used in forensic medicine
Medicine
Introduction Discuss different prevailing medicolegal systems in the world
to medicolegal
system
1 Define law.
 Introduction Describe its various types.
to Law
Legal Describe court procedures for a doctor
proceedings
Chain of Describe evidence, its types and recording of evidence
evidence
PPC and CrPC Describe the relevant sections of Pakistan penal code and CrPC

Medical Describe the components of medical jurisprudence (consent, negligence,

jurisprudence secrecy, professional misconduct and privileged communication)
Describe code of medical ethics
Describe the duties of a registered medical practitioner
ENT Introduction 1 Describe common ENT symptoms.
to the subject Name common diseases of ENT.
Name recommended books that students must read.
Ophthalmology Introduction 1 Define Ophthalmology and its branches
to the subject; Highlight the scope of field of Ophthalmology as a future career
Career in
Ophthalmolog
y
 Refractory 1 Describe refractive error and its effect on vision.
errors Describe the concept of myopia and its correction.
Describe the concept of hypermetropia and its correction.
Describe the concept of astigmatism & cylindrical lens.
Describe the concept of presbyopia, its possible causes and correction.
Describe aphakia and possible methods of its correction.
Watery Eyes 1 Explain the structural details, development and functions of lacrimal
system.
Correlate the clinical presentation of watery eye with anatomical
structures.
Correlate the clinical features with a disease entity.
Describe the causes, clinical features and treatment of congenital
nasolacrimal duct obstruction.
Assess the time of probing.
Describe the causes, clinical presentation and treatment modalities.
Differentiate between acute and chronic dacryocystitis.
Community Introduction 1 Define Community medicine and Public health
medicine
to the subject Describe the role of teaching of public health in prevention of diseases
Health system 1 Define health care system of Pakistan using WHO Health system frame
of Pakistan: work
Introduction
Health and 2 Define community medicine, public health and preventive medicine.
disease Discuss the history and philosophy of public health as well as its concepts
and functions regionally & globally.
Describe the stages in the natural history of a disease.
Describe epidemiological triad, web of causation and multifactorial
causation
Describe the dimensions and determinants of health
Describe the indicators of health and its characteristics
Discuss the concept of disease control
Discuss the different levels of prevention and their modes of
interventions.
Explain the natural history of disease.
Describe the iceberg phenomenon
Describe mode of intervention of diseases with emphasis on health
education.
Primary 1 Define Primary health care (PHC).
Health Care Describe the elements of PHC, its principles and strategies for
implementation of PHC.
Describe Health for all by the year 2000.
Enumerate the MDGS & SDGS related to health.
 Describe the history of development of PHC
Describe comprehensive & selective PHC
Describe reasons for failure of PHC
Describe Health Systems before & after PHC
Describe district health care system
Enumerate indicators for assessing PHC
PRIME Personal 1 Describe personal identity in the context of medical education
identity
Professional Define professional identity and Describe the basic pre-requisites of
identity professional identity formation
Patient safety, 1 Explain the concept of patient safety, clinical governance and quality
clinical improvement in primary healthcare
governance
and quality
improvement
Professionalis 1 Explain the dynamics of professionalism and trust in health professional-
m-Trust patient relationship
Adheres to principles of trust in day to day professional interactions
Professional Define professional identity formation and explain the Students’ roles in
identity terms of professional identity
formation-
 Types and
Multiple
identities
Motivation 1 Explain motivational skills for team members for clinical tasks

Theme-2 (Aging and Death)

Subject Topic Hours Learning objectives

Pathology Cellular 2 Define the following terms: Pathology, disease, etiology, pathogenesis,
injury, cell morphology, cell injury and homeostasis.
death Describe the causes of cell injury from gross physical trauma to single
gene defect.
Describe the nature and severity of cell injury with cellular responses.
Enumerate different classes of pathology.
Describe the following basic mechanisms of cell injury: General
Biochemical mechanisms, Ischemic and hypoxic injury,
Ischemic/reperfusion injury, Free radical induced cell injury and chemical
injury.
Differentiate between reversible and irreversible cell injury.
Describe the mechanism, morphological and biochemical changes and
functional alterations in reversible and irreversible cell injury.
 Define phagocytosis, endocytosis, pinocytosis, autophagy and
heterophagy.
Describe the subcellular responses to injury including lysosomal
catabolism, heterophagy and autophagy.
Cellular 1 Describe types of cellular adaptations.
adaptation Differentiate between physiologic and pathologic adaptation.
Define hypertrophy, hyperplasia, atrophy and metaplasia.
Describe the causes and mechanism of hypertrophy, hyperplasia, atrophy
and metaplasia.
Describe hypertrophy of the smooth endoplasmic reticulum with examples
and mitochondrial alterations.
Describe cytoskeletal abnormalities in pathological states with examples.
Necrosis 1 Define necrosis.
Describe types of necrosis with examples.
Describe the mechanism and morphology of necrosis.
Apoptosis Define apoptosis.
Describe physiological and pathological causes of apoptosis with examples.
Describe morphology with alterations in cell structure.
Describe the biochemical features of apoptosis altering the cell structure.
Describe the intrinsic and extrinsic pathways of apoptosis.
Differentiate between necrosis and apoptosis.
 Describe role of apoptosis in health and disease.
Describe the mechanism and causes of cellular ageing including genetic &
environmental factors, structural & biochemical changes.
Describe adaptive changes in clinical settings.
Steatosis 1 Describe causes and mechanism of steatosis.
Explain the morphology and consequences of steatosis.
Intracellular Describe three general pathways for abnormal intracellular accumulations.
accumulations Define steatosis.
Describe causes, mechanism, morphology and consequences of lipid
accumulation.
Describe causes, mechanism, morphology, consequences of protein and
glycogen accumulation
Describe types of pigments
Differentiate between endogenous and exogenous pigments.
Pathologic Define Pathologic calcification
calcification Describe types, morphology and functional alterations of pathologic
calcification with examples.
Differentiate between dystrophic and metastatic calcification.
Forensic Introduction 1 Define death and describe its phases.
Medicine
to Describe criteria of diagnosis of death.
Thanatology; Enlist the importance of diagnosis of death
 Death Describe the medicolegal aspects of brain stem death and suspended
animation
Define cause, mode, manner and mechanism of death
Enlist various methods of disposal of dead body
Death 1 Define cause of death
certificate
Describe the WHO format of death certificate

Ophthalmology Cataracts 1 Define cataract

Describe the types of cataracts
Describe the pathogenesis and complications of cataracts
Describe the management of cataracts
PRIME Research 1 Describe the steps of developing a research protocol
Research
Protocol
Health system 1 Define research and health system research.
research List types of research.
Describe characteristics of health system research.
Describe building blocks of health system.
Discuss key areas of concern in health system.
Discuss briefly research methodology.
Define and categorize types of health research
 Purpose and 1
process of Explain the purpose of health research
health
research
Family Medicine History and 1 Describe the historical perspectives of general practice
current Explain the structure of general practice nationally and internationally
structure of
general
practice
Models of describe the models of healthcare
healthcare

Essential Describe the levels of health services in the province of KP.

health service
package
(levels of
health
services in KP)
Practical work
Pharmacology Lab protocols; 1.5 Identify and name common apparatus used in pharmacy laboratory.
Introduction Identify and label common apparatus used in the field of Pharmacy.
to Pharmacy;
Apparatus
used in
Pharmacy

Metrology & 1.5 Define metrology.

Medical Describe metric and imperial systems of measurements.
abbreviations Calculate the equivalency of metric system with imperial system.
Describe the common medical abbreviations.
Apply these abbreviations correctly in medical documentations.
Dosage forms 1.5 Define dosage form.
of drugs Enlist the types of dosage forms.
Describe the characteristic properties of each dosage form.
Identify dosage forms administered through different routes.
Searching 1.5 Define formulary.
information in Describe National Formulary.
a formulary Demonstrate searching accurate information quickly in a formulary.
1.5 Describe the general protocols for IM and IV injection of a drug.
 To Demonstrate standard protocols during administration of a drug through
demonstrate Intramuscular route.
IM and IV Demonstrate standard protocols during administration of an IV drug through
injection of Intravenous route.
drugs on a
dummy
(manikin)
Prescription 1.5 Define a medical prescription.
writing Describe the components of a prescription.
Describe how to reduce medication errors.
Define compliance to the prescribed treatment.
Write down the basic format of drug prescription.
Pathology Biosafety 1.5 Define sterilization and disinfection.
procedures/Pr Demonstrate steps of hand washing.
ecautions in Enlist various physical and chemical methods of sterilization and
Microbiology disinfection.
Lab Define biosafety and biosecurity.
Tissue 1.5 Describe steps involved in tissue processing.
processing Identify various tools/instruments involved in tissue processing and their
indications.
Demonstrate slide focusing.
Gram staining 1.5 Describe principal and significance of Gram staining.
Enlist steps of Gram staining.
Demonstrate Gram staining procedure.
Identify Gram positive and Gram-negative bacteria morphologically under
the microscope.
ZN staining 1.5 Describe principal and significance of ZN staining.
Enlist steps of ZN staining.
Demonstrate ZN staining procedure.
Identify AFB and inflammatory cells microscopically.
Culture media 1.5 Define terms like culture, bacterial colony, media, aerobe, anaerobe, agar,
selective and differential.
Describe classification of culture media.
Describe basic and enriched media, transport media, selective media and
differential media.
Describe preparation/ inoculation of culture media.
Enlist ingredients, indications, important properties
and organisms grown on various culture media.
Bacterial 1.5 Enumerate motile bacteria
motility Identify motile bacteria under the microscope
Hyperplasia 1.5 Define hypertrophy and hyperplasia.
(BPH) Differentiate between hypertrophy and hyperplasia.
 Describe gross and microscopic morphology of BPH.
Identify the slide of BPH.
Atrophy Define atrophy
(Testicular Describe gross and microscopic features of atrophy over a slide of testicular
atrophy) atrophy as an example
Pathologic Describe causes and various types of calcification.
calcification Identify the slide.
Forensic Death 1.5 Formulate death certificate based on WHO criteria
medicine
certificate
Legal 1.5 Doctor in a witness box- role play
procedure
Recording of 1.5 Recording of dying declaration
evidence
Consent form 1.5 Take written informed consent for various procedures
 Learning Resources
S.No Subjects Textbooks
1. Community 1.Community Medicine by Parikh
Medicine 2. Community Medicine by M Illyas
3. Basic Statistics for the Health Sciences by Jan W Kuzma
2. Forensic 1. Nasib R. Awan. Principles and practice of Forensic Medicine 1st ed. 2002.
Medicine 2. Parikh, C.K. Parikh’s Textbook of Medical Jurisprudence, Forensic Medicine and Toxicology.
7th ed.2005.
3.Knight B. Simpson’s Forensic Medicine. 11th ed.1993.
4. Knight and Pekka. Principles of forensic medicine. 3rd ed. 2004
5. Krishan VIJ. Text book of forensic medicine and toxicology (principles and practice). 4th ed.
2007
6. Dikshit P.C. Text book of forensic medicine and toxicology. 1st ed. 2010
7. Polson. Polson’s Essential of Forensic Medicine. 4th edition. 2010.
8. Rao. Atlas of Forensic Medicine (latest edition).
9. Rao.Practical Forensic Medicine 3rd ed ,2007.
10. Knight: Jimpson’s Forensic Medicine 10th 1991,11th ed.1993
11. Taylor’s Principles and Practice of Medical Jurisprudence. 15th ed.1999
3. Pathology 1. Robbins & Cotran, Pathologic Basis of Disease, 9th edition.
2. Rapid Review Pathology, 4th edition by Edward F. Goljan MD
4. PHARMACOLOGY 1. Lippincott Illustrated Pharmacology
2. Basic and Clinical Pharmacology by Katzung
5. ENT Diseases of Ear, Nose and Throat, 7th Edition by P. L. Dhingra

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 Assessment Plan – 3rd Year MBBS
The year-3 will be assessed in 3 blocks
1) Block-1 (Foundation 2 and Infection and Inflammation modules) will be assessed in paper-G
2) Block-2 (Multisystem, blood and MSK modules) will be assessed in paper-H
3) Block-3 (CVS and Respiratory module) will be assessed in paper-I
4) Each written paper consists of 120 MCQs and
5) Internal assessment will be added to final marks in KMU as shown in below table.
6) In OSPE, each station will be allotted 6 marks, and a total of 120 (+10% marks of internal
assessment) marks are allocated for each OSPE/OSCE examination.

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 Year 3 Professional Exam in System-based Curriculum

Theory Modules Theory Internal OSPE/OSPE Internal TOTAL

paper marks assessment assessment MARKS
theory (10%) OSPE/OSPE
(10%)

Paper G Foundation-II 120 14 120 14 268

Inf.&Inflamm.
Paper H Multisystem 120 13 120 14 267
Blood
MSK-II
Paper I CVS-II 120 13 120 12 265
Respiratory-II
360 40 360 40 800
TOTAL MARKS

*Research viva of 20 marks will be conducted in paper-L. However, the rest of 15 marks will be decided by the concerned
department internally for the contribution of the students in research project/thesis.

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 Assessment Blueprints
Table 2: Paper G (Infection & Inflammation & Foundation II)
Subjects Total MCQs
Infection & Inflammation 54
Foundation 2 66
Total 120

Table 3: Paper G OSCEs

Subject Total OSCE stations
Infection & Inflammation 10
Foundation 2 10
Total 20

A minimum of 20 stations will be used in final exams. Total marks will be 120 (6 marks for each
station).

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Teaching and learning strategies:
The following teaching learning methods are used to promote better understanding:

 Interactive Lectures

 Hospital Clinic visits

 Small Group Discussion

 Skills session

 Self-Directed Study

Interactive lectures:

An interactive lecture is an easy way for instructors to intellectually engage and involve students as active participants in a lecture-based class of

any size. Interactive lectures are classes in which the instructor breaks the lecture at least once per class to have students participate in an activity

that lets them work directly with the material.

 The instructor might begin the interactive segment with an engagement trigger that captures and maintains student attention.

 Then the instructor incorporates an activity that allows students to apply what they have learned or give them a context for upcoming lecture

material.

 As the instructor feels more comfortable using interactive techniques he or she might begin to call upon a blend of various interactive

techniques all in one class period.

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Hospital/Clinic visits:

In small groups, students observe patients with signs and symptoms in hospital or clinical settings. This helps students to relate knowledge

of basic and clinical sciences of the relevant module.

Small Group Discussion (SGD):

The shy and less articulate are more able to contribute. Students learn from each other. Everyone gets more practice at expressing their

ideas. A two way discussion is almost always more creative than individual thoughts. Social skills are practiced in a 'safe' environment e.g.

tolerance, cooperation. This format helps students to clarify concepts acquire skills or attitudes. Students exchange opinions and apply knowledge

gained from lectures, tutorials and self-study. The facilitator role is to ask probing questions, summarize, or rephrase to help clarify concepts.

Skills Practical Session:

Skills relevant to respective module are observed and practiced where applicable in skills laboratory or Laboratories of various

departments.

Self-Directed learning (SDL):

Self-directed learning, which involves studying without direct supervision in a classroom Library, is a valuable way to learn and is quickly

growing in popularity among parents and students. Students’ assume responsibilities of their own learning through individual study, sharing and

discussing with peers, seeking information from Learning Resource Centre, teachers and resource persons within and outside the college. Students

can utilize the time within the college scheduled hours of self-study.

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 Time Table:
The timetables for the module will be shared via Edmodo and the notice boards in advance.

Assessment tools:
Theoretical knowledge is tested by a written examination system constituted by multiple choice questions (MCQs). The assessment of

practical knowledge involves oral, spot, or objective structured practical examinations (OSPE).

Multiple Choice Questions (MCQs):

 Multiple choice questions (MCQs) are a form of assessment for which students are asked to select the best choice from a list of answers.

 MCQ consists of a stem and a set of options. The stem is usually the first part of the assessment that presents the question as a problem to

be solved; the question can be an incomplete statement which requires to be completed and can include a graph, a picture or any other

relevant information. The options are the possible answers that the student can choose from, with the correct answer called the key and the

incorrect answers called distractors.

 Correct answer carries one mark, and incorrect ‘zero mark’. There is NO negative marking.

 Students mark their responses on specified computer-based sheet designed for the college.

 The block exam will comprise of 120 MCQs and will be compiled according to the shared blueprint.

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 Objective Structured Practical Examination (OSPE)

 The content may assess application of knowledge, or practical skills.

 Student will complete task in define time at one given station.

 All the students are assessed on the same content by the same examiner in the same allocated time.

 A structured examination will have observed, unobserved, interactive and rest stations.

 Observed and interactive stations will be assessed by internal or external examiners.

 Unobserved will be static stations in which students will have to answer the questions related to the given pictures, models or specimens the

provided response sheet.

 Rest station is a station where there is no task given, and in this time student can organize higher thoughts.

 The Block OSPE will be comprise of 20 examined station and 5 rest stations. The stations will be assigned according to the shred blueprint.

There will be 8 stations for viva of core subjects like Pathology, Pharmacology, Forensic Medicine and Community Medicine (2 station for

viva of each core subject) and 2 clinical station and rest of 10 out of 20 stations will be assigned according to shared blueprints.

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 Internal Evaluation:
Internal evaluation is a process of quality review undertaken within an institution for its own ends. 10% marks of internal evaluation will be

added to final marks. This 10% will be based on

13 out of total 40 marks of internal

Marks obtained
assessment in block G Paper

13 out of total 40 marks of internal

assessment in block G OSPE
Marks obtained

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 Attendance Requirement:

More than 75% attendance is mandatory to sit for the examinations.

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Physiology

 Guyton nd Hall physiology

 Ganong physiology
 Human Physiology from cells to system by lauralee sherwood
 BRS Physiology
 Neuroscience by Dale Purves

Biochemistry
 Chatterjee text book of Biochemistry
 Harpers Biochemistry
 Lippincotts Biochemistry
 Satya Narayan biochemistry

Pharmacology
 Basic & Clinical Pharmacology, 14edition

 Katzung & Trevor's Pharmacology: Examination & Board Review, 10edition

 Lippincott Illustrated Reviews: Pharmacology, 8th edition

 Pharmacology for Medical Graduates by Tara V. Shanbhag

Forensic Medicine
 Parikh’s textbook of Medical Jurisprudence and Toxicology.
 Principles and Practice of Forensic Medicine by Nasir R Awan
 Forensic medicine and toxicology principals and practice by Krishan Vij
 Knights forensic pathology by Bernard knight, Pekka saukko
 Forensic medicine and toxicology Nagesh Kumar G rao

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 Pathology
 Robbins textbook of pathology
 Harsh mohan text book of pathology
 Levison text book of microbiology
 Paniker parasitology
 Chatterjee book of parasitology

Apart from these resources learning, students can consult books available in library or recommended by the specialty experts.