Course Specification of Internal Medicine University: Assiut Faculty: Medicine Course specifications: Internal Medicine Programme(s) on which the course is given: M. B. B. ch Departments offering the course



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Course Specification of Internal Medicine
University: Assiut Faculty: Medicine
Course specifications: Internal Medicine
Programme(s) on which the course is given: M.B.B.ch
Departments offering the course:

General medicine

tropical

cardiology

neurology

pysichatry

dermatology

chest

Clinical pathology

Geriatric topics




Academic year / Level: 4th year, 5th year, and 6th year course of M.B.B.ch Program
Date of specification approval:

B- Professional Information
Overall aims of the course
-Students must understand the etiology; the pathogenesis; and the clinical, laboratory, roentgenologic, and pathologic manifestations of the diseases or medical conditions they are likely to confront in the practice of their specialty.
-Students must be highly skilled in providing care to individual patients.
- They must be able to obtain from their patients an accurate medical history that contains all relevant information; to perform in a highly skilled manner a complete organ system specific, physical examination; to perform skillfully those diagnostic procedures warranted by their patients’ conditions and for which they have been trained;
- They must be able to obtain, interpret properly, and manage information from laboratory and radiology studies that relate to the patients’ conditions; and seek consultation from other physicians and other health professionals when indicated.
-Students as future physicians must be able to communicate with patients and patients’ families about all of their concerns regarding the patients’ health and well being.
- They must understand the economic, psychological, occupational, social, and cultural factors that contribute to the development and/or prognosis of conditions that impair health.
-In caring for individual patients, they must apply the principles of evidence-based medicine and cost effectiveness in making decisions about the utilization of limited medical resources.


Intended Learning Outcomes (ILOs)

Knowledge and understanding : Medical students should be able to:

a.1-Mention and demonstrate a thorough knowledge of the etiology, pathogenesis, clinical features, complications, principles of prevention and management of common and life-threatening illnesses affecting the body and each of its major organ systems, presenting throughout the age spectrum,
a.2- Express the relative certainties of a differential diagnosis of common clinical problems
a.3- Express the relative risks and benefits of outcomes and treatment options of common clinical problems.
a.4- Describe the determinants of health and principles of disease prevention and behavior change appropriate for specific patient populations within the community and internationally, and apply these to patient care responsibilities and broader patient care initiatives.( natural history of disease and relationships with risk factors and disease prevention;
a.5- Demonstrate an understanding of the power of the scientific method in establishing the causation of disease and efficacy of traditional and non-traditional therapies.
- Professional clinical skills: Medical students should be able to:
b.1 Obtain an accurate medical history that covers all essential aspects of the history, including issues related to age, gender, and socio-economic status.
b.2- Perform both a complete and an organ system specific examination, including a mental status examination.
b.3-Demonstrate how to perform routine technical procedures including at a minimum venipuncture, inserting an intravenous catheter, arterial puncture, thoracentesis, lumbar puncture, inserting a nasogastric tube, inserting a Foley’s catheter, and suturing lacerations.
b.4- Select and Interpret the results of, commonly used diagnostic procedures and commonly-employed laboratory tests, including tests of blood and other body fluids, modalities, and other basic specific tests such as electrocardiography.
b.5-Identify the most frequent clinical, laboratory, roentgenologic, and pathologic manifestations of common diseases.

b.6- Integrate the above history, physical and laboratory test findings into a meaningful diagnostic formulation.(define problem and formulate differential diagnosis)
b.7-recognize patients with immediately life threatening cardiac, pulmonary, or neurological conditions regardless of etiology, and institute appropriate initial therapy
- Intellectual skills: Medical students should be able to:
c.1- Reason deductively in solving clinical problems.( recognize, define and prioritize problems; analyze, interpret, objectively evaluate and prioritize information, recognizing its limitations;)
c.2- Integrate the results of history, physical and laboratory test findings into a meaningful diagnostic formulation.(define problem and formulate differential diagnosis)
c.3- Identify and locate, when possible, the crucial pieces of missing clinical information, and determine when it is appropriate to act on incomplete information.
c.4-Construct appropriate management strategies (both diagnostic and therapeutic) for patients with common conditions, both acute and chronic, including medical, psychiatric, and surgical conditions, and those requiring short- and long-term rehabilitation.
c.5- Recognize and outline an initial course of management for patients with serious conditions requiring critical care.
c.6- Identify factors that place individuals at risk for disease or injury, to select appropriate tests for detecting patients at risk for specific diseases or in the early stage of disease, and to determine strategies for responding appropriately.
c.7-Retrieve, analyze, and synthesize relevant and current data and literature, using information technologies and library resources, in order to help solve a clinical problem (EBM).
c.8- Propose clinical decisions utilizing methods which integrate the best research evidence with clinical expertise and patient values (EBM).
c.9- Recognize and cope with uncertainty by:

a- Accepting that uncertainty is unavoidable in the practice of medicine;

b- Using appropriate cognitive and intellectual strategies to deal with uncertainty when it arises.
General and transferable skills: Medical students should be able to:
d.1-Communicate effectively with patients, their families and the community through verbal, written and other non-verbal means of communication, respecting the differences in beliefs and backgrounds among patients and students.
d.2-Establish professional relationships with patients, their families (when appropriate) and community that are characterized by understanding, trust, respect, empathy and confidentiality.
d.3- Deliver information to the patient and family (as appropriate) in a human manner, and in such a way that it is easily understood, encourages discussion and promotes the patient’s participation in decision-making.
d.4-Gather information, and develop and interpret a treatment plan, while considering the influence of factors such as the patient’s age, gender, ethnicity, cultural and spiritual values, socioeconomic background, ethical conditions, and communication challenges.
d.5-Develop a care plan for a patient he/she has assessed, including investigation, treatment and continuing care, in collaboration with the members of the interdisciplinary team.

d.6-Demonstrate altruism, honesty and integrity and respect in all interactions with patients, families, colleagues, and others with whom physicians must interact in their professional lives.
d.7-Demonstrate compassionate treatment of patients and respect for their privacy and dignity and beliefs.


Course Contents:
Title: internal medicine

unit

department

lectures

practical

tutorial

hematology




7

24

nephrology




18

23

gastroenterology




11

22

endocrinology




17

14

rhematology




17

18

tropical




32

27 21

cardiology




30

20

neurology




19

40

pysichatry




11

12

dermatology










chest










Clinical pathology










Geriatric topics





7

8



Unit: Clinical Hematology
Overall aims of the course

Medical students should be able to:

1-Mention basic principles of diagnosis and treatment of deficiency anemias, common hematological emergencies (hemolytic, hemorrhagic, aplastic).

2- Differentiate between primary and secondary hematological disorders.

3- Mention endemic causes of splenomegaly and lymph-adenopathy.

4- Know steps of diagnosis of hematological and reticulo-endothelial benign disorders malignancies.

5- Have basic information about physiology of blood (cells), platelets, coagulation system and plasma, hematopoietic system, reticulo-endothelial system.

6- Have an account about common neoplastic disorders affecting blood cells, lymph nodes and/or other sites of reticulo-­endothelial system.

7- Determine critical cases which need urgent isolation, blood transfusion, special care or urgent higher centre referral.

8- Know main indications, hazards and precautions of blood products transfusion.

Intended Learning Outcomes (ILOs)

I-Knowledge and understanding : Medical students should be able to:

A- Mention basic principles of diagnosis and treatment of deficiency anemias, common Hematological emergencies (hemolytic, hemorrhagic, aplastic).

B - Explain differences between primary and secondary hematological disorders.

C- Mention endemic causes of splenomegaly and lymph-adenopathy.

D- Mention steps of diagnosis of hematological and reticulo-endothelial benign disorders

malignancies.

E- Mention basic information about physiology of blood (cells) , platelets, coagulation system and plasma, hematopoietic system , reticulo-endothelial system.

F- Define neoplastic disorders affecting blood cells, lymph nodes and/or other sites of reticulo-­endothelial system.

G- Define critical cases which need urgent isolation, blood transfusion or special care.

H- Mention indications, hazards and precautions of blood products transfusion.

II- Professional clinical skills: Medical students should be able to:

A- Take proper history from patients with hematological problem.

B- Conduct general and abdominal examination for signs of significance in patient (organomegaly, abdominal masses, skin manifestations of blood diseases).

C- Perform simple bed-side laboratory test (urine examination, whole-blood clotting time) and clinical test ( Hiss test).

III- Intellectual skills: Medical students should be able to:

A- Analyse clinical data to give logic differential diagnosis.

B- Suggest suitable laboratory and other investigations to reach diagnosis in an economic pattern using least possible necessary steps.

C- Interpret clinical data with investigations.

IV- General and transferable skills: Medical students should be able to:

  1. Write a good medical report for patients with hematological problem.

  2. Communicate with other medical centre to ask medical service not available in his locality.

C-Discuss with the patient his disease about disease etiology, pathogenesis, clinical features, and complications and give proper medical advice principles of prevention and management.

Contents:

Topic

No. hours

lecture

tutorial/practical

I-Anemias & Red cell disorders

10

2

8

II-White blood cell disorders

4

1

3

III-Platelet & Clotting disorders

10

2

8

IV-Myelo and lympho proliferative disorders

6

1

5

V-Blood transfusion and BMT

1

1

-


Teaching and Learning Methods

1. Lecture

2. Demonstration

3. Small group clinical teaching, discussion and problem solving

Course schedule:

Topic

teaching methods

coverd ilios

hours

time

by whom

I

1,2, 3

I, II, III, IV

10

1st weak 6th year

Pr.Dr Youseryia

II

1,2, 3

I, II, III, IV

4

2nd weak 6th year

Dr Eman

III

1,2, 3

I, II, III, IV

10

3rd weak 6th year

Pr.Dr Esam

IV

1,2, 3

I, II, III, IV

6

4th weak 6th year

Dr Osama

V

1

I, II, III, IV

1

5th weak 6th year

Dr Howayda


5- Student assessment methods:

        1. Case taking in clinical rounds (2-3 times /student) to assess clinical, intellectual and communication skills and interpretation of clinical and investigation data to reach logic differential diagnosis.

        2. Mid-term examination: A set of processes, including 3 MCQ or short note examination (written) to assess knowledge and intellectual skills.

        3. Final-term examination: assess clinical, intellectual and communication skills and interpretation of clinical and investigation data to reach logic differential diagnosis.

Assessment schedule:

  1. Case taking in clinical rounds 2-3 times /student in 5 months/course.

  2. Mid-term examination once/ course after 10 weeks course in the 6th year.

  3. Final-term examination: once/ course at the end of the 6th year.

Weighting of assessments:

Mid-term examination….……………………20%

Final-term examination………………………80% including:

  • Oral examination……10% ( 2 groups of examiners)

  • Clinical examination…50% (25% short cases & 25% long case)

  • Written Examination………20%


Recommended Reference readings:

  • Course notes

  • Hutchinson's Clinical Medicine.

  • Davidson's Principles and Practice of Medicine.

Facilities:

Books available in Int.Medicine Dept. and Faculty l
Course Coordinator: Prof.Dr. Esam El-Beih beih
Head of Dept. Prof. Dr Youseryia A.Ahmad
Unit: Clinical Nephrology
Overall aims of the course: Medical students should be able to:

1- Know the basic principles of diagnosis and treatment of primary and secondary glomerulonephritis.

2 –Differentiate between primary and secondary glomerular disorders.

3- Know the mechanisms of immune-mediated glomerular diseases.

4- Know the steps of diagnosis of Nephrotic syndrome.

5- Know the basic information about anatomy and physiology of the kidney.

6- Have an account on the common causes of renal diseases stressing on common causes in Egypt and those related to environment.

7- Have basic information about the critical cases which need urgent management of renal failure.

8- Determine the indications, hazards and dose adjustment in prescribing drugs for patients with renal disease.
Intended Learning Outcomes (ILOs)

Content

I-Knowledge and understanding : Medical students should be able to:

A- Mention basic information about anatomy and physiology of the kidney.

B - Explain differences between primary and secondary glomerular disorders.

C- Mention mechanisms of immune-mediated glomerular diseases.

D- Mention steps of diagnosis of Nephrotic syndrome.

E- Mention basic principles of diagnosis and treatment of primary and secondary glomerulonephritis.
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