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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4- Know steps of diagnosis of arthritis.

5- Can determine activity of rheumatic diseases and how can deal with.

6- Know main indications, mechanism of actions and side effects of antirheumatic drugs.
Intended Learning Outcomes (ILOs)

Content

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

A- Mention basic principles of diagnosis and treatment of rheumatoid arthritis-systemic lupus erythematosis-seronegative arthropathy-juvenile rheumatoid arthritis-systemic sclerosis-polymyositis-gout -pseudogout-osteoarthritis

B - Explain differences between various form of arthritis

C- Mention systemic causes of arthritis.

D- Mention steps of diagnosis of arthritis.

.

G- Define disease activity and how you deal with

H- Mention indications, action, side effects and contra indications of anti rheumatic drugs

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

A- Take proper history from patients with rheumatic problem.

B- Conduct complete clinical examination and joint examination

).

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 rheumatic problem.

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

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

Contents

Topic

No. of Hours

Lecture

Practical

Introduction to Reumatology

3

1

2

Rheumatoid arthritis -systemic lupus erythematosis

8

4

4

Seronegative arthropathy - juvenile rheumatoid arthritis

7

3

4

Systemic sclerosis –poly myositis-vasculitis –osteoarthritis-differential diagnosis of arthritis

12

6

6

Crystal induce arthropathy - arthritis in systemic diseases

5

3

2



Teaching and learning methods

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 Nabuia

II

1,2, 3

I, II, III, IV

10

2nd weak 6th year

Pr.Dr.El Badry

III

1,2, 3

I, II, III, IV

8

3rd weak 6th year

.Dr Salwa El GENdi

IV

1,2, 3

I, II, III, IV

7

4th weak 6th year

Dr Omar



















By the end of the course the student should be

A. able to:

  1. Name the appropriate laboratory and radiological investigations (written MCQexam)

  2. Explain various form of arthritis (written MCQ exam.).

  3. Mention treatment of various rheumatic diseases (written MCQ exam.).

  4. Give correct differential diagnosis of simple case as a problem-solving type of questions (clinical exam.).

  5. Define causes, diagnosis, treatment and, complications of common form of arthritis(written and clinical exam.).

  6. Take proper history that lead to logic differential diagnosis from patients in the ward of rheumatology (clinical exam.).

  7. Mention proper laboratory investigations for patients in the ward of rheumatology and use these data with clinical data to reach diagnosis of simple cases (written and clinical exam.).

  8. Discuss diagnosis based on clinical and laboratory data mention lines of treatment and possible complications (clinical exam.).

Corriculum

Unit I: Introduction to rheumatology. This unit introduces the general principles of rheumatological evaluation, differential diagnosis of poly arthritis monoarthritis,specimen collection, and basic laboratory and radiological procedures.

Unit II: Immunological aspect of rheumatic diseases.

Unit III: Various rheumatic diseases rheumatoid arthritis- systemic lupus erythematosis systemic sclerosis- polymyositis –vasculitis- seronegative arthropathy -osteoarthritis

Unit IV: Crystal induce arthropathy (gout- pseudogout)

Unit V: Arthritis in children(juvenile rheumatoid arthritis)

Unit VI: Arthritis in systemic diseases. Arthritis with skin rash. Arthritis with fever

UniteVII:Arthritis in eldery

Unit VIII: This unit presents famous indications, hazards action and side effects of anti rheumatic drugs.

Student Evaluation:

Upon successful completion of this course the students, with at least 70% accuracy, will be able to:

A) In written MCQ examination

1. Recognize and identify the causes of arthritis

 2. Describe various form of rheumatic diseases

 3. Know crystal induce arthropathy

4. Discuss the etiology, symptoms, and clinical laboratory findings of the different arthritis a) Rheumatoid arthritis
b) Systemic lupus erythematosis c) seronegative arthropathyd) systemic sclerosis
e-arthritis in children f-vasculitis g-polymyositis h- osteoarthritis

 6 Discuss the etiology, symptoms, clinical and laboratory findings of crystal induce arthropathy:  a) Gout b) Pseudogout



7. Discuss arthritis in systemic diseases. .

8. Discuss indications, actions, side effects of anti rheumatic drugs

B) In oral examination:

1. Can give correct differential diagnosis of simple case as a problem-solving type of questions for cases of arthritis

2 Give an account in management of rheumatic diseases

C) In clinical examination: student was evaluated about his ability to:

1. Take and write history and detect physical signs and to reach differential diagnosis.

2. Use patient history and physical signs to reach differential diagnosis.

3.Skill of examination of joints.4- Chose proper investigations, lines of treatment of possible diagnosis.

5-Communicate with the patient and give the patient best medical knowledge to prevent complications and approach cure.
Clinical course (3 hours per week clinical round with staff members alternatively with clinical teaching of physical signs with the help of assistant lecturers).

The student should be able to

Each 2-3 students visit a patient twice per month and take full history and examination to be demonstrated and discussed next day with staff member in front of other students.

Student assessment:

        • A set of processes, including 3 MCQ or short note examination (written) 8-10 points in different specialties (1.5 hour test).

        • Assessments of students' achievements in clinical rounds by the attending staff then give structured feedback that supports their continuing learning.

Weighting of assessments:

Mid-term examination………………………20%

Mid-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 readingd:

Hutchinson's Clinical Medicine.

Davidson's Principles and Practice of Medicine.

Cardiovascular Unit
Introduction:

Cardiovascular medicine is a branch dealing with different diseases of heart and blood vessel. Such course is essential for general practitioner for proper expectation, treatment or referral for such group of important and sometimes life threatening diseases

1.Overall aims of the course
Medical Ethics as a physician:

  1. To be dedicated to providing competent medical care, with compassion and respect for human dignity and rights.

  2. To uphold the standards of professionalism, be honest in all professional interactions, and strive to report physicians deficient in character or competence, or engaging in fraud or deception, to appropriate entities.

  3. To respect the law and also recognize a responsibility to seek changes in those requirements which are contrary to the best interests of the patient. To respect the rights of patients, colleagues, and other health professionals, and shall safeguard patient confidences and privacy within the constraints of the law.

  4. To continue to study, apply, and advance scientific knowledge, maintain a commitment to medical education, make relevant information available to patients, colleagues, and the public, obtain consultation, and should know which patient need higher center consultation for proper referral.

  5. To provide appropriate patient care in emergencies, be free to choose whom to serve, with whom to associate, and the environment in which to provide medical care.

  6. To recognize a responsibility to participate in activities contributing to the improvement of the community and the betterment of public health.

  7. To care for a patient, regard responsibility to the patient as paramount.



2. Intended Learning Outcomes (ILOs)

Basic Medicine Medical students should:

- Understand: - Basic principles of diagnosis and treatment of coronary artery diseases with special stress on acute coronary syndromes, rheumatic heart diseases, dieases of the pericardium, myocardium and great arteries especially the aorta .

- Know the basics of ECG interpretation especially for urgent cases.

- know indications of referral to CCU and the first aid measures given to these cases.

- know detailed meticulous cardiac examination and have enough chance to practice that under supervision.

- Have the chance to attend the outpatient clinic and know how things work there.

- Know the indications of different diagnostic tests used in cardiovascular medicine and the advantages and disadvantages of each test.

- Medical students should be trained to write a good medical report for patients with cardiovascular problem and to ask medical service not available in his locality.

CLINICAL & PRACTICAL SKILLS:

Clinical course (3 hours per week clinical round with staff members alternatively with clinical teaching of physical signs with the help of assistant lecturers). The student should be able to take history and detect physical signs and to reach differential diagnosis.

Each 2-3 students visit a patient twice per month and take full history and examination to be demonstrated and discussed next day with staff member in front of other students.
Contents:





Topic

Number of hours

Lecture

Practical



Dyspnea

1

1






Chest pain

1

1

2



Medical emergencies including ACS

2

1

3



Aging and cardiovascular system

2

2

2



Hypertension, shock, and syncope

1

2

1



Anticoagulants

1

1




By the end of the course the student should be

  1. Know anatomy of the cardiovascular system.

  2. Take efficient history.

  3. Do good general and systematic examination.

  4. Present cases in clinical rounds and discuss the possible differential diagnosis of these cases.

  5. Know the recommended treatment plans for each case.


Course Schedule:





Teaching method

Covered ILOS

Hours

By whome



1-3

І, П , Ш, IV

1

Dr.Mahmoud A. Ashry



1-2-3

І, П , Ш, IV

1

Dr.Alaa E.Abd Elmoniem



1-3

І, П , Ш, IV

2

Dr.Mahmoud A. Ashry

Dr.Alaa E.Abd Elmoniem



1-2-3

І, П , Ш, IV

2

Prof.Mohamed M. Ashmawy



1-2-3

І, П , Ш, IV

1

Prof.Mohamed M. Ashmawy



1

І, П , Ш, IV

1

Dr.Mohamed Hossam Maghraby


Student assessment:

        • A set of processes, including 3 MCQ or short note examination (written) 8-10 points in different specialties (1.5 hour test).

        • Assessments of students' achievements in clinical rounds by the attending staff then give structured feedback that supports their continuing learning.

Teaching and learning methods:

The methods, which are used by teachers to help students to achieve the ILOs for the Hematology course include:

1- A case study to teach students how to analyze information and reach a decision and specific conclusions in problem solving manner of clinical cases.

2- Practical ward sessions for the students to gain practical skills.

  1. Lectures that repeated 4 times each year.


Weighting of assessments:

Mid-term examination………………………20%

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

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

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

  • Written Examination………20%


Unit: Tropical Medicine
1. Overall Aims of Course


  • Students must understand the etiology, the pathogenesis, the clinical manifestations, the complications, and the principles of management and prevention of common hepatic diseases, gastrointestinal diseases, infectious diseases, and nutritional diseases in our locality

  • Students must be able to obtain from the patient an accurate medical history and perform in
    a highly skilled manner both general and abdominal examination


  • Students must be able to interpret properly information from laboratory and radiology studies that relate to the patient's condition

  • They must be able to outline first aid management for gastrointestinal bleeding, hepatic encephalopathy, and hyperpyrexia

  • They must understand the scientific basis and evidence of effectiveness for each therapeutic option

  • They must be able to communicate effectively with patients and their families through verbal, written, or other means regarding patient's health and well being.


2. Intended Learning Outcomes of Course
A. Hepatology
1. Jaundice
a. Knowledge and understanding

Students should be able to:

A.1.a.1 mention bilirubin metabolism as an underlying background of jaundice (essay)

A.1.a.2 define jaundice (OWE, clinical round)

A.1.a.3 define types of jaundice (OWE, clinical round)

A.1.a.4 list causes of each type of jaundice (OWE, clinical round)

A.1.a.5 mention the clinical symptoms and signs of each type (essay, oral exam)

A.1.a.6 mention diagnostic criteria (clinical and investigatory) of each type of jaundice (essay, clinical round, oral exam)

A.1.a.7 describe management of each type (essay, oral exam).
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