a. |
General Internal medicine (Acute and Emergency Medicine) with sub specialties |
– 12 months. |
b. |
Anesthesiology |
– 6 months. |
c.
|
Critical Care / Medicine Care
|
– 3 months.
|
Block No.- 01. |
|
||
Internal Medicine |
45 days |
||
Cardiology |
45 days |
||
Total |
= |
90 days |
|
Block No.- 02. |
Gastroenterology |
– |
15 days |
Haematology
|
—
|
15 days
|
|
Nephrology |
15 days |
||
Physical Medicine
|
– |
15 days
|
|
Total |
= |
90 days |
Block No.- 03. |
|||
Pulmonology |
– |
45 days |
|
Neurology |
– |
45 days |
|
Total |
= |
90 days |
|
Block No.- 04. |
Radiology
|
30days
|
|
Psychiatry |
– |
15 days |
|
Total |
= |
90 days |
|
Block No.- 05. |
Anesthesia: Basic |
||
Pre-operative assessment |
– |
30 days |
|
Operation theater (General , Obstetric Emergency, Otolaryngology) |
– |
60 days |
|
Total |
= |
90 days |
|
Block No.- 06. |
Anesthesia: |
||
Emergency and Primary Trauma Care |
– |
30 days |
|
Neuro surgery emergency |
– |
30 days |
|
Post operative and pain |
– |
30 days |
|
Total |
= |
90 days |
|
Block No.- 07.
|
Critical Care Basic
|
– |
90days |
Total |
= |
90 days |
|
Mouth, nose, pharynx, larynx, trachea, main bronchi, segmental bronchi, structure of bronchial tree: differences in the child |
Airway and respiratory tract, blood supply, innervations and lymphatic drainage |
Pleura, mediastinum and its contents |
Lungs, lobes, microstructure of lungs |
Diaphragm, other muscles of respiration, innervation |
The thoracic inlet and 1st rib |
Interpretation of a normal chest x-ray |
Heart, chambers, conducting system, blood and nerve supply |
Pericardium |
Great vessels, main peripheral arteries and veins |
Fetal and materno- fetal circulation |
Brain and its subdivisions |
Spinal cord, structure of spinal cord, major ascending and descending pathways |
Spinal meninges, subarachnoid and extradural space, contents of extradural space |
CSF and its circulation |
Spinal nerves, dermatomes |
Brachial plexus, nerves of arm |
Intercostals nerves |
Nerves of abdominal wall |
Nerves of leg and foot |
Autonomic nervous system |
Sympathetic innervations, sympathetic chain, ganglia and plexuses |
Parasympathetic innervations |
Satellite ganglion |
Cranial nerves: base of skull: trigeminal ganglion |
Innervation of the larynx |
Eye and orbit |
Cervical, thoracic, and lumbar vertebrae |
Sacrum, sacral hiatus |
Ligaments of vertebral column |
Surface anatomy of vertebral spaces, length of cord in child and adult |
Structures in antecubital fossa |
Structures in axilla: identifying the brachial plexus |
Large veins and anterior triangle of neck |
Large veins of leg and femoral triangle |
Arteries of arm and leg |
Landmarks for tracheotomy, cricothyrotomy |
Abdominal wall (including the inguinal region): landmarks for suprapubic urinary and peritoneal lavage catheters |
Organization of the human body and control of internal environment |
Variations with age |
Function of cells; genes and their expression |
Cell membrane characteristics; receptors |
Protective mechanisms of the body |
Acid base balance and buffers |
Ions e.g. Na + , K+, Ca++ , Cl-, HCO3 |
Cellular metabolism |
Enzymes |
Capillary dynamics and interstitial fluid |
Osmolarity: osmolality, partition of fluids across membranes |
Lymphatic system |
Special fluids especially cerebrospinal fluid: also pleural, pericardial |
and peritoneal fluids |
Red blood cells: haemoglobin and its variants |
Blood groups |
Haemostasis and coagulation |
White blood cells |
The inflammatory response |
Immunity and allergy |
Action potential generation and its transmission |
Neuromuscular junction and transmission |
Muscle types |
Skeletal muscle contraction |
Smooth muscle contraction: sphincters |
Motor unit |
Cardiac muscle contraction |
The cardiac cycle: pressure and volume relationships |
Rhythmicity of the heart |
Regulation of cardiac function; general and cellular |
Control of cardiac output (including the Starling relationship) |
Fluid challenge and heart failure |
Electrocardiogram and arrhythmias |
Neurological and humeral control of systemic blood pressures, blood volume and blood flow (at rest and during physiological disturbances e.g. exercise, hemorrhage and Valsalva maneuver) |
Peripheral circulation: capillaries, vascular endothelium and arteriolar smooth muscle |
Characteristics of special circulations including: pulmonary, coronary, cerebral, renal, portal and foetal |
Blood flow and glomerular filtration and plasma clearance |
Tubular function and urine formation |
Assessment of renal function |
Regulation of fluid and electrolyte balance |
Regulation of acid-base balance |
Micturition |
Path physiology of acute renal failure |
Gaseous exchange: O2 and CO2 transport, hypoxia and hyper- and hypocapnia, hyper-and hypobaric pressures |
Functions of haemoglobin in oxygen carriage and acid-base equilibrium |
Pulmonary ventilation: volumes, flows, dead space |
Effect of IPPV on lungs |
Mechanics of ventilation: ventilation/perfusion abnormalities |
Control of breathing, acute and chronic ventilatory failure, effect of oxygen therapy |
Non-respiratory functions of the lungs |
Functions of nerve cells: action potentials, conduction and synaptic mechanisms |
The brain: functional divisions |
Intracranial pressure: cerebrospinal fluid, blood flow |
Maintenance of posture |
Autonomic nervous system: functions |
Neurological reflexes |
Motor function: spinal and peripheral |
Senses: receptors, nociception, special senses |
Pain: afferent nociceptive pathways, dorsal horn, peripheral and central mechanisms, neuromodulatory systems, supraspinal mechanisms, visceral pain, neuropathic pain, influence of therapy on nociceptive mechanisms |
Spinal cord: anatomy and blood supply, effects of spinal cord section |
Functional anatomy and blood supply |
Metabolic functions |
Gastric function; secretions, nausea and vomiting |
Gut motility, sphincters and reflex control |
Digestive functions |
Nutrients: carbohydrates, fats, proteins, vitamins and minerals |
Metabolic pathways, energy production and enzymes; metabolic rate |
Hormonal control of metabolism: regulation of plasma glucose, response to trauma |
Physiological alterations in starvation, obesity, exercise and the stress response |
Body temperature and its regulation |
Mechanisms of hormonal control: feedback mechanisms, effect on membrane and intracellular receptors |
Hypothalamic and pituitary function |
Adrenocortical hormones |
Adrenal medulla: adrenaline (epinephrine) and noradrenalin (nor epinephrine) |
Pancreas: insulin, glucagon and exocrine function |
Thyroid and parathyroid hormones and calcium homeostasis |
Physiological changes associated with normal pregnancy |
Materno-fetal, fetal and neonatal circulation |
Functions of the placenta: placental transfer |
Fetus: changes at birth 3. Pathology:Acute and Chronic inflammation
|
Types of intermolecular bonds |
Laws of diffusion. Diffusion of molecules through membranes |
Solubility and partition coefficients |
Ionization of drugs |
Drug isomerism |
Protein binding |
Oxidation and reduction |
Dynamics of drug-receptor interaction |
Agonists, antagonists, partial agonists, inverse agonists |
Efficacy and potency. Tolerance |
Receptor function and regulation |
Metabolic pathways; enzymes; drug: enzyme interactions; Michaelis-Menten equation |
Enzyme inducers and inhibitors |
Mechanisms of drug action |
Ion channels: types: relation to receptors. Gating mechanisms |
Signal transduction: cell membrane/receptors/ion channels to intracellular molecular targets, second messengers |
Action of gases and vapours |
Osmotic effects. pH effects. Adsorption and chelation |
Mechanisms of drug interactions |
Inhibition and promotion of drug uptake. Competitive protein binding. Receptor inter-actions |
Effects of metabolites and other degradation products |
Drug uptake from: gastrointestinal tract, lungs, transdermal, subcutaneous, IM, IV, epidural, intrathecal routes |
Bioavailability |
Factors determining the distribution of drugs: perfusion, molecular size, solubility, protein binding |
The influence of drug formulation on disposition |
Distribution of drugs to organs and tissues: Body compartments |
Influence of specialized membranes: tissue binding and solubility |
Maternal-fetal distribution |
Distribution in CSF and extradural space |
Modes of drug elimination |
Direct excretion |
Metabolism in organs of excretion: phase I & II mechanisms |
Renal excretion and urinary pH |
Non-organ breakdown of drugs |
Pharmacokinetic analysis: |
Concept of a pharmacokinetic compartment |
Apparent volume of distribution |
Clearance |
Clearance concepts applied to whole body and individual organs |
Simple 1 and 2 compartmental models: concepts of wash-in and wash-out curves |
Physiological models based on perfusion and partition coefficients |
Effect of organ blood flow: Fick principle |
Pharmacokinetic variation: influence of body size, sex, age, disease, pregnancy, anesthesia, trauma, surgery, smoking, alcohol and other drugs |
Effects of acute organ failure (liver, kidney) on drug elimination |
Pharmacodynamics: concentration-effect relationships: hysteresis |
Pharmacokinetics: familial variation in drug response |
Adverse reactions to drugs: hypersensitivity, allergy, anaphylaxis, anaphylactoid reactions |
Anesthetic gases and vapors |
Hypnotics, sedatives and intravenous anesthetic agents |
Simple analgesics |
Opioids and other analgesics; and opioid antagonists |
Non-steroidal anti-inflammatory drugs |
Neuromuscular blocking agents (depolarizing & non-depolarizing), and anticholinesterases |
Drugs acting on the autonomic nervous system: cholinergic and adrenergic agonists and antagonists |
Drugs acting on the heart & cardiovascular system (including inotropes, vasodilators, vasoconstrictors, anti arrhythmic, diuretics) |
Drugs acting on the respiratory system (including respiratory stimulants & bronchodilators) |
Anti hypertensive |
Anticonvulsants |
Anti- Diuretics diabetic agents |
Antibiotics |
Corticosteroids and other hormone preparations |
Antacids. Drugs influencing gastric secretion and motility |
Antiemetic agents |
Local anesthetic agents |
Plasma volume expanders |
Antihistamines |
Antidepressants |
Anticoagulants |
Vitamin K, B12 and thiamine |
Mathematical concepts: relationships and graphs |
Concepts only of exponential functions and logarithms: wash-in, wash-out and tear away |
Basic measurement concepts: linearity, drift, hysteresis, signal: noise ratio, static and dynamic response |
SI units: fundamental and derived units |
Other systems of units where relevant to anesthesia (e.g. mmHg, bar, atmospheres) |
Simple mechanics: mass, force, work and power |
Heat: freezing point, melting point, latent heat |
Conduction, convection, radiation |
Mechanical equivalent of heat: laws of thermodynamics |
Measurement of temperature and humidity |
Colligative properties: osmometry |
Physics of gases and vapors |
Absolute and relative pressure |
The gas laws; triple point; critical temperature and pressure |
Density and viscosity of gases |
Laminar and turbulent flow; Poiseuille’s equation, the Bernoulli principle |
Vapor pressure: saturated vapor pressure |
Measurement of volume and flow in gases and liquids |
The pneumotachograph and other respirometers |
Principles of surface tension |
Basic concepts of electricity and magnetism |
Capacitance, inductance and impedance |
Amplifiers: band width, filters |
Amplification of biological potentials: ECG, EMG, EEG |
Sources of electrical interference |
Processing, storage and display of physiological measurements |
Bridge circuits |
Basic principles and safety of lasers |
Basic principles of ultrasound and the Doppler effect |
Principles of cardiac pacemakers and defibrillators |
Electrical hazards: causes and prevention |
Electrocution, fires and explosions |
Diathermy and its safe use |
Principles of pressure transducers |
Resonance and damping, frequency response |
Measurement and units of pressure |
Direct and indirect methods of blood pressure measurement |
Principles of pulmonary artery and wedge pressure measurement |
Cardiac output: Fick principle, thermo dilution |
Measurement of gas and vapor concentrations, (oxygen, carbon dioxide, nitrous oxide, and volatile anesthetic agents) using infra-red, paramagnetic, fuel cell, oxygen electrode and mass spectrometry methods |
Measurement of pH, PCO2 , PO2 |
Measurement CO2 production/ oxygen consumption/ respiratory quotient |
Simple tests of pulmonary function e.g. peak flow measurement, spirometry |
Capnography |
Pulse oximetry |
Measurement of neuromuscular blockade |
Measurement of pain
|
Simple aspects of study design |
Defining the outcome measures and the uncertainty of measuring them |
The basic concept of meta-analysis and evidence based medicine |
Types of data and their representation
|
Simple probability theory and the relation to confidence intervals |
The null hypothesis |
Choice of simple statistical tests for different data types |
Type I and type II errors |
1. Resuscitation and initial stabilization |
2. Clinical assessment |
3. Investigation, data interpretation and diagnosis |
4. Organ system support and related practical procedures |
5. Monitoring and clinical measurement |
6. Safe use of equipment |
7. Specific circumstances
|
8. Pre and Post CCM care |
9. End-of-life care |
10. Professionalism |