Psychiatry syllabus for MBBS in India (Competency based Education/CBME 2019)

Topics & competencies in Psychiatry as per the CBME

Topic	Competencies	Practicals	Procedures for certification	Integrations
1. Doctor patient relationship	4	3	Nil	NIL
2. Mental health	5	NIL	Nil	NIL
3. Introduction to psychiatry	12	4	Nil	V-0 / H-2
4. Psychotic disorders	7	3	Nil	V-3 / H-5
5. Psychotic disorders	6	2	Nil	V-2 / H-0
6. Depression	7	3	Nil	V-2 / H-0
7. Bipolar disorders	7	3	Nil	V-2 / H-0
8. Anxiety disorders	7	3	Nil	V-2 / H-0
9. Stress related disorders	7	3	Nil	NIL
10. Somatoform disorders	7	3	Nil	V-2 / H-5
11. Personality disorders	7	3	Nil	V-2 / H-0
12. Psychosomatic disorders	7	3	Nil	V-2 / H-4
13. Psychosexual and gender identity disorders	7	3	Nil	V-1 / H-0
14. Psychiatric disorders in childhood and adolescence	6	2	Nil	V-5 / H-0
15. Mental retardation	4	1	Nil	V-4 / H-0
16. Psychiatric disorders in the elderly	5	1	Nil	V-3 / H-0
17. Psychiatric emergencies	3	NIL	Nil	NIL
18. Therapeutics	3	NIL	Nil	V-1 / H-0
19. Miscellaneous	6	NIL	Nil	V-5 / H-0
Total: 19	117	40	NIL	V-36 / H-16

Sample of the detailed description of the competencies:

No	Competency	DLC	Teaching	Assessment	V/H
PS12.1	Enumerate and describe the magnitude and etiology of psychosomatic disorders	K-KH-Y	Lecture, Small group discussion	Written/ Viva voce	H: General Medicine
PS12.2	Enumerate, elicit, describe and document clinical features in patients with magnitude and etiology of psychosomatic disorders	S-SH-Y	Bedside clinic, DOAP session	Skill assessment	H: General Medicine
PS12.3	Enumerate and describe the indications and interpret laboratory and other tests of psychosomatic disorders	S-SH-Y	Bedside clinic, DOAP session	Skill assessment	H: General Medicine

Abbreviations & details:
- No & Competencies: No – serial number of the competency with subject/topic coding, & Competencies – description of competencies
- Domain/level-Core (DLC):
  1. Domain (Identifies the domain): K- Knowledge, S – Skill, A – Attitude/professionalism, C- Communication.
  2. Level (Identifies the level of competency): K – Knows, KH – Knows How, SH – Shows how, P- performs independently.
  3. Core: Y – must achieve/compulsory, N – non-core/desirable/optional
- Skills required to certify: P – many procedures must be done independently for certification/ graduation.
- Integration: V – Vertical Integration, H – horizontal integration.

General Objectives of Psychiatry for MBBS

Objectives (Knowledge): Student will be able to

1. Understand human behaviour and its application in patient care.
2. Understand the concept of motivation, its impact on human behaviour and illness related behaviour.
3. Understand different types of emotions and their impact on health of the individual.
4. Define learning, comprehend different types of learning and conditioning. State methods of effective learning and demonstrate application of learning in treatment.
5. Understand different cognitive processes, comprehend memory process, describe short term memory and differentiate with long term memory., list causes of forgetting, and illustrate methods of improving memory.
6. Comprehend concept of thinking and its application to health care.
7. Understand nature of intelligence, explain growth of intelligence, compare role of heredity and environment in intellectual development. Method of assessment of intelligence.
8. Define personality, list determinants of personality, understand different theories of personality and learn methods of personality assessment.

Teaching and learning methodology in Psychiatry as per the CBME

Details of the competencies, lectures, practicals & skills to be acquired are mentioned in the table given above.
Teaching Learning Method:
1. Learner centric didactic lectures with Vertical/horizontal integrations (CBME).
2. Tutorial & Seminars
3. Problem-based Learning (PBL) & Small group discussions (especially focus on practical & clinical implications of the knowledge through cases)
4. Conventional Practical classes & DOAP session (Demonstrate, Observe, Assess, Perform),
5. Self-directed learning +/- multimedia aids (Audiovisual presentations).
6. Seminars, symposia & quizzes.

Distribution of approximate teaching hours in Psychiatry for MBBS

NBE provided the particulars of competencies, teaching methodology, Vertica/.horizontal integrations, AETCOM & Exam methodology however the distribution of hours per class/tutorial & practicals are left for the individual universities to be handled therefore subjected to inter-university variability.

Total number of teaching hours: approximately 150 hrs (teaching hours & distribution might differ slightly per university).
Theory & Practicals:

	Topic	Hours
1	Introduction and classification of Psychiatric disorders, Concept of psychiatric disorders; need for classification; types of classification e.g. atheoretical, symptom – based; introducing the International Classification of Diseases ((ICD) and the Diagnostic and Statistical Manual (DSM); major categories of psychiatric disorders; diagnosis of organic disorders.	1 hour
2	Schizophrenia: Epidemiology, clinical features, subtypes, diagnosis, overview of aetiology, course, treatment –pharmacological, role of ECT.	1 hr
3	Bipolar disorders: Epidemiology, clinical features, diagnosis, overview of aetiology, course, treatment – pharmacological.	1 hr
4	Depression: Epidemiology, clinical features, diagnosis, overview of aetiology, co-morbidity with organic disorders, course, treatment – pharmacological.	1 hr
5	Anxiety neurosis, phobia and OCD: Types of anxiety disorders; phobia, OCD, clinical features and epidemiology; diagnosis, differential diagnosis; overview of aetiology; course; treatment – pharmacological and non-pharmacological.	1 hr
6	Hysterical neurosis (Conversion and Dissociative disorders) Epidemiology, clinical picture, diagnosis, differential diagnosis, aetiology, prognosis, treatment.	1 hr
7	Somatoform disorders: Type of somatoform disorders, clinical features, diagnosis, differential diagnosis, treatment, prognosis	1 hr
8	Drug and Alcohol dependence: Concept of abuse and dependence, epidemiology of alcohol and opiate dependence; clinical features, withdrawal symptoms including complicated withdrawal, psychosocial complications, aetiology, outcome, treatment	1 hr
9	Personality disorders: Concept of personality disorders, epidemiology, classification, assessment, overview of clinical features, aetiology, and prognosis.	1 hr
10	Psychiatric disorders of childhood and adolescence, Classification of childhood psychiatric disorders, epidemiology, clinical features, aetiology, assessment.
11	Counselling and psychological therapies Counselling process, skills, different counseling approaches, behaviour therapy, cognitive therapy and its applications.	1 r
12	Psychological testing What are psychological tests, standardization, reliability, validity, intelligence test, personality test, application.	1 hr
13	Psycho-sexual disorders.	1 hr
14	Psychiatric emergencies including suicide.	1 hr
15	Organic mental disorder like delirium	1 hr
16	Learning (different types) memory (Types of memory, cause of forgetting etc.)	1 hr
17	Psychiatric interventions like ECT, rTMS,	1 hr
18	Psychotropics drugs	1 hr
19	History of Psychiatry and issue of stigmas regarding mental illnesses	1 hr
20	Difference between normal and abnormal behaviour. Doctor-Patient relationship and communication skills	1 hr

Examination pattern & marks distribution in Psychiatry for MBBS

Exam pattern:
1. The formative or internal assessment will not be added to the university examination marks.
  - Should score 50 % & in theory and practical combined to be eligible to sit for university exams.
2. University exam: Each subject will have two papers.
  - 200 marks will be reserved for the theory of two papers.
  - Another 100 will be reserved for either practical, oral, or clinical exam.
  - Should secure 50 % in theory and practical to pass in university examinations

Formative Assessment:
1. Theoretical assessment: clickers, one-minute papers, and muddiest point
2. Practical/clinical assessment: one-minute preceptor (OMP) and/or viva voce.
3. Scheduling: during teaching-learning activities & planned by the teachers on a day to day basis and modified depending on the tasks at hand.
Internal assessment
1. Theory: Written tests, should have essay questions, short notes, and creative writing.
2. Practical / Clinical: practical/clinical tests, Objective Structured Clinica/Objective Structured Practical Examination (OSPE) and/or viva voce.
3. Scheduling:
  - Minimum Number of tests during the year: 2
  - Clinical subjects should also be tested at end of each posting (EOP)-Theory and Practical
  - There should be at least one short question from AETCOM in each subject
  - One of the tests in Ophthalmology, Otorhinolaryngology/Forensic Medicine & Toxicology/ Community Medicine should be prelim or pre-university examination
Summative assessment (For Universities)
- Theory Papers: 2 papers for 200 marks
  1. Suggested combination of various types of question:
    1. Structured essays (Long Answer Questions – LAQ)
    2. Short Answers Questions (SAQ)
    3. Objective type questions (Various type of MCQs: < 20% weightage)
  2. Distribution of the competencies: The examiner must sample the contents appropriately from competencies.
- Practicals for 100 marks:
  1. Application-oriented exercises (Should not be simple tests of knowledge).
  2. Objective Structured Practical Examination (OSPE), One- Minute Preceptor (OMP), Directly Observed Procedural Skills (DOPS) etc. can be suitably modified for this purpose and/or viva voce.
- Scheduling: