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

Topics & competencies in Anatomy for MBBS as per the CBME

The syllabus of Anatomy in India has been modified as per the competency based education (CBME) implemented by the NMC in 2019.

Topic	Competencies	Practicals	Procedures for certification	Integrations
1. Anatomical terminology	2	1	Nil	V-0 / H-0
2. General features of bones & Joints	6	1	Nil	V-2 / H-0
3. General features of Muscle	3	NIL	Nil	V-0 / H-1
4. General features of skin and fascia	5	4	Nil	V-3 / H-0
5. General features of the cardiovascular system	8		Nil	V-2 / H-5
6. General Features of lymphatic system	3	NIL	Nil	V-1 / H-0
7. Introduction to the nervous system	8	NIL	Nil	V-2 / H-4
8. Features of individual bones (Upper Limb)	6	6	Nil	V-2 / H-0
9. Pectoral region	3	2	Nil	V-1 / H-0
10. Axilla, Shoulder and Scapular region	13	8	Nil	V-4 / H-0
11. Arm & Cubital fossa	6	5	Nil	V-2 / H-0
12. Forearm & hand	15	11	Nil	V-6 / H-0
13. General Features, Joints, radiographs & surface marking	8	4	Nil	V-1 / H-0
14. Features of individual bones (Lower Limb)	4	3	Nil	V-1 / H-0
15. Front & Medial side of thigh	5	5	Nil	V-2 / H-0
16. Gluteal region & back of thigh	6	6	Nil	V-2 / H-0
17. Hip Joint	3	1	Nil	V-2 / H-0
18. Knee joint, Anterolateral compartment of leg & dorsum of foot	7	4	Nil	V-3 / H-0
19. Back of Leg & Sole	7	2	Nil	V-4 / H-0
20. General Features, Joints, radiographs & surface marking	10	7	Nil	V-5 / H-0
21. Thoracic cage	11	9	Nil	V-0 / H-1
22. Heart & Pericardium	7	4	Nil	V-2 / H-4
23. Mediastinum	7	5	Nil	V-3 / H-0
24. Lungs & Trachea	6	3	Nil	V-3 / H-3
25. Thorax	9	4	01	V-6 / H-4
26. Skull osteology	7	6	Nil	Nil
27. Scalp	2	1	Nil	V-1 / H-0
28. Face & parotid region	10	7	Nil	V-4 / H-0
29. Posterior triangle of neck	4	2	Nil	V-2 / H-0
30. Cranial cavity	5	3	Nil	V-3 / H-0
31. Orbit	5	2	Nil	V-2 / H-0
32. Anterior Triangle	2	2	Nil	V-0 / H-0
33. Temporal and Infratemporal regions	5	3	Nil	V-3 / H-0
34. Submandibular region	2	1	Nil	V-2 / H-0
35. Deep structures in the neck	10	5	Nil	V-4 / H-0
36. Mouth, Pharynx & Palate	5	NIL	Nil	V-5 / H-0
37. Cavity of Nose	3	1	Nil	V-3 / H-0
38. Larynx	3	1	Nil	V-3 / H-0
39. Tongue	2	1	Nil	V-1 / H-0
40. Organs of hearing and equilibrium	5	2	Nil	V-5 / H-0
41. Eyeball	3	1	Nil	V-3 / H-0
42. Back Region	3	2	Nil	V-0 / H-0
43. Head & neck Joints, Histology, Development, Radiography & Surface marking	9	7	Nil	V-5 / H-0
44. Anterior abdominal wall	7	4	Nil	V-5 / H-0
45. Posterior abdominal wall	3	3	Nil	V-3 / H-0
46. Male external genitalia	5	3	Nil	V-3 / H-0
47. Abdominal cavity	14	7	Nil	V-10 / H-0
48. Pelvic wall and viscera	8	3	Nil	V-4 / H-0
49. Perineum	5	4	Nil	V-4 / H-0
50. Vertebral column	4	1	Nil	V-2 / H-0
51. Sectional Anatomy	2	2	Nil	V-2 / H-0
52. Histology & Embryology	8	3	Nil	V-4 / H-0
53. Osteology	4	4	Nil	V-3 / H-0
54. Radiodiagnosis	3	2	Nil	V-3 / H-0
55. Surface marking	2	2	Nil	V-2 / H-0
56. Meninges & CSF	2	1	Nil	V-2 / H-1
57. Spinal Cord	5	1	Nil	V-2 / H-2
58. Medulla Oblongata	4	1	Nil	V-1 / H-2
59. Pons	3	1	Nil	V-0 / H-1
60. Cerebellum	3	1	Nil	V-1 / H-1
61. Midbrain	3	1	Nil	V-1 / H-1
62. Cranial nerve nuclei & Cerebral hemispheres	6	2	Nil	V-4 / H-4
63. Ventricular System	2	1	Nil	V-1 / H-2
64. Histology & Embryology	3	1	Nil	V-1 / H-0
65. Epithelium histology	2	2	01	NIL
66. Connective tissue histology	2	2	Nil	V-1 / H-1
67. Muscle histology	3	3	Nil	V-0 / H-1
68. Nervous tissue histology	3	3	Nil	V-0 / H-1
69. Blood Vessels	3	3	Nil	V-0 / H-1
70. Glands & Lymphoid tissue	2	2	Nil	V-2 / H-0
71. Bone & Cartilage	2	2	Nil	V-2 / H-0
72. Integumentary System	1	1	Nil	NIL
73. Chromosomes	3	NIL	Nil	NIL
74. Patterns of Inheritance	4	NIL	Nil	V-4 / H-0
75. Principle of Genetics, Chromosomal Aberrations & Clinical Genetics	5	NIL	Nil	V-5 / H-0
76. Introduction to embryology	2	NIL	Nil	NIL
77. Gametogenesis and fertilization	6	NIL	Nil	V-6 / H-0
78. Second week of development	5	NIL	Nil	V-2 / H-0
79. 3rd to 8th week of development	6	NIL	Nil	V-3 / H-0
80. Fetal membranes	7	NIL	Nil	V-5 / H-0
81. Prenatal Diagnosis	3	NIL	Nil	V-3 / H-0
82. Ethics in Anatomy	1	1	Nil	V-1 / H-0
Total: 82	409	209	02	V-229 / H-40

Sample of the detailed description of the competencies:

Hip joint
No	Competency	DLC	Teaching	Assessment	V/H
AN17.1	Describe and demonstrate the type, articular surfaces, capsule, synovial membrane, ligaments, relations, movements and muscles involved, blood and nerve supply, bursae around the hip joint	K/S-SH-Y	Practical, Lecture, Small group discussion, DOAP session	Written/ Viva voce/ skill assessment
AN17.2	Describe anatomical basis of complications of fracture neck of femur	K-KH-N	Lecture	Written/ Viva voce	V: Orthopedics
AN17.3	Describe dislocation of hip joint and surgical hip replacement	K-KH-N	Lecture	Written/ Viva voce	V: Orthopedics

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 Anatomy for MBBS

The subject of anatomy is taught under the following heads :

1. Gross anatomy
2. Microanatomy
3. Embryology and Genetics
4. Neuroanatomy

Objectives: The student should be able to

1. Comprehend the normal disposition, inter-relationships, gross, functional and applied anatomy of the various structures in the body
2. Identify the microscopic structures of various tissues, and organs in the human body and correlate the structure with the functions as a prerequisite for understanding the altered state in various disease processes.
3. Comprehend the basic structure and connections between the various parts of the central nervous system so as to analyze the integrative and regulative functions on the organs and systems. He/She should be able to locate the site of gross lesions according to the deficits encountered.
4. To understand the basic principles of embryology including genetic inheritance and stages involved in development of the organs and systems from the time of conception till birth. The student should recognise the critical stages of normal development and the effects of common teratogens, genetic mutations and environmental hazards on it. He/She should be able to explain the developmental basis of the occurrence of major variations, abnormalities and congenital anomalies.

Teaching and learning methodology in Anatomy for MBBS

Details of the competencies, lectures, practicals & skills to be acquired are mentioned in the table given above.
Faculties & Staff teach fundamentals of:
1. Gross anatomy (All divisions of Anatomy are taught with the help of didactic lectures on specific topics followed by dissection/practicals)
2. Microscopic anatomy and its correlation with function,
3. Developmental anatomy and anatomical basis of occurrence of congenital defects, nerve lesions, and its anatomical basis and the applied aspects of relevant clinical conditions.
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

Gross Anatomy Practicals:
- Upper Limb:
  - Dissection: Pectoral and scapular, axillary and shoulder region, arm, forearm.
  - Prosected parts: Joints, Palm and dorsum of hand.
- Thorax :
  - Dissection: Chest wall, mediastinum, pleura, lungs, heart.
- Abdomen:
  - Dissection: Anterior abdominal wall and inguinal region, external genitalia. Viscera and Posterior Abdominal wall and nerve plexus.
- Pelvis:
- Dissection: Pelvic viscera, blood vessels and nerves.
  - Prosected Parts: Perineum including ischio-rectal fossa.
- Lower Limb:
  - Dissection: Gluteal region, front and back of thigh popliteal fossa, front back and lateral side of leg and dorsum of foot.
  - Prosected Parts: Sole of the foot and joints
- Head & Neck:
  - Dissection: Superficial and deep dissection of face and neck, orbit, and eye ball. Submandibular region temporal and infratemporal fossa, cranial cavity, naso, and oropharyngeal regions. Ear, Larynx and pharynx.
Neuro Anatomy Practicals:

- Gross specimen of full brain, meninges, spinal cord, prosected specimens to demonstrate visual system, auditory and vesibular pathways and major functional areas.
- Stained sections of brain and spinal cord at various levels to demonstrate cranial nerve nuclei, ascending and descending tracts, thalamic nuclei and important functional areas.
Demonstrations

1. Bones of skull and vertebral column
2. Brain and spinal cord
3. Cross-sectional anatomy
4. Radiological anatomy
5. CT and MRI scan

Histology practicals:

- Routine and special stained slides of all the tissues and organs of
- Electron micrographs to demonstrate filtration barrier of kidney, alveolar septum, tight junctions of capillaries and such relevant
Embryology practicals:

- Models to demonstrate various stages of the early fetus and different organ
- Slides of ovary and testis to show follicles and stages of maturation of spermatozoa: early chick and pig embryos to understand the development of tissues and organs from conception.
Genetics Practicals:

- Demonstration of normal karyotype and common abnormal conditions including banding; Pedigree chart, syndromes, and their clinical phenotype.
- Demonstration of various new techniques such as FISH.

Distribution of approximate teaching hours in Anatomy 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.
Tentative number of teaching hours: approximately 500 hrs (teaching hours & distribution differ university to university)

Subject	Approximate hours
1. Gross Anatomy
Lectures	38
Practicals	349
2. Microanatomy
Lectures	20
Practicals	43
3. Embryology
Lectures	21
Practicals	18
4. Genetics
Lectures	5
Practicals	1
5. Neuroanatomy
Lectures	19
Practicals	27

Examination pattern & marks distribution in Anatomy 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: 3
  - ECE assessment should be included subject wise
  - There should be at least one short question from AETCOM in each subject
  - One of the 3 tests in preclinical subjects 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)/cross-sections and important arrangement/relation of structures.
    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: Include identification of slides, models, photographs, specimen, prosected parts, X-rays, MRI and structure in cross-sections at various levels of body.
  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:

List of recommended books in Anatomy for MBBS

Gross Anatomy

1. BD Chaurasia’s Textbook of Anatomy
2. Vishram Singh’s Textbook of Anatomy
3. Dutta’s Textbook of Anatomy
4. Gray’s Anatomy for Students

Atlas & dissection manual
1. Cunningham’s Manual of Practical Anatomy
2. Grant’s Dissector
3. Netter’s Atlas of Anatomy
4. McMinn’s Atlas of Anatomy
5. Grant’s Atlas of Anatomy
Clinical, Surface & Radio Anatomy

1. Clinically Oriented Anatomy, K L Moore
2. Clinical Anatomy by Regions, Richard Snell
3. Clinical Anatomy (A Problem Solving Approach) (2 volumes), Neeta Kulkarni
4. Surface and radiological anatomy, A Halim
5. Surface and radiological anatomy, Ashwini Appaji and Roopa Kulkarni

Histology

1. Textbook of Human Histology with colour Atlas, Inderbir Singh
2. Wheater’s Functional Histology: A Text and Colour Atlas
3. diFiore’s Atlas of Human Histology with Functional Correlation, Victor P Eroschenko
4. Textbook of Histology and Practical Guide, Gunasegaran
5. Histology: Text and Atlas, Brijesh Kumar

Embryology

1. Textbook of Human Embryology, Inderbir Singh
2. Textbook of Human Embryology, Vishram Singh
3. Langman’s’s textbook of Medical Embryology, TW Sadler