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

Topics & competencies in Biochemistry for MBBS as per the CBME

The syllabus of Biochemistry 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. Basic Biochemistry	1	NIL	Nil	V-0 / H-1
2. Enzyme	7	1	Nil	V-4 / H-0
3. Chemistry and Metabolism of Carbohydrates	10		Nil	V-5 / H-1
4. Chemistry and Metabolism of Lipids	7	NIL	Nil	V-7 / H-0
5. Chemistry and Metabolism of Proteins	5	NIL	Nil	V-4 / H-1
6. Metabolism and homeostasis	15	NIL	Nil	V-12 / H-8
7. Molecular biology	7	NL	Nil	V-3 / H-0
8. Nutrition	5	NL	Nil	V-5 / H-0
9. Extracellular Matrix	3	NIL	Nil	V-1 / H-0
10. Oncogenesis and immunity	5	NIL	Nil	V-5 / H-1
11. Biochemical Laboratory Tests	24	11	05	V-6 / H-1
Total: 11	89	12	05	V-52 / H-13

Sample of the detailed description of the competencies:

No	Competency	DLC	Teaching	Assessment	V/H
BI2.4	Describe and discuss enzyme inhibitors as poisons and drugs and as therapeutic enzymes	K-KH-Y	Lecture, Small group discussion	Written/Viva voce	V: Pathology, General Medicine
BI2.5	Describe and discuss the clinical utility of various serum enzymes as markers of pathological conditions.	K-KH-Y	Lecture, Small group discussion	Written/Viva voce	V: Pathology, General Medicine
BI2.6	Discuss use of enzymes in laboratory investigations (Enzyme-based assays)	K-KH-Y	Lecture, Small group discussion	Written/ Viva voce	V: Pathology, General Medicine
BI2.7	Interpret laboratory results of enzyme activities & describe the clinical utility of various enzymes as markers of pathological conditions.	K-KH-Y	Lecture, Small group discussion, DOAP sessions	Written/ Viva voce	V: Pathology, General Medicine

General Objectives of Biochemistry for MBBS

Objectives: Knowledge – At the end of the course, the student should be able to demonstrate his knowledge and understanding of the:

1. Molecular and functional organization of a cell, and sub-cellular components;
2. Structure, function, and interrelationship of biomolecules and consequences of deviation from normal;
3. Basic and clinical aspects of enzymology and regulation of enzymatic activity;
4. Digestion and assimilation of nutrients and consequences of malnutrition;
5. Integration of the various aspects of metabolism, and their regulatory pathways;
6. Biochemical basis of inherited disorders and their associated sequelae;
7. Mechanisms involved in the maintenance of body fluid and pH homeostasis;
8. Molecular mechanisms of gene expression and regulation, the principles of genetic engineering and their application in medicine;
9. Molecular concepts of body defense and their application in medicine;
10. Biochemical basis of environmental health hazards; and biochemical basis of cancer and carcinogenesis, principles of metabolism, and detoxication of xenobiotics.
11. Principles of various conventional and specialized laboratory investigations and instrumentation, analysis and interpretation of a given data; the ability to suggest experiments to support theoretical concepts and clinical diagnosis.

Objectives: Skills – At the end of the course, the student should be able to make use of conventional techniques/ instruments to perform biochemical analysis relevant to clinical screening and diagnosis

1. analyze and interpret investigative data
2. demonstrate the skills of solving clinical problems and decision

Teaching and learning methodology in Biochemistry for MBBS

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) to inculcate skills of reasoning, meaningful approaches to learning, and facilitate understanding of the subject.
4. Conventional Practical classes (Practical bench work, Demonstration, Analyses and interpretation of data & Discussions on the practicals with the help of clinical and scientific problems) & DOAP session (Demonstrate, Observe, Assess, Perform),
5. Self-directed learning +/- multimedia aids (Audiovisual presentations).
6. Seminars, symposia & quizzes.

Distribution of approximate teaching hours in Biochemistry for MBBS

NBE provided the particulars of competencies, teaching methodology, Vertical/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 250 hrs (teaching hours & distribution might differ slightly per university).
Theory:

Chapter	Duration
1. Introduction to Biochemistry and its relevance to Medical practice	1
2. Cell and sub cellular organelles	1
3. Cell membrane and transport	2
4. pH, water, buffers and acid base balance and its disorders	2
5. Physical biochemistry	3
6. Chemistry of carbohydrates	3
7. Chemistry of lipids	5
8. Chemistry of amino acids	5
9. Structure and function of proteins	5
10. Hemoglobin and myoglobin	2
11. enzymes	5
12. Thermodynamics and biological oxidation	3
13. Introduction to metabolism	1
14. Carbohydrate metabolism	8
15. Lipid metabolism	8
16. Amino acid metabolism	8
17. Nucleotide chemistry	2
18. Nucleotide metabolism	2
19. Heme metabolism	2
20. Introduction to molecular biology	1
21. Structure and function of nucleic acids	2
22. DNA replication	3
23. transcription	3
24. Translation	2
25. Genetic code & Mutations	1
26. Regulation of gene expression	2
27. Recombinant DNA technology	3
28. Cell cycle and cancer	1
29. immunology	6
30. Nutrition	3
31. hormones	4
32. xenobiotic	1
33. vitamins	6
34. minerals	3
35. Free radicals and antioxidants	1
36. Glycoproteins, Proteoglycans, Extracellular matrix	2
37. Maintenance of homeostasis	5
38. Clinical Chemistry	4
Total

Practicals:

Chapter	Duration
1. Introduction to Biochemistry Laboratory	2
2. Demonstration of pH meter	2
3. General tests of carbohydrates	2
4. General tests of proteins	2
5. Identification of carbohydrates	2
6. Reactions of R group of proteins	2
7. Normal urine	2
8. Pathological urine	2
9. Principles of colorimetry	2
10. Standard curve in colorimetry by using protein standard	2
11. Blood sugar estimation	2
12. Quantitative estimation of serum total proteins	2
13. Glucose tolerance test	2
14. Test for blood urea	2
15. Urea clearance test	2
16. Serum creatinine test	2
17. electrophoresis	2
18. chromatography	2
19. Liver function tests	2
20. Kidney function tests	2
21. Thyroid function tests	2
22. Gastric function tests	2
Total

Examination pattern & marks distribution in Biochemistry 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)
    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:

List of recommended books in Biochemistry for MBBS

Theory

1. Textbook of Biochemistry for Medical students, DM Vasudevan
2. Biochemistry for MBBS,S.K.Gupta
3. Biochemistry, Pankaja Naik
4. Textbook of Medical Biochemistry, Dinesh Puri
5. Case oriented approach towards Biochemistry, Namrata Chhabra
6. Essentials of Medical Biochemistry with clinical cases, Bagavan and Ha.
7. Harpers’ Illustrated Biochemistry