General Medicine syllabus for MBBS in India (Competency based Education/CBME 2019) including Respiratory Medicine

General Medicine: Topics & competencies as per the CBME

Topic	Competencies	Practicals	Procedures for certification	Integrations
1. Heart Failure	30	8	Nil	V-14 / H-0
2. Acute Myocardial Infarction/ IHD	24	10	02	V-11 / H-0
3. Pneumonia	19	12	Nil	V-10 / H-0
4. Fever and febrile syndromes	26	11	Nil	V-20 / H-0
5. Liver disease	18	5	Nil	V-13 / H-3
6. HIV	23	10	Nil	V-19 / H-0
7. Rheumatologic problems	27	8	Nil	V-9 / H-10
8. Hypertension	20	8	Nil	V-9 / H-0
9. Anemia	21	10	Nil	V-13 / H-0
10. Acute Kidney Injury and Chronic renal failure	31	12	Nil	V-15 / H-0
11. Diabetes Mellitus	24	8	02	V-10 / H-0
12. Thyroid dysfunction	15	3	Nil	V-6 / H-8
13. Common malignancies	19	NIL	Nil	V-14 / H-7
14. Obesity	15	NIL	Nil	V-5 / H-0
15. GI bleeding	18	3	Nil	V-9 / H-18
16. Diarrheal disorder	17	2	Nil	V-11 / H-3
17. Headache	14	2	Nil	V-8 / H-1
18. Cerebrovascular accident	17	5	Nil	V-7 / H-2
19. Movement disorders	9	NIL	Nil	V-4 / H-1
20. Envenomation	9	3	Nil	V-7 / H-0
21. Poisoning	8	4	Nil	V-8 / H-0
22. Mineral, Fluid Electrolyte and Acid base Disorder	13	NIL	Nil	V-9 / H-1
23. Nutritional and Vitamin Deficiencies	5	1	Nil	V-4 / H-4
24. Geriatrics	22	1	Nil	V-3 / H-13
25. Miscellaneous Infections	13	7	Nil	V-9 / H-0
26. The role of the physician in the community	49	11	Nil	V-1 / H-0
Total: 26	506	144	04	V-248 / H-71

Respiratory Medicine: Topics & competencies as per the CBME

Topic	Competencies	Practicals	Procedures for certification	Integrations
1. Tuberculosis	19	7	01	V-13 / H-0
2. Obstructive airway disease	28	12	01	V-13 / H-0
Total: 2	47	19	02	V-26 / H-0

Sample of the detailed description of the competencies:

No	Competency	DLC	Teaching	Assessment	V/H
IM1.1	Describe and discuss the epidemiology, pathogenesis clinical evolution and course of common causes of heart disease including: rheumatic/ valvular, ischemic, hypertrophic inflammatory	K-KH-Y	Lecture, Small group discussion	Written/ Viva voce	V: Pathology, Physiology
IM1.2	Describe and discuss the genetic basis of some forms of heart failure	K-KH-N	Lecture, Small group discussion	Written	V: Pathology, Physiology
IM1.3	Describe and discuss the aetiology microbiology pathogenies and clinical evolution of rheumatic fever, criteria, degree of rheumatic activity and rheumatic valvular heart disease and its complications including infective endocarditis	K-KH-Y	Lecture, Small group discussion	Written/ Viva voce	V: Pathology, Physiology, Microbiology

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 General Medicine for MBBS

Objectives: Student should be able to

1. Understand the various manifestations of infectious and non-infectious diseases.
2. Understand the basic principle of history taking and clinical examinations.
3. Elicit a detailed history, perform a thorough physical examination including mental status examination and examination of an unconscious patient.
4. Correlate the clinical symptoms and physical signs to make a provisional anatomical, physiological, etiopathological diagnosis along with the functional disability and suggest relevant investigation.
5. Interpret reasonably the relevant investigations.
6. Professionally present and discuss the principles involved in the management of the patient, initiate first-line management and outline short-term and long-term management.
7. Manage common acute medical emergencies.
8. Acquire the skills to perform minor procedures under supervision (IV cannulation, urinary bladder catheterisation &doing an ECG etc)
9. Acquire the skills to perform minor procedure under supervision like – IV cannulation, insertion of nasogastric tube, urinary bladder catherisation, use of peak flow meter, doing an ECG etc.

Teaching and learning methodology in General Medicine for MBBS in India

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. Symposia & quizzes.

Distribution of approximate teaching hours in General Medicine for MBBS in India

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	Pain management and palliative care	1 Hrs
2	Poisonings	5 Hrs
3	Specific environmental and occupational hazards	2 Hrs
4	Immune response and Infections	9 Hrs
5	Specific Infections – Epidemiology, clinical features, laboratory diagnosis, treatment and prevention	31 Hrs
6.	Cardiovascular system	19 Hrs
7	Respiratory system	15 Hrs
8	Kidney and genitourinary system	15 Hrs
9	Gastrointestinal tract	20 Hrs
10	Diseases of the pancreas	2 Hrs
11	Liver and Biliary tract disease	15 Hrs
12	Endocrinology and Metabolism & Diabetes mellitus	7 Hrs
13.	Thyroid gland	4 Hrs
14.	The reproductive system	3Hrs
15.	The parathyroid glands	2Hrs
16.	The adrenal glands	2 Hrs
17.	The endocrine pancreas and gastrointestinal tract	2 Hrs
18.	The hypothalamus and the pituitary gland	2 Hrs
19.	Hematological disorders	12 Hrs
20.	Disorders of the immune system, connective tissue and joints	10 Hrs
21.	Neurological diseases	24 Hrs

Examination pattern & marks distribution in Dermatology for MBBS

Exam pattern:

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.
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:

Theoretical assessment: clickers, one-minute papers, and muddiest point
Practical/clinical assessment: one-minute preceptor (OMP) and/or viva voce.
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

Theory: Written tests, should have essay questions, short notes, and creative writing.
Practical / Clinical: practical/clinical tests, Objective Structured Clinica/Objective Structured Practical Examination (OSPE) and/or viva voce.
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:

List of recommended books in General Medicine for MBBS

Davidsion’s Principles and Practice of Medicine, ELBS-Livingstone publications
Kumar & Clark’ Clinical Medicine – A textbook for medical students and doctors, ELBS publications
Harrison’s Principles of Internal Medicine, McGraw Hill publications (Reference book)
Oxford Textbook of Medicine Vol I & II, ELBS publication (Reference book)
Hutchison’s Clinical Methods, ELBS publications
Macleod’s Clinical Examination, ELBS publications
API textbook of Medicine