Microbiology syllabus (Competency based) in India

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

Topics & competencies in Microbiology for MBBS as per the CBME

Sample of the detailed description of the competencies:

• 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 Microbiology for MBBS

• The goal of teaching microbiology to medical students is to: Provide an understanding of infectious disease in order to deal with the etiology, pathogenesis, laboratory diagnosis, treatment and control of infections.

• Objectives: Knowledge – At the end of the course, the student shall be able to:

1. 1. state the infective micro-organisms of the human body and describe the host parasite relationship
   2. list pathogenic micro-organisms and describe the pathogenesis of the diseases produced by them
   3. state or indicate the modes of transmission of pathogenic and opportunistic organisms and their sources, including insect vectors responsible for transmission of infection
   4. describe the mechanisms of immunity to infection
   5. acquire knowledge on suitable antimicrobial agents for treatment of infection and scope of immunotherapy and different vaccine available for prevention of communicable diseases
   6. apply methods of disinfection and sterilization to control and prevent hospital and community acquired infections
   7. recommend laboratory investigations regarding bacteriological examination of food, water, milk and air

• Objectives: Skills – At the end of the course, the student shall be able to :

1. 1. plan and interpret laboratory investigations for the diagnosis of infectious diseases and to correlate the clinical manifestations with the etiological agents
   2. identify the common infectious agents with the help of laboratory procedures and use antimicrobial sensitivity tests to select suitable antimicrobial agents
   3. use the correct method of collection, storage and transport of clinical material for microbiological investigations

Teaching and learning methodology in Microbiology 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 on the etiology, pathogenesis, laboratory diagnosis, treatment, and control of infections 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 Microbiology 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 250 hrs (teaching hours & distribution might differ slightly per university).
• Practicals:

• • Microscopy and micrometry

• • • Introduction to microscopes
    • Focussing slides under low/ high power and oil immersion
    • Principles and demonstration of various types of microscopes

• • Direct demonstration of bacteria by staining

• • • Gram staining
    • Albert’s staining
    • Acid-fast staining

• • Motility tests and biochemical tests for bacterial identification

• • • Hanging drop method for motility testing
    • Important biochemical tests: principles and interpretation

• • Laboratory diagnosis of viral infections

• • • Collection and transport of samples
    • Demonstration of egg inoculation techniques, cell culture, cytopathic effect, plaque assay, serological tests (complement fixation, haemagglutination inhibition, neutralization, ELISA)

• • Laboratory diagnosis of fungal infections

• • • Collection and transport of specimens
    • Gram stain, KOH preparation, India ink preparation for direct demonstration
    • Sabouraud’s dextrose agar/media
    • Lactophenol cotton blue for identification
    • Latex agglutination test

• • Sterilization and disinfection

• • • Visit to media and sterilization room (demonstration of autoclave and hot air oven)
    • Visit to CSSD

• • Stool examination for cysts

• • Collection and transport of stool sample for parasites
  • Direct examination (saline and iodine preparations)
    • Concentration of stool for parasites
    • Identification of cysts

• • Stool examination for intestinal nematodes and cestodes

• • • Collection/transport and concentration of sample
    • Identification of ova of intestinal nematodes and cestodes
    • Identification of adult worms and larvae

• • Enterobacteriaceae

• • • Common media and biochemical tests
    • Culture characteristics of members of Enterobacteriaceae

• • Laboratory diagnosis of coli infection and shigellosis

• • • Stool examination for pus cells and RBCs
    • Processing of stool specimen for bacterial culture
    • Cultural characteristics, tests for coli and its virulence factors
    • Cultural characteristics of Shigella and its identification (incl. slide agglutination test)

• • Laboratory diagnosis of cholera

• • • Collection and transport of specimen
    • Culture media and characteristics
    • Identification (incl. motility, oxidase and other tests)
    • Biotyping and serotyping

• • Laboratory diagnosis of food poisoning

• • • Focus on: laboratory diagnosis of salmonellosis
    • Demonstration for Clostridium perfringens and others

• • Laboratory diagnosis of filariasis

• • • direct examination/staining for microfilaria
    • demonstration of other aspects of filariasis – including vector
    • include revision of stool examination for helminthic ova
    • include demonstration of hydatid cyst

• • Laboratory diagnosis of upper respiratory infections

• • • Focus on: laboratory diagnosis of Streptococcus infection
    • Albert’s stain
    • Media, identification and toxin of Corynebacterium (demonstration)

• • Laboratory diagnosis of lower respiratory tract infections

• • • Focus on: Klebsiella and Streptococcus pneumoniae
    • Viral respiratory infection (demonstration of diagnostic methods)
    • Laboratory diagnosis of tuberculosis
    • Collection of specimens (focus: sputum)
    • Concentration methods
    • Acid-fast staining
    • LJ medium and culture characteristics
    • Differentiation between Mtb and NTM (basic concept/demonstration)

• • Laboratory diagnosis of UTI

• • • Collection, storage and transport of urine
    • Significant bacteriuria and quantitative/semiquantitative methods of culture
    • Media: including CLED
    • coli/ Klebsiella (revision)
    • Focus on: Identification of Proteus and Pseudomonas – cultural characteristics like swarming, pigment production; and tests like OF and oxidase

• • Laboratory diagnosis of wound infections

• • • Focus on: Staphylococcus (culture/ identification including tests like catalase and coagulase)

• • Laboratory diagnosis of anaerobic infections

• • • Demonstration of collection of samples for anaerobic culture
    • Methods of anaerobiasis – RCMB, anaerobic jar
    • Demonstration of media and culture for Clostridium, smears showing sporing and non-sporing GPB, Nagler’s reaction etc. and cultures of GN anaerobes like melaninogenicus

• • Laboratory diagnosis of superficial, subcutaneous and deep mycoses
  • Laboratory diagnosis of malaria

• • • Preparation, staining and examination of peripheral blood smear for malarial parasite
    • Identification of various species and stages
    • Thick smear
    • Demonstration of vector and newer methods

• • Laboratory diagnosis of leishmaniasis

• • • Sample collection
    • Demonstration of LD bodies
    • Demonstration of vector, culture methods and serological tests
    • Revision of peripheral blood smear examination

• • Laboratory diagnosis of enteric fever

• • • Sample collection methods and transport
    • Blood culture (in detail)
    • Stool and urine culture for Salmonella
    • Widal test
    • Identification tests and slide agglutination for Salmonella

• • Laboratory diagnosis of meningitis

• • • Collection, aliquoting and transport of CSF
    • Other useful specimens
    • Direct smear examination
    • Culture media, growth characteristics and identification tests (focus: Neisseria, Haemophilus and Streptococcus pneumoniae)
    • Chronic meningitis: pathogens (demonstration g. India ink for Cryptococcus)
    • Antigen detection

• • Laboratory diagnosis of STD

• • • Collection and transport of specimens
    • Direct demonstration
    • Serological tests (focus: syphilis, HIV)

• • Entomology

• • • Demonstration of medically important entomological specimens

Examination pattern & marks distribution

• 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 exams.
     • Should secure 50 % in theory and practical to pass in university examinations

1. 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.
2. 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
      • Clinical subjects should also be assessed 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 3 tests in Para-clinical subjects should be prelim or pre-university examination
3. 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 Microbiology for MBBS

• Theory
  1. Textbook of Medical Microbiology, Arora and Arora
  2. Textbook of Microbiology, R. Ananthanarayan
  3. Textbook of Medical Parasitology, C. K. JayaramPanikar
  4. Textbook of Medical Parasitology, Arora and Arora
  5. Textbook of Medical Parasitology, S.C.Parija
  6. Medical Microbiology Greenwood Slack, Peutherer
  7. Jawetz, Melnick and Adelberg’s Medical Microbiology, Geo Brooks, Stephen A. Morse, Janet Butel
  8. Parasitology (Protozoology and Helminthology),  D. Chatterjee
• Practicals
  1. Practical Microbiology, Arora
  2. Practical Microbiology, Randhawa

Also watch:

• Lecturer in MBBS 2nd year Microbiology:

• Practical in MBBS 2nd year Microbiology: