Ophthalmology syllabus (Competency based) in India

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

Topics & competencies in Ophthalmology 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 Ophthalmology for MBBS

• Objectives (Knowledge): student will have knowledge of :

1. 1. Common problems affecting the eye
   2. Magnitude of blindness in India and its main causes
   3. Principles of management of major ophthalmic emergencies
   4. Major systemic diseases affecting the eye
   5. Effect of local and systemic diseases on the patient’s vision and the necessary action required to minimise the sequelae of such diseases
   6. Adverse drug reactions with special reference to ophthalmic manifestations
   7. National programme for prevention of blindness and its implementation at various level
   8. Eye care education for prevention of eye problems
   9. Role of Primary Health Centres
   10. Organisation of primary health care and the functioning of the Ophthalmic assistant
   11. Integration of the National programme for control of blindness with the other
   12. National health programmes
   13. Eye bank organisation

• Objectives (Skills): Student will be able to:

1. 1. Elicit a history pertinent to general health and ocular status
   2. Perform diagnostic procedures
   3. Diagnose and treat common problems affecting the eye
   4. Interpret ophthalmic signs in relation to common systemic disorders
   5. Perform therapeutic procedures
   6. Provide first aid in major ophthalmic emergencies
   7. Organise community surveys for visual health
   8. Organise primary eye care services through Primary Health Centres
   9. Use effective means of communication with the public and individuals to motivate them for surgery for cataract, glaucoma etc and for eye donation
   10. Establish rapport with his seniors, colleagues and paramedical workers, so as to effectively function as a member of the eye care team

Teaching and learning methodology in Ophthalmology 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)
  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 Ophthalmology 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:
  1. visual acuity testing,
  2. Examination of the eye,
  3. Tonometry,
  4. Staining for corneal pathology,
  5. Confrontation perimetry,
  6. Subjective refraction including correction for presbyopia and aphakia,
  7. Direct ophthalmoscopy,
  8. Conjunctival smear examination and cover test,
  9. Subconjunctival injection,
  10. Corneal/conjunctival foreign body removal,
  11. Carbolic cautery for corneal ulcers,
  12. Nasolacrimal duct stringing,
  13. Tarsorraphy

Examination pattern & marks distribution in Ophthalmology 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

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: 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
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 Ophthalmology for MBBS

1. Parson’s diseases of the Eye, 19th Edition.
2. Clinical Ophthalmology – Kanski.

Also watch:

• Lecturer in Ophthalmology for MBBS:

• Practical class in Ophthalmology for MBBS: