MCI RULES AND REGULATIONS

The rules and regulations proposed for the MBBS degree course based on the recommendations of the Medical Council of India 1997 are detailed under the following heads.

1.             Introduction

2.             General considerations and teaching approach

3.             Objectives of medical graduate training programme

4.             Admission, selection and migration

5.             Training

6.             Examination regulations

INTRODUCTION

IMC regulations on graduate medical education in 1997 envisage a change in the pattern of medical education. The basic concept is to increase vertical integration of medical curriculum. A reduction of six months is made for the I MBBS course, increasing the training period of the II and III MBBS. The overall course duration is the same, but is reorganised into nine semesters of six months each. The reduction of six months of the I MBBS is meant to reduce the quantum of teaching of preclinical subjects to the medical students and to give time during the later years for revising the preclinical subjects with relevance to the clinical teachings. Organisation of teaching of clinical subjects should be done concentrating on vertical integration, incorporating the teaching staff of preclinical and paraclinical subjects also. Uniform time table for clinical postings and lectures / practicals is presented. A new pattern is designed for the internal assessment and University examinations. Paediatrics is being separated from Medicine and organised as a separate examination in Final MBBS Part II. An examination calendar is prepared with designated dates for all. The calendar for the new batch is made ready on the starting of the course. House surgeons postings is reorganised according to the IMC norms with suitable modifications.

II             GENERAL CONSIDERATIONS AND TEACHING APPROACH

(1)           Graduate medical curriculum is oriented towards training students to undertake the responsibilities of a physician of first contact who is capable of looking after the preventive, promotive, curative and rehabilitative aspects of medicine.

(2)           With a wide range of career opportunities available today, a graduate's training though broad based and flexible should aim to provide an educational experience of the essentials required for health care in our country.

(3)           To undertake the responsibilities of service situation which is a changing condition and of various types, it is essential to provide adequate placement training tailored to the needs of such services as to enable the graduates to become effective instruments of implementation of those requirements. To avail of opportunities and be able to conduct professional requirements, the graduate shall endeavour to have acquired basic training in different aspects of medical care.

(4)           The importance of the community aspects of health care and of rural health care services is to be recognized. This aspect of education and training of graduates should be adequately recognized in the prescribed curriculum. Its importance has been systematically upgraded over the past years and adequate exposure to such experiences should be available throughout all the three phases of education and training. This has to be further emphasized and intensified by providing exposure to field practice areas and training during the internship period. The aim of the period of rural training during internship is to enable the fresh graduate to function efficiently under such settings.

(5)           The educational experience should emphasize health and community orientation instead of only disease and hospital orientation or being concentrated on curative aspects. As such, all the basic concepts of modern scientific medical education are to be adequately dealt with.

(6)           There must be enough experiences provided for self learning. The methods and techniques that would ensure this must become a part of teaching - learning process.

(7)           The medical graduate of modern scientific medicine shall endeavour to become capable of functioning independently in both urban or rural environment. He/she shall endeavour to give emphasis on fundamental aspects of the subjects taught and on common problems of health and disease avoiding unnecessary details of specialization.

(8)           The importance of social factors in relation to the problems of health and diseases should receive proper emphasis throughout the course and to achieve this purpose the educational process should also be community based than only hospital based. The importance of population control and family welfare planning should be emphasized throughout the period of training with the importance of health and development duly emphasized.

(9)           Adequate emphasis is to be placed on cultivating logical and scientific habits of thought, clarity of expression, independence of judgement and ability to collect and analyze information and to correlate them.

(10)         The educational process should be placed in a historic background as an evolving process and not merely as an acquisition of a large number of disjointed facts without a proper perspective. The history of medicine with reference to the evolution of medical knowledge both in this country and the rest of the world should form a part of this process.

(11)         Lectures alone are generally not adequate as a method of training and are a poor means of transferring / acquiring information and even less effective at skill development and in generating the appropriate attitudes. Every effort should be made to encourage the use of active methods related to demonstration and on first hand experience. Students will be encouraged to learn in small groups through peer interactions, so as to gain maximal experience through contacts with patients and the communities in which they live. While the curriculum objectives often refer to areas of knowledge or science, they are best taught in a setting of clinical relevance and hands on experience for students who assimilate and make this knowledge a part of their own working skills.

(12)         The graduate medical education in clinical subjects should be based primarily on outpatient teaching, emergency departments and within the community including peripheral health care institutions. The outpatient departments should be suitably planned to provide training to graduates in small groups.

(13)         Clinics should be organized in small groups of preferably not more than 10 students so that a teacher can give personal attention to each student with a view to improve his skill and competence in handling of the patients.

(14)         Proper records of the work should be maintained which will form the basis of the student's internal assessment and should be available to the inspectors at the time of inspection of the college by the Medical Council of India.

(15)         Maximal efforts have to be made to encourage integrated teaching between traditional subject areas using a problem based learning approach starting with clinical or community cases and exploring the relevance of various preclinical disciplines in both understanding and resolution of the problem. Every attempt should be made to de-emphasize compartmentalisation of disciplines so as to achieve both horizontal and vertical integration in different phases.

(16)         Every attempt is to be made to encourage students to participate in group discussions and seminars to enable them to develop personality, character, expression and other faculties which are necessary for a medical graduate to function either in solo practice or as a team leader when he begins his independent career. A discussion group should not more than 20 students.

(17)         Faculty members should avail of modern educational technology while teaching the students and to attain this objective, Medical Education Units/Departments should be established in all medical colleges for faculty development and providing learning resource material to teachers.

(18)         To derive maximum advantage out of this revised curriculum, the vacation period to students in one calendar year should not exceed one month, during 4½ years Bachelor of Medicine and Bachelor of Surgery (MBBS) Course.

(19)              In order to implement the revised curriculum in toto, State Governments and Institutional Bodies must ensure that adequate financial and technical inputs are provided.

III.           OBJECTIVES OF MEDICAL GRADUATE TRAINING PROGRAMME

(1)                 National Goals

At the end of undergraduate programme, the medical student shall endeavour to be able to:

(a)           recognize “health for all' as a national goal and health right of all citizens and by undergoing training for medical profession, fulfill his/her social obligations towards realization of this goal;

(b)           learn every aspect of national policies on health and devote himself/herself to its practical implementation;

(c)           achieve competence in practice of holistic medicine, encompassing promotive, preventive, curative and rehabilitative aspects of common diseases;

(d)           develop scientific temper, acquire educational experience for proficiency in profession and promote healthy living;

(e)                 become exemplary citizen by observation of medical ethics and fulfilling social and professional obligations, so as to respond to national aspirations.

(2) Institutional Goals

(a)           In consonance with the national goals each medical institution should evolve institutional goals to define the kind of trained manpower (or professionals) they intend to produce. The undergraduate students coming out of a medical institute should:

(i)            be competent in diagnosis and management of common health problems of the individual and the community, commensurate with his/her position as a member of the health team at the primary, secondary or tertiary levels, using his/her clinical skills based on history, physical examination and relevant investigations;

(ii)           be competent to practice preventive, promotive, curative and rehabilitative medicine in respect to the commonly encountered health problems;

(iii)          appreciate rationale for different therapeutic modalities, be familiar with the administration of the "essential drugs" and their common side effects;

(iv)          be able to appreciate the socio-psychological, cultural, economic and environmental factors affecting health and develop human attitude towards the patients in discharging one's professional responsibilities;

(v)           possess the attitude for continued self learning and to seek further expertise or to pursue research in any chosen area of medicine;

(vi)          be familiar with the basic factors which are essential for the implementation of the National Health Programmes including practical aspects of the following:-

(i)            Family Welfare and Maternal and Child Health (MCH),

(ii)           Sanitation and water supply,

(iii)          Prevention and control of communicable and non-communicable diseases,

(iv)          Immunization,

(v)           Health Education;

(vii)         acquire basic management skills in the area of human resources, materials and resource management related to health care delivery;

(viii)        be able to identify community health problems and learn to work to resolve these by designing, instituting corrective steps and evaluating outcome of such measures;

(ix)           be able to work as a leading partner in health care teams and acquire proficiency in communication skills;

(x)            be competent to work in a variety of health care settings;

(xi)           have personal characteristics and attitudes required for professional life such as personal integrity, sense of responsibility and dependability and ability to relate to or show concern for other individuals.

(b)           All efforts must be made to equip the medical graduate to acquire the skills as detailed in APPENDIX A.

APPENDIX  A

A COMPREHENSIVE LIST OF SKILLS RECOMMENDED AS DESIRABLE FOR BACHELOR OF MEDICINE AND BACHELOR OF SURGERY (MBBS) GRADUATE:

I. Clinical Evaluation:

(a)           To be able to take a proper and detailed history.

(b)           To perform a complete and thorough physical examination and elicit clinical signs.

(c)           To be able to properly use the Stethoscope, Blood Pressure Apparatus, Autoscope, Thermometer, Nasal Speculum, Tongue Depressor, Weighing Scales, Vaginal Speculum etc.;

(d)           To be able to perform internal examination - Per Rectum (PR), Per Vaginum (PV) etc.;

(e)           To arrive at a proper provisional clinical diagnosis.

II. Bed side Diagnostic Tests:

(a)           To do and interpret Haemoglobin (Hb), Total Count (TC), Erythrocytic Sedimentation Rate (ESR), blood smear for parasites, Urine examination - albumin / sugar / ketone / microscopic;

(b)           Stool exam for ova and cysts;

(c)           Gram staining and Ziehl-Nielsen staining for AFB;

(d)           To do skin smear for lepra bacilli;

(e)           To do and examine a wet film vaginal smear for Trichomonas;

(f)            To do skin scraping and Potassium Hydroxide (KOH) stain for fungus infections;

(g)           To perform and read Mantoux Test.

III. Ability to carry out Procedures:

(a)           To conduct CPR (Cardiopulmonary resuscitation) and First aid in newborns, children and adults.

(b)           To give Subcutaneous (SC) / Intramuscular (IM) / Intravenous (IV) injections and start Intravenous (IV) infusions.

(c)           To pass a nasogastric tube and give gastric lavage.

(d)           To administer oxygen - by mask / catheter

(e)           To administer enema

(f)            To pass a urinary catheter -  male and female

(g)           To insert flatus tube

(h)           To do pleural tap, ascitic tap & lumbar puncture

(i)            Insert intercostal tube to relieve tension pneumothorax

(j)            To relieve cardiac tamponade

(k)           To control external haemorrhage

IV. Anaesthetic Procedures:

(a)           Administer local anaesthesia and nerve block

(b)           Be able to secure airway patency and administer Oxygen by Ambu bag.

V. Surgical Procedures:

(a)           To apply splints, bandages and Plaster of Paris (POP) slabs;

(b)           To do incision and drainage of abscesses;

(c)           To perform the management and suturing of superficial wounds;

(d)           To carry on minor surgical procedures, e.g. excision of small cysts and nodules, circumcision, reduction of paraphimosis, debridement of wounds etc.;

(e)           To perform vasectomy;

(f)            To manage anal fissures and give injections for piles.

VI. Mechanical Procedures:

(a)           To perform thorough antenatal examination and identify high risk pregnancies.

(b)           To conduct normal delivery;

(c)           To apply low forceps and perform and suture episiotomies;

(d)           To insert and remove IUDs and perform tubectomy.

VII. Paediatrics:

(a)           To assess new born and recognize abnormalities and intra uterine retardation;

(b)           To perform immunization;

(c)           To teach infant feeding to mothers;

(d)           To monitor growth by the use of “road to health chart” and to recognize development retardation;

(e)           To assess dehydration and prepare and administer Oral Rehydration Therapy (ORT);

(f)            To recognize acute respiratory infection clinically.

VIII. ENT Procedures:

(a)           To be able to remove foreign bodies;

(b)           To perform nasal packing of epistaxis;

(c)           To perform tracheostomy;

IX. Ophthalmic Procedures:

(a)           To evert eye-lids;

(b)           To give Subconjunctival injection;

(c)           To perform epilation of eye-lashes;

(d)           To measure the refractive error and advise correctional glasses;

(e)           To perform nasolacrimal duct syringing for patency.

X. Dental Procedures:

To perform dental extraction.

XI. Community Health:

(a)           To be able to supervise and motivate community and para-professionals for corporate efforts for the health care;

(b)           To be able to carry on managerial responsibilities; e.g. Management of stores, indenting and stock keeping and accounting;

(c)           Planning and management of health camps;

(d)           Implementation of national health programmes;

(e)           To effect proper sanitation measures in the community; e.g. disposal of infected garbage and chlorination of drinking water;

(f)            To identify and institute control measures for epidemics including its proper data collecting and reporting.

XII. Forensic Medicine including Toxicology:

(a)           To be able to carry on proper medicolegal examination and documentation of injury and age reports;

(b)           To be able to conduct examination for sexual offences and intoxications;

(c)           To be able to preserve relevant ancillary materials for medicolegal examination;

(d)           To be able to identify important post-mortem findings in common un-natural deaths.

XIII. Management of Emergencies:

(a)           To manage acute anaphylactic shock;

(b)           To manage peripheral vascular failure and shock;

(c)           To manage acute pulmonary oedema and left ventricular failure;

(d)           Emergency management of drowning, poisoning and seizures;

(e)           Emergency management of bronchial asthma and status asthmaticus;

(f)            Emergency management of hyperpyrexia;

(g)           Emergency management of comatose patients regarding airways, positioning - prevention of aspiration and injuries;

(h)                 Assess and administer emergency management of burns.

IV.           ADMISSION, SELECTION AND MIGRATION

1. Eligibility Criteria

No candidate shall be allowed to be admitted to the medical curriculum of first Bachelor of Medicine and Bachelor of Surgery (MBBS) course until:

(a)           He/she has completed the age of 17 years on or before the 31^st of December of the year commencing the prescribed academic session of the said course.

(b)           He/she has passed qualifying examination as under:

(i)            The higher secondary examination or the Indian School Certificate Examination which is equivalent to 10+2 Higher Secondary Examination after a period of 12 years study, the last two years of study comprising of Physics, Chemistry, Biology and Mathematics or any other elective subject with English at a level not less than the core course for English as prescribed by the National Council for Education Research and Training after the introduction of the 10+2+3 years educational structure as recommended by the National Committee on education;

Note: Where the course content is not as prescribed for 10 + 2 education structure of the National Committee, the candidates will have to undergo a period of one year pre-professional training before admission to the Medical Colleges.

or            (ii)           The intermediate examination in science of an Indian University/Board or other recognized

examining body with Physics, Chemistry and Biology which shall include a practical test in these subjects and also English as a compulsory subject.

or            (iii)          The pre-professional / pre-medical examination with Physics, Chemistry and Biology, after passing either the higher secondary school examination, or the pre-university or an equivalent examination. The pre-professional / pre-medical examination shall include a practical test in Physics, Chemistry and Biology and also English as a compulsory subject;

or            (iv)          The first year of the three years degree course of a recognized University, with Physics, Chemistry and Biology including a practical test in these subjects provided the examination is a "University Examination" and candidate has passed 10+2 with English at a level not less than a core course.

or            (v)           B.Sc examination of an Indian University, provided that he/she has passed the B.Sc examination with not less than two of the following subjects - Physics, Chemistry, Biology (Botany, Zoology) and further that he/she has passed the earlier qualifying examination with the following subjects - Physics, Chemistry, Biology and English.

or            (vi)          Any other examination which, in scope and standard is found to be equivalent to the intermediate science examination of an Indian University/ Board, taking Physics, Chemistry and Biology including a practical test in each of these subjects and English.

Note: The pre-medical course may be conducted either at Medical College or a Science College.

Marks obtained in Mathematics are not to be considered for admission to MBBS Course.

After the 10+2 course is introduced, the integrated courses should be abolished.

2. Selection of Students

The selection of students to Medical Colleges shall be based solely on merit of the candidate and for determination of merit, the following criteria be adopted uniformly throughout the country:

(1)           In states having only one Medical College and one university / board / examining body conducting the qualifying examination, the marks obtained at such qualifying examination may be taken into consideration;

(2)           In states, having more than one university / board / examining body conducting the qualifying examination (or where there are more than one Medical Colleges under the administrative control of one authority) a competitive entrance examination should be held so as to achieve a uniform evaluation as there may be variation of standard at qualifying examination conducted by different agencies;

(3)           Where there are more than one colleges in a state and only one university / board conducting the qualifying examination, then a joint selection board be constituted for all the colleges;

(4)           A competitive entrance examination is absolutely necessary in cases of Institutions of All India character;

(5)           To be eligible for competitive entrance examination, the candidate must have passed any of the qualifying examinations as enumerated under the head note "Eligibility Criteria";

Provided also that-

(i)            In case of admission on the basis of qualifying examination, a candidate for admission to medical course must have passed in the subjects of Physics, Chemistry, Biology and English individually and must have obtained a minimum of 50% marks taken together in Physics, Chemistry and Biology at the qualifying examination;

(ii)           In case of admission on the basis of a competitive entrance examination, a candidate for admission to medical course must have passed in the subjects of Physics, Chemistry, Biology and English individually and must have obtained a minimum of 50% marks taken together in Physics, Chemistry and Biology at the qualifying examination and in addition must have come in the merit list prepared as a result of such competitive entrance examination by securing not less than 50% marks in Physics, Chemistry and Biology taken together in the competitive examination.

Provided further that in respect of candidates belonging to Schedule Caste/Schedule Tribes and Other Backward Classes (OBCs) the marks obtained be read as 40% instead of 50%.

3. Migration

(a)           Migration from one Medical College to another is not a right of a student. However, migration of students from one Medical College to another Medical College in India may be considered by the Medical Council of India only in exceptional cases on extreme compassionate grounds (like death of a supporting guardian, illness of the candidate causing disability or disturbed conditions as declared by Government in the Medical College area). Routine migrations on other grounds shall not be allowed.

(b)           Both the colleges i.e. one at which the student is studying at present and one to which migration is sought, are recognized by the Medical Council of India.

(c)           The applicant candidate should have passed first professional MBBS examination.

(d)           The applicant candidate submits his application for migration; complete in all respects, to all authorities concerned within a period of one month of passing (declaration of results) the first professional Bachelor of Medicine and Bachelor of Surgery (MBBS) examination.

(e)           The applicant candidate must submit an affidavit stating that he/she will pursue 18 month of prescribed study before appearing at IInd professional Bachelor of Medicine and Bachelor of Surgery (MBBS) examination at the transferee Medical College, which should be duly certified by the Registrar of the concerned University in which he/she is seeking transfer. The transfer will be applicable only after receipt of affidavit.

Note:

(i)           Migration during clinical course of study shall not be allowed on any ground.

(ii)          All applications for migration shall be referred to Medical Council of India by College authorities. No institution/University shall allow migrations directly without the approval of the Council.

(iii)         Council reserves the right not to entertain any application which is not under the prescribed compassionate grounds and also to take independent decisions where applicant has been allowed to migrate without referring the same to the Council.

V.            TRAINING

1. Training Period and Time Distribution

The admission should be organised in such a way that teaching in first semester starts by August 1 each year.

(a)           Every student shall undergo a period of certified study extending over 4½ academic years divided into 9 semesters (i.e. of 6 months each) from the date of commencement of his study for the subjects comprising the medical curriculum to the date of completion of examination and followed by one year compulsory rotating internship. Each semester will consist of approximately 120 teaching days of 8 hours each college working time, including one hour of lunch. The nomenclature of semester system will be uniformly followed in place of years as they are nomenclatured now.

(b)           The period of 4½ years is divided into three phases as follows:-

(i) Phase I (two semesters of six months each totalling approximately 240 teaching days) -consisting of Pre-clinical subjects - Human Anatomy, Physiology including Bio-physics, Bio-chemistry and Introduction to Community Medicine including Humanities. Half the time available is allotted for Anatomy. Of the remaining half, two third time will be for Physiology and one third for Biochemistry. Basic knowledge of Anatomy, Physiology and Biochemistry of the human body should be transmitted to the students, giving a proper exposure to clinical studies to be undertaken later. Newer modalities of investigation like ultrasound, CT scan, contrast x-ray, NMR and DSA should be introduced to the students. Anatomy dissection should be reoriented to suit the objectives of the new regulation. Rather than letting the students do their own dissection and consequently wasting precious time, the teachers should organise dissected specimens and teach the students more of clinical anatomy, stressing on surgical importance. The reduction in the course of I MBBS has reduced the burden of teaching of preclinical subjects (there being only one batch at a time). The time made available should be utilised for simplifying the learning process of the students, suiting to the new pattern of examination in Anatomy, which does not envisage dissection. Seminars are to be arranged for the benefit of the students to simplify the process of learning. They should be organised by departments incorporating vertical integration with the participation of preclinical, paraclinical and clinical teachers. Even though it is desirable to involve student participation in the seminars, it is inadvisable to put the whole stress on the students. Combined interdepartmental seminars should be held. 60 hours are allotted to Community Medicine including Humanities and introduction to a broader understanding of the perspective of medical education leading to delivery of health care.

Note:

1.             Students will work for 7 hours a day - 8.00 am. to 4.00 pm. One hour lunch break will be given.

2.             Teaching in semester I should start on 1^st of August each year.

3.             No student shall be permitted to join the Phase II (Para-clinical/clinical) group of subjects until he has passed in all the Phase I (Pre-clinical) subjects for which he will be permitted not more than four chances (actual examination), provided four chances are completed in three years from the date of enrollment. Additional batch of students will have separate postings.

4.             Teaching methods: Students are to be encouraged in self learning. Methods in which students are actively involved should be introduced. Only one third of the available time should be used for lectures. The rest is to be used for discussions, seminars, practical demonstrations and problem based learning.

5.             Integrated teaching is emphasized - Integration should be between preclinical departments (horizontal integration) and with clinical departments (vertical integration).

6.             More stress is to be laid on basic principles of the subjects, with more emphasis on applied aspects.

(ii) Phase II. After passing the pre-clinical subjects, 1½ years (3 semesters) shall be devoted to para-clinical / clinical subjects, along with clinical posting. During this phase teaching of para-clinical and clinical subjects shall be done concurrently. The para-clinical subjects shall consist of Pathology, Pharmacology, Microbiology, Forensic Medicine including Toxicology and part of Community Medicine. The clinical subjects shall consist of all those detailed below in Phase III. The clinical postings will have clinical lectures from 8.00 to 9.00 a.m. from the third to the ninth semesters. Out of the time for Para-clinical teaching approximately equal time should be allotted to Pathology, Pharmacology, Microbiology and Forensic Medicine and Community Medicine combined (1/3 Forensic Medicine and 2/3 Community Medicine) as detailed in Appendix B.

(iii) Phase III (Continuation of study of clinical subjects for seven semesters after passing Phase I). The clinical subjects to be taught during Phase II and Phase III are Medicine and its allied specialities, Surgery and its allied specialities, Obstetrics and Gynaecology and Community Medicine. During phase III, pre-clinical and para-clinical teaching will be integrated into the teaching of clinical subjects where relevant. Besides clinical posting as per schedule mentioned herewith, rest of the teaching hours be divided for didactic lectures, demonstrations, seminars, group discussions, etc. in various subjects. The time distribution shall be as per Appendix B. The Medicine and its allied specialties training will include General Medicine, Paediatrics, Tuberculosis and Chest, Skin and Sexually Transmitted Diseases, Psychiatry, Radio-diagnosis, Infectious diseases etc. Surgery and its allied specialties training will include General Surgery, Orthopaedic Surgery including Physio-therapy and Rehabilitation, Ophthalmology, Otorhinolaryngology, Anaesthesia, Dentistry, Radio-therapy etc. The Obstetrics & Gynaecology training will include family medicine, family welfare planning etc.

Didactic lectures should not exceed one third of the time schedule; two third schedule should include practical, clinical or / and group discussions. Learning process should include living experiences, problem oriented approach, case studies and community health care activities. Modern teaching schedules / methodologies should be introduced in all Medical Colleges.

2. Phase Distribution and Timing of Examinations

The nine semesters of six months each are distributed to the three phases as detailed below.

The lectures, practical classes and clinical postings in different semesters are scheduled to suit the convenience of the students, so that the students will have no clinical postings during the time of the final internal assessment and University examinations as detailed in the monthwise distribution of teaching schedule in table below.

*              FIA - Final Internal Assessment;      UE - University Examinations;           R - Waiting for results - Vacation

Clinical postings are adjusted leaving free time for examinations. There will be no clinical postings during the months of final internal assessment. However, revision lecture classes will be held during these months. There will be no regular vacation in May. This is to give time for study leave. There will be two spans of vacation during the course - one at the end of Semester II and the other at the end of Semester IX after the University examinations.

Note:

(a)          Passing the Ist professional examination (I MBBS) of this University or any other University recognized by the University as equivalent thereto is compulsory before proceeding to Phase II training. For appearing for the second professional examination (II MBBS) the candidate must have undergone a course of study extending over a period of three semesters for Pharmacology, Pathology, Microbiology and Forensic Medicine, taken concurrently subsequent to passing the I MBBS Examination.

(b)          A student who fails in the IInd professional examination, shall not be allowed to appear in IIIrd professional Part I examination unless he passes all subjects of IInd professional examination.

(c)                Passing in IIIrd professional (Part I) examination is not compulsory before entering into semesters VIII and IX training, however passing  of IIIrd professional (Part I) is compulsory for being eligible for appearing for IIIrd professional (Part II) examination.

APPENDIX  B

Prescribed Teaching Hours and Suggested Model Time Tables

Following minimum hours are prescribed in various disciplines:

A.            PRE-CLINICAL SUBJECTS - (Phase-I - Semesters I and II)

Anatomy                                                               650 hrs.

Physiology                                                            480 hrs.

Biochemistry                                                         240 hrs.

Community Medicine                                         60 hrs.

B.            PARA-CLINICAL SUBJECTS - (Phase-II - Semesters III, IV and V)

Pathology                                                              300 hrs.

Pharmacology                                                       300 hrs.

Microbiology                                                        250 hrs.

Community Medicine                                         90 hrs.    (+ practical / clinical posting)

Forensic Medicine                                               100 hrs.

Teaching of para-clinical subjects shall be 3 hrs. per day in Semesters III, IV and V (See attached Time Table). The total number of hours will not include University examinations (beginning of examination to publication of results), but will include internal assessment examinations and revision classes.

C.            CLINICAL SUBJECTS (Phase II and III - Semesters III to IX)

1.                    Clinical posting of three hours duration daily (+ one hour of clinical lecture) in the different Departments will be held as per time tables detailed below. All semesters cannot be considered as equal because of the occurrence of examinations in the Semesters II, V, VII and IX. Since the results of the examinations of I MBBS and Final MBBS part II have to be published before the end of the semester, the University examinations will have to start on the beginning of the 5th month of the concerned semester. The final average examination which has to be conducted in the pattern of the University examination will take one month in an institution with an annual intake of 200 students. So the teaching has to be completed by the end of the 3rd month of Semester II and Semester IX. The posting will have to end by the end of the fourth month of Semester V and Semester VII. So Semesters I, III, IV, VI and VIII can have full complement of six months of postings. Revision classes will he held during the month set for final internal assessment in Semesters II, V, VII and IX. During Semesters III to IX, following clinical posting for each student of 4 hrs. duration is decided for various departments.

CLINICAL POSTINGS IN VARIOUS DEPARTMENTS

Subjects                                                          Semesters and duration in weeks

III        IV        V          VI        VII       VIII     IX        Total

General Medicine* 8          -           -           4*         -           8          4          24

Clinical Pathology -           2          -           -           -           -           -           02

Paediatrics -           -           4          -           -           4          2          10

T.B. & Chest -           2          -           -           -           -           -           02

Skin & STD -           2          -           4          -           -           -           06

Radiology -           -           2          -           -           -           -           02

General Surgery 8          -           -           6          -           8          2          24

Anaesthesia -           -           2          -           -           -           -           02

Orthopaedics** -           4          -           4**       -           -           2          10

Ophthalmology -           4          -           -           4          -           -           08

ORL (E.N.T) -           4          -           -           4          -           -           08

Obst. & Gyn. 8          -           -           4          4          4          2          22

Family Planning -           2          -           -           -           -           -           02

Community Medicine -           4          2          -           4          -           -            10

Psychiatry -           -           2          -           -           -           -           02

Radiotherapy -           -           2          -           -           -           -           02

Casualty -           -           -           2          -           -           -           02

Dentistry -           -           2          -           -           -           -           02

Total 24         24         16         24         16         24         12 140

Clinical Orientation classes in Medicine and Surgery will start in the 3rd Semester.

*          This posting in Semester VI includes exposure to infectious diseases.

**        This posting in Semester VI includes exposure to Rehabilitation physiotherapy.

2.

CLINICAL POSTINGS

SEMESTER III                                             6 Months                                            3 Batches

SEMESTER IV                                             6 Months                                            6 Batches

SEMESTER V                                               4 Months                                            4 Batches

University Exam - Pathology, Microbiology, Pharmacology, Forensic Medicine

SEMESTER VI                                             6 Months                                            4 Batches

SEMESTER VII                                            4 Months                                            4 Batches

Exam - Ophthalmology, Oto-Rhino-Laryngology, Community Medicine

SEMESTER VIII                                          6 Months                                            3 Batches

SEMESTER IX                                             3 Months                                            6 Batches

University Exam - Medicine, Surgery, Obstetrics and Gynaecology, Paediatrics

3.                    Theory lectures, demonstrations, Seminars etc.

In addition to clinical posting, theory lectures, demonstrations, seminars etc will be held from 3^rd Semester onwards as detailed below.

Gen. Medicine                                                                                      300 hrs.

Gen. Surgery                                                                                         300 hrs.

Paediatrics                                                                                             100 ,,

Orthopedics                                                                                          100 ,,

T.B. & Chest                                                                                         20 ,,

Ophthalmology                                                                                    100 ,,

Psychiatry                                                                                             20 ,,

Oto-Rhino-Laryngology (E.N.T)                                                       70 ,,

Skin & STD                                                                                           30 ,,

Radiology                                                                                              20 ,,

Community Medicine                                                                          106 ,,

Dentistry                                                                                               10 ,,

Anaesthesia                                                                                          20 ,,

Obstetrics & Gynaecology                                                                 300 ,,

Note: This period of training is minimum suggested. Adjustments where required depending on availability of time be made. This period of training does not include university examination period. Extra time available be devoted to other Sub-specialties.

Uniform time table for lectures / practicals is enclosed. Organisation of teaching of clinical subjects will be done, concentrating on vertical integration, incorporating the teaching staff of preclinical and paraclinical subjects also. Seminars are to be arranged for the benefit of the students to simplify the process of learning. Seminars should be organised by departments incorporating vertical integration with the participation of preclinical, paraclinical and clinical teachers. Specific types of lectures will be decided by the Departments concerned; eg. lecture demonstration hours to the Physical Medicine, Radiodiagnosis, incorporation of behavioural principles in clinical teaching etc.

TOTAL NUMBER OF TEACHING HOURS (Including Lecture and Practicals)

(All Subjects included)

S  E  M  E  S  T  E  R

Not more than one third of the time is to be utilised for lectures. Rest of the time should be utilised for Practicals, Group Learning, Innovative Teaching and Learning Methodology.

* This includes 25 hours of Clinical Pathology lectures in the morning of Semester III. In places, where this is not possible due to the distance between the College and Hospital, the classes can be covered during the Clinical Pathology posting in Semester IV.

TIME TABLE FOR LECTURES / PRACTICALS

SEMESTERS I and II                       6 + 3 months                           25 + 13 weeks

The time tables for Semesters I and II are essentially the same. There will be revision classes during the fourth month of Semester II, when the final internal assessment will be held simultaneously.

Note:      L              = Lecture (not more than 1/3 time for Lectures)

P             = Practicals, Group learning, Innovative Teaching, Learning Methodology

University Exam - Anatomy, Physiology and Biochemistry

Semester III                                       6 Months                                25 weeks

Semester IV                                                   6 Months                                25 weeks

Semester V                                                     4 Months                                17 weeks

Exam - Pathology, Microbiology, Pharmacology, Forensic Medicine

Semester VI                                                   6 Months                                25 weeks

Semester VII                                      4 Months                                            17 weeks

University Exam - Ophthalmology, O-R-L (ENT), Community Medicine

Semester VIII                                                6 Months                                            25 weeks

Semester IX                                       3 Months                                            13 weeks

University Exam - Medicine, Surgery, Obstetrics and Gynaecology, Paediatrics

VI.                                                                     EXAMINATION REGULATIONS

1. Schedule of Internal Assessment and University Examinations

Note:      1. There will be revision classes in the concerned subjects during the month of final internal assessment. 2. There will be no classes during the month of University Examinations. 3. Vacations will be during 6th month of Semesters II and IX (waiting for results). 4. Theory internal assessment exams other than final will be of objective type. They will be held in the afternoons of the last week of the concerned Semester (Examination week in Semesters I, III, IV, VI and VIII).

2.             Essentialities for qualifying to appear in professional examinations.

The performance in essential components of training are to be assessed, based on:

(a) Attendance

75% of attendance for lectures in a subject is compulsory for appearing in the examination provided he/she has 80% attendance in non lecture teaching, ie. seminars, group discussions, tutorials, demonstrations, practicals, hospital (Tertiary, Secondary, Primary) postings, bed-side clinics etc.

INTERNAL ASSESSMENT MARKS

Of the total internal assessment marks, 50% will be for theory and 50% will be for practicals. Of these, 50% of the marks will be decided by the marks obtained in the examinations except the last and the day to day assessment based on the practical / clinical skills, participation in seminars and discussions, and other outstanding performances. 50% of the marks will be those obtained in the last internal assessment examination. Internal assessment examinations will be conducted in the last week of semesters I, III, IV, VI and VIII as examination week over and above the final internal assessment just before the University examination. The duration of preliminary internal assessments will be one hour each and will be objective type. The final internal assessment examination will be conducted exactly in the pattern of University exams.

It shall be based on periodical assessment (see note), evaluation of student assignment, preparation for seminar, clinical case presentation etc. Regular periodical examinations shall be conducted throughout the course. The question of number of examinations is left to the institution. Day to day assessment should be given importance during internal assessment. Weightage for the internal assessment shall be 20% of the total marks in each subject. Student must secure at least 35% of the total marks fixed for internal assessment in a particular subject in order to be eligible to appear in final University Examination of that subject.

Note: Internal assessment shall relate to different ways in which student's participation in learning process during semesters is evaluated. Some examples are as follows: (i) Preparation of subject for students seminar, (ii) Preparation of a clinical case for discussion, (iii) Clinical case study/problem solving exercise, (iv) Participation in project for health care in the community (planning stage to evaluation). (v) Proficiency in carrying out a practical or a skill in small research project and (vi) Multiple choice questions (MCQ) test after completion of a system. Each item tested shall be objectively assessed and recorded. Some of the items can be assigned as Home / Vacation work.

Of the consolidated internal assessment marks, 50% will be based on the last internal assessment examination (which shall be conducted in the actual pattern of the University Examination) and the rest 50% based on earlier internal assessment examinations and continuous evaluation during the course / clinical postings, which will include work book maintenance, performance in clinics, seminars, attendance and outstanding skills. Objective methods of evaluation like OSCE are to be introduced for clinical examinations. Internal assessment examinations will be conducted in the last week of semesters I, III, IV, VI and VIII as examination week over and above the final internal assessment just before the University Examination. The duration of preliminary internal assessment examinations will be of one hour each and questions will be of objective type, which may include MCQs, multiple true/false, match the following - relationship analysis type and objective diagrams.

UNIVERSITY EXAMINATIONS

The pattern of the University examinations will be as would below. Anatomy Physiology and Biochemistry exams are held at the end of semester II, Pathology, Microbiology, Pharmacology and Forensic Medicine exams are held at the end of semester V, Ophthalmology, Oto-rhino-laryngology (ENT) and Community Medicine at the end of semester VII and Medicine, Surgery, Obstetrics and Gynaecology and Paediatrics at the end of semester IX. Ophthalmology and Oto-rhino-laryngology are separated to form two separate subjects rather than a combined paper as is conducted earlier.

In order to avoid course lag, an examination calendar is prepared with fixed dates for all future examinations and published. The pattern of examinations is modified according to the new regulations. Accordingly theory questions will be objective type / short answer / structured questions. Essay type questions will be avoided. A basic pattern will be followed for all the subjects. In the University examinations, the objective type questions will be MCQ, one word answers, true/false, match and objective diagram type. Structured questions on applied aspects will be incorporated to account for 10 marks in each of the preclinical and paraclinical papers. Clinical papers should contain questions for 10 marks from preclinical and paraclinical aspects. In order to establish a foolproof bank of objective questions, efforts should be made in that direction, utilising scientific principles in setting such questions. OSCE (Objective Structured Clinical Evaluation) is introduced in the clinical examinations. The examination calendar for a new batch should be made ready on the beginning of the course.  The pattern of examinations for individual subjects for both internal assessment and University examinations is formulated. Currently 25% of mark is tentatively decided for objective type question. The problems of the objective type of questions are that there can be instances of copying using coded messages, the possibility of a student guessing particularly in the true/false questions and the dilution of the seriousness of the examination as the students will have a chance to obtain very high marks. Even though this as such is not wrong, the possibility of the student taking the examination lightly and thereby preparing less for the examination will make it undesirable for the student.

Model question papers for all subjects are prepared. Because of the incorporation of objective type of questions, the requirement of time for writing the examinations has reduced and hence the theory papers of subjects having 40 marks are designed for two hours and those papers having 50 or 60 marks are designed for three hours.

The examinations are to be designed with a view to ascertain whether the candidate has acquired the necessary knowledge, minimum skills, as detailed in Appendix A along with clear concepts of the fundamentals which are necessary for him to carry out his day to day work competently. Evaluation will be carried out on an objective basis.  An examination calendar should be prepared with designated dates for all internal and University examinations. A candidate before presenting himself for any University Examination shall produce certificates of having attended the recognized courses of instruction in the subject.

Pattern for University Exam

The duration of the theory examinations shall be 2 hours each for papers carrying a total of 40 marks (Pharmacology, Pathology, Microbiology, Forensic Medicine, Ophthalmology, Oto-rhino-laryngology, Obstetrics and Gynaecology and Paediatrics) and three hours each for papers carrying a total of 50 marks (Anatomy, Physiology and Biochemistry) or 60 marks (Community Medicine, Medicine and Surgery). Every question paper shall have 2 sections carrying equal marks; Section A should include objective type of questions which may include MCQs, multiple true/false, match the following - relationship analysis type and objective diagrams, limiting to 25% of the marks of that paper or 50% of that section. The rest of the questions shall be of short structure / short answer type. Unstructured essay type questions shall be avoided. The answer sheet of objective type of questions along with the question papers will be collected at the end of the prescribed time allotted. Section B should include short structure / short answer questions. Anatomy, Physiology, Biochemistry and Microbiology should have one applied question of 10 marks in each paper. Pharmacology should have one question of 10 marks on Clinical therapeutics in the second paper. Ophthalmology and Oto-rhino-laryngology shall have one question of 10 marks on clinical / paraclinical aspects. Medicine, Surgery and Obstetrics and Gynaecology shall have one question of 10 marks each in paper II. Theory papers will be prepared by the examiners as detailed above.

Practical / clinical examination will be conducted in the laboratories or hospital wards.  Objective will be to assess proficiency in skills, conduct of experiment, interpretation of data and logical conclusion. Clinical cases should preferably include common diseases the student is likely to  come across in practice. Rare cases / obscure syndromes, long cases of neurology etc. shall not be kept for the final examination.  Emphasis should be on candidate's capability in eliciting physical signs and their interpretation. Practical examination should be objective and should test skills and ability to interpret the results. Structured evaluation should be done. OSCE (Objective Structured Clinical Evaluation) should be incorporated in the practical examinations.

Viva / oral includes evaluation of management approach and handling of emergencies. Candidate's skill in interpretation of common investigative data, x-rays, identification of specimens, ECG, etc. also is to be evaluated.

Pass, First Class and Distinction for University Exam

In each of the subjects, a candidate must obtain 50% in aggregate with a minimum of 50% in theory including

orals and separate minimum of 50% in Practical. A separate minimum of 45% for University theory (written) Examination is to be insisted for a pass. Candidates who pass the whole examination shall be ranked in the order of proficiency as determined by the total marks obtained by each in both parts and shall be arranged in three classes, the first consisting of those who have obtained not less than 75% of the aggregate marks (Passed with Distinction), the second consisting of those who have obtained not less than 65% of the aggregate marks (Passed in First Class) and all the others (Passed in Second Class). All candidates who fail in the first attempt in any subject and pass subsequently shall not be ranked in distinction or first class. Grace marks upto a maximum of 5 in total may be awarded for an examination (I MBBS, II MBBS, III MBBS Part I or III MBBS Part II) at the discretion of the passing board for a student to pass one subject in that examination, provided the candidate has passed in all the other subjects in that examination. A candidate who fails in any one subject but obtains pass marks in another subject of the same examination shall be exempted from re‑examination in the subject, which the candidate has passed. Candidates who fail in any subject shall be required to produce a certificate for further study for the period, which shall extend to the next succeeding examination.

In the case of candidates who fail at the M.B.B.S. examinations or having applied for admission do not appear for the examination or having obtained the prescribed certificate, do not apply for admission to the examination although qualified to do so, shall be required to produce a certificate of further study including hospital posting / practical work in the subject concerned for the period between the last examination at which they had failed or not appeared and the next succeeding examination, which shall not be less than one semester. In the case of candidates who do not appear for the next succeeding examination, the period of further study shall be decided by the Principal of the College concerned, provided that such study does not exceed two terms. No candidate shall be admitted to the examination unless he/she has produced satisfactory evidence of having complied with the provisions contained in the regulations and has produced the prescribed certificates of study.

The examinations shall be held twice a year in the month of December/January and June/July. There shall be one main examination in a year and one supplementary. University Examinations shall be held as under:-

First Professional - Anatomy, Physiology and Biochemistry.

Second Professional - Pathology, Microbiology, Pharmacology and Forensic Medicine.

Third Professional - Part I - Ophthalmology, Oto-rhino-laryngology and Community Medicine.

Third Professional - Part II - Medicine, Surgery, Obstetrics & Gynaecology and Paediatrics.

Note: Results of all University Examinations shall be declared before the start of teaching for next semester. Examination includes publication of results.

Distribution of Marks to Various Disciplines

(A)           First Professional Examination: (Pre-clinical subjects):-

(a)           Anatomy:

Theory - Two papers of 50 marks each (One applied question of 10 marks in each paper)                100 marks

Oral (Viva)                                                                                                                                               20 marks

Practical                                                                                                                                                   40 marks

Internal Assessment (Theory-20; Practical-20)                                                                                      40 marks

Total                                                                                                                    200 marks

(b)           Physiology including Biophysics

Theory - Two papers of 50 marks each (One applied question of 10 marks in each paper)                100 marks

Oral (Viva)                                                                                                                                               20 marks

Practical                                                                                                                                                   40 marks

Internal Assessment (Theory-20; Practical-20)                                                                                      40 marks

Total                                                                                                                    200 marks

(c)            Biochemistry

Theory - Two papers of 50 marks each (One applied question of 10 marks in each paper)                100 marks

Oral (Viva)                                                                                                                                               20 marks

Practical                                                                                                                                                   40 marks

Internal Assessment (Theory-20; Practical-20)                                                                                      40 marks

Total                                                                                                                    200 marks

(B)           Second Professional Examination: (Para-clinical subjects):

(a)           Pathology:

Theory - Two papers of 40 marks each (One applied question of 10 marks in each paper)                 80 marks

Oral (Viva)                                                                                                                                               15 marks

Practical                                                                                                                                                   25 marks

Internal Assessment (Theory-15; Practical-15)                                                                                      30 marks

Total                                                                                                                    150 marks

(b)           Microbiology:

Theory - Two papers of 40 marks each (One applied question of 10 marks in each paper)                  80 marks

Oral (Viva)                                                                                                                                               15 marks

Practical                                                                                                                                                   25 marks

Internal Assessment (Theory-15; Practical-15)                                                                                      30 marks

Total                                                                                                                    150 marks

(c)            Pharmacology:

Theory - Two papers of 40 marks each (One question of 10 marks on clinical therapeutics)               80 marks

Oral (Viva)                                                                                                                                               15 marks

Practical                                                                                                                                                   25 marks

Internal Assessment (Theory-15; Practical-15)                                                                                      30 marks

Total                                                                                                                    150 marks

(d)           Forensic Medicine:

Theory - One paper                                                                                                                                 40 marks

Oral(Viva)                                                                                                                                                10 marks

Practical/ Clinical                                                                                                                                     30 marks

Internal Assessment (Theory-10; Practical-10)                                                                                      20 marks

Total                                                                                                                    100 marks

(C)          Third Professional Examination

Part I (Clinical subjects) To be conducted during end period of seventh semester.

(a)           Ophthalmology:

Theory: One paper (should contain one question on pre / para-clinical aspects, of 10 marks)              40 marks

Oral (Viva)                                                                                                                                               10 marks

Clinical                                                                                                                                                     30 marks

Internal Assessment (Theory-10; Practical-10)                                                                                      20 marks

Total                                                                                                                    100 marks

(b)           Oto-Rhino-Laryngology:

Theory: One paper (Should contain one question on pre / para-clinical aspects, of 10 marks)              40 marks

Oral (Viva)                                                                                                                                               10 marks

Clinical                                                                                                                                                     30 marks

Internal Assessment (Theory-10; Practical-10)                                                                                      20 marks

Total                                                                                                                    100 marks

(c)            Community Medicine including Humanities:

Theory: Two papers of 60 marks each                                                                                                 120 marks

(Includes problem solving, applied aspects of management at primary level, including

essential drugs, occupational (agro based) disease, rehabilitation and social aspects of community).

Oral (Viva)                                                                                                                                               10 marks

Practical/Project evaluation                                                                                                                      30 marks

Internal Assessment (Theory-20; Practical-20)                                                                                      40 marks

Total                                                                                                                    200 marks

Part II: To be conducted during the end of the ninth semester

a. Medicine:

Theory - Two papers of 60 marks each                                                                                                120 marks

Paper I - General Medicine; Paper II - General Medicine (including Psychiatry, Dermatology and S.T.D.)

(One question of 10 marks on basic sciences and allied subjects)

Oral (viva) Interpretation of X-ray ECG, etc.                                                                                         20 marks

Clinical (Bed side)                                                                                                                                  100 marks

Internal assessment (Theory-30; Practical-30)                                                                                        60 marks

Total                                                                                                                                    300 marks

b. Surgery:

Theory - Two papers of 60 marks each                                                                                                120 marks

Paper I - General Surgery (section 1), Orthopaedics (section 2)

Paper II - General Surgery including Anaesthesiology, Dental and Radiology.

(One question of 10 marks on basic sciences and allied subjects)

Oral (Viva) Interpretation of Investigative data                                                                                      20 marks

Clinical (Bed side)                                                                                                                                  100 marks

Internal Assessment (Theory-30; Practical-30)                                                                                      60 marks

Total                                                                                                                                    300 marks

The questions on Orthopaedics shall be set and assessed by teachers in the Orthopaedics.

c. Obstetrics and Gynaecology

Theory Two papers of 40 marks each                                                                                                    80 marks

Paper I - Obstetrics including social obstetrics. Paper II - Gynaecology, Family Welfare and Demography

(One question of 10 marks on basic sciences and allied subjects)

Oral (Viva) including record of delivery cases (20+10)                                                                           30 marks

Clinical (Bed side)                                                                                                                                    50 marks

Internal Assessment (Theory-20; Practical-20)                                                                                      40 marks

Total                                                                                                                                    200 marks

d. Paediatrics: (including Neonatology)

Theory: One paper (shall contain one question on basic and allied subjects) 40 marks

Oral (Viva)                                                                                                                                               10 marks

Clinical (Bed side)                                                                                                                                    30 marks

Internal Assessment (Theory-10; Practical-10)                                                                                      20 marks

Total                                                                                                                                    100 marks

Resume of Marks for Various Examinations

Appointment of Examiners

1.             No person shall be appointed as an examiner in any of the subjects of the professional examination leading to and including the final professional examinations for the award of the MBBS degree unless he has taken at least five years previously, a doctorate degree of a recognized university or an equivalent qualification in the particular subject as per recommendation of the Council on teachers' eligibility qualification and has had at least five years of total teaching experience in the subject concerned in a college affiliated to recognized university at a faculty position.

2.             There shall be at least four examiners for 100 students, out of whom not less than 50% must be external examiners. Of the four examiners, the senior most internal examiner will act as the Chairman and co-ordinator of the whole examination programme. The Chairman of the Board of Examiners shall be of the rank of Professor and fully independent and shall supervise and co‑ordinate the examination, so that uniformity in the matter of assessment of candidates is maintained. Where candidates appearing are more than 100, one additional examiner, for every additional 50 or part there of candidates appearing, be appointed.

3.             Non medical scientists engaged in the teaching of medical students as whole time teachers, may be appointed examiners in their concerned subjects, provided they possess requisite doctorate qualifications and five years teaching experience of medical students after obtaining their postgraduate qualifications. Provided further that the 50% of the examiners (internal & external) are from the medical qualification stream.

4.             External examiners shall not be from the same university and preferably be from outside the state.

5.             The internal examiner in a subject shall not accept external examinership for a college from which external examiner is appointed in his subject.

6.             A University having more than one college shall have separate sets of examiners for each college, with internal examiners from the concerned college.

7.             External examiners shall rotate at an interval of 2 years.

8.             There shall be a chairman of the Board of paper-setters who shall be an internal examiner and shall moderate the questions.

9.             Except Head of the department of subject concerned in a college / institution, all teachers with the rank of Associate Professor and above with requisite qualifications and experience shall be appointed Internal Examiners by rotation in their subjects provided that where there are no posts of Associate Professors, then an Assistant Professor of 5 years standing as Assistant Professor may be appointed as internal examiners.

TEACHING METHODOLOGIES

Modern teaching schedules / methodologies are introduced. Basic knowledge of Anatomy, Physiology and Biochemistry of the human body will be transmitted to the students, giving a proper exposure to clinical studies to be undertaken later. Newer modalities of investigation like ultrasound, CT scan, contrast x-ray, NMR and DSA will be introduced to the students. Anatomy dissection will be reoriented to suit the objectives of the new regulation, rather than letting the students do their own dissection and consequently wasting precious time. The teachers should organise dissected specimen and teach the students more of clinical anatomy, stressing on surgical importance. The reduction in the course of I MBBS has reduced the burden of teaching of preclinical subjects (there being only one batch at a time). The time made available will be utilised for simplifying the learning process of the students. The new pattern of examination in anatomy does not envisage dissection. The clinical students will have clinical lectures from 8.00 to 9.00 a.m. from the third to the ninth semesters. With the advent of internet facilities and various web sites on medical learning, it is high time that teaching institutions start up online teaching facilities in the lecture halls and libraries. Audiovisual aids, micro teaching methodologies, projection slides, video projection facilities and LCD projection facilities should be incorporated in the lecture halls. A session on computer education will be an invaluable asset to the teachers of Medical Colleges. Facilities like Power point program and scanning hardware should be made available for organising the teaching of the students.

STUDENT POSTINGS

Pre clinical postings are given in the first two semesters. Clinical postings are given during the third to the ninth semesters organised for 142 weeks. The University examinations will be held at the end of semesters II (I MBBS), V (II MBBS), VII (Final MBBS Part I) and IX (Final MBBS Part II). Since the results of the examinations of I MBBS and Final MBBS part II have to be published before the end of the semester, the University examinations will have to start on the beginning of the 5^th month of the concerned semester. The final average examination which has to be conducted in the pattern of the University examination will take one month in a College having intake of 200 students. So the teaching has to be over by the end of the 3rd month of semesters II and IX. The posting will have to be over by the end of the fourth month of semesters V and VII. So semesters I, II, IV, VI and VIII can have full complement of six months of teaching, where as there will be four months of teaching in semesters V and VII and three months of teaching in semesters II and IX. Many clinical postings are currently lost for many students because of the examinations overlapping with clinical postings. This problem has been solved by avoiding clinical postings during the time of the examinations. Revision classes will continue during the period of the final internal assessment.

VACATION

There will be two spans of vacation during the course; one at the end of semester II and the other at the end of semester IX after the University examinations. Over and above, there will be a week’s holiday each for Onam and Christmas every year. There will be no regular vacation in May. This is to organise time for study leave.

INTERNSHIP

Internship training programme will include

Surgery (a)           Two months Surgery including 15 days Casualty

(b)           15 days Orthopaedics

(c)           15 days Oto-rhino-laryngology

Medicine (a)           Two months Medicine

(b)           15 days Ophthalmology

(c)           15 days Radiology / Dermatology / Forensic Medicine / Psychiatry / Blood bank / Anaesthesia

Obstetrics & Gynaecology (a)          Two months Obstetrics & Gynaecology

(b)           One month Paediatrics

Community Medicine (a)           Two and half months Community Medicine

(b)           15 days Respiratory Medicine / Physical Medicine

Grading for Internship should be done according to the proposed evaluation schedule. If high marks are given, reason should be given. Skills to be learnt should be made known according to a check list to be filled up at the end of the posting. Final Internship certificate should show grade according to IMC norms, based on the log book appended.

EPILOGUE

It is hoped that this curriculum will provide better standards of medical education in the country. Students should be involved in technical aspects of clinical teaching and newer teaching methods like LCD projection, CD ROMs on teaching methodologies, internet access etc. Changes in teaching methodologies in medical education should be devised as national policies for better implementation. A doctor should be exposed to actual treatment modalities in the Casualty department of the Medical Colleges in order to tackle emergencies in any rural set up.