Curriculum/Statutes & Regulations 5 Years Degree Programme Dermatology
Curriculum/Statutes & Regulations 5 Years Degree Programme Dermatology
Curriculum/Statutes & Regulations 5 Years Degree Programme Dermatology
FOR
5 YEARS DEGREE PROGRAMME
IN
DERMATOLOGY
(MD DERMATOLOGY)
2. Course Title:
MD Dermatology
3. Training Centers
Departments of Dermatology (accredited by UHS) in affiliated institutes of
University of Health Sciences Lahore.
4. Duration of Course
The duration of MD Dermatology course shall be five (5) years (first year in
Part I, first two years in Part II and next three years in Part III) with
structured training in a recognized department under the guidance of an
approved supervisor.
The course is structured in three parts:
Part I is structured for the 1st calendar year. The candidate shall undertake
didactic training in Basic Medical Sciences, Behavioural Sciences and
Biostatistics & Research Methodology. At the end of first year the
examination shall be held in Basic Medical Sciences. The clinical training in
fundamental concepts of Internal Medicine shall start from the 1st day of
enrollment.
Part II is structured for the 1st and 2nd calendar years. The candidate shall
undertake clinical training in fundamental concepts of Internal Medicine. At
the end of 2nd year, the examination shall be held in fundamental concepts of
Internal Medicine. The clinical training in Dermatology shall start from 3rd
year onwards in the in recognized institutions.
Part III is structured for 3rd, 4th and 5th calendar years in MD Dermatology.
The candidate shall undergo training to achieve educational objectives of MD
Dermatology (knowledge & skills) along with rotation in relevant fields. Over
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Curriculum/Statutes & Regulations -MD Dermatology
the five years duration of the course, candidate will spend total time equivalent
to one calendar year for research during the training. Research can be done as
one block in 5th year of training or it can be done in the form of regular periodic
rotations over five years as long as total research time is equivalent to one
calendar year.
5. Admission Criteria
• Total number of students enrolled for the course must not exceed 2 per
supervisor/year.
• The maximum number of trainees that can be attached with a supervisor at
a given point of time (inclusive of trainees in all years/phases of MD
training), must not exceed 6.
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Curriculum/Statutes & Regulations -MD Dermatology
• Beds to trainee ratio at the approved teaching site shall be at least 5 beds
per trainee.
• The University will approve supervisors for MD courses.
• Candidates selected for the courses after their enrollment at the relevant
institutions shall be registered with UHS as per prescribed Registration
Regulations.
A). Faculty
Properly qualified teaching staff in accordance with the requirements of
Pakistan Medical and Dental Council (PMDC)
C). Library
Departmental library should have latest editions of recommended books,
reference books and latest journals (National and International).
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Curriculum/Statutes & Regulations -MD Dermatology
GENERAL OBJECTIVES
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Curriculum/Statutes & Regulations -MD Dermatology
Manage patients in ways that demonstrate sensitivity to their
physical, social, cultural and psychological needs
Recognize disorders of the Dermatological system and differentiate
those amenable to medical treatment
Effectively recognize and manage complications
Accurately identify the benefits, risks and mechanisms of action of
current and evolving treatment modalities
Indicate alternatives in the process of interpreting investigations
and in decision-making
Manage complexity and uncertainty
Consider all issues relevant to the patient
Identify risk
Assess and implement a risk management plan
Critically evaluate and integrate new technologies and techniques.
Organize diagnostic testing, imaging and consultation as needed:
Select medically appropriate investigative tools and monitoring
techniques in a cost-effective and useful manner
Appraise and interpret appropriate diagnostic imaging and
investigations according to patients' needs
Critically evaluates the advantages and disadvantages of different
investigative modalities
Communicate effectively:
Communicate appropriate information to patients (and their
family) about procedures, potentialities and risks associated with
procedure in ways that encourage their participation in informed
decision making
Communicate with the patient (and their family) the treatment
options including benefits and risks of each
Communicate with and co-ordinate health management teams to
achieve an optimal management of the patient
Initiate the resolution of misunderstandings or disputes
Modify communication to accommodate cultural and linguistic
sensitivities of the patient
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Curriculum/Statutes & Regulations -MD Dermatology
Recognize the value of knowledge and research and its application to clinical
practice:
Assume responsibility for self-directed learning
Critically appraise new trends in Dermatology
Facilitate the learning of others
Appreciate ethical issues associated with Dermatology:
Consistently apply ethical principles
Identify ethical expectations that impact on medico-legal issues
Recognize the current legal aspects of informed consent and
confidentiality
Be accountable for the management of their patients.
Professionalism by:
Employing a critically reflective approach to Dermatology
Adhering with current regulations concerning workplace harassment
Regularly carrying out self and peer reviewed audit
Acknowledging and have insight into their own limitations
Acknowledging and learning from mistakes
Work in collaboration with members of an interdisciplinary team where
appropriate:
Collaborate with other professionals in the selection and use of
various types of treatments assessing and weighing the indications
and contraindications associated with each type
Develop a care plan for a patient in collaboration with members of an
interdisciplinary team
Employ a consultative approach with colleagues and other
professionals
Recognize the need to refer patients to other professionals.
Management and Leadership
Effective use of resources to balance patient care and system resources
Identify and differentiate between system resources and patient needs
Prioritize needs and demands dealing with limited system resources.
Manage and lead clinical teams
Recognize the importance of different types of expertise which
contribute to the effective functioning of clinical team
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Curriculum/Statutes & Regulations -MD Dermatology
Maintain clinically relevant and accurate contemporaneous records
Health advocacy:
Promote health maintenance of patients
Advocate for appropriate health resource allocation
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Curriculum/Statutes & Regulations -MD Dermatology
SPECIFIC LEARNING OUTCOMES
Residents completing MD Dermatology training will have formal instruction,
clinical experience, so that at the end of this training a resident should be able to
Diagnose and manage independently common skin diseases, sexually
transmitted diseases and leprosy.
Manage independently and efficiently all medical emergencies related with
skin, leprosy and venereal disease.
Adopt preventive measures at individual and community levels against
communicable skin, venereal diseases and leprosy.
Teach requisite knowledge and laboratory skills to other
medical/paramedical team members.
Adopt a compassionate attitude towards the patients (and their families)
under his/ her charge.
Critically evaluate and initiate investigation for solving problems relating to
skin, venereal diseases and leprosy.
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Curriculum/Statutes & Regulations -MD Dermatology
Discuss the natural history, signs, symptoms and the differential diagnosis
of seborrheic dermatitis in all age groups.
Discuss the natural history, develop a differential diagnosis and propose a
treatment plan for pruritus.
Discuss the natural history, signs, symptoms, differential diagnosis and
treatment for each of the following eczematous dermatoses:
1. Contact dermatitis
2. Atopic eczema
3. Nummular eczema
4. Dyshidrotic eczema
5. Hand dermatitis
6. Stasis dermatitis
7. General exfoliative dermatitis
Discuss the natural history, differential diagnosis, signs, symptoms and
treatment of the following reactive dermatoses:
1. Urticaria
2. Erythema multiforme
3. Erythema nodosum
4. Henoch-Schoenlein purpura
Discuss the dermatological manifestations of the following collagen vascular
diseases:
1. Systemic lupus erythematosus
2. Discoid lupus erythematosus
3. Scleroderma
4. Raynaud's phenomenon
Discuss the chronic vesiculobullous disorders including:
1. Pemphigus vulgaris
2. Dermatitis herpetiformis
3. Erythema multiforme
4. Epidermolysis bullosa
5. Bullous pemphigoid
Discuss the natural history, signs, symptoms, differential diagnosis and
treatment for each of the following:
1. Psoriasis
2. Parapsoriasis
3. Lichen planus
4. Pityriasis rosea
Discuss the natural history, differential diagnosis, signs, symptoms and
treatment for each of the following pyodermas:
1. Impetigo contagiosum
2. Ecthyma
3. Pyogenic granuloma
4. Pyoderma gangrenosum
5. Erythrasma
6. Folliculitis
7. Furuncles and carbuncles
8. Hidradenitis suppurativa
9. Erysipelas and ecthyma
Discuss the natural history, signs, symptoms, differential diagnosis and
treatment for each of the following fungal infections:
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Curriculum/Statutes & Regulations -MD Dermatology
1. Tinea capitis
2. Tinea corporis
3. Tinea pedis and manum
4. Onychomycosis
5. Tinea cruris
6. Tinea barbae
7. Moniliasis
8. Tinea versicolor
Discuss the natural history, signs, symptoms differential diagnosis and
treatment for each of the following viral infections:
1. Herpes simplex
2. Herpes zoster
3. Vaccinia
4. Varicella
5. Rubeola
6. Rubella
7. Infectious mononucleosis
8. Scarlet fever
9. Erythema infectiosum
10. Roseola infantum
Discuss the natural history, signs, symptoms, differential diagnosis and
treatment of the following venereal diseases:
1. Syphilis
2. Gonorrhea
3. Herpes progenitalis
Discuss the natural history, signs, symptoms, differential diagnosis and
treatment of each of the following parasitic diseases:
1. Scabies
2. Pediculosis
3. Swimmers itch
4. Spider bites
5. Mosquito bites
6. Tick bites
7. Wasp and bee stings
Discuss the natural history, signs, symptoms, differential diagnosis and
treatment of each of the following nevoid anomalies:
1. Junctional pigmented nevus
2. Intradermal pigmented nevus
3. Compound intradermal nevus
4. Spindle and epithelioid nevus
5. Blue nevus
6. Mongolian spot
7. Lentigo
Develop a differential diagnosis for a patient presenting with alopecia.
Discuss the natural history and etiology, as well as develop a management
and prevention plan for the problem of ingrown nails.
Describe and discuss the following dermatologic problems of the newborn:
1. Erythema toxicum neonatorum
2. Seborrhea
3. Scaling
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Curriculum/Statutes & Regulations -MD Dermatology
4. Strawberry angioma
5. Milia
6. Diaper dermatitis
Discuss the natural history, signs, symptoms differential diagnosis and
management of warts and calluses.
Discuss the natural history, signs, symptoms and management of the
following nodules:
1. Molluscum contagiosum
2. Keloid
3. Neurofibroma
4. Lipoma
5. Seborrheic keratosis
6. Pilar cyst
7. Epidermal inclusion cyst
8. Dermoid cyst
Discuss the natural history, signs, and symptoms of each of the following
premalignant and malignant tumors:
1. Actinic keratosis
2. Cutaneous horns
3. Basal cell carcinoma
4. Squamous cell carcinoma
5. Keratoacanthoma
6. Bowen's disease
7. Paget's disease
8. Malignant melanoma
9. Lentigo maligna melanoma
10. Mycosis fungoides
11. Leukemia cutis
12. Lymphoma cutis
Clinical Skills:
Carry out the laboratory investigations related to the diseases of
skin, STD and Leprosy, such as-
Scrapings of skin, nails and hair for fungus and ecto parasites
Various types of skin biopsies
Slit smear examination
Cytopathological examination
Tzanck smear
FNAC, dermal smear
Woods lamp examination
Basic staining procedures e.g Zheil Nelson, Geimsa, PAP smear, Dark
ground microscopy
Desrcibe the current treatment modalities for various diseases of
skin, STDs and leprosy.
Describe the preventive aspects, education, counseling services to the
patient and National Control Programmes for Leprosy, STDs
and HIV infections.
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Curriculum/Statutes & Regulations -MD Dermatology
Procedural Skills:
Photochemotherapy and photo therapy
Electric cautery, cryotherapy, electrolysis, tattooing, intra-lesional
injections, etc.
Cryosurgery
Skin punch grafting
Micrographic surgery
Wound dressings
Hair colouring-artificial or permanent dyes
Nail surgery
Punch grafting
Split skin grafting
Dermabrasion and suction blister grafting
Tattooing
Scar revision
Chemical peeling
Chemical face peels with glycolic ad trichloroacetic acid
Cryosurgery
Comedone/Milia extraction
Exicision of growth/papilloma/cysts etc
Electrosurgery
Use of CO2 laser
Sclerotherapy for varicose and telangiectatic veins
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Curriculum/Statutes & Regulations -MD Dermatology
REGULATIONS
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Curriculum/Statutes & Regulations -MD Dermatology
2. Examinations
Part-I Examination
1. All candidates admitted in MD Dermatology courses shall appear in Part-I
examination at the end of 1st calendar year.
2. The examination shall be held on biannual basis.
3. The candidate who fails to pass the examination in 3 consecutive attempts
availed or un-availed, shall be dropped from the course.
4. The examination shall have two components:
Paper-I MCQs (single best) 100 Marks
Paper-II SEQs 100 Marks
5. Subjects to be examined shall be Basic Sciences relevant to Dermatology
(Anatomy, Physiology, Biochemistry, Pathology, Pharmacology),
Behavioural Sciences and Biostatistics & Research Methodology.
6. To be eligible to appear in Part-I examination the candidate must submit;
i. duly filled, prescribed Admission Form to the Controller of
Examinations duly recommended by the Principal/Head of
the Institution in which he/she is enrolled;
ii. a certificate by the Principal/Head of the Institution, that
the candidate has attended at least 75% of the lectures,
seminars, practical/clinical demonstrations;
iii. Examination fee as prescribed by the University
7. To be declared successful in Part-I examination the candidate must
secure 60% marks in each paper.
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Curriculum/Statutes & Regulations -MD Dermatology
Part-II Examination
1. All candidates admitted in MD Dermatology course shall appear in Part-II
examination at the end of 2nd calendar year, and having passed the Part-I
examination.
2. The examination shall be held on biannual basis.
3. The candidate who fails to pass the examination within 3 years of passing
the Part-I examination shall be dropped from the course.
4. The examination shall have the following components:
a. Written 200 Marks
b. OSCE 50 Marks
c. Clinical examination 100 Marks
d. Log Book Evaluation 80 Marks (40 marks per year)
5. There shall be two written papers of 100 marks each:
Papers 1 & 2: Principles of Internal Medicine
6. The types of questions shall be of Short/Modified essay type and MCQs
(single best).
7. Oral & practical/clinical examination shall be held in clinical techniques in
Internal Medicine.
8. To be declared successful in Part-II examination the candidate must
secure 60% marks in each component and 50% in each sub-component.
9. Only those candidates, who pass in theory papers, will be eligible to
appear in the Oral & Practical/clinical Examination.
10. The candidates, who have passed written examination but failed in oral
& practical/ clinical examination, will re-appear only in oral &
practical/clinical examination.
11. The maximum number of attempts to re-appear in oral & practical
/clinical Examination alone shall be three, after which the candidate shall
have to appear in both written and oral & practical/clinical examinations
as a whole.
12. To be eligible to appear in Part-II examination the candidate must
submit;
i. duly filled, prescribed Admission Form to the Controller of
Examinations duly recommended by the Principal/Head of
the Institution in which he/she is enrolled;
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Curriculum/Statutes & Regulations -MD Dermatology
ii. a certificate by the Principal/Head of the Institution, that the
candidate has attended at least 75% of the lectures,
seminars, practical/clinical demonstrations;
iii. a certificate of having passed the Part-I examination;
iv. Examination fee as prescribed by the University.
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Curriculum/Statutes & Regulations -MD Dermatology
Part-III Examination
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Curriculum/Statutes & Regulations -MD Dermatology
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Curriculum/Statutes & Regulations -MD Dermatology
4. Submission of Thesis
5. Thesis Examination
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Curriculum/Statutes & Regulations -MD Dermatology
4. The Vice Chancellor shall appoint three external examiners for thesis
evaluation, preferably from other universities and from abroad, out of
the panel of examiners approved by the Advanced Studies & Research
Board. The examiners shall be appointed from respective specialty.
Specialists from Internal Medicine and related fields may also be
appointed/co-opted, where deemed necessary.
5. The thesis shall be sent to the external examiners for evaluation,
well in time before the date of defense examination and should be
approved by all the examiners.
6. After the approval of thesis by the evaluators, the thesis defense
examination shall be held within the University on such date as
may be notified by the Controller of Examinations. The
Controller of Examinations shall make appropriate arrangements
for the conduct of thesis defense examination in consultation
with the supervisor, who will co-ordinate the defense examination.
7. The thesis defense examination shall be conducted by two External
Examiners who shall submit a report on the suitability of the
candidate for the award of degree. The supervisor shall act as
coordinator.
and qualifying Part-I, Part-II and Part-III examinations, the degree with
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Curriculum/Statutes & Regulations -MD Dermatology
CONTENT OUTLINE
Part I MD Dermatology
Basic Sciences:
Student is expected to acquire comprehensive knowledge of Anatomy,
Physiology, Pathology (Microbiology), Biochemistry, Pharmacology relevant to
the clinical practice appropriate for Dermatology.
1. Anatomy
Clinical and functional anatomy with pathological and applied relevance
Histology and embryology of skin and appendage
Embryology
General Features of Human Development
Features of mitotic and meiotic modes of cell division. Genetic
consequences of meiotic division.
Abnormal miototic and meiotic divisions of clinical importance.
Gametogenesis: origin of germ cells.
Oogenesis: prenatal and postnatal development of ova.
Spermatogenesis: proliferation and maturation of male germ cells.
Abnormal gametes, their clinical significance.
Ovulation, fertilization and the consequences of fertilization.
Early Embryonic Development:
Cleavage, morula and blastocyst formation and implantation.
Formation of the three primary germ layers.
List of the derivatives of the respective germ layers.
Period of the Growing Fetus:
Various stages and salient features of the fetus development
Extraembryonic Membranes:
Development, functions and anomalies of yolk sac, amnion, chorion,
allantois, umbilical cord and placenta.
Development of the External Body Form:
Ectoderm and Mesoderm Origin
Simple ectoderm epithelium and mesenchyme.
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Curriculum/Statutes & Regulations -MD Dermatology
Connective tissue and blood vessels.
Basement membrane.
Neural crest cells- (melanocytes)
Embryonic connective tissue
Nails, hair follicles and glands.
Teratogenesis:
Factors known to be involved in the development of congenital anomalies
especially related to the dermatological system.
Concept of critical periods.
Histology:
2. Physiology
Cellular organization, structure function correlations and physiological
alterations in the integumentary system of body
3. Biochemistry
Membrane biochemistry and signal transduction
Gene expression and the synthesis of proteins
Bioenergetics; fuel oxidation and the generation of ATP
Carbohydrate metabolism
Lipid metabolism
Nitrogen metabolism
Enzymes and biologic catalysis
Tissue metabolism
Biotechnology and concepts of molecular biology with special emphasis
on use of recombinant DNA techniques in medicine and the molecular
biology of cancer
General principles of biochemical investigations
Basic techniques in molecular biology
Cloning and gene analysis
Immunochemical techniques
Protein chemistry and enzymology
Cloning & PCR
Protein chemistry and quantification
Electrophoretic techniques; PAGE
Immunoblotting
Raising and purifying antibodies
ELISA
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Curriculum/Statutes & Regulations -MD Dermatology
4. Pharmacology
The evolution of medical drugs
British pharmacopeia
Pharmacokinetic processes
Pharmacodynamic process
Drug effect
Beneficial responses
Harmful responses
Allergic responses
Drug dependence, addiction, abuse and tolerance
Drug interactions
Drug prescription in dermatology
Principles of toxicology
Antibiotics, antifungals, antivirals, antiparasitics etc.
Corticosteroids
Histamine and antihistamine
Classification of cytotoxic agents and immunosuppressants
Dermatologically relevant cytotoxics and immunosuppresants
Azathioprine
Methotrexate
Cyclophosphamide
Cyclosporin
Tactolimus etc.
Analgesics, antipyretics and anti inflammatory agents
Vitamins and skin disorders
Principles of topical dermatological therapy
5. Pathology
Pathological alterations at cellular and structural level in infection,
inflammation, ischaemia, neoplasia and trauma affecting the skin and
appendages
Related Microbiology
General aspects of microbiology and replication of bacteria, viruses and
fungi
Principles of laboratory diagnosis in microbiology (Bacteria, viruses, fungi
and parasites)
Sterilization and disinfection
Bacteriology:
Normal flora of the skin and adjoining mucosae
Pathogenesis of bacterial infections
Classification of medically important bacteria
Clinically relevant features of the following:
Gram positive cocci especially streptococci and staphylococci
Gram negative cocci especially Neisseriae gonorrhea
Gram positive bacilli especially bacillus anthrax, clostridia, coryniform
Gram negative bacilli especially pseudomonas and proteus
Mycobacteria especially M.tuberculosis, M.leprae and atypical
mycobacteria
Actinomycetes
Spirochetes especially Treponema pallidum and Borrelia burgdorferi
Chlamydiae especially Chlamydia trachomatis
Rickettsiae
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Curriculum/Statutes & Regulations -MD Dermatology
Virology
Pathogenesis of viral infections
Classification of medically important viruses
Clinically relevant features of the following:
Herpes viruses
Pox viruses
Papilloma viruses
Parvovorus B 19
Measles and rubella viruses
HIV
Mycology:
Basic mycology
Classification of medically important fungi
Parasitology:
General aspects of dermaatologically relevant parasites, especially
Leishmania, Sarcoptes scabiei, Pediculosis.
Immunization
Personnel protection from communicable diseases
Use of investigation and procedures in laboratory
Basics in allergy and immunology
Special Pathology
Pathophysiology in different diseases of skin
Common skin lesions, their causes and treatments.
Terminology of pathological lesions in skin and subcutaneous tissue
Cause, treatment and lesions associated with inflammatory conditions.
Bacterial and viral infections including impetigo, furuncles, herpes
simplex, herpes zoster and warts.
Fungal skin infections; various forms of tinea
Scabies and pediculosis.
Skin neoplasms. Etiology, predisposing factors metastasis and prognosis
of common skin malignancies in Pakistan
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Curriculum/Statutes & Regulations -MD Dermatology
7. Behavioural Sciences
1. Bio-Psycho-Social (BPS) Model of Health Care
2. Use of Non-medicinal Interventions in Clinical Practice
• Communication Skills
• Counseling
• Informational Skills
3. Crisis Intervention/Disaster Management
4. Conflict Resolution
5. Breaking Bad News
6. Medical Ethics, Professionalism and Doctor-Patient Relationship
• Hippocratic Oath
• Four Pillars of Medical Ethics (Autonomy, Beneficence,
Non-malficence and Justice)
• Informed Consent and Confidentiality
• Ethical Dilemmas in a Doctor’s Life
7. Delivery of Culturally Relevant Care and Cultural Sensitivity
8. Psychological Aspects of Health and Disease
• Psychological Aspect of Health
• Psychological Aspect of Disease
• Stress and its Management
• Psychological Aspect of Pain
• Psychological Aspect of Aging
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Curriculum/Statutes & Regulations -MD Dermatology
Part II MD Dermatology
Internal Medicine training for first two years starting from first day of
enrollment. Resident should get exposure in the following organ and
system competencies (listed below) while considering and practicing each
system in terms of: -
Medical ethics
Professional values, student teachers relationship
Orientation of in-patient, out-patients and Dermatological labs
Approach to the patient
History taking
General physical examination
Systemic examination
Routine investigations
Special investigations
Diagnostic and therapeutic procedures
Course Contents:
1. Cardiovascular Medicine
Common and / or important Cardiac Problems:
Arrhythmias
Ischaemic Heart Disease: acute coronary syndromes, stable angina,
atherosclerosis
Heart Failure
Hypertension – including investigation and management of accelerated
hypertension
Valvular heart disease
Endocarditis
Aortic dissection
Syncope
Dyslipidaemia
Clinical Science:
Physiological principles of cardiac cycle and cardiac conduction
Pharmacology of major drug classes: beta blockers, alpha blockers, ACE
inhibitors, Angiotensin receptor blockers (ARBs), anti-platelet agents,
thrombolysis, inotropes, calcium channel antagonists, potassium channel
activators, diuretics, anti-arrhythmics, anticoagulants, lipid modifying
drugs, nitrates, centrally acting anti-hypertensives
4. Renal Medicine
Common and / or Important Problems:
Acute renal failure
Chronic renal failure
Glomerulonephritis
Nephrotic syndrome
Urinary tract infections
Urinary Calculus
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Curriculum/Statutes & Regulations -MD Dermatology
Renal replacement therapy
Disturbances of potassium, acid/base, and fluid balance (and appropriate
acute interventions)
Clinical Science:
Measurement of renal function
Metabolic perturbations of acute, chronic, and end-stage renal failure and
associated treatments
5. Respiratory Medicine
Common and / or Important Respiratory Problems:
COPD
Asthma
Pneumonia
Pleural disease: Pneumothorax, pleural effusion, mesothelioma
Lung Cancer
Respiratory failure and methods of respiratory support
Pulmonary embolism and DVT
Tuberculosis
Interstitial lung disease
Bronchiectasis
Respiratory failure and cor-pulmonale
Pulmonary hypertension
Clinical Science:
Principles of lung function measurement
Pharmacology of major drug classes: bronchodilators, inhaled
corticosteroids, leukotriene receptor antagonists, immunosuppressants
6. Allergy
Common or Important Allergy Problems
Anaphylaxis
Recognition of common allergies; introducing occupation associated
allergies
Food, drug, latex, insect venom allergies
Urticaria and angioedema
Clinical Science
Mechanisms of allergic sensitization: primary and secondary prophylaxis
Natural history of allergic diseases
Mechanisms of action of anti-allergic drugs and immunotherapy
Principles and limitations of allergen avoidance
7. Haematology
Common and / or Important Problems:
Bone marrow failure: causes and complications
Bleeding disorders: DIC, haemophilia
Thrombocytopaenia
anticoagulation treatment: indications, monitoring, management of over-
treatment
Transfusion reactions
Anaemia: iron deficient, megaloblastic, haemolysis, sickle cell,
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Curriculum/Statutes & Regulations -MD Dermatology
Thrombophilia: classification; indications and implications of screening
Haemolytic disease
Myelodysplastic syndromes
Leukaemia
Lymphoma
Myeloma
Myeloproliferative disease
Inherited disorders of haemoglobin (sickle cell disease, thalassaemias)
Amyloid
Clinical Science:
Structure and function of blood, reticuloendothelial system, erythropoietic
tissues
8. Immunology
Common or Important Problems:
Anaphylaxis (see also ‘Allergy’)
Clinical Science:
Innate and adaptive immune responses
Principles of Hypersensitivity and transplantation
9. Infectious Diseases
Common and / or Important Problems:
Fever of Unknown origin
Complications of sepsis: shock, DIC, ARDS
Common community acquired infection: LRTI, UTI, skin and soft tissue
infections, viral exanthema, gastroenteritis
CNS infection: meningitis, encephalitis, brain abscess
HIV and AIDS including ethical considerations of testing
Infections in immuno-compromised host
Tuberculosis
Anti-microbial drug monitoring
Endocarditis
Common genito-urinary conditions: non-gonococcal urethritis,
gonorrhoea, syphilis
Clinical Science:
Principles of vaccination
Pharmacology of major drug classes: penicillins, cephalosporins,
tetracyclines, aminoglycosides, macrolides, sulphonamides, quinolones,
metronidazole, anti-tuberculous drugs, anti-fungals, anti-malarials, anti-
helminthics, anti-virals
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Curriculum/Statutes & Regulations -MD Dermatology
Dementia
Movement disorders including Parkinson’s disease
Depression in the elderly
Osteoporosis
Malnutrition
Osteoarthritis
Clinical Science:
Effects of ageing on the major organ systems
Normal laboratory values in older people
12. Neurology
Common or Important Problems:
Acute new headache
Stroke and transient ischaemic attack
Subarachnoid haemorrhage
Coma
Central Nervous System infection: encephalitis, meningitis, brain abscess
Raised intra-cranial pressure
Sudden loss of consciousness including seizure disorders (see also above
syncope etc)
Acute paralysis: Guillian-Barré, myasthenia gravis, spinal cord lesion
Multiple sclerosis
Motor neuron disease
Clinical Science:
Pathophysiology of pain, speech and language
Pharmacology of major drug classes: anxiolytics, hypnotics inc.
benzodiazepines, antiepileptics, anti-Parkinson’s drugs (anti-muscarinics,
dopaminergics)
13. Psychiatry
Common and /or Important Problems:
Suicide and parasuicide
Acute psychosis
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Substance dependence
Depression
Clinical Science:
Principles of substance addiction, and tolerance
Pharmacology of major drug classes: anti-psychotics, lithium, tricyclic
antidepressants, mono-amine oxidase inhibitors, SSRIs, venlafaxine,
donepezil, drugs used in treatment of addiction (bupropion, disulpharam,
acamprosate, methadone)
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Curriculum/Statutes & Regulations -MD Dermatology
Principles of genetic testing including metabolite assays, clinical
examination and analysis of nucleic acid (e.g. PCR)
Investigative Competencies
.
Outline the Indications for, and Interpret the Following Investigations:
Basic blood biochemistry: urea and electrolytes, liver function tests, bone
biochemistry, glucose, magnesium
Cardiac biomarkers and cardiac-specific troponin
Creatine kinase
Thyroid function tests
Inflammatory markers: CRP / ESR
Arterial Blood Gas analysis
Cortisol and short Synacthen test
HbA1C
Lipid profile
Amylase
Full blood count
Coagulation studies
Haemolysis studies
D dimer
Blood film report
Blood / Sputum / urine culture
Fluid analysis: pleural, cerebro-spinal fluid, ascitic
Urinalysis and urine microscopy
Auto-antibodies
Chest radiograph
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Curriculum/Statutes & Regulations -MD Dermatology
Abdominal radiograph
Joint radiographs (knee, hip, hands, shoulder, elbow, dorsal spine, ankle)
Procedural Competencies
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Curriculum/Statutes & Regulations -MD Dermatology
Part III MD Dermatology
1. General Dermatology
History taking and examination of dermatological patient
Symptoms & signs in dermatological medicine
Diagnostic approach to common skin problems
Type of skin lesions
Distribution patterns
Aids in diagnosis of skin diseases etc.
Structure and development of skin
Biochemistry and Physiology of epidermis and its appendages
including melanin synthesis, keratinization etc.
Pathophysiologic reactions of skin
Basic immunology of skin diseases
Disorders of keratinization and epidermal proliferation
Disorders affecting skin appendages, hair, nail, sebaceous glands,
sweat glands and apocrine glands etc.
Neoplastic disorders of skin
Genodermatosis
Vesiculo bullous diseases, e.g. pemphigus, pemphigoid, erythema
multiforme, dermatitis herpetiformis etc.
Dermatitis:- exogenous – contact dermatitis, patch testing,
endogenous – atopic acquired endogenous nummular
Disorders of pigmentation
Disorders of collagen and connective tissue
Disorders of hair, nail, sweat glands, sebaceous glands, apocrine
glands, mastocytosis etc.
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Curriculum/Statutes & Regulations -MD Dermatology
Disorders of mucous membranes, stamotological disorders
Disorders involving genitalia
Disorders due to physical agents, heat, cold, light, radiation etc.
Disorders due to chemical agents – reactions to chemicals,
occupational dermatosis
Autoimmune connective tissue disorders
Lichen planus and lichenoid eruptions
Pyoderma
Fungal infections-superficial and deep
Viral infection
Parasitic infestations, insect bites etc.
Dermatology in relation to internal medicine
Nutritional diseases – protein and vitamin deficiencies
Metabolic disorders
Diabetes mellitus
Amino acid metabolism
Porphyrin metabolism
Lipoidosis
Dysproteinemias and agamma glubulinemias etc.
Carcinoid syndrome
Glycolipid lipoidosis
Calcinosis cutis
Histiocytosis
Hematological systems-reticulosis-leukema etc.
Gastro – intestinal system
Endocrine system
Neuroctaneous disorder
Psychocutaneous disorders
Dermatoses of pregnancy
Allergic disorders
Anaphlaxis – urticaria / angioedema, serum sickness, reactions to
drugs etc.
Diseases of veins, arteries and lymphatics draining the skin
Disorders of connective tissue and subcutaneous fat
Regional dermatoses affecting
External ear
Lips and oral cavity
Breast
Genital and perianal area
Umbilicus etc.
2. Dermatopathology
To be able to correctly interpret a written dermatopathology report and
to offer discussion and differential diagnosis of the described
distinguishing histological features.
To be able to choose a range of laboratory techniques to optimize
diagnostic accuracy.
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Curriculum/Statutes & Regulations -MD Dermatology
Explain the relationship of biopsy procedure to histological artefact.
Define correct handling of specimens, including fixation, transport
medium
Outline histological laboratory techniques, including special stains
and immunochemistry, and their value in specific diseases.
Discusses appropriate differential diagnoses with histopathology
team.
Interprets special stains/ immunohistochemistry correctly.
3. Venereal Disorders
Anatomy of male and female genitalia
Syphilis and other treponematoses, immunology, pathology,
diagnosis, treatment, control etc.
Gonococcal uretheritis and complications
Lymphogranuloma venereum
Chancroid
Granuloma inguinale
Other disorders involving male and female genitalia
Sexually transmitted diseases (STDs) and control
STD and Reproductive health
Epidemiology of STD’S
AIDS; transmission, prevention, clinical manifestations, prophylaxis
of opportunistic infections, Anti-retroviral therapy, treatment in
HIV+ve STD cases.
4. Leprosy
Epidemiological aspects
Structure, biochemistry, microbiology of Mycobacterium leprae
Pathogenesis
Immunology and molecular biological aspects
Diagnosis – clinical features, classifications, laboratory aids
Reactive phase – Ocular involvement, Bone involvement
Approach to the patient with leprosy
Systemic involvement (ocular, bone, mucosa, testes and endocrine
etc.)
Pregnancy and leprosy
HIV infection and leprosy
Therapeutic aspects including newer drugs
Immunotherapy
Disabilities, deformities and rehabilitation
Prevention, education and counseling
Leprosy control and rehabilitation etc.
5. Paediatric Dermatology
Skin diseases common/specific to infancy and childhood.
Mechanisms/pathophysiology of diseases specific to childhood.
Childhood manifestations of skin disease.
Papulosquamous diseases
Bullous diseases
Viral, bacterial and fungal infections of the skin
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Curriculum/Statutes & Regulations -MD Dermatology
Infestations of the skin
Drug reactions
Genodermatoses
Developmental anomalies
Neonatal skin disorders
Disorders of cornification
Hair and nail disorders
Acne
Skin malignancies
Connective tissue diseases
Granulomatous diseases
Vascular anomalies
Melanocytic lesions
Paediatric specific pharmacology/prescribing.
History taking from parents
Skin biopsy techniques
Potassium hydroxide examinations
Tzanck examinations
Mineral oil examinations
Hair mounts
Fungal cultures
Curettage and electrodesiccation
Cryotherapy
Laser therapy
Surgical excisions
6. Dermatosurgery
The course would consist of lesions in basic techniques of dermatosurgery
of various diseases and laser.
Photochemotherapy and photo therapy
Electric cautery, cryotherapy, electrolysis, tattooing, intra-lesional
injections, etc.
Cryosurgery
Skin punch grafting
Micrographic surgery
Wound dressings
Cosmeceuticals
Pigmentary abnormalities
Hair colouring-artificial or permanent dyes
Botox treatments, facial rejuvenation
Skin resurfacing : chemical peels
Skin resurfacing : dermabrasion
Skin resurfacing : Laser
Sclerotherapy for varicose and telangiectatic veins
Tumescent liposuction
Substances for soft tissue augmentation
Hair transplantation and alopecia reduction
Nail surgery
For Vitiligo
Punch grafting
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Curriculum/Statutes & Regulations -MD Dermatology
Split skin grafting
Dermabrasion and suction blister grafting
Tattooing
For Acne
Dermabrasion
Scar revision
Chemical peeling
For Melasma
Chemical face peels with glycolic ad trichloroacetic acid
For Nevi and Keloid etc.
Cryosurgery
Excision
Electrosurgery
Use of CO2 laser
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Curriculum/Statutes & Regulations -MD Dermatology
Sun- screens, cytotoxic agents, cosmetics and skin care in
practice, emollients and moisturizer etc.
Systemic Therapy
Systemic glucocorticoids
Antihistaminics
Antibiotics, sulfones, aminoquinolines
Cytotoxic and antimetabolic agents
Oral retinoids
Antiviral drugs, oral antifungal agents, immunosuppressive and
immunomodulatory drugs, thalidomide.
9. Psychodermatology
Clinical features of psychodermatoses
Serious or incidental psychiatric morbidity in patients presenting
with or being followed up for skin disease
Features of depression, and risk factors for suicide
Basic use of antidepressants, tranquilizers and antipsychotics
Structure of liaison services to psychiatry and addiction
Psychiatric history and mental state examination
Research Experience
The active research component program must ensure meaningful, supervised
research experience with appropriate protected time for each resident while
maintaining the essential clinical experience. Recent productivity by the
program faculty and by the residents will be required, including publications in
peer-reviewed journals. Residents must learn the design and interpretation of
research studies, responsible use of informed consent, and research
methodology and interpretation of data. The program must provide instruction
in the critical assessment of new therapies and of the surgical literature.
Residents should be advised and supervised by qualified staff members in the
conduct of research.
Clinical Research
Each resident will participate in at least one clinical research study to
become familiar with:
1. Research design
2. Research involving human subjects including informed consent and
operations of the Institutional Review Board and ethics of human
experimentation
3. Data collection and data analysis
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Curriculum/Statutes & Regulations -MD Dermatology
4. Research ethics and honesty
5. Peer review process
This usually is done during the consultation and outpatient clinic
rotations.
Laboratory Research
Bench Research
Participation in laboratory research is at the option of the resident and
may be arranged through any faculty member of the Division. When
appropriate, the research may be done at other institutions.
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Curriculum/Statutes & Regulations -MD Dermatology
METHODS OF INSTRUCTION/COURSE CONDUCTION
As a policy, active participation of students at all levels will be
encouraged.
Following teaching modalities will be employed:
1. Lectures
2. Seminar Presentation and Journal Club Presentations
3. Group Discussions
4. Grand Rounds
5. Clinico-pathological Conferences
6. SEQ as assignments on the content areas
7. Skill teaching in ICU, emergency and ward settings
8. Attend genetic clinics and rounds for at least one month.
9. Attend sessions of genetic counseling
10. Self study, assignments and use of internet
11. Bedside teaching rounds in ward
12. OPD & Follow up clinics
13. Long and short case presentations
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Curriculum/Statutes & Regulations -MD Dermatology
a. Journal Club Meeting
c. Skill Development
Two hours twice a month should be assigned for learning and practicing
clinical skills.
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Curriculum/Statutes & Regulations -MD Dermatology
7. This training should emphasize effective communication techniques for
diverse populations, as well as organizational resources useful for
patient and community education.
8. Residents may attend the series of lectures on Nuclear Medicine
procedures (radionuclide scanning and localization tests and therapy)
presented to the Radiology residents.
9. Residents should have experience in the performance of clinical
laboratory and radionuclide studies and basic laboratory techniques,
including quality control, quality assurance and proficiency standards.
10. Each resident will observe and participate in each of the following
procedures, preferably done on patients firstly under supervision and
then independently (pg.12-13)
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Curriculum/Statutes & Regulations -MD Dermatology
LOG BOOK
The residents must maintain a log book and get it signed regularly by the
supervisor. A complete and duly certified log book should be part of the
requirement to sit for MD examination. Log book should include adequate
number of diagnostic and therapeutic procedures observed and
performed, the indications for the procedure, any complications and the
interpretation of the results, routine and emergency management of
patients, case presentations in CPCs, journal club meetings and literature
review.
Procedures Performed
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Curriculum/Statutes & Regulations -MD Dermatology
Case Presented
Supervisor’s
Sr.# Date Topic
Signature
1
2
3
4
Evaluation Record
(Excellent, Good, Adequate, Inadequate, Poor)
At the end of the rotation, each faculty member will provide an evaluation
of the clinical performance of the fellow.
Method of Evaluation
(Oral, Practical, Theory) Rating Supervisor’s
Sr.# Date
Signature
1
2
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Curriculum/Statutes & Regulations -MD Dermatology
Assessment
Peer Assessment
The students will also be expected to evaluate their peers after the
monthly small group meeting. These should be followed by a constructive
feedback according to the prescribed guidelines and should be non-
judgmental in nature. This will enable students to become good mentors
in future.
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Curriculum/Statutes & Regulations -MD Dermatology
It will include:
a. Punctuality
b. Ward work
c. Monthly assessment (written tests to indicate particular areas
of weaknesses)
d. Participation in interactive sessions
Formative Assessment
Will help to improve the existing instructional methods and the curriculum
in use
Summative Assessment
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Curriculum/Statutes & Regulations -MD Dermatology
MD DERMATOLOGY EXAMINATIONS
Part I MD Dermatology
Total Marks: 200
Part II MD Dermatology
Total Marks: 430
There shall be two written papers of 100 marks each, Oral & practical/
clinical examination of 150 marks and log book assessment of 80 marks.
Theory:
Only those candidates, who pass in theory papers, will be eligible to appear
in the Oral & Practical/Clinical Examination.
OSCE 50 Marks
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Curriculum/Statutes & Regulations -MD Dermatology
There shall be two written papers of 150 marks each, Oral & Practical/
Clinical examination of 300 marks, log book assessment of 120 marks
and thesis examination of 200 marks.
Theory
Only those candidates, who pass in theory papers, will be eligible to appear
in the Oral & Practical/ Clinical Examination.
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Curriculum/Statutes & Regulations -MD Dermatology
Clinical 200 Marks
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