Surgery : Courses offered

Courses offered

M.B.B.S.

M. S. (General Surgery)

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Goals

Patient care ability: A candidate in General Surgery at the end of its 3-year course should develop proper clinical acumen to interpret diagnostic results and correlate them with symptoms.  He should become capable to diagnose common clinical conditions/diseases in the speciality and to manage them effectively with success.   He should be able to decide for making a referral to consultation with a more experienced colleague/professional friend while dealing with any patient with a difficult problem.

Teaching ability:

He/she should be able to teach MBBS students about the commonly encountered conditions in General Surgery, pertaining to their diagnostic features, basic pathophysiological aspects and the general and basic management strategies.

Research Ability:

He/she should also acquire elementary knowledge about research methodology, including record-keeping methods, and be able to conduct a research inquiry including making a proper analysis and writing a report on its findings.

Teamwork:

He/she should be capable to work as a team member. He/She should have aptitude to work in a closely-knit structure of General Surgery and trauma team consisting of various medical and paramedical personnel.  He/she should develop general humane approach to patient care with communicating ability with the patients’ relatives, especially in emergency situations such as in casualty department, while dealing with cancer patients and victims of accidents.  He/she should also maintain human values with ethical considerations.

Objectives to be achieved by an individual at the end of 3 years of MS training A candidate at the end of a 3-year course should acquire the following:

  1. Cognitive knowledge: Describe embryology, applied anatomy, physiology, pathology, clinical features, diagnostic procedures and the therapeutics including preventive methods (medical/surgical) pertaining to body system.
  2. Clinical decision-making ability & management expertise: Diagnose conditions from history taking, clinical evaluation and investigations and to develop expertise to manage medically as well as surgically the commonly encountered disorders and diseases in different areas.
  3. Teaching: Acquire ability to teach the MBBS students in simple and straightforward language about the common General Surgical ailments/disorders, especially about their signs/symptoms for diagnosis with their general principles of therapy.
  4. Research: Develop ability to conduct a research enquiry on clinical materials available in hospital and in community.
  5. Preventive Aspect: Acquire knowledge about prevention of common conditions especially malignancies, diabetic foot, etc.

Tentative Schedule for three years of MS Training   (6 terms, 6 months each)
Clinical Posting (1st Term)

  1. Spend 6 (six) months in orientation program including exposure to casualty.
  2. Learns bedside history taking in ward, OT exposures, casualty, ICU requirement and their visit to related disciplines such as Pathology/Radiology/Internal Medicine/Anaesthesia.
  3. Care of indoor (medical preoperative and postoperative) patients for a minimum period of 6 months and learn techniques of suturing, wound care, dressing and splintage.
  4. Attends operation theatre and emergency operations for acclimatization.
  5. Assists ward rounds and visits other wards with senior colleagues to attend call/consultation from other departments.
  6. Participates in the teaching sessions in wards for bedside clinical teaching in the weekly afternoon seminar/journal club.

Remaining 5 Terms (Two and Half Years)

  1. Attends General Surgery OPD 2 days in a week
  2. Discuss problematic cases with consultant (s) in OPD/ward
  3. Attends Major operation room/theatre 2 days in a week
  4. Attends 2 morning rounds/week
  5. Care of the indoor patients on beds allotted to him/her.
  6. Attends the fortnight journal Club and seminar and presents the same by rotation.
  7. Attends speciality clinics and presents cases; participates in discussions including therapy-planning etc.
  8. During the 2 and half years, the resident must attend the combined teaching Program (Integrated Teaching) of the other departments.
  9. Does full-emergency duties twice a week/as per roster of the department.
  10. Attends lectures by the visiting faculty to the department/college from India/abroad.
  11. Attends/participates/presents papers in state/zonal national conferences.
  12. Actively participates/helps in organization of departmental workshop, courses in specialized areas like Laparoscopy, Endoscopy, Urology, Paediatric Surgery, Plastic Surgery and Neuro Surgery from time to time.

Thesis

Research methodology/reporting on research: Learns the basics in research methodology.

  1. Problem oriented record keeping including the use of computer.
  2. Use of medical literature search through the Internet or library.
  3. Attends Biostatistics classes by arrangement.
  4. Research Report – preparation and writing of Protocol for Research/Thesis.
  5. Writing an abstract/short paper/presentation style (slide-making & audiovisual aids).
  6. Preparation of a report on a research project/Thesis.
  7. Humanity/Ethics: Lectures on humanity, personality development, team spirit and ethical issues in patient care and human relationship including, public relations, by Psychologist and public relation officers are to be arranged by the department/college.

Methods of Training and Teaching

The following learning methods are to be used for the teaching of the postgraduate students:
1.   Journal Club:– Paper presentation/discussion – once per week (Afternoon).
2.   Seminar: One seminar every 1st Friday of month (Afternoon)
3.   Lecture/discussion: Lectures as per curriculum (I to II in a week) by faculty.
4.   Case presentation in the ward: Resident will present a clinical case for discussion before a faculty and discussion made pertaining to its management and decision to be recorded in case files.
5.   Case Conference – Residents are expected to work-up one long case and three short cases and present the same to a faculty member and discuss the management.
6.   Basic Surgical Skill Classes – Held twice monthly in after noon in which basic dissection skill and suturing and knotting will be demonstrated and taught to the students by the consultant from the Department.
7.   Surgicopathological Conference: Special emphasis is made on the surgical pathology and the radiological aspect of the case in the pathology department such exercises helps the General Surgery/Pathology/Radiology Residents.
8.   Combined Round/Grand Round: These exercises are to be done for the hospital twice week involving presentation of usual or difficult patients.   
9.   Community camps: For rural exposure and also for experiences in preventive aspect in rural situation/hospital/school, patient care camps are to be arranged 2-3/year, involving residents/junior faculty.
10. Emergency situation: Casualty duty to be arranged by rotation among the PGs with a faculty cover daily by rotation.
11. Special clinics: Residents will participate in specialty clinics.
12. Besides clinical training for patient care management and for bed side manners: Daily for ½ to one hour’s during ward round with faculty and 1-2 hours in the evening by senior resident/faculty on emergency duty, bed side patient care discussions are to be made.
13. Clinical teaching: In OPD, ward rounds, emergency, ICU and the operation theatres:
Residents/Senior Residents and Faculty on duty in respective places – make discussion on clinical diagnosis/surgical procedures/treatment modalities, including postoperative care and preparation of discharge slip

 

THEORY & PRACTICAL EXAMINATION SYLLABUS

Basic Sciences

  1. History of Surgery
  2. Regional Applied Clinical Anatomy of Human Body
  3. Fluid & Electrolyte and Nutritional management
  4. Endocrine & Metabolic responses to injury, Wound healing & wound care
  5. Hemostasis, Surgical Bleeding, Transfusion & shock
  6. Surgical infections, Burns
  7. Basics of Oncology, Transplantation and Anaesthesia
  8. Peri-operative care & post operative Surgical Complications
  9. Principles of Laparoscopic Surgery
  10. Sterile Precautions and Operation Theater Safety
  11. Prevention & Management of HIV

Principles & Practice of General Surgery

  1. Skin & Subcutaneous Tissue
  2. Breast
  3. Vascular Disorders (Artery, Vein, Lymphatics)
  4. Abdominal Wall Hernias
  5. Amputations
  6. Acute Abdomen
  7. Critical Care in Surgical Patients
  8. Surgical Audit
  9. Surgical Ethics

Principles & Practice of Surgical Sub Specialties

  1. Gastro-intestinal Tract
  2. Genito-urinary Tract
  3. Cardio-thoracic Surgery
  4. Neuro-surgery
  5. Plastic & Reconstructive Surgery
  6. Paediatric Surgery
  7. Oncosurgery
  8. Endocrinology
  9. Traumatology
  10. Head & Neck Surgery

General surgical principles & allied specialities

Obstetrics & Gynecology, Orthopedics, ENT Surgery, Oncology, and Medicine as applicable to the General Surgical disorders/disease.

Radiology

Imaging – computed tomography and magnetic resonance imaging and interventional radiology and angiography as related to General Surgery.

General pathologic

aspects and pathogenesis of diseases, Histopathology, cytology, haematology, and immunology as applicable to General Surgery.

Management of Trauma

Trauma in this country is one of the main causes of morbidity and mortality in our demographic statistics.  The student is expected to be duly conversant with trauma in its entirety.  In any type of posting after qualification the General surgeon would be exposed to all varieties of acute trauma. Hence, it is his responsibility to be able to recognize, assess and manage it including the medico legal aspects.

Psychological and social aspect

Some elementary knowledge in clinical Psychology and social, work management is to be acquired for management of patients, especially those terminally ill and disabled-persons and interacting with their relatives.

Semester-wise Break up of Syllabus

First Semester (6 months)

  1. Humanity/Ethics -Lectures on humanity, personality development, team spirit, Ethical issues in patients, Doctor- patient relationship and interpersonal relationship- 3 lectures
  2. Basic Sciences
  3. Emergency management of the Injured patient including critical care-lectures by Anesthetist for airway maintenance & shock management, Basic splintage and transportation techniques, BLS, ATLS
  4. Medical record keeping and bio-statistics
  5. Preparation for thesis/ protocol
  6. History taking and clinical examination of the patient

Second Semester

  1. Common General Surgical conditions diagnosis and management
  2. Interpretation of plain x-rays and clinico-radiological co-relation
  3. Diagnosis and management of acute and chronic Surgical infections

Third Semester

  1. Skin & Subcutaneous Tissue
  2. Breast
  3. Vascular Disorders (Artery, Vein, Lymphatics)
  4. Abdominal Wall Hernias
  5. Amputations
  6. Acute Abdomen
  7. Critical Care in Surgical Patients
  8. Surgical Audit
  9. Surgical Ethics

Fourth Semester

  1. Cardio-thoracic Surgery
  2. Neuro-surgery
  3. Plastic & Reconstructive Surgery
  4. Paediatric Surgery

Fifth Semester

  1. Gastro-intestinal Tract
  2. Genito-urinary Tract
  3. Oncosurgery
  4. Endocrinology
  5. Traumatology
  6. Head & Neck Surgery

SAMPLE CASES FOR PRESENTATION AND DISCUSSION

Clinical Patient presentation/discussion.

(i)   Long case: The long case will be structured comprising, history taking, clinical examination, investigations, decision making, proposed treatment modalities, ethical justification and personal attributes.
(ii) Short cases: The short cases will be also be structured in which only one particular system may be considered and therapy decision/discussion made.
(iii) Spotting of short cases.

Long cases

  1. Peripheral Vascular Disease
  2. Varicose Veins
  3. Goitre
  4. Breast Lump
  5. Lump in Abdomen
  6. Obstructive Jaundice
  7. Portal Hypertension
  8. Incisional Hernia
  9. Parotid Swelling

Short cases

  1. Swelling
  2. Ulcer
  3. Hernia
  4. Hydrocele
  5. Lymphadenopathy
  6. Undescended testis
  7. Sq. Cell Carcinoma
  8. Basal Cell Carcinoma
  9. Colostomy, Ileostomy
  10. Amputations
  11. Fistula
  12. Congenital Abnormalities
  13. Neck Swelling

Spots / Table

  1. Identification of Surgical Pathology, excised specimens & discussion
  2. Reading X-rays, USG & CT scan/MRI
  3. Discussion on Thesis
  4. Soft part Dissection
  5. Identification of instruments and description & discussion of Surgical

 

CURRICULUM OF SURGERY FOR THIRD M.B.B.S.