Course specification

  • Department offering the course: Pathology.
  • Third academic year of M.B. B.Ch. program.

·         Date of specification approval: 15/7/2010

                                A) Basic Information:

·         Allocated marks: 300 marks

·         Course duration: 30 weeks

·         Teaching hours: 240 hours

o    Theoretical: 120 hours.

o    Practical: 120 hours.

                       

                                B) Professional Information:

1- Overall Aim of the Course:

?          To familiarize students with the basic disease patterns and their underlying mechanisms within the specific organ systems as a step to prepare the students for their clinical rounds and future as a practitioners.

?          To promote life long competencies necessary for continuous professional development.

 

2- Intended Learning Outcomes (ILOs):

a- KNOWLEDGE and UNDERSTANDING:

By the end of the course, students should be able to:

a.1- Discuss the main disease categories that may affect the body, general pathology, as well as the basic mechanisms underlying these disorders, including etiology , pathogenesis & natural history (a.1-2-3-5-6-9)

a.2- Describe the morphologic, gross & microscopic, changes occurring as a result of such disease processes in various organ systems (a.5)

a.3- Determine the fate & complications of each particular disease and outline the general management procedures (a.6)

 

 

b-PROFESSIONAL AND PRACTICAL SKILLS (CLINICAL & LABORATORY SKILLS):

By the end of the course, students should be able to be prepared for their upcoming clinical training by:

b.1-Diagnosing and fully reporting and/or describing the pathologic picture of a disorder based on gross or microscopic morphology. (b 1-2-5)

c-ATTITUDE & behavioral skills

By the end of the program, the undergraduate student will acquire the skills required to

c.1-Interact effectively with individuals regardless of social, cultural or ethnic backgrounds and regardless of their disabilities (c.5,6 d.1).

c.2-Respond appropriately according to the seriousness of the pathologic diagnosis in an acceptable humane manner, treating the patient as a whole rather than a lesion or specimen (c1-.2 )

c.3-Identify   difficult ethical situations and how to properly deal with them (e.2 d.4)

c.4-Respect the patient's right to know and share in decision making as well as dignity, privacy, information confidentiality and autonomy.(c.2)

c.5-Cope compassionately with situations of stress and grief, where communication for breaking bad news is difficult (c.1 d.3-4)

c.6-Maintain a professional image in manner, dress, speech and interpersonal relationships that is consistent with the medical profession’s accepted contemporary standards in the community (c.5,6 d.5)

d-Communication skills

d.1-Communicate clearly, sensitively and effectively with the patients and their families or relatives and with colleagues from different health care professions, respecting their contributions in patient's management regardless of degree or occupation.(c.4 d2)

e- INTELLECTUAL SKILLS

DATA ACQUISITION, DATA ANALYSIS & PROBLEM SOLVING

By the end of the course, students should be able to:

e.1- Predict the signs and symptoms of a disease based on the underlying gross & microscopic tissue changes responsible for   symptomatology and physical changes in the patient, thereby enabling the student recognize patients with life/organ threatening conditions (e.1-2)

e.2- Interpreting   in a professional manner a pathology report (b.2)

e.3- Choosing the most appropriate cost effective pathologic diagnostic procedures   (e.3)

e.4- Selecting the necessary techniques for sample reception & processing according   to the nature of specimen received (e.3)

e.5- Prepare for scientific research by collection and interpretation of medical data (a.8)

 

f- GENERAL AND TRANSFERABLE SKILLS

By the end of the course, students should be able to:

f.1-Appreciate the importance of life long learning and show a strong commitment to it (f-1)

f.2-Use the sources of biomedical information to remain current with the advances in knowledge & practice (f-2)

f.3-Express themselves freely and adequately by improving their descriptive capabilities and enhancing their communication skills (f.3-4)

f.4-Apply English language as needed for appropriate learning and communication in relation to medicine (f.8)

3- Course contents:

Topic

% total hours

Number of hours

 

 

Total

Lectures/

e-Learning

Practical /

IL

General Pathology

45.8

110 hrs

56 hrs

 

54 hrs

(6+48)

  1. 1.Introduction to the science -PATHOLOGY & its related disciplines

0.4

1

1

 

2.      TECHNICAL POINTERS ON SAMPLE HANDLING, SENDING, PROCESSING & REPORTING & quality control of surgical biopsy/cytology material

3.3

8

2

     6

(Student assistancy program)

3.      CELL INJURY,

ACCUMULATIONS   DEPOSITIONS & diseases of AGEING

 

4.2

 

10

 

6

 

       4

4.      INFLAMMATION & REPAIR

5.4

13

9

       4

5.      GROWTH DISTURBANCES & NEOPLASIA & Cytology

10.4

25

9

     16

6.      IMMUNE RESPONSE & BACTERIAL         INFECTION (TB,Syphilis, Leprosy….)

5.4

13

9

       4

7.      FLUID & HEMODYNAMIC DISTURBANCES

5.8

14

6

       8

8.      MYCOTIC, Parasitic & viral DISEASES ,   GENETIC, ENVIROMENTAL, NUTRITIONAL DISORDERS & IONIZING RADIATION EFFECTS         IMMUNOHISTOCHEMISTRY& HOW TO         RESEARCH A TOPIC

7.1

17

9

       8

9 Question types

3.8

9

5

4

Special Pathology

54.2%

130

64

22 & 44 (66 hrs)

Tut       Pract

 

 

 

 

 

9.      CARDIOVASCULAR(heart & blood vessels

6.3

15

9

2             4

10.  RESPIRATORY

5

12

6

2             4

11.  GASTROINTESTINAL

5.8

14

8

2             4

12.  HEPATOBILIARY & PANCREATC

4.6

11

5

2             4

13.  KIDNEY

5

12

6

2             4

14.  URINARY TRACT & MALE GENITAL

3.8

9

3

2             4

15.  FEMALE GENITAL

5

12

6

2             4

16.  BREAST

2.9

7

3

               4

17.  BLOOD&LYMPHORETICULAR

2.9

7

3

               4

18.  SKELETAL SYSTEM ,SOFT TISSUE, JOINTS & SKIN

3.3

8

4

               4

19.  ENDOCRINE & PERIPHERAL & CENTRAL NERVOUS SYSTEMS

5.8

14

6

               4

    24. How to answer an exam & revision

5.4

13

5

8

 

100%

240

120

120

 

III-A) TOPICS:

A) GENERAL PATHOLOGY    

  1. 1.INTRODUCTION TO PATHOLOGY
  • Overview and orientation
  • Pathology & its related disciplines
  1. 2.TECHNICAL POINTERS ON SAMPLE HANDLING, SENDING, PROCESSING & REPORTING & quality control of surgical biopsy material
  2. 3.INFLAMMATION & REPAIR

1.    Acute inflammation

2.    Chronic inflammation

3.    Repair : Regeneration-Organization & healing in special conditions

   4. CELL INJURY, ACCUMULATIONS & DEPOSITIONS  

  • Cell response to injury: degenerative changes, necrosis & apoptosis
  • Accumulations & storage diseases
  • Depositions, abnormal calcifications & abnormal pigmentations
  • Diseases of ageing

   5. IMMUNE RESPONSE & NON SPECIFIC INFECTIONS

  • Immunity & hypersensitivity
  • Immunodeficiency
  • Autoimmunity
  • Non specific bacterial infections: bactremia, pyemia, septicemia & toxemia
  • Viral infections

     6. SPECIFIC INFECTIONS- GRANULOMA

  • Bacterial: TB- syphilis - leprosy
  • Fungal
  • Parasitic: Bilharziasis

 

7. FLUID & HEMODYNAMIC DISTURBANCES

  • Hyperemia – congestion- edema-thrombosis – embolism
  • Ischemia – infarction- gangrene- hemorrhage-shock

8. GROWTH DISTURBANCES & NEOPLASIA

  • Hyperplasia- metaplasia- dysplasia- hypertrophy-atrophy-hamartoma- tumor-like lesions
  • Benign tumors
  • Malignant tumors

9. GENETIC, ENVIROMENTAL, NUTRITIONAL DISORDERS & IONIZING RADIATION DISORDERS

  • Basis of genetic disease- hereditary disorders & congenital malformations
  • Environmental disorders
  • Nutritional disorders: protein calorie malnutrition – vitamin disorders – trace element disturbances
  • Disorders of ionizing radiation

     10. CYTOLOGY

ü  Types of samples & proper handling, fixation of material& necessary clinical data

ü  General features of reactive, benign & malignant cells

ü  Pitfalls in diagnosis & how to interpret a cytology report

   11. IMMUNOHISTOCHEMISTRY

   12. HOW TO RESEARCH A TOPIC: How to write a review article, how to collect data , reference writing , using the available resources (library & internet), writing structure etc……..

B- SYSTEMIC/ SPECIAL PATHOLOGY

All diseases in each organ systems are studied covering :

  1. a)Definition, incidence of disease ands its epidemiology
  2. b)Etiology, pathogenesis & molecular genetics
  3. c)Morphologic aspects: gross & microscopic changes
  4. d)Fate & complications
  5. e)Others (clinical presentation, prognosis, management etc…)

Systems studied include the following

  1. 1.Cardiovascular system: Heart and blood vessels
  2. 2.Respiratory system: upper and lower respiratory tract & lungs
  3. 3.Gastrointestinal tract: stomach, small and large intestine
  4. 4.hepatobiliary systems & pancreatic diseases
  5. 5.Urinary tract and renal pathology
  6. 6.Male genital system
  7. 7.Female genital system & breast disorders
  8. 8.Endocrine pathology
  9. 9.Blood diseases ( peripheral blood and bone marrow disorders) & Lymphoreticular disorders ( lymph nodes & splenic diseases)
  10. 10.Skeletal system, soft tissue, joint pathology & pathology of the skin
  11. 11.Peripheral and central nervous system pathology

III-B) Interactive learning/ TUTORIAL (PROBLEM BASED CASES):          Are based on the topics discussed in the above mentioned list

  1. 1.Acute & chronic Inflammation & repair
  2. 2.Degenerative changes
  3. 3.Necrosis & cell injury
  4. 4.Granulomas
  5. 5.Nonspecific infections & immunity disturbances
  6. 6.Circulatory disturbances
  7. 7.Neoplasms
  8. 8.Cardiovascular cases
  9. 9.Respiratory case
  10. 10.GIT case
  11. 11.Hepatobiliary case
  12. 12.Kidney
  13. 13.Female genital tract & breast
  14. 14.Skeletal system case
  15. 15.Ethical problems
  16. 16.Technical problems
  17. 17.Research problem- ethics- terminology
  18. 18.Exam question types and how to answer them
  19. 19.Evidenced based pathology problem

III-C) PRACTICAL CLASSES:

     3C.1 LIST OF SLIDES: (66 slides)

 

 

General

 

Systemic

I

Fibrinous inflammation(peritonitis), liver

62

Atherosclerosis, small artery

2

Acute suppurative appendicitis

63

Allergic nasal polyp

7

Myocardical scar

67

Bronchogenic carcinoma

10

Amyloidosis, Kidney

68

Pleomorphic adenoma salivary gland

12

Hepatic steatosis

73

Liver cirrhosis

14

Chronic venous congestion, lung

75

Hepatocellular carcinoma

15

Chronic venous congestion liver

77

Seminoma

17

Recent thrombus

78

Chronic diffuse glomerulonephritis

18

Spleen infarction

79

Renal cell carcinoma

20

Recent infarction, lung

80

Nephroblastoma

22

Tuberculosis, lymph node.

81

Benign prostatic hyperplasia

23

Chronic fibrocaseous T.B. lung

82

Papillary transitional cell carcinoma,

24

Miliary T.B lung

84

Secretory phase, endometrium

25

Rhinoscleroma

85

Simple endometrial hyperplasia

26

Mycetoma

86

Vesicular mole (hydatidiform mole)

28

Schistosomiasis, large intestine

89

Mammary cystic hyperplasia

29

Schistosomal polyp intestine

90

Intraductal carcinoma, breast

30

Schistosomiasis, urinary bladd

91

Lymphocytic lymphoma

31

Schistosomial hepatic fibrosis

92

Reactive follicular hyperplasia L.N

33

Schwannoma

93

Hodgkin’s lymphoma

34

Leiomyoma

94

Leukemic infiltrates liver.

35

Lipoma

96

Colloid goiter

37

Chrondroma.

97

Primary hyperplasia (Toxic goiter)

38

Capillary hemangioma

98

- papillary ca, thyroid gland

39

Cavernous hemangioma

99

Meningioma

40

Cavernous hemangioma

 

 

41

Squamous cell papilloma

 

 

42

Adenomatous polyp, large intesine

 

 

43

Pericanalicular fibroadenoma.

 

 

44

Intracanalicular fibroadenoma

 

 

45

Giant cell tumor (osteoclastoma)

 

 

46

Fibrosarcoma

 

 

48

Osteosarcoma

 

 

50

Benign melanocytic nevus

 

 

51

Nodular melanoma

 

 

52

Squamous cell carcinoma

 

 

53

Basal cell carcinoma

 

 

54

lnvasive duct carcinoma(Scirrhous) breast

 

 

56

Adenocarcinoma, colon

 

 

57

Mucoid carcinoma, large intestine

 

 

58

Metastatic carcinoma, lymph node

 

 

 

NB: slides of new disorders may be added depending on availability of samples           

3-C.2: LIST OF MUSEUM SPECIMENS: (165 jars)

  1. 12.Cardiovascular system: 29 Jars
  2. 13.Respiratory system : 18
  3. 14.GIT: 24
  4. 15.Hepatobiliary systems & pancreatic diseases : 17
  5. 16.Urinary tract, male genital system and renal pathology :22
  6. 17.Female genital system & breast disorders 20
  7. 18.Endocrine pathology 3
  8. 19.Blood diseases ( peripheral blood and bone marrow disorders) & Lymphoreticular disorders ( lymph nodes & splenic diseases) 6
  9. 20.CNS & PNS 6
  10. 21.Skeletal system & joint pathology 15
  11. 22.Soft8

 

3-C.3: Fresh SPECIMENS: (according to availability, from autopsy or surgical material see CD)

 

3-D: E learning:

Technical aspects: TECHNICAL POINTERS ON SAMPLE HANDLING, SENDING, PROCESSING & REPORTING & quality control of surgical biopsy/cytology material

 

4- Teaching and learning methods:

LECTURES

Lectures: division into 5 groups average 300 students/group5 lectures/week   1 hour duration

 

Lecture halls   3/5.         Each hall provides seating for 300 students and the same lecture is given in each hall on the same day by 5 different professors( times 8-9 am /9-10 /10-11 am). Total number of hours 108 hrs per academic year ( 45 first term and 65 hrs second term).

Lectures should be Illustrated, animated contain video clips or film strips or contain explanatory diagrams and algorithms

 

E-Learning:

Technical aspects. Material on our Website. For home study or at MEDC facility 2 hrs http://www.medicine.cu.edu.eg/ and on CD which will be distributed for free to all students (Other topics are under construction)

 

TUTORIALS / Interactive learning activities(22 hrs)

14 hours of tutorials (14 hours second term). To be held after main lectures in 3

rooms. Groups maximum 300 students i.e. 60-100/ per tutor   3 staff members average   from 2.30-4 pm. Half an hour will be for discussing the case of the week , then students will discuss the 3 problems of the week. This would include important topic discussions , case studies, problem solving & discussion of end of year project   will also be conducted. An extra 8 hrs for revision questions & answers covering all parts of the course are included at the end of the last tutorial session

 

PRACTICAL

  1. A)Histopathology

Students are divided into groups of 150-200 and given a brief half hour data show on the topics of the week in the small lecture room of Pathology Dept. on the ground floor. They then go to the students lab for their training in microscopy .

Every 4-6 students share a box of 66 slides and 1 microscope and spend 2 hours /session. There are 2 daily sessions 12-2 pm and 2 -4 pm. Total number of hours 46 hours (24 hours 1st term 22hrs 2nd term). This would include photos,& diagrammatic representations of both normal & diseased tissues at the microscopical level and how that disease would be at the level of the whole organ

 

  1. B)Museum Students are divided into groups of 150-200 and given a brief half hour data show on the jars of the week 3 Staff members are responsible for demonstration of the jars. Students are then divided into groups of 50/ staff .

        Museum is located on the 4th floor of the main theatre building and students spend 2 hours /session. There are 2 daily sessions 12-2 pm and 2 -4 pm. Total number of hours 46 hours (hours 24 1st term 22 hrs 2nd term) total number of jars 165

  1. C)Postmortem & fresh surgical specimens

Will be displayed with the jars in the museum lesson and included in student CD

 

  1. D)Assistancy program: 15-20 students/week rotate and act as student assistants in the biopsy sessions, grossing and cytology unit from 11-12 daily

 

Time plan:

Item:

Time schedule

Teaching hours

Total hours

Lectures

Once Daily : 8-9 am /9-10/   10-11 am

same lecture in 3/5 halls at same time

1 hr/day 30 weeks

26 weeks for teaching & remaining weeks for revision & training on how to solve exams.

118

Histopathology

laboratory

Once Weekly 12-2 pm same session repeated at 2 -4 pm

2 hrs x 28 weeks

24 weeks for teaching & remaining weeks for revision & training on how to solve exams.

46  

Museum & Postmortem

Once Weekly 12-2 pm same session repeated at 2 -4 pm

2 hrs x 28 weeks

24 weeks for teaching & remaining weeks for revision & training on how to solve exams.

46    

Tutorial - Q&A & assistancy

Once Weekly at 2 -4 pm

2 hours x 14 weeks

 

28 (22+6)

E-Learning

 

2 hrs

2

TOTAL

 

 

240

 

5- Students Assessment methods:

5-A: ATTENDANCE CRITERIA:

               

The minimum acceptable attendance is 75%, Students who fail to meet their attendance requirements are not allowed to sit for their final exams.

 

5-B: ASSESSMENT TOOLS:

 

TOOL

PURPOSE

Written exam:

Assessment of knowledge & understanding, intellectual skills

Oral exam

Assessment of knowledge & understanding, general and transferable skills (communication), professional attitudes/skills & intellectual skills

Practical exam  

Descriptive & diagnostic abilities and theory application (intellectual skills) and professional / practical skills & general and transferable skills

Pop Quizzes (written in lect or   in practical class)

Assessment of knowledge & understanding, intellectual skills, professional, practical skills and general and transferable skills

Assignment & end of year projects (CD/Poster or review article)

Assessment of knowledge & understanding

Assessment of general and transferable skills (life long learning skills & presentation skills)

Interactive learning

Assessment of knowledge & understanding, intellectual skills & Assessment of life long learning skills, ethical attitudes & communication skills

Log book (attendance-assistancy & grade record)

Assessment of attendance- discussion participation-quizzes/drills & activities evaluation (intellectual skills and professional / practical skills

 

5-C: TIME SCHEDULE:

 

EXAM

WEEK

Mid year exam

January mid Jan

2nd half of academic year

2nd semester exam

Mid Feb

March   4th wk

Practical exam

May     first week

Final exam

June   first week

NB Dates are liable to change so check in administration

 

Mid year & 2nd half of academic year EXAMS: A 2 hour written exam Is held in January and covers topics present in general path course another term exam is held in March duration 8 mins

FINAL EXAM

  1. A)Written 4 hour exam covers topics present in special pathology and selected topics in general pathology ( over 2 days)
  2. B)Practical exam of 50 mins duration ( 10 stations- 5 minutes for each)

Microscopic

  • 3 microscopic slides: diagnose and comment
  • 2 Photographs of microscopic pictures of lesions in your box of slides with questions on the lesion's microscopic picture

Gross

  • 2 jars to write a report on Jar
  • 1surgical unfixed specimen to report on
  • 1 jar photograph with questions on the lesion
  • 1 Photograph of a surgical unfixed specimen in the CD of your slide box + MCQ
  1. C)Oral exam 10-15 mins

5-D: GRADING SYSTEM:

 

Examination:

Marks allocated % Marks

Mid year 1st Term exam I January

2nd half exam March

Pop Quizes, activities & end of year project 1

40                           13 %              

   8                             3%

12                             4%

Final exam         May

 

Written

150                               50%

Oral

20                             7%

Practical

70                             23%

TOTAL

300                               100%

 

  1. oThe minimum passing score is ( 60% ) provided at least 40% of marks are obtained in the final written exam
  2. oPassing grades are: EXCELLENT >85%, VERY GOOD 75- <85%, GOOD 65- <75% and FAIR 60- <65%.

NB :  

  • Students with acceptable excuses during the year : Result of practical, oral & written exams will be multiplied by a factor so long as their years work and attendance was acceptable
  • Rest of students will have their years work and attendance added to their final result (12 marks)
  • If the student is a doubler. The results of his written are multiplied by a factor and his grade considered as just pass

 

5-E: EXAMINATION DESCRIPTION:

Examination:

DESCRIPTION

Marks allocated

 

Mid year exam I (2hrs)

 

 

2nd half exam (16 mins)

March

 

Pop Quizzes activities & projects

Written 2 hour exam covering topics in general pathology

short questions- true or false –define- MCQ

 

Topics:   4 special Pathology topics

short questions-     true or false -MCQ-define- labeled photos

 

40

 

 

 

8

 

 

12

Final exam

                                    

 

 

240                                      

Written

2 days

(2hrs)

Written 3 hour exam covering topics in general & special pathology: short essay questions-   true or false, define & MCQ + short case + problems in Pathology

150

Oral

10-15min

Covers, topics in general & special pathology. 1/2 examiners

20

Practical

(50min)

2 unknown slides – report (14)

3 photomicrograph+ MCQ (21)

1 Photograph of a surgical unfixed specimen + MCQ (7)

2 jars +   report on Jar (14)

1 fresh autopsy/surgical report (7)

1 jar photograph with MCQ/ short question-(7)

70

TOTAL

 

300

 

 

 

6- List of references:

6-A BASIC MATERIALS

ý  Department books: available at faculty bookshops & in the department:

- General & Special pathology for medical students parts 1 &2 Department books

     - Color atlases of Gross Pathology and Histopathology G. Nada et al .

ý  Box of average 66 slides + CD with microscopic images to complement unavailable slides - museum photos - fresh specimens- Course specs-Tutorial-activities-e-learning) . Box is   to be used during the academic year and returned to department before written exam

ý  E-learning material on our web site & also available on CD

     http://elc.cu.edu.eg/

 

6-B SUGGESTED MATERIAL

ý  Department tutorials & practical data shows, available in the department for department use

ý  Recommended Textbook : Basic Pathology by Kumar, Cotran & Robbins - or General & systemic pathology J.C.E Underwood 3d edition Livingstone- or Illustrated Pathology Govan-Macfarlane & Callander. Available at faculty bookshops & main library

ý  Lecture & practical lesson CDs available in the department on request

ý  Important web sites

     http://www.pathology.kasralainy.edu.eg

http://www.medicine.cu.edu.eg/beta/en/jcalpro/2428.html

http://elc.cu.edu.eg/

http://www.kasralainy.edu.eg/elearning/

http://www.pathmax.com/

http://www-medlib.med.utah.edu/WebPath/LABS/LABMENU.html#2

http://www.med.uiuc.edu/PathAtlasf/titlePage.html

http://www.medscape.com/pathologyhome

http://www.gwumc.edu/dept/path/2F.HTM

http://www.path.uiowa.edu/virtualslidebox/

http://web.med.unsw.edu.au/pathology/Pathmus/pathmus.htm#InteractiveImages

http://www.virtualpathology.leeds.ac.uk/

http://histopathsho.34sp.com/index.html

http://pathology.class.kmu.edu.tw/index.htm

http://www.gla.ac.uk/faculties/medicine/teaching/MedCALlist.htm

 

 

7- Facilities required for teaching and learning:

Facilities used in this course include:

  1. Lecture halls 5 halls
  2. Interactive learning groups 5 rooms
  3. Laboratory
  4. Museum specimens
  5. Fresh material from PM or organs/lesions sent as surgical specimens
  6. Projector slides & power point presentations covering all slides in slide box & fresh specimens
  7. Set of slides for every 4-6 students to be used throughout the year and handed in before finals
  8. CD with all 66 microscopic images in addition to - museum photos - fresh specimens- Course specs-Tutorial-activities-e-learning) Data show
  9. Overhead projector
  10. E-learning material on our website also available on CD