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:

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)

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/group- 5 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:

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:

5-C: TIME SCHEDULE:

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: