Surgery

Final professional Examinations:

Marks distribution for assessment of surgery

Total marks Surgery and allied Subjects – 500

• Written = 200 (Formative Assessment-20 +(MCQ- SBA & MTF) 40+ (SAQ +SEQ) 140 =200)
• Structured Oral = 100 (60+20+20)
• Clinical = 100 (60+20+20) Practical (OSPE/OSCE) = 100 (60+20+20) Total in Surgery and allied—500.

Course Contents in Surgery

CORE

Phase II

1. History, evolution, and scope of surgery

2. Approach to a surgical patient

3. Surgical diagnostic process and techniques

4. Surgical Infection (Boil, Furuncle, Abscess, Carbuncle, cellulitis)

5. Septicemia (causes, complications and treatment)

6. Sinus, Fistula and cysts

7. Wounds (classification and management)

8. Ulcers, pressure sores

9. Groin hernias

10. Hemorrhage

11. Shock Phase III

12. Metabolic response to injury

13. Principles of Management of Trauma

14. Management of a severely injured patient

15. Fluid and electrolytes balance

16. Enteral and Parenteral Nutrition Phase IV

17. Pre-operative assessment and preparation

18. Tumors of skin

19. Lymphadenopathy (causes, investigations, diagnosis, biopsy)

20. Surgical ethics

 

ADDITIONAL

Organ transplantation, Robotics in surgery

CORE

Phase II

• Complications of Peptic ulcer (Perforation, Pyloric stenosis)
• Upper G.I. Tract bleeding
• Appendicitis
• Intestinal obstruction;

 

Phase III

• Abdominal trauma (Diagnostic and Management principles)
• Ruptured Spleen
• Ruptured liver
• Ruptured intestine

Phase IV

• Tongue, Lip & other oral lesions (ulcer, cancer)
• Oesophagus
• Carcinoma esophagus and stricture
• Carcinoma stomach Neoplasm of colon and rectum
• Intestinal tuberculosis
• Anal canal Hemorrhoids, Fistula, Sinus & Fissure, Carcinoma anus
• Colostomy & ileostomy (indications and management)
• Abdominal incisions (Tutorial)

 ADDITIONAL

• Intra-abdominal abscess
• Diseases of salivary glands
• Hiatus hernia.

CORE

Phase III

1. Urinary symptoms & definitions

2. Urological investigations and their interpretations,

3. Developmental Genito-urinary anomalies

4. Scrotal swelling

• Hydrocele
• Scrotal cellulitis

5. Acute scrotal conditions

• Epididymis- orchitis
• Torsion testis

Phase IV

6. Urolithiasis (Causes, Diagnosis, Principles, and modalities of treatment)

7. Retention of urine (acute and chronic

8. Hydronephrosis

9. UTI

10. Urinary tract injury.

• Renal injury
• Urethral injury

11. Renal Neoplasm

• RCC
• Wilm’s Tumor

12. Testicular Tumour

13. BPH

14. Stricture urethra

ADDITIONAL

• Male infertility
• Minimal Invasive Surgery in Urology

CORE

Phase II

• Cholelithiasis (causes and complications)
• Cholecystitis (acute & chronic)
• Pancreatitis (acute pancreatitis)

Phase IV

• Obstructive jaundice
• Pancreatic tumors
• Liver abscess

ADDITIONAL

• Hepatic neoplasm
• Cysts of liver
• Neoplasm of Gall Bladder

CORE

Phase IV

Thyroid

Goiter and Neoplasms of the thyroid

Breast

Breast pain, Mastitis, and Breast Abscess Fibro-adenosis and Fibroadenoma Carcinoma         of the breast

ADDITIONAL

• Diseases of the adrenal gland
• Diseases of the Parathyroid gland

CORE

 

Phase IV

• Chest injury (Hemothorax, Pneumothorax)
• Chest tumors, Chest drain

ADDITIONAL

• Dysphagia
• Empyema thoracic

CORE

Phase IV

• Head injury
• ICSOL
• PLID Paraplegia/hemiplegia

ADDITIONAL

• Hydro Cephalus
• Tumors of brain
• Tumors of spinal cord

CORE

Phase III

• Principles of Asepsis & Antisepsis
• Pre-operative assessment & preparation
• Venus’s access
• Circumcision
• Operation for hydrocele Repair of D.U perforation
• Wound care

Tutorials

Universal precautions (Scrubbing, gloving & gowning) O.T. environment & behavior Preoperative skin preparation and draping Suturing materials, Stitches

Phase IV

• Common Abdominal incision
• Operation for inguinal hernia
• Drainage of abscesses
• Catheterization, Supra-pubic cystostomy
• Anastomosis
• Appendicectomy
• Cholecystectomy
• Gastrojejunostomy
• Basic principles of Laparoscopy.

Additional

• Thyroidectomy, Nephrectomy, Mastectomy / Prostatectomy

CORE

Phase III

a)General Orthopedics

• Introduction to orthopedics
• Hard tissue trauma: –
• Fracture classification
• Principal of management of open and closed facture
• Fracture healing –nonunion, malunion, delayed union.
• Infection of bone (Acute and chronic osteomyelitis)

 

Phase III

b) Regional orthopedics

• Upper limb
• Colles’ fracture Supracondylar fracture
• Clavicle fracture
• Radius Ulna fracture (Shaft)
• Homarus fracture (Shaft)
• Lower limb
• Fracture of Shaft of femur
• Fracture of Tibia fibula

Phase IV

Regional Orthopedics

• Upper Limb Hand injuries and Hand Infection
• Lower Limb Fracture of Neck of femur Fracture of Pelvis Ankle and foot injuries Amputations
•  Additional

Dislocation – Hip, Hemarthrosis

• Soft tissue trauma (muscle and tendon injuries, compartmental syndrome)
• Infection of joint including osteoarticular tuberculosis
• Mass Casualty- ATLS, Disaster management.
• Bone tuberculosis

Additional

a) Dislocation of shoulder and elbow

b) Pediatric orthopedics: Congenital anomalies-talipes, DDH, Bow legs, Polydactyly, Claw

c) Bone tumors: Classification of bone tumor Common benign and malignant bone tumor – osteochondroma, Giant cell tumor, Osteosarcoma, Metastatic bone tumor.

Vertebral fracture – (primary management, transportation. Principles of definitive management)

Additional

d) Tendinitis, Tenosynovitis, bursitis.

Phase III

CORE

a) Anesthesia as a subject: its scope, outline- present & future

b) Anesthesia Pharmacology: Drugs: induction, maintenance, muscle relaxants

c) Intra-operative management

d) Post-operative management and complication

e) General GAnes (G.A)

f) Local/Regional anesthesia

g) Management of Pain (chronic)

h) Intensive Care Unit (ICU)

i) Basic life support.

j) Cardio-Pulmonary Resuscitation (CPR)

Exposure to practical procedures (Tutorial) :

• Pre-operative assessment
• Induction
• Endo tracheal Intubation
• CV line
• Artificial ventilation
• Face mask ventilation.
• Recovery room experience

CORE

Phase IV

• Introduction of radiology & imaging including CT & MRI
• Hazards of radiation and protection for personals, and patients.
• Principles of ultra-sonography & its clinical application
• Plain & contrast X-Rays
• Interventional imaging
• USG

CORE:

• Normal and pathological image
• Pneumonic and Tuberculous consolidation
• Pleural effusion
• Pneumo Thorax

Additional

• Lung abscess
• Mediastinal mass

Contents

Core:

• Plain X-ray findings of Acute abdomen.
• Indications & contraindications for barium studies. Hepatobiliary system Cholangiogram & ERCP
• USG of HBS and Pancreas

Additional:

MRCP

CORE

• Diagnosis of common fractures of upper and lower limb
• skull fractures
• Spinal fractures and caries spine
• Acute osteomyelitis
• common bone tumors
• diseases of joints
• dislocations

CORE

• X-ray KUB & IVU
• USG of Kidney, Ureter, Bladder and prostate

Phase IV

CORE

Introduction to Radiotherapy

Radiation oncology, basic principles and practices:

• Aims of radiation oncology
• Sources of radiation, Isotopes and their mechanism of action
• Curative/Palliative radiotherapy
• Radiosensitivity, radio resistance, radio curability and normal tissue tolerance.
• Common radiation reactions and management.

 

Medical oncology, basic principles and practice:

• Cell cycle and Mechanism of action of cytotoxic drugs
• Clinical aspect of cancer chemotherapy
• Complications of chemotherapy (Infection and bleeding tendency)
• Chemotherapy of common cancers,
• Common Chemotherapeutic regimes

Prevention of common cancer:

• Primary prevention, Secondary prevention
• Early diagnosis
• Referral to appropriate center

Palliative support and terminal care:

• Follow-up of cancer patients and terminal care

 

Nuclear Medicine, basic Principles and practice:

• Radio-isotope in diagnosis
• Radio-isotope in therapy

CORE

Phase III

• Examination of a child and neonate (Special considerations)
• Infantile Inguino scrotal swellings
• Acute abdomen in infants & children
• Congenital hypertrophic pyloric stenosis

Phase IV

• Neonatal/Infantile intestinal obstruction
• Intussusception
• Anorectal malformations.
• Maldescended Testis
• Torsion Testis
• Haemangioma and other Cutaneous lesions
• Child-hood tumours.
• Rectal bleeding and prolapsed rectum

 

Tutorials

• Cystic hygroma, Branchial fistula
• Phimosis/balanitis
• Paraphimosis
• Phimosis/balanitis
• Paraphimosis