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3 CONTENTS PAGE 1) PROGRAM KLINIK ASAS ) PERSONAL AND PROFESSIONAL DEVELOPMENT YEAR (FF3714 & FF3723) 3) INTERNAL MEDICINE (FF3118) 4) MEDICINE & SOCIETY 3 (COMMUNITY HEALTH) (FF3618) 5) OBSTETRICS & GYNAECOLOGY (FF3226) 6) SURGERY (FF3128) 7) CONCEPT LECTURE ) ELECTIVE PROGRAMME Perkara 6(i) Bahagian II Tatatertib Am AUKU 1971 Kaedah-Kaedah Universiti Kebangsaan Malaysia (Tata Tertib Pelajar-Pelajar 1999) STUDYGUIDE YEAR

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5 UNDERGRADUATE MEDICAL PROGRAMME General objectives of the programme This curriculum is designed to enable students to apply knowledge and skills effectively in a holistic manner, to uphold professionalism expected of a doctor in the local and global context to prepare them to be leaders in the field of medicine. Programme Learning Outcomes: 1. Ability to apply knowledge and clinical skills to practice safely and competently. 2. Scientific approach and critical thinking to problem solving and decision making. 3. Ability to work collaboratively within a multi-professionals team with integrity and enthusiasm and to assume a leadership role when appropriate. 4. Ability to lead and collaborate with other health professionals in health promotion and disease prevention. 5. Caring attitude and sensitivities to the needs of self, patient and their families, colleagues and the community. 6. Ability to adopt a holistic approach to patient management. 7. Effective communication and social skills. 8. Ethical, spiritual and moral principles and abide by legal requirements 9. Competency in information and communication technology and its management. 10. Appropriate teaching skills and willingness to educate patients, family, the community and colleagues. 11. Commitment to life long learning STUDYGUIDE YEAR

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7 UKM Undergraduate Medical Curriculum Learning Outcomes; 1. Ability to apply knowledge and clinical skills to practice safely and competently. 2. Scientific approach and critical thinking to problem solving and decision making. 3. Ability to work collaboratively within a multi-professionals team with integrity and enthusiasm and to assume a leadership role when appropriate. 4. Ability to lead and collaborate with other heal the professionals in health promotion and disease prevention. 5. Caring attitude and sensitivities to the needs of self, patient and their families, colleagues and the community. 6. Ability to adopt a holistic approach to patient management. 7. Effective communication and social skills. 8. Ethical, spiritual and moral principles and abide by legal requirements 9. Competency in information and communication technology and its management. 10. Appropriate teaching skills and willingness to educate patients, family, the community and colleagues. 11. Commitment to life long learning. YEAR 3 Learning outcome At the end of Year 3, the students should be able to; 1. Take a complete history, perform a proper physical examination, formulate provisional and differential diagnoses, justify relevant investigations and plan patient management taking into considerations the pathogenesis of diseases; pharmacological principles of drug use; medicolegal aspect; psychosocial, cultural, religious, and ethical values of patients, family and the community. 2. Perform basic investigations and procedures. 3. Communicate effectively as an individual, a leader and a team member. 4. Demonstrate a sense of responsibility in self development and life long learning ability as a junior doctor. 5. Discuss the health services provided by the district health officers, health clinics and hospitals. 6. Make a research proposal, conduct a survey, diagnose the main health problems in the community and perform health promotion activities. STUDYGUIDE YEAR

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9 CASE REPORT GUIDELINES FOR STUDENTS Year 3 Faculty of Medicine Universiti Kebangsaan Malaysia 1. Students are required to submit ONE case report during their medical posting and TWO case reports in surgical and O&G postings. 2. Identify the case that you would like to write up by the second week of your posting. Keep the case simple and ensure that you choose a case that you can learn from. It is advisable at your level not to choose a case with too many complications. If you are in doubt or unable to find a suitable case discuss it with your group supervisor. 3. All case reports are to be typed out (Times New Roman, font size 12, single spacing) and must be bound before submission. 4. The suggested format for the case report is as follows: Core Clinical Component i) Patient identification A brief description of your patient which should include name, age, sex, address, HUKM registration number and date of admission. ii) iii) iv) Case report A concise account of the patient s history, physical signs, investigation results, treatment and outcome should appear in the case report. Discussion You should begin the discussion by recapitulating some of the relevant points in the case report and stating the provisional diagnosis with points to support it. You should then suggest some differential diagnoses, if there are any, and discuss them in detail. Discuss the diagnostic criteria, treatment, response to treatment, progress and prognosis of the medical condition, citing relevant references where required. New and future thoughts and trends about the condition may be added. Keep your discussion to a maximum of 2 1/2 pages. Preventive and community health Suggest a list of preventive measures that could be implemented in relation to your patient s condition. v) Basic medical documentation skills A mock prescription of the patient s discharge medications and a referral letter to a Health Clinic! General Practitioner! other health professionals to facilitate the patient s future folow-up visit. The referral should include a brief description of the pat ent s hospi al stay which must include an outline of the management, complications, investigations and discharge medications. The student should include the contact details in the event the doctor requires further information. vi) References Limit yourself to approximately 5 references and identify them in the text. An example of how to identify your references can be seen in any reputable medical journal. Please remember that referencing does not mean copying. STUDYGUIDE YEAR

10 Professionalism Component vii) Professional judgment Discuss the various factors which can potentially influence the attending clinician s decision making as well as the patient s decision and the consequences of the decisions made. viii) Communication issues What are the commun cation issues in your patient s case? For example, did the patient have trouble understanding the doctors or staff because he/she was only able to speak his/her own language? Are there any failures of communication with either the patient or their family? Describe on how the doctor-patient communication influence the therapeutic relationship and how has it influenced the effectiveness of the treatment. Identify these communication issues and suggest ways to correct them. Demonstrate basic medical documentation skills (e.g. prescription, referral letter) ix) Ethical issues Are there any ethical issues that appear while managing the patient? Examples of ethical issues would include respecting the patients right to confidentiality and dealing with a family request to withhold information from the patient. How the issues do influences the clinician s clinical judgment and the treatment outcome of the patient? x) Spiritual issues or Complementary Medicine (choose either one) Are there any spiritual issues that appear while managing the patient? Or does the patient practice any complementary medicine? Discuss the influences of these issues on the patient s reaction to ilness and how this has affected the effectiveness of the clinical treatment. Example of spiritual issue would include refusing medical treatment due to religious belief. The examples given above are not all inclusive. Please approach each case individually and discuss communication, ethical and spiritual issues as such. xi) Lifelong learning In your own words give us your opinion of what was done for this patient. Do you think he/she was managed properly? Could anything else have been done? What have you learnt from the case? Please ensure that the opinion given is yours and justify your views. STUDYGUIDE YEAR

11 xii) Critical appraisal You will be assessed on your ability to - think critically in assessing and managing patients. - search and use information critically - evaluate problem and its solutions using critical skills Please refrain from using case reports of previous batches as examples and do not copy their reports either. Any student found doing this will be failed. 5. Case reports must be submitted no later than the 7th week of your posting or at the discretion of your supervisor. STUDYGUIDE YEAR

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13 YEAR 3 FOUNDATION CLINIC 2015/2016 Overview The Year 3 Foundation Clinic (Klinik Asas) aims to reinforce students basic clinical skills and information for use in their subsequent postings. It provides an excellent opportunity for students to further familiarize themselves with aspects of clinical as well preventive and community medicine and the Malaysian healthcare system. At the end of the rotation, students are expected to be able to competently obtain history, perform out physical examination and formulate basic provisional and differential diagnoses. Dates: 17 August September 2015 Venues: Department of Medicine, Department of Surgery, Department of O & G, Department of Medicine & Society, PPD Unit Objectives: Revisiting and reinforcement of Clinical skills Learning, Medicine and Society and Personal and Professional Development in Years 1 and 2. Assessment: Attendance and log book MEDICAL POSTING Basic Clinical Skills Program Year III : Teaching-learning activities Time/Day Monday Tuesday Wednesday Thursday Friday 8.00 am am Briefing by Year III coordinator (Seminar room) Grand Ward Round (Seminar room) CPC (auditorium) Department CME (Seminar room) PPD common lecture 9.00 am am Video session 1. Upper limb examination 2. Lower Limb examination 3. Cardiovascular examination 4. Respiratory examination (Seminar room) Upper limb examination Bed-side teaching SDL* (Medical wards) Lower limb examination Bed-side teaching SDL* (Medical wards) Cardiovascular examination Bed-side teaching SDL* (Medical wards) Respiratory examination Bed-side teaching SDL* (Medical wards) am pm Ward orientation and briefing on aseptic technique (Medical wards) pm -2.00pm: Lunch break STUDYGUIDE YEAR

14 2.00 pm pm SDL* (Medical wards) Upper limb examination Bed-side teaching SDL* Lower limb examination Bed-side teaching SDL* Cardiovascular examination Bed-side teaching SDL* Respiratory examination Bed-side teaching SDL* (Medical wards) (Medical wards) (Medical wards) (Medical wards) *Self-directed learning Ward orientation: To be conducted by Ward Sisters (Ketua Jururawat). Students will be divided into 4 groups Aseptic technique briefing: To be conducted by ward Staff Nurses. Students will be divided into 4 groups The afternoon sessions in the ward are to be used for clerking and examining patients by students on their own Venues: Medical Wards 6 th Floor PPUKM 6B 6E 6F 6G 6H 6J Seminar Room 8 th Floor PPUKM Lecturers commitment 1. Minimum of 2 sessions of bed side teaching within 1 week. 2. Each session is a minimum of 1 hour 3. Monitoring of student via checking i. Attendance ii. Log of cases examined (minimum 1 per system) Students commitment 1. Attend all video sessions 2. Be present at all bedside teaching sessions with lecturers 3. To practice clinical examination on at least 1 patient for each system 4. To present log book at end of week to respective supervisors. 5. To be pro-active in self teaching and self learning activities Ward / Clinic orientation 1. To familiarize students with ward / clinic layout 2. To formally introduce students to ward/ clinic staff 3. To be informed of rules and regulation in ward / clinic with regards to : STUDYGUIDE YEAR

15 I. Students conduct in ward/clinic II. Relationship with ward/clinic staff III. Relationship with patients and relatives of patient IV. Proper use of medical documents in ward/clinic Topics covered for ward/clinic orientation 1. Ward/clinic and floor layout patient cubicles, nurses counter, treatment room, seminar room, tutorial room, pantry, toilets 2. Organization/hierarchy in ward medical, nursing, allied health and support staff 3. Dress code clinical white coat with proper identification 4. Medical documents handling of patients case notes. 5. Disposal how to dispose various types of item (sharps, clinical waste, non clinical waste) 6. Student-patient relationship a. proper bedside manner of clerking and examining a patient (esp female patients) b. patients right to refuse examination c. patients right to confidentiality d. protection of patients modesty 7. Student-staff relationship a. Proper manner in relaying / exchanging information b. Aware of ward/clinic staff s responsibilities towards patients Briefing on aseptic technique 1. To learn definition of aseptic techniques 2. To observe proper methods of conducting an aseptic procedure 3. To learn about surgical instruments commonly used for an aseptic procedure Topics covered on aseptic briefing. 1. Defining aseptic procedures 2. Proper hand washing / scrub 3. Wearing of gloves 4. Disposing and clearing up after an aseptic procedure STUDYGUIDE YEAR

16 5. Methods of wearing gown / apron 6. Introduction to aseptic solutions 7. Introduction to surgical instruments used in aseptic procedures STUDYGUIDE YEAR

17 SURGICAL POSTING Basic Clinical Skills Program Year III : Teaching-learning activities Time/Day Monday Tuesday Wednesday Thursday Friday 8.00 am am PPD common lecture 9.00 am am Briefing by Year III coordinator SDL SDL SDL SDL (Stargate) (Stargate) (Stargate) (Stargate) (Stargate) 9:30 am am Video session Abdominal and hernia examination Neck examination Breast examination Lower limbs and vascular examination Lumps and bumps examination Abdominal and hernia examination (Surgical wards) Head and Neck examination (Surgical wards) Breast examination (Surgical wards) All Systems (Surgical wards) (Stargate) 10: am Tea break 11:00 am- 12:30 pm Briefing on Aseptic technique Abdominal and hernia examination Lower limbs and vascular Breast examination All systems (Surgical wards) (Surgical Wards) (Surgical wards) (Surgical wards) (Surgical wards) 12:30 am-2.00 pm Lunch break 2: pm Ward orientation Head and neck examination Lower limbs and vascular Lumps and bumps All systems (Surgical wards) (Surgical wards) (Surgical wards) (Surgical wards) (Surgical wards) Activity: SDL: Self directed learning Aseptic technique briefing: To be conducted by Ward Staff Nurses. Students will be divided into 4 groups Ward orientation: To be conducted by Ward Sisters (Ketua Jururawat). Students will be divided into 4 groups Venues: STUDYGUIDE YEAR

18 Surgical Wards 5 th Floor, PPUKM - Wards 5B, 5C, 5D, 5E. Stargate 8 th Floor, PPUKM Lecturers commitment 1. Minimum of 2 sessions of bed side teaching within 1 week 2. Each session is 1 hour 3. Monitoring of student via checkingi. Attendance ii. Log of cases examined (minimum 1 per system) Students commitment 1. Attend all video sessions 2. Be present at all bedside teaching sessions with lecturers 3. To practice clinical examination on at least 2 patients for each type of systemic examination 4. To present log book at end of week to respective supervisors. 5. To be pro-active in peer teaching and self learning activities Ward orientation 1. To familiarize students with ward layout 2. To formally introduce students to ward staff 3. To be informed of rules and regulation in ward with regards to i. Students conduct in ward (including attire and attitude) ii. iii. iv. Relationship with ward staff Relationship with patients and relatives of patient Proper use of medical documents in the ward Topics covered for ward orientation 1. Ward and floor layout patient cubicles, nurses counter, treatment room, seminar room, tutorial room, pantry, toilets 2. Hierarchy in ward management nursing and medical doctor 3. Dress code clinical white coat with proper identification 4. Medical documents handling of patients case notes. STUDYGUIDE YEAR

19 5. Disposal how to dispose various types of item (sharps, clinical waste, non clinical waste) 6. Student-patient relationship: a. proper bedside manner of clerking and examining a patient (especially female patients) b. patient s right to refuse examination c. patient s right to confidentiality d. protection of patients modesty 7. Student-staff relationship: a. Proper manner in relaying / exchanging information b. Aware of ward staff s responsibilities towards patients and not hindering their responsibility. Briefing on aseptic technique 1. To learn definition of aseptic techniques 2. To observe proper methods of conducting an aseptic procedure 3. To learn about surgical instruments commonly used for an aseptic procedure Topics covered on aseptic briefing. 1. Defining aseptic procedures 2. Proper hand washing / scrub 3. Methods of wearing gown / apron 4. Wearing of mask and gloves 5. Introduction to aseptic solutions 6. Introduction to basic surgical instruments used in aseptic procedures 7. Disposing and clearing up after an aseptic procedure OBSTETRICS AND GYNAECOLOGY POSTING Basic Clinical Skills Program Year III : Teaching-learning activities DAY ACTIVITY VENUE Monday 8.00 am am 9.00 am am am pm Briefing History- taking : Obstetrics (lecture & video) Ward orientation and briefing on aseptic technique Lecture Hall, Dept of O&G Lecture Hall, Dept of O&G Wards STUDYGUIDE YEAR

20 Tuesday 9.00 am am am pm 2.00 pm pm Wednesday 9.00 am am am pm 2.00 pm pm History- taking : Gynae (Lecture & Video) Clerking patients Session with supervisor Physical examination : Obstetric & Gynaecology (Lecture & video) Clerking patients Session with supervisor Lecture Hall, Dept of O&G Wards Lecture Hall, Dept of O&G Wards Thursday am pm 2.00 pm pm Friday 8.00 am am am pm 2.00 pm pm Clerking patients Session with supervisor PPD common lecture Clerking patients Session with supervisor Wards Wards Students will be subdivided into 4 small groups and will be assigned to 4 lecturers. Lectures on history- taking (Obs & Gynae), physical examination (Obs & Gynae) will be conducted during the posting. These lectures will be in the form of videos and live concept lectures Students are expected to practice obtaining history and performing physical examination on their own. Dedicated sessions with the supervisors will be conducted during the posting whereby the lecturers will take the students to the wards and clinics to refine their skills. A log book will be given to the students to ensure that they have performed history taking and physical examination in Obs & Gynae, which will be counter-checked by their supervisors and ward registrar. Lecturers commitment 1. Minimum of 2 sessions of bed side teaching within 1 week 2. Each session is 1 hour 3. Monitoring of student via checking- i. Attendance ii. Students commitment Log of cases clerked and examined (minimum 1 per system) 1. Attend all video sessions 2. Be present at all bedside teaching sessions with lecturers STUDYGUIDE YEAR

21 3. To practice clinical examination on at least 2 patients for each type of systemic examination 4. To present log book at end of week to respective supervisors. 5. To be pro-active in self teaching and self learning activities LECTURERS Week 1: Assoc Prof. Dr Shuhaila Ahmad Assoc Prof. Dr Norzilawati Mohd Naim Assoc Prof. Dr Nur Azurah Abdul Ghani Dr Rahana Abd. Rahman Week 2: Prof. (C) Dr Mohd Hashim Omar Prof. Dr Zainul Rashid Mohamad Razi Assoc Prof. Dr Ahmad Zailani Hatta M Dali Dr Lim Yun Hsuen Week 3: Dr Lim Pei San Dr Ixora binti Atan Prof. (C) Dr. Muhammad A. Jamil Yassin Assoc Prof. (C) Dr Norazlin Mohamed Ismail Week 4: Dr. Mohamad Nasir Shafiee Dr. Chandralega a/p Kampan Dr. Aqmar Suraya Dato' Sulaiman Dr Yulianty Arifuddin STUDYGUIDE YEAR

22 BASIC CLINIC TIME TABLE MEDICINE & SOCIETY III WEEK 1 Time Title Lecturer Hours Location 17/8/2015 (MONDAY) AM MES: Community Survey. Introduction to research methodology: Information gathering Proposal writing PM MES: HIRARC: Hazard Identification, Risk Assessment and Risk Control Dr Norfazilah Dr Rosnah Ismail PM MES: QAP in environmental health PM Dr Rozita PM BREAK Dewan Kuliah 2 Blok Pendidikan PPUKM 18/8/2015 (TUESDAY) 19/8/2015 (WED) 20/8/15 (THURS) 21/8/2015 (FRIDAY) PM SLP: Malaysian Healthcare System History. Current implementations Private and public services. OPD and inpatient services PM Student Self Learning PM Student Self Learning PM MES: Introduction to data analysis MES: Descriptive and inferential statistical analysis Dr Taufik PM Dr Azmi Mohd Tamil pm BREAK pm MES: Computerised statistical analysis PM Dr Azmi am MES: Nutrition problem MES: Methods of nutritional assessments pm MES: Health promotion & Education Its importance and type of outreach PM Dr Zaleha Mohd Isa Dr.Faiz MAKMAL KOMPUTER TKT 5 Dewan Kuliah 1 Blok PRAKLINIKAL PPUKM STUDYGUIDE YEAR

23 WEEK 2 Time Title Lecturer Hours Location 24/8/2015 (MONDAY) AM AM MES: Community Survey. Introduction to research methodology: Information gathering Proposal writing SLP: Malaysian Healthcare System History. Current implementations Private and public services. OPD and inpatient services PM MES: QAP in environmental health Dr Azmawati Dr Taufik PM Dr Rozita Dewan Kuliah 2 Blok Pendidikan PPUKM PM BREAK 25/8/2015 (TUESDAY) PM PM pm BREAK pm MES: HIRARC: Hazard Identification, Risk Assessment and Risk Control MES: Nutrition problem MES: Methods of nutritional assessments MES: Health promotion & Education Its importance and type of outreach Dr Rosnah Ismail PM Dr Zaleha Mohd Isa Dr.Faiz Dewan Kuliah 2 Blok Pendidikan PPUKM 26/8/15 (WED) PM Student Self Learning 27/8/15 (THU) pm Student Self Learning 28/8/2015 (FRIDAY) am pm MES: Introduction to data analysis MES: Descriptive and inferential statistical analysis MES: Computerised statistical analysis PM Dr Azmi Mohd Tamil MAKMAL KOMPUTER TKT 5 STUDYGUIDE YEAR

24 WEEK 3 Time Title Lecturer Hours Location 31/8/15 PUBLIC HOLIDAY AM MES: Community Survey Introduction to research methodology: 1/9/2015 Information gathering TUESDAY Proposal writing AM SLP: Malaysian Healthcare System History. Current implementations Private and public services. OPD and inpatient services pm Break 2/9/2015 WEDNESDAY Dr Azmawati Dr Taufik pm Student Self Learning pm MES: Introduction to data analysis PM Dr Azmi Mohd 2 MES: Descriptive and inferential statistical Tamil analysis pm Break pm MES: Computerised statistical analysis Dewan Kuliah 2 Blok Pendidikan PPUKM MAKMAL KOMPUTER TKT 5 3/9/2015 THURSDAY am (3/9/15) MES: HIRARC: Hazard Identification, Risk Assessment and Risk Control Dr Rosnah Ismail pm Break pm MES: QAP in environmental health PM Dr Rozita Hod 2 24/8/15 (MONDAY) pm Student Self Learning 3 Dewan Kuliah 2 Blok Pendidikan PPUKM 4/9/2015 FRIDAY am MES: Nutrition problem MES: Methods of nutrition assessments pm MES: Health promotion & Education Its importance and type of outreach PM Dr Zaleha Mohd Isa Dr.Faiz Dewan Kuliah 2 Blok Pendidikan PPUKM WEEK 4 Time Title Lecturer Hours Location AM Student Self Learning - 2 Dewan Kuliah 2 Blok Pendidikan STUDYGUIDE YEAR

25 7/9/2015 (MONDAY) AM SLP: Malaysian Healthcare System History. Current implementations Private and public services. OPD and inpatient services pm Break Dr Taufik PPUKM 8/9/2015 (TUESDAY) 9/9/2015 (WED) 10/9/2015 (THURSDAY) pm MES: HIRARC: Hazard Identification, Risk Assessment and Risk Control am MES: Nutrition problem MES: Methods of nutritional assessments pm MES: Health promotion & Education Its importance and type of outreach PM Student Self Learning PM BREAK PM Student Self Learning am MES: Community Survey Introduction to research methodology: Information gathering Proposal writing Dr Rosnah Ismail PM Dr Zaleha Dr.Faiz Dr Norfazilah pm Break pm MES: QAP in environmental health PM Dr Mohd Hasni pm Student Self Learning Dewan Kuliah 2 Blok Pendidikan PPUKM Dewan Kuliah 2 Blok Pendidikan PPUKM 11/9/2015 (FRIDAY) pm MES: Introduction to data analysis MES: Descriptive and inferential statistical analysis pm Break PM Dr Azmi Mohd Tamil pm MES: Computerised statistical analysis PM Dr Azmi Mohd Tamil MAKMAL KOMPUTER TKT 5 STUDYGUIDE YEAR

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27 PERSONAL AND PROFESSIONAL DEVELOPMENT Basic Clinic Year III : Teaching-learning activities Date Venue Title of lecture Lecturer Auditorium Medical Ethics PPUKM 21st August th August th September th September 2015 Auditorium PPUKM Auditorium PPUKM Dewan Kuliah 2, Blok Praklinikal Etiquette-based medicine Interpersonal Communication & Patient- Doctors relationship Clinical Desicion Making Profesor Dato Dr. Mahmud Mohd Nor Profesor Adjung Surgeri Pediatrik Jabatan Surgeri mmohdnor@gmail.com Prof. Madya Dr. Dayang Anita Abul Aziz Jabatan Surgeri dayanganita@yahoo.co.uk Prof. Madya Dr. Harlina Halizah Hj Siraj Jabatan Pendidikan Perubatan drharlina.siraj66@gmail,com Dr. Noorlaili Mohd Mohd Tauhid Jabatan Perubatan Keluarga lailitauhid@yahoo.com Lecture topics will include: 1. Patient privacy 2. Informed consent 3. Bedside etiquette 4. Medical documentation STUDYGUIDE YEAR

28 PERSONAL & PROFESSIONAL DEVELOPMENT III FFFF3723 AND FFFF3713 I. DIRECTORY OF PPD COORDINATORS A. Coordinators at Faculty level 1. Dr Siti Mariam Bujang Head of PPD Unit, Department of Medical Education Ext Dr Halim Ismail Module Coordinator Year 3 Department of Community Health Ext drhalimismail@yahoo.com NO DEPARTMENT NAME OF LECTURERS EXT AND PHONE NO. 1. Community Dr. Halim Ismail Ext 8783 Health Dr. Idayu Badilla Idris Ext O&G Dr. Chew Kah Teik Ext Dr. Ng Beng Kwang Ext ADDRESS drhalimismail@yahoo.com idayu_badillah@yahoo.com drchewkt@gmail.com nbk_9955@yahoo.com 3. Medicine Dr. Jeevinesh Naidu Aplanaidu Ext jeevinesh@ppukm.ukm.edu.my Dr. Rizna Abdul Cader Ext Surgery AP. Dr. Goh Eng Hong Ext Dr. Hairul Faizi Haron Ext rizna_c@hotmail.com goh.enghong@gmail.com hairulfaiziharon@yahoo.com Supporting staff: NurBariah Ahmad Razali PPD Unit, Department of Medical Education berry.ahmadrazali@gmail.com STUDYGUIDE YEAR

29 INTRODUCTION TO PPD III PPD module is to facilitate adaptation to clinical work and life as future doctors. There is more emphasis given to medical ethics leadership, teamwork and communication skills. The module will also familiarize the students with the uncertain nature of clinical medicine as well as the unpredictable and varied behavior of patients. PREREQUISITES The student should have gone through all the previous PPD modules satisfactorily and have also undergone the second PPD camp with satisfactory report and outcome. The students should have internalized positive attitudes and must be able to integrate the knowledge and skills fully into their daily work as clinical students. PPD CAMP 2 Date : 17/9/15-19/9/15 Venue :Kem Permata Resort, Alor Gajah, Melaka Objectives of the camp The three days camp should enable the students to: 1. demonstrate intrapersonal professionalism (within self) in the following aspects : honesty knowledgeable self-improvement self-care adaptation skills personaletiquettes 2. demonstrate interpersonal professionalism (among colleagues, teachers and other health professionals) in the following aspects : professional conduct (medical ethics) accountability teamwork and leadership managing diversity giving and receiving feedback STUDYGUIDE YEAR

30 3. demonstrate public professionalism (doctor-patient relationship) in the following aspects : empathy and caring respect confidentiality honesty managing diversity PRINCIPLES OF PPD-CLINICAL INTEGRATION IN YEAR 3 1. The PPD objectives are clearly defined and applicable to all postings. 2. Certain PPD objectives will be emphasized more in relevant postings. 3. Specific formal sessions for PPD are limited to general lectures only. 4. PPD learning activities need to be relevant and related to the particular clinical posting. 5. Teaching-learning activities would be integrated into the clinical sessions. 6. PPD formal assessment is compulsory. Students must pass PPD module before proceeding to year 4. II. COURSE LEARNING OUTCOMES At the end of this module, the students should be able to: CRITICAL THINKING 1. Think critically in assessing and managing patients 2. Search and use information critically 3. Evaluate problems and their solutions using critical thinking skills. COMMUNICATION SKILLS 4. Communicate and interact in clinical practice with patients and their family, colleagues and other health care providers. 5. Document medical data as case notes and reports. 6. Break bad news (with regards to chronic physical and psychiatric illnesses and disabilities, genetic disorders, terminal illness, and death). 7. Deal with sensitive issues in clinical practices appropriately (e.g. sexuality) 8. Obtain consent prior to invasive procedures 9. Communicate with dissatisfied patients STUDYGUIDE YEAR

31 10. Communicate with a multidisciplinary team of professionals (colleagues and paramedical staff). SPIRITUAL DEVELOPMENT 11. Discuss spiritual aspects of patients in different clinical situations 12. Approach patients in a holistic manner, incorporating both their physical and psychospiritual needs. TEACHING SKILLS 13. Teach peers, patients and their families, and the community 14. Evaluate teaching skills and provide feedback to peers 15. Demonstrate commitment to life-long learning in clinical practice (eg SDL, case write-ups, seminars) PROFESSIONAL JUDGEMENT 16. Identify the various factors which can potentially influence their clinical decision. 17. Discuss the consequences of clinical decision-making. 18. Identify the various factors which can influence patients decision (including traditional or alternative therapies) LEADERSHIP & TEAMWORK 19. Outline the role of each member in the clinical management team 20. Participate in clinical team activities effectively 21. Demonstrate leadership values and skills in clinical practice involving multi-professional teams 22. Identify leadership styles of doctors and their impact on patient s management 23. Identify the need to be an effective leader at a personal level 24. Demonstrate teamwork and leadership in the community MEDICAL ETHICS 25. Discuss how medical ethics influence their behavior and conduct towards patients. MANAGING DIVERSITY 26. Manage diversity with respect to patients management 27. Deal with diverse patients appropriately (by challenging own assumption and converting to positive transformation) STUDYGUIDE YEAR

32 DEALING WITH UNCERTAINTY AND DEATH 28. Discuss issues related to uncertainty, death and dying 29. Demonstrate appropriate skills in dealing with uncertainty, death and dying 30. Demonstrate professional and humanistic attitude towards patients, their families, friends, colleagues and team members in handling uncertainty, death and dying 31. Analyze constructively the consequences of their clinical decision upon the patient, patient s relatives, and other medical colleagues in issues pertaining to death, uncertainty and dying. LEGAL ASPECTS OF MEDICAL PRACTICE 32. Explain the various aspects of medical professional liability. 33. Identify and discuss ethical issues in a given clinical scenario.* 34. Outline the principles involved in performing a postmortem examination. Specific PPD contents to be achieved in a specific posting include: POSTING SPECIFIC CONTENT TEACHING LEARNING METHODS Medicine Critical Thinking Professional judgement Dealing with uncertainty & death 1. Workshop (2 hours) Medical ethics JKM Leadership & Teamwork Communication Skills Teaching Skills 1. Seminar/Debate (2 hours) O&G Communication skills Dealing with uncertainty & death Managing diversity Medical ethics Surgery Spiritual development Legal aspect of medical practice 1. Workshop (4 hours): 1. Role play 2. Video session STUDYGUIDE YEAR

33 III. LECTURES List of lectures: 1. Medical ethics and doctor-patient relationship 2. Etiquette based medicine covered in KlinikAsas 3. Interpersonal and communication skills in clinical practice 4. Clinical decision making 5. Patient counseling 6. Interfaith forum IV. TEACHING-LEARNING METHODOLOGY Camp2 PPUKM : SGDs, role-play, large group activities, jungle tracking : lectures, workshops, seminar, video session, role play PRE-REQUISITES FOR END OF SEMESTER EXAMINATION 1. Attendance throughout the whole posting is compulsory (100%). Refer to BukuPeraturanTatatertibPelajarFakultiPerubatan, UKM for details. 2. Continuous assessments are completed and submitted. Students who fail to fulfill the above criteria will be barred from the examination and considered to have failed the module. V. ASSESSMENT Continuous assessment Would be carried out by respective clinical department. THEORY Reflective writing 10% Module Supervisor s report 20% Mentor report 20% Total 50% 1 Key Features Question for each clinical module 30% CLINICAL 1 OSCE for each clinical module 20% TOTAL MARKS 100% STUDYGUIDE YEAR

34 APPENDIX I - RESOURCE MATERIALS 1. Learning To Teach In Higher Education Second Edition Paul Ramsden. New York :RoutledgeFalmer, Reflection : Principles and Practice for healthcare professionals Tony Ghaye,Sue Lilyman. Dinton : Mark Allen, Understanding Multicultural Malaysia Delights, Puzzles & Irritations AsmaAbdullah, Paul B. Pedersen. PetalingJaya :Prentice Hall, Field Guide to the Difficult Patient Interview Second Edition Frederick W. Platt,Geoffrey H. Gordon. Philadelphia : Lippincott Williams &Wilkins, The Doctor-Patient Relationship Paul Freeling, Conrad M. Harris Foreword by William A.R. Thomson. Edinburgh: Churchill Livingstone, Handbook of Communication Eileen Scholes Infinity Books, The rise of Islam HarunYahya. Kuala Lumpur : A.S. Noordeen, Ten Days To Self-Esteem David D. Burns, M.D. New York :Quill, Psychology An International Perspective Michael W. Eysenck. New York : Psychology Press, Leadership Passages David L. Dotlich, James L. Noel and Norman Walker San Francisco : John Wiley &Sons, Communication Skills for Doctors Peter Maguire. London : Arnold,2000 STUDYGUIDE YEAR

35 12. Medical Law & Ethics Bonnie F. Fremgen. Upper Saddle River,N.J.: Prentice Hall, Medical Ethics Second Edition Robert M. Veatch. Boston: Jones and Bartlett, Communication Skills for Medicine Margaret Lloyd & Robert Bor Foreword by Professor Sir David Weatherall. New York: Churchill Livinstone, Teaching and Learning Communication Skills in Medicine Suzanne Kurtz, Jonathan Silverman and Juliet Draper forewords by Barbara Sir David Weatherall. Korsch and Oxford: Radcliffe Medical Press,1998 STUDYGUIDE YEAR

36 APPENDIX II PERSONAL AND PROFESSIONAL DEVELOPMENT (PPD) MODULE Faculty of Medicine UKM INFORMATION STUDENT-DRIVEN Assessment for Professional Conduct: Year 3 & Year 4 Starting from session 2011/2012, PPD Unit will implement a new strategy for continuous assessment of personal and professional development (PPD) of Year 3 and Year 4 medical students. Previously, supervisors would have to complete a PPD assessment form for each student and submit the form to PPD Unit at the end of the semester. Students were usually not aware of what the supervisors commented regarding the level of their PPD, as there was no proper feedback mechanism. As an improvement strategy, a STUDENT-DRIVEN assessment is introduced. WHAT A student-driven PPD assessment focuses on the student, who is the ONE responsible to obtain assessment of his/her own PPD level, directly from the supervisor. Supervisor is only required to assess students who come forward with the assessment form and comply with this instruction. WHEN Students can start giving their PPD assessment forms to their allocated supervisors in the beginning of the posting. Together with the supervisors, they should determine an appropriate date within the last two weeks to the end of the posting, as a deadline for the supervisors to return the completed form, so students can submit them personally to the PPD Unit, Department of Medical Education. WHERE Students are required to download the PPD assessment form: SUPERVISOR REPORT from the e-learning websitehttp:// WHO Once a student receives a completed PPD assessment form returned by his/her supervisor (students might have to remind the supervisors regarding this), he/she should take this opportunity to obtain feedback regarding his/her area of strength and weaknesses -directly from the supervisor. The student MUST submit the completed assessment form to PPD Unit, Department of Medical Education at week 8 of the posting, to ensure that the assessment marks provided by the supervisor could be included into the continuous assessment. WHAT IF? If a student fails to carry out the following tasks: (a) obtain a completed PPD assessment from the supervisor (supervisor report); and (b) submit a completed PPD supervisor report to PPD Unit, he/she would lose a significant portion of the whole continuous assessment marks for that particular posting. LOG-SHEET (Kindly download from e-learning websitehttp:// In the log sheet provided, students are required to prove that they have : Submitted the form to the supervisor Received the completed form, returned by the supervisor Submitted the completed form to PPD Unit, Department of Medical Education at the end of the final posting for each semester. Prepared by: PPD Unit, Dept of Medical Education, UKMMC (revised May 2013) STUDYGUIDE YEAR

37 APPENDIX III STUDENT S GUIDELINE FOR REFLECTIVE WRITING YEAR 3, FACULTY OF MEDICINE, UKM You are required to reflect on your recent case presentation during a bedside teaching session in your clinical posting that related to ONE of the components of professionalism listed below. 1. Communication issues, or 2. Spiritual issues, or 3. Traditional / Complementary medicine, or 4. Medical ethics, or 5. Professional judgment. STUDYGUIDE YEAR

38 STUDYGUIDE YEAR

39 YEAR 3 Module Objectives At the end of 7 weeks, the students should be able to; 1. Take a complete history, perform a proper physical examination, formulate provisional and differential diagnoses, justify relevant investigations and plan patient management taking into considerations the pathogenesis of diseases; pharmacological principles of drug use; medico-legal aspect ; psychosocial, cultural, religious, and ethical values of patients, family and the community. 2. Perform basic investigations and procedures. 3. Communicate effectively as an individual, a leader and a team member. 4. Demonstrate a sense of responsibility in self development and life long learning ability as a junior doctor. 5. Discuss the health services provided by the district health officers, health clinics and hospitals. 6. Make a research proposal, conduct a survey, diagnose the main health problems in the community and perform health promotion activities. STUDYGUIDE YEAR

40 INTERNAL MEDICINE MODULE FFFF3118 Head of Department : Module Head : Prof. Datin Dr. Norlinah Mohamed Ibrahim Prof. Madya Dr Norasyikin A. A. Rahman DIRECTORY OF TEACHING STAFF NO NAME OF LECTURERS EXT ADDRESS 1 Prof Dato Dr. Raymond Azman Ali 5001 raymond@ppukm.ukm.edu.my 2 Prof Datin Dr. Norlinah Mohamed Ibrahim 6083 norlinah@ppukm.ukm.edu.my 3 Prof Dr. Nor Azmi Kamaruddin 6928 norazmi@ppukm.ukm.edu.my 4 Prof Dr. S. Fadilah Abd Wahab 6090 sfadilah@ppukm.ukm.edu.my 5 Prof Dr. Roslina Abdul Manap 6073 roslina@ppukm.ukm.edu.my 6 Prof Dr. Norlela Sukor 6087 drlela2020@yahoo.com 7 Prof Madya Dr. Tan Hui Jan 7311 tanhuijan@gmail.com 8 Prof Madya Dr. Norlaila Mustafa 6079 norlaila@ppukm.ukm.edu.my 9 Prof Dr. Mohd Shahrir Mohammed Said 6093 drobiwan@gmail.com 10 Prof Madya (K) Dr. Oteh Maskon 6795 auajwad@yahoo.com 11 Prof Dr. Abdul Halim Abdul Gafor 6091 halimgafor@gmail.com 12 Prof Madya Dr. Hamizah Razlan 6092 hamizahr@gmail.com 13 Prof Madya (K) Dr. Wong Chieh Lee 6081 wongchiehlee@hotmail.com STUDYGUIDE YEAR

41 14 Dr Ramesh A/L Sahathevan Dr. Hayati Yaakup Prof Madya Dr. Rozita Mohd Prof Madya Dr. Norasyikin A. Wahab Dr. Ramesh K. Periyasamy 6936 petrick@ppukm.ukm.edu.my 19 Dr. Wan Nur Nafisah Wan Yahya 7924 nafisahyahya@gmail.com 20 Prof Madya Dr. Adawiyah Jamil 7924 adda_jamil@yahoo.com 21 Dr. Andrea Ban Yu-Lin 7924 andreaban@gmail.com 22 Dr. Hamat Hamdi B. Che Hassan 6098 hamathamdi@yahoo.com 23 Dr. Nor Rafeah Tumian 6078 rafeah_tumian@yahoo.com 24 Dr. Rabani Remli 6082 rabaniremli@yahoo.com 25 Dr. Ngiu Chai Soon 6093 csngiu@ppukm.ukm.edu.my 26 Dr. Norazirah Md Nor 6575 norazirah78@gmail.com 27 Prof Madya Dr. Sakthiswary A/P Rajalingham 6097 drsakthis5@gmail.com 28 Dr. Syahrul Sazliyana Shaharir sazliyana@hotmail.com 29 Dr. Rizna Abdul Cader rizna_c@hotmail.com 30 Dr. Wong Zhiqin 6138 wzhiqin@yahoo.com 31 Dr. Choor Chee ken choor123@gmail.com 32 Dr. Kong Wei Yen 6084 wykong1979@yahoo.com STUDYGUIDE YEAR

42 33 Dr. Law Zhe Kang Dr. S. Ravih A/L Subramaniam Dr. Ruslinda Mustafar 36 Dr. Rizawati Rizal Isfahani 37 Prof Madya Dr. Raja Affendi Raja Ali 6094 ppukm.ukm.edu.my 38 Dr. Wan Fariza Wan Jamaluddin Dr. Jeevinesh Naidu A/L Aplanaidu 40 Dr. Hazlina Mahadzir Dr. Mohd Shawal Faizal Mohamad 42 Dr. Shamila A/P Rajendran skaruthu@gmail.com 43 Dr. Mohamed Faisal Abd Hamid arabinose@hotmail.com 44 Dr. Soo Chun Ian scianray@gmail.com 45 Dr. Yap Sze Wei Ernie Cornellius ernie.yap@ppukm.ukm.edu.my 46 AP Dr Tidi Maharani Hassan tidi.hassan@gmail.com 47 Dr Siva Kumar A/L Palaniappan siva_redknapp@hotmail.com Supporting Staff: Puan Norhayati Ibrahim Ext 7748 *Dr. Wong Zhiqin - study leave : 1 June may 2016 * Prof Madya Dr. Hamizah Razlan - sabbatical leave: 1 July - 30 November 2015 * Dr Ramesh A/L Sahathevan - Unpaid leave : 15 January -25 November 2015 *Dr. Choor Chee Ken - study leave: august January 2016 STUDYGUIDE YEAR

43 INTRODUCTION TO MEDICINE The module discusses the clinical approach to the various diseases in medicine. By applying basic and clinical sciences, the students learn through an integrated approach encompassing history taking, clinical examination and principles of patient management in a holistic manner. Students will also be expected to perform simple clinical procedures. PRE- REQUISITES The students should have knowledge of: 1. Clinical sciences 2. Biomedical sciences MODULE OBJECTIVES At the end of the posting, students should be able to: 1. Communicate effectively with patients, their families and health professionals. 2. Take a complete history from the patient and/or caregiver. 3. Perform a proper physical examination. 4. Interpret the history and physical signs to formulate a proper provisional diagnosis and differential diagnoses. 5. Relate the clinical findings with the basic medical sciences, psychosocial and environmental factors. 6. Identify and request the appropriate investigations. 7. Interpret the results of investigations in the context of the patient s condition. 8. Use basic instruments such as a sphygmomanometer (both manual and electronic), pulse oximeter and peak flow meter and interpret the measurement. 9. Perform and interpret basic bedside investigations such as urine dipstick, capillary blood sugar and electrocardiogram (ecg). 10. Competently perform basic invasive procedures such as venepuncture and intravenous cannulation. 11. Comply with ward rules and regulations. 12. Discuss and demonstrate skills in approaching patients in a holistic manner incorporating both physical and psycho spiritual needs. 13. Discuss and apply the influence of medical ethics, behaviour and conduct towards patients. 14. Discuss and demonstrate appropriate skills in dealing with uncertainty, death and dying. STUDYGUIDE YEAR

44 COURSE CONTENTS Must Know Should Know Nice To Know Cardiovascular system Anatomy and physiology of cardovascular system Symptoms and signs of cardiovascular disorders Ischaemic heart disease Valvular heart disease Cardiac failure Cardiomyopathies Secondary causes of hypertension Rheumatic fever and chronic rheumatic heart disease Pericarditis Cyanotic and acyanotic congenital heart disease Stress test Hypertrophic obstructive cardiomyopathy Interpretation of electrocardiogram (ECG) Marfan disease Arrhythmias- various types of bradycardia and tachycardia, narrowed completx tachycardia, broad complex tachycardia Infective endocarditis Clinical approach to chest pain Clinical approach to acute breathlessness Essential Hypertension Peripheral vascular disease Differential diagnosis of noncardiac chest pain Respiratory system Symptoms and signs of respiratory diseases Asthma Chronic obstructive pulmonary disease Pneumonia Cor pulmonale Respiratory failure- acute and chronic Bronchiectasis Aspiration pneumonia Empyema Lung abscess Clinical approach to acute breathlessness Clinical approach to acute haemoptysis Approach to interstitial lung diseases Occupational lung disease Sarcoidosis Fungal pneumonia Mediastinal mass Pulmonary complications of AIDS Pleural effusion STUDYGUIDE YEAR

45 Lung cancer Pneumothorax Pulmonary embolism Tuberculosis Clinical approach to chronic cough Interpretation of ABG Interpretation of chest X-ray Neurological system Anatomy of central and peripheral nervous system Stroke CNS infections: Meningitis and encephalitis Epilepsy Peripheral neuropathy Approach to paraparesis Guillian-Barre syndrome Cranial neuropathies Headache disorders Approach to confusional state Space occupying lesions and brain tumours Multiple sclerosis Dementia Hyperkinetic disorders Neurodegenerative disorders Bell s palsy Developmental disorders Parkinsons disease Myasthenia gravis Cerebellar disorders Endocrinology Physiology of endocrine system Symptoms and signs of endocrine disorders Calcium disorders Metabolic syndrome Osteoporosis Diabetes mellitus Pituitary disease Hyperthyroidism and hypothyroidism Acromegaly Cushing s syndrome and adrenal insufficiency Secondary hypertension (Endocrine) Interpretation of oral glucose tolerance test, thyroid function test Hyperlipidaemia STUDYGUIDE YEAR

46 Nephrology Renal anatomy and physiology Symptoms and signs of renal diseases Polycystic kidney disease Analgesic nephropathy Tubulointerstitial nephritis Renal artery stenosis Renal replacement therapy Acute and chronic renal failure Clinical approach to acute and chronic renal failure Acid-base disorders Urinary tract infection Nephrotic and nephritic syndrome Glomerulonephritis Drugs and the kidneys Interpretation of renal profile Renal calculi Diabetic nephropathy Obstructive nephropathy Fluid and electrolyte disturbances Gastroenterology and hepatology Physiology and anatomy of gastrointestinal system Symptoms and signs of gastrointestinal and liver disorders Malabsorption syndromes Primary biliary cirrhosis Wilson s disease Hemochromatosis Neuroendocrine tumour Pancreatic cyst and tumour Viral hepatitis / Vaccination Alcoholic liver disease Autoimmune hepatitis Fatty liver Basics of acute liver failure Liver cirrhosis, portal hypertension and complications Liver abscess Peptic ulcer disease Reflux oesophagitis Acute GI bleed Acute gastroenteritis Acute and chronic Pancreatitis Hepatocellular carcinoma Gastric and colorectal STUDYGUIDE YEAR

47 cancer Inflammatory bowel disease Irritable bowel syndrome Approach to jaundice Approach to diarrhoea Interpretation of liver function test and viral hepatitis serology Hematology Physiology of blood and coagulation pathway Symptoms and signs of hematologic disorders Lymphoma Leukaemia Hemolytic anemias Myeloproliferative neoplasm Side effects of chemotherapy Various types of anemia Various blood products and indication Coagulopathies and thrombophilias Interpretation of peripheral blood count and blood film Approach to anaemia Approach to bleeding disorders Approach to patient with leucocytosis Rheumatology Physiology of Immune system Systemic inflammatory vasculitis Symptoms and signs of rheumatologic disorders Ankylosing spondylitis Septic arthritis Rheumatoid arthritis Seronegative arthropathies Gout Systemic lupus erythematosus Scleroderma Clinical approach to joint pains Basic investigations of rheumatology STUDYGUIDE YEAR