MD-Dermatology NMC Syllabus
MD-Dermatology NMC Syllabus
MD-Dermatology NMC Syllabus
Preamble:
The purpose of PG education is to create specialists who would provide high quality
health care and advance the cause of science through research & training.
A post graduate specialist having undergone the required training should be able to
recognize the health needs of community, should be competent to handle effectively the
medical problems and aware of recent advances pertaining to the discipline. The PG
student should acquire basic skills in teaching medical/para-medical students. The
student should be able to counsel patients and relatives in infectious diseases like
HIV/AIDS, STDs, cutaneous tuberculosis, leprosy and any event of serious illness or
death.
The purpose of this document is to provide teachers and learners illustrative guidelines to
achieve defined outcomes through learning and assessment. This document was prepared
by various subject-content specialists. The Reconciliation Board of the Academic
Committee has attempted to render uniformity without compromise to purpose and
content of the document. Compromise in purity of syntax has been made in order to
preserve the purpose and content. This has necessitated retention of “domains of
learning” under the heading “competencies”.
Student should have acquired practical and procedural skills related to the subject.
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Should plan and advise measures for the prevention and rehabilitation of patients
with various dermatological conditions.
By the end of the course, the student should have acquired knowledge (cognitive
domain), professionalism (affective domain) and skills (psychomotor domain) as
given below:
A. Cognitive domain
At the end of the course, the student should have acquired following theoretical
competencies:
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Describe pharmacokinetics and principles of topical and systemic therapy.
Describe drug reaction, its diagnosis and management.
Describe cutaneous manifestations of systemic disorders.
Describe anatomy of male and female genitalia, epidemiological transmission,
clinical aspects and management of STDs and HIV.
Describe clinical features, reactions, treatment and rehabilitation in leprosy.
Describe etiology, pathophysiology, principles of diagnosis and management of
common problems in dermatology including emergencies in adults and children.
Describe indications and methods for fluid and electrolyte replacement therapy
including blood transfusion in dermatological conditions.
Describe common dermatological malignancies in the country and their
management including prevention.
Should be expert in evaluation of ECG, chest X-ray (CXR), biochemical,
haematology and immunology reports related to dermatology.
Acquire knowledge of common laboratory stains and procedures used in the
histopathologic diagnosis of skin diseases and special techniques such as
immuno-fluorescence, immuno-peroxidase and other related techniques.
Acquire knowledge of the basics of laser operation and precautions which needs
to be taken.
Demonstrate competence in basic concepts of research methodology and
interpretation of data in medical literature/publications.
Skilled as a self-directed learner, recognize continuing educational needs; use
appropriate learning resources and critically analyze relevant published literature
in order to practice evidence-based dermatology;
Should also have a broad idea how to approach an uncommon dermatological
disease.
B. Affective Domain
At the end of the course, the student should have acquired the following attitudinal
competencies:
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Should be able to maintain confidentiality with regards to history, physical
examination and management of patients.
Identify social, economic, environmental, biological and emotional determinants
of patients, and institute diagnostic, therapeutic, rehabilitative, preventive and
promotive measures to provide holistic care to patients at individual and
community level against skin, venereal disease and leprosy.
Recognize the emotional and behavioral characteristics of patients and keep these
fundamental attributes in focus while dealing with them.
Demonstrate empathy and humane approach towards patients and their families
and respect their sensibilities.
Demonstrate communication skills of a high order in explaining management and
prognosis, providing counseling and giving health education messages to patients,
families and communities.
Organize and supervise the desired managerial and leadership skills.
Should be able to function as a part of a team, develop an attitude of cooperation
with colleagues, and interact with the patient and the clinician or other
colleagues to provide the best possible diagnosis or opinion.
Always adopt ethical principles and maintain proper etiquette in dealings with
patients, relatives and other health personnel and to respect the rights of the
patient including the right to information and second opinion.
C. Psychomotor Domain
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Acquire skills in history taking, physical examination, diagnosis and management
of patients in dermatology, venereology and leprosy.
Be able to identify, classify and differentiate cutaneous findings in dermatological
terms in a systematic way.
Be able to perform systemic examination (chest, cardiac, abdomen, neurological,
genitals, oral, eye and gynaecological examination) relevant to dermatologic
condition.
Be competent to manage dermatologic emergencies like angioedema, toxic
epidernmal necrolysis (TEN), Stevens-Johnson syndrome (SJS), pemphigus, drug
reaction and necrotic erythema nodosum leprosum (ENL).
Be able to plan and deliver comprehensive treatment for diseases using principles
of rational drug therapy.
Be able to plan and advice measures for the prevention of infectious disease.
Be able to plan rehabilitation of patient suffering from chronic illness and
disability and those with special needs like leprosy.
Demonstrate skills in documentation of case details and of morbidity/mortality
data relevant to the assigned situation.
Laboratory Skills
The student:
Surgery in dermatology
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4. Should be able to perform cryosurgery, nail surgery and acne surgery.
5. Able to perform chemical cauterization, cryotherapy, patch and photopatch test,
slit smears and tissue smears.
Venereology
1. Should be competent in the clinical approach to the patient of STDs and
HIV/AIDS.
2. Should be able to interpret the histopathological diagnosis including laboratory
aids related with venereology.
3. Able to perform dark ground illumination, gram stain, Bubo aspiration and tissue
smear.
4. Able to manage the patient according to syndromic approach for treatment of
STDs.
Leprosy
The student should be:
1. Able to diagnose and approach the case of leprosy.
2. Perform AFB smear.
3. Able to manage cases of lepra reaction.
4. Identify, judge and decide when to refer the patients at appropriate level for
surgery or rehabilitation.Should able to manage pediatric cases with skin diseases.
Syllabus
Course contents
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- Mechanism of cutaneous wound healing.
- Cellular and molecular biology of cutaneous inflammation and arachidonic acid
metabolism.
- Immunologic aspects of epidermis.
- Human leukocyte antigen (HLA) system.
- Immunoglobulins.
- Cytokines and chemokines.
- Lymphocytes, neutrophils, eosinophils, basophils and mast cells.
- Complement system.
- Hypersensitivity and allergy.
- Cutaneous carcinogenesis (chemical, viral and radiation).
- Basics of cutaneous bacteriology, mycology, virology, parasitology and host
resistance.
- Common laboratory procedures, stains,culture media etc. related to the cutaneous
diagnosis.
- Basic pathologic patterns and reactions of skin.
- Common laboratory stains and procedures used in the histopathologic diagnosis
of skin diseases and special techniques such as immunofluorescence,
immunoperoxidase and other related techniques.
Clinical dermatology
Papulosquamous diseases
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- Subcorneal pustular dermatoses.
- Pustular eruptions of palms and soles.
Disorders of melanocytes
- Panniculitis
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- Lipodystrophy
- Neoplasms of the subcutaneous fat
- Acute and chronic effects of ultraviolet radiation and sun light on the skin
- Narrow-band ultraviolet B (NBUVB) therapy, phototherapy, photochemotherapy
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- Ageing of skin
- Geriatric dermatological problems
- Lupus Erythematosus
- Dermatomyositis
- Scleroderma
- Systemic Necrotizing Arteritis
- Cutaneous Necrotising venulitis
- Cryoglobulinemia and Cryofibrinogenemia
- Relapsing Polychondritis
- Rheumatoid Arthritis, Rheumatic Fever and Gout
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- Sjogren’s syndrome
- Raynaud’s phenomenon
- Reiter’s syndrome
- Multicentric Reticulohisticytosis
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- Erythema Infectiosum and Parvovirus B 19 infection
- Herpes simplex
- Varicella and Herpes Zoster
- Cytomegalovirus Infection
- Epstein - Barr Virus Infections
- Human Herpes virus 6 & 7 infections and Exanthem subitum
(Roseola Infantum or Sixth Disease)
- Smallpox and Complications of small pox vaccination
- Contagious Pustular Dermatitis, Contagious Ecthyma: Orf virus infection
- Milluscum Contagiosum
- Miller’s Nodules
- Warts
- Human Retroviral Disease: Human T-Lymphotropic Virusviruses
Therapeutics
Topical therapy
Systemic therapy
Surgery in dermatology
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- Nail Surgery
Venereology
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A post graduate student pursuing the course should work in the institution as a full time
student. No candidate should be permitted to run a clinic/laboratory/nursing home while
studying postgraduate course. Each year should be taken as a unit for the purpose of
calculating attendance. Every student shall attend teaching and learning activities during
each year as prescribed by the department and should not be absent from work without
valid reasons.
Teaching methodology:
A list of teaching and learning activities designed to facilitate students acquire essential
knowledge and skills outlined is given below.
1) Bio-statistics
2) Use of library
3) Research Methodology
4) Medical code of Conduct and Medical Ethics
5) National Health and Disease Control Programmes
6) Communication Skills
These topics may preferably be taken up in the first few weeks of the first year.
b) Integrated Lectures: Some of the topics may be taken up by
multidisciplinary teams eg. Jaundice, Diabetes mellitus, Thyroid etc.
2. Journal Club & Subject seminars: Both are recommended to be held once a
week. All PG students are expected to attend and actively participate in discussion
and enter relevant details in the Log Book. Further, every post graduate student
must make a presentation from the allotted journal(s), selected articles at least four
times a year. The presentations would be evaluated and would carry weightage for
internal assessment.
3. Student Symposium: Recommended as an optional multi-disciplinary programme.
The evaluation may be similar to that described for subject seminar.
4. Ward Rounds: Ward rounds may be service or teaching rounds.
a) Service Rounds: Post graduate students and Interns should be responsible
for everyday care of the patients. Newly admitted patients should be
worked up by the PGs and presented to the seniors the following day.
b) Teaching Rounds: Every unit should have 'grand rounds' for teaching
purpose. A diary (log book) should be maintained for day to day activities
by the students.
Entries of (a) and (b) should be made in the Log book. Log books shall be
checked and assessed periodically by the faculty members imparting the
training.
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5. Clinical Case Presentations: Minimum of 5 cases to be presented by every post
graduate student each year. They should be assessed using check lists and entries
made in the log book
6. Clinico-Pathological Conference (CPC): Recommended once a month for all
post graduate students. Presentation is to be done by rotation. If cases are not
available, it could be supplemented by published CPCs.
Pathology: A dozen interesting cases may be chosen and presented by the post
graduate students and discussed. The staff of Pathology department would then
show the slides and present final diagnosis. In these sessions, the advances in
immuno-histochemical techniques can be discussed.
8. Teaching Skills: The post graduate students shall be required to participate in the
teaching and training programme of undergraduate students and interns.
9. The post graduate students should undertake audit, use information technology tools
and carry out research, both basic and clinical, with the aim of publishing the work
and presenting the same at various scientific fora.
10. Continuing Medical Education Programmes (CME): At least two CME
programmes should be attended by each student during the MD programme.
11. Conferences: The student should attend courses, conferences and seminars relevant
to the speciality.
12. A postgraduate student of a postgraduate degree course in broad specialities/super
specialities would be required to present one poster presentation, to read one paper
at a national/state conference and to present one research paper which should be
published/accepted for publication/sent for publication during the period of his
postgraduate studies so as to make him eligible to appear at the postgraduate degree
examination.
14. Rotation:
Clinical Postings
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A short posting for 2-4 weeks in the Department of Medicine is to be arranged for
exposure to Emergency Medicine and Resuscitation.
There should be intra - and inter- departmental meetings for discussing uncommon /
interesting medical problems. Each student must be asked to present a specified
number of cases for clinical discussion, perform procedures/tests/operations/present
seminars/review articles from various journals in inter-unit/interdepartmental
teaching sessions. These should be entered in a Log Book; log books should be
checked and assessed periodically by the faculty members imparting the training.
ASSESSMENT
The summative examination would be carried out as per the Rules given in
POSTGRADUATE MEDICAL EDUCATION REGULATIONS, 2000.
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Thesis shall be submitted at least six months before the Theory and Clinical /
Practical examination. The thesis shall be examined by a minimum of three
examiners; one internal and two external examiners, who shall not be the examiners
for Theory and Clinical examination. A post graduate student shall be allowed to
appear for the Theory and Practical/Clinical examination only after the acceptance of
the Thesis by the examiners.
2. Theory Examination:
There shall be four papers each of three hours duration. Each paper shall consist of
two long essay questions, three short essay questions and four short notes. These are:
Recommended Reading:
Books (latest edition)
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Leprosy, Dharmendra, 2 Volumes, Samant and Company, Mumbai.
Recent Advances in Dermatology, Champion, R.H. Pye, R.J. 8th Volumes.
Venereal Diseases, Amborse King Claude Nicol Philip Rodin, EL.BS English
Language Book Society/ Baillere Tindal, East Sussex.
Sexually Transmitted Diseases, King K Holmes, McGraw-Hill Health profession
Hand Book of leprosy, Jopling W.H, William Hethgunnah Medical Book Ltd.,
London.
Dermatology in General Medicine, Thomas B. Fitzpatrick, McGraw Hill Book
Company.
Fundamentals of Pathology of skin, Mysore Venkataram
Journals
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Annexure I
Postgraduate Students Appraisal Form
Clinical Disciplines
Name of the Department/Unit :
Name of the PG Student :
Period of Training : FROM…………………TO……………
Sr. PARTICULARS Not Satisfactory More Than Remarks
No. Satisfactory Satisfactory
1 2 3 4 5 6 7 8 9
1. Journal based / recent
advances learning
2. Patient based
/Laboratory or Skill
based learning
3. Self directed learning
and teaching
4. Departmental and
interdepartmental
learning activity
5. External and Outreach
Activities / CMEs
6. Thesis / Research work
7. Log Book Maintenance
Publications Yes/ No
Remarks*_____________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
_________________
*REMARKS: Any significant positive or negative attributes of a postgraduate student to be
mentioned. For score less than 4 in any category, remediation must be suggested. Individual
feedback to postgraduate student is strongly recommended.
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