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LIAQUAT NATIONAL HOSPITAL

& MEDICAL COLLEGE

RESPIRATORY II MODULE

THIRD YEAR MBBS SEMESTER 5

STUDY GUIDE

2017

3RD YEAR MBBS, SEMESTER 5 RESPIRATORY II MODULE LIAQUAT NATIONAL MEDICAL COLLEGE

2017 Page | 2

STUDY GUIDE FOR RESPIRATORY II MODULE

S.No

CONTENTS Page No.

1 Overview 3 2 Introduction to Study Guide 4

3 Learning Methodologies 5 4 Module 3: Respiratory II 7

4.1 Introduction 7

4.2 Objectives and Strategies 8

5 Learning Resources 14 6 Assessment Methods 16 7 Semester Examination Rules and Regulations of JSMU 18

8 Modular Examination Rules and Regulations (LNMC) 20

9 Schedule 22


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Module name: Respiratory II

Semester: Five Year: Three Duration: 4 weeks (Jan - Feb 2017)

Timetable hours: Lectures, Case-Based Integrated Learning (CBIL), Clinical Rotations, learning

experience in LNH outreach centers, Laboratory, Practical, Demonstrations, Skills, Self-Study

Credit hours: 3 credit hours in theory and 1.5 credit hours in practical

MODULE INTEGRATED COMMITTEE

DEPARTMENTS’ & RESOURCE PERSONS’ FACILITATING LEARNING

MODULE COORDINATOR: Dr. Zafar Ahmed (Pulmonology)

CO-COORDINATORS: Professor Nighat Huda (DHCE) Dr. Sheeba Mahjabeen (Pulmonology) Dr. Amna Khursheed (Pathology)

BASIC HEALTH SCIENCES CLINICAL AND ANCILLARY DEPARTMENTS ANATOMY

Professor Zia-ul-Islam

CHEMICAL PATHOLOGY Dr. Howrah Ali

COMMUNITY MEDICINE Professor Rafiq Soomro

PEDIATRICS Prof. Samina Shamim

FORENSIC MEDICINE Professor Murad Zafar

PULMONOLOGY Professor Ali Arsalan Dr. Ali Abbas Dr. Zafar Ahmed Dr. Sheeba Mahjabeen

PATHOLOGY

Professor Naveen Faridi Dr. Amna Khursheed

RADIOLOGY Dr. Muhammad Ayub Mansoor Dr. Roomi Mahmud

PHARMACOLOGY Professor Nazir Ahmad Solangi

RESEARCH & SKILLS DEVELOPMENT CENTER Dr Kahkashan Tahir

PHYSIOLOGY

Professor Syed Hafeez-ul-Hassan RESEARCH

Dr. Shaheena Akbani

DEPARTMENT of HEALTH CARE EDUCATION Professor Nighat Huda Dr. Mirza Aroosa Beg

LNH&MC MANAGEMENT

Professor Amir Ali Shoro, Dean & Principal, Director FHS LNH&MC Dr. Shaheena Akbani, Controller A.A & R.T LNH&MC

STUDY GUIDE COMPILED BY: Department of Health Care Education

Dr. Muhammad Suleman Sadiq

Dr. Rabia Mahmood

Dr. Afifa Tabassum


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INTRODUCTION

WHAT IS A STUDY GUIDE?

It is an aid to:

Inform students how student learning program of the semester-wise module has been

organized

Help students organize and manage their studies throughout the module

Guide students on assessment methods, rules and regulations

THE STUDY GUIDE:

Communicates information on organization and management of the module.

This will help the student to contact the right person in case of any difficulty.

Defines the objectives which are expected to be achieved at the end of the module.

Identifies the learning strategies such as lectures, small group teachings, clinical skills,

demonstration, tutorial and case based learning that will be implemented to achieve the

module objectives.

Provides a list of learning resources such as books, computer assisted learning programs,

web- links, journals, for students to consult in order to maximize their learning.

Highlights information on the contribution of continuous and semester examinations on the

student’s overall performance.

Includes information on the assessment methods that will be held to determine every student’s

achievement of objectives.

Focuses on information pertaining to examination policy, rules and regulations.

CURRICULUM FRAMEWORK

Students will experience integrated curriculum similar to previous modules of all 4 semesters.

INTEGRATED CURRICULUM comprises of system-based modules such as Infectious Diseases,

Hematology, Respiratory system and CVS which links basic science knowledge to clinical problems.

Integrated teaching means that subjects are presented as a meaningful whole. Students will be

able to have better understanding of basic sciences when they repeatedly learn in relation to clinical

examples.

LEARNING EXPERIENCES: Case based Integrated discussions, skills acquisition in skills lab. computer-

based assignments, learning experiences in clinics, wards, and outreach centers


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LEARNING METHODOLOGIES

The following teaching / learning methods are used to promote better understanding:

Interactive Lectures

Small Group Discussion

Case- Based Integrated Learning (CBIL)

Clinical Experiences o Clinical Rotations o Experience in LNH outreach centers

Practicals

Skills session

Self-Directed Study

INTERACTIVE LECTURES: In large group, the lecturer introduces a topic or common clinical conditions and

explains the underlying phenomena through questions, pictures, videos of patients’ interviews,

exercises, etc. Students are actively involved in the learning process.


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SMALL GROUP SESSION: This format helps students to clarify concepts, acquire skills or desired

attitudes. Sessions are structured with the help of specific exercises such as patient case, interviews or

discussion topics. Students exchange opinions and apply knowledge gained from lectures, tutorials and

self study. The facilitator role is to ask probing questions, summarize, or rephrase to help clarify concepts.

CASE- BASED INTEGRATED LEARNING (CBIL): A small group discussion format where learning is focused

around a series of questions based on a clinical scenario. Students’ discuss and answer the questions

applying relevant knowledge gained previously in clinical and basic health sciences during the module and

construct new knowledge. The CBIL will be provided by the concern department.

CLINICAL LEARNING EXPERIENCES: In small groups, students observe patients with signs and symptoms

in hospital wards, clinics and outreach centers. This helps students to relate knowledge of basic and

clinical sciences of the module and prepare for future practice.

o CLINICAL ROTATIONS: In small groups, students rotate in different wards like Medicine, Pediatrics,

Surgery, Obs & Gyne, ENT, Eye, Family Medicine clinics, outreach centers & Community Medicine

experiences. Here students observe patients, take histories and perform supervised clinical

examinations in outpatient and inpatient settings. They also get an opportunity to observe medical

personnel working as a team. These rotations help students relate basic medical and clinical

knowledge in diverse clinical areas.

o EXPERIENCE IN LNH OUTREACH CENTERS: Learning at outreach centers of LNH have been

organized and incorporated as part of training of third year medicinal students. The objective of

these visits is to provide clinical training experiences for students in primary care settings.

PRACTICAL: Basic science practicals related to pharmacology, microbiology, forensic medicine, and

community medicine have been schedule for student learning.

SKILLS SESSION: Skills relevant to respective module are observed and practiced where applicable in

skills laboratory.

SELF-DIRECTED STUDY: Students’ assume responsibilities of their own learning through individual study,

sharing and discussing with peers, seeking information from Learning Resource Center, teachers and

resource persons within and outside the college. Students can utilize the time within the college

scheduled hours of self-study.


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SEMESTER 5 MODULE 3 : RESPIRATORY II

INTRODUCTION

The Respiratory System II (RES II) module is designed to consolidate, and build on the Semester OneRES1

module which covered basic medical sciences concepts for understanding the causes and treatment of

diseases.

RES (II) will focus on the respiratory system, its associated diseases, treatment options, and prevention of the

diseases such as obstructive lung diseases, hypersensitivity related diseases, pulmonary infections, respiratory

failure and restrictive lung diseases. The community medicine learning will aim at sessions on preventive

medicine and various program such as TB DOTS and national tuberculosis control program of Pakistan. The

module will enable students to relate their theoretical learning through common clinical presentations, case-

based learning, interactive lectures, patient, simulated-based experiences and video-based learning.

Forensic Medicine, family medicine clinics and research will run parallel with the module.


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COURSE OBJECTIVES AND STRATEGIES

At the end of the module the students will be able to:

OBJECTIVES FACULTY LEARNING

STRATEGY

OBSTRUCTIVE LUNG DISEASES (COPD)

Perform Respiratory System Examination Skills Lab

Group Learning,

Simulation Based

Hands-on Practice

Discuss overview of clinical anatomy of Thorax including thoracic wall, lungs and trachea-bronchial tree

Anatomy

Small Group

Discussion

Explain the different Stages of development of Lung and its congenital anomalies

Interactive

Lecture/Small Group

Discussion

Enlist and describe the different volumes and capacities of lungs

Physiology

Interactive

Lecture/Small Group

Discussion

Take focused history

Perform examinations in Respiratory Diseases

Discuss abnormal assessment findings associated with pulmonary diseases

Pulmonology

Interactive

Lecture/Small Group

Discussion

Discuss the investigations relevant to respiratory diseases Interactive Lecture

Discuss the epidemiology, patho-physiology and etiology related to the development of COPD

Explain the signs and symptoms of the disease

Discuss the investigations & diagnostic strategies for COPD

Explain the management of COPD

Pulmonology Interactive Lecture

Discuss the differential diagnosis of granulomatous inflammation including TB

Pathology

Small Group

Discussion

Analyze histopathological changes in given slide of a patient suffering from chronic obstructive pulmonary disease

Small Group

Discussion

Explain the etiology and pathogenesis of obstructive lung disease including chronic bronchitis, bronchiectasis, asthma and emphysema

Interactive Lecture

Discuss pathogenesis of Anaphylaxsis

Interactive Lecture


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HYPERSENSITIVITY RELATED DISEASES (Asthma)

Explain the different types of asthma

Explain the role of histamine and antihistamine in bronchial asthma

Discuss the drugs used in preventive therapy

Describe drugs used in acute attack of asthma

Discuss the treatment of status asthmatics

Discuss drugs used in COPD

Explain the adverse effect of different drugs

Pharmacology Interactive Lecture

Discuss the epidemiology, pathophysiology, etiology, and contributing factors related to the development of asthma

Describe the clinical presentation, diagnostic process and assessment of asthma

Review the pharmacologic treatments for different types of asthma

Identify the elements of long-term asthma management

Discuss the roles of respiratory, physical, and occupational therapy in the long-term management of asthma


Discuss the etiology, pathogenesis, clinical presentation and management of asthma in children

Pediatrics Interactive Lecture

Describe the prevalence, causes and strategies of primary prevention of asthma

Community

Medicine Interactive Lecture

Discuss the treatment approach of bronchial asthma

Demonstrate the methods of administration of drugs used in asthma including nebulizer and inhaler

Pharmacology Practical

PULMONARY INFECTIONS (Tuberculosis)

Identify the common causative agents, modes of transmission and risk factors for the common acute respiratory tract infections in pediatric age group

Explain the management of acute respiratory tract infections in children

Explain the most effective ways to prevent and control ARIs

Describe the clinical presentations and complications of ARIs, and the danger signs of severe pneumonia


Explain the different types of cough

Explain the treatment strategy of cough

Discuss the adverse effect of anti-tussive drugs

Describe allergic rhinitis and its triggering factor

Explain the drugs used in the treatment of allergic rhinitis and its treatment strategy

Pharmacology

Small Group

Discussion

Discuss the first line drugs used in treatment of tuberculosis, mechanism of action and adverse effects

Discuss the second line drugs used in treatment of tuberculosis, indications for use and adverse effects

Describe WHO guidelines for treatment of tuberculosis –

Interactive Lecture


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The DOTS Regimen

Explain monitoring of Anti-Tuberculosis (AT) therapy

Explain Multiple Resistance Drugs (MRD) TB, causes of resistance and prevention of resistance

Discuss drugs for prevention of TB in exposed patients

List the immunological differences of TB in child and adult

Explain the signs and symptoms of various forms of TB presenting in children

Recall the diagnostic criteria for TB in pediatric age group

Discuss the treatment protocol for TB


Discuss the clinical diagnosis, investigation and management protocol for TB and MDR TB


Explain tuberculosis as a public health problem globally including Pakistan

Discuss the mode of transmission such as droplets, dust, physical contact etc

Describe the various screening tests of tuberculosis

Discuss the preventive strategies at primary level and the National Tuberculosis Control Program of Pakistan

Community


Pneumonia

Explain the community acquired pneumonia with special emphasis on its general features and causative agents


Discuss the causative organisms of pneumonia Pathology Interactive Lecture

Disucss community acquired pneumonia along with its pathogens

Discuss the clinical features of disease

Discuss the investigations required for diagnosis

Discuss the drugs used in community acquired pneumonia, atypical and suppurative pneumonia

Discuss Penicillin in detail along with pharmacokinetic and pharmacodynamic profile

Pharmacology

Case-Based

Learning/Small

Group Discussion

RESPIRATORY FAILURE (Pneumothorax)

Distinguish between inflammatory and non-inflammatory pleural effusions

Pathology Small Group

Discussion

Classify the different types of respiratory failure along with the essentials of diagnosis

Discuss the investigations and management respiratory failure diseases

Pulmonology

Interactive Lecture

Discuss the etiology and classification of pneumothorax

Discuss the diagnosis and management of pneumothorax

Interactive Lecture

Classify Pleural effusion

Discuss the approach in the diagnosis and management of pleural effusion

Interactive Lecture


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Discuss the normal acid base status of the body and the normal levels of pH, PCO2, PO2 and HCO3

Interpret the ABG report according to the pH, PCO2 and HCO3 levels

Diagnose the different acid base disorders along with the compensatory responses

Enumerate the common causes mixed acid base disorders and single acid base disorder with compensation

Calculate the anion gap and the delta ratio

Diagnose double disorders and triple disorders

Chemical

Pathology

Small Group

Discussion

Explain Pulmonary hypertension

Pathology Interactive Lecture Discuss the diseases of vascular origin

Discuss pathogenesis of pulmonary embolism and infarction

Identify the etiological factors for the development of ARDS

Discuss the diagnostic features of ARDS

Explain various treatment strategies available for ARDS

Discuss pharmacological and non-pharmacological therapies for the management of patients with or at risk ALI


Describe the basic concepts of arterial blood gases (ABGs) Physiology

Interactive

Lecture/Small Group

Discussion

Perform ABGs sampling Skills Lab

Small Group

Discussion

Explain the normal constituents of pleural fluid, mainly pH, protein, glucose and lactate dehydrogenase (LDH)

Diagnose whether the pleural fluid is an exudate or transudate according to the Light’s criteria for pleural fluid

Calculate serum to pleural albumin gradient (SPAG) and its interpretation

Enumerate the causes of exudative and transudative pleural effusions

Chemical

Pathology Interactive Lecture

RESTRICTIVE LUNG DISEASES

Discuss, classification, etiology and pathogenesis of restrictive lung diseases

Pathology

Interactive Lecture

Differentiate between obstructive and restrictive lung disease in term of clinical presentation, pulmonary function test and pathology

Small Group

Discussion

Describe the general and specific preventive measures against various pneumoconiotic diseases such as silicosis, bysinosis, asbestosis, anthracosis etc

Explain the ergonomics and its application to optimize human well-being and overall system performance, fit the job to the worker in occupational environment

Community



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Discuss the imaging techniques in respiratory disease Radiology Interactive Lecture

Classify lung tumors

Describe characteristics of lung tumors Pathology

Interactive Lecture

Explain the histo-pathological features of lung tumors

Small Group

Discussion

Describe classification of bronchogenic carcinomas

List risk factors of lung cancer

Discuss clinical features and investigations for bronchogenic carcinoma

Explain staging of lung cancer

Identify complications and management of lung carcinoma


Forensic Medicine

Post Mortem Examination

Describe the objectives, rules, essentials, and precautions

for post mortem or autopsy examination

Discuss the different types of autopsy

Forensic Medicine

Interactive Lecture

Medicolegal Autopsy

Describe procedure of medicolegal autopsy

Describe importance of examination of dead body at scene

Interactive

Lecture/Video-

Based Learning

Discuss the objectives, rules, essentials, and precautions for

post mortem or autopsy examination

Small Group

Discussion

Exhuming The Dead

Describe Exhumation of human remains for medico-legal

purposes

Interactive Lecture

Explain Mortuary facility set up and handling the dead

Small Group

Discussion

Negative and Obscure autopsy

Explain Negative and Obscure autopsy

Interactive Lecture

Postmortem Artifacts.

Discuss the different types of postmortem artifacts

Interactive Lecture

Post mortem Autopsy report

Scribe a post mortem autopsy report

Interactive Lecture

Asphyxial deaths

Classify asphyxial deaths

Explain etiology & patho-physiology of asphyxia

Interactive Lecture


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Discuss Cause Of Death (COD) in asphyxia –Difference

between, Suicide and Murder, and Accidental deaths.

Antemortem and Postmortem appearances

Small Group

Discussion

Mechanical asphyxia I

Describe classical signs, cause of death, fatal period, and postmortem appearances of the followings:

o Hanging

o Strangulation

o Throttling

o Smothering

o Traumatic asphyxia

Interactive Lecture

Mechanical asphyxia II

Describe classical signs, cause of death, fatal period, and postmortem appearances of the followings:

o The sexual asphyxia

o Suffocation / Environmental asphyxia

o Gagging/Choking

o Café coronary

Interactive Lecture

Drowning

Explain Drowning & Immersion

Describe post mortem examination of bodies recovered from water

Interactive Lecture

Discuss Pesticide poisons/ Metallic poisons- Lead, Mercury

Poisoning

Small Group

Discussion


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LEARNING RESOURCES

SUBJECT RESOURCES

COMMUNITY MEDICINE

TEXT BOOKS 1. Community Medicine by Parikh 2. Community Medicine by M Illyas 3. Basic Statistics for the Health Sciences by Jan W Kuzma

FORENSIC MEDICINE

TEXT BOOKS 1. Nasib R. Awan. Principles and practice of Forensic Medicine 1st

ed. 2002. 2. Parikh, C.K. Parikh’s Textbook of Medical Jurisprudence, Forensic

Medicine and Toxicology. 7th ed.2005. REFERENCE BOOKS

3. Knight B. Simpson’s Forensic Medicine. 11th ed.1993. 4. Knight and Pekka. Principles of forensic medicine. 3rd ed. 2004 5. Krishan VIJ. Text book of forensic medicine and toxicology

(principles and practice). 4th ed. 2007 6. Dikshit P.C. Text book of forensic medicine and toxicology. 1st

ed. 2010 7. Polson. Polson’s Essential of Forensic Medicine. 4th edition.

2010. 8. Rao. Atlas of Forensic Medicine (latest edition). 9. Rao.Practical Forensic Medicine 3rd ed ,2007. 10. Knight: Jimpson’s Forensic Medicine 10th 1991,11th ed.1993 11. Taylor’s Principles and Practice of Medical Jurisprudence. 15th

ed.1999 CDs:

1. Lectures on Forensic Medicine. 2. Atlas of Forensic Medicine.

WEBSITES:

www.forensicmedicine.co.uk

GENERAL MEDICINE

REFERENCE BOOKS: 1. Hutchison’s Clinical Methods, 23rd Edition 2. MacLeod's clinical examination 13th edition 3. Davidson's Principles and Practice of Medicine 4. Kumar and Clark's Clinical Medicine 5. HCAI guidelines CDC 6. WHO TB guidelines

PATHOLOGY/MICROBIOLOGY

TEXT BOOKS 1. Robbins & Cotran, Pathologic Basis of Disease, 9th edition. 2. Rapid Review Pathology, 4th edition by Edward F. Goljan MD

http://www.amazon.com/s/ref=dp_byline_sr_book_1?ie=UTF8&field-author=Edward+F.+Goljan+MD&search-alias=books&text=Edward+F.+Goljan+MD&sort=relevancerank


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WEBSITES: 1. http://library.med.utah.edu/WebPath/webpath.html 2. http://www.pathologyatlas.ro/

PEDIATRICS

TEXT BOOK: 1. Basis of Pediatrics (8th Edition Pervez Akbar)

PHARMACOLOGY

A. TEXT BOOKS 1. Lippincot Illustrated Pharmacology 2. Basic and Clinical Pharmacology by Katzung

ADDITIONAL LEARNING RESOURCES

Hands-on Activities/ Practical Students will be involved in Practical sessions and hands-on activities that link with the respiratory II module to enhance the learning.

Labs Utilize the lab to relate the knowledge to the specimens and models

available.

Skills Lab Provides the simulators to learn the basic skills and procedures. This helps

build the confidence to approach the patients.

Videos

Familiarize the student with the procedures and protocols to assist

patients.

Computer

Lab/CDs/DVDs/Internet

Resources:

To increase the knowledge students should utilize the available internet

resources and CDs/DVDs. This will be an additional advantage to increase

learning.

Self Learning

Self Learning is scheduled to search for information to solve cases, read

through different resources and discuss among the peers and with the

faculty to clarify the concepts.

http://library.med.utah.edu/WebPath/webpath.html

http://www.pathologyatlas.ro/


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ASSESSMENT METHODS:

Theory:

o Best Choice Questions (BCQs) also known as MCQs (Multiple Choice Questions) are used to asses

objectives covered in each module.

A BCQ has a statement or clinical scenario followed by four options (likely answer).

Students after reading the statement/scenario select ONE, the most appropriate response

from the given list of options.

Correct answer carries one mark, and incorrect ‘zero mark’. There is no negative marking.

Students mark their responses on specified computer-based/OMR sheet designed for LNHMC.

o EMQs:

An EMQ has:

o An option list of 5-15 which may be nerve supply, functions, diagnosis, investigations etc

o A Lead In –Statement/Question

o Two to four Stems or Clinical Scenarios

For each stem or clinical scenario, the student should choose the most appropriate option from the

option list.

A single option can be used once, more than once or not at all.

Correct answer carries one mark and incorrect ‘zero mark’. There is NO negative marking.

Student mark their responses on a specified computer-based sheet for EMQs.

OSPE/OSCE: Objective Structured Practical/Clinical Examination:

Each student will be assessed on the same content and have same time to complete the task.

Comprise of 12-25 stations.

Each station may assess a variety of clinical tasks, these tasks may include history taking, physical examination, skills and application of skills and knowledge

Stations are observed, unobserved, interactive and rest stations.

Observed and interactive stations will be assessed by internal or external examiners.

Unobserved will be static stations in which there may be an X-ray, Labs reports, pictures, clinical

scenarios with related questions for students to answer.

Rest station is a station where there is no task given and in this time student can organize

his/her thoughts.


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Internal Evaluation

During the module, students will be assessed to determine achievement of module objectives.

Module Examination: will be scheduled on completion of each module. The method of

examination comprises theory exam which includes BCQs, EMQs and OSPE/OSCE (Objective

Structured Practical Examination/Objective Structured Clinical Examination).

20% marks of internal evaluation will be added in theory of JSMU semester exam. That

20% will include class tests, assignments and the modular exam which all have specific

marks allocation.

Example : Number of Marks allocated for Semester Theory and Internal Evaluation

Semester

Semester Examination Theory Marks

Internal Evaluation (Class test + Assignments

+ Modular Exam)

Total (Theory)

80% 20% 100%

Formative Assessment

Individual department may hold quiz or short answer questions to help students assess their

own learning. The marks obtained are not included in the internal evaluation

More than 75% attendance is needed

to sit for the modular and semester

examinations


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SEMESTER EXAMINATION RULES & REGULATIONS OF JINNAH SINDH MEDICAL UNIVERSITY

(JSMU)

In one academic year there will be two semesters. The semester duration is approximately

sixteen/seventeen weeks.

Each semester may have two to three modules from two to eight weeks duration.

JSMU EXAMINATIONS:

JSMU will schedule and hold Semester Examinations on completion of each semester.

In one academic year, there will be two semester examinations and one Retake Examination.

MBBS Third year:

Semester V examination is scheduled on completion of Infectious Diseases, Hematology, Respiratory II and CVS modules.

Semester VI examination is scheduled on completion of GIT, Renal and Endocrine modules.

Examination Protocols:

In each semester, module will be assessed by theory paper comprising MCQs and EMQs. For

example semester 5 will have separate theory paper of Infectious Diseases, Hematology,

Respiratory II and CVS II modules.

There will be one OSPE (Objective Structured Practical Examination)/OSCE (Objective Structured

Clinical Examinations) which will cover all four modules of semester five.

1. Theory

Theory paper will comprise of 80 one best type MCQs and 20 EMQs.

Time duration for theory paper will be 120 minutes.

Students will mark their responses on JSMU specified response sheets assessed by computer

software.

It will carry out 80% contribution in theory results of the Semester.

There is no negative marking.

2. OSPE/OSCE:

It is to be held at the respective college unless specified by JSMU.

It may comprise between 12- 25 stations. Each station will carry 10 marks.


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3. JSMU Grading System

It will be based on GPA – 4 system

Marks obtained in Percentage range

Numerical Grade

Alphabetical Grade

80-100 4.0 A+ 75-79 4.0 A 70-74 3.7 A- 67-69 3.3 B+ 63-66 3.0 B 60-62 2.7 B- 56-59 2.3 C+ 50-55 2.0 C

<50 Un-grade-able 0 U

A candidate obtaining GPA less than 2.00 (50%) is declared un-graded (fail).

Cumulative transcript is issued at the end of clearance of all modules.

4. Retake Examination

The failures are to re-appear in subsequent examinations.

It is held once a year that is after the even number semesters. For example at the end of second, fourth, sixth, eighth or tenth semester.

Retake examinations are for those students who fail in semester examinations, and who wish to

improve grades (GPA) secured in semester examinations.

The candidate who has passed the semester examinations with GPA less than 3.0 GPA may re- appear in respective retake examination to improve grades.

MBBS first year Candidates failing in retake examinations may re-appear in semesters’

examinations of the following year. The format is exactly the same as in semester examinations.

EXAMPLE OF PROMOTION RULES:

A student who fails in Semester One Examination and passes Semester Two, s/he will take Retake for

Semester One Examination. S/he passes Semester Two and is promoted to 2nd year. If that student

FAILS in Retake, s/he will be promoted to 2nd year BUT will have to Pass Semester One examination in

Second year along with Semester Three and Four examinations for promotion to third year.


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5. Promotion to next class

Students who pass both semester examinations are promoted from first year to second year.

Students who fail the MBBS first year semester retake examination will be promoted to second year.

Students will be promoted from second year to third year and onward only if they have passed

the semester examinations of that year.

Clearance of all modules and their components of semester one to four are mandatory for promotion from second year to third year (as per PMDC rules).

As per PMDC rules any candidate failing to clear a module or its component in four (1+3)

attempts is not allowed to carry out further medical education.

Clearance of all modules and their components of semester/s are mandatory for promotion from third year onward.


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MODULAR EXAMINATION RULES & REGULATIONS (LNH&MC)

Student must report to examination hall/venue, 30 minutes before the exam.

Exam will begin sharp at the given time.

No student will be allowed to enter the examination hall after 15 minutes of scheduled

examination time.

Students must sit according to their roll numbers mentioned on the seats.

Cell phones are strictly not allowed in examination hall.

If any student is found with cell phone in any mode (silent, switched off or on) he/she will be not

be allowed to continue their exam.

No students will be allowed to sit in exam without University Admit Card, LNMC College ID Card

and Lab Coat

Student must bring the following stationary items for the exam: Pen, Pencil, Eraser, and

Sharpener.

Indiscipline in the exam hall/venue is not acceptable. Students must not possess any written

material or communicate with their fellow students.


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SCHEDULE:

WEEKS 3rd Year SEMESTER 5 MONTH

WEEK 1

INFECTIOUS DISEASES MODULE

7th Nov 2016

WEEK 2 WEEK 3 WEEK 4 WEEK 5 10th Dec’2016

MODULAR EXAM 14th & 15th Dec’ 2016

WEEK 1

HEMATOLOGY MODULE

19th Dec’ 2016 WEEK 2 WEEK 3 WEEK 4 10th Jan’ 2017

MODULAR EXAM 13th & 14th Jan’ 2017

WEEK 1

RESPIRATORY II MODULE

16th Jan’ 2017

WEEK 2 WEEK 3 WEEK 4 11th Feb’ 2017 MODULAR EXAM 16th & 17th Feb’ 2017*

WEEK 1 CVS II

MODULE

20th Feb’ 2017*

WEEK 2

WEEK 3 WEEK 4 17th March 2017*

MODULAR EXAM 20th & 21st March’ 2017*

PREPARATORY LEAVE

SEMESTER EXAM 25th March-1st April* *Final dates will be announced later References (title page)

1. http://www.aboutcancer.com/lung_xrays_abnormal.htm 2. http://www.mhhe.com/biosci/esp/2001_gbio/folder_structure/an/m7/s4/index.htm

http://www.aboutcancer.com/lung_xrays_abnormal.htm

http://www.mhhe.com/biosci/esp/2001_gbio/folder_structure/an/m7/s4/index.htm