Subject curriculum

Postgraduate Courses in Tuberculosis and Respiratory Medicine

M.D. in Tuberculosis and Respiratory Medicine.



The postgraduate training course would be train a MBBS doctor who will :



The following objectives are laid out to achieve the goals of the course. These objectives are to be achieved by the time the candidate completes the course. The objectives may be considered under the subheadings.





Human values, Ethical practice and communication abilities











    • Practice efficiently and effectively, backed by scientific knowledge and skill base
    • Exercise empathy and a caring attitude and maintain high ethical standards
    • Continue to evince keen interest in continuing education in the specialty irrespective of whether he is in a teaching institution or is the specialty
    • Be a motivated �teacher� � defined as specialist keen to share his knowledge and skill with a colleague or a junior or any learner
    • Knowledge ( Cognitive domain )
    • Skills ( Psycho motor domain )
    • Human Values, Ethical practice and Communication abilities)
    • Describe aetoilogy , pathophysiology, principles of diagnosis and management of common problems including emergencies , in adults and children.
    • Describe indications and methods for fluid and electrolyte replacement therapy including blood transfusion.
    • Describe common malignancies in the country and their management including prevention.
    • Demonstrate understanding of basic science relevant to this specialty
    • Identify social, economic, environmental and emotional determinant in a given case, and take them into account for planning therapeutic measures.
    • Recognize conditions that may be outside the area of his specialty/competence and to refer them to the proper specialist.
    • Advise regarding the operative or non-operative management of the case and to carry out this management effectively.
    • Update oneself by self study and by attending courses, conferences and seminars relevant to the specialty.
    • Teach and guide his team, colleagues and other students.
    • Undertake audit, use information technology tools and carry out research. both basic and clinical, with the aim of publishing his work and presenting his work at various scientific for a.
    • Take a proper clinical history, examine the patient, perform essential diagnosis procedures and order relevant tests and interpret them to come to a reasonable diagnosis about the condition.
    • Provide basic and advanced life saving support services ( BLS & ALSI ) emergency situations
    • Undertake complete patient monitoring including the care of the patient
    • To perform pulmonary function tests including spirometry 
    • Develop communication skills, in particular the skill to explain various option available in management and to obtain a true informed consent from the patient.
    • Provide leadership and get the best out of his team in a congenial working atmosphere.
    • Apply high moral and ethical standards while carrying out human or animal research.
    • Be humble and accept the limitations in his knowledge and skill and to ask to help from colleagues when needed.
    • Respect patient�s rights and privileges including patient�s right to information and right to seek a second opinion.
    • Basic sciences including Anatomy, Physiology, Pathology, Microbiology and Pharmacology.
    • Arterial blood gases and acid base disturbance.
    • Tuberculosis � Pulmonary- Extra- Pulmonary and allied topics in Tuberculosis
    • Non-Tubercular Respiratory Diseases.
      1. Immunology of respiratory diseases.
      2. Upper respiratory tract infection
      3. Pneumonia
      4. Emphysema
      5. Lung abscess
      6. Disease of Pleura
      7. Fungal infection of the lung
      8. Chronic bronchitis and emphysema
      9. Pulmonary hypertension
      10. Respiratory failure
      11. Bronchiectasis
      12. Parasitic diseases of the lung
      13. Sarcoidosis
      14. Bronchial asthma
      15. Pulmonary eosinophilia, PAN, Wegener�s granulomatosis
      16. Pneumothrax and Mediastinal emphysema
      17. Pulmonary thrombo embolism
      18. Occupational lung diseases
      19. Tumors of the lung
      20. Diffuse fibrosing alveolitis
      21. Respiratory manifestations of systemic diseases
      22. Hyaline Membrane Diseases, Cystic Fibrosis Goodpasture�s syndrome
      23. Diseases of Mediastinum
      24. Diseases of chest wall
      25. Diseases of diaphragm
      26. Lung transplantation
    • Pulmonary function test
    • Spirometry
    • ICD

      Pleural biopsy

    • Arterial puncture
    • FNAC
    • Trucut lung biopsy
    • Clinical Case discussion    - twice a week
    • Journal Club    - Once a week
    • Subject Seminar    - once in 15 days
    • Mortality Meeting    - Once a month
    • A candidate 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 not absent himself/herself from work without valid reasons.
    • A list of teaching and learning activities designed to facilitate students acquire essential knowledge and skills outlined is given below. Depending on the facilities available, any or all of these methods may be employed. However, the activities for which details are given mandatory.
      1. Lecture :

        Lecture are to be kept to a minimum. They may, however, be employed for teaching certain topics. Lectures may be didactic or integrated.

        1. Didactic Lectures : Recommended for selected common topics for post graduate students of all specialties. Few topics are suggested as examples
          1. Bio-statistics
          2. Use of library,
          3. Research Methods
          4. Medical code of conduct and Medical Ethics
          5. National Health and Diseases Control Programmes
          6. Communication skill etc.

          These topics may preferable taken up in the first few weeks of the 1st year

        2. Integrated Lectures: These are recommended to be taken by multidisciplinary teams for selected topics, eg, Jaundice. Diabetes mellitus, Thyroid etc.
      2. Journal Club : Recommended to be held once a week. All the PG students are expected to attend and actively participate in discussion and enter in the log book relevant details. Further, every candidate must make a presentation from the allotted journal(s), selected articles at least four times a year and a total of 12 seminar presentation in three years. The presentation would be evaluated using checklist and would carry weightage for internal assessment (see checklist in chapter IV) time table with names o the students and the moderator should be announced at the beginning of the every year.


      3. Subject Seminar : Recommended to be held once a week. All the PG students are expected to attend actively participate in discussion and enter in the log book relevant details. Further, every candidate must present on selected topics at least four times a year and total of 12 seminar presentations in three years. The presentation would be evaluated using check lists and would carry weightage for internal assessment (See checklist in chapter IV) A timetable for the subject with names off the student and the moderator should be scheduled at the beginning of every year.
      4. Student Symposium : Recommended as an optional multi disciplinary programmed the evaluation may be similar to that described for subject seminar.
      5. Ward Rounds : Ward rounds may be service or teaching rounds.
        1. Service Rounds : Postgraduate students and Interns should do every day for the care of the patients. Newly admitted patients should be worked up by the PGs and presented to the seniors the following day.
        2. Teaching Rounds: Every unit should have �grand rounds� for teaching purpose. A diary should be maintained for day to day activities by the students.

        Entries of (a) and (b) should be made in the Log Book.

      6. Clinico :

        Pathological Conference : Recommended once a month for all post graduate students. Presentation is done by rotation. If cases are not available due to lack of clinical postmortems, it could be supplemented by published CPCs.

      7. Inter Departmental Meetings : Strongly recommended particularly with department of pathology and Radio-Diagnosis at least once a week. These meeting should be attended by post graduate students and relevant entries must be made in the Log book.
        1. Pathology : A dozen interesting cases may be chosen and presented by the post graduate students and discussed by them as well as the senior staff of surgery department. The staff of Pathology department would then show the slides and present final diagnosis. In the sessions the advance immuno-histo-chemical techniques, the burgeoning markers other recent developments can be discussed.
        2. Radio-diagnosis : Interesting cases and the imaging modalities should be discussed.
      8. Microbiology : Collection of specimen, AFB staining, Culture techniques and interpretation
      9. Work in PFT laboratory
      10. Teaching Skills : Post graduate students must teach under graduate students ( Eg. Medical, Nursing) by taking demonstrations, bedsides clinics, tutorials, lectures etc. Assessment is made using a checklist by surgery faculty as well students. ( See model checklist in chapter IV) . Record of their participation be kept in Log book. Training of post graduate students in educational science and technology is recommended.
      11. Continuing Medical Education Programmes (CME) : Recommended that at least 2 state level CME Programmes should be attende by each students in 3 years.
      12. Conferences : Attending conference is optional. However it is encouraged.
    • Rotation Postings
      1. In the parents department of TB and Respiratory Medicine - 26 months
      2. Department of Medicine 6 months
      3. ICCU 2 months
      4. Department of Radio-diagnosis 1 month
      5. Casualty 1 month

    It is essential to monitor the learning progress of each candidate through continuous appraisal and regular assessment. It not only also helps teachers to evaluate students, but also students to evaluate themselves. The monitoring be done by the staff of the department based on participation of students in various teaching/learning activities. It may be structured and assessment be done using checklists that assess various aspects. Checklist is given in chapter IV.

    The learning out comes; to be assessed should included (i) Personal attitude (ii) Acquisition of knowledge (iii) Clinical and operative skills (iv) Teaching skills and (v) Dissertations

      1. Personal Attitude : The essential items are
        • Caring attitude
        • Initiative
        • Organizational ability
        • Potential to cope with stressful situation and undertake responsibility
        • Trust worthiness and reliability
        • To understand and communicate intelligible with patients and others
        • To behave in a manner which establishes professional relationship with patients and colleagues
        • Ability to work it team
        • A critical enquiring approach to the acquisition of knowledge The methods used mainly consisted of observation. It is appreciated that these terms requires a degree of subjective assessment by the guide, supervisors and peers.
      2. Acquisition of knowledge : The methods used comprise of �Log book� which records participation in various teaching / learning activities by the students. The number of activities attended and the number in which presentation are made to be recorded. The log book should periodically be validated by supervisors. Some of the activities are listed. The list is not complete Institution may include additional activities , if so, desired.
        • Journal Review Meeting ( Journal Club) : The ability to do literature search, in depth study, presentation skills, and use audio-visual aids are to be assessed. The assessed is made by faculty members and peers attending the meeting using a checklist ( see Model Checklist-I Chapter-IV)
        • Seminars / Symposia : The topics should be assigned to the students well in advance to facilitate in depth study. The ability to do literature search, in depth study, presentation skills and use of audio-visual aids are to be assessed using a checklist ( see Model Checklist-II, Chapter IV)
        • Clinico-Pathological Conferences : This should be a multidisciplinary case study of an interesting case to train the candidate to solve diagnostic and therapeutic problems by using an analytical approach. The presenter(s) are to be assessed using a check list similar to that used for seminar.
        • Medical Audit : Periodic morbidity and mortality meeting be held. Attendance and participation in these must be insisted upon. This may not be included in assessment
      3. Clinical Skills :
        • Day to day work : Skills in outpatient and ward work should be assessed periodically. The assessment should include the candidates sincerity and punctuality, analytical ability and communication skills ( see Model Checklist III, Chapter IV)
        • Clinical Meetings : Candidate should periodically presents cases to his peers and faculty members. This should be assessed using a checklist ( See Model checklist IV Chapter IV)
        • Clinical and Procedural skills : The candidate should be given graded responsibility to enable learning by apprenticeship. The performance is assessed by the guide by direct observation particulars are recorded by the students in the log book ( Table No 3, Chapter IV)
      4. Teaching skills : Candidate should be encouraged to teach undergraduate medical students and paramedical students, if any. This performance should be based on assessment by the faculty members of the department and from feedback from the undergraduate students ( See Model Checklist V, Chapter IV)
      5. Dissertation in the Department: Periodic presentation are to be made in the department. Initially the topic selected is to be presented before submission to the University for registration, again before finalization for critical evaluation and another before final submission of the complete works ( see Model Checklist VI & VII Chapter IV)
      6. Periodic tests : The departments may conduct three tests, two of them be annual tests, one at the end of first year and other in the second year. The third test may be held three months before the final examination. The tests may include written papers Practical / clinical and Viva voce.
      7. Work diary / Log book : every candidate shall maintain a work diary and record his/her participation in the training Programmes conducted by the department such as journals reviews, seminars etc special mention may be made of the presentation by the candidate as well as details of clinical or laboratory procedures, if any conducted by the candidate.
      8. Records : Records logbooks and marks obtained in tests will be maintained by the head of the departments and will be made available to the University or MCI

    The logbook is a record of the important activities of the candidates during his training, Internal assessment should be based on the evaluation of the log book. Collectively, log books are a tool for the evaluation off the training Programmes of the institute by external agencies. The record includes academic activities as well as the presentation and procedures carried out by the candidate

    Format for the Log book for the different activities is given in table 1,2 and 3 of chapter IV. Copies may be made and used by the institutions

    Postgraduate student�s diary should include following activities:

    Format for PG Diary ( Log book )

    • Every department should have a committee to review such situations. The defaulting candidate is counseled by the guide and head of the department. In extreme cases of default the department committee may recommend that defaulting candidate be withheld from appearing examination. If she/he fails to fulfill the requirements in spite of being adequate chances to set himself or herself right.

      1. Cases seen on rounds � description of interesting cases and other miscellaneous topics discussed.
      2. Outpatient cases seen and details of interesting cases will follow up.
      3. Procedures done on inpatients and outpatients and consultation done.
      4. Undergraduate teaching done during the day details.
      5. PG training programmes attended � details of bedside clinic, basic sciences, subject and clinical seminars , journal clubs, mortality meet and hospital conference.
      6. Night duties � details of patients managed and emergencies , consultation. Ward calls attended.
      7. Details of study with topics covered during off hours in library / home. Periodicals and Journals reviewed with notes on interesting articles
      8. Medical meeting Seminars . Local API / CSI meeting or other interesting CME seminars attended.
      9. Diary should be reviewed on weekly basis by unit faculty and certified on monthly basis for PG �s benefit at the end of each medical/speciallity rotation. Faculty should comment regarding absences and irregularities (Late arrivals and early departure ) and make appropriate comment and suggest remedial measure for problematic prodigies.
      10. Size of note books: 15 cm with 200 pages. All note books should have seal of college and H.O.D�s approval: Extra note books may be utilized as and when necessary. Dairy should be presented at the time of University clinical exam for review by examiners as per University regulation.
      11. Procedure for defaulters: