ZagazigUniversity - Faculty of Medicine
Department of ( )
Course specifications
(pediatric medicine)
Medical Doctorate
Academic year( 2012 / 2015 )
approved( )
Programme (s) on which the course is given:pediatric medicine
Major or minor element of Programmes:pediatrics medicine
Department offering the course:pediatric department
Academic year/level:2012 / 2015
Date of specification approval: new date
Course director: Chairman Prof. Dr. / : Mohammed Badr
Course Coordinator:
A- Basic information:
Title: MD degree of pediatrics Code: PMMD
Course duration: 36 months ( the minimum).
Total teaching hours: 2392 hrs
Lectures: 736 hrsClinical/small group sessions: 1656hrs
Allocated marks:.500
Teaching staff:
I. AIMS OF THE COURSE:
- To provide competencies , knowledge and skills pertaining to pediatrics that are required to be practiced in the community and at all levels of health care system
- To make the candidate familiar with the fields of Pediatrics subspecialties to enable them to participate as team members in the care of patients with acute,chronic and complex disorders.
- To recognizes the health needs of infants, children and adolescents and carries out professional obligations in keeping with principles of National Health Policy and professional ethics;
- To be aware of the contemporary advances and developments in medical sciences as related to child health
- To continue to strive for excellence by continuing medical education throughout his other professional career.
- To enable the development and application of appropriate professional attitudes, communication and problem solving skills.
- Be competent in handling social and ethical issues related to the patient and his/her family
- To develop competence in basic concepts of research methodology and epidemiology
- To be Able to take the lead and accept leadership from other members of the multi-disciplinary team
10. To play the assigned role in the implementation of national health programs, effectively and responsibly
- To acquireskills in educating medical and paramedical professionals.
II. INTENDED LEARNING OUTCOMES:
A-Knowledge and Understanding:
By the end of the course, the postgraduate students should be able to:
A-1 Identify the importance of child health in the context of the health
priority of the country.
A-2 Describe normal growth and development during infancy, childhood and
adolescence.
A-3 Describe appropriate management for abnormalities affecting growth and
development.
A-4 Demonstrate and understanding the impact of congenital and inherited
diseases on children and their families.
A- 5Determine the nutritional requirements and the most common nutritional
disorders affecting infants and children, and describe appropriate
management for disorders.
A- 6 Identify the metabolic adaptation to post-natal life and be
able to managethe treatment of newborn infants with metabolic problems.
A- 7 Identifythe screening program and management of inborn errors
of metabolism.
A- 8 Identify the unique features of neonatal immunity and pathogenesis of
perinatal / neonatal infection.
A- 9 Mention the factors affecting post-natal growth, in particular, in
the pretermbaby, including breast feeding, composition and use of
neonatal formulae andsupplements.
A-10 Describe in details and manage different hematology / oncology problems.
A- 11Identify the appropriate diagnostic tools and therapeutic lines for the common neonatal and Pediatric problems.
A- 12Mention different pediatric emergencies and how to manage.
A-13 Describe the indications, contraindications, administration and precautions of the immunizations necessary for infants and children according to the national schedule and the condition of the child.
A- 14 identify the most important behavioral and social issues during childhood and adolescence.
A- 15Describe appropriate measures for health promotion as well as prevention of disease and injury in infants, children and adolescents.
A- 16Mention and defferentiate different renal , cardiovascular and endocrine disorders and describe management protocols.
A- 17 Identify basics of ethics, medico legal aspects of health problems,
malpractice and common medical errors.
A- 18 Identify different neurological and psychological problems and how to deal with.
A-19 Identify normal and abnormal chromosomal patterns and mode of inheritance together with common genetic disorders.
A – 20 Describe different gastrointestinal and hepatic disorders , underlying pathogenesis and how to diagnose and manage.
A-21 identify social, economic, environmental, biological and emotional determinants of child and adolescent health, rehabilitative, preventive and promotive measures to provide holistic care to children.
A-22Describe the appropriate diagnosis and manage chronic problems that require tertiary care.
B-Intellectual Skills:
By the end of the course, the postgraduate students should be able to:
B-1 Make decisions regarding common clinical situations using appropriate problem solving skills.
B-2 Construct appropriate management strategies for patients with common diseases, both acute and chronic, including medical, psychiatric, and surgical conditions.
B-3 Integrate the results of history, physical and laboratory test findings into a meaningful diagnostic formulation.
B-4 Design an initial course of management for stabilization of patients with serious illness.
B-5 Retrieve, analyze, and evaluate relevant and current data from literature, using information technologies and library resources, in order to help solve a clinical problem based on evidence (EBM).
B-6 Recognize and cope with uncertainty that is unavoidable in the
practice of medicine by accepting and reacting to uncertain situation through proper counseling ,consultation and referral.
B-7 Classify factors that place individuals at risk for disease or injury, to determine strategies for appropriate response.
B-8 Involvement into research and scientific methods through:
a. Formulation of research questions that is pertinent to medicine.
b. Recognition of the importance of precision in collecting, analyzing and interpreting medical data.
C- Professional and Practical Skills:
By the end of the course, the postgraduate students should be able to:
C-1 Understand and respect the different cultural beliefs and values in the community they serve.
C-2 Recognize one’s own limitations of knowledge and skills and refer patients to appropriate health facility at the appropriate stage.
C-3 Check vital signs in neonates, infants, children and adolescents.
take detailed history, perform full physical examination including neuro-development and behavioral assessment and anthropometric measurements of the child and make clinical diagnosis
C-4 Identify abnormal growth patterns and Interpret data obtained by anthropometric measurement and developmental assessment.
C-5 Assess nutritional status and determine if the child is getting adequate nutrition.
C-6 Provide nutritional advice for newborn babies, infants, children and adolescents.
C-7 perform relevant investigative and therapeutic procedures for the pediatric patient;
C-8 interpret important imaging and laboratory results;
diagnose illness in children based on the analysis of history, physical examination and investigate work up;
C-9 Discuss the differential diagnosis of symptoms, signs and presentations in neonates, infants, children and adolescents.
C-10 plan and deliver comprehensive treatment for illness in children using principles of rational drug therapy;
C-11 plan and advise measures for the prevention of childhood disease and disability;
C-12 manage childhood emergencies efficiently;
C-13 provide comprehensive care to normal, ‘at risk’ and sick neonates;
C-14 demonstrate skills in documentation of case details, and of morbidity and mortality data relevant to the assigned situation;
C-15 identify the emotional and behavioral characteristics of children, and keep these fundamental attributes in focus while dealing with them;
C-16 demonstrate empathy and humane approach towards patients and their families and keep their sensibilities in high esteem;
C-17 Plan & decide upon and interpret appropriate cost effective investigation.
C-18 Perform, resuscitate and stabilize children in Pediatric or Neonatal emergencies.
C-19 Learn procedures directed both towards therapeutic and diagnostic purposes e.g., bone marrow, lumbar puncture etc
C-20 Perform efficiently different invasive maneuvers as endotracheal, chest tubes, intraosseous, umbilical and central lines.
C-21 Interpret different diagnostic tools such as radiological, ECG, and other laboratory investigations and how to implement these data in the diagnosis, management and follow up of cases.
C-22 Perform proper counseling of patients and families.
C-23 function as a productive member of a team engaged in health care, research and education.
D- General and transferable skills
D-1 Be prepared for the lifelong learning needs of the medical profession.
D-2 Use information and communication technology effectively in the
field of medical practice.
D-3 Retrieve, manage, and manipulate information by all means,
including electronic means.
D-4 Present information clearly in written, electronic and oral forms.
D-5 Communicate ideas and arguments effectively.
D-6 Analyze and use numerical data including the use of simple statistical methods.
D-7 Manage time and resources effectively and set priorities.
D-8 work efficiently within the health care team.
D-9 solve problems related to patients, work management and among colleagues.
D-10 cope with changing work environment.
D-11 apply safety and infection control measures during practice.
D-12 evaluate their work and that of others using constructive feedback
III. COURSE CONTENTS:
I) Growth and Development
Normal pattern and factors affecting growth and development. Recognition of
Normal variants of growth and development.
Developmental assessment in infancy and childhood.
Physiological changes during adolescence and problems facing adolescents.
Assessment of growth.
Deviations from normal patterns of growth and development: Recognition,
Prevention, Early intervention and Management.
Tools for assessment of growth and development at various ages including Indian adaptations.
II) Nutrition
Understanding of energy balance in humans.
Basic biochemistry of proteins, carbohydrates and fats.
Proximate Principles, Vitamins, Minerals and Micronutrients: Biochemistry,
Physiological Functions, Daily Requirements, Manifestations and Management of
deficiency and excess states.
Normal requirement of protein, fat, carbohydrate for newborns, children,and Adolescents.
Breastfeeding and lactation management
Infant feeding and weaning foods.
Balanced diet.
Assessment of nutritional status.
Nutritional disorders-Etiology, Clinical features, patho-physiology, pathogenesis
and management
Pathological features of various nutritional disorders.
Planning of diet during illness.
Total parental nutrition.
III) Fluids and Electrolytes
Pathophysiology of body fluids, fluid therapy, electrolytes, acid-base balance, parenteral and enteral fluid therapy
IV) Emergency pediatric services
Pediatric resuscitation
Evaluation of critically ill child.
Pediatric Emergencies and poisoning.
Pediatric injuries and injury control and accidents.
Insect, animal and snakebites.
Planning and management of pediatric intensive care unit
Anesthesia, perioperative care and pain management.
Principles of drug therapy.
V) Genetics
Principles and molecular basis of genetic disorders.
Clinical features and management of genetic and chromosomal disorders.
Prenatal diagnostic techniques and neonatal screening tests.
Effects of teratogenic agents.
Genetic counseling.
Gene therapy.
VI) Metabolic diseases
Metabolic diseases of protein (amino acids), carbohydrates, fats, mucopolysaccharides,
purines, pyrimidines, heme and others
VII) Neonatology: The fetus and neonatal infant
High-risk pregnancy
Assessment of fetal growth, wellbeing and maturity.
Fetal distress: Manifestation, identification and management
Maternal diseases and their effects on the fetus and newborn.
Assessment of fetal wellbeing.
Identification and management of various fetal diseases.
High-risk infant – identification and management.
Delivery room emergencies, resuscitation of newborn and care of normal new born.
Birth injuries.
Adaptation of newborn.
Examination of newborn and assessment of maturity.
Etiology, clinical features, pathophysiology, pathogenesis and management of various diseases of newborn.
Neonatal transport.
Neonatal procedures.
Developmental assessment and early intervention programmes for infants at high risk for developmental delay.
Care of newborn in the community.
Planning and organization of level I, level II, Level III Neonatal care centers.
VIII) Infectious diseases
Clinical features, management of viral, bacterial, fungal, spirochetal, rickettsial, parasitic, protozoal and other infections.
Prevention and management of nosocomial infections.
Infection control and preventive measures.
Immunization against infections diseases.
Fever
Laboratory techniques for diagnosis of infections diseases.
Infections in immunocompromized host.
Clinical syndromes caused by various infections agents.
IX) Immunological system and its disorders
Components of immune system and their functions.
Disorders of immune system – Etiology, Clinical features, pathophysiology,
Pathogenesis and management.
Pharmacotherapy.
Transplantation medicine.
Allergic diseases – etiology, clinical features, patho-physiology, pathogenesis and management.
Relevant diagnostic and therapeutic modalities in various immunological and allergic disorders.
X) Rheumatic diseases and connective tissue disorder of childhood.
Etiology, pathogenesis, manifestation, laboratory diagnosis and management of Rheumatic diseases and connective tissue disordersin childhood and adolescents
XI) Respiratory system
Development of respiratory system, congenital anomalies.
Physiology of respiration and mechanics of ventilation.
Etiology, clinical features, pathophysiology, pathogenesis and management of
various respiratory diseases.
Pathological features of various respiratory diseases.
Relevant diagnostic and therapeutic modalities in respiratory diseases in children.
Pharmacotherapy of respiratory diseases.
XII) Cardiovascular system
Embryology of heart and vascular system.
Adaptations of cardiovascular system at and after birth.
Etiology, pathophysiology, pathogenesis, clinical features and management of congenital and acquired heart and vascular diseases and rheumatic heart disease.
Rheumatic fever – Epidemiology, clinical features, pathophysiology, pathogenesis, prevention and management.
Relevant diagnostic and therapeutic modalities in heart diseases in children.
Congestive cardiac failure – Etiology, pathophysiology, pathogenesis, clinical features and management.
Pharmacotherapy of cardiovascular diseases.
XIII) Gastrointestinal tract
Development of gastrointestinal tract, hepatobiliary system and their abnormalities.
Physiology of digestion.
Etiology, pathophysiology, pathogenesis, clinical features and management of various gastrointestinal and hepatobiliary and other abdominal diseases.
Pathological features of gastrointestinal, hepatobiliary and pancreatic disorders.
Surgical emergencies in gastrointestinal tract diseases.
XIV) Hematology and Neoplastic diseases
Physiology of erythropoiesis, leukopoiesis and physiology of hemostasis.
Etiology, pathophysiology, pathogenesis, clinical features and management of hematological and oncological diseases.
Laboratory diagnosis and other relevant diagnostic and therapeutic modalities in hematological and oncological disorders.
Pharmacotherapy of Hematological and Oncological Diseases.
Component therapy in Pediatric Practice.
XV) Nephrology and genitourinary tract
Development and developmental anomalies of the kidneys and the genitourinary tract.
Physiology of urine formation and metabolic functions of the kidney.
Etiology, pathophysiology, pathogenesis, clinical features and management of various disorders of the kidney and the genitourinary tract.
Pathological features of diseases of the kidney and genitourinary tract.
Relevant diagnostic and therapeutic modalities for diseases of the kidney and the genitourinary tract.
Pharmacotherapy of renal and genitourinary disorders.
Management of end stage renal disease.
XVI) Central and peripheral Nervous System
Development of the brain, spinal cord and peripheral nervous system and their anomalies.
Neurological evaluation of newborns, infants and children.
Etiology, pathophysiology, pathogenesis, clinical features and management of various diseases affecting central nervous system and peripheral nervous system.
Seizures in childhood.
Neuromuscular diseases – etiology, clinical features, pathophysiology and management.
XVII) Endocrine system
Synthesis, physiological functions and pharmacological actions of various hormones.
Disorders of the endocrine glands.
Pubertal development and its disorders.
XVIII)Psychological Behavioral manifestations disorders
Identification and assessment of Psychological and behavioral disorders.
Intervention and management strategies for Psychological and behavioral disorders.
XIX) Congenital and acquired disorders of eye, ear, nose, throat, bones and joints.
XX) Miscellaneous diseases
Unclassified diseases including SIDS, Sarcoidosis, Progeria histiocytosis, chronic fatigue syndrome.
Metabolic bone diseases.
Genetic skeletal dysplasias.
III-A) THEORETICAL TOPICS:
TOPIC / No. of hours / % Total hoursLectures / Practical/ small groups / TOTAL
1 / Nutrition and Infection / 48 / 108 / 156 / 6.5
2 / Respiratory system / 48 / 108 / 156 / 6.5
3 / Cardiovascular system / 48 / 108 / 156 / 6.5
4 / Gastrointestinal tract / 48 / 108 / 156 / 6.5
5 / Hematology and Neoplastic diseases / 48 / 108 / 156 / 6.5
6 / Nephrology and genitourinary tract / 48 / 108 / 156 / 6.5
7 / Central and peripheral Nervous System / 48 / 108 / 156 / 6.5
8 / Endocrine system / 48 / 108 / 156 / 6.5
9 / Immunological system and its disorders / 48 / 108 / 156 / 6.5
10 / Genetics and metabolism / 48 / 108 / 156 / 6.5
11 / Neonatology / 48 / 108 / 156 / 6.5
12 / Emergency pediatric / 48 / 108 / 156 / 6.5
13 General pediatrics / 160 / 360 / 520 / 22
TOTAL / 736 / 1656 / 2392 / 100( %)
III-B)CLINICAL /PRACTICAL TOPICS:
Growth and development :
_ precocious and delayed puberty _ developmental delay
_ impaired learning
3.2.2 Neonatology :
_ normal newborn _ low birth weight newborn
_ sick newborn
3.2.3 Nutrition :
_ lactation management and complementary _ protein energy malnutrition
feeding (underweight, wasting, stunting)
_ failure to thrive and micronutrient deficiencies
3.2.4 Cardiovascular :
_ murmur _ cyanosis
_ congestive heart failure _ systemic hypertension
_ arrhythmia _ shock
3.2.5 GIT and liver :
_ Acute diarrhea _ persistent and chronic diarrhea
_ abdominal pain and distension _ ascites
_ vomiting _ constipation
_ gastrointestinal bleeding _ jaundice
_ hepatosplenomegaly _ hepatic failure and encephalopathy
3.2.6 Respiratory :
_ Cough/chronic cough _ noisy breathing
_ wheezy child _ respiratory distress
_ hemoptysis
3.2.7 Infections :
_ acute onset pyrexia _ prolonged pyrexia with and
_ recurrent infections _ without localizing signs
_ nosocomial infections
3.2.8 Renal :
_ Hematuria/dysuria _ bladder/bowel incontinence
_ voiding dysfunctions _ renal failure (acute and chronic)
3.2.9 Hematoncology :
_ lymphadenopathy _ anemia
_ bleeding
3.2.10 Neurology :
_ limping child _ convulsions
_ abnormality of gait _ paraplegia, quadriplegia
_ macrocephaly & microcephaly _ floppy infant
_ acute flaccid paralysis _ cerebral palsy and other
_ headache neuromotor disability
3.2.11 Endocrine :
_ thyroid swelling _ ambiguous genitalia
_ obesity _ short stature
_ precocious &delayed puberty
3.2.12 Skin/Eye/ENT :
_ skin rash _ pigmentary lesions
_ pain/discharge from ear _ hearing loss
_ epistaxis _ refractory errors
_ blindness _ cataract
_ eye discharge _ redness
_ squint _ proptosis
3.2.13 Miscellaneous :
_ habit disorders _ hyperactivity and attention deficit
_ arthralgia syndrome
_ arthritis _ multiple congenital anomalies
3.3 Skills
3.3.1 History and examination :
_ history taking including psychosocial history
physical examination including newborn examination, including gestation examination
assessment _ assessment of growth
_ nutritional anthropometry and its assessment _ use of growth chart
_ SMR rating _ developmental evaluation
_ full systemic examination _ health functionaries and social
_ communication with children parents support groups
_ genetic counseling
3.3.2 Bedside procedures :
Therapeutic skills :
_ hydrotherapy _ nasogastric feeding
_ endotracheal intubation _ cardiopulmonary resuscitation
_ administration of oxygen (pediatric and neonatal)
_venepuncture and establishment of vascular _ administration of fluids, bloodaccess
blood components
_ parenteral nutrition _ intraosseous fluid administration