Standard 4 - Curriculum Organisation

Standard 4 – Curricular Organisation

(Conforms to Standards 4.1, 4.2, 4.3, 4.4, 4.5, 4.6, 4.7, 4.1s, 4.2s, 4.3s and 4.4s)

 

General:

Medical Education in Pakistan is well regulated and its aims, conduct and outcomes all are in coordination with the policies of the Higher Education Commission (HEC), the Pakistan Medical & Dental Council (PM&DC) which is the regulating authority and the affiliating university which in the case of Avicenna Medical College is the University of Health Sciences (UHS).

 

As a consequence of this coordination and alignment, Avicenna Medical College has studied and achieved the implementation of the policy of Higher Education Commission (HEC) and also studied in detail the Medical Education Manual issued by the Pakistan Medical & Dental Council. However, the task is made much easier since the University, for the purpose of uniformity of its constituent colleges, has issued syllabus, table of specifications and specified the reading material and has prescribed/recommended the books on the subject. The University has laid adequate emphasis on the objectives, outcomes that are expected from an individual on graduation.

 

The Academic Council

Pakistan Medical & Dental Council accreditation standards in Regulations of 2012 vide clause 21 demands the existence of Academic Council with the primary task to determine Institutional Academic Policies, Curricular delivery techniques with the responsibility to determine and provide scenarios and appropriate patient access with clear learning objectives in each discipline. Academic Council shall function as a supervisory and oversight body. (Authority – The gazette of Pakistan of 26th January, 2012 Page 9)

 

Study Boards and Curriculum

Study boards and Curriculum Committee are required to be formed by the institution to ensure that there are mechanisms for direct Faculty involvement in decisions related to educational programs its delivery and evaluation. (Authority – The Gazette of Pakistan 26th January 2012 – Clause 22)

 

Curriculum Management and Delivery

The curriculum shall be as laid down by the Council. The institution shall be governed by the statutes, regulations, rules framed by the Council from time to time including general scheme of studies , duration of courses, the medium of instructions and' examinations, detailed syllabi for examinations and the condition under which students shall be admitted to examinations. (Authority – The Gazette of Pakistan 26th January 2012 – Clause 35)

 

Roles and Responsibilities

There is integrated institutional responsibility for the overall management, delivery and evaluation of the- curriculum and quality assurances. The Principal and the faculty shall ensure the effective delivery and implementation of the components of the curriculum and quality assurances. The Principal or Dean shall be provided sufficient resources and authority to fulfill this responsibility. (Authority – The Gazette of Pakistan 26th January 2012 – Clause 36)

 

Confidentiality of Student Record

It is the responsibility of the institution concerned to keep the student records confidential and available only to members of the faculty and administration on a need to know basis. Laws concerning confidentiality of record need to be kept in view. Students are to be allowed to review and challenge their records if there is a valid reason for it (Authority – The Gazette of Pakistan 26th January 2012 – Clause 37)

 

Academic Atmosphere

The program of MBBS and BOS education are to be conducted in an environment that fosters the intellectual Challenge and spirit of inquiry appropriate to a community of scholars. Institutions shall make available sufficient opportunities for MBBS and BDS students and faculty to participate in research and other scholarly activities including continuing medical and dental education and professional development programs .The faculty shall encourage and support student participation in these activities. (Authority – The Gazette of Pakistan 26th January 2012 – Clause 38)

 

The Curriculum Committee:

The curriculum affairs at Avicenna Medical College are managed, controlled, monitored and reviewed by the Curriculum Committee. The Committee consists of all the HODs of the Departments and is headed by the Principal of the College. The Curriculum Committee is composed of:

Sr.

Name

Designation

1

Prof. Dr. Gulfreen Waheed (MHPE)

Chairperson Committee

Principal & ME Expert

2

Prof. Dr. Rehana Shahid

HOD Anatomy

3

Prof. Dr. Binyamin Ahmed

HOD Physiology

4

Prof. Dr. Zubair Ahmed

HOD Biochemistry

5

Prof. Dr. Rubina Hafeez

HOD Pathology

6

Prof. Dr. Najma Naz

HOD Pharmacology

7

Prof. Dr. Zainab Perveen

HOD Forensic Medicine

8

Prof. Dr. Rana Muhammad Akhtar Khan

HOD Community Medicine

9

Prof. Dr. Luqman Ahmed

HOD Medicine

10

Prof. Dr. Mehmood Alam

HOD Surgery

11

Prof. Dr. Nuzhat Parveen Khwaja

HOD Obs & Gynae

12

Prof. Dr. Mariam Waheed

HOD Paediatrics

13

Prof. Dr. M. Ayub Khan

HOD ENT

14

Prof. Dr. Khalid Mehmood

HOD Ophthalmology

15

Assistant Prof. Dr. Fatima Aslam

HOD Behavioral Sciences / Psychiatry

 

Other Stakeholders:

Other members of the Faculty are also encouraged to give their feedback and the following members of the Faculty prefer to attend and are a part of the Curriculum Committee.

 

  1.  

Prof. Dr. Abdul Sami Qazi

HOD Radiology

  1.  

Assistant Prof. Dr. Abeer Fahad

HOD Dermatology

  1.  

Prof. Dr. Anayat Araen

HOD Anaesthesia

  1.  

Prof. Dr. Talat Bashir

HOD Orthopaedics

 

Since the curriculum is a set course, involving subject content, teaching & learning methods and assessments and the guidelines of the PM&DC and UHS are explicit so, the contents of the syllabus and curriculum are seldom changed. Therefore keeping itself in alignment with the directives of the PM&DC, Avicenna Medical College has adhered to the directives and has only made changes in the conduct of it in the form of interventions that in fact augment the wishes and desires of the PM&DC as well as UHS.


The General Practitioners’ Forum

The HEC and PM&DC guidelines vide their Clause-III lay emphasis on population health and health systems. The curriculum caters for informal learning that takes place through day-to-day interactions of the students with peers, teachers, colleagues, other health care providers and their patients and their families.

 

Avicenna Medical College being located at the artery of 65 villages has to receive, treat and refer medical emergencies. In most cases these emergencies are received from other healthcare providers in the area. Therefore, a liaison has to be maintained with these health services providers who are in all cases general practitioners.

 

The General Practitioners and especially those of affiliated clinics are associated with the formulations of the curriculum and the decisions on the educational contents. Three General Practitioners remain in the loop for consultation and are called to attend the Curriculum sessions as and when required. They are

  1. Dr. Zafar Wasi                                  Wasi Muhammad Hospital
  2. Dr. Faiza Rabbani Jawad                 Heir Surgical Poly Clinic
  3. Dr. Kamran Ahmed Butt                 Kamran Clinin - Lidher

 

The input by the general practitioners help to take into consideration issues of equality, equity and diversity. They are particularly helpful in enabling the curriculum committee to take decisions for healthcare using demography, biostatistics and epidemiology and they help in focusing the members of the faculty on matters most concerned to the area.

 

Curriculum Committee Meetings:

Meetings quorum is maintained with 75% attendance of committee members. Curriculum committee meetings are convened as required discussing issues pertaining to planning, implementation, timetable etc. The meetings are held at least once a year or more frequently if needed.

The Student Involvement:

Avicenna medical Colleges encourages the involvement of students especially feedback of students for the purpose of constant review and improvement. The students are involved at the following levels:

  1. Allocation of additional periods on the feedback of students for topics where development of concepts is difficult.
  2. Formulation of annual planner and the timelines for various grand tests and the session examinations.
  3. The timelines for the revision tests in consultation with the very good, the average and the weak students.
  4. The holding of directed self-study classes in the evenings to enable the students to develop their concepts in subjects they find difficult to understand.
  5. The availability of various technical aids, simulators and skills labs to enable the students to remain abreast with the latest developments and research.

Students’ Electives:

Avicenna Medical College, like all other colleges affiliated with the University of Health Sciences is following a traditional curriculum and there is little choice of the students to make any selection from the curriculum document. However, the college has endeavored to give the student latitude and to make a choice of the batch for the rotations for the clinical subjects in the final exams. Avicenna Medical College has already worked and awaits the enforcement of the integrated system which shall give the student an opportunity to select components that would be termed as his electives.

 

Study Guides:

Avicenna Medical College recognizes that sooner or later, it has to shift over to the integrated curriculum.  Study guides have already been formulated for the integrated curriculum. Linked in student section.

 

Standard Operating Procedures for Curriculum Committee:

Avicenna Medical College has developed standard operating procedures for the curriculum committee involving scope, role and TORs of the subject committee. It also outlines the selection and duties & responsibility of the Chair as well as the members and the system of attendance beside specifying the details of conduct of a curriculum committee session. 

 

Review & Information to Stakeholders:

The incorporation of the curriculum committee and other stakeholders and the importance given to the students on student feedback helps review of the curriculum and most importantly the conduct of the curriculum in the meetings.

 

Avicenna Medical College has an informal system of getting the feedback as any student can walk into the office of the Chairman and give his/her feelings about any difficulty without being identified as such. The Chairman ensures that the feedback from the student is passed on to the Principal who makes an assessment of the feedback provided and if need be, the issue is taken up in the Curriculum Committee Meeting for review and necessary action.

 

The Curriculum Committee since its incept has through series of meetings framed the method of conduct of the medical education for each department has been derived from the Curriculum provied by the HEC/PM&DC which can be found on the following link:

http://www.pmdc.org.pk/LinkClick.aspx?fileticket=EKfBIOSDTkE%3D

 

Rationale of Sequence and Concepts:

A perusal of above Syllabi of the First Prof, Second Prof, Third Prof, Forth Prof and Final Prof would show a rationale in the sequence in which the topics are covered and a clear provision of the opportunity for students to link concepts.

 

Systematic & Organized Learning:

A perusal of the table of specifications and allocation of periods as given for each Prof shows an element of integrated learning designed to make to organize the learning entirely systematic for the clinical sciences.

 

It can be seen that various departments are teaching their subject in a manner that it revolves around the same topic. Each department contributing their aspect to the topic under study.

 

Vertical & Horizontal Integration:

The University of Health Sciences have taken care ensure vertical and horizontal integration of each subject. The study of the subjects in first prof is added to and built upon in second prof. The subjects of the third prof, together with the additional element of clinical classes achieve a logical mix for the vertical and horizontal integration. It can also be perused that the advent of two clinical subjects of Eye and ENT in the fourth prof along with the added clinical evening classes achieves a gradual conversion from the study of the basic sciences to that of the clinical sciences.

 

Allocations & Priorities – Basic / Clinical Ratio 50% Each:

Avicenna Medical College has taken care to abide by the allocation of priorities and periods to topics as specified by the University of Health Sciences in the table of specifications. Nearly 50% of the periods of allocated for clinical study. Avicenna Medical College has gone a step ahead by organization evening clinical classes in the hospital in addition to the allocations made through the University guideline. Thus nearly 55 to 60% of the total number of hours available through programed and evening classes, are allocated to clinical sciences. Avicenna Medical College has been selected one of the colleges to implement the integrated curriculum from session 19-20. The college is in regular communication and coordination with the University of Health Sciences and the probable allocation of hours for each subject are as follows:

  1. Anatomy – 500 hours
  2. Physiology – 500 hours
  3. Biochemistry – 200 hours
  4. Pharmacology – 300 hours
  5. Pathology – 500 hours
  6. Forensic Medicine – 100 hours
  7. Community Medicine – 270 hours including 120 hours for research methodology
  8. ENT – 150 hours
  9. Ophthalmology – 150 hours
  10. Gynaecology & Obs – 300 hours
  11. General Surgery – 600 hours
  12. Anaesthesia – 50 hours
  13. Orthopaedics – 100 hours
  14. Allied Surgical Departments – 150 hours
  15. General Medicine – 550 hours including 50 hours of Family Medicine
  16. Allied Medicine – 200 hours for
    1. Paediatrics Cardiology
    2. Neonatology
    3. Endocrinology
    4. Rheumatology
    5. Stroke Medicine
    6. Medical Oncology
    7. Clinical Haematology
    8. Geriatrics
    9. Acute Medicine
  17. Psychiatry / Behavioral Sciences – 250 hours to include communication skills, medical ethics, professionalism and leadership and management skills
  18. Emergency & Trauma – 50 hours
  19. Dermatology – 50 hours
  20. Cardiology – 50 hours
  21. Pulmonology – 50 hours
  22. Nephrology – 50 hours
  23. Neurology – 50 hours
  24. Gastroenterology – 50 hours
  25. Paediatrics – 200 hours
  26. Islamiyat and Pakistan Studies – 15 + 15 hours
  27. Patient Safety Curriculum – 25 hours
  28. Infection Control – 25 hours
  29. Self-directed learning – 500 hours

The above allocation becomes 6000 credit hours. However besides this the holding of evening study support classes and the classes for the weak students are additional. The hours allocated to the clinical classes and teaching are a little over 50%.

 

Allocations for Traditional Curriculum:

Pakistan Medical & Dental Council has clearly specified the allocation of periods for the traditional curriculum. This has been done subject wise and year wise. The following allocations have been made:

  1. Anatomy                                                                                           500 hrs
  2. Physiology                                                                                         500 hrs
  3. Biochemistry                                                                                     200 hrs
  4. Pharmacology                                                                                   300 hrs
  5. Pathology                                                                                          500 hrs
  6. Forensic Medicine                                                                             100 hrs
  7. Community Medicine                                                                         250 hrs
  8. Medicine & Allied to include Emergency Medicine,                           820 hrs

Medicine Elective, Psychiatry, Dermatology & General

Practice with an element of nuclear medicine

  1. Behavioral Sciences                                                                          25 hrs
  2. Paediatrics                                                                                        150 hrs
  3. Surgery & Allied to include Radiology, Orthopaedics                        840 hrs

Paeds Surgery, Neurosurgery, Surgery Elective, Emergency

Surgery and Anaesthesia

  • Gynae & Obs                                                                                    300 hrs
  • Ophthalmology                                                                                 100 hrs
  • ENT                                                                                                   100 hrs
  • Clinico-Pathological Conferences                                                      60 hrs
  • Islamiyat & Pakistan Studies                                                              50 hrs

 

Year Wise Distribution of Hours:

PM&DC directive seeks to have a fine mix of various subjects which progress from basic sciences to clinical sciences and from study of theory to the practical handling of patients with the involvement of technology, training aids, simulators and availability of dedicated teaching / study material available at the college website www.avicennamch.com and digital library digital.avicennamch.com. The year wise distribution of hours as given in Para 20 is as under.

  1. 1st year                                   740 hrs
  2. 2nd year                                 790 hrs
  3. 3rd year                                  1060 hrs
  4. 4th year                                  1265 hrs
  5. 5th year                                  940 hrs

Note: Please note that in the final year, the instructions in the form of lectures etc. are grossly reduced and all the time is made available for clinical hands-on study.

 

Theory & Practical

  1. The HEC and PM&DC co-prepared syllabus and guidelines for MBBS classes. Have distributed the subjects, instructional contents into theory and practical learning. The table is attached with PM&DC document already attached as Annex-V. In that the distribution is as under.

Type of Subject

Theory Content

Practical Skills Content

All Basic Sciences

50%

50%

Pre-Clinical Sciences

(Pharmacology and Therapeutics, Forensic Medicine, Community Medicine, Pathology)

40%

60%

Clinical Sciences

30%

70%

Internship / Housejob

0%

100%

 

Note: The above indicate that 70% of the emphasis is on practical skills and only 30% periods are allocated for theory. Page 119 of curriculum for MBBS issued for PM&DC.

 

Outcome Based Concept – Skills determine confidence at graduation:

The most important element of medical education is that it has to be based on outcomes and the achievement of which should give a fresh graduate the confidence of the skills that he attains at the end of the program. For this purpose, excessive use of technology, training aids, videos are used and skilled classes held in the skills lab of the college and additionally in that of the Obs & Gynae Department to give the confidence in the student in his clinical skills. Thus the knowledge, skills and attitude all combine to give the confidence to a graduate in his ability to handle the patient effectively. List of Skills taught to the students are appended in the college Skills book.

 

Patient Centered:

The curriculum designed by the UHS has ensured that the curriculum is centered around the patient. As per the contents and conduct of the curriculum the patient is given priority over everything else.

 

Avicenna Medical College takes pains in producing ethical doctors who are taught to deal with human beings and not carriers of disease. This helps the doctor to acquire a habit of taking holistic care of the patients.

 

Community, Health & Disease Relevant:

The syllabus and the table of specification design, development and conduct achieve the much cherished requirement of making the curriculum relevant to the community. It also achieves promotion of health and prevention of disease.

 

Innovative Learning Methodology:

The curriculum achieves the much desired self-directive learning, independent learning and learning that heal to connect each prof with the next one. A free use of technology, wifi, internet browsing, simulators, CDs, videos and the availability of Avicenna Medical College digital library at http://digital.avicennamch.com/ which enables the students to have optimum learning due to the multiple use of resources.

 

An exclusive feature of innovative teaching is the system of Pink list that has been innovated at Avicenna medical College alone. The performance of the students is monitored very closely and continued weak performance makes the student liable to becoming a part of Pink list. The students in this list have to attend 2-3 hours of lectures/self-study every evening till such time that they make up for the weaknesses they have suffered from. The system of evening classes has gone a long way in the achievement of good results by the college.

 

Interactive Conduct of Classes:

Avicenna Medical College lays a lot of emphasis on personal and eye contact and has achieved a reasonable mix of the lectures, tutorials and small group discussions. The students are given an opportunity to learn through interactive sessions involving thought provoking scenarios. The students are encouraged to do their own original thinking and interactivity is encouraged.

 

Passage of Information – Prospectus / Website:

Avicenna Medical College prospectus and the website http://www.avicennamch.com are an efficient media in the passage of information about various academic activities held at the college. These include:

  1. The grand tests
  2. Revisions tests
  3. Session examination
  4. Send-up examination
  5. Prof examination

 

The importance of each of the above is made available in the prospectus and at the website to emphasis the importance of each academic activity and the benefit or penalties that the students are likely to face in case adequate focus is not placed on Medical Education.

 

Research Management:

The department of Community Medicine has research on community health problems as a vital component of their education. Students are given complete know-how on how to carry out and manage research projects. This research is carried out in a group of five and students are encouraged to apply their innovations and management skills.

 

Community Visits:

Avicenna Medical College through its department of Community Medicine arranges weekly community visits for the fourth prof students. The class is divided into three groups and three different community healthcare establishments are visited in rotations. These visits, which are supervised by the senior faculty of the department, usually involve community healthcare projects where the students visit any of the following amongst others:

  1. BHU
  2. THQ
  3. DHQ
  4. Family Planning Centers
  5. Immunization Centers
  6. Mother & Child Vaccination Centers
  7. Drug Testing Labs
  8. Pharmaceutical Manufacturing Companies
  9. Clinical Labs
  10. Water Projects
  11. Sewerage Projects
  12. Visit to Blood Transfusion centers

 

Adequate Provision of Equipment:

Avicenna Medical College has not confined itself to the numbers and type of equipment specified in the criteria of 2018 or 2019. In fact the college and the hospital bear far more equipment than recommended. The essence has been that imparting of quality education and provision of quality healthcare should be the basis that decides that how much of equipment the college shall hold. The college as well as the hospital runs with surplus equipment.