Dr Adel Bondok

Mansoura-Manchester Programme

for Medical Education

Adel Bondok, PhD

Phase 1 Director

:

Phase 1 Semesters & Chief Tutors

Working Week

Brief Curriculum of Phase 1

Methods of Assessment

Classical Week Time Table

Semester Plan: cases and ILOs

Dr Adel Bondok ®

Semester 1: Foundation

Semester 2: Life cycle

Semester 3: Cardio-Respiratory Fitness

Semester 4: Abilities & Disabilities

Semester 5: Nutrition & Metabolism

Semester 6: Tropical & Community Medicine

Sem 1, 3 & 5: run from Sep - Jan

Sem 2, 4 & 6: run from Feb - June

Semester 1: Prof Amal Mustafa (Histology)

Semester 2: Prof Ghada Meghawry Elnady (Microbiology)

Semester 3: A Prof Nisreen Abo-elmaaty (Physiology)

Semester 4: A Prof Dalia Saleh (Anatomy)

Semester 5: A Prof Amany Abdelmageed (Biochemistry)

Semester 6: Prof Mohamed El-Farash (Microbiology)

Dr Adel Bondok ®

Dr Adel Bondok ®

• General anatomy • General embryology

Anatomy

• General histology Histology • Blood, Kidney, Calcium homeostasis • Digestion and absorption, Muscle & nerve • Control of blood sugar • Cardiac cycle & physiology of heart attack

Physiology

• Carbohydrates, Proteins & Lipids • Chromosomes and genes • Replication, Translation, Transcription • Vitamines & Minerals …. Others

Biochemistry

• Healing of skin wounds Pathology • Types & differences of human races Forensic Med

• Concept of epidemiology of diseases Community Medicine

• Types and complication of diabetes • Imaging: digestive & respiratory systems Clinical

Dr Adel Bondok ®

• Upper limb and Lower limb • Pelvis and perineum Anatomy • Respiratory System, Skin, • Breast, FGT, MGT • Pancreas, Spleen , Lymph nodes

Histology

• Pregnancy, labour, puberty, menopause • Aging & Reproduction • Hormones, Short stature • Osteoporosis

Physiology

• Pharmacokinetics & Pharmacodinamics • Drugs and pregnancy; Drugs and lactation • Polypharmacy & geriatrics; Drug genetics • Antiviral Drugs; Anticancer Drugs

Pharmacology

• General pathology Pathology

• General microbiology, virology, mycology • Immunology, SL, RA • Antibiotics, Sensitivity, Media, Gram stain

Microbiology

• Epidemiology of breast cancer Community Medicine

• Genetics of Down Syndrome, Thalassemia,

• Growth charts , Mendelian Inheritance

• Classification & Staging of breast cancer

• Breast cancer genetics

• In utero diagnosis of disorders

• Methods of contraception

• Imaging during pregnancy

• Imaging of breast cancer

• Cognitive development

• Psychological development of adolescence

• Phobias

• Psychological impact of chronic illnesses

Clinical:

Pediatrics

Surgery

Obs & Gyn

Psychiatry

Dr Adel Bondok ®

• Thorax Anatomy

• Revision of airways • Arteries & veins Histology

• Respiration, COPD • Circulation, Heart sounds • Coronary BF, Regional BF, ECG • Haematopoiesis, Blood transfusion • Acid base balance, Hemostasis

Physiology

• Asthma , COPD & Pneumonia, TB • Anemia, HF, Hypertension, Angina & MI • Fluid replacement therapy

Pharmacology Therapy of:

• Asthma , COPD & Pneumonia, TB

• Thromboembolic disorders, Atherosclerosis

• Anemias, Rheumatic fever, Angina & MI Pathology

• Asthma, Smoking, TB (+ microbiology) • Rheumatic fever, CHD, Hypertension

Community M Epidemiology of:

• Effect of obesity on CVS

• Heart sounds; ECG of angina and MI

• Hypoxia & cyanosis; Basic life support

• Interpretation of:

• 1. Normal chest X-ray

• 2. Pneumothorax X-ray

• 3. Emphysema X-ray

• Apathy of bystanders

• Basics of consciousness

• Posttraumatic stress disorder

• Psychosomatic disorders; Informed consent

• Consent to treatment in unconscious patients

• Adherence to therapy

• Language barrier

Clinical:

Cardiology

Chest

Psychiatry

Dr Adel Bondok ®

• Neuroanatomy • Head and Neck

Anatomy

• Neurohistology Histology

• Neurophysiology Physiology

• Local anesthetics; Analgesics • Anti-Parkinson’s drugs; Drug dilution • Treatment of drug and alcohol abuse • Effect of drugs on the eye

Pharmacology

• Neural tube defects

• Demyelinating disease Pathology

• Multiple sclerosis, Drug & alcohol abuse • Socioeconomic consequences of disabilities and chronic pain

Community M Epidemiology of:

• Depression & control of chronic pain

• Models of disability & their management

• Use of appropriate language when discussing chronic illness & disability

• Attention & its role in information processing

• Psychological consequences of hearing loss

• Psychological consequences of stroke

• Coping strategies with severe illness

• Quality of life in Parkinson's disease

• Psychology of motivation and emotions

• In utero diagnosis of neural tube defects

• Otoscope, Audiogram, Tonsillitis, Otitis media

• Rehabilitation

• Using of ophthalmoscope; Strabismus

Clinical:

S4

Psychiatry

Obs & Gyn

E.N.T.

Rheumatol

Ophthalmol

• Neural tube defects.

• Cranial nerve examination

• Cerebro-vascular stroke

• Upper & lower motor neuron lesion

• Neurological examination

• Cerebellar diseases

• Parkinson’s disease

• EMG

• Spina bifida

• Low back pain

• Management of head trauma

S4

Clinical:

Neurology:

Neurosurgery:

Dr Adel Bondok ®

• Abdomen, Oral cavity, Salivary glands • Esophagus, Thyroid gland

Anatomy • GI tract and accessory organs • Thyroid g, Kidney, U bladder, Prostate

Histology • Saliva & swallowing; GIT and digestion • Liver Functions, Nutrition; • Glucose homeostasis & insulin action • Functions of the Kidney, Bladder & Prostate • Thyroid Gland; Regulation of body temp.

Physiology

• Digestion, Absorption & Metabolism of carbohydrates, Proteins & Lipids

• Mechanism of hormonal action • Tumor markers; Detection of glucose

Biochemistry

• Swallowing disorders; Peptic ulcer

• Malabsorption syndrome

• General path of tumors; Tumors of intestine

• Hepatitis; Bilharziasis

• Glomerular disease & Prostatic enlargement

Pathology

• Virology of viral hepatitis • Parasitology of Bilharziasis Micro & Para

• Drugs of peptic ulceration • Basic concepts of Tumor chemotherapy • Anti-thyroid drugs; Diuretics • Anti-bilharzial treatment • Basis for treatment of viral hepatitis • Drug therapy of diabetes mellitus

Pharmacology

• Digestion, Absorption & Metabolism of carbohydrates, Proteins & Lipids

• Mechanism of hormonal action • Tumor markers; Detection of glucose

Biochemistry

• Swallowing disorders; Peptic ulcer

• Liver diseases; Haematemesis & Melena

• Thyroid disorders; Diabetes Mellitus

• Renal diseases & haemodialysis

• Failure of kidney functions

• Alcohol addiction & withdrawal

• Current trends in obesity

• Health problems in elderly men & women

Clinical MEDICINE:

• Psychological reactions in cancer patient

• Measuring health status & quality of life

• Key features of health belief mode

• Key features of healthy life style

• Theories of addiction

• Psychosomatic disorders

• Theory of planned behavior

• Causes of mood disorders

• Anxiety and how to reduce it

• Confidentiality & ethical basis for withdrawing information

• Treatment of BPH

• Organ transplantation (ethics & legality)

• Transmission & prevention of sexually transmitted diseases

• Imaging techniques of GIT

• Imaging of kidney functions

Clinical

Psychiatry

Urology:

Dermatol:

Radiology:

Dr Adel Bondok ®

• Streptococci, meningococci, coliform group, Neisseria, salmonella & shigella

• Cholera; Brucella; Clostridium • Blood borne pathogens • Serological tests • Infection control

Microbiology

• Methods of viral diagnosis

• Influenza viruses; Hepatitis viruses

• Viruses causing diarrhea Virology

• Entamoeba hitolytica; Giardia lamblia • Parasites transmitted by green salad • Parasites transmitted by raw meat • Hydatid disease; Filariasis; Malaria • Ascaris; Entrobius • Schistosoma; Leishmaniasis

Parasitology

• Antiviral drugs

• Antibiotic and Antimalarial drugs Pharmacology

• Prevention & control of strept infection, influenza, meningitis, Malaria, Tetanus

• Childhood immunization • Ministry of health plan for flu pandemic • Health care facility • Measures to trace source of infection • Environmental health measure • Epidemiology of chronic liver diseases • Infection control measures in blood bank • Public health of Giardiasis & Malaria • Public health measures in water borne

epidemics; Epidemiology of gastroenteritis in developing countries

• Lines of treatment in GE • Epidemiology of parasitic infections • Work related diseases • Prevention strategies • Rehabilitation, occupational & physical

therapy

Community

Medicine

• Management & complications of influenza. • Bacterial meningitis • C/P & assessment of patients with fever • Examination and assessment of chronic

liver diseases • Bilharzial hepatic fibrosis • Chronic hepatitis • Management of parasitic infections • C/P & management of malaria

Tropical

Medicine

• Pediatrics:

• C/P of upper RT infection

• Surgery:

• Liver abscess

• Hydatid disease

• Swollen limb

• Lymphoedema

• Surgical infections

Clinical

Dr Adel Bondok ®

Each Semester

10 teaching weeks

1 week study break for midterm exam

3 weeks study break before the final exam

10 cases: 1 case/week

5 working days: 2 days off to collect data

Dr Adel Bondok ®

ILOs of each case are covered by:

1. Academic aspects (about 80%)

2. Clinical aspects (about 20%)

Clinical

Academic Dr Adel Bondok ®

2 PBL

5

Lectures

2

Practicals

Student

Presentation

Early

Experience

Dr Adel Bondok ®

Each Week (One Case): 13 - 16 hrs

2 PBL classes: 3 hours (1.5 hrs each)

PBL 1: open the case & find out the ILOs

PBL 2: close the case & discuss the ILOs

5 – 6 Lectures: 1 hour each

2 – 3 Practicals: 2 hours each

Early experience: in the hospital

Students presentations: 1 hour

cover the ILOs not covered in lectures / practicals

Dr Adel Bondok ®

11 students in the group

Each has a role in the presentation

Team work, group training, not one man show

Each student has a role

Some prepare the material

Others prepare the PowerPoint

Others present the presentation

Tutor

Coordinate

Revise And

Validate

Dr Adel Bondok ®

Classical Week Time Table:

PBL Classes

Dr Adel Bondok ®

Generic Time Table: Sem 4

9:00 – 10:30 11:00 – 12:00 12:30 – 14:30

Wednesday PBL 1 Lecture 1

Practical:

Early Experience:

Neurological examination

Thursday Lecture 2 Lecture 3

Practical:

Early Experience:

Neurological examination

Sunday Lecture 4

Practical:

Early Experience:

Neurological examination

Monday Lecture 5

Practical:

Early Experience:

Neurological examination

Tuesday PBL 2 Students

Presentation

Tutor Meeting (TM)

Tutor Availability (TA)

Having Fun is Part of the Program

Methods of Assessment

penalty of cheating in Bangaladish, prison

Dr Adel Bondok ®

Methods of Assessment

Ongoing (assessment) Exams (20%)

Final Semester Exams (80%)

20% of the total mark: 110/550

1. Midterm Exam: MCQ/EMQ Exam: 35 marks.

2. Student Activities: 25 marks (75 for Sem 2 & 4) for:

Attendance, PBL activity & Student’s presentation.

3. Review Article: 50 marks for Semester 3

4. Poster Presentation: 50 marks for Sem 5 & 6

Poster Presentation by Semester 5 Students

80% of the total mark. Divided into 3 exams:

1.MCQ / EMQ: 200 marks (200 Qs).

2.Short Essay: 140 marks (15 Qs) (50-75 Qs)

3.OSCE/OSPE: 100 marks (10 Stations / 50 Q)

The marks are applied to Phase 1 Dr Adel Bondok ®

200 questions

200 marks

200 minutes

Prof. Mohamed Attia Bayomi will discuss it

The heading statement (STEM) should be as

short as possible

The Stem should be followed by 5 responses

“a - e” not 4, one of them is the best answer.

Avoid using:

All of the above

None of the above

Except Dr Adel Bondok ®

Three cases with nerve lesion.

Match each case with the appropriate nerve affected:

a. Ophthalmic nerve.

b. Oculomotor nerve.

c. Facial nerve.

d. Abducent nerve.

e. Sympathetic fibers to the head

1. Case 1: Ptosis and miosis.

2. Case 2: Ptosis and mydriasis.

3. Case 3: Loss of corneal reflex & inability to close the eye.

Dr Adel Bondok ®

Computer Based Exam

Dr Adel Bondok ®

OSCE and OSPE OSCE:

Objective structured clinical

examination.

OSPE:

Objective structured practical examination (Practical exam)

Prof. Alaa Mosbah will talk

about the clinical one

3

4

Name two conditions

causing urine sample to

appear like this sample:

Q1. ……………….………..

Q2. ……………….………..

Q3. Give 2 ECG findings in case of myocardial

ischemia (infarction):

a. ………………..…………………………..

b. ……………………..……………………..

Sem 1: ECG

1. Name 2 structures inside this joint:

a: …………………… b: ……………….….

Sem 2: Qs 1 & 2

2. Name the muscle performing this

movement & its nerve supply: …………

5

4. A case of nerve injury:

A: Name this hand deformity:

……………………………………..…………….……….

B: Name the nerve affected:

……………………………………………..…………….

4

5. A case of nerve injury:

A: Name this deformity:

……………………………..………….……….

B: Name the nerve affected:

………………………….………..…………….

Sem 2: OSCE 3

5

A Case of

a Cranial Nerve Paralysis

1. Identify the nerve affected and

the side of the paralysis:

1a: Nerve: ………………………………………………

1b: Side of paralysis: ………………………

Sem 4: Q 1

SHORT ESSAY EXAM

How to Beat Exam Stress !

Short Essay: 140 Marks

It is structured, objective, justifiable, focused and targeted exam: Structured means =

planning the essay (what do you want from the student?) +

arrange the main points in a logical order +

the answer is clear, focused and relevant to the question

3 clinical scenarios. Each one is followed by 3 - 5 short questions.

Each question is divided into 3-5 ultra-short Qs that examine the knowledge, skills, understanding and clinical application or integration (total of 50-75 Q).

Avoid: discuss or give short notes.

Specific action verbs (words) are used

Dr Adel Bondok ®

Action Verbs:

The questions should not be in the traditional essay

format but rather in objective, targeted, justifiable,

focused short essay format that are easy for

correction and evaluation like:

“Definition”: Define the following: ………………………

“Enumerate”: Enumerate branches / types / anything else …...

“Causes”: Give causes of …………………………………….

“Explain”: ……………………………………………………….

“Functions of”: ……………………………………..………….

“Indications”: What are the indications of ………………….. Dr Adel Bondok ®

Action Verbs:

“Results”: What are the results of : …………………

“Mechanism”: What is mechanism of ……………....

“Correlate”: ……………………………………….

“Compare”: in a table form (specific # of rows): …..

“Describe” …………………………………………..

“Anything else” you suggest that helps evaluating a

topic ………………………………………..…………. Dr Adel Bondok ®

Q: Regarding blood sample: (4 marks):

1. Name 2 usual sites for taking a venous blood sample? (1 mark)

1. ………………………………………………………………………………

2. ………………………………………………………………………………

2. Name 2 usual sites for taking an arterial blood sample? (1 mark)

1. ………………………………………………………………………………

2. ………………………………………………………………………………

3. Give one indication (use) of arterial blood sample (1 mark)

4. How can you obtain a blood sample from a newborn (1 mark)

Q: Regarding histology of the thyroid and parathyroid gland: (4 marks):

1. What are 2 main cells in the thyroid gland & their functions? (2 marks)

1. ………………………………………………………………………………

2. ………………………………………………………………………………

2. What are the 2 cell types present in the parathyroid gland? (1 mark)

1. ………………………………………………………………………………

2. ………………………………………………………………………………

3. Which one of the above cell types is essential for life and why? (1 mark)

Angelina Jolie, 37-year-old famous

Hollywood star, was tested positive for

breast cancer antigen gene (BRCA1).

After watching her mother die from

ovarian cancer, she decided to undergo

an elective double mastectomy to reduce the high risk of

developing breast cancer from a terrifying 87% to below 5%.

The media described her as "absolutely heroic" for making the

decision. Dr Adel Bondok ®

Q: Regarding Surgical Anatomy of the Breast: (10 marks):

Name 2 muscles forming the breast bed (deep to the breast):

1. …………………………………………………………………………………….. (1 mark)

2. ……………………………………………………………………………………… (1 mark)

Name the nerve that is commonly injured in mastectomy operations:

1. Nerve: …………………………………………………………………………………….. (0.5 mark)

2. Deformity caused by its injury: ………………………………………………….. (0.5 mark)

What is the location of each of the following?

1. Tail of the breast: ……………………………………………………………………… (0.5 mark)

2. Nipple in the male: …………………………………………………………………… (0.5 mark)

Name 2 arteries supplying the breast:

1. …………………………………………………………………………………..………….. (0.5 mark)

2. …………………………………………………………………………………..………….. (0.5 mark)

Describe the lymph drainage of the breast: (5 marks)

……………………………………………………………………………………………………..…………..

……………………………………………………………………………………………………..…………..

……………………………………………………………………………………………………..…………..

……………………………………………………………………………………………………..………….. Dr Adel Bondok ®

Q: Regarding Breast Cancer: (10 marks):

List 3 risk factors for the development of breast cancer: 3 marks

1. …………………………………………………………………………………….. (1 mark)

2. ……………………………………………………………………………………… (1 mark)

3. …………………………………………………………………………………….. (1 mark)

Describe the role of each radiological method in diagnosis of breast cancer:

1. Mammography: …………………………………………………………………… (2 marks)

2. CT Scan: ………………………………………………………………………………. (1 mark)

3. Positron Emission Tomography: …………………………………………. (1 mark)

List 4 etiological factors for phobia: (2 marks)

1. …………………………………………………………………………………..………….. (0.5 mark)

2. …………………………………………………………………………………..………….. (0.5 mark)

3. …………………………………………………………………………………..………….. (0.5 mark)

4. …………………………………………………………………………………..………….. (0.5 mark)

List 2 psychopharmacological drugs for phobia: (1 mark)

1. …………………………………………………………………………………..………….. (0.5 mark)

2. …………………………………………………………………………………..………….. (0.5 mark) Dr Adel Bondok ®

Dr Adel Bondok ®

Q: Nerves of the upper limb are vulnerable to injury.

In the following conditions, name the nerve that may be

affected and the expected deformity: 10 marks):

1. Fracture midshaft of the humerus: Nerve: …………………………………………………………………………………….. (1 mark) Deformity: ……………………………………………………………………………..… (1 mark)

2. Fracture surgical neck of the humerus:

Nerve: …………………………………………………………………………………….. (1 mark) Deformity: ……………………………………………………………………………..… (1 mark)

3. Fracture medial epicondyle of the humerus:

Nerve: …………………………………………………………………………………….. (1 mark) Deformity: ……………………………………………………………………………..… (1 mark)

4. Forward dislocation of carpal bones (carpal tunnel syndrome):

Nerve: …………………………………………………………………………………….. (1 mark) Deformity: ……………………………………………………………………………..… (1 mark)

5. Violent traction of the head during delivery:

Nerve: …………………………………………………………………………………….. (1 mark) Deformity: ……………………………………………………………………………..… (1 mark) Dr Adel Bondok ®

Q: Regarding anatomy of the bronchial tree: (10 marks):

1. List 4 differences between the left and right main bronchi? (5 marks)

2. What is the carina? ……………………………………………… (1 mark)

3. What is the vertebral and sternal level of the carina? (2 marks)

1. Vertebral level: ………………………………………………………………

2. Sternal level: …………………………………………………………………

4. What is the major lymphatic duct draining the right and left lung? (2 marks)

1. Right lung:……………………………………………………………………

2. Left lung: …………………………………………………..…………………

Left main bronchus Right main bronchus

Length ……………………….…………..……… ½ …………………….…………………..… ½

Width ……………………….………………..… ½ …………………….…………………..… ½

Angle with the

trachea ……………………….………………..… ½ …………………….………………..…… ½

Arterial supply: Number: …………….……….………..…½

Origin: ……………….…………….....… ½

Number: ……………….……………..…½

Origin: ………………………………..…½ Dr Adel Bondok ®

Q: Regarding histopathology of the bronchial tree: (10 marks):

1. Draw a histological diagram of TS section of the bronchus? (5 marks)

2. Describe the MP of bronchogenic carcinoma? (5 marks)

Q: Regarding Smoking: (10 marks):

1. What are the hazards of smoking? (6 marks)

……………………………………………………………………………………………...

………………………………………………………………………………………………

2. Explain why it is difficult to quit smoking: (4 marks)

……………………………………………………………………………………………...

……………………………………………………………………………………………… Dr Adel Bondok ®

Q: Regarding Pulmonary Blood Flow: (10 marks):

1. Define autoregulation of blood flow: (1 mark)

……………………………………………………………………………………………...

………………………………………………………………………………………………

2. Explain the intrinsic mechanism regulating pulmonary BF: (2 marks)

……………………………………………………………………………………………...

………………………………………………………………………………………………

3. Explain why the pulmonary circulation is a low pressure system: (1 mark)

……………………………………………………………………………………………...

………………………………………………………………………………………………

4. Enumerate reasons why it is low pressure system: (3 marks)

……………………………………………………………………………………………...

………………………………………………………………………………………………

5. Describe and explain mechanism keeping the lungs dry: (3 marks)

……………………………………………………………………………………………...

……………………………………………………………………………………………… Dr Adel Bondok ®

Regarding Liver Functions: (10 marks)

A. Enumerate 4 synthetic functions of the liver: (2 marks)

B. Mention & explain types and causes of jaundice: (3 marks)

C. What are the laboratory tests done to diagnose liver disease? (4 marks)

D. What is the most definitive test to confirm diagnosis of FL: (1 marks)

Regarding Fatty Liver: (10 marks)

A. Describe histopathological changes in fatty liver: (3 marks)

B. Mention 3 complications of fatty liver: (3 marks)

C. What are the lines of treatment of fatty liver (4 marks)

Dr Adel Bondok ®

Teacher student

relationship

Dr Adel Bondok ®