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Medical College

Students' Training Guide

BOOK

Clerkship

I. Introduction:-

A clerkship is an educational exercise that brings the student into personal

contact with patients, under close supervision of faculty (trainer).

It is a total emersion experience that involves the student throughout a full

working day for the duration of the clerkship.

II. Objectives:-

1 Essential Demonstrate the ability to take focused

history in a logical, organized, and thorough

manner.

2 Essential Demonstrate skills of appropriate physical

examination without incorporating

unnecessary maneuvers or omission of

essential maneuvers.

3 Very

desirable

Synthesize the information obtained from

history and Physical examination into logical

differential diagnosis.

4 Very

desirable

Develop a working management plan.

5 Desirable Demonstrate ability to plan appropriate and

cost-effective investigations to reach the

diagnosis.

6 Very

desirable

Demonstrate ability to ascertain and

interpret results of investigations.

7 Very

desirable

Demonstrate learning skills and ability to

identify and meet emerging information for

most appropriate diagnosis.

8 Desirable Demonstrate ability to make appropriate

choice of therapeutic options including

cost, risks, benefits and efficacy.

9 Very

desirable

Demonstrate basic proficiencies in

competencies in procedural skills relevant

to each specialty.

10 Desirable Recognize medical manifestation of

diseases.

11 Very

desirable

Maintain ethical attitudes and

professional behavior of student during

training, concentrating on punctuality,

responsibility and teamwork.

12 Very

desirable

Encourage every student to develop his/her

steam by analyzing his/her weakness and

strengths, during training.

13 Very

desirable

Demonstrate appropriate and affective

verbal skills (using language appropriate to

the patient "doctor/patient relationship) as

well as effective listening skills

14 Very

desirable

Demonstrate ability for critical thinking and

self-learning.

III. General information:

1. Dress and badge:

The student must wear respectable dress and the white coat of AlMaarefa

Colleges and his/her badge all the time during training.

2. Required tools and books:

- Stethoscope

- Otoscope

- Reflex hammer

- Penlight

- Pocket text

- Maxwell quick medical reference.

- Elision’s pocket reference.

- Hutchison's clinical method

- Clinical examination 5th

Edition

Mason & Swash

3. Registration / Rules and Regulation:

- All students must register in the training hospital (Recommended two days

before the start of the training).

- Student must follow the hospital rules and regulations. Any violation of these

rules might cause expelling of student from training by the hospital authority.

- Student must respect too all hospital staff and interact with them professionally.

- Student must respect confidentiality of patients, staff, files and the training

hospital.

- Taking pictures of hospital sights, patients or staff is forbidden.

4. PROFESSIONALISM:

Students are introduced to professionalism and other core competencies that are

essential for lifetime professional practice. Students are expected to

demonstrate:

Compassion, integrity, and respect for others.

Responsiveness to patients’ needs that supersedes self-interest.

Respect for patients’ privacy and autonomy.

Accountability to patients, society and the profession.

Sensitivity and responsiveness to a diverse patient population.

Professionalism will be evaluated by the hospital training during the rotations.

5. ATTENDANCE AND PUNCTUALITY:

Attendance, punctuality, and participation in academic activities should be

evaluated on the overall performance in these areas during the rotation. Any

lateness and or absenteeism will certainly affect the over assessment of

clerkship training, and may result in repetition of rotation.

6. On last day of hospital rotations:

On the last day of rotation, the student should make sure certain tasks are

completed as follows:

Department:

- Return any items borrowed from the department.

- Obtain the signature of the authorized trainer on the cases/skills log, and

evaluation forms.

Hospital:

- Return any items borrowed from the hospital.

- Obtain his/her clerkship completion certificate signed by the academic training

department.

IV. Clerkship training:-

i. Knowledge (Pre clerkship didactic lectures):

This aims to increase students’ medical knowledge (information’s pyramid),

before being exposed to practically seeing patients.

The theoretical part is given in the form of lectures, tutorials, group discussions,

presentations, and Directed Self Learning (DSL) sessions.

ii. Rotations (Clerkships)

During rotation in different specialties, the student must fulfill the following

responsibilities:

1. General responsibilities:

a. Act professionally at all time.

b. Be punctual and dependable.

c. Cell phone should not be used during time of consultation or dealing with

patients, lectures and teaching sessions.

2. Specific responsibilities:

a. Assist in accumulation of lab results and patient’s records.

b. Deal with patients in a respectful, compassionate, and empathetic

manner.

c. Must be prepared to participate in all educational opportunities.

d. Keep a log of patients and / or procedures that you have actively attended

and followed.

e. Refrain from idle talk about cases on the wards, conference room, elevator

and cafeteria.

f. Attend morning reports, grand rounds, and any other required activity in the

department.

g. Should be prepared to present patients’ cases and updated follow-ups on

rounds and other teaching activities.

3. Specialties clerkship Rotations:-

After the preparation year ( first year), the study of medicine, consists of 6 years

three years are basic science ( preclinical), and two years are clinical

medicine in the form of hospital rotations ( level 9,10,11 & level 12)

A full year of internship in hospital rotation after graduation will add to

maturity of the graduated physician before she / he peruse his specialty.

The clerkship of 5th and

6th year compromise different specialties which varies in

duration. During hospital rotation the students will learn certain competencies

and skills.

Students will develop professionalism and learn the skills of patient's

communication.

The hospital training may involve ambulatory care settings (outpatient clinics),

and/or inpatient settings (bedside teaching). Students will learn some procedures

and skills in different specialties. The rotation might include attending some

operative sessions according to specialty.

Welcoming and orientation:-

In the first morning session, the students will be welcomed and will be shown

the places of the specialty clinics and deferent facilities and introduced to the

department staff.

The students also will be guided to the location of the library, cafeteria and the

conference room / teaching room.

An overview of the rules and regulations of the institute are given, with

emphasis on ethical and professional behavior.

Competencies learning:-

The core of medicine teaching and learning is based on how the learners

(students) collect information which will no doubt with others skills and

competencies students have to learn; will help to reach the best available

methods to manage a patient medical condition.

Students have to learn the skills of history taking and how to master physical

examination. On top of that students will learn how to intellectually select the

appropriate investigation to enable physician to reach to the final diagnosis.

Students will develop skills of giving most likely differential diagnosis he

would expect from information collected and findings of physical examination.

This intellectual thinking would develop with time to enable ones to plan the

appropriate treatment (management plan).

With such teaching and learning approach, students will have confident with

time to be independent treating safe physician.

The students should make every effort to perfectly learn and master the

following competencies:-

A. History taking and physical examination:-

These two competencies are considered of importance to learn at this stage.

Although emphasis on these two does not in any way mean, that other

competencies should be ignored. They are very desirable to learn.

C. Differential diagnosis:-

After a student collect information (history taking), and did physical

examination, with findings will be able to formulate differential diagnosis.

This skill should be upgraded with more experience. The list of differential

diagnosis will be less in number with time, and this indicates maturity in

judgment.

D. Requesting investigation(s):-

Student should during this training period, learn the skills of appropriate

judgment of what are the investigation(s) should be requested to help him to

reach to the final diagnosis or at least reduce the differential diagnosis numbers

in the list. At the same time, students should exercise proper judgment to take in

consideration of cost and safety to patients.

E. Giving a treatment plan:-

Planning a treatment is not less importance than what have been discussed

earlier. At this stage it is enough for students to know how to treat a patient and

with more time, students will learn all aspects of treatment plan.

F. CASE REPORT:

Students are required to record and follow patients' conditions utilizing the

"SOAP" format as follows:

S= Subjective (overnight events, what the patient tells you about how they are

feeling). Usually includes brief chief complaints, Brief history of present

illness, medication, many include patient past medical, surgical, family and social

history.

O = Objective (what you find on vital signs, clinical exam, labs, tests) objective

information.

A = Assessment (brief recap the clinical situation in few lines) usual a one-line,

run on sentence.

P = Plan (what we are going to do about each and every issue) organized either by

system or by problem.

The length and style of a SOAP note varies with each clerkship (shorter note in

surgery, longer ones in medicine, and in between in family medicine) but the idea is

the same.

Each student will have an opportunity to formulate one written case report (in the

SOAP format), for each major specialty (Medicine, Surgery, and Pediatrics) and one

for each of obstetrics and gynecology, and Orthopedics.

G. ORAL CASE PRESENTATION:

During the rotation students are given regular exercise on case presentation. This is an

important part of the clinical clerkship and each student will have to make out of the

case report; a power point case presentation.

The student has to present a case presentation in the designated sessions in the tutorial

days in the college.

ROTATIONS EXPOSURES:-

IN-PATIENT CLINICAL SESSIONS:

The numbers of in-patient sessions will vary from specialty to other (as stated in the

session's distribution of each specialty below).

In-patient sessions will include the following activities:

1. Daily ward rounds.

2. Writing a case report (in structured form of subjective, objective, assessment

and plan (SOAP) format).

3. Bedside teaching.

BEDSIDE TEACHING:-

The bedside teaching sessions are at the core of the clinical clerkship in which

students learn and practice clinical examination and proper interaction with

patients.

OBJECTIVES:

By the end of the course, students should be able to:

Take an appropriate history and conduct proper physical examination,

adapting the scope and focus appropriately according to the nature of the

encounter.

Demonstrate empathy in patient interactions and commitment to caring for all

patients regardless of their background.

Identify and prioritize problems with which a patient presents, appropriately

synthesizing these into logical clinical scenario.

Formulate a differential diagnosis based on the findings from the history and

physical examination demonstrating clinical reasoning.

Apply differential diagnosis as would be relevant from history and physical

examination.

Interpret the results of commonly used diagnostic tests.

Formulate the initial and follow-up management plan and explain the extent of

the plan based on diagnostic reasoning and scientific evidence.

Write up the history, physical examination and assessment plan in a format

appropriate to the clinical situation under separate cover (the SOAP system is

recommended).

Orally present a complete, well-organized summary of the patient’s history

and physical examination findings, including an assessment plan.

Demonstrate proficiency in specific communication skills.

ORGANIZATION OF BEDSIDE TEACHING:

There will be numbers of bedside teaching sessions in each rotation for these

specialties. The hospital trainer will identify an inpatient case(s) and ask the students

to take history and perform physical examination, make up a differential diagnosis,

think of what investigations may be needed and suggest a management plan.

After one hour, the trainer will discuss and comment on/correct history taking and

ensure students are able to perform a proper physical examination and elicit the

findings correctly. This is followed by discussion of the case in the light of observed

and recorded physical signs formulated differential diagnosis and management plan.

09:00 – 010:00 students’ time with the patient.

10:00 – 12:00 Discussion on history taking, physical examination,

investigations, differential diagnosis and management plan.

OUTPATIENT CLINICS SESSIONS:

The outpatient clinics provide students with scope of a wide spectrum of diseases and

health issues commonly encountered in the community. Many diseases are almost

exclusively seen and managed at the outpatient level. Students shall seek the

opportunity to learn from these sessions and observe physical signs and case

management. Students will be involved in history taking, clinical examination and

discussion of management plan with the trainer. Student are encouraged to insists

on getting as much he can from the trainers and be persistent to learn how to

take history and do physical examination. Students not to wait for training to

volunteer teaching (spoon fed).

Patient Presentation:-

Pre-rounding is the time before rounds when a student in clerkship can gather

information on patients, including what happened to them overnight and how they are

feeling, as well as a focused physical exam. For example, if the team meets at 8 am for

morning rounds, most students would arrive at 7 am to perform a pre-round on

patients. Pre-round notes do not have to be written by the time rounds start (if

possible, better) but the student should have a good general sense of what the patient

issues are, and what course of treatment should be pursued so he/she can present the

patient to the team during rounds.

Issues to find out while pre-rounding:

- Vital signs:

Maximum and current temperatures, heart rate, blood pressure, respiratory rate,

oxygen saturation, level of pain (scale 0-10) .

- How the patient felt overnight

- Labs:

Record any early morning labs that were drawn or lab from previous night and make

note of any labs pending.

- Management:

Look in the chart for any new orders written overnight.

- Medications:

Look at the medication chart for what the patient received. It is important to make sure

that all medications ordered have actually been taken.

- Input / Output chart:

Whenever appropriate, an input / output balance chart and amounts of drains, urine

output, passing wind or bowel motion, etc. should be mentioned

- Physical Exam:

Perform a patient physical exam

- The student is expected to present a patient case (at least once) on the patient

grand round. Therefore the student must take a full history and full examination

of a patient (directed by the hospital trainer before round).

Presenting a patient:

Students should be prepared to present a patient in the morning rounds (at least once

during clerkship duration) an effort should be made to make your presentation

without the use of notes (personal note are acceptable in early rotation).

Limit presentation to 2 – 4 minutes.

Presenting a patient is one of the important skills of medicine you will learn this year.

If you know your patient well enough that you can present to anyone, then you have

done half your job already.

Presenting a patient involves:-

- Explaining the patient’s chief complaints.

- History of patient illness.

- Past medical history.

- Allergies

- Finding on physical exam.

A general presenting pattern is as follow.

1. Chief complaint.

2. Why is the patient here?

3. Past medical history.

4. Medications / allergies.

5. Social and family history.

6. What has been done since admission?

7. How the patient did overnight.

8. Vital signs and physical exam.

9. Assessment.

10. Plan.

Clinical Procedures learning:

The students will have the opportunity to be taught application of clinical procedures

in the hospital rotations in different specialties (medicine, surgery, pediatrics, Ob/Gyn,

orthopedics and emergency) and also will be taught in during tutorial sessions in the

college whenever possible.

Cases/Skills Log:

The student must document frequency of the cases/skills encountered, in the

designated form (below) and an overall summary of all encounters and exposures is

gathered. Student will make sure that the trainer sign cases/skills forms at the end of

the clinics and or procedures performed by the doctor and watched by the student.

The form will be used one for each clinic attended (i.e. more than one form in each

specialty rotation).

In the cases/skills space, student will write the diagnosis, skills name respectively.

Also student will document the action decided by the treating doctor (whether

medication or referral or other management plan).

Student will document how the procedure is done with detailed steps.

These forms will be handed to the course organizer for / or to the clerkship coordinator

when there is no specialty organizer.

Cases/skills Action / Plan

Though student must write every encounter; it is important that student only write

what he attends, not coping his pears cases/skills log.

5th

year clerkship rotations:-

This year consist of two levels, level nine (9) and level ten (10).

Level 9 consists of the following:-

MEDICINE–1 Clerkship:-

I. COURSE DESCRIPTION:-

The medicine-1 clerkship runs over a total of six (6) weeks. This includes one

week of didactic lectures before the start of clerkship rotations, one week for

end of rotation assessment, and four (4) weeks of clinical rotation. During this

clerkship students participate in all activities related to medicine-1. Students

attend clinical rounds and outpatient clinics with the medical consultants,

registrars, and chief residents. Students observe and assist under supervision

interventional diagnostic and therapeutic procedures. Generally students are

expected to master history taking and perform clinical examination on medical

patients as well as participate in patient-care related activities.

Medicine -1 Surgery – 1 Pediatrics – 1

This four (4) week interdisciplinary clerkship of internal medicine offers

students a range of experiences and opportunities in the fields of

medicine.

Each week has five full working days with four days in hospital rotations,

with one full working day of the week is set aside for lectures/tutorials at

the College.

II. Objectives:

Specific objectives:-

1 Essential Have understanding of the principles and practice for ambulatory care and those requiring admission to wards. Develop knowledge, attitudes and skills in the management of all patient encounters.

2 Essential Develop professional competence for excellence of patient care, understand and advance knowledge to become leaders in their chosen fields.

3 Desirable Practice medicine within the context of society and its expectations. Practice evidence-based approaches and broaden its application from individual patients to health care service in general.

5 Desirable Understand the limits of one’s personal knowledge, remediate inadequacies. Keep abreast with current advances, and integrate increased self-knowledge into their daily practice.

III. MEDICINE- 1 CLERKSHIP SYLLABUS:

The clinical clerkship rotation for medicine at level 9 is for sixteen (16) days.

Each working day is divided in two sessions one in the morning and another in

the afternoon with break between two sessions (for prayer and lunch). The

total thirty two (32) sessions of clerkship is structured for internal medicine

and medical sub-specialties and is inclusive of session attendance at outpatient

clinics as follows:

SESSION DISTRIBUTION:-

Days

Session (s)

Activities

8 16 Bed-side teaching - Inpatient (Wards)

3 6 Outpatient clinic

2 4 Emergency department for medical emergency cases 3 6 Skills /procedures learning (see details)

16 32 Total sessions

HOSPITAL BED SEIDE TEACHING SESSIONS DISTRIBUTION:

ACTIVIITY SESSION(S) Internal Medicine 2

Neurology 2

Cardiology 2 Respiratory Medicine 2

Gastroenterology 2

Endocrinology 2

Rheumatology 2

Hematology 2 Total 16

SKILLS/PROCEDURES LEARNING AT HOSPITAL:

In the skills / procedures learning sessions, the hospital trainer will teach students in a

group basic skills and procedures employed specific to a clinical situation for an

individual patient. These include:

Venous Blood withdrawal: Principles and practice of withdrawing blood for

biochemical, hematological and microbiological investigations.

Arterial blood withdrawal: Indications and technique of withdrawing arterial

blood samples.

Setting up I/V line: Indication, safety measures and technique for setting up

I/V line (s).

Naso-gastric tube insertion: Indications and technique used for naso-gastric

tube insertion and verification of its placement at correct site.

Lumber puncture: Indications and technique employed for performing lumber

tap.

Abdominal fluid aspiration: Indications and technique used for peritoneal

fluid aspiration.

Urinary catheter insertion: Indications and technique used for urinary catheter

insertion.

Pleural fluid aspiration: Indications and technique used for pleural fluid

aspiration and insertion of chest drain.

SUGERY-1 CLERKSHIP:-

I. COURSE DESCRIPTION:

The surgery -1 clerkship runs over a total of six (6) weeks. This includes one

week of didactic lectures before the start of rotations, one week for end of

rotation assessment, and four (4) weeks of clinical rotation. During this

clerkship students participate in all activities related to surgery. Students attend

clinical rounds with the surgical consultants, registrars, and residents, attend

outpatient consultations assist in surgical procedures and attend surgery

sessions. Generally students are expected to master history taking and perform

clinical examination on surgical patients as well as participating in patient-care

related activities.

Students will also be involved in preoperative preparations, post-operative care

and other day to day activities within a surgical unit.


with one full working day of the week is set aside for lectures/tutorials at

the College.

II. OBJECTIVES:

Specific objectives:

Essential:

1. Develop understanding and clinical application of basic surgical

principles.

2. Develop understanding of pathophysiology & management of common

surgical disorders.

3. Develop understanding of indications and interpretation of laboratory,

radiological and other investigations in surgical diseases.

4. Understand the principles of trauma management and learn the essential

skills in the management of trauma patients.

Very desirable:

5. Learn how to prepare patients for surgery.

6. Learn how to care for postoperative patients.

7. Develop understanding of the surgical and non-surgical management of

surgical disease.

III. SURGERY-1 CLERKSHIP SYLLABUS:

The clinical clerkship rotation for surgery at level 9 is for sixteen (16) days. Each

working day is divided in two sessions one in the morning and another in the

afternoon with break between two sessions (for prayer and lunch). The total

thirty two (32) sessions of clerkship is structured for general surgery and is

inclusive of session attendance at outpatient clinics as follows:

DISTRIBUTION OF SESSIONS:

Days Session (s)

Activities

8 16 Bed-side teaching ( inpatient sessions)

3 6 Outpatient clinic 2 4 Emergency department for surgical emergency cases

3 6 Skills /procedures learning (see details) 16 32 Total sessions


In the skills / procedures learning sessions, the hospital trainer will teach students in

group basic skills related to the clinical rotation. These include:

Reading x-rays and other imaging techniques of various surgical diseases and

surgical traumas

Data interpretation of related investigations (e.g. blood, biochemistry, serology,

etc.).

PR exam

Prostate examination

Proctoscopy

Colostomy bag

Wound care

Suturing

Breast exam

Catheterization

(Male & Female).

IV line.

Nasogastric tube insertion.

PEDIATRICS -1 CLIERKSHIP:-

I. Course description:

The pediatrics -1 clerkship runs over a total of six (6) weeks. This includes one week

of didactic lectures before the start of clerkship rotations, one week for end of rotation

assessment, and four (4) weeks of clinical rotation. During this clerkship students

participate in all activities related to pediatrics-1. Students attend clinical rounds and

outpatient clinics with the pediatrics consultants, registrars, and chief residents.

Students observe and assist under supervision. On the inpatient services, students

encounter a broad range of pediatric patients from birth through age

The students are involved in the care of patients hospitalized for acute illnesses,

chronic conditions with exacerbations, scheduled or emergent surgeries, and minor to

life threatening injuries.

Student will focus on admission histories and physical examinations as well as cross

coverage skills. On the inpatient, students will perfect their focused history taking and

physical examination skills, differential diagnoses for pediatric problems, practice

their oral presentation skills.

On the outpatient portion of the pediatric clerkship, students will learn the basics of

health supervision and preventative medicine, including immunization schedules and

developmental milestones. They will see children and adolescents for acute care visits

as well. Students will understand the importance of the longstanding patient-physician

relationship as it relates to health maintenance. During the outpatient portion of the

rotation, most students will spend some sessions in the normal newborn nursery,

with emphasis on the normal newborn exam and anticipatory guidance for parents.

Each week has five full working days with four days in hospital rotations, and one

full working day of the week is set aside for lectures/tutorials at the College.

II. OBJECTIVES:

Specific Objectives:-

1

Essential

Acquisition of basic knowledge of growth and development (physical,

physiologic and psychosocial) and of its clinical application from birth

through adolescence.

2

Essential

Development of communication skills that will facilitate the clinical

interaction with children, adolescents and their families and thus

ensure that complete, accurate data are obtained.

3

Very desirable

Development of competency in the physical examination of infants,

children and adolescents.

4 Essential Acquisition of the knowledge necessary for the diagnosis and initial

management of common acute and chronic illnesses in children.

5 Very desirable Development of clinical problem-solving skills in children.

6 Very desirable An understanding of the influence of family, community and society

on the child in health and disease.

7 Essential Development of strategies for health promotion as well as disease and

injury prevention in children.

8 Essential Development of the attitudes and professional behaviors appropriate

for clinical practice.

9 Very desirable An understanding of the approach of pediatricians to the health care of

children and adolescents.

10 Very desirable Understand and explain the risks and benefits of

investigations and treatments.

11 Very desirable Demonstrate competency in basic diagnostic and procedural

skills relevant to common pediatric conditions.

12 Essential Rapidly recognize and start essential initial management of

pediatric emergencies and traumas. III. PEDIATRICS-1 CLERKSHIP SYLLABUS:-

The clinical clerkship rotation for pediatrics at level 9 is for sixteen (16) days.

Each working day is divided in two sessions one in the morning and another in

the afternoon with break between two sessions (for prayer and lunch). The

total thirty two (32) sessions of clerkship is structured for pediatrics and is

inclusive of session attendance at outpatient clinics as follows:


Days Sessions Activities

5 10 Bed side teaching sessions

This includes history taking and physical examination.

2 4 Newborn nursery Normal newborn examinations and

anticipatory guidance for parents.

2

4

Outpatient department

Observe how history and physical examination are done for children and if possible do developmental

milestones. They also will see children

and adolescents for acute care visits as

well. Students will understand the

importance of the longstanding patient-

physician relationship as it relates to

health maintenance.

2 4 Emergency department

If no emergency department, then can be added as bedside teaching.

2 4 Immunization clinics

Learn how to do growth assessment and what immunization recommended at different age.

3 6 Skills learning As in list below.





Reading x-rays and other imaging techniques of various pediatrics diseases and

trauma


etc.).

How to take blood sample.

How to place in tube.

How to give injections.

How to give oxygen therapy.

How to use Ventolin in the nebulizer.

How to use growth chart.

Observe how lumber puncture is done.


FM ENT Ophthalmology Dermatology Psychiatry Anesthesia

FAMILY MEDICINE

I. Course Description:-

Family medicine clerkship rotation will be for ten (10) days.

Family medicine is now recognized as a specialty based on a body of

knowledge and an approach to care unique to its discipline. Because family

physician commitment is to the person and not to a particular organ system, age

group, or technique, they must be skilled in accepting responsibility for the full

scope of care of patients in health and illness at all stages of the life cycle.

While facets of this comprehensive patient centered approach are not present in

the care provided by others, no other discipline has all of these tenets as its core

raison.

This approach is described according to the four principles of family medicine.

1. The family medicine is a skilled clinician.

2. The patient physician relationship is central to family physician role.

3. The family physician is resource to a defined population.

4. Family medicine is community based.

II. Objectives:

By the end of family medicine clerkship rotation, students will be able to:-

General objectives:-

1 Essential Demonstrate the ability to take focused history for

patients presenting with common medical diseases.


examination with emphasis on normal and abnormal

features on physical examination.

3 Very desirable Synthesize the information obtained from history and

Physical examination into logical differential

diagnosis.

4 Very desirable Develop a working management plan.

5 Desirable Develop plans for appropriate and cost-effective

investigation to reach the diagnosis.

6 Very desirable Develop the skills to interpret these investigations.

7 Very desirable Demonstrate competencies in basic diagnosis

relevant to common medical conditions.

8 Desirable Able to select the proper therapy and be aware of its

interaction, side effect and complication.

9 Very desirable Distinguish medical conditions requiring normal or

immediate referral to concerned specialties.

10 Very desirable Rapidly recognize medical and trauma emergencies

requiring urgent a plan for action.

11 Very desirable Demonstrate basic proficiencies in competencies in

procedural skills relevant to each specialty.

12 Desirable Recognize medical manifestation of diseases.

13 Very desirable Maintain ethical attitudes and professional

behavior of student during training, concentrating on

punctuality, responsibility and teamwork.

14 Very desirable Encourage every student to develop his/her steam by

analyzing his/her weakness and strengths, during

training.

15 Very desirable Demonstrate appropriate and affective verbal skills

(using language appropriate to the patient

"doctor/patient relationship) as well as effective

listening skills

16 Very desirable Get used to critical thinking and self-learning.


1 Essential Describe how illness presents differently in the

family medicine compared to other specialty setting.

Essential Demonstrate an approach to the diagnosis and

management of undifferentiated patient problems that

present to family physician.

Essential Use patient centered record-keeping when caring for

patients.

Essential Able to obtain informed consent appropriate to their

level of care.

Very desirable Have an approach to polypharmacy.

Very desirable Able to identify what health-promotion and disease

prevention during patient encounters that reflect best

evidence and patient preferences and values.

Very desirable Understand the family physician’s role in maternity

childhood care, palliative care, home health care and

other setting in work.

Essential Appreciate the value of continuity of care for

developing a deep knowledge of patients.

Very desirable Demonstrates a willingness to become involved in the

full range of difficulties which patients bring to their

physicians and not just their biomedical problems.

Essential Demonstrate an evidence–based approach to decision

making with in a patient centered clinical method.

III. Family medicine Clerkship Syllabus:

IV. Since KSMC family medicine department only accept six (6) students for the

clerkship rotation. The total of 12 students will be divided into two groups (A &

B) of six (6) students. The rotation for group A will be at hospital and group B

at the college on alternate days (one day in hospital and one day in the college

for tutorial sessions).The total hospital rotation for each group in two weeks'

time will be for five (5) days in the hospital and five (5) days in the college for

each group. But the total clerkship and tutorial for each group will be for ten

(10) days. The clerkship rotation is composed of a total of five (5) full working

days according to the hospital time.

V. The working day is divided into two sessions. One morning session, and

another afternoon session, with a break in-between (for prayer and lunch). This

will be equal to total of twenty (10) sessions

SESSIONS DISTRIBUTION:-

Days Sessions Actions

4 8 General clinic (primary clinic)

1 2 Dressing room & phlebotomy

5 10 Total sessions

Primary care clinics:-

The students during the rotations in the family medicine specialty will be exposed to

general primary care clinics, staff health clinics, well women clinics, well men clinics,

well baby clinics, and chronic diseases clinics.

Tutorial sessions at college:-

There will be a program of tutorial sessions at the college for five (5) days, and will be

sent to you at later stage.

OTOLARYNGOLOGY

I. Course Description:

The ENT clerkship is a ten (10) days clinical rotation designed to explore the

common ENT health problems and mastering skills of ENT specialty. The

clerkship rotation will be in outpatient's clinics, operation room and inpatient

ward. Also student will be exposed to the related activities of ENT.

II. Objectives:

By the end of rotation, students shall be able to:-




2 Essential Demonstrate skills of appropriate physical examination

with emphasis on normal and abnormal features on

physical examination.


Physical examination into logical differential diagnosis.





7 Very desirable Demonstrate competencies in basic diagnosis and

procedural skills relevant to common medical

conditions.










13 Very desirable Maintain ethical attitudes and professional behavior

of student during training, concentrating on punctuality,

responsibility and teamwork.



training.


(using language appropriate to the patient "doctor/patient

relationship) as well as effective listening skills



1 Essential Perform ENT physical examination

2 Desirable Identify and analyze common ENT problems.

III. OTOLYRINGOLOGY CLERKSHIP SYLABUS:

The clerkship rotation is composed of a total of ten (10) full working days

according to the hospital time. The working day is divided into two sessions.

One morning session, and another afternoon session, with a break in-between

(for prayer and lunch).

This will be equal to total of twenty (20) sessions.


OPHTHALMOLOGY


Using the material covered in the, lectures, seminars, pre-clerkship tutorials and

clinical skills sessions, students are required to develop a problem based

approach to main topics in ophthalmology including acute and chronic causes of

visual loss, ocular pain, the red eye, pediatrics, genetics, trauma and

emergencies. This shall be achieved available by observation and active

participation in the outpatient clinics, discussion sessions and tutorial sessions.

Students shall be responsible for talking complete ophthalmological history and

performing clinical examination as well as formulating a differential diagnosis

and plan of management for common diseases in Ophthalmology under the

supervision of attending staff members.

Objectives

By the end of the course, students shall be able to:

General Objectives:-

1 Essential Demonstrate the ability to take focused history

for patients presenting with common medical

diseases.



2 4 Bed side teaching (inpatient wards)

5 10 Out-patient clinic

3 6 Tutorial sessions ( slides show and case discussion)


examination with emphasis on normal and

abnormal features on physical examination.

3 Very

desirable

Synthesize the information obtained from history

and Physical examination into logical

differential diagnosis.

4 Very

desirable

Develop a working management plan.



6 Very

desirable

Develop the skills to interpret these

investigations.

7 Very

desirable

Demonstrate competencies in basic diagnosis

and procedural skills relevant to common

medical conditions.

8 Desirable Able to select the proper therapy and be aware

of its interaction, side effect and complication.

9 Very

desirable

Distinguish medical conditions requiring normal

or immediate referral to concerned specialties.

10 Very

desirable

Rapidly recognize medical and trauma

emergencies requiring urgent a plan for action.

11 Very

desirable

Demonstrate basic proficiencies in competencies

in procedural skills relevant to each specialty.


13 Very

desirable

Maintain ethical attitudes and professional

behavior of student during training,

concentrating on punctuality, responsibility and

teamwork.

14 Very

desirable

Encourage every student to develop his/her

steam by analyzing his/her weakness and

strengths, during training.

15 Very

desirable

Demonstrate appropriate and affective verbal

skills (using language appropriate to the patient


listening skills

16 Very

desirable

Get used to critical thinking and self-learning.


1 Essential Understand and explain the risks and benefits of

investigations and treatments.

2 Very desirable Demonstrate competency in basic diagnostic and procedural

skills relevant to common ophthalmic conditions.

3 Essential Rapidly recognize and start essential initial management of

ocular emergencies and traumas.

4 Very desirable Recognize the ocular manifestations of systemic diseases.

II. Ophthalmology Syllabus:

Since KSMC family medicine department only accept six (6) students for the

clerkship rotation. The total of 12 students will be divided into two groups (A &

B) of six (6) students. The rotation for group A will be at hospital and group B

at the college on alternate days (one day in hospital and one day in the college

for tutorial sessions).The total hospital rotation for each group in two weeks'

time will be for five (5) days in the hospital and five (5) days in the college for

each group. But the total clerkship and tutorial for each group will be for ten

(10) days. The clerkship rotation is composed of a total of five (5) full working

days according to the hospital time.

The working day is divided into two sessions. One morning session, and

another afternoon session, with a break in-between (for prayer and lunch). This

will be equal to total of twenty (10) sessions

Sessions Allocation:-


3 6 Out-patient clinic

1 2 Refraction clinic (optician)

1 2 Operative room (OR)

5 10 Total sessions

Tutorial sessions at the college:-

Since KSMC will only accept maximum of six (6) students in hospital rotation,

and the total of ophthalmology clerkship rotation is for ten (10) days, there will

be college tutorial sessions for five (5) days. The program of these tutorials will

be given at later stage.

DERMATOLOGY


The clinical dermatology clerkship is for ten (10) days rotation. This provides

a comprehensive overview of outpatient dermatology. Students are expected

to integrate the basic of dermatology to develop an approach to increase

familiarity with common dermatologic diagnosis and dermatologic

vocabularies.

The students will be given didactics lectures before they are actually posted

in hospitals.

Objective:

By the end this rotation, the student should be able to:









diagnosis.





7 Very desirable Demonstrate competencies in basic diagnosis relevant

to common medical conditions.















training.




listening skills



1 Essential Learn basic descriptive terminologies of skin lesions.

2 Essential Recognize and understand pathophysiology and

therapeutic options for some common skin diseases such

as-

- Acne

- Dermatitis

- Cutaneous malignancy

- Exanthema (viral , drug)

- Psoriasis

- Common skin infections

4 Essential Recognize the dermatological manifestation of internal

diseases.

5 Very desirable Develop a basic practical approach to investigations and

treatment of common skin conditions.

6 Very desirable Demonstrate an understanding of the role of the immune

system in the pathogenesis of some skin diseases.

II. Dermatology Clerkship Syllabus:

The clinical clerkship rotation is a total of ten (10) days. The working day is

divided into two sessions. One morning session, and another afternoon session,

with a break in-between (for prayer and lunch). Therefore the rotation will be

equal to twenty (20) sessions.



8 16 Outpatient clinics

2 4 Tutorial sessions


Tutorial sessions: (slide presentation)

In these sessions, trainer will present cases on slides and followed by case discussion.

PSYCHIATRY

I. Course description:

The psychiatry clerkship is a 10 days rotation that is intended to give students a

brief yet in-depth experience in practical aspects of psychiatry.

During the rotation, the student will learn about general adult psychiatry, child

psychiatry and outpatient psychiatry through exposure to outpatient, inpatient and

emergency departments.

The clerkship should give at least some exposure (either practical or didactic) to

major themes, including common types of psychiatry disease, treatment and

psychiatry interview and mental status examination.

II. Objectives:

By the end of the clerkship rotation the student should be able to:









diagnosis.





7 Very desirable Demonstrate competencies in basic diagnosis

relevant to common medical conditions.















training.




listening skills



1 Essential Develop awareness of proper methods of

interaction with disturbed patients and patients

with chronic psychiatric illnesses.

2 Very desirable Perform a complete mental status examination and

recognize significant findings.

3 Very desirable Identify and acquire basic knowledge related to

major psychiatric disorders, e.g. mood and anxiety

disorders, psychoses, personality disorders,

substance disorders and disorders involving

cognitive impairment (delirium / dementia).

4 Desirable Be familiar with major classes of psychotropic

medications, including pretreatment work-up,

indications and contra indications, starting and

adequate maintenance does ranges, common drug

interactions and common side effects.

III. Psychiatry Syllabus:

The clerkship rotation is composed of a total of ten (10) full working days according

to the hospital time.

The working day is divided into two sessions. One morning session, and another

afternoon session, with a break in-between (for prayer and lunch). This will be equal

to twenty (20) sessions.

Clerkship Sessions distribution:-


5 10 Outpatient clinic

3 6 Inpatient bedside teaching

2 4 Emergency cases in emergency department


ANESTHESIOLOGY

I. Course description:-

The anesthesiology clerkship is five (5) days rotation. Students obtain clinical

experience in the operating room under supervision, reinforced with didactic

teaching session. Also this rotation provides students an exceptional

opportunity to learn about airway management. The students will have five

(5) days tutorial sessions at the college.

II. Objectives:-

At the end of rotation student will be able to:









diagnosis.





7 Very desirable Demonstrate competencies in basic diagnosis relevant

to common medical conditions.















training.




listening skills



1 Essential Increase capability of initiating appropriate therapy in

acute problems which lead to respiratory and

circulatory arrest.

2 Essential Acquire techniques of IV placement and airway

management.

3 Essential Review pharmacology of vasoactive drugs and their

physiology effects.

2 Very desirable Become familiar with the role of anesthesiologist in

the operating room, the intensive care Unit.

4 Very desirable Learn fundamental anesthetic technique, procedures

and pre-anesthetic patient evaluation and preparation.

III. Anesthesia Clerkship Syllabus:-

Total rotation is for five (5) days. This will be for a full day according to hospital

time. The working day is divided into two sessions, one session in the morning and

another in the afternoon, with a break in between (for prayer and lunch). This will

equal to ten (10) sessions.


Tutorial sessions at college:-

The students will have five days tutorial sessions at the college. Students will be

providing with the list of items to be taught in the college at later stage.


Obstetrics' & gynecology Orthopedics Emergency Forensics & history of medicine

OBSTERICS AND GYNECOLOGY Clerkship:-


The obstetrics and gynecology clerkship runs over a total of six (6) weeks. This

includes one week of didactic lectures before the start of clerkship rotations, one

week for end of rotation assessment and four (4) weeks of clinical rotation.

During this clerkship students participate in all activities related to obstetrics

and gynecology. Students attend clinical rounds and outpatient clinics with the

consultants, registrars, and chief residents. Students observe and assist under

supervision interventional diagnostic and therapeutic procedures. Emphasizes

Days Session Activities

1 2 Tutorial – air way management

1 2 Pre- operative preparation

3 6 Operative room/ post-operative recover room

5 10 Total sessions

health care for women of reproductive and postmenopausal ages. Student will

rotate through three clinical segments, emergency department and outpatient

clinic, obstetrics (labor and delivery room) and gynecology. Also this includes

preparation of patient for surgery and assisting at surgery and deliveries, post-

operative and post-partum care.

Generally students are expected to master history taking and perform clinical

examination on medical patients as well as participate in patient-care related activities.

This four (4) weeks interdisciplinary clerkship of obstetrics and gynecology

offers students a range of experiences and opportunities in the fields of this

specialty.

Each week has five full working days with three days in hospital rotations, with

two full working days of the week is set aside for lectures/tutorials at the College.


At the end of obstetrics and gynecology rotation, the student will be able to:-

1 Essential Adequately perform a thorough and organized

menstrual obstetrics, gynecology, contraceptive

and sexual history.

2 Essential Demonstrate competency in the performance of

breast and pelvic exams.

3 Very desirable Recognize the presentation and course of

common diseases specific to women.

4 Essential Demonstrate understanding of physiologic

changes of normal pregnancy.

5 Very desirable Be able to discuss common problems in

obstetrics.

II. Obstetrics and Gynecology Clinical Rotation:-

The clinical clerkship part of the course runs for a period of four weeks. In every

week, three days are spent in the hospital for clinical activities and two days in the

college for lectures/tutorials and skill sessions. Thus, students will spend a total of

twelve (12) full working days in the hospital according to the hospital time

regulation. The working day is divided into two sessions; a morning session (8 am

– 12 noon), and an afternoon session (1 pm – 4 pm), with a break in between (for

prayer and lunch). The total clinical sessions in the Rotation is thirty (24) sessions

Distribution of Sessions:-


4 8 Bed side teaching

2 4 Obstetrics outpatient clinics.

2 4 Gynecology outpatient clinics.

1 2 Emergency department.

1 2 Operation room.

2 4 Skills / Procedures learning.


SKILLS / PROCEDURES LEARNING AT HOSPITAL:-



- Data interpretation (e.g. blood results, ECG, Radiology imaging etc.)

- Vaginal examination.

- How to take a pop smear.

- Interpretation of fetal heart rate monitoring.

- Wound care.

- Breasts examination.

- Female urinary catheterization.

- Other relevant skills/procedures.

ORTHOPEDIC ROTATION:-


The orthopedics runs over a total of six (6) weeks. This includes one week of didactic

lectures before the start of clerkship rotations, one week for end of rotation assessment

and four (4) weeks of clinical rotation. During this clerkship students participate in all

activities related to orthopedics. Students attend clinical rounds and outpatient clinics

with the consultants, registrars, and chief residents. Students observe and assist under

supervision interventional diagnostic and therapeutic procedures. Generally students

are expected to master history taking and perform clinical examination on medical

patients as well as participate in patient-care related activities.

This four (4) week interdisciplinary clerkship of orthopedics offers students a

range of experiences and opportunities in the fields of orthopedics.

Each week has five full working days with three days in hospital rotations, and

two full working days of the week is set aside for lectures/tutorials at the College.


By the end of orthopedic rotation, the students will be able to:-

1 Essential Develop a greater understanding of congenital and

acquired disorders of the musculoskeletal system.

2 Very desirable Develop on understanding of the basic principles

involved in the management of orthopedic disorders by

physical, medical and surgical means.

3 Desirable Develop further skills in preoperative, surgical and

postoperative care of the orthopedic patient.

4 Very desirable Develop a basic understanding of the general

requirements for rehabilitation of the orthopedic

patient.

5 Desirable Learn how to write and implement on exercise

prescription and physical therapy prescription.

6 Essential Understand and discuss the concepts of injury

prevention.

II. ORTHOPEDIC CLINICAL ROTATION:

The clinical clerkship part of the course runs for a period of four (4) weeks. In every

week, three days are spent in the hospital for clinical activities and two days in the

college for tutorials, discussions, and skill sessions. Thus, students will spend a total

of twelve (12) full working days in the hospital according to the hospital time

regulation. The working day is divided into two sessions; a morning session (8 am –

12 noon), and an afternoon session (1 pm – 4 pm), with a break in between (for

prayer and lunch). The total clinical sessions in the rotation are thirty (24).



In the skills / procedures learning sessions, the hospital trainer will teach students

in group basic skills related to the clinical rotation. These include:

Reading x-rays and other imaging techniques of various orthopedic diseases and

musculoskeletal trauma


..etc.)

Knee aspiration

Knee injection

Cast application and removal

Basic techniques of fracture manipulation and joint reduction

Initial emergency splinting of fractures and injuries, and safe mobilization of

injured patients

EMERGENCY ROTATION:-


The emergency clerkship runs over a total of six (6) weeks. This includes one

week of didactic lectures and tutorials before the start of clerkship rotations, one

week for end of rotation assessment and four (4) weeks of clinical rotation. The

student will see more patients as the primary provider. Because most ED

patients present without an already made diagnosis (i.e. are undifferentiated),

will have an opportunity to more fully develop and fine tune diagnosis skills,

including those related to history-taking physical examination, and appropriate

use of laboratory and radiographic testing modalities. Additionally, student will

learn to develop broad and appropriately prioritized differential diagnosis. Many


6 12 Bed side teaching

2 4 Outpatient Clinical Sessions


1 2 Operating room

2 4 Skills / Procedures learning


patients who present to the ED do so with common outpatient problems that he

will frequently see and manage. Other patients will present with acute,

potentially life-threating disease or injury requiring quick therapeutic decisions.

This will provide student with the knowledge, experience and self-confidence

necessary to effectively diagnose and manage other patients with acute and

often life-threatening illness. Student will also have the opportunity to develop

skills in several basic and common procedures, including blood draws, insertion

of intravenous catheter, incision and drainage of abscesses, laceration repair and

lumbar puncture.

This four (4) week interdisciplinary clerkship of emergency offers


emergency.


and one full working day of the week is set aside for lectures/tutorials at

the College.

II. Specific Objectives:-

By the end of emergency rotation student will be able to:-

1 Very desirable Initial resuscitation and stabilization.

2 Very desirable Learn selected procedural and wound care

technique.

III. Emergency Syllabus:-

The clinical clerkship part of the course runs for a period of four weeks. In

every week, four days are spent in the hospital for clinical activities and one

day in the college for tutorials, discussions, and skill sessions. Thus, students

will spend a total of sixteen (16) full working days in the hospital according to

the hospital time regulation. The working day is divided into two sessions; a

morning session (8 am – 12 noon), and an afternoon session (1 pm – 4 pm),

with a break in between (for prayer and lunch). The total clinical sessions in the

rotation are thirty two (32).

Distribution of Sessions:-

Emergency department activities:-

During the posting in the department of emergency, student will be exposed to

general emergency activities, emergency department resuscitating room, casting /

splinting room, Obstetric room and pediatric room.

Skills / Procedures learning at hospital:

In the skills / procedures learning sessions, the hospital trainer will teach students

in group basic skills related to the clinical rotation. These include:

Blood draws


.etc.)

Insertion of intravenous catheter

Incision and drainage of abscesses

Laceration repair

Wound care

Observe lumber puncture performance

This year consist of two levels, level nine (9) and level ten (10).


MEDICINE – 2 clerkship

I. COURSE DESCRIPTION:

The medicine-II clerkship runs over a total of six (6) weeks. This includes one

week of didactic lectures, one week for end of rotation assessment and four (4)

weeks of clinical rotation. During this clerkship students participate in all

clinical activities related to medicine-II module. Students attend clinical rounds

Days Session Activities

4 8 Tutorial sessions at hospital


2 4 Skills / Procedures learning


Medicine -2 Surgery – 2 Pediatrics – 2

and outpatient clinics with the medical consultants, registrars, and chief

residents in groups at designated hospitals of the capital city of Riyadh, Saudi

Arabia. Students observe and assist under supervision diagnostic and

therapeutic procedures related to the practice of internal medicine. Generally

students are expected to master history taking and learn to perform systematic

physical examination of patients admitted to wards and seen at ambulatory

practice. They also participate in the institutional teaching and training activities

within the realm of the continuing medical education professional development.

This four (4) week interdisciplinary clerkship of internal medicine offers


internal medicine.

Each week has five full working days with first four days divided in two

morning and afternoon sessions. The last working day of the week

(Thursday) is set aside for tutorials at the Al Maarefa College.

II. Objectives:

General objectives

1 Essential Demonstrate the ability to take focused history in a logical, organized, and thorough manner.

2 Essential Demonstrate skills of appropriate physical examination without incorporating unnecessary maneuvers or omission of essential maneuvers.

3 Very desirable

Synthesize the information obtained from history and physical examination into logical differential diagnosis.

4 Very desirable

Having interviewed and examined a patient demonstrate ability to make clear oral presentation.

5 Very desirable

Demonstrate ability to plan appropriate and cost-effective investigations to reach the diagnosis.

6 Desirable

Demonstrate ability to ascertain and interpret results of investigations.

7 Very desirable

Demonstrate learning skills and ability to identify and meet emerging information for most appropriate diagnosis.

8 Desirable Demonstrate ability to make appropriate choice of therapeutic options including costs, risks, benefits and efficacy.

9 Essential Demonstrate ability in patient encounters of behavior that is consistent with high standards of medical ethics and professionalism.

10 Very desirable

Demonstrate skills for coordination of care and skills of communication with colleagues.

11 Very desirable

Demonstrate ability for critical thinking and self-learning.

Specific objectives:

1 Essential Have understanding of the principles and practice for ambulatory care and those requiring admission to wards. Develop knowledge, attitudes and skills in the management of all patient encounters.

2 Essential Develop professional competence for excellence of patient care, understand and advance knowledge to become leaders in their chosen fields.

3 Desirable Practice medicine within the context of society and its expectations. Practice evidence-based approaches and broaden its application from individual patients to health care service in general.

5 Desirable Understand the limits of one’s personal knowledge, remediate inadequacies. Keep abreast with current advances, and integrate increased self-knowledge into their daily practice.

III. MEDICINE CLERKSHIP SYLLABUS:

The clinical clerkship rotation for medicine at level 12 alone for Med II

semester is for sixteen (16) days, Each working day is divided in two sessions

one in the morning and another in the afternoon with break between two

sessions (for prayer and lunch). The total (32) sessions for medicine clerkship is

structured for internal medicine and medical sub-specialties and is inclusive of

session attendance at outpatient clinics as follows:

SESSION DISTRIBUTION:

Days

Session (s)

Activities

9 18 Bed-side teaching - Inpatient (Wards) 2 4 Outpatient clinic

2 4 Emergency department 3 6 Skills /procedures learning (see details)


HOSPITAL BED SEIDE TEACHING SESSIONS DISTRIBUTION:

ACTIVIITY SESSION(S)

Internal Medicine 3

Neurology 2

Cardiology 3

Respiratory Medicine 2

Gastroenterology 2

Endocrinology 2

Rheumatology 2

Hematology 2

Total 18


In the skills / procedures learning encounters, the hospital trainer will teach students

in a group basic skills and procedures employed specific to a clinical situation for an

individual patient. These include:

Venous Blood withdrawal: Principles and practice of withdrawing blood for

biochemical, hematological and microbiological investigations.

Arterial blood withdrawal: Indications and technique of withdrawing arterial

blood samples for blood gas analysis.

Setting up I/V line: Indication, safety measures and technique for setting up

I/V line (s).

Naso-gastric tube insertion: Indications and technique used for safe naso-

gastric tube insertion and verification of its placement at correct site.

Lumber puncture: Indications and technique employed for performing safe

aseptic lumber tap.

Abdominal fluid aspiration: Indications and technique used for peritoneal fluid

aspiration.

Urinary catheter insertion: Indications and technique used for safe and aseptic

urinary catheter insertion.

Pleural fluid aspiration: Indications and technique used for pleural fluid

aspiration and insertion of chest drain.

IV. Evaluation:-

The college will control the evaluation patterns and define the parameters of the

evaluation.

i. Theory.( 30 marks)

Assessment of knowledge (theoretical) shall be performed through written

examinations (MCQS) by ALMAAREFA College at the end of each

specialty hospital rotation as outlined below:

Specialty Number of MCQs

Total time/minutes

Medicine , Surgery & pediatrics 90 135

Ob/Gyn, Orthopedics, Emergency 60 90

ENT, Ophthalmology, Dermatology, Psychiatry, Family medicine and Anesthesia

40 60

The questions will cover the total medical topics.

It should be emphasized that examinations are based on the intended learning objectives (ILO) of the course and

the reference text books for each specialty.

Each question will last for 1.5 minutes

ii. Clinical Rotation Evaluation (70 marks).

Introduction:-

At the end of rotation there will be an assessment of the students. This assessment

will ensure that students master the skills and competencies they learn during

rotation in each specialty.

The student is assessed for his/her ability focused history taking, performing physical

examination, patient management and other skills such as case presentation and

case report.

Objectives:-

i. To ensure that students’ achieve the maximum benefits of training.

ii. To evaluate students’ training performance fairly.

SPECIALTIES MARKS DISTRIBUTION:-

Specialty Exam. Method Clinical cases Marks

Slides Show marks

Case presentation

Case report

Total marks

Medicine & Surgery Two Real patients 40 (40)

20 (20)

5 (5)

5 70

Orthopedics Two clinical case scenarios + SPs pts

40 (40)

20 (20)

5 (5)

5 70

Pediatrics, Ob/Gyn Two Clinical case scenarios

30 (30)

30 (30)

5 (5)

5 70

Emergency three clinical case scenarios

45 (45)

20 (20)

5 (5)

- 70

Dermatology, ENT, Two clinical case scenarios

30 (30)

40 (40)

- - 70

Ophthalmology Two clinical case scenarios

30 (30)

40 (40)

- - 70

Psychiatry Seven (7) MEQs 70 (126)

- - - 70

Anesthesia Seven (7) modified clinical case scenario

70 (105)

- - - 70

Family medicine Clinical assessment will be done in tutorial sessions at college

( ) Means total time for this procedure

Assessment conduction process

I. Clinical cases

1. Real patient's cases:- (20 marks and last for 15 minutes)

This is applied in Medicine and Surgery on real patients at the training

hospitals.

A. History taking:

The student will be given a brief complaints history and asked to take further

history, in the examiner attendance.

The student is expected to take history for those complaints and not to take

full systems history.

The examiner will observe student taking history from patient and grade

student based on a ready marking sheet.

Examiner must remember that he evaluates undergraduate student, and only

evaluating student's competency level of history taking skills.

This process will be allocated five (5) minutes and evaluated out of five (5)

marks.

B. Physical examination:

Student then will be asked to perform physical examination pertinent to

history taking, on the same patient. Student might be asked to examine a

system (of examiner's choice) not necessary related to history taken.

After doing physical examination, student will describe findings (or expected

finding) from physical examination.

Examiner will observe student physical examination performance and grade

student based on a ready marking sheet.

Again the examiner will evaluate the student's physical examination process

at this level of learning.

The process will last five (5) minutes and evaluated out of five (5) marks.

B. Clinical management: (10 marks)

After taking history and doing physical examination, students are expected to:

- Formulate differential diagnoses

Student will give differential diagnoses, depending on history taking and

findings of physical examinations. The number will be defined by the

examiner.

- Request relevant investigation(s).

Student then will be asked to mention relevant investigation(s), which

enable ones to reach to a diagnosis.

These investigation(s) must be relevant to the history and differential

diagnosis, for student to deserve the marks.

- Give a treatment plan.

Student has to suggest appropriate treatment plan.

A plan might be a drug(s) medication, non-drug(s) medication

(physiotherapy) and or referral for further treatment (surgery) depending

on clinical problem(s).

Examiner must not expect from a student to give detailed medication

prescription at this stage, if done then this must be considered as

distinction marks.

Again the examiner will give students marks for correct answers based on a

ready check list.

Clinical management process will be allocated five (5) minutes and

evaluated out of ten (10) marks. Weight of each elements will vary form

specialty to another.

The total time to finish one clinical case is fifteen (15) minutes.

The total clinical case process will be manned by one examiner.

Student will be assessed by two independent examiners with two

different clinical cases.

2. Standardized patients:- (SPs)

This is a normal individual, who will act as a patient based on a given clinical

scenario.

This method of examination is applied for orthopedics at the present time for

doing physical examination.

The student will be instructed to do physical examination on SPs of the

examiner's choice.

The examiner will observe student's performance in examination and

score student according to a ready marking sheet.

This process will last for five (5) minutes and evaluated out of five (5) Marks

Student will be assessed by two independent examiners with two

different clinical Examinations.

3. Clinical scenario:-

- Medical case scenario:- (total 15 marks and last 20 minutes)

There will be a brief medical patient's complaints history followed by

questions. The number and type of questions will be similar to what

applied in medicine and surgery, apart from physical examination. The

marks distributions will be five (5) marks for history taking and ten (10)

marks for other questions on the case. Since history taking is very

essential competency for a student to learn, the skill must be given

emphasis as follows:

A. History taking.

After a brief complaints history, student is asked to take further

history. Student should not write a full systems history. Student

should limit himself to only write history of a system relevant to the

complaints history given.

This process will last for five (5) minutes and student's history writing

will be evaluated out of five (5) marks according to a ready marking

sheet.

B. Clinical management. (10 marks)

After taking history, the student will be asked to give differential

diagnosis, request relevant investigation(s) and to give a

treatment plan. Similar to what done in real patients in medicine

and surgery.

This type of examinations will be applied to other specialties.

- Modified medical case scenario: (total of 10 marks and last 15

minutes)

In case of anesthesia; there will be seven (7) medical case scenarios

followed by ten (10) MCQs and each MCQ question will last for 1.5

minute and will be given one (1) marks

- Modified essay questions (MEQ): (total of 10 marks and last 18

minutes)

This is a building up medical story. Presented in different medical

scenarios and each scenario have relevant questions.

Each MEQ will last for eighteen (18) minutes and will be graded out

of ten (10) marks.

II. Clinical based slides show:-

There will be slides show; number will vary from a specialty to another

(mentioned in the above table). In these slides show there will be at least three

(3) data interpretations, three (3) instruments identifications and remaining

spot diagnosis.

Each slide will last for two (2) minutes and given two (2) marks.

III. Communication competencies:-

1. Case report (write- up)

The students will prepare one detailed case report during the hospital

rotations of (Medicine, surgery, Pediatrics, Ob/Gyn, and Orthopedics). This

case report should be handed to the college before a student is evaluated

for the case presentation.

The case report will be evaluated out of five (5) marks.

IV. Case presentation

The student will put this case report into a form of power point

presentation.

The presentation will last for five (5) minutes. And evaluated out of five

(5) marks.

The examiner will assess the presentation base on a ready marking sheet.

The purpose of this, students will get used to utilize the technology for

better communication.

The elements to be evaluated during the presentation are:

- Relevant history taking

- Physical examination reached to finding.

- Relevant differential diagnosis

- Appropriate suggested treatment plan.

- Clarity of presentation.

- Time management of presentation.

Reference books:-

These are the books which are recommended by the college, and they are not

obligatory on the students' choice. Students can read from any reference of his choice.

Medicine principles are same in all medical books. What differ between one book and

another is whether its language is difficult or easy to read, and whether the book is

written in details or in brief (concise). In my personal opinion, I would recommend

that students read detailed books for better remembering and understanding.

Dermatology

Fitzpatrick's color Atlas & Synopsis of Clinical dermatology

KLAUS WOLFF

RICHARD ALLEN JOHNSON.

Ophthalmology

Lectures notes; ophthalmology 11th edition

Otolaryngology

Pl Dhingra

FAMILY MEDICINE A Practical Approach

Khalid S. Al-

Gelban.Yahia M. A-Khaldi. Mohammad M. Diab

Psychiatry

First aid of psychiatry clerkship 3rd

edition

Obstetrics and gynecology

Essential of obstetrics and gynecology 5th

edition

ORTHOPEDICS

Apley's concise orthopedic & fractures 3rd

edition

EMERGENCY MEDICINE

FIRST AID FOR THE EMERGENCY MEICINE clerkship.

THIRD EDITION- A STUDENT TO STUDENT GUIDE

MIDICINE REFERENCE

Davidson's Principles and practice of medicine, 21st Edition

SURGERY Browse’s Introduction to The Symptoms and Signs of Surgical Disease

Principles and Practice of Surgery: Editors Garden, Bradbury, Forsythe and Parks

Pocket Books:

Churchill’s pocket book- Surgery by Raftery and Delbridge

Oxford’s Handbook of Surgery

Bailey & Love's Short Practice of Surgery 26E

Norman Williams, Christopher Bulstrode, P Ronan O'Connell

PEDIATRICS

NILSON

Essentials of Pediatrics

FIFTH EDITION

Clerkship Rotation evaluation by students (students' feedback):-

Students' views, about the rotation and syllabus in general will be discussed in a

meeting with the students at the end of rotations. Modification based on students'

suggestion shall be considered to improve the clerkship organization in the future.

Student is asked to fill the clerkship rotation assessment form at the end of each

specialty rotation.

It is very important and useful if the student puts his personal remark points at the end

of each rotation. This will help in better organization of future training; therefore

students are encouraged to give their constructive feedback opinions at the end of each

specialty rotation. All responses will be kept confidential.

Students Evaluation of Faculty

Faculty Name:-

Student’s Name:

Rotation name: Rotation Period: - From / / to / /

Please evaluate your faculty’s performance during this rotation utilize the following

scale:

4 = Outstanding 3 = above average 2 = Average 1 = below average 0 = Unacceptable

All individual responses will be kept CONFIDENTIAL. Composite summary data will

be provided to faculty in an ANONYMOUS format. Place a check mark in the

appropriate box for each area:

0 1 2 3 4

Medical Knowledge

Professional Attitude

Teaching Skills

Availability to you

during rotation

Value of teaching

sessions

Value of rotation

Students Evaluation of Rotation

Student's name:-

Specialty :-

1. Was the duration of specialty sufficient?

Yes No

If no, then write the suggest period

2. Was the distribution of sessions appropriate?.

Yes No

If no, please write your views.

3. What are your suggestions to improve the rotation?

4. Is the specialty rotation in this hospital worthwhile?

Yes No

If no, please write why.

-

-

-

-

Please return NO LATER THAN ONE WEEK AFTER END OF EACH ROTATION

to training director in AlMaarefa College.

THANK YOU

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