STUDY GUIDE - Liaquat National Hospital & Medical College GUIDE-CVS-… · · 2017-08-192 Introduction to Study Guide 04 3 Learning Methodologies 05 ... 9 Schedule 24. ... • Help

21st Aug – 19th Sept 2017

LIAQUAT NATIONAL HOSPITAL

& MEDICAL COLLEGE

CARDIOVASCULAR SYSTEM MODULE-I

FIRST YEAR MBBS SEMESTER 2

STUDY GUIDE

1ST YEAR MBBS, SEMESTER 2 CVS MODULE-I LIAQUAT NATIONAL MEDICAL COLLEGE

2017 Page | 2

STUDY GUIDE FOR CARDIOVASCULAR SYSTEM MODULE-I

S.No

CONTENTS Page No

1 Overview 03

2 Introduction to Study Guide 04

3 Learning Methodologies 05

4 Module 3: Cardiovascular System-I 07

5 Importance 07

6 Objectives and strategies 08 6.1 Learning Resources 16 6.2 Assessment Methods 18 7 Semester Examination Rules And Regulations of JSMU 20 8 Modular Examination Rules And Regulations (LNMC) 23 9 Schedule 24


2017 Page | 3

Module name: Cardiovascular System-I

Semester: Two Year: One Duration: 4 weeks (Aug 2017 – Sept 2017)

Timetable hours: Lectures, Case-Based Learning (CBL), Self-Study, Practicals, Skills,

Demonstrations, Visit to Wards & Laboratory

Credit hours: 3 credit hours in theory and 1.5 credit hours in practical

MODULE INTEGRATED COMMITTEE

DEPARTMENTS’ & RESOURCE PERSONS’ FACILITATING LEARNING

MODULE COORDINATOR: • Prof. Syed Hafeez-ul-Hassan (HoD Physiology)

CO-COORDINATORS: • Professor Nighat Huda (DHCE) • Dr. Ahsan Ashfaq (Physiology)

BASIC HEALTH SCIENCES CLINICAL AND ANCILLARY DEPARTMENTS ANATOMY

• Professor Zia-ul-Islam

• Professor Faiz Muhammad

CARDIOLOGY • Dr. Faisal Ahmed • Dr. Imran Sandeelo

BIOCHEMISTRY • Professor Jawed Altaf Baig

RADIOLOGY • Dr Muhammad Ayub Mansoor • Dr. Roomi Mahmud

COMMUNITY MEDICINE • Professor Rafiq Soomro

RESEARCH & SKILLS DEVELOPMENT CENTER • Dr Kahkashan Tahir

PATHOLOGY • Professor Naveen Faridi

PHARMACOLOGY • Professor Nazir Ahmad Solangi

PHYSIOLOGY • Professor Syed Hafeezul Hassan

DEPARTMENT of HEALTHCARE EDUCATION • Professor Nighat Huda • Dr. Mirza Aroosa Beg • Dr. Sobia Ali

LNH&MC MANAGEMENT

•Professor Amir Ali Shoro, Dean & Principal, Director FHS LNH&MC •Dr. Shaheena Akbani, Controller A.A & R.T LNH&MC

STUDY GUIDE COMPILED BY: Department of Health Care Education

• Dr. Muhammad Suleman Sadiq

• Dr. Mehnaz Mehmood

• Dr. Afifa Tabassum


2017 Page | 4

INTRODUCTION

WHAT IS A STUDY GUIDE?

It is an aid to:

• Inform students how student learning program of the semester-wise module has been

organized

• Help students organize and manage their studies throughout the module

• Guide students on assessment methods, rules and regulations

THE STUDY GUIDE:

• Communicates information on organization and management of the module.

This will help the student to contact the right person in case of any difficulty.

• Defines the objectives which are expected to be achieved at the end of the module.

• Identifies the learning strategies such as lectures, small group teachings, clinical skills,

demonstration, tutorial and case based learning that will be implemented to achieve the

module objectives.

• Provides a list of learning resources such as books, computer assisted learning programs,

web- links, journals, for students to consult in order to maximize their learning.

• Highlights information on the contribution of continuous and semester examinations on the

student’s overall performance.

• Includes information on the assessment methods that will be held to determine every student’s

achievement of objectives.

• Focuses on information pertaining to examination policy, rules and regulations.

CURRICULUM FRAMEWORK Students will experience integrated curriculum of 1st & 2nd semesters.

INTEGRATED CURRICULUM comprises of system-based modules such as Locomotor system, Respiratory

System and Cardiovascular system which links basic science knowledge to clinical problems. Integrated

teaching means that subjects are presented as a meaningful whole. Students will be able to have

better understanding of basic sciences when they repeatedly learn in relation to clinical examples.

Case-based discussions, computer-based assignments, early exposure to clinics, wards, and skills

acquisition in skills lab and physiotherapy department are characteristics of integrated teaching program.


2017 Page | 5

LEARNING METHODOLOGIES

The following teaching / learning methods are used to promote better understanding:

• Interactive Lectures

• Hospital / Clinic visits

• Small Group Session

• Case- Based Learning

• Practicals

• Skills session

• E-Learning • Self Study

INTERACTIVE LECTURES

In large group, the lecturer introduces a topic or common clinical conditions and explains the underlying

phenomena through questions, pictures, videos of patients’ interviews, exercises, etc. Students are

actively involved in the learning process.

HOSPITAL VISITS: In small groups, students observe patients with signs and symptoms in hospital or

clinical settings. This helps students to relate knowledge of basic and clinical sciences of the relevant

module.


2017 Page | 6

SMALL GROUP SESSION (SGS): This format helps students to clarify concepts acquire skills or

attitudes. Sessions are structured with the help of specific exercises such as patient case, interviews or

discussion topics. Students exchange opinions and apply knowledge gained from lectures, tutorials and

self study. The facilitator role is to ask probing questions, summarize, or rephrase to help clarify concepts.

CASE- BASED LEARNING: A small group discussion format where learning is focused around a series of

questions based on a clinical scenario. Students’ discuss and answer the questions applying relevant

knowledge gained in clinical and basic health sciences during the module.

PRACTICAL: Basic science practicals related to anatomy, biochemistry, pathology, pharmacology and

physiology are scheduled for student learning.

SKILLS SESSION: Skills relevant to respective module are observed and practiced where applicable in

skills laboratory or Department of Physiotherapy.

E-LEARNING: E-Learning is a strategy by which learning occurs through the utilization of electronic

media, typically the Internet, MOODLE or other electronic mediums. The basic concepts of CVS-I module will

be addressed on MOODLE through an e-learning course via Videos, E-Lectures, animations and Review

topics. All the topics on MOODLE are complementary to the topics covered in lectures and small group

sessions and will assessed through quiz on moodle.

The end of module quiz on the MOODLE will be included in internal evaluations.

SELF STUDY: Students’ assume responsibilities of their own learning through individual study, sharing and

discussing with peers, seeking information from Learning Resource Center, teachers and resource

persons within and outside the college. Students can utilize the time within the college scheduled

hours of self-study.


2017 Page | 7

MODULE 3 : CARDIOVASCULAR SYSTEM-I

INTRODUCTION

Welcome to the Cardiovascular System Module-I. In the next four weeks you will have the opportunity to

develop understanding of the basic concepts of cardiovascular system through an integrated course

designed by basic and clinical science faculty.

Heart being the main organ of cardiovascular system is responsible for distributing blood all over human

body. A perfectly functioning cardiovascular system is so important for human body, that if it stops for a

minute, rapid death may occur. In the 3rd year in cardiovascular system - II module students will learn in

depth about the cardiovascular diseases.

Cardiovascular diseases are one of the leading causes of illness and death worldwide leading to reduced

quality of life. The disease burden of Ischemic Heart Disease in Pakistan is estimated as 5.09375 million,

with one out of every three individual suffering from hypertension1. Therefore cardiovascular diseases

account for the biggest group of disorder presenting to the general physician.

The medical curriculum is not only the study of disease outcomes but also about “prevention being better

than cure” Unhealthy lifestyle choices such as rich fat diet, overweight, smoking, increase the risk of

cardiovascular diseases. Therefore as a medical student it is important to understand how the risk of

cardiovascular disorders can be reduced by adapting healthy lifestyle.

We hope you enjoy the next four weeks. There will be other modules ahead, but a good grounding in

cardiovascular module will be an important stage of your journey through this system-based course. As a

physician you are expected to counsel individuals, families and communities on prevention of illnesses

including cardiac disorders

1. Shahid Abbas et al. Disease Burden of Ischemic Heart Disease in Pakistan and its Risk factors. Ann. Pak. Inst.

Med. Sci. 2009; 5(3): 145-150


2017 Page | 8

COURSE OBJECTIVES AND STRATEGIES

At the end of the module the students will be able to:

ANATOMY

TOPICS & OBJECTIVES TEACHING STRATEGIES

EMBRYOLOGY:

• Explain the development of cardiovascular system

Interactive Lectures

• Describe the following congenital heart defects: a. Atrial septal defect b. Ventricular septal defect c. Tetralogy of fallot d. Patent DuctusArteriosus e. Transposition of great vessels

• Describe the development of aortic arches

• Describe fetal circulation with relation to changes that occur at birth

HISTOLOGY:

• Describe the microscopic features of a. Artery b. Vein c. Lymph vessels

Interactive Lecture & Practical

• Describe the microscopic features of cardiac muscle Practical

GROSS ANATOMY:

• Describe pericardium and pericardial sinuses

Lecture

• Demonstrate internal structure of heart

Demonstration

• Describe heart wall and fibrous skeleton

Interactive Lectures • Describe the gross anatomy of heart valves

• Demonstrate the anatomical position, borders and surfaces of the heart

Interactive Lectures & Demonstrations

• Demonstrate the surface marking of a. Heart b. Aorta c. Superior venacava


2017 Page | 9

• Perform Precordial examination on human subject

Demonstration

• Describe the position, extent and branches of : a. Ascending aorta b. Arch of aorta c. Descending aorta

• Describe pulmonary trunk, superior vena cava, inferior vena cava and brachiocephalic vein

• Explain the role of lymphatic’s in prevention of edema

Case-Based Learning • Describe the neurovascular supply of heart in context to ischemic heart diseases

BIOCHEMISTRY


• Define lipoproteins

• Classify lipoproteins and describe their functions

• Explain the role of lipoproteins in cardiovascular diseases Interactive Lectures • Define Hyperlipidemia

• Describe the structure & functions of cholesterol

• Explain the clinical correlation of cholesterol in cardiovascular diseases

• Perform estimation of cholesterol in serum Practical

• Enumerate the biochemical markers of Myocardial Infarction (MI)

• Interpret the pattern of rise & fall of each marker in MI

• Define isoenzymes & their significance in MI


• Perform the estimation of cardiac enzymes Practical

• Describe the role of electrolytes in normal cardiac function

• Explain the biomedical importance of electrolyte imbalance in causing cardiac arrest and tetany


• Discuss the role of nutrition and antioxidants in cardiovascular diseases

• Perform the estimation of calcium and Potassium in serum Practical


2017 Page | 10

CARDIOLOGY


• List and identify the imaging techniques used for diagnosis of cardiovascular diseases using knowledge of anatomy and physiology of heart. a. Echo b. Angiography c. Thallium scan

Small Group Learning

• Differentiate the normal & abnormal features of pulse including rate, rhythm, volume and character

• Interpret ECG in relation to abnormalities in myocardial ischemia along with abnormalities of rhythm and block


• Perform the examination of chest in relation to precardium (Inspection, palpitation, auscultation)

NORMAL AND ABNORMAL HEART SOUNDS

• Auscultate heart sounds (S1, S2, S3 and S4) using a stethoscope.


COMMUNITY MEDICINE


• Discuss coronary heart diseases and its prevention

Interactive Lectures • Discuss how hypertension and rheumatic heart diseases can be

prevented

• Discuss the hazards of smoking and its significance

• Discuss risk factors of cardiovascular diseases and role of healthy lifestyle in its prevention



2017 Page | 11

PATHOLOGY


ISCHEMIC HEART DISEASE (IHD)

• Define the term IHD and list the syndromes associated with IHD

• Discuss the pathogenesis of IHD and discuss its causes and outcomes

• Correlate the type of angina pectoris with the pathology of coronary arteries

• Describe the pathology of myocardial infarction (MI) including: types, morphological changes, main clinical features and complications

ATHEROSCLEROSIS (AS)

• Define the term atherosclerosis

• List the risk factors and recognize the precursor lesions associated with atherosclerosis

• Describe the pathogenesis, gross & histological features of AS

• List the complications and effects of atheromatous plaque


• Describe histological features of Myocardial Infarction (MI) and atherosclerosis

• List the biomarkers raised in Myocardial Infarction (MI)

Case Based Learning

CARDIAC FAILURE

• Explain the patho-physiological mechanisms leading to cardiac hypertrophy and progression to heart failure

• List the causes and consequences of cardiac hypertrophy

• Differentiate between left and right sided heart failure

• Describe clinical and morphological changes in the heart and various organs as a consequence of heart failure

Interactive Lectures HYPERTENSIVE VASCULAR DISEASE (HVD) & HYPERTENSIVE HEART DISEASE

(HHD)

• Define types of hypertension, including essential, secondary and malignant hypertension

• List the causes of hypertension

• Explain the pathogenesis of hypertension and recognize the vascular pathology associated with hypertension

• Discuss the consequence of hypertension and pressure overload on the heart and progression to heart failure


2017 Page | 12

VALVULAR HEART DISEASE

• Differentiate between stenosis and insufficiency of valve

• List the major etiologies of acquired valvular diseas

RHEUMATIC HEART DISEASE (RHD)

• Describe the main features of rheumatic fever (RF)

• Discuss the etiology and pathogenesis of RF

• List the pathognomonic lesions of RF & rheumatic heart disease (RHD)

• Describe the changes in the heart and other organs in RF

INFECTIVE ENDOCARDITIS

• Discuss the pathogenesis and list the organisms causing endocarditis

• List the possible complications of bacterial endocarditis

• Describe briefly Libman-Sacks disease


&


PHARMACOLOGY


ANTI-HYPERTENSIVE DRUGS

• Explain the rationale for use of and adrenergic blockers in hypertension and discuss their adverse effects

• Describe the diuretic used in hypertension

• List the ACE inhibitors and describe their mechanism of action and adverse effects

• Explain the rationale for use of calcium channel blockers in hypertension

• Describe the direct vasodilators used in hypertension

• Discuss application of clonidine and methyl dopa in hypertension

• Discuss the treatment of hypertensive crisis

Interactive Lectures and

Case-Based Learning

DRUGS USED IN HEART FAILURE

• Explain the rationale for use of ACE inhibitors in congestive heart failure

• Explain the rationale for use of blockers in CCF

• Discuss the mechanism of action of digoxin, its adverse effects and treatment of digoxin overdose

• Explain the use of diuretics in CCF

• Discuss the treatment of acute CCF


Case-Based Learning


2017 Page | 13

DRUGS USED IN ANGINA PECTORIS

• List the drugs used in treatment of angina pectoris

• Discuss the mechanism of action and adverse effects of nitrates

• Explain the use of blockers in angina pectoris

• Classify calcium channel blockers and describe their mechanism of action and adverse effects


Case-Based Learning

ANTI-ARRHYTHMIC DRUGS

• Classify anti-arrhythmic drugs

• Discuss the effects of quinidine and procainamide on cardiac action potential, their uses and adverse effects

• Discuss the effects of amiodarone on cardiac action potential, its uses and adverse effects

• Discuss the application of calcium channel blockers and blockers as anti-arrhythmic drugs

• Explain the mechanism of action of adenosine, its application and adverse effects


PHYSIOLOGY


• Describe the Physiologic anatomy of heart and properties of cardiac muscles


• Explain the phenomenon of generation of action potential in cardiac muscle & process of excitation contraction coupling

• Describe conducting system of heart & role of pacemaker in maintaining cardiac rhythm

• Explain neural regulation of heart through autonomic nervous system & its effect on cardiac rate (chronotropic), force of contraction (ionotropic), & velocity of conduction (dromotropic) on junctional tissue

• Describe events of cardiac cycle & associated events ( pressure changes, heart sound generation, & effect on volume of heart chambers & vessels, aorta, pulmonary artery

• Describe 12 leads ECG record with appropriate placement on the body

• Interpret Normal ECG waves

Small Group Session/Practical


2017 Page | 14

• Analyze ECG/vectors and their interpretation

Interactive Lectures • Define principles of hemodynamics applicable to heart/blood vessels

• Define cardiac output and factors regulating cardiac output

• Demonstrate and describe pulse, heart sounds & its auscultation

Practical

• Explain preload/after load & its effect on heart

Interactive Lectures • Define arterial blood pressure & state mechanism of regulation of blood pressure (short, intermediate , long term)

• Record blood pressure and explain changes in arterial pressure in

different body positions (lying, upright, standing)

Practical

• Explain Hypertension


• Define capillary fluid shift mechanism

• Explain auto regulation of local blood flow and list vasodilator/vasoconstrictor

• Describe cardiovascular adaptation to exercise

• Enlist content of lymph and lymphatic circulation

• Describe Circulatory shock

• Demonstrate proper arrangement of ECG machine and placement of its leads on human subject Practical

• Demonstrate the refractory period of cardiac muscle through power lab

RADIOLOGY


• Describe the X-ray chest in relation to CVS Interactive Lectures


2017 Page | 15

RESEARCH AND SKILLS LAB


VITALS (BLOOD PRESSURE, PULSE)

• Measure blood pressure by palpatory and auscultatory methods

• Check pulse with respect to rate, rhythm, volume, tension

Small Group Learning CARDIOPULMONARY RESUSCITATION

• Identify the patient in Cardiac Arrest

• Perform cardiac compressions at correct depth and rate

• Give ventilations

Apart from attending daily scheduled sessions, students too should engage in self-study to

ensure that all the objectives are covered.


2017 Page | 16

LEARNING RESOURCES

SUBJECT RESOURCES

ANATOMY

A. GROSS ANATOMY 1. K.L. Moore, Clinically Oriented Anatomy 2. Neuro Anatomy by Richard Snell

B. HISTOLOGY 1. B. Young J. W. Health Wheather’s Functional Histology

C. EMBRYOLOGY 1. Keith L. Moore. The Developing Human 2. Langman’s Medical Embryology

BIOCHEMISTRY

A. TEXTBOOKS 1. Harper’s Illustrated Biochemistry 2. Lehninger Principle of Biochemistry 3. Biochemistry by Devlin

COMMUNITY MEDICINE

A. TEXT BOOKS 1. Community Medicine by Parikh 2. Community Medicine by M Illyas 3. Basic Statistics for the Health Sciences by Jan W Kuzma

PATHOLOGY/MICROBIOLOGY

A. TEXT BOOKS 1. Robbins & Cotran, Pathologic Basis of Disease, 9th edition. 2. Rapid Review Pathology, 4th edition by Edward F. Goljan MD

1. http://library.med.utah.edu/WebPath/webpath.html 2. http://www.pathologyatlas.ro/

PHARMACOLOGY

A. TEXT BOOKS 1. Lippincot Illustrated Pharmacology 2. Basic and Clinical Pharmacology by Katzung

PHYSIOLOGY

A. TEXTBOOKS 1. Textbook Of Medical Physiology by Guyton And Hall 2. Ganong ‘ S Review of Medical Physiology 3. Human Physiology by Lauralee Sherwood 4. Berne & Levy Physiology 5. Best & Taylor Physiological Basis of Medical Practice

B. REFERENCE BOOKS 1. Guyton & Hall Physiological Review 2. Essentials Of Medical Physiology by Jaypee 3. Textbook Of Medical Physiology by InduKhurana 4. Short Textbook Of Physiology by Mrthur 5. NMS Physiology

http://www.amazon.com/s/ref=dp_byline_sr_book_1?ie=UTF8&field-author=Edward+F.+Goljan+MD&search-alias=books&text=Edward+F.+Goljan+MD&sort=relevancerank

http://library.med.utah.edu/WebPath/webpath.html

http://www.pathologyatlas.ro/


2017 Page | 17

ADDITIONAL LEARNING RESOURCES

Hands-on Activities/ Practical Students will be involved in Practical sessions and hands-on activities that link with the CVS module-I to enhance learning with understanding.

Labs Utilize the lab to relate the knowledge to the specimens and models

available.

Skill Lab A skills lab provides the simulators to learn the basic skills and procedures.

This helps build the confidence to approach the patients.

Videos

Video familiarize the student with the procedures and protocols to assist

patients.

Computer

Lab/CDs/DVDs/Internet

Resources:

To increase the knowledge students should utilize the available internet

resources and CDs/DVDs. This will be an additional advantage to increase

learning.

Self Learning

Self Learning is scheduled to search for information to solve cases, read

through different resources and discuss among the peers and with the

faculty to clarify the concepts.


2017 Page | 18

ASSESSMENT METHODS:

Theory (knowledge): Best Choice Questions (BCQs) also known as MCQs (Multiple Choice Questions)

and EMQs (Extending Matching Questions) are used to asses objectives covered in each module.

BCQs:

• A BCQ has a statement or clinical scenario of four options (likely answers).

• Correct answer carries one mark, and incorrect ‘zero mark’. There is NO negative marking.

• Students mark their responses on specified computer-based sheet designed for LNHMC.

EMQs:

• An EMQ has:

o An option list of 5-15 nerve supply, functions, diagnosis, investigations etc o A Lead In –Statement/Question o Two to four Stems or Clinical Scenarios

• Correct answer carries one mark and incorrect ‘zero mark’. There is NO negative marking.

• Student mark their responses on a specified computer-based sheet for EMQs.

OSPE: Objective Structured Practical Examination

• The content may assess application of knowledge, or practical skills.

• Student will complete task in define time at one given station.

• All the students are assessed on the same content by the same examiner in the same allocated

time.

• There are observed, unobserved, interactive and rest stations.

• Rest station is a station where there is no task given, and in this time student can

organize his/her thoughts.


2017 Page | 19

Internal Evaluation

• During the module, students will be assessed to determine achievement of module objectives.

• Module Examination: will be scheduled on completion of each module. The method of

examination comprises theory exam which includes BCQs, and practical (Objective

Structured Practical Examination).

• 20% marks of internal evaluation will be added in theory of semester exam. That 20%

may include class tests, assignment, journals and the modular exam which all have

specific marks allocation.

Example : Number of Marks allocated for Semester Theory and Internal Evaluation

Semester

Semester Examination Theory Marks

Internal Evaluation (Class tests + Journals + Assignments + Modular

Exam)

Total (Theory)

80% 20% 100%

Formative Assessment

• Individual department may hold quiz or short answer questions to help students assess

their own learning. The marks obtained are not included in the internal evaluation

More than 75% attendance is

needed to sit for the modular and

semester examinations


2017 Page | 20

SEMESTER EXAMINATION RULES & REGULATIONS OF JINNAH SINDH MEDICAL UNIVERSITY

(JSMU)

• In one academic year there will be two semesters. The semester duration is approximately

sixteen weeks.

• Each semester may have two to three modules from two to eight weeks duration.

JSMU EXAMINATIONS:

• JSMU will schedule and hold Semester Examinations on completion of each semester.

• In one academic year, there will be two semester examinations and one Retake Examination.

MBBS First year:

• Semester I examination is scheduled on completion of Foundation & Blood Modules.

• Semester II Examination is scheduled on completion of Locomotor, Respiratory-I and CVS-I Modules.

Examination Protocols:

• In each semester, module will be assessed by theory paper comprising MCQs and EMQs. For

example, semester 2 will have separate papers for Locomotor, Respiratory-I and CVS-I Modules.

• There will be one OSPE (Objective Structured Practical Examination) which will cover all the

modules of semester 2.

1. Theory (Knowledge)

• Theory paper will comprise of 80 one best type MCQs and 20 EMQs.

• Time duration for theory paper will be 120 minutes.

• Students will mark their responses on JSMU specified response sheets assessed by computer

software.

• It will carry out 80% contribution in theory results of the Semester.

• There is no negative marking.

2. OSPE:

• It may comprise between 12- 25 stations. Each station will carry 10 marks.

• All students begin and end at the same time.

• The content assessed is the same for all students.

• The time allocated for each station is the same.


2017 Page | 21

3. JSMU Grading System

• It will be based on GPA – 4 system

Marks obtained in Percentage range

Numerical Grade

Alphabetical Grade

80-100 4.0 A+ 75-79 4.0 A 70-74 3.7 A- 67-69 3.3 B+ 63-66 3.0 B 60-62 2.7 B- 56-59 2.3 C+ 50-55 2.0 C

<50 Un-grade-able 0 U

• A candidate obtaining GPA less than 2.00 (50%) is declared un-graded (fail).

• Cumulative transcript is issued at the end of clearance of all modules.

4. Retake Examination

• Retake examination will be held after each semester examination as per meeting held on 12 April

2017 (Ref.No.JSMU/REG/2017/-314)

• Retake examinations are for those students who fail in semester examinations, and those who

have passed semester examinations with GPA less than 3.0 may reappear in respective retake

examination to improve grades.

• The format of the retake examination is exactly the same as in semester examinations.

• Retake examination will be conducted 3 weeks after declaration of results.

EXAMPLE OF PROMOTION RULES:

A student who fails in Semester One Examination and passes Semester Two, s/he will take Retake for

Semester One Examination. S/he passes Semester one retake and is promoted to 2nd year. If that

student FAILS in Retake, s/he will be promoted to 2nd year BUT will have to Pass Semester One

examination in Second year along with Semester Three and Four examinations for promotion to third

year.


2017 Page | 22

5. Promotion to next class

• Students who pass both semester examinations are promoted from first year to second year.

• Students who fail the MBBS first year semester retake examination will be promoted to second year.

• Students will be promoted from second year to third year and onward only if they have passed

the semester examinations of that year.

• Clearance of all modules and their components of semester one to four are mandatory for promotion from second year to third year (as per PMDC rules).

• As per PMDC rules any candidate failing to clear a module or its component in four (1+3)

attempts is NOT allowed to carry out further medical education.

• To pass all modules and their components of semester/s are mandatory for promotion from third year onward.


2017 Page | 23

MODULAR EXAMINATION RULES & REGULATIONS (LNH&MC)

• Student must report to examination hall/venue, 30 minutes before the exam.

• Exam will begin sharp at the given time.

• No student will be allowed to enter the examination hall after 15 minutes of scheduled

examination time.

• Students must sit according to their roll numbers mentioned on the seats.

• Cell phones are strictly not allowed in examination hall.

• If any student is found with cell phone in any mode (silent, switched off or on) he/she will be not

be allowed to continue their exam.

• No students will be allowed to sit in exam without University Admit Card, LNMC College ID Card

and Lab Coat

• Student must bring the following stationary items for the exam: Pen, Pencil, Eraser, and

Sharpener.

• Indiscipline in the exam hall/venue is not acceptable. Students must not possess any written

material or communicate with their fellow students.


2017 Page | 24

SCHEDULE:

WEEKS 1ST YEAR SEMESTER 2 DATES

WEEK 1

LOCOMOTOR MODULE

8th May 2017 WEEK 2 WEEK 3 WEEK 4 WEEK 5 WEEK 6 WEEK 7 WEEK 8 12th July 2017

MODULAR EXAM 14th & 15th July 2017 WEEK 1

RESPIRATORY MODULE - I

17th July 2017 WEEK 2 WEEK 3 WEEK 4 12th Aug 2017

MODULAR EXAM 18th & 19th Aug 2017 WEEK 1

CVS MODULE - I

21st Aug 2017 WEEK 2 WEEK 3 WEEK 4 16th Sept 2017*

MODULAR EXAM 18th & 19th Sept 2017*

PREPARATORY LEAVE

SEMESTER EXAM Oct 2017*

*Final dates will be announced later.

Documents

STUDY GUIDE - Liaquat National Hospital & Medical College GUIDE-CVS-… · · 2017-08-192 Introduction to Study Guide 04 3 Learning Methodologies 05 ... 9 Schedule 24. ... • Help