2024 Courses Under MEDICAL BIOCHEMISTRY, PHYSIOLOGY, PATHOLOGY, MICROBIOLOGY

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Courses Under

MEDICAL BIOCHEMISTRY,

DEPARTMENT OF MEDICAL BIOCHEMISTRY

Objectives

The prime objective of teaching of medical biochemistry is to illustrate the biochemical basis of human function and disease.

BIOC 201	Molecular Cell Biology	(3 Credits)
BIOC 202	Intermediary Metabolism	(5 Credits)
BIOC 204	Medical Genetics	(4 Credits)

Molecular Cell Biology: Bioc 201 (3 Credits)

Overview: The program outlines the molecular components of the cells, cell function with regards to selected tissues, introduction of macromolecules, Protein structure and function.

Molecular Components of Cells: principal chemical constituents and main metabolic activities. Characteristics of and differences between eukaryotes, prokaryotes and viruses.

Functional role of the sub-cellular orgenelles; nucleus, ribosomes, Golgi complexes, endoplasmic reticulum, mitochondrium, peroxisomes and lysosomes. Structure and role of the cytoskeleton, extra-cellular matrix, cell movement. Membranes: occurrence and function; lipid and protein composition. Membrane transport. Lipid rafts and caveolin, cell/cell interaction and adhesion. Body osmolality, transport across cell membranes and membrane potentials, calcium and calcium-binding proteins. Erythrocyte membrane as a model: morphology, formation and destruction; rh factors, blood antigens, clinical correlation-hemoglobinopathies.

Carbohydrates, lipids, nucleic acid and proteins: structure and function. Glyco-biology and cell surface; sorting of molecules into sub-cellular compartments, diseases of sorting. Cellular fractionation. Biochemical techniques for investigating cell structure and function.

Amino acids: structures and properties, stereoisomers, side chain characteristics. Acids and bases. Buffers.

Protein structure: Peptide bond, levels of structure of proteins. Protein stability and protein folding and misfolding and disease; prion disease. Eg. Amyloidosis. Molecular chaperons. Protein purification and techniques for investigating their structure and function. Protein function related to their structure: myoglobin; structure, function and properties. Hemoglobin; structure, function, properties and abnormalities. Carbon monoxide poisoning. Immunoglobulin; structure, functions and properties. Fibrous structural proteins; collagen structure, function and diversity biosynthesis of collagen and elastin secretion and aggregation. Bone formation. Glycosylation of proteins: intra-cellular and extra-cellular modification of proteins after translation. The collagen gene; disturbances in collagen synthesis.

Enzyme catalysis: classification, structure, and properties. Kinetics. Coenzymes and vitamins. Inhibition. Drugs and their effects on enzymes. Allosteric control of enzyme activity. Mechanisms of enzyme action. Clinical applications of enzymes: isoenzymes,

Regulation of enzyme activity. Biochemical markers of disease: the role of serine protease family in health and disease.

Signal transduction; Surface-acting hormones; Catecholamines, polypeptide hormones and growth factors. Receptors and G-Protein transducers, second messengers, intra cellular-acting hormones, steroids, thyroid hormones and retinoids.

Intermediary Metabolism BIOC 202 5 Credits

Overview: Biochemical pathways in the metabolism of macromolecules and selected clinical correlates. Also

included is a section on elements of nutrition

Bioenergetics: Chemical energy and concepts of energy transfer within cells; free energy change. Reaction coupling equilibrium constants and their significance.

“High energy” compounds as “energy currency”: Inter-conversion of high-energy phosphate via ‘equilibrium’ kinases. Principles of energy abstraction. Energy source and utilization: NADH and NADPH; Caloric value of fuels; Respiration Quotient. Energy balance; Basal Metabolic Rate. Diseases associated with changes in NAD and NADP levels.

Macronutrients: nutritional requirements; recommendations for a healthy diet. Importance of dietary protein and maintenance of nitrogen balance. Caloric intake and energy status. Micronutrients: vitamins; water-soluble and lipid-soluble. Minerals. Antioxidants, Assessment of nutritional status. Current dietary trends.

Causes of malnutrition. Overview of energy metabolism. Factors influencing metabolic rate, calorimetry. Energy balance, obesity. Special diets for treatment of specific clinical conditions.

Carbohydrate: structures and properties of monosaccharide, epimers and cyclic structures. Dietary disaccharides and higher polymers. Hetero-polysaccharides: proteoglycans and glyco-proteins. Synthesis of oligosaccharide on the lipid carrier dolicol. Linkage with proteins. Degradation of proteoglycans. Digestion and absorption of carbohydrate; hydrosis of dietary carbohydrates; transport of dietary carbohydrates; disaccharide intolerance. Liver and muscle glycogen, role of liver glycogen in the maintenance of blood sugar. Glycogenolysis and glycogenesis. Glycogen storage diseases. Glycolysis and gluconeogenesis; glycolytic ability of various tissues, hexoses monophosphate shunt, metabolism of galactose and fructose; glactosemia, fructosuria and fructose intolerance. Role of glycolysis in cancerous tissues and limiting oxygen environments. Aerobic metabolism of pyruvate, starvation, obesity. The coenzyme role of B vitamins. TCA cycle; central role of TCA cycle in metabolism. Changes in nutritional requirement and metabolic rate in injury and disease. Alcohol metabolism.

Lipids: Physical and chemical characteristics of fats; structure and properties, nomenclature and roles of fatty acid. Lipid Metabolism:. Intestinal absorption, transport and storage of fat. Mobilizing lipase. Fatty acids and betaoxidation, ketone bodies and ketosis. Brief details of the fatty acid biosynthetic pathways and triacylglycerol formation. Elongation and desaturation of fatty acids.

Lipid transport: structure of plasma lipoproteins. Conversion of fatty acids and cholesterol from the diet to lipoproteins in intestine (chylomicron). Glucose from the diet to lipoprotein in the liver; VLDL. Metabolism of triacylglycerol-rich lipoproteins by lipoprotein lipase. Role of HDL and LCAT in the formation of LDL by receptormediated endocytosis. Cholosterol, bile acids and steroid hormones metabolism. Synthesis of cholesteryl esters by LCAT in plasma and ACAT in endoplasmic reticulum. Metabolism of cholesterol to steroid hormones. Biochemistry of atherosclerosis and thrombosis, metabolism of special lipids, phospholipids, sphingolipids, prostaglandins, and thromboxanes.

Electron transport and oxidative phosphorylation: oxidations and reductions, electron transfers. Specific enzymes associated with inner and outer mitochondrial membranes, matrix and inter-membrane space. Reversed electron transport, the concept of “high-energy pool”. Mitchell’s chemiosmotic theory. Mitochondrial transport and decoupling of electron transport and oxidative phosphorylation and inhibitors of mitochondrial function. Brown adipose tissue and thermogenesis. Mutation in mitochondria genes and disease; role of mitochondria in apoptosis. Nitrogen metabolism: An overview of amino acids metabolism. Essential and non-essential amino acids, catabolic fates of amino acids; roles of glutamate dehydrogenase and some amino transferases. Tryptophan as a precursor nicotinamide in the formation of NAD and NADP. The Harnup disease. Formation of serotonine. Carbamoyl phosphate synthetase and urea cycle. The urea cycle and its role in gluconeogenesis from amino acids. Hyperammonimia and urea cycle defects. Glucogenic and ketogenic amino acids; fate of the amino acid carbon skeletons.

Interplay between muscle and liver during starvation and re-feeding, alanine-glucose cycle. Formation and role of glutamines.

Inborn errors of amino acid metabolism: illustrated by phenylketonuria, methylmalonic- acidurias, maple syrup urine disease, and propionicacidemia. The formation and breakdown of serine and glycine. The catabolism of histidine. Tetrahydrofolate as a one-carbon carrier. The One-carbon metabolism. Discussion of inter-relationships among choline, methionine, S-adenosylmethionine, and derivatives of tetrahydrofolate and cobalamine. Formation of creatine, polyamines and phosphatidylcholine.

Xenobiotic Oxidation: The role of cytochrom P450-dependent monoxygenase system in the metabolism of drugs and other xenobiotics.

Factors affecting foreign compound metabolism. Oxidation of different classes of xenobiotics and induction of cytochrome P450s of different specificity. Role of P450 systems in “normal” metabolism: cholesterol synthesis, synthesis of prostaglandin, leukotriene and 1, 25-dihydroxy-vitamin D3; synthesis of adrenocorticosteroid hormones.

Porphyrin Metabolism: Heme structure and biosynthesis; its control in bone marrow and liver. Degradation of heme to bilirubin and its excretion. Disease states, the porphyrias: porphyria cutanea tarda, acute intermittent porphyria and erythropoietic protoporphyria. Heme catabolism. Jaundice: neonatal jaundice, hemolytic jaundice, obstructive jaundice, hepatocellular jaundice.

Determining bilirubin concentration using the Van den Bergh reaction. Iron metabolism; transport and storage, disease state resulting from aberrations in these processes.

Integration and Control of Metabolism: Interplay of tissues, pathways and hormones in energy metabolism. Key regulatory enzymes; allosteric control of pyruvate carboxylase, phosphofructokinase, fructose 1,6-phosphatase, pyruvate dehydrogenase. Effects of ATP, AMP, NADH, citrate; relevance of energy status to control. Distribution of enzymes between organs and subcellular compartmentation. Energy metabolism after eating and in short and long term starvation.Insulin-dependent diabetes mellitus. “Futile” cycles and function in thermogenesis and control sensitivity. Convalent modification: beta-adrenergic receptor and cascade processes.

BIOC 204 Medical Genetics 3 Credits

Overview: Gene structure and function/structural and functional genomics

Genes and Heredity: Dominance and recessiveness, central dogma, Mutation and evolution. Genetic disorders, somatic cell mutations and cancer. Structure of nucleic acids, chromosome structure, and organization of human genetic information. Differences between eukaryotic and prokaryotic genes.

Nucleotides and Nucleotide Metabolism: Nitrogen bases, the pentoses of nucleic acids, nucleosides and nucleotides, nucleic acids, classes and hydrolysis. Biosynthesis, degradation and salvage pathways for nucleotides and their regulation. Defects in nucleotide metabolism. One carbon transfers, roles of vitamins. Nucleotide and one-carbon reactions in cancer chemotherapy. Biochemical basis of cancer.

DNA Replication Repair and Recombination: Replication of DNA, proof-reading for errors. Mutation and repair mechanisms, defects in repair and their consequences (xeroderma pigmentosum, etc). Changes in allele frequencies and selection of new alleles in a population.The mechanism of recombination; transposition. Expression of genetic information. Genomics, Human Genome Project.

Transcription and RNA processing: differences between eukaryotic and prokaryotic transcription; antibiotics as inhibitors. Gene profiles and quantitative traits.

Protein-coding genes; Primary transcript and processing; introns/exons, 5’-caps, poly (A) tail. Alternative processing e.g. IgM, calcitonin. Processing defects e.g. some thalassaemias.

Translation: The genetic code and translation of RNA (protein biosynthesis). Accuracy of protein biosynthesis. Antibiotics and gene expression, plasmids and drug resistance. Regulation of gene expression by hormones and during differentiation. Defects in gene expression. Gene replication and expression in viruses. Retroviruses (HIV1). Oncogene cancer. Post-translational modification of proteins and intracellar targeting of proteins. Monogenic and polygenic disorders

Recombinant DNA Technology in Medicine: Gene Cloning and Recombinant DNA technology in medicine. Hybridization, oligo probes for diagnosis, Restriction enzymes, Northern, Western and Southern blots. Polymerase chain reaction (PCR) for gene amplification. Strategies for genetic screening illustrated by sickle cell gene; allelespecific probes, direct and indirect RFLPs. (DNA microarray)

Chromosomal diseases: mendellian disorders; inborn errors of metabolism; multifactorial disorder; non-classic Mendelian disorders; laboratory investigations of genetic diseases. Bioinformatics/systemic approaches in genomics.

DEPARTMENT OF PHYSIOLOGY

Objectives

The objective of this subject is to emphasize the physiological concepts of homeostasis and mechanisms of regulation. Clinical relevance of topics in all systems is given prominence.

PHYG 201 Endocrine and Reproductive Physiology (4 Credits) PHYG 202 Cardiopulmonary Physiology (4 Credits)

PHYG 204 Renal and Gastrointestinal Physiology (3 Credits

Introduction

The department of physiology currently provides a 2-semester 13-credit undergraduate programme of study which aims to help students to acquire new knowledge and skills, and independent-learning habits and attitudes essential for future medical practice. The following describe organization of the subject, methods of instruction and assessment, credit distribution in the courses, broad objectives of courses, and outlines of lecture topics.

Subject presentation

The subject is taught by systems and emphasizes the physiological concepts of homeostasis and mechanisms of regulation. Clinical relevance of topics in all systems is given prominence.

The following systems are currently taught, essentially in sequence.

1^st semester

The cell

General principles of cellular physiology

Excitable tissue

Blood physiology

Endocrine system Metabolism

Reproduction

2^nd semester

Gastrointestinal system

Body Fluids and Renal system

Cardiovascular system

Respiratory system

Neuroscience

Methods of Instruction

Lectures to deliver up-to-date knowledge in a concise form, stimulate interest in topics, and provide a guide to further learning
Practicals to reinforce factual information and develop critical observation and analytical skills. Computer simulation of some experiments is provided, where equipment is unavailable. Interactive computer software is also available in the laboratory for student self-study.
Tutorials to develop problem-solving skills, and the ability of students to integrate knowledge.
Seminars on course-relevant topical issues, presented by students to students and faculty, aims to develop skills in independent knowledge acquisition.
Study guides and Reference materials are provided from recommended textbooks, journals, and the internet.

Methods of Assessment

In-course assessment (I.A) tests are conducted basically at the end of every system or module, taught within each course. The number of IA’s therefore, range from 1 to 3 in each course, depending on the number of systems covered. All I.A.’s count for a total of 30% of the final course mark of 100.

End-of-semester exams assess material covered in all courses taken in the semester. The end-of-semester paper in each course counts for a total of 70% of the final course mark of 100.
To obtain a pass in Physiology as a subject, student must have passed with a weighted percentage point of 50 (i.e. 50%), considering all courses and credits taken in both semesters.

Recommended Textbooks

The department recommends the following textbooks for lectures in all courses, for tutorials and for independent study.

Textbook of Medical Physiology by Guyton & Hall ii. Review of Medical Physiology by Ganong iii. Human Physiology: From cells to Systems by Sherwood

OUTLINE OF PHYSIOLOGY COURSES

Level 200

Semester 4

BIOC. 201 Cell Biology (1 Credits)

The course reviews the functional organization of the cell. The student should know cell organelles and their functions, understand cell membrane structure as it relates to membrane function, and know the types of transport through membranes, as well as, the regulation of transport systems. In this course the student should understand the concept of homeostasis and balance, be aware of the different types of feedback systems and their impact, understand control systems, their effects and regulation, and overall understand the process of signal transduction including intercellular messengers, receptors, their properties and regulation.

The Cell and its function
Functional systems of the cell, membranes of the cell, intercellular connections
Membrane transport
The cell and its environment: homeostasis and feedback mechanisms

Body Fluids & Physiology of blood

In addition the student will be able to understand the classifications of blood groups and appreciate their roles in blood transfusion. Also, during this course the student will recognize the mechanism of haemostasis and blood coagulation so as to understand the pathophysiology of diseases arising from excessive bleeding or intravascular clotting.

Composition, size, compartments and function of body fluids
Function of Blood and lymph
Inflammatory responses
Immune mechanisms
Blood groups, and blood transfusion
Haemostasis
The autonomic nervous system: components and function

Laboratory Practicals: Introduction to laboratory work; General instrumentation; Red cell osmometry. Skeletal muscle and compound action potential; Blood composition and blood grouping.

PHYG 204 Renal/Gastrointestinal Physiology 3 Credits

Renal Physiology

By the end of this course, the student should learn sufficient basic renal physiology. He should be able to recognize the importance of renal function in homeostasis through regulation of water and electrolyte balance and acid-base balance; and appreciate the kidney as endocrine organ secreting important regulatory hormones.

Functional Structure, components of renal function
Methods used in studying renal function
The process of glomerular filtration and its measurement
Renal haemodynamics
Renal handling of various solutes – reabsorption and secretion
Renal concentrating mechanisms
The kidney in homeostasis: renal involvement in total body sodium, potassium, water and acid-base regulation
Renal hormonal function
Micturition and its control
Effects of loss of renal function
Acid-base balance
Clinical correlates in acid-base balance

Laboratory practicals: Regulation of urine volume in man. Effect of haemorrhage and replacement fluid infusion on renal function.

Gastrointestinal Physiology

By the end of this course, the student should learn sufficient basic gastrointestinal physiology. Through lectures, practicals and tutorials, he should be able to describe the functions and regulation of the gastrointestinal tract, and understand the pathophysiology and mechanisms of certain gastrointestinal problems e.g. peptic ulcer.

Organisation of the digestive system
Gastrointestinal hormones
Mechanical processes of the digestive system
Secretions and chemical digestion
Absorption from the gastrointestinal tract
Pancreas, liver and gall bladder
Clinical physiology of peptic ulcer, cholecystectomy, pancreatectomy and malabsorption

Laboratory practicals: Salivary secretions; Gastrointestinal motility in vitro.

PHYG 202 Cardiopulmonary Physiology 4 credits

Cardiovascular System

This course deals with the heart and the circulation system. At the end of this course the student will be able to explain how the heart works as a pump and the role of the chambers, valves and the muscle. Special emphasis will be placed on heart sounds, E.C.G. and introduction to abnormal cardiac function. In the second part of this course, the student will be introduced to the physics of haemodymics and the regulation of circulation. This will enable the student to understand the responses of cardiovascular system to stress, e.g. haemorrhage and exercise, and to develop an awareness of the disturbed physiology underlying some major cardiovascular problems such as heart failure and cardiac ischaemia. In addition, during this course, the student will acquire basic preliminary skills in using laboratory and bed side techniques commonly encountered in clinical cardiology e.g. recording an E.C.G., and measuring blood pressure and pulse.

Overview, function, components and architecture of the CVS
The heart as a pump: mechanical and electrical events
Electrocardiography
Clinical correlates
The vascular tree: structural adaptation of the vascular segments and their functions
Haemodynamics
Regulatory mechanisms; regulation of cardiac output, systemic blood pressure, general and regional blood flow  Circulation through special regions: cerebral, renal, coronary, splanchnic and skeletal muscle blood flow.
Cardiovascular adjustments in health and disease

Laboratory practicals: Physiology of cardiac muscle, factors affecting cardiac output, effect of haemorrhage and replacement transfusion. Blood pressure measurement and ECG in man.

Pulmonary physiology

Students will be expected to relate above principles to the diagnosis, presentation, pathophysiology and management of common clinical respiratory conditions such as acute bronchial asthma, acute airway obstruction, and chest wall injuries etc.

Organization of the respiratory system
The physics of breathing
Gas laws
Spirometry
Elastic and none elastic forces
Surface tension
Dynamics of ventilation
Work of breathing
Transport and exchange of gases
Clinical problems of gas transport and exchange
The pulmonary circulation
Ventilation perfusion relationships and clinical correlates
Regulation of respiration
Respiratory adjustments in health and disease
Pulmonary function tests

Laboratory practicals: Spirometry and respiratory patterns in different states.

PHYG 201 Endocrine/Reproduction 3 Credits

Endocrine /Reproduction

In this course the student should be able to understand the basic principles of endocrine physiology, know the types of hormones and their regulation, and comprehend the concept of hormones as fine control systems. For each of the major endocrine systems, the student should be aware of their functional anatomy, synthesis of hormones, secretion and metabolism of hormones, action of hormones, and pathophysiological changes related to hypo-and hyperfunction.

General Principles of intercellular communication in a multicellular organism
Endocrine; pancrine end autocrine mechanisms  The endocrine and nervous systems compared  Molecular Basis of Hormone Action.  Main types of chemical messenger
Signal transduction across membranes.
Surface-action hormones; catecholamines, polypeptide hormones and growth factors.
Receptors and G-protein transducers, second messengers, classes of protein kinases (cyclic nucleotide regulated, Ca2+ regulated, tyrosine protein kinases) cascades and signal amplification  Relation of oncogenes to signal tranduction molecules.
Defects in cell signalling.
Intra cellular-acting hormones, steroids, thyroid hormones and retinoids.
Steroids as regulators of gene transcription
Cytoplasmic nuclear receptors for steroid hormones.
Biochemical aspects of neuro-transmission and neuroactive drugs.
Characteristics of endocrine glands
Hormones: definition, synthesis, secretion and transport
Hormone tissue interaction: receptors, second messengers and “cascade phenomenon”  Experimental methods in endocrinology
The hypothalamus and pituitary axis.
Regulation of hormone secretion: negative and positive feedback control
Homeostatic role of hormones
Regulation of blood glucose
Regulation of body fluid volume and composition
Regulation of energy balance
Hormones of the pancreas
Suprarenal glands
Thyroid gland
Parathyroid glands
Posterior pituitary hormones
The growth axis
Prostaglandins and thromboxanes
Clinical correlates of endocrine hyper – or hypo – function

Laboratory practicals:

Reproduction

At the completion of the course, students are expected to have clear knowledge of the essential elements of male and female reproductive physiology including: sex determination, sex differentiation, spermatogenesis, sperm viability, male sex hormones, ovarian structure and hormonal changes from birth to menopause, female sexual cycles, ovarian and placental hormones, pregnancy, parturition and lactation, contraception, important clinical/pathophysiological correlations.

Genetics in relation to reproduction
Sexual differentiation
Gametogenesis
Male and Female reproductive physiology
The menstrual cycle: ovarian, uterine and vaginal cycles
Physiology of pregnancy
Hormones of placenta
The feto-placental unit
Hormonal control of parturition
Physiological changes in lactation and breast development
Hormonal contraception

Laboratory practicals:

ANAT 202 NEUROSCIENCE 4 Credits

Neuroscience

This course aims to provide basic information on the functions of the central nervous system which enables the body to perform coordinated and accurate voluntary and involuntary movements. The course highlights reflex functions that adapt the body to changing environmental conditions and bring about appropriate responses to a very large variety of stimuli. It also emphasizes the highly integrated nature of neurological mechanisms especially in the performance of such complex processes as memory, learning, judgment and speech. Certain topics of related pathophysiology are included along with the normal neurophysiology to reinforce the concepts of normal function.

General design of the nervous system
Sensory system
Receptor physiology
Somatic and visceral sensory mechanisms
Special sensory organs, optics and vision, taste and olfaction, audition.
Motor system
Organisation of the spinal cord for motor functions – spinal reflexes, spinal integration
Lower motor neurone function
Pyramidal and Extrapyramidal systems
Disturbances of the pyramidal and extrapyramidal system functions
Sleep and consciousness – the reticular activating system, the generalized thalamocortical system, the EEG  Hyperactivity of the nervous system – epilepsy
Sleep and wakefulness.
Visceral function of the nervous system
The medulla oblongata control of vital function (respiration, heart rate and blood pressure)  Medullary autonomic reflexes, vomiting etc.
Autonomic nervous system
The hypothalamus and its function
Behavioral functions of the central nervous system  The limbic system, motivation  Sexual behaviour.
Higher functions of the central nervous system
Learning, Memory, Speech, Calculations, Social awareness.

Laboratory practicals: Reflexes in frog and rabbit, vision and audiometry, human cutaneous sensation and reflexes in man.

PHYSIOLOGY CURRICULUM

Introduction

The Department of Physiology currently provides a 2-semester 13-credit undergraduate programme of study which aims to help students to acquire new knowledge and skills, and independent-learning habits and attitudes essential for future medical practice. The following describe organization of the subject, methods of instruction and assessment, credit distribution in the courses, broad objectives of courses, and outlines of lecture topics.

Subject presentation

The subject is taught by systems and emphasizes the physiological concepts of homeostasis and mechanisms of regulation. Clinical relevance of topics in all systems is given prominence.

The following systems are currently taught, essentially in sequence.

1^st semester

The cell

General principles of cellular physiology

Excitable tissue

Blood physiology

Endocrine system

Metabolism

Reproduction

2^nd semester

Gastrointestinal system Body Fluids and Renal system

Cardiovascular system

Respiratory system

Neuroscience

Methods of Instruction

Lectures to deliver up-to-date knowledge in a concise form, stimulate interest in topics, and provide a guide to further learning

Practicals to reinforce factual information and develop critical observation and analytical skills. Computer simulation of some experiments is provided, where equipment is unavailable. Interactive computer software is also available in the laboratory for student self-study.

Tutorials to develop problem-solving skills, and the ability of students to integrate knowledge.

Seminars on course-relevant topical issues, presented by students to students and faculty, aims to develop skills in independent knowledge acquisition.
Study guides and Reference materials are provided from recommended textbooks, journals, and the internet.

Methods of Assessment

In-course assessment (I.A) tests are conducted basically at the end of every system or module, taught within each course. The number of IA’s therefore, range from 1 to 3 in each course, depending on the number of systems covered. All I.A.’s count for a total of 30% of the final course mark of 100.
End-of-semester exams assess material covered in all courses taken in the semester. The end-of-semester paper in each course counts for a total of 70% of the final course mark of 100.
To obtain a pass in Physiology as a subject, student must have passed with a weighted percentage point of 50

(i.e. 50%), considering all courses and credits taken in both semesters.

Recommended Textbooks

The department recommends the following textbooks for lectures in all courses, for tutorials and for independent study.

Textbook of Medical Physiology by Guyton & Hall v. Review of Medical Physiology by Ganong
Human Physiology: From cells to Systems by Sherwood

OUTLINE OF PHYSIOLOGY COURSES

Level 200

Semester 4

BIOC 201 Cell Biology 1 Credit

The Cell and its function
Functional systems of the cell, membranes of the cell, intercellular connections
Membrane transport
The cell and its environment: homeostasis and feedback mechanisms

Body Fluids & Physiology of blood

The student should understand that the body may be viewed as a system of fluid compartments separated by membranes, and to appreciate the mechanisms which determine the volume and composition of the various compartments. This course deals with blood. At the end of this course the student will be able to describe the structure, formation and functions of different blood cells in order to understand the causation and pathophysiology of common haematological disorders such as anaemias. In addition the student will be able to understand the classifications of blood groups and appreciate their roles in blood transfusion. Also, during this course the student will recognize the mechanism of haemostasis and blood coagulation so as to understand the pathophysiology of diseases arising from excessive bleeding or intravascular clotting.  Composition, size, compartments and function of body fluids

Function of Blood and lymph
Inflammatory responses
Immune mechanisms
Blood groups, and blood transfusion
Haemostasis
The autonomic nervous system: components and function

Laboratory Practicals: Introduction to laboratory work; General instrumentation; Red cell osmometry. Skeletal muscle and compound action potential; Blood composition and blood grouping.

PHYG 204 Renal/Gastrointestinal Physiology 3 Credits

Renal Physiology

Functional Structure, components of renal function
Methods used in studying renal function
The process of glomerular filtration and its measurement
Renal haemodynamics
Renal handling of various solutes – reabsorption and secretion
Renal concentrating mechanisms
The kidney in homeostasis: renal involvement in total body sodium, potassium, water and acid-base regulation
Renal hormonal function
Micturition and its control
Effects of loss of renal function
Acid-base balance
Clinical correlates in acid-base balance

Laboratory practicals: Regulation of urine volume in man. Effect of haemorrhage and replacement fluid infusion on renal function.

Gastrointestinal Physiology

Organisation of the digestive system
Gastrointestinal hormones
Mechanical processes of the digestive system
Secretions and chemical digestion
Absorption from the gastrointestinal tract
Pancreas, liver and gall bladder
Clinical physiology of peptic ulcer, cholecystectomy, pancreatectomy and malabsorption

Laboratory practicals: Salivary secretions; gastrointestinal motility in vitro.

PHYG 202: Cardiopulmonary Physiology – (4 Credits)

Cardiovascular System

Overview, function, components and architecture of the CVS
The heart as a pump: mechanical and electrical events
Electrocardiography
Clinical correlates
The vascular tree: structural adaptation of the vascular segments and their functions
Haemodynamics
Regulatory mechanisms; regulation of cardiac output, systemic blood pressure, general and regional blood flow

Circulation through special regions: cerebral, renal, coronary, splanchnic and skeletal muscle blood flow. Cardiovascular adjustments in health and disease

Laboratory practicals: Physiology of cardiac muscle, factors affecting cardiac output, effect of haemorrhage and replacement transfusion. Blood pressure measurement and ECG in man.

Pulmonary physiology

The course covers the general functions of the respiratory system but concentrates mainly on the role of the system as a gas exchange organ. This involves a consideration of the principles of the mechanics of breathing, ventilation, gas transfer, gas transport in blood, and the regulation of ventilation. The acute changes and the compensatory response of the respiratory system to high altitude. Students will be expected to relate above principles to the diagnosis, presentation, pathophysiology and management of common clinical respiratory conditions such as acute bronchial asthma, acute airway obstruction, and chest wall injuries etc.

Organization of the respiratory system
The physics of breathing
Gas laws
Spirometry
Elastic and none elastic forces
Surface tension
Dynamics of ventilation
Work of breathing
Transport and exchange of gases
Clinical problems of gas transport and exchange
The pulmonary circulation
Ventilation perfusion relationships and clinical correlates
Regulation of respiration
Respiratory adjustments in health and disease
Pulmonary function tests

Laboratory practicals: Spirometry and respiratory patterns in different states.

PHYG 201 Endocrine/Reproduction 3 Credits

Endocrine /Reproduction

General Principles of intercellular communication in a multicellular organism
Endocrine; pancrine end autocrine mechanisms  The endocrine and nervous systems compared  Molecular Basis of Hormone Action.
Main types of chemical messenger
Signal transduction across membranes.
Surface-action hormones; catecholamines, polypeptide hormones and growth factors.
Receptors and G-protein transducers, second messengers, classes of protein kinases (cyclic nucleotide regulated, Ca2+ regulated, tyrosine protein kinases) cascades and signal amplification  Relation of oncogenes to signal tranduction molecules.
Defects in cell signalling.
Intra cellular-acting hormones, steroids, thyroid hormones and retinoids.
Steroids as regulators of gene transcription
Cytoplasmic nuclear receptors for steroid hormones.
Biochemical aspects of neuro-transmission and neuroactive drugs.
Characteristics of endocrine glands
Hormones: definition, synthesis, secretion and transport

Hormone tissue interaction: receptors, second messengers and “cascade phenomenon” Experimental methods in endocrinology

The hypothalamus and pituitary axis.
Regulation of hormone secretion: negative and positive feedback control
Homeostatic role of hormones
Regulation of blood glucose
Regulation of body fluid volume and composition
Regulation of energy balance
Hormones of the pancreas
Suprarenal glands
Thyroid gland
Parathyroid glands
Posterior pituitary hormones
The growth axis
Prostaglandins and thromboxanes
Clinical correlates of endocrine hyper – or hypo – function

Laboratory practicals:

Reproduction

Genetics in relation to reproduction
Sexual differentiation
Gametogenesis
Male and Female reproductive physiology
The menstrual cycle: ovarian, uterine and vaginal cycles
Physiology of pregnancy
Hormones of placenta
The feto-placental unit
Hormonal control of parturition
Physiological changes in lactation and breast development
Hormonal contraception

Laboratory practicals:

ANAT 202 Neuroscience 4 Credits

Neuroscience

This course aims to provide basic information on the functions of the central nervous system which enable the body to perform coordinated and accurate voluntary and involuntary movements. The course highlights reflex functions that adapt the body to changing environmental conditions and bring about appropriate responses to a very large variety of stimuli. It also emphasizes the highly integrated nature of neurological mechanisms especially in the performance of such complex processes as memory, learning, judgment and speech. Certain topics of related pathophysiology are included along with the normal neurophysiology to reinforce the concepts of normal function.

General design of the nervous system
Sensory system
Receptor physiology
Somatic and visceral sensory mechanisms
Special sensory organs, optics and vision, taste and olfaction, audition.
Motor system
Organisation of the spinal cord for motor functions – spinal reflexes, spinal integration  Lower motor neurone function

Pyramidal and Extrapyramidal systems

Disturbances of the pyramidal and extrapyramidal system functions

Sleep and consciousness – the reticular activating system, the generalized thalamocortical system, the EEG  Hyperactivity of the nervous system – epilepsy  Sleep and wakefulness.
Visceral function of the nervous system
The medulla oblongata control of vital function (respiration, heart rate and blood pressure)  Medullary autonomic reflexes, vomiting etc.
Autonomic nervous system
The hypothalamus and its function
Behavioral functions of the central nervous system  The limbic system, motivation  Sexual behaviour.
Higher functions of the central nervous system
Learning, Memory, Speech, Calculations, Social awareness.

Laboratory practicals: Reflexes in frog and rabbit, vision and audiometry, human cutaneous sensation and reflexes in man.

THE PARA-CLINICAL SCIENCES

All the courses available under the Para-clinical Sciences programme in the Medical School are compulsory

DEPARTMENT OF CHEMICAL PATHOLOGY

Objectives

To introduce students to basic principles and concepts of biochemical bases of diseases and to provide hands –on

approach to experimental and investigative procedures.

CPAT 301	General Chemical Pathology (Theory)	(2 Credits)
CPAT 303	General Chemical Pathology (Practical)	(1 Credit)
CPAT 302	Systematic Chemical Pathology (Theory)	(1 Credit)
CPAT 304	Systematic Chemical Pathology (Practical)	(1 Credit)
CPAT 301	General Clinical Chemistry
	Introducing Chemical Pathology
	Methodology, Standardization, Quality Control
	Nutrition 1 –PEM
	Nutrition II – Vitamins & Antioxidants
	Nutrition III – Trace Elements
	CSF
	Proteins
	Enzymes in Diagnosis
	Liver Function
	In-born Errors of Metabolism
	Biochemical Effects of Malignancy
	Tumour Markers
	Interpretation of Laboratory Results
	Toxicology
	Water & Electrolytes
	Acid-Base Balance
	Renal Function
CPAT 302	Systematic Chemical Pathology theory Carbohydrate Metabolism
	Diabetes mellitus Hypoglycaemia

	CaPTH, Vit D
	Metabolic Bone Disease
	Clinical Laboratory Practice
	Quality Assurance
	Data Interpretation
	Gastric Function
	Disorders of Gastro-intestinal Function: Achlorhydria, Pernicious Anaemia, Hyperacidity The Pancreas Function & Disorders Disorders of Purine metabolism Gout Disorders of Iron Metabolism Hypothalamic-Pituitary Axis Pituitary Hormones Adrenal Function Sex Hormones Causes & Investigation of Infertility Disorders of Thyroid Function Lipid Disorders The Metabolic Syndrome Clinical Laboratory Practice Instrumentation Insulin Actions & Disorders
CPAT 303	General Clinical Chemistry Practical
	Cerebro-Spinal Fluid (CSF): Physical and Chemical Examinations Determination of total serum Proteins & Albumin using the Biuret & Bromocresol green methods Serum Protein electrophoresis Liver Function tests Bilirubin: Total, Direct and Indirect
CPAT 304	Systemic Clinical Chemical Practical
	Serum glucose estimation
	Determination of Urine glucose using a. glucose oxidase urine strip Determination of glucose and protein in urine using URS-2P Urine strip Determination of Serum/Plasma Cholesterol Determination of serum/plasma triglyceride

DEPARTMENT OF HAEMATOLOGY

Objectives

To train medical students to understand and appreciate the structure, composition and functions of blood and blood forming organs as well as the causes and effects of their diseased states. The student must also know the principles of diagnosis and management of these diseases and the use of blood and blood products.

HAEM 301	Fundamental haematology, the Anaemias (1 Credit)
	and Blood Transfusion (Theory)
HAEM 303	Fundamental haematology, the Anaemias (1 Credit)
	and Blood Transfusion (Practical)
HAEM 302	Abnormal haemostasis and Haemato-oncology (Theory) (1 Credit)
HAEM 304	Abnormal haemostasis and Haemato-oncology (Practical) (1 Credit)

Semester 5

HAEM 301, 303

Cellular Haemopathology

Week 1

Normal Haemopoiesis. Functions of cellular elements Of blood.

Haemopoietic stem cells and haemopoietins Blood formation, embryonic, foetal and adult.

Hb, RBC, WBC and platelet count in the new born, child and adult.

Practical

Erythropoiesis and myelopoiesis using projected slides.

Blood collection techniques, anticoagulants, Determination of Hb and Hct.

Week 2

Classification and general features of anaemia.

Definition, aetiological and morphological classification of anaemia.

Compensatory physiological changes accompanying anaemia. Signs, symptoms and complications of anaemia.

Practical

Slide projection, normal film, microcytic anaemia, macrocytic anaemia, anisocytosis.

Hb, Hct and Reticulocyte count. Calculation of indices.

Week 3

Iron metabolism, hypochromic anaemias and iron overload. Sources of iron, iron absorption, metabolism, storage excretion.

Causes of iron deficiency anaemia and storages in development of I.D.A Symptoms and signs of I.D.A. Iron overload. Inherited and acquired.

Organ damage in iron overload.

Practical

Slide projection. Iron deficiency anaemia slide. Compare to elliptocytosis.

Anisochromasia slide and polychromasia slide.

Preparation and staining of thin blood films.

Interpretation of red cell indices.

Week 4

Folic Acid and Vitamin B₁₂metabolism, Megaloblastic anaemias.

Sources of Vitamin B₁₂ and folic acid. Absorption, metabolism, storage and excretion of B₁₂and folic acid.

Causes of deficiency: symptoms and signs of macrocytic anaemia due to these deficiencies. Features of megaloblastosis. Other causes of macrocytic anaemia.

Practical

Slide projection of megaloblastic marrow and peripheral blood features of B₁₂ and folate deficiency.

Slide work. Macrocytosis, polychromasia, interpretation of red cell indices.

Week 5

Haemolytic anaemia I. General features and classification. Haemoglobin structure, formation and catabolism.

Excessive Catabolism causing haemolysis – intravascular and extravascular.

Definition of haemolytic anaemia.

Compensatory mechanisms in chronic haemolysis.

Practical

Slide projection of sickle cell anaemia, spherocytosis, and polychromasia.

Sickling test, Osmotic fragility test, Recticulocyte count.

Week 6

Haemolytic Anaemia II.

Haemoglobinopathies and Thalassaemias.

Genetic basis of structural haemoglobin variants and Thalassaemias.

Malaria and balance polymorphism. The sickle cell syndromes (AS, SS, SC etc) and other Haemoglobinopathies prevalent in Africa: inheritance, clinical features, diagnosis. Properties of foetal haemoglobin.

The peripheral blood appearance in the alpha and beta thalassaemias. Clinical features of Beta thalassaemia major.

Practical

Projection: Clinical and peripheral blood features of SCA and thalassaemia major. Slide SCA and thalassaemia major.

Haemoglobin electrophoresis and Kleihauer test Hb F estimation.


Week 7	Haemolytic Anaemia III G6PD deficiency, congenital membrane defects and acquired haemolytic anaemia. Red cell metabolism: Forms of G6PD Inheritance and clinical effects of acquisition of G6PD enzyme defect. Hereditary spherocytosis: inheritance, the membrane defect and disease state. Acquired defects – PCH, PNH, bacterial and parasitic causes.
	Practical
	Test for haematuria and haemoglobinuria. Examination of thin blood films. Reporting of thin blood films.
Week 8	Aplastic anaemia and other causes of Bone Marrow failure. Definition of aplasia and bone marrow failure. Aetiological classification of aplasia, emphasis on environmental pollutants, occupational hazards and drugs. Congenital causes. Presentation, diagnosis and management.

Week 9	The White Cell.
	Stem cell and myelopoiesis; haemopoietic growth factors.
	Mononuclear and polymorphonulear cells Functions of various leucocytes. Morphology and maturation. Neutrophil kinetics and cytochemistry. Lymphocyte subsets. Changes in count following disease.
	Practical
	Slide projection
	Total white cell count and differential count. Demonstration ESR
Week 10	The Acute Leukaemias Classification: epidemiology, chromosomal abnormalities, presentation, complications, diagnosis and cytochemistry. Practical
	Slide projection: Differential white cell count. Lymphocytosis, neutrophilia and eosinophilia.
Week 11/12	myeloproliferative disorders. CML, primary proliferative polycythaemia, myelosclerosis, thrombocythaemia. CML epidemiology, clinical features, changes in peripheral blood and marrow, course and complications. Primary and secondary polycythaemia, clinical course and complications of primary polycythaemia. Myeloscrelosis, pathogenesis, bone marrow and peripheral blood changes, clinical course. Primary thrombocythaemia, nature, clinical features, course and prognosis.
	Practical Slide projection; Thin film on CML, CLL and Neutrophilia.
Week 13	The Spleen and Lymphoproliferative disorders Structure and function of the Spleen.
	Extramedullary haemopoiesis.
	Causes of splenomegaly, effect of splenectomy.
	Definition of lymphoproliferative disorders.
	Practical
	Cytochemical staining;
	Differential leucocyte count. CLL.
Week 14	Lymphoproliferative disorders
	The lymphomas including Burkitt Lymphoma. Classification and staging of lymphomas, presentation and clinical course. Chronic lymphocytic leukaemia. Diagnosis and clinical course. Practical Slide projection Thin blood films.
Week 15	The platelet and vessel wall Megakaryocyte and formation of platelets. Structure and function of the platelet; adhesion, aggregation and procoagulant function: the vessel wall. Practical Platelet count, thin blood film, Hess test, bleeding time.
Week 16	Quantitative and qualitative abnormalities of platelet including IT P. Tests of platelet function; aggregation tests.
Week 17	Assessment on white cells and platelets

Semester 6

HAEM 302, 304

Clinical Haematology and Transfusion Medicine

Week 1

Principles of Haematologic examination.

Cell counting, red cell indices and their interpretation, interpretation of total and differential cell count, histochemical staining, bone marrow examination, aspiration and trephine, scanning. Principles of management of the patient with anaemia or agranulocytosis.

Practical

Interpretation of indices

Week 2

The approach to the patient with anaemia.

Manifestations of acute and chronic anaemia. Specific clinical features of iron deficiency, B₁₂ and folic acid deficiency. Symptoms and signs to include integumentary, cardiac, respiratory, alimentary, genitourinary and neuromuscular systems. Differential diagnosis.

Laboratory diagnosis of iron deficiency, folic acid and B₁₂deficiency, biochemistry, occult blood, serum and urine chemistry, absorption studies e.g. Schilling test.

Tutorial. Slide projection. Interpretation of data. Clinical case problem.

Week 3

Treatment of Anaemia

Iron deficiency, Vit B12 or folic acid deficiency, simple anaemias.

Treatment of underlying disorder. Indications for blood (Red Blood Cell) transfusion.

Monitoring of therapy.

Anaemia of chronic disorders.

Tutorial. Clinical case problem.

Week 4.

The Haemolytic Aanaemias.

Clinical presentation of sickle cell disease, crisis, organ damage, management of crisis, steady state, bone marrow transplantation.

Radiological changes

Prevention including genetic counselling, prenatal diagnosis.

Thalassaemia major and thalassaemia intermedia. Differences in clinical presentation, course and prognosis. Laboratory diagnosis.

Hypertransfusion and problems of iron overload.

Acute haemolysis in G6PD deficiency. Diagnosis and management.

Practical

G6PD assay, cellulose acetate gel electrophoresis, screening.

Sickle cell solubility test

Tutorial on haemolytic anaemias.

Week 5

Blood coagulation and inhibitory systems; the fibrinolytic system. Vascular and platelet bleeding disorders and their investigation.

Practical

Assessment on anaemias Theory and Clinical problems.

The acute leukaemias. Clinical presentation, diagnosis; preparation of patient for chemotherapy; chemotherapy and bone marrow transplantation, their complications and management.

Week 6

Inherited and acquired deficiency of clotting factors

Haemophilia, liver failure.

Practical

P.T., A.P.T.T., T.T.

The lymphomas, Clinical staging.

Presentation, diagnosis, combination and single drug chemotherapy, radiotherapy.

Week 7

Hypercoagulable state and control of anticoagulant.

Practical

Investigation of patient with a bleeding disorder including platelet disorders.

Immune deficiency states Acquired and inherited.

Week 8

The Blood Groups. ABO and Rhesus blood groups. The genetics and biochemistry of ABH blood group substances. Secretors and non secretors.

ABO and Rhesus blood grouping, tile and microplate methods.

Red cell membrane and metabolism of the red cell.

Week 9

HLA system. Application of blood group in clinical medicine, anthropology, genetics and forensic pathology.

Assessment. Bleeding disorders and haematological malignancies. Theory and Clinical case problem.

Burkitt’s lymphoma compared to Hodgkin’s.

Week 10

Antigen – antibody reactions and factors affecting them.

Immunoglobulins and complement. The coomb’s test. ELISA test.

Practical

Tests for Haemolysins, ELISA tests and coomb’s test. Radionucleids. Schilling test and red cell survival.

Use of radio isotopes in haematology. Regulations and precautions; scanning.

Week 11

Clinical Blood Transfusion I

The blood donor; screening and bleeding. Storage of blood and components.

Particle agglutination. Tanned red cells and latex.

Tutorial on Chronic Lymphocytic leukaemia.

Week 12

Clinical Blood Transfusion II

Blood, blood components and Blood substitutes

Compatibility testing

Practical

Compatibility testing.

Immune Haemolytic anaemias

Cold and warm type. Haemolytic disease of newborn.


Week 13	Complications of blood transfusion, their investigation, prevention and management. Visit to the Blood Bank. Free.
Week 14	Tutorial
	Clinical Case Problem.
	Free
Week 15	Assessment. Theory and practical. Blood Transfusion, immune haemolytic anaemia and radionucleids.
Week 16.	Visit to Atomic Energy.
	Tutorial. Haematological malignancies.
Week 17	Tutorial. Haemolytic anaemias.
	Practical
	Clinical Case Problem
	Safe Blood Transfusion

DEPARTMENT OF MICROBIOLOGY

Objectives

The course intends to let the students know the structure of a microorganism, its antigens and pathogenic mechanisms relate to disease causation and the antimicrobial agents, which could be used for treatment. At the end of the course, the student should have a sound theoretical knowledge of specific examples of microorganisms and be able to perform simple tests and interpret them. They should also know the principles underpinning investigation of infectious diseases.

MICB 301	Bacteriology and mycology (Theory) (4 Credits)
MICB 303	Bacteriology and mycology (Practical) (1 Credit)
MICB 302	Virology/Parasitology (Theory) (4 Credits)
MICB 304	Virology/Parasitology (Practical) (1 Credit)
MICB 301	Introduction to Microbiology (Bacteriology/Mycology)	4 Credits

The course is designed to give initial introduction to microbial agents and their classification Followed by detailed study of bacteria and fungi of medical importance.

Objectives

The student should be able to:

Describe the general characteristics of bacteria, fungi, parasites and viruses and their antigenic components.
Describe growth requirements and methods of identification of bacteria and fungi
Explain the pathogenic mechanisms of various disease causing organisms
Demonstrate an understanding of investigation of infectious disease
State causes of nosocomial infection and principles of control – sterilization and disinfection, isolation etc  Explain immunological basis of disease causation and prevention.  State the use of vaccines for prophylaxis

Content

General characteristics and classification of bacteria, parasites, fungi and viruses.

Growth characteristics of bacteria and fungi and their identification.

Innate and acquired immunity, hypersensitivity, Normal flora of various sites in the body.

Methods of Sterilization and disinfection, Disinfectants

Pathogenesis of diseases caused by various bacteria – Staphylococcus, Streptococcus, Neisseria, Enterobacteria, (especially Salmonella, Shigella) Mycobacteria, Clostridium, Bacillus, Cornynebacteria, Parvobacteria, Vibrio, Spirochaetes Actinomyces & fungi of medical importance.

Antimicrobial & antifungal agents, Nosocomial infection, Investigation of bacterial and fungal infections.

MICB 303 Practical I (Bacteriology/Mycology) 1 Credit

General

This practical course is designed to teach the student about morphology of microbial agents and simple staining and other techniques for their identification.

Objectives

To perform various staining techniques
Identify organisms in either stained or unstained specimens by morphological characteristics
Demonstrate an understanding of basic principles of investigation of disease

Content

Staining: – Gram, Methylene blue, Ziehl-Neelsen, Nigrosin

Simple tests for identification of bacteria and fungi

Reading of sensitivity plates and interpretation of findings

MICB 302 Virology/Parasitology 4 Credits

General

The course is designed to introduce students to the principles underlying the dynamics of parasitic and viral infections. This will enable them to understand how the interaction between parasites/viruses, humans and the environment promote the occurrence of parasitic and viral infections and human immunological response to their infection.

Objectives

The student should be able to:

Describe the general characteristics and classification of viruses, chlamydiae, mycoplasma and rickettsiae and how infection caused by these are transmitted
State principles of immunization and antimicrobial treatment
Explain the pathogenic mechanisms of viruses, chlamydiae, mycoplasma and rickettsiae
Explain host parasite relationships.
Describe the general characteristics of parasitic protozoa, helminthes and their pathogenic mechanisms
State methods of diagnosis, control and treatment of parasitic infections
Demonstrate an understanding of investigation of parasitic and viral diseases

Classification of viruses, chlamydiae, mycoplasma and rickettsiae. Morphology, effect of chemical and physical agents, pathogenesis, clinical features, epidemiology, laboratory diagnosis, treatment, prevention and control of viral, chlamydial, mycoplasma and rickettsial infections. Host parasite relationships. Investigation of infectious diseases. Types of vaccines, methods of production and vaccination against infectious agents. Epidemiology and pathogenesis of common tropical parasitic diseases: Clinical manifestations associated with parasitic infections with emphasis on Malaria, Schistosomiasis, Amoebiasis, Trypanosomiasis, Filariasis and Gastrointestinal infections. Vector borne parasitic diseases. Principles of diagnosis, investigation, treatment and control of parasitic and viral diseases. Immunological basis of parasitic and viral diseases.

MICB 304: Practical II (Virology/Parasitology) (1 Credits)

General

The course is designed to illustrate the experimental principles involved in course MICB 402 and to acquaint students with the laboratory methods applied in clinical diagnosis.

Objectives:

Describe methods of virus cultivation and identification
Explain the basic laboratory techniques for identification of viruses and diagnosis of viral infections.
Explain the basic laboratory techniques for identification of parasites and diagnosis of parasitic infection of medical importance.

Contents:

Demonstration practicals will be mounted on the following test methods: ELISA, Western blot, Complement fixation test, Immunofluoresence test, Haemagglutination inhibition test and Simple rapid test. Tissues cultures will be mounted for identification of viral CPE (and description of types). Animal and embryonated egg inoculation. Electron micrographs showing morphological characteristics of representative virus groups. Basic laboratory techniques (Microscopy/ELISA/Culture) for identification of parasites. Direct and Iodine wet smears, Preparation of thick/thin blood films, Giemsa staining. Examination of prepared slides of parasites. Identification of vectors of medical importance, Simple rapid test.

DEPARTMENT OF PATHOLOGY

Curriculum for Level 300

Introduction

The Department of Pathology currently offers the following courses at Level 300:

PATH 305	General Pathology (Practical)	(1 Credit)
PATH 303	Immunology & Immunopathology	(2 Credits)
PATH 304	Systemic Pathology (Practical)	(2 Credits)
PATH 301	General Pathology (Theory)	(3 Credits)
PATH 302	Systemic Pathology (Theory)	(5 Credits)

Objectives

To make the student understand the basic principles of causation, mechanisms and characteristics including manifestations of the major categories of diseases and subsequently, to know the specific diseases as they affect individual organs or multiple organs of causation and processes featuring in general pathology.

General Pathology (PATH 301 and PATH 305)

This is the current understanding of the basic principles of causation, mechanisms and characteristics including manifestations of the major categories of diseases. It is the foundations of knowledge that must be laid down before the pathology of the general pathology are understood before attempt is made to teach and study.

Immunology and Immunopathology (PATH 303)

This is the current knowledge and understanding of the basic components of the immune system and the principles of the basic immune reactions and how abnormal reactions lead to disease.

Systemic Pathology (PATH 302 and PATH 304)

This is the current knowledge of specific diseases as they affect individual organism or systems and their effects on the body as a whole. The operation of one or more categories of causation and processes featuring in general pathology may be responsible for the genesis of each specific disease.

Recommended textbooks include:

Robbins Pathologic Basis of Disease (Cotran, Kumar and Collins) Sixth Edition

Muir’s Textbooks of Pathology

General and Systematic Pathology (ed. Underwood) Second Edition

General Pathology (Walter and Israel)

Pathology (Rubin and Faber) Third Edition

The student is expected to learn by a process of gathering information, acquiring and organizing knowledge, gaining understanding, and striving toward wisdom. In this process, participation in and “doing” are, at least, as important as listening and hearing. Students must attend all lectures and participate in all laboratories and tutorials. Prior preparation before lectures, practicals and tutorials is beneficial and essential. Every student must make the effort to contribute to discussions during practical sessions and formal tutorials.

Lectures must be considered as guide to the material to be covered. When reading or written assignments are given, students must take note and comply.

PATH 301 General Pathology Theory 3 Credits

Course Objectives

At the end of the course the student shall, when required, be able to:

Describe and explain in own words the scientific basis of disease causation
Classify the various causes of disease
Describe in a logical and sequential fashion the events and explain the mechanisms involved in various process
Describe and analyze the morphologic and/or functional changes induced by various pathogenetic processes
Differentiate between processes and mechanisms that produce similar morphologic and/or functional changes
State and explain clearly all the terminology introduced in the course
Deduce and predict the outcomes (morphologic, biochemical and/or functional changes/consequences) of a given pathogenetic process
State and/or explain the underlying pathogenetic process when given a specific scenario
Write an essay, short or long, on any of the topics treated in the course. Here the emphasis is on the clarity of thought, good usage of language including appropriate terminology and clear understanding of the topic – Answer multiple-choice including True/False and matching questions on every topic treated in class Content

Introduction to Pathology
- History of pathology
- Techniques available in pathology
Characteristics and Nomenclature Of Disease
- Aetiology; Pathogenesis; Manifestation and Presentation; Complications and Sequelae; Prognosis.
- Primary and Secondary; Acute and Chronic; Prefixes and Suffixes; Syndromes.
- Inherited and Acquired; Congenital; Iatrogenic
Cellular Basis of Disease
- Cell proliferation; Homeostasis and steady state.
- Cellular response to injury
Tissue Response to Injury – Inflammation,

Healing and Repair – Acute inflammation

Chronic inflammation
Healing and repair

Circulatory Disturbances
- Hyperaemia and congestion
- Oedema
- Thrombosis
- Disseminated intravascular coagulation
- Embolism
- Ischaemia and infarction
- Shock

Disorders of Growth and Neoplasia
- Disorders of development
- Dysplasia
- Neoplasia

General Pathology Practical ((PATH 305) – 1 Credit

This course is held in the first semester of level 300 (semester 5 of the B.Sc. program).

There is one session of two hours duration every week. The class is discussions are on Microscopic and Gross Pathology Practicals.

Course Objectives

At the end of the course:

Microscopy: Given a histological section the student will be able to:

Clearly describe the histologic features present
Identify the pathologic process giving rise to those features
State and explain the underlying mechanisms
List/predict and give reasons for likely beneficial and harmful (complications) effects Gross Pathology: Given a potted gross pathologic specimen the student will be able to:
Identify all the organs present
Clearly describe the gross pathologic features present
Identify the pathologic process giving rise to those features
State and explain the underlying mechanisms
List/predict and give reasons for likely beneficial and harmful (complications) effects

Microscopy: The practical or laboratory sessions consist of histological examination of typical examples of the morphologic changes produced by the various processes discussed in lectures and tutorials. Slides for each session are selected according to the pathologic process under discussion. Students must be able to identify and describe either in writing or verbally, the histological features of the various processes and explain the underlying mechanisms. They must be able to state/predict beneficial and harmful (complications) effects of the processes. Demonstration slides may be mounted to show examples of various processes, which may not be in the class sets.

Gross Pathology: Students will be shown formalin-fixed potted specimens in the W. N. Laing Museum, pictures or fresh autopsy specimens in the autopsy room to illustrate various conditions discussed in the course. Students must be able to describe, either in writing or verbally, the gross appearances of the specimens and state and the particular pathologic process (es) and explain the mechanisms of the process (es) involved. They must be able to state/predict beneficial and harmful (complications) effects of the processes. The format of the session shall be in the form of a group discussion and, while it is instructor-led, it is student based

Immunology and Immunopathology

This course is run in the first semester of the level 300 (semester 5 of the B.Sc. program). Lectures will identify and explain the features and functions of key chemical and cellular components of the immune system and how they interact and respond to foreign agents. Tutorials will be organized periodically to further explain key principles.

Course Objectives

At the end of the course the student shall, when required, be able to:

Describe in own words the chemical and cellular components of the immune system and explain the function(s) of each.
Classify the various immune responses that result in disease
Describe in a logical and sequential fashion the events and explain the immunological mechanisms involved in various disease processes
State and explain clearly all the terminology introduced in the course
Deduce and predict the outcomes (morphologic, biochemical and/or functional changes/consequences) of a given pathogenetic process
State and/or explain the underlying pathogenetic process when given a specific scenario.

Content

Introduction to immunology
Antigen; antibody
Cellular basis of immune response
Humoral immune response
Regulation of immune response
Immunological tolerance
Hypersensitivity reactions
Transplantation
Autoimmune diseases

Recommended Textbooks for Immunology include:

Basic and clinical immunology by Daniel P Stiles and Abba I Terr

Immunobiology-the immune system in health and disease br Charles A Jancway. Paul Travers, Mark Walport, J Donald Capra

Essential Immunology by Ivan Riott

Robbins Pathologic Basis of Disease (Cotran, Kumar and Collins) SEVENTH Edition

Systemic Pathology (PATH 302) -5 Credits

Lectures will cover definition, classification and aetiology including associations and risk and predisposing factors, pathogenesis, morphologic manifestations, complications and natural course of the disease as appropriate.

Course Objectives

At the end of the course the student shall, when required, be able to:

Give the definitions of the diseases covered in the course
State the aetiology or aetiological factors including predisposing and risk factors, age and sex differences and other epidemiological factors (as appropriate) of the various diseases covered in the cause
Classify each disease into subtypes where appropriate
Describe in a logical and sequential fashion the pathogenesis of each disease taught during the course
Described and analyze the morphologic and/or functional changes seen in the diseases discussed during the course
State and explain clearly all the terminology introduced in the course
State and describe with reasons the possible outcomes (morphologic, biochemical and/or functional changes/consequences) of a given disease including effects on other organs or systems.
Write an essay, short or long, on any of the diseases treated in the course. Here the emphasis is on the clarity of thought, good usage of language including appropriate terminology; clear understanding of the disease and ability to relate to effects on other organs or systems.
Answer multiple-choice including True/False and matching questions on every topic treated in class.

Content

Cardiovascular System – Vascular diseases – Systemic hypertension
- Cardiac failure
- Pathophysiological concepts; manifestations; compensatory mechanisms
- Ischaemic heart disease
- Rheumatic fever
- Endocarditis
- Myocarditis
- Pericarditis
- Valvular diseases
- Congenital heart disease

Respiratory System
- Nose, nasal sinuses, nasopharynx
- Larynx and trachea
- Bronchial asthma; bronchitis; emphysema; bronchietasis
- Pneumonias
- Interstitial lung diseases
- Pulmonary oedema; uraemic lung
- Pulmonary hypertension and corpulmonale
- Respiratory failure
- The pleura
- Neoplasms: Lung and pleura

Lymphoreticular System
- The spleen: Functions; inflammatory conditions; storage diseases; neoplasms
- Lymph nodes: Inflammatory and infectious diseases; lymphomas; metastatic neoplasms

Gastrointestinal System Diseases of:

Salivary glands

Pharynx
Oesophagus
Stomach
Intestines
Anus

Liver, Biliary Tract, Pancreas Circulatory disturbances of liver
- Jaundice; liver failure; hepato-renal syndrome
- Infections:
  1. Viral hepatitis: HVA, HVB, HVD, HVC, HVE, HVG infections
  2. Yellow fever and other viral infections
  3. Schistosomiasis; Amoebic abscess

– Chemical-induced liver injury

Alcoholic liver disease
Bile-induced: Intra – and extra-hepatic biliary obstruction
Drug-induced: Predictable and unpredictable; hepatotoxic and cholestatic

Cirrhosis of liver
Tumour of liver
Gall stones and cholecystitis
Neoplasms of gall bladder
Acute and chronic pancreatitis
Neoplasms of pancreas

Nervous System
- Congenital abnormalities of nervous system
- Pathology of intra-cranial expanding lesions
- Traumatic lesions of CNS
- Hydrocephalus
- Circulatory disturbances of CNS
- Infections of nervous system
- Demyelinating diseases
- Storage diseases
- Spinal cord degeneration; motor neurone lesions

Urinary System

Kidney

Structure and function
Congenital diseases
The glomerular diseases
Acute and chronic renal failure
Pyelonephritis: Acute and chronic
Miscellaneous renal diseases
1. Cortical necrosis, interstitial nephritis
2. Neoplasms of kidney

Pelvis, Ureters, Bladder

Lithiasis
Obstructive uropathy
Inflammation
Neoplasms of urothlium
Congenital anomalies

Male Genital System
- Congenital anomalies
- Inflammations
- Neoplasms of penis and scrotum
- Neoplasms of testis
- Male infertility
Female Genital System and Breast

Disease of:

Vulva and vagina
Cervix
Endometrium
Ovary and fallopian tubes
Breast

Diseases of Bone
- Inflammatory disease of bone: Osteomyelitis (Acute and chronic)
- Metabolic diseases of bone
- Paget’s disease of bone
- Neoplasms: Osteogenic sarcoma: Chrondrosarcoma

Diseases of Joints
- Arthritis
- Tumours of synovium and tendon sheath

Diseases of Skeletal Muscle
- Inflammatory diseases: Bacterial myositis: Viral polymyositis
- Muscular dystrophies
- Drug induced, toxic and endocrine myopathies
- Disorders of neuromuscular transmission: Myasthenia gravis: Eaton-Lambert syndrome.

Autoimmune Diseases
- Systemic lupus erythematosus
- Progressive systemic sclerosis
- Others

Endocrime System Diseases of:
- The pituitary
- The adrenals
- The thyroid
- The parathyroids
- The pancreas (endocrine)

Systemic Pathology Practical (PATH 304) 2 Credits Course Objectives

At the end of the course:

Microscopy: Given a histological section the student will be able to: – Identify the tissue or organ(s)

Clearly describe the histological features present
Make a diagnosis based on the features identified and described
State the cause (s) of the disease
Identify the pathologic process giving rise to those features when requested
State and explain the underlying mechanisms when requested
List/predict and give reasons for likely complications

Gross Pathology: Given a potted gross pathologic specimen the student will be able to:

Identity all the organs present
Clearly describe the gross pathologic features present
Make a diagnosis based on the features identified and described
Identify the pathologic process giving rise to those features
State and explain the underlying mechanisms
List/predict and give reasons for likely complications

This course is run in the second semester of the level 300 (semester 6 of the B.Sc. program). It is divided into two sessions a week, each of two hours duration. The sessions are devoted to histological examination of typical examples of the morphologic features of the various diseases discussed in lectures and tutorials. Slides for each session are selected according to the pathologic system and disease under discussion and students must be able to identify and describe, either in writing or verbally, the histological features and state the diagnosis. Students must be able to state the aetiology, list and explain complications and discuss pathogenesis and predict the prognosis. Students will be shown formalin-fixed specimens in the W.N. Laing Museum or fresh autopsy specimens in the autopsy room to illustrate various conditions discussed in the course. Students must be able to describe, either in writing or verbally, the gross appearances of the specimens, state the particular pathologic process (es) involved and explain their mechanisms, state diagnosis and predict likely complications and prognosis giving reasons.

The format of each session in gross pathology shall be in the form of a group discussion and, while it is instructorled, it is student based. l be a management question

Continuous Assessment

Objective questions shall be used to assess theoretical knowledge during the semester. This will constitute 10-30% of final theory course mark

Practical assessments shall be done by in-course format and will be the final course mark.

Terminal Assessment

The end of semester examination shall comprise a theory paper of objective type questions for 2-3 hours. There will be multiple choice questions and the true or false type objective questions. Marks would be deducted for wrong answers for the true/false type questions. The terminal assessment will form 70-90% of final course mark.

DEPARTMENT OF PHARMACOLOGY

Objectives

In this course students will be trained to know and explain: the general principles that apply to all areas of pharmacology, the pharmacologic role of endogenous substances (autacoids) in inflammation, with the view to interpret the rational use of their antagonists in clinical practice, how synthetic drugs (chemotherapeutic agents) and products of micro-organisms (antibiotics) produce toxic effect on organisms that invade the body and thereby produce therapeutic effect, the action of drugs on organ systems of the body with the view to identifying their effect, therapeutic uses, toxicity and contraindications and the basic principles, occupational and environmental toxicology, recognition of toxicity, and antidotal procedures.

At the end of the entire programme the student should be able to apply the knowledge acquired to drug management of diseases and apply the knowledge and skills acquired to define and explain emerging concepts in drug action.

Revised Curriculum

Undergraduate Syllabus

PHAM 301	General & Autonomic Pharmacology (Theory) (3 Credits)
PHAM 302	Systemic Pharmacology, Endocrines & Toxicology (Theory) (4 Credits)
PHAM 303	General & Autonomic Pharmacology (Practical) (1 Credit)
PHAM 304	Systemic Pharmacology, Endocrines & Toxicology (Practical) (1 Credit)
PHAM 305	Autacoids, Anti-inflammatory & Antimicrobial Agents (Theory) (2 Credits) DETAILS OF UNDERGRADUATE SYLLABUS
PHAM 301	General & Autonomic Pharmacology (3 Credits)

General Pharmacology

Definition of Pharmacology, Definition of a drug, Routes of drug administration, Drug Absorption, Drug

Distribution, Drug Biotransformation, Drug Excretion, The Receptor Concept, Drug-Receptor Concept, Receptor Occupancy-Response Coupling, Drug dose (concentration) and response, Interaction between drugs, Individual variation in drug responsiveness, Factors Influencing dosage and drug response, Pharmacognetics, Drug development and Clinical trials.

Autonomic Pharmacology

Introduction to Autonomic Nervous System, Cholinergic System, Cholinomimetic drugs, Anticholinergic drugs, Adrenergic System, Direct acting sympathomimetic drugs, Mixed and Indirect acting sympathomimetic drugs, Adrenoceptor-blockers (α-blockers), Adrenoceptor-blockers (β-blockers)

Pham 302 Systems Pharmacology (4 Credits)

Cardiovasculo-Renal Pharmacology

Diuretic agents, Antihypertensive drugs, Antianginal drugs, Antidysrrhythmic drugs, Drugs used to treat heart failure, Anticoagulants, Drugs used to treat anaemia, Anti-hyperlipidaemic drugs.

Respiratory Pharmacology

Drugs for treatment of Asthma, Anti-allergic agents, Mucolytics, Antitussives, Respiratory Stimulants

Pharmacology of the Nervous System

General Anaesthetic Agents, Local Anaesthetic Agents, Sedative-Hypnotic Drugs, Antidepressants drugs,

Opiod Analgesics and Antagonists, Antipsychotic Drugs, Drugs used in Parkinsonism, Anticonvulsants, Drugs of Abuse and Addiction

Gastro-Intestinal Pharmacology

Antacids, Anti-spasmodics, Laxatives and Costives, H₂-receptor antagonists, Proton Pump Inhibitors, Antiemetics

Endocrine Pharmacology

Corticosteroids, Anti-thyroid drugs, Antidiabetic drugs, Sex hormones and Antifertility, Oxytocics and Tocolytics

Chemotherapeutics

Principles of Chemotherapy, Antifungal Agents, Anthelmintics, Anti-protozoal drugs, Antituberculous drugs, Drugs used in the treatment of Leprosy, Cancer Chemotherapy, Antiviral Drugs

Toxicology

Principles of Toxicology, Environmental and Occupational Toxicology, Snake, Insects & Crustaceans bites etc., Therapeutic drugs of toxicological importance.

PHAM 303 & 304 Practicals (1 Credit Each)

Introduction to Laboratory Studies/Practices
Routes of drug Administration and variations in drug response
Relationship between drug dose and pharmacological response
Action of some agonists and antagonists on the isolated guinea-pig ileum
Effect of histamine on the microcirculation and its blockade by H₁-receptor antagonists
Action of Local anaesthetics – X² test
Modes of action of neuromuscular blockers
Action of drugs on the human eye
Rational Pharmacotherapy & P-Drug Concept

PHAM 305 Autacoids, Anti-Inflammatory and Antimicrobial Drugs (2 Credits)

Autacoids and Anti-inflammatory Drugs

Histamine and Antihistamines, 5-Hydroxytryptamine, Kinnins, Prostaglandins, Non-Steroidal AntiInflammatory Drugs, Drugs used in the treatment of gout

Antimicrobial Agents

Quinolones, Sulphonamides and Trimethoprim, Penicillins, Cephalosporins, Tetracyclines, Chloramphenicol, Aminoglycosides, Polymyxins, Antibiotics with Specialized Indications and Urinary antiseptics

REGULATIONS FOR THE CLINICAL PART OF THE BACHELOR OF MEDICINE AND BACHELOR

OF SURGERY (MB, ChB) DEGREE PROGRAMME

ADMISSION
Further to the General Regulations regarding admission into the University of Ghana, a candidate for admission to the Clinical Part of the MB ChB degree programme shall have obtained the B.Sc. (Med. Sci.) degree of the University of Ghana.

Candidates with the Bachelor’s degree in Basic Medical/Biological Sciences, as well as those who may have completed part of the MB ChB (or its equivalent) in a recognized university, may be considered for admission on the recommendation of a special committee appointed by the Dean. The Special Committee shall vet the transcript of the candi-date as well as course content of the degree, with a view to determining the suitability of the degree or previous training and make appropriate recommendations to the Dean.

DURATION AND STRUCTURE
The Clinical Part of the MB ChB degree programme shall be of 3 years duration and structured as follows: (a) 1^st Clinical Year – 37 weeks (b) 2^nd Clinical Year – 45 weeks

3.0 ACADEMIC YEAR

The Academic Year shall comprise two semesters.

STRUCTURE OF SEMESTER
First Clinical Year – 37 Teaching Weeks
- Semester 7 – 23 Weeks Clinical Rotations
- Inter-Semester Break – 2 weeks
- Semester 8 – 14 Weeks

Clinical Rotations

4.2 Second Clinical Year – 45 Teaching Weeks

Semester 9 – 24 weeks Clinical Rotations
Inter-Semester Break – 2 weeks
Semester 10 – 21 Weeks

Clinical Rotations

4.3 Third Clinical Year – 44 Teaching Weeks

Semester 11 – 24 weeks

Clinical Rotations

Inter-Semester Break – 2 weeks
Semester 12 – 20 Weeks

Clinical Rotations

SUBJECTS FOR CLINICAL YEARS 1 – 3
First Clinical Year – Semesters 7 & 8

5.1.2 Semester 7 shall be devoted to the following:

Junior Clerkship in Community Health* 8 weeks

Medical Psychology* 8 weeks

Introduction to Nursing Skills 1 week

Introduction to Clinical Skills 4 weeks

Coordinated Course I (Medicine & Surgery, 10 weeks

Community Health, and Applied Pathology and

Inputs from other Clinical Departments)

Medical Ethics 10 weeks

* These courses run concurrently. This Semester shall last 23 weeks.

Lectures in Medical Ethics shall be given concurrently with Coordinated Course I and examined at the end of the semester.

Semester 8

Semester 8 shall cover the following:

Coordinated Course II (Medicine, Surgery, Community

Health and Applied Pathology)

Trauma & Orthopaedics

This Semester shall last 14 weeks.

5.2 Second Clinical Year – Semesters 9 and 10

Semester 9

Semester 9 subjects shall be:

Junior Clerkship in Obstetrics/Gynaecology

Junior Clerkship in Child Health

Junior Clerkship in Psychiatry

Specialties I (Dermatology, Ophthalmology, ENT) Forensic Medicine

This semester shall last 24 weeks.

Semester 10

Semester 10 subjects shall be: –

Senior Clerkship in Obstetrics/Gynaecology

Senior Clerkship in Child Health

This Semester shall last 21 weeks.

5.3 Third Clinical Year – Semesters 11 and 12

Semester 11

Semester 11 subjects shall be: –

Clinical Psychiatry

Senior Clerkship in Medicine & Therapeutics

Senior Clerkship in Surgery

Senior Clerkship in Community Health

Specialties II (Anaesthesia, Urology and Orthopaedics, Radiology

The semester shall last 24 weeks.

Semester 12

In this semester, the subjects taken in Semester 11, except Clinical Psychiatry, shall be continued for another 20 weeks.

MINIMUM/MAXIMUM PERIOD FOR COMPLETING THE MB CHB PROGRAMME
The minimum period for completing the Clinical MB ChB programme shall be 6 semesters or three academic years.
The maximum period for completing the Clinical MB ChB programme shall be 12 semesters or 6 academic years.
A candidate who is unable to complete his/her programme within the maximum period allowed shall lose all credits accumulated. Such a candidate shall not be allowed to re-apply for admission into the BSc

(Med. Sci.) and MB ChB degree programmes.

Subject to the provision under Regulation 6.5, candidates are required to take the first examination immediately following the completion of the relevant subjects and may not postpone their entry without special written permission of the Board of the Medical School.
The candidate who has not complied with the prescribed requirement for any subject or who has not performed satisfactorily in other duties prescribed or associated with a course of instruction may, on the recommendations of the relevant department, be refused admission to the examination of the year concerned and be required to repeat part or the whole of the course of instruction leading to the particular examination.
A candidate who fails in only one subject of an examination at the first examination shall be referred in that course/subject and shall be required to take the examination in the referred course/subject at the supplementary examination following the main examination.

(See Regulation 11.0).

A candidate who fails in more than one subject at the first examination shall be deemed to have failed the whole examination and may on the recommendation of the Board of Examiners be required to:
- Repeat the whole of the examination at the supplementary examination immediately following the main examination, or
- repeat only those subjects in which he/she failed, provided that he/she obtains at least 55% in the subject(s) in which he/she passed and not less than 45% in the subject(s) in which he/she failed (pass mark is 50%), or
- Repeat the year without the option of the supplementary examination.
A candidate who fails to complete an examination at the Supplementary Examination may, on the recommendation of the Board of Examiners, be required to withdraw from the Medical School or to repeat the whole or part of the course of instruction leading to that examination, before presenting him/herself for reexamination.
Notwithstanding the provisions of Regulation 6.2 above, a candidate shall not present himself/ herself for the whole or any part of the same examination on more than three occasions.
A candidate who passes an examination as a whole at the first attempt and reaches the requisite high standard in a subject(s) may, on the recommendation of the Board of Examiners be awarded Honours:

(a) Distinction, or (b) credit in such subject(s), in accordance with such rules as may be approved by the Academic Board.

6.11 Criteria for such Honours are:

Distinction – 75 – 100%

Credit – 65 – 74%

6.12. Further to Regulation 1.2 above, the Board of the Medical School is empowered to determine whether a course of study pursued in the examinations passed in other recognized institutions by any candidate wishing to enter the professional courses at the Medical School may be accepted for the purpose of exemption from part or all of the Basic and Para-Clinical Sciences.

6.13 No exemption shall be granted from any part of the MB ChB subjects and examination.

INTERRUPTION OF STUDY PROGRAMME
A student may break his/her study programme but may not break for more than 4 continuous semesters, so however that the maximum period allowable for the completion of the programme is not exceeded. Such a

student shall be allowed to continue the programme from where he/she had left off.

A student who wishes to interrupt his/her course of study shall apply in advance to the Dean of the Medical

School, stating reasons why he/she wants to interrupt his/her study pro-gramme, and permission duly granted before he/she leaves the University. The decision of the Dean shall be communicated to the applicant by the Executive Secretary before he/she leaves the University.

A student who breaks his/her studies for more than 4 continuous semesters shall be deemed to have lost any accumulated credits. Such a student may be allowed to re-apply for admission to Medical School.
Where the ground for interruption of studies is medical, the Head of the Medical School Clinic shall be required to advise the Dean on the propriety and length of period of interruption. The Dean shall cause the Head of the Medical School Clinic to investigate any medical report reaching his office from any health delivery facility outside the Medical School Clinic and advice accordingly.

SCHEME OF EXAMINATIONS FOR CLINICAL SUBJECTS
The clinical part of the MB ChB degree programme shall be examined as indicated in Sections 8.2 to 8.5 below.
First Clinical Year – Semesters 7 & 8

In semesters 7 & 8, candidates shall be assessed entirely by continuous assessment and end-of-rotation tests. Candidate must have performed satisfactorily in the continuous assessment and end-of-rotation tests in order to proceed to the Second Clinical Year.

Second Clinical Year – Semesters 9 & 10 (MB ChB Final Part I)

At the end of the Second Clinical Year, candidates shall be required to take the MB ChB Final Part I Examinations in Child Health and Obstetrics & Gynaecology.

Third Clinical Year – Semesters 11 & 12 (MB ChB Final Part II,)

At the end of the Third Clinical Year, candidates shall be required to take the MB ChB Final Part II Examinations in Medicine & Therapeutics, Psychiatry, Surgery and Anaesthesia and Community Health.

The methods of examination shall be:
- Written – MCQ, short essays
- Clinical – one long case and two short cases
- Orals
- Objective Structured Clinical Examination (OSCE) in Anaesthesia and Obstetrics and Gynaecology.
A candidate shall not proceed to the Third Clinical Year (i.e. MB ChB Final Part II) until he or she has completed the course and passed each subject in the MB ChB Final Part I Examinations.
The pass mark for all subjects at the MB ChB Final Parts I & II Examinations shall be 50%.
ELIGIBILITY FOR EXAMINATIONS
A student shall attend all such lectures, tutorials, seminars, ward rounds and clerkships and undertake all other assignments as approved by the University.
Each Department shall, with the approval of the Academic Board, determine the requirements for the subjects they offer.
A student who does not fulfill the requirements for any subject shall not be allowed to take the examination for that subject.
In any case, a student who is absent for a cumulative period of 21 days from all lectures, tutorials, ward rounds, clerkships and other activities prescribed for any subject in any semester shall be deemed to have withdrawn from the course/subject. Such a student shall not be permitted to sit for the semester examination.

REGISTRATION FOR EXAMINATIONS
Registration for a Medical School Examination shall require endorsement of the Registration Form by the Head of Department to the effect that the candidate has pursued satisfactorily the approved course(s) of study being offered over the prescribed period, and has attended at least 85% of lectures, tutorials, ward rounds, clerkships and other activities prescribed for the subjects. A candidate’s registration shall not be valid unless it is so endorsed.
Endorsement as in (10.1) above shall be withheld if a candidate is not deemed to have followed satisfactorily the approved course of study (as in Section 9).
In any event of the withholding of an endorsement, the Head of Department shall request the confirmation by the Board of the Medical School.

SUPPLEMENTARY EXAMINATIONS
Supplementary examinations for Final Part I shall be held in six (6) weeks after the main examinations.
Supplementary examinations for Final Part II shall be held in three (3) months after the main examinations.
The provisions of Regulation 6.8 above shall apply to all supplementary examinations.

EXTERNAL EXAMINERS
External examiners shall be required for both the main and supplementary examinations for the MB ChB Final Parts I & II Examinations.
All External Examiners shall be required to submit a written report on all aspects of the examination in which they took part.

DEFERMENT OF EXAMINATION
On Grounds of Ill-Health: A student who has satisfied all the requirements as specified in Section 8, but is unable to take the main (end of semester) examination on grounds of ill health, shall, on application to the Executive Secretary, and on provision of a Medical Certificate issued or endorsed by the Head of the Medical School Clinic be allowed to take supplementary examination as his/her main examination. He/she shall be credited with the grade obtained in the supplementary examination.

Subsequent application for deferment, on grounds of ill-health, shall be subject to a Medical Certificate issued by a properly constituted Medical Board.
On Grounds other than Ill-Health: In cases of deferment on grounds other than ill-health, the Dean of the Medical School shall invite the applicant for interview. It shall be the student’s responsibility to satisfy the Medical School beyond reasonable doubt why he/ she wishes to defer the examinations.
In all cases of deferment of examinations, the applicant(s) shall obtain written responses from the Executive Secretary before leaving the Medical School.

EXAMINERS’ BOARD
There shall be Examiners’ Board for the main and supplementary examinations in respect of:

i) MB ChB Final Part I ii) MB ChB Final Part II

The Examiners’ Board for MB ChB Final Part I shall comprise the following:-

Dean – Chairman

Vice Dean

Heads of Departments of Child Health, and Obstetrics and Gynaecology

Internal Examiners

External Examiners (optional)

Executive Secretary

Senior Assistant Registrar (AA) – Secretary

The Examiners’ Board for MB ChB Final Part II shall comprise the following:-

Dean – Chairman

Vice Dean

Heads of Departments of:

Medicine & Therapeutics

Surgery

Community Health

Anaesthesia

Pathology

Psychiatry

Radiology

Internal Examiners

External Examiners (optional)

Executive Secretary

Senior Assistant Registrar (AA) – Secretary

14.4 Examiners’ Board(s) shall receive, consider and determine the results of the respective examinations.

14.5 Each Board shall be required to make appropriate recommendations on any candidate based on his/her performance and also on any aspect of the examination as it deems fit.

15.0 DECLARATION OF RESULTS

15.1 Results of end of rotation examinations shall normally be published on the department notice boards with copies to the Executive Secretary.

15.2. Results of the MB ChB Final Part I and II Examinations shall normally be published by the Executive Secretary on the School Notice Board after the Examiners’ Board has determined the results.

15.3 The results as published shall be subject to the approval of the Board of the Medical School and the Academic Board.

15.4 A results slip indicating the student’s performance shall be made available to him/her.

16.0 ELIGIBILITY FOR THE MB ChB DEGREE

16.1 The MB ChB degree shall be awarded to a candidate who has been properly admitted to the University, has followed the approved courses of study over the prescribed period and has satisfied the conditions as stated in Regulations 16.2 and 16.3 below.

16.2 University Requirements ii. evidence of regular enrolment in the degree programme ii. Discharge of all obligations owed to the University iii. a pass in all University required courses iv. Satisfactory performance in the appropriate University Examinations. 16.3 Faculty/Departmental Requirements

Satisfactory discharge of such requirements as may be prescribed for the degree.

17.0 REQUIREMENTS FOR GRADUATION

17.1 A candidate shall be deemed to have:

Satisfied all General University and Faculty requirements;
Obtained at least 50% in each subject featured in the MBChB Final Part I and II examinations;

17.2 In addition to the above, all candidates are required to attend the Swearing-in-Ceremony and take the Hippocratic Oath.

CONFIRMATION OF AWARD OF DEGREE
A list of candidates who are deemed eligible as in Regulations 16 and 17 shall be laid before the Academic Board of the University for approval as soon as practicable.
No award shall be confirmed unless the Academic Board of the University is satisfied that the candidate has satisfied all the conditions for the award of a degree.

CANCELLATION OF AWARD
Notwithstanding previous confirmation of an award of a degree as in Regulation 18 the Academic Board of the University may at any time cancel an award even with retrospective effect if it becomes known that:

a candidate has entered the University with false qualifications
a candidate has impersonated someone else
a candidate has been guilty of examination malpractice for which a grade Z would have been awarded
There are other reasons that would have led to the withholding of confirmation of the award in the first place.

19.2 In any such event, the decision of the Academic Board of the University shall be published on the University Notice Boards and the candidate notified. Such cancellation and the reasons for it shall be entered on the candidate’s transcript.

20.0 TRANSCRIPT OF ACADEMIC RECORD

At the end of a student’s programme, the University shall, on the payment of an appropriate fee, issue to the particular student a complete transcript of his/her academic record. This transcript shall be marked Student’s Copy and shall record all courses attempted and all results obtained.

21.0 CLASSIFICATION OF DEGREE

The MB ChB degree shall not be classified.

COMPETENCIES THAT A STUDENT SHOULD EXHIBIT ON GRADUATION IN RELATION TO THEIR SUBSEQUENT TRAINING AND FUTURE ROLES IN THE HEALTH SYSTEM

Knowledge

At the end of the training the student must be able to demonstrate knowledge and under-standing of the Basic, Para-Clinical, Clinical, Behavioural and Social Sciences including Public Health relevant to the practice of medicine.

Attitude

The student should be able to:

maintain the highest standard of professional conduct and medical ethics
demonstrate respect for, and the responsibility for, preserving human life from the time of conception and the need for human beings to live and be treated with dignity and humanity
Accept and demonstrate the importance of team work in health delivery.

Skills

The students must be able to demonstrate appropriate:

Communication skills.
Clinical Skills.
Promotive, preventive, rehabilitative skills and be able to organise and carry out health programmes in collaboration with other members of the health team to improve health.
Management skills.

LIFE LONG LEARNING AND CONTINUING PROFESSIONAL DEVELOPMENT

The student should be able to demonstrate the importance of research in the management of patients and the advancement of medical knowledge and cultivate life long learning habits.

Further to the above, it is deemed essential to inculcate into the student a sense of patriotism to serve the motherland.

OBJECTIVES OF THE CLINICAL COURSES OF THE MB CHB DEGREE PROGRAMME

DEPARTMENT OF ANAESTHESIA

Objectives

At the end of the clerkship, the students should be able to: –

assess patients properly before anaesthesia and surgery for both elective and emergency Operations
know the types of anaesthesia that can be given for surgery, e.g. General Anaesthesia

Regional techniques, different types of anaesthetic drugs, their side-effects and drawbacks

take care of the critically ill patient peri-operatively
resuscitate patients (CPR)
know the various methods of pain relief and the problems associated with them

Lecture Topics

Introduction to Anaesthesia
Pre-Operative Assessment and Premedication
Intravenous General Anaesthesia Agents1-Thiopentone, Ketamine
Intravenous General Anaesthesia Agents 2-Propofol Other Agents Including Neuroleptics
Inhalational Anaesthetic Agents 1 – General Considerations Ether, Stages of Anaesthesia, Etc
Inhalational Anaesthetic Agents 2 – Halothane and Newer Agents
Muscle Relaxants 1- General and Deporalizers
Muscles Relaxants 2-Non-Deporalizers
Local Anaesthesia Agent 1- General Considerations Including Mechanism of Action
Local Anaesthesia 2- Clinical Applications and Techniques Including Spinal/Epidural
Pain Relief – Acute /Chronic Pain
Airway Management Including Endotracheal Intubation
Monitoring In Anaesthesia (Peri-Operative, Intensive Care)
Obstetric Anaesthesia & Analgesia
Emergency Anaesthesia

Tutorial Topics

Obstetric Anaesthesia & Analgesia
Airway Management Including Endotracheal Intubation
ECG
Post-Operative Complications
Chest X-Ray
Head Injuries & Management of the Unconscious Patient
Maintenance of Anaesthesia and Reversal
Difficult Airway, Assessment and Management
Intravenous Injection Techniques, Complications of Common Intravenous Anaesthetic Agents, and Their Management
Positioning In Theatre – Supine, Prone, Lateral, Sitting
Anaesthetic Machines and Circuits
Inadequate Ventilation – Causes, Management
Basic Life Support and Advance Cardiac Life Support
Local Anaesthetic Agents – Spinal, Epidural and Complications
Modes of Pain Relief (Acute and Chronic)
Anaesthesia for the Patient with Sickle Cell Disease, Diabetes
Anaesthesia for the Patient with Hypertension, Asthma
Management of Multiple Trauma Patients

Practicals

CPR1 Theory & Practical, BLS, Acls

CPR Practical Manikin Practices

N/B: Practical Theatre Sessions to cover all the above and more

DEPARTMENT OF COMMUNITY HEALTH

Objectives

The goal of the department of community health is to train medical students to be able to identify major problems affecting the health of communities and their solutions.

The student should be able to function effectively as a Medical Officer at district level, and should be interested in deepening his/her knowledge and interest in the field of community health after the undergraduate course through medical update courses and research.

SENIOR CLERKSHIP PROGRAM IN COMMUNITY HEALTH

The Senior Clerkship in Community Health is to expose the medical student to the Health and Health Systems of the Country. It investigates whether the health facilities are meeting the health needs of the people in the rural and urban communities. Students get an indepth understanding of how the local government collaborates with the various sectors of health. The programme relies on a strong understanding of the scientific basis of Community Health topics given during the Junior Clerkship programme and the contents of the Coordinated Course in Medicine and Surgery.

Students rotate through the department in subgroups and for a period of 10 weeks covering the areas below
Study of urban health system (Urban Health Programme)
Ankaful Leprosarium programme
District Clerkship
Community Diagnosis at Danfa Rural area
Field visits to major public health facilities in Accra and
End of clerkship examinations (10-day programme)

The programme also aims at equipping students with skills in research, data analysis and playing advocacy role for health improvement.

Departmental Objectives of Community Health Training Programme

The goal of the department of community health is to train medical students to identify major problems affecting the health of communities and their solutions. The student should be able to function effectively as a medical officer at the district level, and should be interested in deepening his/her knowledge and interest in the field of community health after the undergraduate course through medical update courses and research.

Specific Objectives

Make a diagnosis of the health problems in a community, taking into considerations the major ecological factors, which influence health such as social, physical and biological environment
Draw up health programmes feasible for the existing health care system with due consideration of resources and interests of the community
Organize and carry out the programmes in collaboration with members of the health team and the community
Stimulate the community to modify their behavior with a view of improving their health status.
Administer health programmes and personnel, using appropriate management and evaluation techniques
Maintain the development of knowledge and skills in Community Health.
Carry out scientific investigations/research into the health problems of a community or individuals.

Field Stations:

Danfa Rural Health Centre

District Health Clerkship Hospitals

Akosombo Hospital

Apam Hospital

Nkawkaw Catholic

Nsawam Hospital Suhum Hospital

Winneba Hospital

Atibie Hospital

Links with the Ministry of Health and other Organisations

Public Health Reference Laboratory

Disease Control Unit

Centre for Health Information Management

University of Westminster

Liverpool School of Tropical Medicine

Urban Health System (Urban Health Clerkship)

Study of urban health system (Mamprobi clerkship) Mamprobi, Kaneshie, Ussher, La, Mamobi Polyclinics

Learning Objectives

By the end of the rotations, the student will be able to:

Demonstrate knowledge of the staffing, functions and problems of the various units of the polyclinic (study the structure and administration of the polyclinic)

Participate in the different Health Services provided by the polyclinics and to assess their impact on the health consciousness and health status of the community.

Urban Health Programme

Students are to work closesly with the heads of the varios units – Senior PHN, Senior Nursing Office I/C of

Maternity, Sister I/C of FP, Purchasing Officer, Lab Technician, Pharmacists, I/c Nutrition Rehabilitation Centre, Health Inspector etc. In order to learn how they function and also to observe the day to day problems encountered during the course of their work and how they go about solving them. Students are to participate in other field activities to the clinics.

Students should produce a report of their clerkship at the polyclinic and to provide feedback to the staff of the polyclinic as well as staff.

Pharmacy Unit

Describe drug procurement
Explain the need for Book – keeping (entries etc)
Demonstrate knowledge about storage of drugs in the polyclinic
Explain how drugs are dispensed including co-ordination with the prescriber

X-ray Unit

To study types of x’rays usually done at the clinic
To study protection form x’radiation from both staff and patients
To study general problems with the x’ray machine
To study storage and (weather) conditions for films
Chemical and equipment

Laboratory Unit

To participate and learn about

Haemoglobin

WBCs estimation and chemicals involved

Sickling Tests

Blood film for malaria parasites BF

Urine tests, stools tests chemicals and procedure

Records and Statistics Unit

to learn about data collection and analyst
to learn about the various returns in the unit
to learn about various forms used to collect information

Maternity Unit

to participate in deliveries
to observe cord dressing

The School Health Programme

to learn about the functions of the school clinic
to learn about the general sanitation of the school compound
students participate in school hygiene inspection

Visit to 2 private Clinics in the district

to learn about its organisation and functions

Visit to Environmental Health Department

to learn about its organisation and functions

Ankaful Hospital Programme, Ankaful

(1 week field visit to leprosarium)

Objective of the Programme

To expose medical students to control of leprosy in Ghana

Introduction: History of Leprosy, Bacteriology Epidemiology, slit skin smear (practicals)
Immunology, Evolution of lesions, Clinical features, Classification of leprosy, Clinical work in wards (examination of lesions)
Differential diagnosis, complications of leprosy, Reactions in leprosy, Clinical work in wards

(assessment of disability)

Chemotherapy in Leprosy, MDT, rationale and administration, disability grade and prevention of disability, (practical orthopaedics and physiotherapy), Health education sessions with patients
History of Leprosy in Ghana, Principles of Leprosy control and control measures, Charting of patients (practical) Post test, Video on Leprosy.

THE DISTRICT CLERKSHIP: INSTRUCTION GUIDE

A: Work in Hospital

The Objective of the Clerkship is to introduce the students to the types and management of medical problems seen in district hospitals

Students are required within the hospital setting to act as clinical clerks

in all specialties as are relevant in their institutions for the entire duration of the clerkship.

They should examine patients, attend ward rounds, assist in the theatre, laboratory etc. and carry out assignments as are scheduled for them.
They are expected to do night duties and behave as if they were part of the staff of the hospital rather than as visitors. They should keep the regulations of the hospital.
Students should also learn the administrative problems of the running of the hospital – personnel, supplies, relationship to the community etc. through sessions with the Senior Medical Officer in charge and the Hospital Secretary
Students should take part in any outreach programme of the hospital to the district. They should also lean about the sanitation and hygiene of the district in general and of the hospital in particular e.g. water supply, refuse disposal and sanitary measures.

They must see some of the common endemic and communicable diseases e.g. Tuberculosis, Measles, Enteric Fever, Diarrhoea Diseases, Pneumonia, Infectious Hepatitis and study their pathogenesis and natural history.
They should also how common surgical and obstetrical and gynaecological cases are handled at the district level.

Work in the Community

Students should:-

Take part in the programmes being carried out by the health workers in the field.
Observe closely the roles of the various health workers in the team considering their background, training and experience with a view to a critical examination of their appropriateness for their tasks.

(c ) Evaluate the effectiveness of the services e.g. is the service reaching all those at risk? Are the time at which the service is rendered convenient to the community? Are the services technically sound and are they achieving the desire objectives?

(d) Participate in the following programs; Health Education to selected target population such as School Health, Home visiting, Communicable disease control and Environment Sanitation. In particular for Environmental Sanitation.

Environmental Sanitation

With Health Inspector and accompany him on at l east three normal duty rounds, and also do special on site inspections with him. Identify sanitation problems in the health institution and the community. Discuss problems Examine drinking water resources of the community and visit sites of refuse disposal (solid waste) and methods of excreta disposal e.g. wells, ponds, pit latrine construction and sitting. Examine drainage system and determine any health hazards posed.

Food hygiene – slaughtering of animals, food handling, markets, chop bars and drinking places. Examine and discuss vector problems and see what measures of control are used.

Inspect housing in the community, sitting, structures, ventilation, drainage, refuse disposal over crowding, physical planning of community roads, traffic problems, play grounds and other community amenities.

Vital Events (Births and Deaths) Recording

Study procedures and forms used for collecting vital and epidemiological data and how data are dispatched to the centre. Is there a feed-back of information from the centre (e.g. Regional Headquarters, or Ministry of Health, Accra) what are the problems of Maternal Mortality Rate, Crude Death Rate etc) Suggest improvements.

Health Administration

Students should familiarize themselves with the administrative set up for health from Regional MOH down to the local level. What are the lines of authority? How is planning done? What is the method for reviewing performance of health staff at the local level? Who forms the health team? Is the work-load evenly shared?

How do the workers reach out to the community? Is there easy communication with higher levels of health administration? Study the relationship of the local health institution to the local administration and to private medical care in the community.

Local Health Committee or District Council or Town Management Town Management Council

Students should find out the structure of local administration of the community (traditional and modern), and determine how this enhances or impedes health progress.

Who are the opinion leaders in the community? The student must attend one meeting at least of a health committee or any such equivalent body. Students must keep a log book of their activities.

Students should also record in the log book some basic statistical information about the hospital and the district. Information should be gathered about the number of hospital beds, numbers and types of personnel; out-patient attendance, in-patient statistics, spectrum of diseases seen; age and sex distribution of patient etc.

A brief district profile should also be included:

Log Book Account of District Clerkship: Summary

The lay out should include: Date, Place of Activity, Description of Activities and comments. The comments should include notes on topics covered as well as lessons learnt.

DANFA DISTRICT CLERKSHIP (TWO WEEKS)

The main activity is the community diagnosis of one of the villages or communities in or around Danfa Project Area

Then visits to programmes in other health related sectors such as the Abokobi Rural Bank, Abokobi Agricultural Project, Centre for Plant Medicine and Research, Mampong School for the Deaf and others.

Grand Round

At the end of the rotation, a grand round will be held in the conference room where a report of the community diagnosis will be presented. Almost all the members of staff of the department will be present. Different individuals read out findings in the areas of History of the Village, demographical findings, and source of water, environmental sanitations, and attitudes towards common endemic diseases, immunization status etc. and recommendations. This should be put in a form of a report for the department.

FORMAT OF REPORT

The reports should consist of:

Introduction

Location of the village from Danfa Health Centre

Provide the historical background of the village

Description of the layout of the houses and important landmark,

Eg. Chief’s palace.

The type of vegetation, the ethnic composition of the population

The occupation and major economic activity of the people.

Rationale or reason for the survey of the clerkship

To study the health situation of the village with the mind to identify any serious endemic dis eases and any factor that would militate against achieving a higher health status, be it directly or indirectly.
To highlight the felt needs of the community
To make recommendations based on the survey findings as to how to improve the health status of the people with emphasis on the use of local resources and feasible economically accessible methods.

Describe the main and specific objectives, for example to determine

the demographic indices
the level of environmental sanitation
the nutritional status of children under 5 years
the level of immunization
the prevalence of malaria, helminthiasis and schistosomiasis
the accessibility and utilization of medical facilities
finally the utilization of Maternal Child Health and Family Planning Clinics

METHODOLOGY

Describe all the steps taken from preparation of instruments and the arrangement for the field work. The subject areas of the questionnaire, the samples to be taken form the subjects, any measurements. The laboratory examinations and the nature of the analysis to be done.

Limitation of the methodology

Specify any issue which should be taken into consideration in the report of the study.

DATA ANALYSIS AND PRESENTATION OF RESULTS

Demography

Total Population and age-specific population size of interest to health programmes. Migration and mortality rate estimates. Ethnic composition, occupational status, religious and educational status.

Environmental Health

A description of the environmental situation, housing, water supply, refuse disposal facilities, drainage, excreta disposal.

Sources of health care, disease burden, nutritional status, knowledge, attitude and practice regarding health habits and illnesses. Immunization status and use of health services.

Felt needs of the community

Discussion

Discussion of the results of survey and field activities and interpretation of results

Recommendation

Appropriate recommendations based on findings and discussions should be included.

REPORT ON THE FEEDBACK TO THE COMMUNITY

After the community diagnosis in the village, a report of your findings and recommendations must be presented to the community

One Week Programme:

Field visits to major public health facilities in Accra

DAY/DATE	TIME
Monday	1.	Students meet with Faculty (8.30 am)
	2. Statistics 3. Centre for Health Statistics (3.30 – 5.00 pm)
Tuesday	Occu		pational Health – Visits and Discussion (8.30 am) – Lecture (1.00 pm)
Wednesday	1.		Slaughter House (8.30 am)
	2.		City MMOH
	3.		Seminar on Environmental health Problems (2.00pm)
Thursday	1.		Waste management department Lecture and Visit (8.30 am)
	2.		communicable Diseases Hospital (11.00am)
	3.		Weija Water Works (12.00pm)
Friday	1.		Port Health – Tema (8.30 am)
	2.		epidemiology (2. 00 pm)
Monday	Public Health Advocacy (All staff) (8.30 am) Collection of Log Books
Tuesday	Free
Wednesday	End of Clerkship Examinations
Thursday	1. Oral Examination 2. Evaluation (All staff and students)
Friday	Free

ADVOCACY TOPICS

Public Health Advocacy

The purpose of this is to give students the opportunity to critically examine important issues of the public health concern. It is now well recognized that health development requires intersectoral and multidisciplinary approach although doctors diagnose solutions. The learning objectives, the students should be able to:- 1. write reports, memoranda, position papers

present such papers at a plenary of their peers and staff
evaluate the work of their peers

Students ballot for topics on issues of public health concern at the beginning of their sub internship. About 8 weeks later, the students make presentation which is criticized by their peers and the faculty. The content, style logic and the scientific basis. Style of presentation and how convincing the arguments are count in the award of marks.

Examples of some of the topics

Make a case for male involvement in family planning in Ghana
One of the effective strategies identified for the prevention and control of malaria is the use of insecticidetreated mosquito nets (ITNs). Discuss the factors that affect their adoption and appropriate use.
Make a case against the Ministry of Health’s policy of promoting exclusive breastfeeding for the first six months of an infant’s life. Discuss
Rural electrification or portable water for all rural communities. Take a stand and defend it.
Treatment and counseling of rape victims are both vital for recovery and help create a feeling of safety in addition to providing opportunities to talk about the violent experience. Make a proposal for the exemption policy to cover these two services.
The future of Traditional Medicine in Ghana. Discuss
Support for extended family members in dwindling because of Interstate Succession Law. Discuss
At a Ghana Medical and Dental Council Meeting you were appointed the leader of a committee responsible for looking into the topic “Medical education in Ghana is clinically biased. There is an urgent need to incorporate and strengthen other relevant components.” Give an outline of your report and recommendations.
Antiretroviral drugs are being introduced on a larger scale in Ghana by December. Is it the solution to the dilemma of HIV/AIDS?
Evaluate the DOTS management of TB in Ghana
What accounts for the lack of reliable health statistics in Ghana? Give suggestions for improvement
Alcohol and Tobacco Industries in Ghana are a necessary evil. Discuss
Health is too important to be left in the hands of doctors alone. Discuss
You are a principal speaker at a national road safety campaign to be launched on Christmas Eve at Nsawam. Give an outline of your speech
Emancipation of the female species in Ghana is only in name. Discuss 16. Make a case for male involvement in family planning in Ghana
Make a case for Post Mortems for all deaths.
Accra remains filthy. Trace what has been done in the past and suggest what can be done.
Discuss the Human Rights Implication of anti-armed robbery campaign by the Police/Military
Numbers are increasing daily despite massive public education on measures to stop the spread of HIV. Sex between married couples is a major factor. Discuss
Privatization of water. Is it a viable alternative?
Make a case against Capital Punishment
Maintenance of the Aged in Ghana is becoming a big problem. As a concerned citizen discuss how this problem could be managed
Make a case for making HIV counseling and testing during the antenatal period mandatory
Discuss the Human Rights implication of selecting some HIV/AIDS patients for subsidized treatment with antiretroviral drugs in Ghana
Assess the impact of Oral Re-hydration Therapy (ORT) 35 years after its introduction in 1968
The Community Based Health Planning and Services (CHPS) arrangement remains the Key Strategy for expanding health service provision in Ghana.
Why has the Guinea Worm Eradication Programme experienced mixed fortunes over the years?
One of the focal points of the Ghana Poverty Reduction Strategy (SGPRS) is the HIV?AIDS pandemic. Why this emphasis.
The introduction of Additional Duty Hours Allowance (ADHA) and the establishment of a Vehicle Revolving Fund for Health Workers are viable measures to retain Ghanaian Health Workers. Discuss
Each year, April 7 is celebrated as World Health Day. Describe its significance to Ghana’s Public Health Delivery System.
Health is both a consequence and a cause of poverty. Discuss
Adequate efforts are being made by MOH/GHS to ensure universal access to a range of reproductive health services for eligible Ghanaians. Discuss
Make a case against the Donor-pooled Fund popularly known as the common basket. Assess progress being made by the GHS towards the elimination of maternal and neonatal tetanus by 2005
Financing Tertiary Education in Ghana: The way forward. Discuss
World Rural Women’s Day is celebrated every year on October 15. Write a memo to the Minister for Women Affairs on the plight of the rural Ghanaian Women
Make a case for allocating resources for SARS
The carnage on our roads has become a national concern. Suggest strategies to reduce it.
The Government’s proposed policy for financing health care is health insurance. Discuss how this policy is being implemented.
Majority of Ghanaians do not have safe water. The Government has no money to extend the present system to cover all Ghanaians. Suggest ways to extend services.
The environmental Health Unit used to be under Ministry of Health (MOH). It is now under the Ministry of Local Government and Rural Development. Discuss the advantages and disadvantages on this transfer.
Write a memo to the Vice President suggesting strategies which should be adopted to make his campaign against indiscipline more successful.
The proposed National health Insurance scheme is intended to cover all Ghanaians in the near future. Yet, 70% of the working force is in the non-formal sector and 40%of Ghanaians are living below the poverty line. A good ministerial task force on health care financing explaining how the 100% coverage can be achieved.
“It is said that malaria treatment is less expensive than its prevention and we are therefore better of spending the little resource on malaria treatment. Discuss
It appears while communicable diseases are being brought under control, non-communicable diseases are on the increase. Discuss the problem and its implications.
Water is essential to life and the past large outbreaks of disease and many deaths were water associated. Compare and contrast the Government’s recent pronouncement on water supply against the background of water use as enshrined in the PHC concept.
The wide gap between antenatal coverage (98.4% in 2001) and supervised delivery (50.4% in 2001) remains a major challenge to the Ghana Health Service. Suggest feasible ways of closing the gap.
Reproductive and Child Health programmes focus more on the client and on quality of care. Discuss
Fifteen years after the Safe Motherhood Conference in Nairobi, Kenya, Ghana’s institutional maternal mortality rate increased to 2.6/1000 LBS (from 2.14/1000 LBS). Identify effective strategies to reverse this trend.
The provision of quality health care to underserved communities depends on partnerships.

How would you use advocacy as a primary tool to change health policies, laws and programmes.

Financing Health Care should it be Cash and Carry or Health Insurance?
Accra is being invaded by physically challenged persons. How do we reverse this trend?
You have been asked by the Family Health International representative in Ghana to present a paper at one

of its programme planning meetings on the topic “Interdisciplinary and interdepartmental approach to HIV prevention among women of reproductive age.” Give an outline of your objective(s) strategies and action plan.

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