MEDICINE & SURGERY. In the teaching of medicine and surgery the integration of all the preclinical and para clinical subjects in the analysis of the course, pathology, diagnosis and treatment of disease is undertaken (vertical integration). Students are required to spend two periods resident in the teaching hospitals and gain experience in acute on-call medicine and surgery. The duties of the students include clerking of in-patients and attendance at the teaching rounds and organised tutorials.
GENERAL PRACTICE. An introductory lecture course covers organisational and clinical aspects of general practice. During the clinical attachment in general practice, each student takes part in small group seminars and lectures and has an attachment to a GP tutor. Clinical teaching is undertaken during this attachment together with project work and presentations. Students are introduced to aspects of consultation skills involved in general practice using video techniques, simulations and small group discussion. A principal aim of the clinical course is to introduce students to problem-solving techniques as important elements of patient management.
PUBLIC HEALTH MEDICINE AND EPIDEMIOLOGY.The lecture course covers the following topics: health promotion and disease prevention with emphasis on the influence of lifestyle and occupation on health; evidence-based medicine and the randomised controlled trial; interpretation of results of research in medicine; epidemiology of communicable and chronic diseases; the health services of Malaysia and basic health economics.
LEGAL AND ETHICAL MEDICINE. The course consists of lectures and interactive discussion in the areas of medical law, clinical forensic medicine, thanalogy and forensic pathology, prescribing law and toxicology. Instruction also includes an introduction to basic concepts in medical ethics and a detailed review of the Code of Professional Conduct of the Malaysian Medical Council and of the Ethical Code of the Malaysian Medical Association. At the conclusion of the course, students should have a solid working knowledge of medico-legal and forensic matters pertinent to present day and future medical practice, including the legal and ethical obligations of registered medical practitioners.
MEDICAL ETHICS. Ethical issues in obstetrics and gynaecology, paediatrics, experimentation, transplantation of organs and hospice care are discussed by clinicians with specialist experience. To illustrate the moral perspectives from which medico-moral decisions are currently made, two rival moral frameworks are studied, the utilitarian and the classic. The moral principles and conditions of character defining the doctor as a person of conscience are explored. The written examinations encourages the student to work out, and formulate, his or her own personal principles within the moral commitments of the medical profession. The course is closely integrated with instruction in legal medicine in which typical case histories illustrating these issues are presented for discussion.
OBSTETRICS AND GYNAECOLOGY. The teaching in this subject commences with a two week attachment in gynaecology during the junior residency and continues with a two month full time residency in an approved maternity hospital.
PAEDIATRICS. There is a two month, full-time clinical attachment in a recognised paediatric hospital. The course is a systematic one covering the main disorders and infections, normal physical and mental development and infant nutrition.
PSYCHIATRY. There is a two-month, full-time, clinical attachment in a recognised psychiatric hospital or psychiatric unit in a general hospital and related district community psychiatric services. The residency includes day and evening assignments. An opportunity is available to gain experience in overnight duty under supervision. The theoretical aspects of clinical psychiatry are also covered during this period. The theoretical course includes the use of audio and video tapes.
OPHTHALMOLOGY. The course consists of ten lectures and a three-week clinical attachment to the eye department of a general hospital. In addition, for two months prior to the examination, intensive clinical tutorials and further small group teaching sessions are undertaken on a daily basis. All students have to attend casualty and the operation theatre at least once.
EAR NOSE & THROAT. Small group teaching using audio-visual aids such as fibreoptic endoscopy and video monitoring are utilised. There is a study on preventable diseases including head and neck cancer, noise induced hearing loss, knowledge of systemic diseases which may present as local manifestations in the ear, nose and throat.
THE PMC DOCTOR. The PMC curriculum is patient centric and case based reflecting the 6 themes of the PMC curriculum
1. HEALTH PROMOTION AND DISEASE PREVENTION The utilization of every opportunity and patient contact to promote good health and prevent a variety of diseases, including common infections, malignancies and degenerative diseases where prevention has been shown to be effective. It includes the identification of known risk factors at individual, family and population levels and the active promotion of risk reduction practices and policies, all aimed at maximizing health and minimizing the DEVELOPMENT of disease.
2. PERSONAL AND PROFESSIONAL DEVELOPMENT The importance and the need for every graduating student to be fully aware of his/her responsibilities to commit to a Code of Conduct expected of a Medical Practitioner. This includes not only any clinical responsibilities for patient care but also key personal and professional responsibilities to become a life-long learner, teacher, resource manager, team member and researcher. It also means that the young graduate will be a reflective person who is capable of evaluating his/her own competencies and limitations, is open to receiving constructive feedback on their performance and knows when to seek the Counsel and advice of seniors and peers, as appropriate.
3. COMMUNICATION SKILLS This encompasses more than the so-called traditional “bed-side manner” which in the past was often more paternalistic than truly patient-centered. First and foremost this should include a style of relating to patients, which reflects the reality that effective communication can contribute over 80% of the information required in order to define patients’ problems and negotiate the most appropriate solution for each one. This means expanding the traditional model of history-taking, which has focused primarily on what is termed the ‘disease’ or ‘doctor’s agenda’ so that our students in future learn the key behaviors of high-quality listening and explanation, which underpin what is termed the ‘illness’ or ‘patient’s agenda’. Since over 90% of medico-legal claims against doctors can be traced to poor doctor-patient communication, such an emphasis on the key importance of communication skills practical training should serve to enhance PMC graduates’ clinical performance, whilst reducing their risk of being sued for miss- communication.
4. ETHICS AND LAW The key importance of developing an acute awareness of certain ethical principles and practice in our students, as well as their legal obligation to always practice medicine according to the prevailing Codes and Laws of the country in which they might choose to work. It should include being keenly aware of, and sensitive to, certain cultural beliefs and practices which impact on their patients’ lives and which may differ fundamentally from the doctor’s own beliefs and cultural norms.
5. CLINICAL SKILLS Each graduate should possess a deep knowledge and understanding of the range of clinical skills, including communication skills, required of a competent doctor and be proficient in the range of procedures expected of an Intern. It includes a whole gamut of competencies so that the young doctor can define a patient’s problems, carry out investigation where appropriate and initiate first-line management according to agreed protocols and quality standards.
6. DECISION MAKING All graduates must be competent in sound clinical reasoning and decision-making appropriate to their junior grade in their first Intern/ House Officer post. It requires that our students adopt an inquisitive, questioning attitude and behavior during their undergraduate years so that they become both competent and confident at sifting and analyzing key information. Once they have achieved this competency they should be enabled to reach a sound judgment about the clinical problems they encounter and how they should be managed, preferably in partnership with, rather than on behalf of, their patients.
Specifically this theme should foster, amongst both teachers and students, an evidence-based approach to clinical practice whilst recognizing that many clinical decisions still lack sound evidence for their effectiveness. In addition, it is important for the students to learn, at a personal level, that uncertainty abounds in clinical decision-making and that they need to appreciate how to develop coping mechanisms to deal with uncertainty, including how and when to consult more experienced colleagues, rather than being reluctant or afraid to do so.
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