ADOPTION OF THE SYLLABI FOR THE SUBJECTS OF THE LICENSURE EXAMINATION FOR PHYSICIANS

WHEREAS, Sec. 8, Article III R.A. No. 2382, as amended, otherwise known as “ The Medical Act of 1959”, provides that “no person shall engage in the practice of medicine in the Philippines unless he x x x has satisfactory passed the corresponding board Examination and Certificate of Registration duly issued to him by the Board of Medicine

WHEREAS, Sec. 21, Article II of the same Act provides the various subjects of the licensure examination of physicians;

WHEREAS, the primary objective of said examination is to test the over-all knowledge and proficiency of the applicant for registration for the practice of medicine;

WHEREAS, the syllabi of the subjects for examination containing the concepts/topics shall be the basis of the test questions which members of the board shall input in the test questions data bank,

WHEREAS, under Sec. 9(h) of R.A. No. 8981 (the ‘PRC Modernization Act of 2000), the Board is empowered to prepare, adopt and issue the syllabi or tables of specifications of each of the subject for examination, and

WHEREAS, the Board evaluated the solicited comments and suggestions from the Deans of the different schools, faculties or institutes of medicine of colleges and universities, public and private and considered the said suggestions in the formulation of the syllabi.

WHEREAS, the Board RESOLVED, as it hereby resolves, to prescribe and adopt the syllabi of the subjects in Licensure Examination for Physicians contained in the document denominated as “syllabi of the Subjects in the Licensure Examination for Physician” marked as Annex “A” and appended as an integral part of this Resolution.

The syllabi adopted herein shall be used starting with the August 2002 Physicians Licensure Examination.

This Resolution shall take effect after fifteen (15) days following the completion of this publication in the official Gazette or newspaper of general circulation, whichever comes earlier.

Let copies of this resolution be furnished all schools, Institutes of Medicine or colleges and universities, public or private offering the course of Doctor of Medicine for dissemination to their graduates.

Done in the City of Manila, this 24th day of April, 2002.

RODOLFO P. DE GUZMAN, M.D. Chairman

JOSE S. RAMIREZ, M.D. JUANITO B. BILLOTE, M.D. Member member

EDGARDO T. FERNANDO, M.D RICARDO D. FULGENCIO II, MD Member Member

ATTESTED :

CARLOS G. ALMELOR Secretary

Professional Regulatory boards

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APPROVED :

ANTONIETA FORTUNA-IBEChairperson

ALFONSO G. ABAD AVELINA DELA REA-TAN Commissioner Commissioner

Date of Publication in the Official Gazette – July 8, 2002Date of Effectivity – July 24, 2002

SYLLABUS FOR THE PHYSICIAN LICENSUE EXAMINATION

The syllabus is essentially a listing of all topics which may be the basis for formulating questions in the subjects indicated. The preparation took sometime as we requested the different medical schools to submit to the board their syllabi. The board reviewed this and had a syllabi prepared and sent to the Association of the Philippine Medical Colleges, Inc. (APMC) for comments. The current syllabi is an integration of all these efforts.

We want to emphasize that the listing of topics do not reflect the relative importance or frequency of questions in these areas. Neither is it intended to influence the different schools to change their curriculum. The licensure examinations require achievement of standard terminal competencies and instructional objectives which should guide the medical educational process, whether traditional or the Problem Based Learning (PBL) in form.

To the extent possible comments coming from the different medical schools will be given due course when these are reasonable or significant. Effort is expanded so that the bio-medical science can be applied to actual clinical abnormalities or disorders so that at least some of the items are case based problem-solving in nature. To the extent possible, disease process which are encountered locally or the understanding of which is of particular importance in illustrating fundamental biological mechanism will be given due prominence. There is no intention to make all questions “must know”. We have shifted to the criterion referenced grading from the previous norm criterion reference system. We utilized the Nedelsky Method of Setting the Minimum Passing Level (MPL) per item and compute from thereon the MPL of the subject.

The Board acknowledge receipt of the Pediatric Undergraduate Curriculum as prepared by a special committee of the Philippine Pediatric Society. This is a landmark project and the Board member assigned to this subject will have the opportunity to review this for possible inclusion in the syllabi.

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BIOCHEMISTRY

I. Introduction to BiochemistryA. The Living WorldB. BiomoleculesC. Biochemical Process

II. Living CellsIII. Water

Structure, characteristics and importance

IV. BioenergeticsA. ThermodynamicsB. Redox ReactionsC. The Role of ATP

V. Peptides and proteinsClassifications, Characteristics and Properties

VI. Protein Synthesis

VII. Enzymes, Coenzymes, Vitamins and Hormones Characteristics and Functions

VIII. CarbohydratesA. MonosaccharidesB. Disacharides, Oligosacchrides, Polysaccharides and Complex

Carbohydrates

IX. Carbohydrates MetabolismA. Glycogen MetabolismB. GlycogenesisC. Metabolism and Other Sugars

X. Lipids and MembranesClassifications, Characteristics and Functions

XI. Lipid MetabolismXII. Aerobic MetabolismXIII. Nitrogen MetabolismXIV. Integration of MetabolismXV. Nucleic AcidsXVI. Nucleotide MetabolismXVII. Genetic Information

References :

1. Harper’s Biochemistry (Murray, Granner, Mayes and Rodwell)

2. Biochemistry (Mckee and Mckee)3. biochemistry (Mathews and VanHolde)

ANATOMY AND HISTOLOGY

I. Morphology and FunctionA. Bones and JointsB. Muscular systemC. Cardiovascular System

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D. Lymphatic SystemE. Respiratory SystemF. Gastrointestinal SystemG. Urogenital SystemH. Central Nervous System and Peripheral SystemI. Endocrine System

APPLIED ANATOMY

I. Anatomic Basis for Clinical Signs and SymptomsA. Infarcts

1. Cerebro-spinal2. Myocardial3. Pulmonary4. Digestive System5. Extremities6. Placenta

B. Traumatic/Surgical Transactions1. Cranio Spinal Nerves2. Peripheral Vascular and Lymphatic Vessels

C. Space-Occupying Lesions

D. Foreign bodies/substance

II. Anatomic Correlations of Common Surgical and Diagnostic ProceduresA. Cerebro-spinalB. Vascular Ligaments/TransectionC. Tumor surgeries and lymph node dissectionD. Fluid Aspiration from Body Cavities

- common treatment procedures regimens

References :

1. Clemente, C.D. Edition; Anatomy, A. Regional Atlas of the Human Body, 4th Edition, Williams and Wilkins, Philadelphia 1977.

2. Snell, R.S.; Clinical Anatomy for Medical Students, 5th

Edition, Little Brown and Company, Boston 19953. Cormack, D.H.L. Clinical Integrated Histology, Lippincott-

Raven, Philadelphia 1977.

MICROBIOLOGY AND PARASITOLOGY

I. Basic Principles of Microbiology and ParasitologyII. Principles of Immunology; Classifications of Diagnosis and ManagementIII. Pathogenic Organisms; Classification

A. Gram Positive BacteriaB. Gram Negative BacteriaC. Chlamydia, Rickettsia, Coxiella BurnettiD. SpirochetesE. MycobacteriumF. MycoplasmaG. FungiH. VirusesI. Slow viruses and PrionsJ. Parasitologic organisms

IV. Special Problems

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A. Water and Food BacteriologyB. Environmental problems

References :

1. Zinzzer Microbiology, Current Edition2. Beaver Clinical Parasitology, current Edition3. Jawetz Medical Microbiology, current Edition

PHYSIOLOGY

I. General PhysiologyA. Cell Physiology

Extra Cellular Fluid 1. Types and Functions of Cells 2. Cell Membranes 3. Distribution of Body Waters 4. Cellular Transport System

B. Nerve Physiology1. Characteristics of nervous and functions of Nerve Fibers

C. Muscle Physiology1. Characteristics and Functions of muscle fiver

D. Hypothalamus and the autonomic nervous systemE. Cutaneous, deep and visceral sensationF. Physiology and function of the brainG. Sleep PatternH. RASI. EEG Basic and Functions

II. Physiology of Blood Cells, Blood Coagulation and Immunology Mechanism

III. Cardiovascular SystemA. Physiology of the Cardiovascular systemB. Disorders

IV. RespirationA. Physiology of the Respiratory systemB. Disorders

V. Renal PhysiologyA. Physiology of the Renal systemB. Disorders

VI. Gastro-Intestinal TractA. Physiology of GITB. Disorders

VII. Endocrinology and ReproductionA. Physiology of Endocrine glandB. Disorders

VIII. Special SensesA. PhysiologyB. Disorders

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XXI. Aviation, space, Deep Sea and sports Physiology

References :

1. Textbook of Medical Physiology by Guyton Lamb, Ingram Johnson and Pitman:

2. Essentials of Physiology3. Review of medical Physiology by William f. Ganong4. Human Physiology and mechanism of Disease by Arthur C. Guyton and John

E. Hall

LEGAL MEDICINE

I. Legal Medicine, Medical Jurisprudence and EthicsA. Legal Medicine

1. Application of Relevant Laws to the Practice of Medicine1.1 Definition and Determination of the Cause of Death1.2 Determination of the Causes of Death in the adjudication of cases1.3 Medico legal implication in relation mechanism and its

correlations of the body injury and the causes1.3.1 Laceration1.3.2 Hematoma1.3.3 Penetrating and non-penetrating wound1.3.4 Perforating wound1.3.5 Stab wound1.3.6 Incise wound

2. The Battered Child2.1 Recognition2.2 Child and Welfare code2.3 Classification of Child Abuse, Causes and Implications2.4 Management

3. Crime’s Against Chastity3.1 Definition, classifications of Crimes against Chastity3.2 Recognition, diagnosis and management

4. Medico Legal Implication of Pregnancy as a Consequence of Crimes against Chastity4.1 Medical Evidence of Pregnancy by laboratory List4.2 Proof of Delivery

- anti mortem and post mortem

5. Abortion and Miscarriage5.1 types5.2 complication

6. Determination of the Causes of Death7. Post Mortem Charges8. Determination of paternity and Filiations9. Medico Legal Importance and Sterility10.Medico Legal Importance of mental and Psychological Disorder11.Substance Abuse

B. Medical Jurisprudence1. Legal Aspects of Medical Practice2. Licensure and Regulatory laws3. Physician-patient relationship

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4. Different doctrine applicable in the determination as to whether the physician and hospital in cases of medical practice

5. Life threatening medical emergencies6. Delegation of responsibilities of attending Physicians7. Medico Legal problems in Human Organ Transplantation8. Fertility9. Phil. Health Insurance10.Physicians or expert witness in court

10.1 Ordinary and expert witness10.2 Privilege communication10.3 Hearsay Evidence/dying Declaration

References : Legal Medicine by Pedro Solis, MD, LlB.

Medical Jurisprudence (The Practice of Medicine and the Law) by Pedro Solis, MD, LlB.

PATHOLOGY

I. Cell Injury, Necrosis and ApoptosisA. Morphology, Gross and MicroscopicB. Pathogenesis and PathophysiologyC. Clinical Consequences

II. InflammationA. Morphology, Gross and MicroscopicB. Pathogenesis and PathophysiologyC. Clinical Consequences

III. Repair and RegenerationA. Morphology, Gross and MicroscopicB. Pathogenesis and PathophysiologyC. Clinical Consequences

IV. Developmental PathologyA. Morphology, Gross and MicroscopicB. Pathogenesis and PathophysiologyC. Clinical Consequences

V. Circulating DisturbancyA. Morphology, Gross and MicroscopicB. Pathogenesis and PathophysiologyC. Clinical Consequences

VI. Radiation InjuryA. Morphology, Gross and MicroscopicB. Pathogenesis and PathophysiologyC. Clinical Consequences

VII. NeoplasiaA. EteogenesisB. Classification of neoplasmC. Tumor MarkersD. Ploidy

VIII. ImmunopathologyA. B-cells and T-cells and Lymphocyte subpopulations

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B. Immune Deficiency diseasesC. Immune-Mediated Diseases

IX. Cross-Reacting AntibodiesX. Immune complexXI. Anti-ReceptorsXII. PrionsXIII. Amyloidosis

A. Transplantation PathologyB. Tissue typing and DNA Fingerprinting

XIV. Infectious DiseasesA. BacterialB. RickettsialC. ViralD. ParasiticE. MycosisF. Slow Viruses and Prions

XV. Diseases of the Digestive SystemsXVI. Diseases of the heart and LungsXVII. Diseases of the EndocrineXVIII. Diseases of the Urologic and Reproductive systemXIX. Diseases of the Skin and Connective TissuesXX. Diseases of the Central and Peripheral Nervous System and special

Sense Organs

References :

1. Cotran, R.s., Kumar, V. & Collins, T: Robins pathologic Basis of disease; 6th Edition; W.B. Saunders company, Philadelphia 1999.

2. Danjanor, I. And Linden, J.: Anderson’s pathology, 10th

Edition, Volume 1 and 2, Mosby, Boston 1996.

PHARMACOLOGY

I. Definition, Principles and ApplicationA. PharmacokineticsB. PharmacodynamicsC. PharmacotherapeuticsD. Adverse Reactions and Drug-InteractionsE. Toxicity

II. Pharmacological Agents Based in the Management of DisordersA. Synaptic and neuro effector junction sitesB. Central nervous systemC. Cardiovascular systemD. Genitourinary systemE. Reproductive systemF. Respiratory SystemG. Blood and blood forming organsH. Special Organs

III. Pharmacological Agents use for specific IndicationsA. Autocoids; Anti-inflammatory DrugsB. Anti-Microbials and anti-helminticsC. Anti-neoplastic DrugD. Hormones and Hormone antagositsE. VitaminsF. Immunomodulators

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IV. Heavy Metal, Heavy Metal Antagonists and Environmental Planning

V. The Clinical Applications of the Principles of Pharmacodynamics, Kinetics, Adverse Reactions, Drug Interactions and toxicity for Rational Drug use in Patient-Problems

References :

Goodman & Gilman’s the Pharmacological Basis of Therapeutics, Ninth Edition Basic and Clinical Pharmacology by Bertram G. Katzung, MD, PhD.

SURGERY, OPTHALMOLOGY, OTORHINOLARYNGOLOGY

I. Surgical Basic Principles IA. Fluid and Electrolyte BalanceB. Mechanisms of water and electrolyte fluxC. Acid-base balanceD. Normal water and electrolyte requirements response to trauma; SIRSE. Oncotic and osmotic pressureF. TraumaG. ShockH. General Principles of Critical Care

II. Surgical Basic Principles IIA. Wounds and wound healingB. Surgical BacteriologyC. Surgical InfectionsD. Sepsis and antisepsisE. Antimicrobial agents

III. Surgical Basic Principles IIIA. BurnsB. Surgical NutritionC. Blood and blood transfusionsD. Hematologic diseasesE. Molecular biologyF. Immunology and Transplantation

IV. Head and neck surgery, Ophthalmology, OtorhinolaryngologyA. Classification and Etiology of disorders/diseasesB. Principles of diagnosis and management

V. Thoracic and Cardiovascular SurgeryA. Etiology and Classification of TCVS disorderB. Diagnosis and Management of Common Disorders

VI. Peripheral Vascular SurgeryA. Classification, Diagnosis and Management

VII. Abdomen IA. Disorders of the upper Gastrointestinal TractB. The PancreasC. The SpleenD. Retroperitoneal Disorders

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VIII. Abdomen IIA. Disorders of the LiverB. Disorders of the Gallbladder and the Biliary Tract

IX. Abdomen III

A. Disorders of the small IntestinesB. Disorders of the Caecum, Rectum and Anorectum; perineumC. Vermiform Appendix

X. Disorders of the Skin and Soft Tissues

XI. The BreastA. Classification and diagnosis of the Benign and Malignant lesions of the

BreastB. Management of Benign and Malignant lesions of the Breast

XII. Hernias and Abdominal Wall Disorders

XIII. Surgical Specialties IA. Neurosurgery

- Diagnosis and management of common neurosurgical disordersB. Endocrine Surgery

- Diagnosis and Management of Disorders of the Endocrine Glands

C. Urology- Diagnosis and Management of Urologic Disorders

D. Gynecologic disorders of Importance in SurgeryE. Principles of Plastic and Reconstructive Surgery

XIV. Surgical specialties IIA. Classification, characteristics and Indications of Anesthetic AgentsB. Orthopedic disordersC. Pediatric surgery

- classification, characteristics, diagnosis and Management of Common problems

References :

1. Basic surgery (Poll, Gardnesr and Stone)2. Textbook of Surgery (Sabiston)3. Textbook of Surgery (Schwartz)4. Ophthalmology, Principles and concepts (Dewell)5. Ophthalmology,, Secrets (Vander and Gault)6. Fundamental of Otorlaryngology (Adams, Boies and Hilger)

MEDICINE

I. Principles of Physical Diagnosis

II. Infectious Diseases A. Etiologic Agents

1. Bacteria2. Virus3. Fungus4. STD5. HIV6. AIDS

B. Diagnosis and Recognition

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1. Clinical Signs and Symptoms, Diagnostic and Procedures

C. Management

III. Immunologic disorders1. Overview of the Immune System2. Pathogenesis of Immuno disorders3. Allergy : Allergic Reactions, allergic Rhinitis; Urticaria Angioedemas,

Anaphylaxis4. Drug Reactions5. Immunodeficiency disorders6. Rheumatic Disease

IV. Cardiovascular Disorder1. Classification, Etiology, Diagnosis and Management of

Cardiovascular disorder2. Special procedures in the Diagnosis and Management

V. Respiratory Disorders 1. Classification, Etiology, Diagnosis and Management

2. Special procedures in the Diagnosis and Management

VI. Kidney and urinary Tract disorders1. Classification, Etiology, Diagnosis and Management2. Special procedures in the Diagnosis and Management

VII. Gastrointestinal Tract Disorders 1. Classification, Etiology, Diagnosis and Management

2. Special procedures in the Diagnosis and Management

VIII. Endocrine and Metabolic Disorder. 1. Classification, Etiology, Diagnosis and Management 2. Special procedures in the Diagnosis and Management

IX. Oncology 1. Principles of Neoplasia 2. Principles of Cancer Therapy and Treatment Modalities

X. Hematologic DisorderXI. NeurologyXII. Psychiatry - Diagnosis and Management

XIII. Special Problems a. Substance Abuse b. HIV/AIDS c. Problems of the Environment

References :

Cecile, Textbook of Medicine, current Edition Harrison, Textbook of Medicine, Current Edition

OBSTETRICS AND GYNECOLOGY

OBSTETRICS

I. Normal Pregnancy, labor and DeliveryA. Anatomy of the Reproductive TractB. Physiology of Pregnancy

1. Endometrium

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2. Placenta3. Placental Hormones4. Morphological and Physiological Development of Fetus5. Maternal Adaptations to Pregnancy

C. Diagnostic of PregnancyD. Prenatal CareE. Mechanism of Normal Labor in Occiput PresentationF. Conduct of Normal Labor and DeliveryG. Obstetrics Analgesia and AnesthesiaH. Care of the Newborn

II. Abnormal Pregnancy, Labor and Delivery of Puerperium A. Fetal Positions and Related ProblemsB. AbortionsC. Ectopic PregnancyD. Preterm birthE. Post Term birthF. Multifetal PregnancyG. Pregnancy at Extremes of Reproductive LifeH. Complications; Diagnostic Investigation and Management of Abnormal

Pregnancy1. Techniques used to assess fetal health2. Non-invasive and invasive techniques to monitor the fetus3. Operative Obstetrics

3.1 Operative vaginal surgery3.2 Technique of brush delivery3.3 Cesarean delivery and cesarean hysterectomy

III. Family PlanningA. Methods of contraception

1. Medical contraception2. Mechanical Methods of Contraception surgical contraception3. Natural Planning Method

GYNECOLOGY

I. Female Reproductive Tract A. Anatomy and EmbryologyB. Molecular biology and GeneticsC. Reproductive Physiology

II. Diseases and disorder affecting the Female Reproductive SystemA. Pelvic Pain and Dysmenorrhea, Premenstrual syndromeB. Non-Neoplastic Diseases of the FemaleC. Benign and Malignant diseases of the Female Reproductive TractD. Intraephethelial disease of the Cervix Vagina and VulvaE. Changes in the Breast associated with Menstruation, Pregnancy

and DeliveryF. Special problems in Reproductive Health

1. Adolescent gynecology2. Menstrual disorders3. Endometriosis4. Infertility5. Recurrent Spontaneous Early Pregnancy Loss6. Menopause7. Immulogic Disorders

References :

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William Obstetrics, 20th Edition Textbook of Obstetrics, 1st Edition By : Bajon, Panlilio, Baltazar, Garcia, Sumpaico, Tomacruz

Novak’s Gynecology, 12th Edition comprehensive Gynecology, 3rd Edition

PEDIATRICS AND NUTRITION

I. Growth and DevelopmentII. NutritionIII. Preventive and Promotive PediatricsIV. Disease and Disorders of Childhood

A. Immunology, Allergy and GeneticB. Infectious DiseaseC. Cardiovascular SystemD. RespiratoryE. HematologyF. Digestive SystemG. Genito Urinary DisordersH. Nervous SystemI. Musculo Skeletal SystemJ. Metabolic and Endocrine DisordersK. Dermatologic DisordersL. Special Problems

1. Poisoning2. Substance Abuse3. Child Abuse4. Trauma5. Perinatology

References:

1. Textbook of Pediatric by Waldo Nelson2. Textbook of Pediatric and Child Health

Fe Del Mundo, Felix Estrada, Perla D. Santos-Ocampo, Xerxes Navarro

3. Red-Book Committee on Infectious Diseases, American Academy of Pediatrics, 24th Edition, George Peter-Editor

PREVENTIVE MEDICINE

I. Epidemiology and Biostatistics

II. Public Health and Preventive Medicine

A. Family and Community Health CareB. Environmental SanitationC. Occupational Health PracticeD. Herbal Medicine and Nutrition

III. Research Methodology

IV. Special Problems

A. HIV and AIDSB. Transmissible Spongiform Encephelopathy

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C. HepatitisD. Bioengineering Genetic DisordersE. Foot and Mouth Disease

References:

1. Foundations of Statistical Analysis for Health SciencesOphelia Mendoza, Maridel Borja, Caridad Ancheta. Ofelia Saniel. Jesus Sarol

2. Research Methods in Health and Medicine (Philippine Council for Health Research and Development), Department of Science and Technology, Volume I

F.S. Sanchez, S.I. Morelos, J.C. Baltazar

3. Reading in Preventive Medicine II (UST, Dept. of Preventive and Social Medicine)

4. BioethicsA. Angles Tan-Alora, MD

5. The Implementing Rules And Regulations of the National Health and Insurance Act of 1995.

6. Epidemiology Manual by Dr. Rosa Santos-Carreon (UST)

7. Lectures and manuals on Preventive Medicine from different Philippine Medical Schools.

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