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A

IntermedIAte module

In

PAedIAtrICS

CoLLege oF

PhySICIAnS And

SurgeonS

PAkIStAn

REQUIREMENTS FOR TRAINING & EXAMINATION

2012

AddendumBasic Life Support (BLS) is a mandatory course for

all postgraduate trainees (FCPS and MCPS). All Fellowship residents arerequired to attend BLS course before they can

appear in Intermediate Module (IMM) examination.

OFFIC

E CO

PY

B

Composed by:Syed Faisal Babar

Department of Medical Education

Published: August, 2012

COLLEGE OF PHYSICIANS AND SURGEONS PAKISTAN7th Central Street, Defence Housing Authority, Karachi-75500.Phone No. 99207100-10 UAN: 111-606-606 Fax No. 99266432

C

CONTENTS

ABOUT THE COLLEGE

TRAINING AND EXAMINATION

ASSESSMENT

COURSE FOR BASIC PAEDIATRICS TRAINING

USEFUL ADDRESSES AND TELEPHONE NUMBERS

1

4

7

9

34

This is An evolving doCumenT.

The College of Physicians and surgeons Pakistan would appreciate any criticism, suggestions,

advice from the readers and users of this document. Comments may be sent in writing or by

e-mail to the CPSP at:

national directorate Residency Program (ndRP)College of Physicians and Surgeons Pakistan (CPSP)

7th Central Street, Defence Housing Authority, Karachi-75500.

Intermediate Module in Paediatrics 2012

D

D

The College was established in 1962 through an ordinance of theFederal Government. The objectives/functions of the College include promoting specialist practice of Medicine, Obstetrics & Gynaecology,Surgery and other specialties by securing improvement of teachingand training, arranging postgraduate medical, surgical and otherspecialists training, providing opportunities for research, holding andconducting examinations for awarding College diplomas andadmission to the Fellowship of the College.

Since its inception, the College has taken great strides in improvingpostgraduate medical and dental education in Pakistan.Competency-based structured Residency Programs have now beendeveloped, along with criteria for accreditation of training institutions,and for the appointment of supervisors and examiners. The formatof examinations has evolved over the years to achieve greaterobjectivity and reliability in methods of assessment. The recognitionof the standards of College qualifications nationally andinternationally, particularly of its Fellowship, has enormouslyincreased the number of trainees and consequently the number oftraining institutions and the supervisors.

The rapid increase in knowledge base of medical sciences andconsequent emergence of new subspecialties have graduallyincreased the number of CPSP fellowship disciplines to sixty fourAfter completing two years of core training during IMM, the traineesare allowed to proceed to the advanced phase of FCPS training in thespecific specialty of choice for 2-3 years. However, it is mandatory toqualify IMM examinations before taking the FCPS-II exitexaminations including specialties in dentistry.

The work performed by the trainee is to be recorded in the e-Iogbook on daily basis. The purpose of the e-Iog is to ensure that the entries are made on a regular basis and to avoid belated and fabricatedentries. It will hence promote accuracy, authenticity and vigilance on the part of trainees and the supervisors. The average number of candidates taking CPSP examinations each


1

About theCOLLEGE


2

year is to a minimum of 25,000. The College conducts examinations forFCPS I (11 groups of disciplines), IMM, FCPS II (64 disciplines), MCPS20 disciplines, including MCPS in HPE and also Diploma in HealthCare System Management (DCPS-HCSM). A large number of Fellowsand senior medical teachers from within the country and overseas areinvolved at various levels of examinations of the College.

The College, in its endeavor to decrease inter-rater variability andincrease fairness and transparency, is using TOACS (Task Oriented Assessment of Clinical Skills) in IMM and FCPS-II Clinicalexaminations. Inclusion of foreign examiners adds to the credibility of its qualifications at an international level.

It is important to note that in the overall scenario of health delivery over85% of the total functioning and registered health care specialists ofthe country have been provided by the CPSP. To coordinate trainingand examination, and provide assistance to the candidates stationedin cities other than Karachi, the College has established 14 RegionalCenters (including five Provincial Headquarter Centers) in the country.

The five Provincial Headquarter Centers, in addition to organizing thecapacity building workshops/short courses also have facilities of libraries,I.T, and evaluation of synopses and dissertations along with providingguidance to the candidates in conducting their research work. Thetraining towards Fellowship can be undertaken in more than 159accredited medical institutions throughout the country and 44accredited institutions abroad. The total number of trainees in theseinstitutions exceeds 16000.

These continuous efforts of the College have even more importantlydeveloped a credible system of postgraduate medical education forthe country. The College strives to make its courses and trainingprograms 'evidence' and need 'based' so as to meet internationalstandards as well as to cater to the specialist healthcare needs notonly for this country but also for the entire region.

Prof. Zafar ullah ChaudhryPresident

College of Physicians

and Surgeons Pakistan


3

INTERMEDIATE MODULE

To ensure better training, the CPSP introduced an intermediate

module examination in several disciplines in 2001. This mid-training

assessment strengthens the monitoring and in-training assessment

systems by providing trainees with an estimate of mid-training core

competencies. It also serves as a diagnostic tool for trainees and

supervisors, provides a curricular link between basic and advanced

training, and an opportunity for sampling a wider domain of

knowledge and skills

Vide Notifications No. 6-1 / Exam-04 / CPS / 1438 S and R, dated July

21, 2004, the Intermediate Module (IMM) examination is mandatory

eligibility requirement for all specified FCPS II examination as from

September 2007. Trainees who passed FCPS I in 2001 and onwards

are required to complete two years training in Paediatrics, and take

the Intermediate Module (IMM) examination.

Even if they do not appear in the IMM examination, the trainees are

permitted to continue their training in the chosen discipline but must

pass the IMM examination prior to taking the final FCPS II

examination.

GENERAL REGULATIONS

Candidate will be admitted to the examination in the name (surname

and other names) as given in the MBBS degree. CPSP will not

entertain application for change of name on the basis of

marriage/divorce/deed.

REGISTRATION AND SUPERVISION

All trainings must be supervised, and trainees are required to register

with the Research and Training Monitoring Cell (RTMC) within 30 days

of starting their training for the Intermediate Module. In case of delay in

registration, the start of training will be considered from the date of

receipt of application by the RTMC. Registration forms are available

in RTMC and in the Regional Centers. They can also be downloaded

from the CPSP Website. They must submit the name of their

supervisor by the date indicated on the registration form. Training is

compulsorily monitored by an approved supervisor who is a CPSP

fellow or a specialist with relevant postgraduate qualifications

registered at the RTMC. The trainees are not allowed to work

simultaneously in any other department/institutions for financial benefit

and/or for other academic qualifications.

APPROVED TRAINING CENTERS

Training must be undertaken in units, departments and institutions

approved by the College. A current list of approved institutions is

available from the College and its Regional Centres as well as on

the College website: www.cpsp.edu.pk

DURATION

The duration of training for the Intermediate Module (IMM) is

two years; the Intermediate Module examination is taken on

completion of the basic training.

TRAINING ANDEXAMINATION


4


5

BASIC PAEDIATRICS TRAININGPROGRAM FOR INTERMEDIATEMODULE

COMPONENTS OF TRAINING

The two (2) years of core training in Paediatrics consist of:

� Eighteen (18) months of approved residency training inPaediatrics, and

� Three (3) months rotation in two of the following:- Casualty / Emergency- Neonatology

MANDATORY WORKSHOPS

It is mandatory for all Intermediate Module trainees to attendthe following CPSP certified workshops in the two years ofIntermediate Module training:

1. Computer and Internet Orientation2. Research Methodology and Dissertation Writing3. Communication Skills4. BLS/ NALS/PALS/NR Any other workshop/s as may be made available by the CPSP.

noTe: No candidate will be allowed to appear inIMM examination without attending theabovementioned workshops including BLS.

E-logbookThe CPSP council has introduced an E-logbook system for allresidency programs. Upon registration with RTMC each trainee isallotted a registration number and a password to log on to the e-logbook on the CPSP website. The trainee is required to enter allwork performed and the academic activities undertaken in thelogbook on a daily basis. The concerned supervisor is required toverify the entries made by the trainee. This system ensures timelyentries by the trainee and prompt verification by the supervisor. Italso helps in monitoring the progress of trainees and the vigilanceof the supervisors. The College has enforced the e-logbook sinceJuly, 2011

Research (Dissertation / Two Papers)One of the training requirements for fellowship trainees is adissertation or two research papers on the topic related to the fieldof specialization published/accepted for publication in CPSPapproved journals. For trainees in Paediatrics the dissertationsynopsis or abstracts of the research papers must be submitted forapproval to the Research and Evaluation Unit (REU) by the end offirst year of the Intermediate Module.

General Requirements

Training should incorporate the principle of gradually increasingresponsibility, and provide each trainee with a sufficient scope,volume and variety of experience in a range of settings that includeinpatients, outpatients, emergency and intensive care, rehabilitationcenter, or other.

Instructional Methodology

Teaching occurs using several methods that range from formaldidactic lectures to planned clinical experiences. Aspects coveredwill include knowledge, skills and practices relevant to the disciplinein order to achieve specific learning outcomes and competencies.

The theoretical part of the curriculum represents the current body ofknowledge necessary for practice. This can be imparted throughlectures, grand teaching rounds, clinico-pathological meetings,morbidity/mortality review meetings, literature reviews andpresentations, journal clubs, self directed learning, conferences andseminars.

Clinical learning is to be organized to provide appropriate expertiseand competence necessary to evaluate and manage commonclinical problems. Demonstration in outpatient and inpatientclinics, and procedural skills training on simulators, mannequins andpatients are all practical training modalities.


6


7

ASSESSMENTELIGIBILITY REQUIREMENTS

For appearing in Intermediate Module examination a candidateshould have:

� Passed FCPS I in Medicine or granted exemption

� Registered with Registration and Training Monitoring Cell (RTMC).

� Completed two years of RTMC registered training under an

approved supervisor in an institution recognized by the CPSP.A certificate of completion of training must be submitted.

� Completion of entries in e-logbook along with validation by the

supervisor.� Submitted certificates of attendance of mandatory workshops.

EXAMINATION SCHEDULE

The Intermediate Module theory examination are held twice a year.� Theory examinations are held in various cities of the country

usually at Abbottabad, Bahawalpur, Faisalabad, Hyderabad,Islamabad, Karachi, Nawabshah, Larkana, Lahore, Multan,Peshawar Quetta and Rawalpindi centers. The College shalldecide where to hold TOACS examinations depending on thenumber of candidates in a city and shall inform the candidatesaccordingly.

� English is the medium of all examinations for theory and

TOACS.� The College will notify of any change in the centres, the dates

and format of the examination. � A competent authority appointed by the College has the power

to debar any candidate from any examination; if it is satisfiedthat such a candidate is not a suitable person to take theCollege examination because of using unfair means in theexamination, misconduct or other disciplinary reasons.

EXAMINATION FEE

� Applications along with the prescribed examination fee and

required documents must be submitted by the last date notifiedfor this purpose before each examination.

� The details of examination fee and fee for change of centre,

subject, etc shall be notified before each examination.� Fee deposited for a particular examination shall not be carried

over to the next examination in case of withdrawal, absence or

exclusion.

FORMAT OF EXAMINATIONIntermediate Module examination consists of theory and TOACSexamination. Details are given below:

Theory examination:

Theory examination consists of: Paper i 10 Short Answer Questions - SAQsPaper ii 100 One best type of MCQs

Clinical examination:

To test basic clinical skills, the clinical examination consists of:TOACS (Task Oriented Assessment of Clinical Skills)

TOACS will comprise of 12 to 18 stations with a change time ofone minute for the candidate to move from one station to theother. The stations may have an examiner, a patient or both.Structured clinical tasks will be set at each station. At stationswhere no examiner is present the candidates will have tosubmit written responses to short answer questions/ MCQs ona response sheet.

There will be two types of stations: static and interactive. Onstatic stations the candidate will be presented with patientdata, a clinical problem or a research study and will be askedto give written responses about the questions asked. At theinteractive stations the candidate will have to demonstrate acompetency, for example, taking history, performing a clinicalexamination, counseling, assembling an instrument, etc. Oneexaminer will be present at each interactive station and willeither rate the performance of the candidate or ask questionstesting reasoning and problem-solving skills.


8


9

COURSE FOR BASIC PAEDIATRICSTRAINING

GENERAL OBJECTIVES

Upon completion of specified training in the chosen discipline, a

resident must acquire the knowledge, skills and attitudes required

for practice of the discipline, including its foundations in the basic

medical sciences and research scholarship in order to:

� Be a competent specialist able to provide appropriate and

cost-effective care to patients at all levels

� Promote health and prevent disease in patients, families and

communities

� Practice continuing professional development

To attain competency the trainee must achieve:

� Knowledge and expertise in clinical and procedural management

of relevant diseases

� Mastery of relevant skills

� Effective clinical judgment and decision making in dealing

with health problems using evidence based medicine

� Trainees must demonstrate the knowledge, skills and attitudes

relating to gender, culture and ethnicity pertinent to paediatrics

and research

TRAINING FOR INTERMEDIATE MODULE

The curriculum of first two years in Paediatrics involves balanced

and objective integration of basic medical sciences and essential

core clinical knowledge in general. The trainee should be able to

diagnose and manage uncomplicated conditions prevalent in the

region and recognize, stabilize and refer complicated cases.

The coverage that each discipline receives below is not indicative

of the relative importance placed on each discipline in the training

program, or in the examination. These are guidelines and not

comprehensive definitive lists. Only minimum levels of expected

competence have been identified but sufficient scope, volume and

variety of experience are desirable.

BASIC CLINICAL KNOWLEDGE

The trainee should be able to:

� Take good history

� Examine the patient physically

� Write correct medical records which are clear, concise and

accurate

� Write referral for consultation to other specialists

� Demonstrate the ability to communicate clearly, considerately

and sensitively with patients, relatives, other health

professionals and the public

� Use evidence based medicine and evidence based guidelines

� Demonstrate awareness of bio-psycho-social factors in the

assessment and management of a patient


10


11

SPECIFIC CLINICAL KNOWLEDGE

By the end of second year of training in Paediatrics the trainee

should be able to independently manage children with the following

problems / diseases:

GROWTH AND DEVELOPMENT

Anthropometric values

� Normal values

� Rates of increment of weight, height and head

circumference

� Type of measurements used in assessment of growth

� Rates of increments in height, weight and head

circumferences in term and preterm infants

� Microcephaly and hydrocephalus identification

� Dysmorphology assessment and related measurements

nutrition - iYCF (infant and young child feeding)

� Normal nutritional requirements in term infants and

children

- Understand total nutrient requirement for a child

and its calculation

- Failure to thrive

� Breast feeding

- Advantages of breast feeding

- Contraindications of breast feeding

- Contents of breast milk, colostrum

- Contents of cow milk, goat milk, formula milks and

specialized formuls in special circumstances

- Understands qualitative and quantitative

differences between breast milk and non-human milk

� Complementary feeding issues

Child development

� Recognizes the normal developmental milestones of

infants and children

- Identify delays in development

� Preschool Child Development

� School

- Normal cognitive functions

- Knows school related issues

- Age appropriate readiness and ability to separate

from parents

- Identify appropriate age at which child is able to

follow directions

- School screening programmes and their value

PREVENTIVE PAEDIATRICS

vaccination

� Knowledge of the basic schedule of EPI

� Indications and contraindications of vaccines

� Types/ Modes of Administration

� Components of vaccines and newer vaccines

� Global polio eradication initiative and AFP

surveillance program

� Risks and complications of vaccine, Egg allergies -

understands egg based vaccines

screening

� Principles of screening

� Blood Pressure - when to screen and norms

� Hematocrit - when to screen and norms

� Hearing - when to screen and norms

� Vision - when to screen and norms

� Tools for all


12

FLUID & ELECTROLYTES

� Normal composition of body fluids and electrolytes

� Normal fluid requirements in term and preterm infants

and children at different ages

� Acid base physiology

� Dehydration - types, management

� Fluid and electrolyte derangements and its

managements i.e Na K Bicarbonate, identification of

electrolyte abnormalities on ECG rhythm strips

� Metabolic acidosis and metabolic alkalosis - types and

etiology, identification and management

� Evaluation of readings of pH, HCO3 PCO2 and PO2

� SIADH - Causes Management

� Calculation of Anion gap

� Recognize compensated and uncompensated metabolic

acidosis and alkalosis

NEONATOLOGY

� Normal newborns

� Delivery room management and neonatal resuscitation

� Fluid and Electrolyte in newborn

� Knowledge of components of APGAR scores and its

significance

� Differentiation between low birth weight and preterm infants

and their management

� Birth Asphyxia

� Neonatal infections, sepsis, TORCH infection

� Neonatal issues i.e. hemorrhagic diseases of new

born, respiratory distress syndrome, meconium

aspiration syndrome, hyperbilirubinemia types causes

and treatment, exchange transfusions

� Infant of diabetic mothers, monitoring and

management

� Neonatal seizures

� Incubator care


13


14

EMERGENCY AND INTENSIVE CARE MANAGEMENT

Common Accidental Paediatric emergencies

� Poisoning

� Knowledge on the availability of poison control

centers and access of Poison control centers

� Online resources

� Emetics, ipeacac, charcoal, indications and

contraindications

� Management of specific poisons i.e acids, alkali,

kerosene oil, coins, iron, Paracetamol, NSAIDS,

Organophosphorus compoumnds, Hydrocarbons,

Theophylline and Anticholinergics

� Hyperpyrexia

� Coma: causes, types, classifications, management,

level of coma indentification on GCS

� Animal and insect bites and its managements

� Near Drowning

� Electrocution

� Burns

COMMON MEDICAL EMERGENCIES

� Shock

� Seizures

� Acute Respiratory distress

� Coma: causes, types, classifications, management

INFECTIOUS DISEASES

� Common viral exanthemas and Dengue fever

� Malaria

� Typhoid (Enteric fever)

� Helminthiasis

� Meningitis / encephalitis

� Common Bacterial Infections

GASTROINTESTINAL AND LIVER DISORDERS � Diarrhea � Hepatitis - Viral (acute and chronic)� Chronic liver disease� Malabsorption� Constipation � Approach to abdominal pain

HEMATOLOGICAL AND ONCOLOGICAL DISORDERS � Anemia - nutritional � Hemolytic anemia, Etiology, differentials, initial

investigations� Transfusion of blood products, indications and its

complications � Bleeding disorders like ITP, Hemophilias� Common childhood malignancies� Leukemia and lymphoma

CARDIOVASCULAR DISORDERS� Congenital HD recognition, common ones like VSD,

ASD, PDA, TOF, TGA, Co Ao, PS and AS � Causes of CCF and basic principles of management of

CCF� Rheumatic fever and heart diseases � Clinical skills of cardiovascular exam, interpretation of

murmurs� Basics of ECG interpretation� Radiological diagnosis of cardiac diseases

NEUROLOGICAL DISORDERS � Febrile seizures and its management� Epilepsy� Acute flaccid paralysis� Cerebral palsy

NEPHROUROLOGY � Acute kidney injury� Chronic kidney disease� Obstructuve Uropathies� Acute Glomerulo- nephritis� Nephrotic syndrome� Urinary tract infections In

termediate Module in Paediatrics 2012

15

PULMONOLOGY

� Asthma

� Pneumonia and its compications

� Upper respiratory tract infections, otitis media, tonsillitis

stridor

ENDOCRINAL DISORDERS

� Hypothyroidism

� Short stature approach

� Diabetes

� Ambiguous genitalia

MUSCULOSKELETAL DISORDERS

� Arthritis: septic arthritis, rheumatoid arthritis

� Osteomyelitis

� CDH and TEV

GENETIC AND RELATED DISORDERS

� Basics

� Pedigree

� Common disorders of medelian transmission

� Chromosomal defects like Downs, Turner

SOCIAL AND PREVENTIVE PAEDIATRICS

� Child abuse and neglect:, definition, detection and

management

NATIONAL PROGRAMS RELATED TO CHILD CARE

� IMNCI

� Maternal and child health

� Millennium Development goals

� National tuberculosis control program

MISCELLANEOUS


16

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BASIC SKILLS

Psychomotor and technical skills

Demonstrate assessment, diagnostic and procedural skills for ethical

and effective patient care at minimum levels of competencies

identified. Tables below identify only minimum levels of competence

however, sufficient scope, volume and variety of experience are

desirable.

Key for assessing competencies:

1. Observer status

2. Assistant status

3. Performed under supervision

4. Performed independently


17


18

18

Genera

l P

aedia

tric

s

(Fam

ilarity

with P

rincip

les o

f G

enera

l P

aeds)

320

420

--

--

40

ER

/ E

merg

ency

220

320

320

320

80

Neonata

l P

aedia

tric

s (

inclu

din

g p

erinata

l care

)1,2

20

220

320

320

80

PIC

U/S

em

i in

tensiv

e1

51

52

52

520

Pre

ventive/A

mbula

tory

Care

110

210

310

310

40

Paedia

tric

s S

urg

ery

--

--

--

--

-

A:

Pati

en

t m

an

ag

em

en

t

His

tory

takin

g4

40

440

440

440

160

Physic

al E

xam

ination

440

440

440

440

160

Ord

ering &

Inte

rpre

ting I

nvestigations

240

340

440

440

160

Decid

ing a

nd im

ple

menting t

reatm

ent

140

240

340

3,4

40

160

Main

tain

ing f

ollo

w-u

p r

ecord

s4

40

440

440

440

160

Teachin

g/

Tra

inin

g/

Superv

isio

n o

f re

searc

h

(Acquis

itio

n o

f tr

ain

ing in R

esearc

h M

eth

odolo

gy)

Basic

s

COMPETENCIES

First Year

3 Months

6 Months

LevelCasesLevelCases

Total Cases

1st Year

9 Months

12 Months


Pre

pare

and s

ubm

itS

ynopsis

Part

icip

ation in r

esearc

h f

or

obje

ct

learn

ing

critique o

f re

searc

h p

aper


19

B:

Pre

ven

tive P

aed

iatr

ics

Nutr

itio

n,

evalu

ation a

nd m

anagem

ent

25

25

35

35

20

Assessm

ent, m

onitoring a

nd p

rom

otion o

f gro

wth

and d

evelo

pm

ent

23

23

33

33

12

Vaccin

ation

33

33

43

43

12

Specia

l education p

rogra

ms f

or

handic

apped

and d

eprived c

hild

ren

--

--

--

--

-

School health s

erv

ice

--

--

--

--

-

Genetic c

ounselin

g1

11

12

12

14

COMPETENCIES

First Year

3 Months

6 Months


Total Cases

1st Year

9 Months

12 Months



20

20

C:

Pro

ced

ure

s

Venous c

annula

tion

410

410

410

410

40

Venesection

21

21

21

21

4

um

bili

cal art

ery

cannula

tion

22

22

32

32

8

periphera

l art

ery

cannula

tion

21

21

21

31

4

Lum

bar

punctu

re3

53

54

54

520

Subdura

l ta

p1

11

12

12

14

Ple

ura

l ta

p1

11

12

12

14

Pericard

ial ta

p-

--

--

--

--

Perito

neal ta

p1

11

12

12

14

Supra

pubic

aspirate

21

21

31

31

4

Bone m

arr

ow

aspirate

11

11

21

21

4

Bone m

arr

ow

tre

phin

e1

11

12

12

14

COMPETENCIES

First Year

3 Months

6 Months


Total Cases

1st Year

9 Months

12 Months



21

C:

Pro

ced

ure

s

Direct

lary

nogoscopy a

nd e

ndotr

acheal in

tubation

23

33

33

33

12

Card

io p

ulm

onary

resuscitation C

PR

2,3

33

33

33

312

Mechanic

al ventila

tion

11

11

21

21

4

Defibrilla

tion

11

11

21

21

4

Exchange t

ransfu

sio

n1

22

22

23

28

Needle

bio

psy o

f liv

er

11

21

21

31

4

Pro

cto

sig

moid

oscopy

--

--

--

--

-

Chest

dra

in insert

ion (

Pneum

oth

ora

x/

Em

pyem

a)

11

11

21

21

4

Em

erg

ency

pneum

oth

ora

x dra

inage (needle

inse

rtio

n)

11

11

21

21

4

Perito

neal dia

lysis

11

11

21

21

4

Gl endoscopy

11

11

11

11

4

Renal B

iopsy

11

11

21

21

4

COMPETENCIES

First Year

3 Months

6 Months


Total Cases

1st Year

9 Months

12 Months



22

22

Maln

utr

itio

n a

nd m

icro

nutr

ient

deficie

ncie

s2

52

53

53

520

Mala

ria

21

21

31

31

4

A.R

.I.

25

25

35

35

20

Acute

dia

rrhea

2,3

15

2,3

15

315

315

60

Bro

nchia

l asth

ma

25

25

35

35

20

Rheum

atic f

ever

22

22

32

32

8

Menin

gitis

/ E

ncephalit

is2

52

53

53

520

Ente

ric f

ever

22

22

32

32

8

Measle

s a

nd o

ther

exanth

em

ata

22

22

32

32

8

Worm

infe

sta

tion

21

21

31

31

4

Acute

and c

hro

nic

dia

rrhea

22

22

32

32

8

Mala

bsorp

tion s

yndro

mes

21

21

31

31

4

Anem

ias inclu

din

g h

aem

oly

tic A

nem

ias

23

23

33

33

12

Com

mon P

aedia

tric

Dis

eases

COMPETENCIES

First Year

3 Months

6 Months


Total Cases

1st Year

9 Months

12 Months



23

Meta

bolic

dis

ord

ers

12

22

32

32

8

Jaundic

e1

52

53

53

520

Sepsis

13

25

35

35

18

Birth

tra

um

a /

asphyxia

12

22

32

32

8

Congenital m

alform

ation

11

21

31

32

5

Congenital heart

dis

ease

11

21

32

32

6

Respirato

ry d

istr

ess

13

23

33

33

12

Ble

edin

g d

isord

ers

1

12

13

13

14

Seiz

ure

s1

22

23

23

28

Pre

matu

rity

/low

birth

weig

ht

12

22

33

34

11

Ante

nata

l scre

enin

g1

12

13

13

14

Com

mon P

aedia

tric

Dis

eases

COMPETENCIES

First Year

3 Months

6 Months


Total Cases

1st Year

9 Months

12 Months



24

24

Shock

11

22

32

32

7

Convuls

ions/s

tatu

s e

pile

pticus

11

22

32

32

7

Hyperp

yre

xia

11

21

31

31

4

Pois

onin

g

11

21

31

31

4

Dehydra

tion

25

25

35

35

20

Com

a1

12

23

23

38

Sta

tus a

sth

am

aticus

12

22

33

33

10

Card

iac f

ailu

re

11

22

32

32

7

Renal fa

ilure

11

21

31

31

4

Hepatic f

ailu

re1

12

13

13

14

Respirato

ry f

ailu

re1

12

13

13

14

Hypert

ensiv

e c

onditio

ns

11

21

31

31

4

Managem

ent

of

em

erg

encie

s

COMPETENCIES

First Year

3 Months

6 Months


Total Cases

1st Year

9 Months

12 Months



25

Leukem

ias

11

11

21

21

4

Hodgkin

's d

isease.

11

11

21

21

4

UT

I.2

22

23

23

28

AG

N a

nd N

ephro

tic S

yndro

me.

22

22

32

32

8

AR

F a

nd C

RF

22

22

32

32

8

Hypoth

yro

idis

m2

12

13

13

14

Congenital adre

nal hyperp

lasia

.-

-2

23

23

26

Dia

bete

s m

elli

tus a

nd d

iabetic k

eto

acid

osis

21

21

31

31

4

Seiz

ure

dis

ord

ers

22

22

32

32

8

Oste

om

yelit

is a

nd s

eptic a

rthritis

21

21

31

31

4

Com

mon s

kin

pro

ble

ms

21

21

31

31

4

Meta

bolic

and s

tora

ge d

isord

ers

--

--

11

11

2

Genetic d

isord

ers

21

21

31

31

4

COMPETENCIES

First Year

3 Months

6 Months


Total Cases

1st Year

9 Months

12 Months



26

26

Genera

l P

aedia

tric

s

(Fam

ilarity

with P

rincip

les o

f G

enera

l P

aedia

tric

s)

--

--

--

--

-

ER

/ E

merg

ency

420

420

420

420

80

Neonata

l P

aedia

tric

s (

inclu

din

g p

erinata

l care

)4

20

420

420

420

80

PIC

U/S

em

i in

tensiv

e3

53

53

53

520

Pre

ventive/A

mbula

tory

Care

310

310

310

310

40

Paedia

tric

s S

urg

ery

--

15

15

15

15

A:

Pati

en

t m

an

ag

em

en

t

His

tory

takin

g4

40

440

440

440

160

Physic

al E

xam

ination

440

440

440

440

160

Ord

ering &

Inte

rpre

ting I

nvestigations

440

440

440

440

160

Decid

ing a

nd im

ple

menting t

reatm

ent

3,4

40

3,4

40

3,4

40

3,4

40

160

Main

tain

ing f

ollo

w-u

p r

ecord

s4

40

440

440

440

160

Teachin

g/T

rain

ing/

Superv

isio

n o

f re

searc

h

(Acquis

itio

n o

f tr

ain

ing in R

esearc

h M

eth

odolo

gy)

Basic

s

COMPETENCIES

Second Year

15 Months

18 Months


Total Cases

2nd Year

21 Months

24 Months


Part

icip

ation in r

esearc

h f

or

obje

ct

learn

ing c

ritique o

f re

searc

h p

aper


27

B:

Pre

ven

tive P

aed

iatr

ics

Nutr

itio

n,

evalu

ation a

nd m

anagem

ent

45

45

45

45

20

Assessm

ent, m

onitoring a

nd p

rom

otion o

f gro

wth

and d

evelo

pm

ent

43

43

43

43

12

Vaccin

ation

43

43

43

43

12

Specia

l education p

rogra

ms f

or

handic

apped

and d

eprived c

hild

ren

13

23

33

43

12

School health s

erv

ice

13

23

33

43

12

Genetic c

ounselin

g3

13

14

14

14

COMPETENCIES

Second Year

15 Months

18 Months


Total Cases

2nd Year

21 Months

24 Months



28

28

C:

Pro

ced

ure

s

Venous c

annula

tion

410

410

410

410

40

Venesection

31

31

41

41

4

um

bili

cal art

ery

cannula

tion

32

32

42

42

8

periphera

l art

ery

cannula

tion

31

31

41

41

4

Lum

bar

punctu

re4

54

54

54

520

Subdura

l ta

p3

13

14

14

14

Ple

ura

l ta

p3

13

14

14

14

Pericard

ial ta

p-

--

--

-1

11

Perito

neal ta

p3

13

14

14

14

Supra

pubic

aspirate

41

41

41

41

4

Bone m

arr

ow

aspirate

21

21

31

31

4

Bone m

arr

ow

tre

phin

e2

12

13

13

14

COMPETENCIES

Second Year

15 Months

18 Months


Total Cases

2nd Year

21 Months

24 Months


29


C:

Pro

ced

ure

s

Direct

lary

nogoscopy a

nd e

ndotr

acheal in

tubation

43

43

43

43

12

Card

io p

ulm

onary

resuscitation C

PR

43

43

43

43

12

Mechanic

al ventila

tion

31

31

31

31

4

Defibrilla

tion

31

31

41

41

4

Exchange t

ransfu

sio

n3

24

24

24

28

Needle

bio

psy o

f liv

er

31

31

41

41

4

Pro

cto

sig

moid

oscopy

--

--

--

11

1

Chest

dra

in insert

ion (

Pneum

oth

ora

x/

Em

pyem

a)

31

31

31

31

4

Em

erg

ency

pneum

oth

ora

x dra

inage (

needle

inse

rtio

n)

31

31

41

41

4

Perito

neal dia

lysis

31

31

41

41

4

Gl endoscopy

21

21

21

21

4

Renal B

iopsy

21

21

21

21

4

COMPETENCIES

Second Year

15 Months

18 Months


Total Cases

2nd Year

21 Months

24 Months


Co

nt-

2


30

30

Maln

utr

itio

n a

nd m

icro

nutr

ient

deficie

ncie

s4

54

54

54

520

Mala

ria

41

41

41

41

4

A.R

.I.

45

45

45

45

20

Acute

dia

rrhea

415

415

415

415

60

Bro

nchia

l asth

ma

45

45

45

45

20

Rheum

atic f

ever

42

42

42

42

8

Menin

gitis

/ E

ncephalit

is4

54

54

54

520

Ente

ric f

ever

42

42

42

42

8

Measle

s a

nd o

ther

exanth

em

ata

42

42

42

42

8

Worm

infe

sta

tion

41

41

41

41

4

Acute

and c

hro

nic

dia

rrhea

42

42

42

42

8

Mala

bsorp

tion s

yndro

mes

41

41

41

41

4

Anem

ias inclu

din

g h

aem

oly

tic A

nem

ias

43

43

43

43

12

Com

mon P

aedia

tric

Dis

eases

COMPETENCIES

Second Year

15 Months

18 Months


Total Cases

2nd Year

21 Months

24 Months



31

Meta

bolic

dis

ord

ers

32

32

32

42

8

Jaundic

e3

53

54

54

520

Sepsis

35

35

45

45

20

Birth

tra

um

a /

asphyxia

32

32

32

42

8

Congenital m

alform

ation

31

31

31

42

5

Congenital heart

dis

ease

31

31

32

42

6

Respirato

ry d

istr

ess

33

33

33

43

12

Ble

edin

g d

isord

ers

3

13

13

14

14

Seiz

ure

s3

23

24

24

28

Pre

matu

rity

/low

birth

weig

ht

32

32

33

43

10

Ante

nata

l scre

enin

g3

13

13

14

14

Com

mon P

aedia

tric

Dis

eases

COMPETENCIES

Second Year

15 Months

18 Months


Total Cases

2nd Year

21 Months

24 Months



32

32

Shock

32

32

32

42

8

Convuls

ions/s

tatu

s e

pile

pticus

32

32

42

42

8

Hyperp

yre

xia

32

42

42

42

8

Pois

onin

g

31

31

31

31

4

Dehydra

tion

45

45

45

45

20

Com

a3

13

23

23

38

Sta

tus a

sth

am

aticus

32

32

43

43

10

Card

iac f

ailu

re

32

32

32

42

8

Renal fa

ilure

31

31

31

41

4

Hepatic f

ailu

re3

13

13

14

14

Respirato

ry f

ailu

re3

13

13

13

14

Hypert

ensiv

e c

onditio

ns

31

31

31

41

4

Managem

ent

of

em

erg

encie

s

COMPETENCIES

Second Year

15 Months

18 Months


Total Cases

2nd Year

21 Months

24 Months



33

Leukem

ias

31

31

31

41

4

Hodgkin

's d

isease.

31

31

31

41

4

UT

I4

24

24

24

28

AG

N a

nd N

ephro

tic S

yndro

me.

42

42

42

42

8

AR

F a

nd C

RF

42

42

42

42

8

Hypoth

yro

idis

m4

14

14

14

14

Congenital adre

nal hyperp

lasia

.4

24

24

24

28

Dia

bete

s m

elli

tus a

nd d

iabetic k

eto

acid

osis

41

41

41

41

4

Seiz

ure

dis

ord

ers

42

42

42

42

8

Oste

om

yelit

is a

nd s

eptic a

rthritis

41

41

41

41

4

Com

mon s

kin

pro

ble

ms

41

41

41

41

4

Meta

bolic

and s

tora

ge d

isord

ers

21

31

31

41

4

Genetic d

isord

ers

41

41

41

41

4

COMPETENCIES

Second Year

15 Months

18 Months


Total Cases

2nd Year

21 Months

24 Months



34

34

USEFUL ADDRESSESAND TELEPHONENUMBERS

1. Regional Offices of the CPSP

MUZAFFARABAD

CMH Muzaffarabad

Azad Kashmir

TEL: 05822-920998

Email:[email protected]

ABBOTTABAD

Ayub Hospital Complex

Abbottabad

TEL: 0992-383330

Email: [email protected]

PESHAWARHayatabad Medical Complex

Phase IV, Hayatabad,

Peshawar

UAN: 091-111-666-666

TEL: 091-9217011, 091-9217320-1

FAX: 091-9217062


ISLAMABAD

P.I.M.S, Ravi Road, Sector G- 8/ 3

Islamabad.

UAN: 051-111-666-666

TEL: 051-9262590-1,

FAX: 051-9262592


FAISALABAD

Punjab Medical College

Faisalabad

UAN: 041-111-666-666

TEL: 041-9210131, 9210366-8

FAX: 041-9210224


LAHORE

Next to INMOL, Hospital

New Muslim Town, Block-D

Lahore.

UAN: 042-111-666-666

TEL: 042- 9231320-8

FAX: 042- 9231327


MULTAN

Nishtar Medical College,

Distt. Jail Road, Opp Circuit House,

Multan.

UAN: 061-111-666-666

TEL: 061-9200946, 9200952


BAHAWALPUR

Quaid-e-Azam Medical College

Bahawalpur

TEL: 062- 9250461


NAWABSHAH

Peoples Medical College for Girls

Nawabshah

TEL: 0244-9370271, 9370479

FAX: 0244-9370478


LARKANA

Chandka Medical College

Larkana

TEL: 074 – 9410726



35

HYDERABADAdjacent to Sir Cowasji Jehangir

Institute of Psychiatry,

Hyderabad, Sindh.

TEL: 022-3860056FAX: 022-3860057


KARACHI

2.

UAN – 021-111-606-606

� Department of Medical Education99207100 -10 Ext: 235/240

� Examination (FCPS Part I)99207100 -10 Ext: 311

� Examination (FCPS Part II)99207100 -10 Ext: 215

� Registration, Training & Monitoring Cell99207100 -10 Ext: 345 & 324

For further Information:

Phone: 99207100-10

UAN 111-606-606

Facsimile: 99266450

Website: www.cpsp.edu.pk

QUETTA

Near Cenar Hospital,

Off: Brewery Road, Quetta

TEL: 081-9213434 & 081-2913435

FAX: 081-2853326


3. Saudi ArabiaRIYADH Saudi Council for Health Specialities

Diplomatic Quartre P.O.Box 94656,

Riyadh - 11614.

Kingdom of Saudi Arabia

City: Riyadh

Country: Kingdom of Saudi Arabia

TEL: 966-1-4822415 ext:156/141

FAX: 966-1-4884146

4. NepalKATHMANDUInstitute of Medicine, Maharajgunj,

Kathmandu, Nepal

City: Kathmandu

Country: Nepal

TEL: 00977-1-4416224

FAX: 00977-1-4416224Email: [email protected]

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