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					Cairo University
Faculty of Medicine


   Program Specification for Master Degree In Clinical
                      Toxicology
Program type: Single
Department offering the program: Forensic Medicine and Clinical Toxicology
Program code: CLTX 800
Total credit points: 150
Academic year: 2009/2010
Program Coordinators:         Prof. Hala Saied
Assistant Coordinators:       Prof. Mervat Hamdy
                              Prof. Hoda El-Ghamry
External evaluators: Prof. Sawsan Shalabi Professor of Forensic Medicine and Toxicology, Ain
                      Shams University


I. Aim of Program
The program is a professional degree that enables candidates to specialize in the area of
toxicology including clinical, pediatric, analytical and forensic toxicology. The candidates should
achieve satisfactory levels of basic knowledge and clinical skills in all aspects of toxicology
practice, interact with community problems, respect ethical values according to community
culture and promote their medical standards through engaging in continuing medical education.
The program also aims to introduce the candidate to the basics of scientific medical research.


II. Intended learning outcomes of program (ILOs)
A. Knowledge and Understanding: By the end of the program the candidate should be
   able to:
   1) Classify the different routes of toxic exposure, metabolic pathways, and mechanisms of
      distribution within the body and elimination processes.
   2) Define and cite examples of practical importance of toxico-genetics of different body
      systems in Clinical Toxicology.
   3) Describe specific and crucial laboratory investigations of the most common types of
      poisoning.
   4) Describe and recognize pharmacological principles of drugs; their efficacy, their adverse
      reactions and interactions.
   5) Define pathophysiology, adverse effects, diagnosis and management of the most
      common types of poisoning.
   6) Outline the epidemiology, categories, side effects, and management of common drugs of
      abuse in our community.
   7) Mention the etiology, pathogenesis, clinical features, complications, principles of
      prevention and management of common life-threatening illnesses throughout age
      spectrum.
   8) Categorize First aid and life support management.
   9) Identify emergency management of comatose patients, cardiac arrhythmias,
      respiratory demise and organ failure.
   10) Recognize different populations-at risk based on past history, age, geography,
       occupational and environmental exposures.
   11) Recognize the ethical precepts and values of the medical profession, and their
       obligations under law.
   12) Develop the capacity to recognize common medical errors and malpractice.

B. Intellectual Skills: By the end of the program the candidate should be able to:
   1) Interpret the methodology of analytical toxicology and laboratory results of different
      techniques.
   2) Use critical thinking in making effective decisions for patient management.
   3) Integrate the results of physical and laboratory findings into a meaningful diagnostic
      formulation (define problem and formulate differential diagnosis).
   4) Select the emergency cases in need for first aid management.
   5) Retrieve, analyze, and synthesize relevant and current data, using information
      technologies and library resources, to solve a clinical problem.
   6) Participate in poison center operations with knowledge of general hospital administrative
      functions and the legal elements of computerized documentation of patient record
      keeping.
   7) Design a plan in establishment of different community toxicological disasters.
   8) Share and present educational programs with accurate objectives and scientific content
      taking into consideration the audience and learning environment.
   9) Complete a research project, including selection of a problem with appropriate
      methodology, implementation of a research plan, and data analysis with presentation of
      findings and preparation of a scientific manuscript.

C. Professional and Practical Skills: By the end of the program the candidate should be
   able to:
   1) Manage clinical problems in an emergency department setting, employing basic
      scientific principles, and evidenced-based medicine.
   2) Perform first aid procedures for different emergency cases.
   3) Apply basic skills needed for mass casualty management and coordination for the
      hospital and community.
   4) Perform routine technical procedures including patent airway, venipuncture, inserting an
      intravenous catheter, arterial puncture, thoracentesis, lumbar puncture, inserting a
      nasogastric tube and inserting a Foley’s catheter.
   5) Develop the medical skills required for the toxicological emergencies.
   6) Integrate applied toxicological principles and community health practices.
   7) Develop educational skills particularly oral, visual, and written communication and
      promote lifelong learning in medical education.
   8) Advance compassionate and empathetic attitudes in caring for patients, and
      demonstrate truthfulness and trustworthiness in all professional dealings.
   9) Assemble professional leadership and management skills.
   10) Conduct research in clinical toxicology.
   11) Explain and demonstrate how to collect different types of samples.

D. General and Transferable Skills: By the end of the program the candidate should be
   able to:
   1) Deal with and manage patients with acute and chronic exposures to toxic substances
      from different sources.
   2) Evaluate the hazards of environmental poison exposures to the health of patients.
   3) Select and apply relevant principles of pharmacology and toxicology to the management
      of poisoned patients.
   4) Select and interpret relevant laboratory test procedures when evaluating patients,
      potential research questions, and medico-legal studies.
   5) Identify poison prevention strategies relevant to common poison exposure scenarios in
      the home, workplace and environment as well as iatrogenic exposures.
   6) Incorporate epidemiologic data into research questions, protocol development, and
      poison prevention strategies.
   7) Participate in agency and community disaster planning for toxic agent release as a result
      of industrial accidents, hazardous material events, chemical and biological warfare
      events.
   8) Develop experience with library, on-line and other toxicology information resources.


III. Academic Standards
External References for Standards:
   -   Dundee University, England
   -   Monash University, Australia
IV. Program Admission Requirements
According to the bylaws of the faculty of medicine Cairo University applicants should have MB
BCh or equivalent degree. According to Cairo University requirements, all applicants for
postgraduate studies should fulfill preliminary courses on the following subjects; Medical
statistics I (MEDC 1 or equivalent degree – English language (Toefl or equivalent degree) –
Computer skills (MEDC or ICDL). Admission to the program is open during July. Training prior
to registration may be accredited according to departmental evaluation. Admission for the
program is open during July.


V. Program Structure and Contents
Program duration: Three academic years.
Program structure: Total Credit points 150
   ·   First part: 1.5 years - Total credit points 55 - (Table 1)
           § Compulsory courses; one academic year (30 weeks)
                  § General Toxicology                                 3 credit points
                  § Forensic Chemistry                                 3 credit points
                  § Pharmacology                                       1 credit point
                  § Basics of Intensive Care medicine                  1 credit point
                  § Internal Medicine                                  1 credit point
                  § Medical Ethics and Malpractice                     1 credit point
           § Elective courses                                          1 credit point
           § Scientific activities                                     2 credit points
           § Practical training program Part 1                         42 credit points

   ·   Second part: 1.5 years - Total credit points 75 - (Table 2)
          § Compulsory courses; one academic year (30 weeks)
                § Clinical Toxicology                                  6 credit points
                § Analytical Toxicology                                4 credit points
                § Pediatric Toxicology                                 2 credit points
          § Scientific activities                                      2 credit points
          § Residency training program Part 2                          60 credit points


   ·   Master Thesis: completed during second part                     20 credit points.
Table 1: First part

                         Courses                   Credit Points
                                                                            ILOs
        Code Title                                 CPs     Total
COMPULSORY COURSES
  CLTX 810 GT     General Toxicology                3              A1, A2, A3, A5, A6, A7,
                                                                   A10, B1, B2, B3, B4, B7,
                                                                   B8, C3, C4, C5, C6, C9,
                                                                   C11, D1, D2, D3, D4,
                                                                   D5, D6, D8
  CLTX 810 FC     Forensic Chemistry                3              A1, A3, B1, B3, B5, C3,
                                                                   C4, C5, C12, D2, D4, D7
     CLTX 807     Pharmacology                      1              A1, A2, A4, B3, B7
                                                            10
     CLTX 826     ICU                               1              A7, A8, A9, B2, B3, B4,
                                                                   C1, C2, C3, C4, C5,
                                                                   C10, D1
     CLTX 811     Internal Medicine                 1              A7, A8, A9, A10, A11,
                                                                   A12, B2, B5, C1, C3, C7,
                                                                   D1, D2
CLTX 810 ME/M     Medical Ethics and Malpractice    1              A11, A12, B5, B6, C3,
                                                                   C7, C8, D1, D2, D7
ELECTIVE COURSES (MEDC) choose 2 courses
      MEDC 3      Evidence-Based Medicine          0.5
      MEDC 4      Medical statistics II            0.5      1      C10, D3, D5, D6, D8
      MEDC 7      Research Methodology             0.5
SCIENTIFIC ACTIVITIES
       1st Part   Scientific activities             2       2      D3, D4, D5, D8
PRACTICAL TRAINING PROGRAM
  CLTX 810 P1     Practical training program        4       42     C4, C5, C7, C8, C9, D1,
                                                                   D2, D3, D4, D5, D6, D7
  Table 2: Second part

       Courses                                        Credit Points
                                                                               ILOs
        Code Title                                    CPs     Total
COMPULSORY COURSES
   CLTX 810 CT    Clinical Toxicology                   6             A3, A5, A6, A7, A8, A10,
   CLTX 810 AT    Analytical Toxicology                 4       12    B1, B3, B4, B5, C1, C2,
   CLTX 810 PT    Pediatric Toxicology                  2             C6, C8, C11, D2, D4, D5
ELECTIVE COURSES (MEDC) choose 2 courses
  CLTX 810 RE     Research Ethics                      0.5            A11, A12, B2, B3, B8,
 CLTX 810 QCA     Lab Quality Control and Assurance    0.5      1     B9, C1, C3, C9, C10,
CLTX 810 RMLT     Risk Management/Legal Toxicology     0.5            C11, D2, D4, D8
SCIENTIFIC ACTIVITIES
       2nd Part   Scientific activities                 2       2     C1, C3, C6, D3, D4, D5,
                                                                      D7
PRACTICAL TRAINING PROGRAM
   CLTX 810 P2    Practical training program           60       60    B1, B2, B3, B4, B5, B8,
                                                                      C1, C2, C4, C7, C8,
                                                                      C11, D1, D2, D3, D4,
                                                                      D5, D6, D7
MASTER THESIS
                  Master Thesis                        20       20    B2, B5, B6, B8, B9, C7,
                                                                      C8, C11, C12, D2, D4,
                                                                      D5, D6, D7, D8

Practical Training Program
   · Basic Training:
       According to the new bylaws for postgraduate programs (effective since July 2009), all
       the students should have a basic training for 18 months. They should spend at least 6
       months in poisoning control center, 6 months in ICU, 2 months in pharmacology
       department and 2 months in internal medicine department and 2 months in forensic
       chemistry in forensic and clinical toxicology department. During this period the students
       should complete the elective courses.
   ·   Special Training:
       All postgraduate students should complete the special part of the training program in the
       poisoning control center, pediatric department and forensic medicine & clinical toxicology
       department. They should spend 18 months; 6 months in each department, in order to
       acquire the needed credit points. The student is expected to acquire skills in the
       following: Diagnose and manage the acutely intoxicated adult and pediatric patients,
       different analytical procedures and their interpretation as well as recognize the medical
       ethical dilemmas. During this period the students will attend the courses of the second
       part and will participate in the scientific activities of the department.
CLINICAL TOXICOLOGY MASTER DEGREE PROGRAM MATRIX

                                                                    A                                                    B
                   Courses
                                                        Knowledge and Understanding                             Intellectual Skills
          Code      Name                    1   2   3     4   5   6    7   8   9   10     11   12   1   2   3      4    5    6        7   8   9
  CLTX 810 GT       General Toxicology      X   x   x         x   x    x           x                x   x   x      x                  x   x
  CLTX 810 FC       Forensic Chemistry      X       x                                               x       x           x
     CLTX 807       Pharmacology            X   x         x                                                 x                         x
      CLTX 826      ICU                                                x   x   x                        x   x      x
      CLTX 811      Internal Medicine                                  x   x   x      x   x    x        x               x
CLTX 810 ME/M       Medical Ethics                                                        x    x                        x    x
  CLTX 810 CT       Clinical Toxicology             x         x    x   x   x          x             x       x      x    x
  CLTX 810 AT       Analytical Toxicology           x         x    x   x   x          x             x       x      x    x
  CLTX 810 PT       Pediatric Toxicology            x         x    x   x   x          x             x       x      x    x
       MEDC 3       EBM
       MEDC 4       Medical statistics II
       MEDC 7       Research Methodology
  CLTX 810 RE       Research Ethics                                                       x    x        x   x                             x   x
 CLTX 810 QCA       Lab Quality Control                                                   x    x        x   x                             x   x
CLTX 810 RMLT       Risk Management                                                       x    x        x   x                             x   x
        1st Part    Scientific activities
       2nd Part     Scientific activities
  CLTX 810 P1       Training program
  CLTX 810 P2       Training program                                                                x   x   x      x    x                 x
                    Master Thesis                                                                       x               x    x            x   x
CLINICAL TOXICOLOGY MASTER DEGREE PROGRAM MATRIX

                                                                C                                          D
                     Courses
                                                        Professional Skills                     General and Transferable
           Code     Name                    1   2   3   4   5   6    7    8   9   10   11   1   2   3    4   5    6   7    8
   CLTX 810 GT      General Toxicology              x   x   x   x             x        x    x   x   x    x   x    x        x
   CLTX 810 FC      Forensic Chemistry              x   x   x                                   x        x            x
      CLTX 807      Pharmacology
       CLTX 826     ICU                     x   x   x   x   x                     x         x
       CLTX 811     Internal Medicine       x       x                x                      x   x
 CLTX 810 ME/M      Medical Ethics                  x                x    x                 x   x                     x
   CLTX 810 CT      Clinical Toxicology     x   x               x         x            x        x        x   x
   CLTX 810 AT      Analytical Toxicology   x   x               x         x            x        x        x   x
   CLTX 810 PT      Pediatric Toxicology    x   x               x         x            x        x        x   x
        MEDC 3      EBM                                                           x                 x        x    x        x
        MEDC 4      Medical statistics II                                         x                 x        x    x        x
        MEDC 7      Research Methodology                                          x                 x        x    x        x
   CLTX 810 RE      Research Ethics         x       x                         x   x    x        x        x                 x
  CLTX 810 QCA      Lab Quality Control     x       x                         x   x    x        x        x                 x
 CLTX 810 RMLT      Risk Management         x       x                         x   x    x        x        x                 x
         1st Part   Scientific activities                                                           x    x   x             x
        2nd Part    Scientific activities   x       x           x                                   x    x   x        x
   CLTX 810 P1      Training program                    x   x        x    x   x             x   x   x    x   x    x   x
   CLTX 810 P2      Training program        x   x       x            x    x            x    x   x   x    x   x    x   x
                    Master Thesis                                    x    x            x        x        x   x    x   x    x
Master Thesis
All master-degree students should prepare a thesis in the field of Clinical Toxicology. The
department and the ethical committees must approve the protocol of the research. The thesis
should include a research part and a practical part. The thesis is supervised by one or more
senior staff members and may include other specialties according to the nature of the research.
The thesis should be evaluated and approved by a committee of three professors including one
of the supervisors and an external professor.

Scientific Activities:
The postgraduate students should participate in scientific activities of the departments such as:
      · Journal club (presenting scientific articles) once every two weeks.
      · Seminars (including recent topics and controversial issues) once weekly. Students
          are expected to actively participate in the discussions.
      · Scientific meetings arranged by the department
      · Attendance of Thesis discussions
      · National and international conferences in Clinical Toxicology researches.
Each activity will be monitored and given credit points registered in the logbook. The student
should collect the required points before being allowed to sit for final exam.


V. Regulations for Progression and Program Completion
After finishing the first part of attending the specified courses and collecting the required credit
points, the student should pass the first part examination including the basic sciences before
proceeding to the second part. In case the student fails to pass the examination, he may
proceed in the clinical training and can resubmit for the next examination. After passing the first
part, the student submits a protocol for master thesis at the beginning of second part. Before
submitting to the final exam, he should finish the thesis and get approval, complete phase 2 of
special training program, and collect the required credit points. The candidate will receive his
degree after passing this final examination. Master degree should be obtained within a
maximum of 6 years after registration date.


VI. Assessment
A: Assessment Tools
·   Supervision and Monitoring of Training Program
According to the bylaws of the residency, professors carry continuous assessment during the
program. A clinical-training program logbook will be kept for each student to document all
his/her clinical, laboratory and/or operative/procedural activities as well as his/her participation
in different scientific activities. The head of the department should allow the students to undergo
final examination when they complete the training program and collect the credit points needed.

·   Formal Assessment
According the Faculty of Medicine, Cairo University Bylaws for Post Graduate Programs (July
2009). Students should be assessed at the end of first part and of the second part.
    1. First Part Final Exam:
    · General Toxicology: Two-hour written exam (including short assay and multiple choice
       questions) + oral exam + practical exam
    · Forensic chemistry and Medical Ethics & Malpractice: Two-hour written exam
       (including short assay and multiple choice questions) + oral exam + practical exam
    · Pharmacology : one-hour written exam (including short assay and multiple choice
       questions) + oral exam
    · Basics of Intensive care: one-hour written exam (including short assay and multiple
       choice questions) + oral exam.
    · Internal Medicine: one-hour written exam (including short assay and multiple choice
       questions) + oral exam

    2. Second Part Final Exam Part 2:
    · Clinical Toxicology + Analytical Toxicology and Pediatric Toxicology: Three written
       exams (Three-hours each) including short assay questions, and MCQ including problem
       solving + oral exam + clinical exam
    · Elective courses: A written exam (one-hour) including short assay questions, and
       MCQ + oral exam

B: Assessment Schedule:
 1. First Part Final Exam:
        The written exam will be held in April/October (four days):
                Day one: General toxicology (2 hours)
                Day two: Forensic chemistry and Medical Ethics (2 hours)
                Day three: Pharmacology (1 hour)
                Day four: Internal medicine (1 hour) and Basics intensive care medicine (1 hour)
        This will be followed by the clinical and oral exams in separate days

 2. Second Part Final Exam:
      The written exam will be held in May/ November (three days):
              Day one: Clinical toxicology
              Day two: Analytical toxicology and Pediatric toxicology
              Day three: Elective courses
      This will be followed by the clinical and oral exams in separate days

C: Weighing Of Assessment (Marks allocated to courses):
       (50 marks for each credit point)

                 Courses                                            Marks
        Code Title                                  Written      Oral   Clinical     Total
FIRST PART
  CLTX 810 GT    General Toxicology                    70         40          40      150
  CLTX 810 FC    Forensic Chemistry
CLTX 810 ME/M    Medical Ethics and Malpractice
                                                      100         50          50      200
     CLTX 807    Pharmacology                          30         10        ---
     CLTX 826    ICU                                   30         20        ---       150
     CLTX 811    Internal Medicine                     30         10        20
                                                                  Total First Part    650
                  Courses                                               Marks
         Code Title                                     Written      Oral   Clinical    Total
SECOND PART
  CLTX 810 CT    Clinical Toxicology                      150         75        75      300
  CLTX 810 AT    Analytical Toxicology
  CLTX 810 PT
                                                          150         75        75      300
                 Pediatric Toxicology
  CLTX 810 RE    Research Ethics
 CLTX 810 QCA    Lab Quality Control                       30         20         ---     50
CLTX 810 RMLT    Risk Management
                                                                   Total Second Part    650

Remarks
   - It is mandatory to pass all the papers of written exams separately.
   - The passing mark in any written exam is ≥ 60%.


VII. Evaluation of Program Intended Learning Outcomes
 Evaluator                         Tool                            Sample
1. Senior Students               Questionnaire at the end of      All the PG students
                                 the program
2. Alumni                        The faculty is currently         Not yet determined
                                 developing an Alumni
                                 office for postgraduates
3. External Evaluators           Review program and               Once before implementation
                                 courses                          Bi-annual report
                                 Attending the final exam
4. College Quality Assurance     Annual program reviewer
committee



Signatures
Date of approval by department: 6 July 2010
Program coordinator:           Prof. Prof. Hala Saied
Assistant Coordinator:         Prof. Mervat Hamdy
                               Prof. Hoda El-Ghamry

              Program Coordinator                               Head of Department
                  Prof. Hala Saied                               Prof. Dina Shoukry
                  Prof. Mervat Hamdy
                  Prof. Hoda El-Ghamry

				
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