Forensic Medicine Clinical Toxicology Undergraduate Course (2004 by klutzfu59


									                Forensic Medicine & Clinical Toxicology
                  Undergraduate Course (2004-2005)

Overall Objective :
     The main objective of Forensic Medicine & Clinical Toxicology Department
is to build the competencies of the undergraduate (4th year) medical student for the
interpretation of the community medico-legal , toxicological and ethical problems.

  Forensic Medicine Course                   the undergraduate medical student to
       Specifications                        manage the medico-legal problems
Alocated Marks: 100                          and situations that will face them
Course Duration: 32 weeks                    after graduation.
Total Teaching Hours: 144 hrs                Intended     Learning       Objectives
Lectures: 80 hrs                             (ILOs): On completion of the course
Practical: 64 hrs / round                    the student will be able to :
Course Director:                             1.a- Identify medical ethics
Prof. Dr. Sarah El-Reffaey (Head of          1.b- Describe common medicolegal
the department)                              aspects in different medical branches
Teaching staff:    Professors: 6             1.c- Identify relationship between the
Assistant Prof.: 7 Lecturers: 12,            physician and the law
Assist. Lecturers: 2 ,                       1.d- Describe injuries of neglect
Demonstrators: 8                             especially in children
1- Course Aim:                               1.e-   Identify     blood   stain    and
The main goal of Forensic Medicine           differentiate it from other stains
course is to build the competencies of
1.g- Define the problem of disputed         injuries and the period needed for
paternity.                                  each type to heal.
1.h- Manage cases of rape or other        2.g- Differentiate between suicidal,
sexual assaults.                          accidental or homicidal injuries.
1.i- Identify the medico-legal aspects    - General Skills:
of virginity, pregnancy, delivery and     2.h- Retrieve recent medicolegal
abortion.                                 issues from the electronic data bases.
2- Skills:                                3- Behavior:
- Professional (Practical) Skills:        3.a- Behave soundly and
2.a- Write a medico-legal report in       compassionately with patients and
English and Arabic, as well as birth      their families.
and death certificates.                   3.b- Respect the dignity of patients.
2.b- Apply methods for identification     3.c- Respect Patient's confidentiality.
of age, sex, and race of a person         III- Course Content:
either living or dead.                    The    Forensic     Medicine     course
2.c-         Recognize        different   comprises on 16 items taught in
microscopical slides (hair fibers &       lectures and rounds. They are:
blood).                                   1- Medical Ethics and Malpraxis.
- Intellectual Skills:                    2- Identification [identification of
2.d- Differentiate between natural        skeletal structure, identification of
and unnatural death.                      the dead, identification of the living].
2.f- Diagnose different types of          3- The signs of death and post-
  injuries    e.g.   wound,    thermal    mortem changes [definition of death,
  injuries, explosion injuries, violent   signs of death, post-mortem changes,
  asphyxias, road traffic accidents'      conditions     replacing   putrefaction,
estimation of time passed since                    presentation, fate, membrane injuries
death, exhumation].                                and intracranial hemorrhage].
4- Sudden                Natural         Death     9-      Thermal injuries [causes and
[definition, classification of causes,             manifestations of different types,
the sudden infant death syndrome].                 causes of death, medico-legal aspects
5- Medico-legal aspects of wounds                  of death from burn, death from cold].
[definition,        medico-legal         report,   10- Asphyxia       [definition,     general
types,      medico-legal           importance,     post-mortem picture, types of violent
ante-mortem              and     post-mortem       asphyxia,       medico-legal         aspect,
wounds,       causes        of   death    from     causes of death].
wound].                                            11- Medico-legal aspect of death
6- Injuries         of      special      organs    under anesthesia.
[injuries of the neck, injuries of the             12- Sexual offenses [definition of
chest, injuries of the abdomen,                    rape,    conditions       of       consent,
injuries of the urinary bladder and                investigation of a case of rape,
the genitalia].                                    unnatural sexual offenses].
7- Firearm injuries [classification,               13- Medico-legal          aspects        of
different      types        of   ammunition,       pregnancy, delivery and abortion
sequence of events of firing a                     [medico-legal       aspects,      diagnosis,
cartridge, characters and diagnosis of             types of abortion, complications of
firearm injuries, medico-legal aspect              abortion,      intrauterine    fetal    age
of firearm deaths].                                estimation].
8- Head injuries [injuries of the                  14- Infanticide [definition, signs of
scalp,      skull        fractures,   cerebral     live birth, causes of death in infants,
injuries--injuries to the brain, clinical          battered baby].
15- Blood [blood stain identification,    graduation      during    the     general
blood grouping, medico-legal aspects      medical practice.
of blood groups].                         II- Intended Learning Objectives
16- Traffic accidents [different types,   (ILOS): By the end of clinical
autopsy findings].                        toxicology course the undergraduate
                                          medical student will be able to:
  Clinical Toxicology Course
         Specifications                   1- Knowledge:
                                          1.1- State the general principles of
Allocated marks: 100 degrees
                                          care of poisoned patient.
Course duration: 40 weeks
                                          1.2- Define pathophysiology, adverse
Total teaching hours: 75 hrs
                                          effects, diagnosis and management
Lectures: 15 hrs     small group
                                          of the most common poisonings.
sessions: 60 hrs
                                          1.3- Locate specific and crucial
Course director : Prof. Dr. Sarah
                                          laboratory       investigations      and
El- Reffaey (Head of the department)
                                          antidotal management of particular
Teaching staff: 6 professors, 7
assistant professors and 15 lectures, 4
                                          1.4-   Outline      the   epidemiology,
assistant lectures, 8 demonstrators.
                                          categories, and side effects, and
I- Course aims:
                                          management of drug addiction with
   The main goal of the course of
                                          special      reference    to    common
toxicology     is     to   build   the
                                          categories of drugs abused in our
competencies of the undergraduate
medical student to manage cases of
                                          1.5- Cite examples of practical
poisoning that will face them after
                                          importance of pharmacokinetics and
pharmacogenetics        in       clinical   2.7-       Consider          patients   with
toxicology.                                 immediately           life        threatening
2- Skills                                   conditions and select initial course of
2.1- Obtain an accurate medical             management for them.
history that covers all essential           2.8-    Predict   factors        that   place
aspects of poisoning and perform            individuals at risk for poisoning and
both a complete and a focused               select appropriate tests for detecting
clinical examination.                       them at early stages.
2.2-   Perform     routine     technical    2.9- Communicate effectively, both
procedures including at a minimum           orally and in writing, with patients,
venipunture, inserting a cannula, a         patient's families, colleagues, and
nasogasteric tube, and a folly's            others with whom physician must
catheter.                                   exchange information.
2.3-   Perform    general     lines   for   2.10-      Retrieve    (from       electronic
management of a poisoned patient.           database and other resources), and
2.4- Perform Reinsch test.                  utilize these information for solving
2.5- Interpret results of commonly          problems and making decisions that
needed diagnostic laboratory tests          are relevant to care of poisoned
and procedures.                             patient.
2.6-        Construct        appropriate    2.11- Engage in life-long self-
management plans (both diagnostic           directed learning to catch up the
and therapeutic) for patients with          scientific evolution.
common diseases especially those            3- Attitude:
expected to have long term sequels.         3.1- Show respect for the role of
                                            other health care professionals and
the need to collaborate with others in    4- Heavy metals: (general
caring for individual patients and in     characters, Arsenic, lead, mercury,
health promotion.                         iron, phosphorus, antimony, iodine
3.2- Serve honestly with patient's        and effect of irradiation).
families, colleagues, and others with     5- Volatile & gaseous poisoning:
whom physicians must interact in          (carbon monoxide, cyanide, alcohol,
their professional life.                  methanol,      carbon     tetrachloride,
3.3- Compassionate treatment of           chloroform).
patients and respect their privacy.       6-Insecticides: (organophosphorus,
3.4- Advocate at all times the            carbamates, chlorinated insecticide,
interests of one's patient over his       naphthaline, rodenticide, herbicides).
own interest.                             7-Petroleum distillates: (kerosene
III- Course contents:                     and benzene).
1-          General         toxicology:   8-Therapeutic agents and drug
(classification of poisonings, factor     abuse: (barbiturate, meprobamates,
modify action of poisonings, general      benzodiazepines,        phenothiazines,
approach to poisoned patient).            salicylates,    pracetamol,    tricyclic
2- Corrosive poisons: (general            antidepressants, amphetamines, drug
characters of corrosives, general post    addiction and habituation).
mortem pictures, corrosive acids and      9-Animal & food poisons: (spiders,
alkalis).                                 tick paralysis, poisonous snakes,
3- Plant poisons: (atropine,              scorpions, bacterial food poisoning
hyoscyamine, hyoscine, strychnine,        (botulism       and     staphylococcal
nicotine, aconitine, ergot, digitalis,    poisoning),      endogenous        food
cocaine, opium, and hallucinogenics)      poisonings).
Teaching         and        learning      photographs, cases, specimens &
methods:                                  slides.
1- Lectures
2- Tutorials
3- small group discussion
4- Case study
6- Demonstration
7- Audiovisual

    In the form of 2 lectures every
week, one for forensic science and
the second for clinical toxicology

   Small group discussion:
   In the form of 8 weeks Round.
The students are divided into 4 main
groups that are classified equally into
4 small groups to study clinical
cases, practical science and museum

   Independent learning:
    The department encourages
independent learning. It is in the
form    of   activities   including
problem–based learning, researches
                                       Student Activities
    The student's activities in the department are in the form of : Applied research, CDs,
pictures, drawing specimens, preparation of slides, collection of X-rays in the subject & Field
study. The activities are performed under the supervision of the staff .

                               Example of student's activities
                                      Student assessment
Continuous assessment of the student through :
         - Round exams.
         - Small group discussion.
         - Practical exam.
         - Final written exam.
         - Final oral exam.

Attendance criteria:
1- Every student must attend at least 75% of small group discussion classes.
2- The attendance is measured by an attendance sheet assigned by the lecturer.

Assessment tools:
1- Essay examination                    2- Short essay       3- Written exercise
4-Objective written examination          5- Case study        6- Oral examination
7- Project report                      8- Clinical rounds    9- OSPE
10- Clinical examination

Assessment Schedule:
1- Throughout the round (at the end of every week for 8 weeks. (8 exams, 10.00 am - 12.00 pm).
2- At the end of each round. (1.00 pm- 2.00 pm).
3- At the end of the year in the form of :
        Practical 9.00 am- 12.00 pm.
        Written exam. 10.00 am- 12.00 pm.
        Oral / OSPE 10.00 am- 12.00 pm.
Grading System:

              Examination                         Allocated Marks
  Activity & attendance                                   20
  At the end of round                                     20
  Final oral exam (2 settings)                            30
  Final practical exam                                    30
  Final written exam                                     100
                  Total                                  200

Examination Description:
 Throughout the round (case study, project report). Equal 20 marks.
 At the end of each round (written exercise, objective written examination, MCQ, short essay,
 case study) Equal 20 marks.

                                   Program Evaluation
    By the end of each year, the committee which consists of the head of the department and the
staff members of Forensic Medicine and Clinical Toxicology evaluate the effectiveness of the
educational program by documenting the extent to which its objectives have been met.

   By the end of practical exam feed back is obtained from the students in the form of

                          Bylaws of the Department for students
   •   The number of students entering the class is not only determined by the number of
       qualified staff but also by the adequacy of critical resources
   •   The number and size of classrooms , laboratories, clinical training sites are put into
     •     The students are classified equally into 4 main groups to form 4 rounds..
     •     The staff members are classified equally into 4 groups. Each group has a senior professor
           , one assistant professor, 2-3 lecturers, 2-3 assistant lecturers and 2 demonstrators in
           addition to one technician and one administrator ( non-academic staff)
     •     The selection and classification of students have policies and practices that avoid gender,
           racial cultural, social and economic discrimination between students.
     •     The information regarding the manner of students classification describing the admission
           process , their schedule, the staff members is published through :
               1- An information table in the department
               2- The non –medical personnel (employers)
               3- Orally in the main lecturer

Transfer of students
     •     The transfer of students in between the different classes is controlled to avoid diminishing
           the resources available to existing enrolled student.
     •     The transfer of students from another Faculty is allowed in the 4th year according to the
           Faculty rules. The new students are arranged by the same department rules without

  The learning environment
     •     No discrimination is the rule
             Forensic Medicine & Clinical Toxicology Postgraduate studies
1- Diploma :
 - Forensic Medicine and Toxicology
 - Clinical Toxicology

2- Master :
 -       Forensic Medicine and Toxicology
 -       Clinical Toxicology

Objectives of Master Degree in Forensic Medicine: By the end of the course, the candidate
will be able to :

     1- Acquaint with various Medicolegal problems in civil and criminal cases.
     2- Identify living & dead bodies, blood and semen stain (by chemical & serological tests).
     3- Acquaint with the postmortem examinations (Autopsy) and to write a medicolegal report.
   4- Acquaint with the histopathological examination of any suspicious tissue to identify the
      cause of death.
   5- Acquaint with forgery and falsification.

Objectives of Master Degree in Clinical Toxicology:
By the end of the course, the candidate will be able to :
   1- Identify and recognize cases of poisoning as regard the emergency stabilization, of the
        patient , proper diagnosis and proper management.
   2- Consider the procedure of obtaining samples for toxicological analysis.
   3- Perform rapid simple tests that help diagnosis of the common poisons.
   4- Identify & Recognize common toxic plants in Egypt (Pharmacognosy).

3- M.D. :
 - Forensic Medicine and Toxicology
 - Clinical Toxicology

4-Postdoctoral Researches

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