MBBS Programme –Batch 8, Internal Medicine 3, Cohort 2 Semester 10 Clinical Rotation: Internal Medicine

Dates: 6th Jan – 7th Feb 2020

Bachelor of Medicine, Bachelor of Surgery (MBBS)

Batch 8, Semester 10
Posting: Internal Medicine 3
Cohort: 3

(6th Jan 2020 – 7th Feb 2020)

Prepared BY: APPROVED BY: ENDORSED BY:

_____________________ ____________________________ ___________________________________________

DR. SURESH PONNUSAMY ASSOC. PROF. DR. WIN MIN PROF. DR. LAI NAI MING

POSTING COORDINATOR PHASE II PROGRAM DIRECTOR DIRECTOR OF CLINICAL CAMPUS

TAYLOR’S CLINICAL SCHOOL TAYLOR’S CLINICAL SCHOOL TAYLOR’S CLINICAL SCHOOL

Note
© SOM Taylor’s University 2019
MBBS Programme –Batch 8 Cohort 3 Semester 10 Clinical Rotation: Int Med 3
Dates: 6th Jan - 7th Feb 2020

ACADEMIC AND ADMINISTRATIVE STAFF CLINICAL SCHOOL

TAYLOR’S UNIVERSITY

Academic Matters:
Full-time Academic Staff:
Datuk Dr Christopher Lee (Ms. Rita hp no: 0138490049)
Dr. Suresh Ponnusamy (Posting Coordinator) (hp no: 0164363579)
Dr. Benjamin Samraj Prakash Earnest (hp no: 0174504579)
Dr. Lim Su Yin (hp no: 0138482471)
Part-time Academic Staff:
Emeritus Prof Dato’ Dr Md. Tahir (hp no: 0129835865)

Part-time HSB Specialists / Consultants (Hospital Sungai Buloh):

Dr Suresh Kumar Chidambaram (hp no: 0123091690)
Dr Nordiana Nordin (hp no: 0192227799)
Dr Benedict Sim Lim Heng (hp no: 0122918762)
Dr Vijayendran (hp no: 0162176848)

Administrative Matters:
Director of the Clinical Campus
Professor Dr Lai Nai Ming
(NaiMing.Lai@taylors.edu.my)
Tel: 03-56296634
Phase II Program Director
Assoc. Professor Dr Win Min
(MinThein.Win@taylors.edu.my )
Tel: 03-56296632

Posting Coordinator
Dr Suresh Ponnusamy
(Suresh.Ponnusamy@taylors.edu.my)

© SOM Taylor’s University 2019

MBBS Programme –Batch 8 Cohort 3 Semester 10 Clinical Rotation: Int Med 3
Dates: 6th Jan - 7th Feb 2020
Nursing Officer, Clinical Skills
Norisah Ab Latif
(Norisah.AbLatif@taylors.edu.my)
Tel:03-56296635

Administrative Executives:
1) Mrs Chithradevi Kannan
(Chithradevi.Kannan@taylors.edu.my)
Tel:03-56296633

2) Mrs Noorhayati Kardi

(Noorhayati.Kardi@taylors.edu.my)
Tel:03-56296633

3) Mrs Noorain Ibrahim

(Noorain.Ibrahim@taylors.edu.my)
Tel: 03-56296633

© SOM Taylor’s University 2019

MBBS Programme –Batch 8 Cohort 3 Semester 10 Clinical Rotation: Int Med 3
Dates: 6th Jan - 7th Feb 2020
WEEK 1
Date
Monday Tuesday Wednesday Thursday Friday
06/01/2020 07/01/2020 08/01/2020 09/01/2020 10/01/2020
Time
Posting briefing by
Posting coordinator
Ward round Ward round Ward round Ward work
8:30-10.30 Dr Suresh (Taylors) &
Ward work Ward work Ward work Ward rounds
Medicine OP clinic for
Gp B
Posting briefing by
Dr Suresh Kumar Clinical case
Clinical case Clinical case
(HSB) Ward rounds for both presentation
presentation presentation
10:30- Clinical case Gp A & Gp B Datuk Dr Chris
for Gp A for Gp B
13.00 presentation Dr Suresh (Taylors) For Gp B
Dr Benjamin Dato’ Prof Tahir
Datuk Dr Chris (9am-1pm)
For Gp A

13.00-
LUNCH BREAK
14.00
Ward work/pm Review & Examination
rounds of Abdomen (& Renal) Friday Prayers/Self-
study
Ward work/pm rounds Dr Suresh (Taylors) Ward work /pm rounds
Review of Clinical case 2pm-3pm
examination of the presentation Review of examination
14.00-
Chest with Breath Dr Vijayendran (HSB) of the CNS Clinical case
17.00
sounds (RS) for Gp B Ward work/pm rounds Dr Lim Su Yin presentation for Gp A
Dr Benjamin (3pm – 5pm) Self-study (3pm – 5pm) Dr Suresh Kumar
3pm-5pm (HSB)
(3pm to 5pm)

17.00-
On call On call On call On call On call
22.00

© SOM Taylor’s University 2019

MBBS Programme –Batch 8 Cohort 3 Semester 10 Clinical Rotation: Int Med 3
Dates: 6th Jan - 7th Feb 2020

WEEK 2

Date Monday Tuesday Wednesday Thursday Friday

Time 13/01/2020 14/01/2020 15/01/2020 16/01/2020 17/01/2020
Ward round
Ward work Ward round
Ward round Ward round Ward round
8:00 – Medicine OP clinic Ward work
Ward work Ward work Ward work
10:30 for Gp A Ward rounds with
Dr Suresh Dr Suresh for Gp A

Ward work/pm rounds

Clinical case
Clinical case
Clinical case Clinical case presentation/mini-
Clinical case presentation/mini-
10.30- presentation presentation CEX
presentation CEX
13:00 Dr Benjamin Datuk Dr Chris Dato’ Prof Tahir
Dr Vijayendran (HSB) Datuk Dr Chris
For Gp B For Gp A for Gp B
for Gp B for Gp B

13.00-
LUNCH BREAK
14.00
14.00- Seminar Ward work/pm rounds Ward work/pm rounds
17.00
Self-study / Prayer
ECGs and Review of examination Ward work/pm
arrhythmias of the CVS rounds Self-study
Dr Vijayendran (HSB) Datuk Dr Chris Clinical case
(2pm to 5pm) (3pm to 5pm) Clinical case presentation/mini-
presentation CEX
Dr Vijayendran (HSB) for Gp A
for Gp A
Dr Suresh (HSB)
(2.30pm to 5pm) (3pm – 5pm)
© SOM Taylor’s University 2019
MBBS Programme –Batch 8 Cohort 3 Semester 10 Clinical Rotation: Int Med 3
Dates: 6th Jan - 7th Feb 2020

17.00-
On call On call On call On call On call
22.00
WEEK 3

Date Monday Tuesday Wednesday Thursday Friday

Time 20/01/2020 21/01/2020 22/01/2020 23/01/2020 24/01/2020

Ward round
Ward work Ward round Ward round
Ward work Ward round Ward round
8:00 –10:30 Medicine OP clinic for Ward work
Ward work Ward work
Gp B
Dr Suresh

Clinical case Clinical case Clinical case

Clinical case Clinical case
presentation/mini- presentation/mini- presentation / mini-
presentation/mini-CEX presentation / mini-
CEX CEX CEX
10.30 – 13:00 Dr Lim Su Yin CEX
Datuk Dr Chris for Gp B Dr Vijayendran (HSB)
for Gp A Datuk Dr Chris
For Gp B Dr Benjamin for Gp A
for Gp A

13.00-14.00 LUNCH BREAK

Self- study Prayer

© SOM Taylor’s University 2019

MBBS Programme –Batch 8 Cohort 3 Semester 10 Clinical Rotation: Int Med 3
Dates: 6th Jan - 7th Feb 2020

Ward work/pm Ward work/pm

Ward work/pm
rounds rounds
CSS : rounds
Simulation session on
“Approach to Clinical review session Clinical case
CBL 1 presentation for Gp B
Breathlessness” on
14.00-17.00 Thyroid and Journal Club Dr. Suresh Kumar, HSB
HIV-AIDS & TB
parathyroid diseases Dr. Benedict (HSB)
Dr Suresh (Taylor’s) Datuk Dr Chris (2.30pm to 4pm)
(2pm – 5pm) (3pm to 5pm)
Dr Suresh (Taylor’s)
(2.30pm to 4.30pm)

17.00-22.00 On call On call On call On call On call

Note: CSS= Clinical Skills Session CBL= Case-based Learning27TH JANUARY 2020 TO 31ST JANUARY 2020 IS CHINESE NEW YEAR BREAK

WEEK 4

Date Monday Tuesday Wednesday Thursday Friday

Time 03/02/2020 04/02/2020 05/02/2020 06/02/2020 07/02/2020

Ward round Ward round Ward round Ward work

Ward round
8:00-10:30 Ward work Ward work Ward work Ward rounds
Ward work

Clinical case
Clinical case Clinical case Clinical case Clinical case
presentation/mini-
presentation/mini- presentation/mini-CEX presentation/mini-CEX presentation
10.30- CEX
CEX for Gp A for Gp B for Gp A
13:00 for Gp A
for Gp B
Dato Prof Tahir Dr Vijayendran (HSB) Dr Vijayendran (HSB)
Datuk Dr Chris
Datuk Dr Chris

© SOM Taylor’s University 2019

MBBS Programme –Batch 8 Cohort 3 Semester 10 Clinical Rotation: Int Med 3
Dates: 6th Jan - 7th Feb 2020
13.00-
LUNCH BREAK
14.00

Seminar: CBL 2
Ward work/pm rounds
Prescribing safely: Weight loss
Dr Benjamin (Taylor’s) Ward work/pm
analgesia, Portfolio discussion 1 Ward work/pm
(2pm-4.30pm) rounds
antimicrobials, Dr Lim Su Yin rounds
fluids, during
14.00-
cardiac failure, renal
17.00 Portfolio discussion 4
failure and hepatic Clinical case
Datuk Dr Chris
failure states Portfolio discussion 2 presentation for Gp B
Portfolio discussion 3 Dr. Suresh Kumar, HSB
Dr Benjamin
Datuk Dr Chris Dr Suresh (Taylors)
(2pm-5pm)

Debriefing by Dr
17.00- On call
On call On call On call Suresh
22.00
(Taylors)Posting ends

THEMES AND LEARNING MODES:

Seminar:
1. ECGs and arrhythmias
2. Prescribing safely: analgesics, sedatives and anxiolytics, antimicrobials, fluids replacement, cardiac failure treatment, renal failure
and hepatic failure states

Cased Based Learning (CBL):

1. Thyroid and parathyroid diseases
2. Weight loss

Clinical Skill Sessions:

1. Review of cardiovascular examination
2. Review of respiratory examination
3. Review of neurological examination
© SOM Taylor’s University 2019
MBBS Programme –Batch 8 Cohort 3 Semester 10 Clinical Rotation: Int Med 3
Dates: 6th Jan - 7th Feb 2020
4. Simulated medical scenarios on “Approach to a patient with Breathlessness” by using SIM-MAN 3G

Suggested topics for journal review sessions:

1. Introduction to journal club: What is the purpose of a journal club? What is evidence based medicine? How to read a paper?
How to ask a clinical question? How to use review articles, meta-analyses, the Cochrane database of systematic reviews, and
other internet resources to answer clinical questions.
2. Does treatment with corticosteroids affect neurological outcomes in patients with acute bacterial meningitis?
3. Does treatment with IV magnesium sulphate improve peak flow & reduce hospital admissions in patients with acute asthma?
4. Does treatment with ACE-I reduce renal complications and mortality in diabetic patients?
5. Does early initiation of treatment with aspirin and statins improve the cardiovascular prognosis/status in diabetic patients?
6. Which has a greater beneficial effect on morbidity and mortality in patients with myocardial infarction: thrombolysis or PCI?
7. Students define a clinical question they encountered while on the ward rounds and presents critically appraised evidence to
try and answer that question.

TEACHING LEARNING METHODS AND STRATEGIES

WARD WORK AND WARD ROUNDS:

The following teaching and learning methods and strategies are employed in medicine 3 posting with emphasis on practical, professional and
communication aspects in patient management. Some aspects of these were already introduced in Internal Medicine 1 and Internal Medicine 2.
 Participation in ward clinical work.
 Bed side clinical discussion with managing team.
 Mini clinical examination session for enhancing competence in physical diagnosis
 Self-directed and directed self-learning e.g. Portfolio writing and use of evidence-based approach.
 Dedicated sessions for guidance and counselling for slow learners or weak students.

ON CALLS AND NIGHT DUTY

© SOM Taylor’s University 2019

MBBS Programme –Batch 8 Cohort 3 Semester 10 Clinical Rotation: Int Med 3
Dates: 6th Jan - 7th Feb 2020
 Night duty is compulsory.
 Two or three students are rostered per night. Group leader is responsible for the roster, making sure that every weekday
(including Fridays) is covered. Each student is expected to cover AT LEAST TWO WEEKEND DAYS (either Saturday or Sunday)
for the four-week period of posting.
 The on call period starts from 1700 until 2200. Students are expected to be resident in the hospital throughout the on call
period.
 Students shall observe the house officers and medical officer in patient management and help wherever possible, unless
otherwise instructed.
 If the patient turns unstable during the process of clerking, students are to contact the house officer/medical officer
immediately.

PORTFOLIOS
 Portfolio is an in-depth record of student learning in the form of a concise case write-up with critical reflection of patient
encounters as learning issues under specified headings.
 Each student is to submit ONE portfolio for the posting. The portfolio should be submitted to the supervisor for comments
prior to the end of the THIRD WEEK of posting. Portfolio discussion sessions are scheduled in the time table to provide
opportunities to practice in preparation for the end-of-semester summative portfolio discussion session.
 Plagiarism, including from each other, is strictly prohibited. When a student is found to plagiarise, the total case summary
mark will be set at no more than 30.
 A marking scheme of the case summary is provided on page xx of the Internal Medicine 3 logbook. A detailed guide to writing
a case summary in Internal Medicine 3 is available on TIMES.

Self-study topics:
CVS: Acute coronary syndromes and their complications – management
RS: Chronic Obstructive Pulmonary Disorders - management
GIT: Chronic diarrheal illness – clinical approach and management
GUS: Sexually Transmitted Disease – clinical approach and management
CNS: Seizure disorders – clinical approach and management
MSK: Myopathies & Neuropathies – clinical approach and management

READING LIST

© SOM Taylor’s University 2019

MBBS Programme –Batch 8 Cohort 3 Semester 10 Clinical Rotation: Int Med 3
Dates: 6th Jan - 7th Feb 2020
Core Text:
1. Nicki R. Colledge, Brian R. Walker, Stuart H. Ralston. Davidson’s Principles and Practice of Medicine, Elsevier Saunders
2. Kumar PJ and Clarke M. Kumar and Clarke’s Clinical Medicine, Elsevier Saunders
Clinical Methods:
1. Glynn M, Drake W. Hutchison’s Clinical Methods, Elsevier Saunders
2. Douglas G, Fiona Nicol, Colin Robertson. Macleod’s Clinical Examination, Elsevier Saunders
3. Talley NJ and O'Connor S. Clinical Examination. A Systematic Guide to Physical Diagnosis. Sydney: Churchill Livingston, Elsevier,

References
1. Dan Longo, Anthony Fauci, Dennis Kasper, Stephen Hauser, J. Jameson, Joseph Loscalzo Harrison’s Principles of Internal
Medicine, 2 volumes, McGraw Hill.
2. Murray Longmore, Ian Wilkinson, Edward Davidson, Alexander Foulkes, and Ahmad Mafi Oxford Handbook of Clinical Medicine,
Oxford University Press
5. Hampton J, The ECG Made Easy, Elsevier
6. Clarke C & Dux A, X-rays for Medical Students Wiley Blackwell
7. Foster C, Mistry N, The Washington Manual® of Medical Therapeutics, Wolters Kluwer & Lippincott Williams & Wilkins

Online resources
1. Clinical key: www.clinicalkey.com
2. The Cochrane Library: http://www.thecochranelibrary.com
3. PubMed: http://www.ncbi.nlm.nih.gov/pubmed
4. Medscape & e-medicine: www.emedicine.medscape.com
5. BMJ resources:
a) www.bmj.com
b) www.learning.bmj.com
c) www.bestpractice.bmj.com
d) www.onexamination.com

© SOM Taylor’s University 2019