GS Training Manual and Curriculum. May 2020 MG FINAL

Ministry of Health & Population
High Committee of Health Specialties

Egyptian Fellowship Board
General Surgery
Training Manual
and Curriculum
2020
Preface
The Egyptian Fellowship Board and the General Surgery Scientific Council
worked collaboratively are to introduce this new edition of the training manual and
curriculum for trainees, trainers and educational supervisors affiliated to the board.
Postgraduate medical education worldwide is governed by academic standards that

describe the quality and abilities of the graduates, as well as standards of the training
processes, trainers’ selection and methods of assessment. Those standards ensure
transparency and clarify expectations.
The Egyptian Fellowship Board has already defined its standards for the
competencies expected from our graduates in the different specialties upon successful
completion of training. These expectations are clearly reflected in the General Surgery
training manual and curriculum.
The General Surgery training manual and curriculum describes what trainees will
know and be able to do upon completion of training. In addition, methods of teaching
and training are outlined. The manual describes in details, the expectations from trainees
during their rotations, the job description of trainers and educational supervisors and
the methods of assessment and examinations regulations.
All topics covered during practical and theoretical study are outlined. This will
help trainees guide their readings and their choice of learning activities. In addition, all
required operative procedures are listed together with expected level of performance at
various stages of training.
Foundation courses are also mentioned and the Egyptian Fellowship Board will
work closely with the General Surgery Scientific Council to ensure proper organization
and delivery of these courses.
We hope that all our trainees, trainers and educational supervisors will follow the
provided guides in this manual, and cooperate with the Egyptian Fellowship Board and
the General Surgery Scientific Council to ensure the proper implementation and
delivery of training in the best ways.
Secretary General
The High Committee of Medical Specialties
Prof. Magdy El-Serafy
1
May 2020
Introduction
Our Dear Candidate

Welcome to our surgical training program at the High Committee of
Medical Specialties. The Egyptian Fellowship of General Surgery as a full-time
training program of five-year duration.
In this manual, you will find all information and data you need to know
about the training program. The structure of the General Surgery training
includes rotations in different surgical specialties which are presented in this
manual. Duties and responsibilities of the trainees and job description of the
trainers and educational supervisors are explained. All items of the curriculum,
the intended learning outcomes (ILOs), the blue print together with the methods
of assessment are well illustrated in the manual.
The methods of examination of each of the three parts are discussed in
details, and you should remember that all learning outcomes of the program will
be sampled in the exams, so, it is advisable that your study be comprehensive
and includes the whole curriculum.
Trainees should document all activities, comments and reflections in the

logbook which contains sections on outpatient sessions, surgical procedures,
emergency duties, scientific activities, training courses and rotation plan. We
advise you to do this recording regularly so that your logbook is always ready
for revision by your trainers, educational supervisors and by the scientific
council members during the annual review process (ARP).
Our final advice that we wish to be a memorable one, is that “you more
you devote yourself to the care of our patients, and the more you dedicate
yourself to the study od general surgery, the more you will be rewarded by
being a successful, efficient, reliable and safe surgeon”.
We wish you all the success in your training and development.
Head of the Scientific Council

of General Surgery
Prof. Samir Galal
2
May 2020
Acknowledgement
The High Committee of Medical Specialties would like to acknowledge the

scientific efforts of the General Surgery scientific council for their substantial
contribution to the development of the updated and comprehensive General
Surgery Training Manual and Curriculum.
Sincere thanks and appreciation go to the following esteemed members of

the scientific council for their professional contribution, time and effort to
produce this manual:
Prof. Samir Galal

Dr. Mohsen George
Prof. Mohamed Hany Rateb
Prof. Ahmed Shehata
Prof. Monir Azmy
Prof. Alaa Ismail
Prof. Hamed Rashad
Prof. Salma Dowara
The process of developing the training manual and curriculum is a
continuum seeking improvements and updates. For this reason, the manual will
be periodically revised and updated every three to five years. Any updates or
changes that would occur before that, will be circulated as separate amendments
to trainees and trainers, and published at the Egyptian Fellowship Board website
until being included in the revised version.
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May 2020
CONTENTS
SUBJECT Page
PREFACE 1
INTRODUCTION 2
ACKNOWLEDGEMENT 3
STRUCTURE OF THE TRAINING PROGRAM 5
FOUNDATION COURSES 6
TRAINEE'S DUTIES AND RESPONSIBILITIES 7
JOB DESCRIPTIONS 9
REQUIRED SURGICAL PROCEDURES 10
INTENDED LEARNING OUTCOMES (ILOs) 16
CURRICULUM CONTENTS 74
TEACHING & TRAINING METHODS 93
ASSESSMENT METHODS & BLUE PRINTING 94
GUIDE TO THE FINAL EXAMINATION 97
TRAINING ASSESSMENT FORMS 98
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May 2020
The Structure of the General Surgery

Training Program
The Egyptian Fellowship Board in General Surgery requires five-year training program that
must be conducted in accredited hospitals by the board before sitting for the final
examination. During the entire training program, the candidate must be dedicated full time.
Training is mainly in the general surgery department including all activities & clinical
encounters, in addition to rotations in the different surgical specialties including the related
critical care units, according to the following table:
Year Departments
▪ General Surgery (11 months)
First
▪ ICU ( 1 month)
Second ▪ General Surgery (12 months)
▪ Pediatric Surgery (2 months)
▪ Vascular Surgery (2 months)
▪ Plastic Surgery & Burn (2 months)
Third ▪ Orthopedics (2 months)
▪ Urology (2 months)
▪ Neurosurgery (1 months)
▪ Cardiac surgery (1 months)
Fourth ▪ General Surgery (12 months)
Fifth ▪ General Surgery (12 months)
Weekly Activities (as minimum requirements)

(Applied to all years of training)
Title Number of Days
Morning endorsement & ward round Daily
Outpatient Department 1
Operating Room 1
Clinical Grand Round 1
Emergency Department 2
Scientific Activities (morbidity & mortality meeting –
1
lectures – journal club – case presentation – audit ……)
This structure is partially applicable for the rotation in the ICU according to the relevant
activities.
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May 2020
FOUNDATION COURSES
Candidates of first & second years of training must successfully complete
the following FOUNDATION courses:
1- Basic Surgical Skills (including intestinal & vascular anastomoses)
2- Basics of Laparoscopy
3- Basic Life Support
4- Patient Safety
5- Medical Ethics
6- Trauma course
7- Research methodology & EBM
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May 2020
Trainees Duties & Responsibilities
1st, 2nd & 3rd Years
1- INPATIENT DEPARTMENT
▪ Clerking all admissions (history & physical examination)
▪ Attend then perform daily rounds
▪ Supervised investigation requests
▪ Follow & obtain results of investigations & report to seniors
▪ Plan the treatment under supervision
▪ Follow up referrals & consultations to other specialties
▪ Observe seniors while informing patient about their illness, treatment, prognosis &
taking consent for procedures
▪ Prepare patients for surgery
▪ Follow the post-surgical course of patients and manage appropriately under
supervision
▪ Check completeness of patient medical records & complete when needed
▪ Arrange patient discharge, post-discharge treatment & follow up appointments
2- OUTPATIENT DEPARTMENT
▪ Attend OPD
▪ Examine patients under supervision
▪ Ask for investigations & prescribe treatment under supervision
3- EMERGENCY ROOM
▪ Assistance to the first on call
▪ Conduct 1ry assessment & order treatment under supervision
▪ Suggest admission of patients
4- OPERATING ROOM
▪ Follow the surgical procedure schedule distributed on the five years (see below)
▪ Write operative notes & postoperative treatment
5- SCIENTIFIC ACTIVITIES
▪ Attend daily & grand rounds
▪ Case presentation in daily rounds
▪ Attend morbidity & mortality meetings
▪ Participate in journal clubs
▪ Attend lectures & conferences
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4th & 5th Years
1- INPATIENT DEPARTMENT
▪ Clerking all admissions (history & physical examination)
▪ Perform daily rounds
▪ Request investigation
▪ Modify treatment according to investigation results
▪ Plan the treatment
▪ Ask for referrals & consultations to other specialties
▪ Inform patients about their illness, treatment, prognosis & taking consent for
procedures
▪ Prepare patients for surgery
▪ Follow the post-surgical course of patients and manage appropriately and ask for
*consultation of seniors if required
▪ Check completeness of patient medical records & complete when needed
▪ Discharge patients, plan post-discharge treatment & follow up
2- OUTPATIENT DEPARTMENT
▪ Attend OPD
▪ Examine patients
▪ Ask for investigations & prescribe treatment
3- EMERGENCY ROOM
▪ Attend as first on call (4th year) & second on call (5th year)
▪ Conduct 1ry & 2ry assessments & order treatment
▪ Admit patients
4- OPERATING ROOM
▪ Follow the surgical procedure schedule distributed on the five years (see below)
▪ Write operative notes & postoperative treatment
5- SCIENTIFIC ACTIVITIES
▪ Perform daily rounds
▪ Attend grand round
▪ Case presentation in scientific meetings
▪ Prepare morbidity & mortality meetings
▪ Prepare journal clubs
▪ Prepare & conduct lectures
▪ Participate in local, regional & international conferences
N.B. Trainees should document all activities, comments and reflections

in the logbook which contains sections on outpatient sessions, surgical
procedures, emergency duties, scientific activities, training courses and
rotation plan.
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May 2020
Job Descriptions
I- JOB DESCRIPTION OF THE TRAINER
1- Agree with the trainee on the rotation learning objectives and Fill out the Learning
Agreement Record
2- Provide training & teaching for the trainees according to the provided curriculum &
intended learning outcomes
3- Supervise various activities of the trainees
4- Structure the rotation plan of the trainees in the different surgical specialties
5- Insure fulfillment of the logbook activities according to year of training & the
required level of competence & signing them
6- Monthly evaluation of the trainees on work place based assessment, with feedback to
the trainee, and filling out the assessment form which is submitted to the Egyptian
Board Headquarter
7- Attend meeting with the educational supervisor every three months to discuss learning
progress and problems
II- JOB DESCRIPTION OF THE EDUCATIONAL SUPERVISOR
1- Check & evaluate the progress of the training program at the assigned training center.
2- Evaluate the trainer’s monthly reports & propose remedial actions for any deficiencies
3- Meeting with the trainers every three months to discuss learning progress & problems
4- Ensure that all training activities are running according to the curriculum
5- Assess the need for training of trainers
6- Advise on educational condensed clinical & theoretical courses for trainees
7- Arrange for/ participate in monthly clinical teaching for trainees
8- Assess the logbook activities of each trainee & provide needed remarks for both
trainer & trainees
9- Ensure the adherence to the rotation plan of the trainees in the different surgical
specialties
10- Report to the scientific committee the performance of both trainers & trainees, and
decide the trainee’s eligibility to sit for the exam
11- Coordinate with hospital authorities the administrative affairs of the trainees
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May 2020
Required
Surgical procedures
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May 2020
Surgical Procedures distributed over the Five Years

Table Key: Five-point scale (level of contribution)
F1 Has observed
F2 Has assisted
F3 Can do with assistance
F4 Can do whole but may need assistance
F5 Competent to do whole without assistance, including managing complications
4th & 5th

1st & 2nd year 3rd year
Code Subject years
No Level No Level No Level
1 Neck & Salivary Gland Surgery
Excision of thyroglossal 2 F2
1.1 2 F5
cyst/Fistula 1 F4
1.2 Excision of branchial cyst 1 F3 1 F2
1.3 Excision of branchial fistula 1 F2 1 F2
5 F2
1.4 Cervical lymph node biopsy 5 F5
2 F4
1.5 Block dissection of the neck 1 F1 2 F2
1.6 Excision of cervical rib 1 F2
2 F2
1.7 Submandibular sialadenectomy 3 F4
1 F3
2 F1
1.8 Parotidectomy 2 F2
1 F2
2 Breast Surgery
3 F2
2.1 Drainage of breast abscess
2 F3 5 F5
3 F2
2.2 Breast lumpectomy
3 F3 5 F5
2 F2
2.3 Mastectomy
2 F3 2 F5
2 F2
2.4 Axillary Node Dissection
2 F3 2 F5
1 F1
2.5 Needle Aspiration Procedure
2 F3 5 F5
2.6 Sentinel lymph node biopsy 2 F2
3 Vascular & Lymphatic Surgery

3.1 Arterial repair 2 F2
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1 F3
3.2 Embolectomy 2 F2
3.3 Arterial bypass surgery 2 F2
3.4 Aneurysm surgery 1 F2
2 F2
3.5 Arteriovenous fistula
2 F3
2 F2
3.6 Varicose vein surgery
2 F3
3.7 Surgery for lymphedema 1 F2
3 F2
3.8 Amputations 5 F5
1 F5
4 Plastic Surgery
Operations on muscles & 3 F2
4.1
tendons 2 F3
3 F2
4.2 Skin graft
1 F3
2 F2
4.3 Skin flap
1 F3
4.4 Cleft lip/palate 2 F2
4.5 Hypospadias 2 F2
Burn wounds surgery
2 F1
4.6 (debridement, escharotomy,
3 F2
fasciotomy)
5 Endocrine Surgery
5.1 Thyroidectomy 5 F2 5 F4
1 F2
5.2 Aspiration of thyroid cyst
1 F3
5.3 Parathyroidectomy 1 F1 2 F2
5.4 Adrenalectomy 1 F1 2 F2
6 Cardiothoracic Surgery
2 F2
6.1 Chest tube insertion
2 F4
2 F3
6.2 Pleural aspiration
2 F4
Thoracotomy (CABG - valve 2 F1
6.3 replacement - lung resection 2 F2
….)
7 Neurosurgery
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Evacuation of intracranial
7.1 1 F1
hematoma
7.2 Laminectomy / discectomy 2 F1
7.3 Nerve repair 2 F2
7.4 Intracranial surgery 2 F1
8 Orthopedic Surgery
3 F1
8.1 Closed reduction of fractures
3 F2
3 F1
8.2 Internal fixation of fractures
2 F2
2 F1
8.3 External fixation of fractures
1 F2
8.4 Arthroplasty (hip - knee) 2 F1
9 GIT & Abdominal Surgery

3 F2
9.1 Exploratory laparotomy 5 F4
3 F3
9.2 Diagnostic Laparoscopy 3 F2
Esophageal surgery (hiatus
9.3 hernia, achalasia of the cardia, 1 F1 2 F2
etc.)
1 F1
7 F3
9.4 Surgery for complicated peptic 8 F2
3 F4
ulcer 1 F3
1 F1
9.5 2 F2
Gastrectomy 2 F2
1 F3
9.6 1 F4
Gastrostomy 1 F3
9.7 Splenectomy 5 F2 3 F4
9.8 Repair of liver injury 3 F2 3 F3
9.9 surgery for Hydatid cyst 3 F2 3 F3
9.10 Hepatectomy 1 F1 1 F2
8 F2
9.11 Cholecystectomy (Lap./Open) 8 F4
4 F3
2 F1
9.12 Bile duct surgery 2 F3
1 F2
Drainage of pancreatic
9.13 2 F2 1 F3
pseudocyst
9.14 Pancreatectomy 1 F2
Small bowel resection 4 F2
9.15 5 F4
anastomosis 2 F3
9.16 Enterostomy 1 F2
9.17 Colectomy 5 F2 3 F3
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5 F2
9.18 Colostomy 4 F3
1 F3
9.19 Anterior resection of rectum 3 F2 2 F2
Abdomino-perineal resection of 1 F1
9.20 2 F2
rectum 2 F2
9.21 Appendectomy 15 F3 10 F4
5 F3
9.22 Hemorrhoidectomy 5 F5
3 F4
5 F3
9.23 Anal fissurectomy 5 F5
3 F4
5 F3
9.24 Anal Fistula Surgery 5 F5
3 F4
5 F3
9.25 Drainage of perianal abscess 5 F5
3 F4
3 F2
9.26 Pilonidal sinus surgery 5 F4
3 F3
5 F2
9.27 Repair of epigastric hernia 5 F4
2 F3
Repair of 5 F2
9.28 5 F4
Umbilical/paraumbilical hernia 3 F3
5 F2
9.29 Repair of inguinal hernia 5 F4
4 F3
1 F2
9.30 Repair of femoral hernia 1 F4
1 F3
2 F2
9.31 Incisional hernia repair surgery 2 F4
2 F3
10 Pediatric Surgery
3 F2
10.1 Inguinal herniotomy
2 F3
10.2 Pyloromyotomy 2 F2
1 F1
10.3 Congenital megacolon surgery
1 F2
Correction of anorectal 1 F1
10.4 1 F2
malformation
2 F2
10.5 Circumcision
3 F4
11 Urologenital Procedures
11.1 Nephrectomy 2 F2
11.2 Nephrolithotomy 2 F2
11.3 Nephrostomy 1 F2
11.4 Ureterolithotomy 2 F2
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11.5 Cystoscopy 2 F1
1 F2
11.6 Suprapubic cystostomy
1 F4
1 F2
11.7 Cystolithotomy
1 F3
1 F1
11.8 Cystectomy
1 F2
1 F1
11.9 Prostatectomy
1 F2
3 F2
11.10. Varicocelectomy
2 F4
3 F2
11.11 Hydrocelectomy
2 F4
2 F2
11.12 Orchidopexy
1 F3
2 F2
11.13 Orchidectomy
1 F4
12 Miscellaneous
Operations on skin & 8 F3
12.1
subcutaneous tissues 6 F5
Insertion of central venous line /
12.2 2 F2 2 F3
Portacath
12.3 Endotracheal intubation 2 F2 3 F3
12.4 Tracheostomy 2 F2 2 F3
12.5 Abdominal paracentesis 5 F3 5 F4
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INTENDED LEARNING OUTCOMES

(ILOs)
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INTENDED LEARNING OUTCOMES

Code Subject
1 Applied Surgical Anatomy
1.1 Upper Limb
1.2 Lower Limb
1.3 Head, Neck & Spines
1.4 Thorax
1.5 Abdomen, Pelvis & perineum
2 Surgical Physiology
2.1 General Physiological principles
2.2 Physiology of Respiratory System
2.3 Physiology of Gastrointestinal Tract
2.4 Physiology of Cardiovascular System
2.5 Physiology of Endocrine System
2.6 Physiology of Renal System
2.7 Physiology of the Nervous System
3 Surgical Pathology
3.1 Inflammation
3.2 Wound Healing
3.3 Shock
3.4 Surgical Oncology
3.5 Vascular Disorders & Surgical Hematology
3.6 Surgical Infections & Antibiotics
3.7 Disorders of Growth, Differentiation & Morphogenesis
3.8 Surgical Immunology & Organ Transplantation
3.9 Surgical Biochemistry
4 Principles of Surgery
4.1 Preoperative Care
4.2 Postoperative Management & Critical Care
4.3 Surgical Technique & Technology
4.4 Management & Legal Issues in surgery
4.5 Clinical Microbiology
4.6 Emergency Medicine & Management of Trauma
5 Traumatic Surgical Emergencies
6 The Neck
7 Salivary Glands
8 Breast
9 The Vascular System
10 The lymphatic System
11 Plastic Surgery
12 Skin & Subcutaneous Tissue
13 Burns
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Code Subject
14 Endocrine Surgery
14.1 Thyroid Gland
14.2 Parathyroid Glands
14.3 Adrenal Gland
14.4 Endocrine Disorders of the Pancreas
14.5 Carcinoid syndrome
14.6 Multiple Endocrine Neoplasia
15 Cardiothoracic Surgery
16 Neurosurgery, Scalp, Skull & Brain
17 Pharynx & Oesophagus
18 Stomach & Duodenum
19 Hepatobiliary
20 The Pancreas
21 The peritoneum, Omentum & mesentery
22 The Spleen
23 Small & Large Intestine
24 The Appendix
25 The Anal Canal
26 Abdominal Wall & Hernias
27 Pediatric Surgery
28 Acute Abdomen
29 Urogenital System
30 Testis & Scrotum
31 Orthopedic Surgery
32 The Spine & Spinal Cord
33 History taking & Physical examination
34 Surgical Radiology
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Level of knowledge Code

Code Level of Knowledge
A basic knowledge & understanding that does not go much beyond bookwork & general
reading. At this level there is only an elementary linkage of cause & effects between basic
sciences & clinical conditions.
L1
Deeper knowledge & understanding that allows link & cause & effect to be demonstrated. At
this level there is an expectation of a basic ability to define conditions & outline principles of
management & the process of diseases.
L2
In depth knowledge & understanding that can where appropriate, be applied to clinical
situations. At this level there is an expectation of an ability to synthesize information to draw
appropriate conclusions, to explain complex conditions & processes, to make diagnoses & to
discuss conclusions & management in details. It is also expected that candidates' grasp of
subject matter would be sufficient to enable them to justify their conclusions & suggest
L3 alternative approaches or explanations.
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May 2020
1- APPLIED SURGICAL ANATOMY
2-
ILO Written Written Long WPB
Code OSCE
ILO Level 1st Part 2nd Part Case Assessment
1.1 Upper Limb
Describe the course, relations, surface anatomy & branches of
1.1.1 the subclavian, axillary, brachial, radial & ulnar arteries K L3 L3 L3 L3
including collateral circulation
Describe the course, relations, surface anatomy & tributaries
1.1.2 K L3 L3 L3 L3
of cephalic, basilic, brachial, axillary & subclavian veins
Describe the course, relations, surface anatomy & branches of
1.1.3 the brachial plexus, musculocutaneous, radial, ulnar, median K L3 L3 L3 L3
& circumflex nerve & their sensory & motor supply
Enumerate the different groups of axillary lymph nodes &
1.1.4 K L3 L3 L3 L3
identify both afferents & efferents of each group
Discuss the structure, position, relations, blood supply &
1.1.5 K L3 L3 L3 L3
lymphatic drainage of the female breast
Describe the origin, insertion, nerve supply & function of the
1.1.6 K L2 L2 L2 L2
muscles of the upper limb
Name, orientate & describe the bones of the pectoral girdle,
1.1.7 arm, forearm and hands, including shoulder, elbow, radio- K L2 L2 L2 L2
ulnar, wrist & hand joints
Describe the anatomy & clinical significance of the carpal
1.1.8 K L3 L3 L3 L3
tunnel
1.1.9 Identify the dermatomes & tendon reflexes of the upper limb K L3 L3 L3 L3
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Code ILO OSCE
Level 1st Part 2nd Part Case Assessment
1.1.10 Describe the anatomy of cubital fossa K L3 L3 L3 L3
1.1.11 Describe the structures around the wrist K L3 L3 L3 L3
1.1.12 Understand the movements of the thumb IS √ √ √ √

Interpret the findings of plain X-Ray, arteriography &
1.1.13
venography of upper limb bones & vessels
IS √ √
1.2 Lower Limb
Describe the course, relations, surface anatomy &
branches of femoral, popliteal, anterior tibial, posterior
1.2.1 K L3 L3 L3 L3
tibial, peroneal & dorsalis pedis arteries including
collateral circulation
1.2.2 tributaries of long & short saphenous, popliteal & femoral K L3 L3 L3 L3
veins
branches of femoral, obturator, sciatic, common peroneal,
1.2.3 K L3 L3 L3 L3
superficial peroneal, deep peroneal & tibial nerves & their
sensory & motor supply
Discuss the arrangement of inguinal lymph nodes &
1.2.4 K L3 L3 L3 L3
identify their afferents & afferents
Describe the origin, insertion, nerve supply & function of
1.2.5 K L2 l2 L2 L2
the muscles of the lower limb
Describe the anatomy of the femoral triangle & adductor
1.2.6 K L3 L3 L3 L3
canal
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May 2020

Code ILO OSCE
1.2.7 Describe the anatomy of the popliteal fossa K L3 L3 L3 L3
Name, orientate & describe the bones of the thigh, leg &
1.2.8 K L2 L2 L2 L2
foot, including hip, knee, ankle & foot joints
Identify the dermatomes & tendon reflexes of the lower
1.2.9 K L3 L3 L3 L3
limb
Interpret the findings of plain X-Ray, arteriography &
1.2.10
venography of lower limb bones & vessels
IS √ √
1.3 Head, Neck & Spine
1.3.1 branches of common, external & internal carotid, & K L3 L3 L3 L3
middle meningeal arteries
1.3.2 K L3 L3 L3 L3
tributaries of anterior, external & internal jugular veins
1.3.3 branches of cranial nerves & cervical plexus & their K L3 L3 L3 L3
sensory, motor & autonomic supply
1.3.4 Discuss the anatomy & levels of cervical lymph nodes K L3 L3 L3
Describe the origin, insertion, nerve supply & function of

1.3.5 K L2 L2 L2 L2
the surgically important muscles of the head & neck
1.3.6 Describe the anatomy of the triangles of the neck K L3 L3 L3 L3
Identify the anatomical position, relations & blood &

1.3.7 K L3 L3 L3 L3
nerve supply of salivary glands
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Code ILO OSCE
Identify the anatomical position, relations & blood &
1.3.8 K L3 L3 L3 L3
nerve supply of thyroid & parathyroid glands
Identify the relations & blood & nerve supply of Larynx &
1.3.9 K L3 L3 L3 L3
trachea, & pharynx & esophagus
1.3.10 Describe contents & relations of the carotid sheath K L3 L3 L3 L3

Describe the anatomy of skull, mandible,
1.3.11 temporomandibular joint, vertebral column & vertebral K L2 L2 L2 L2
canal
Discuss the anatomy of the eye, orbit, ear, nose, paranasal
1.3.12 K L2 L2 L2 L2
sinuses, mouth & tongue
Discuss the anatomy of the cranial cavity, dural sinuses &
1.3.13 K L2 L2 L2 L2
pituitary gland
Discuss the development of branchial arches, face &
1.3.14 K L2 L2 L2 L2
palate, thyroid & parathyroid glands, & the spines
Describe the anatomical structure of the cerebral
1.3.15 hemispheres, ventricles, cerebellum, brain stem, spinal K L2 L2 L2 L2
cord & meninges
Interpret the findings of plain X-Ray, arteriography, CT,
1.3.16
MRI & arteriography of head & neck
IS √ √
1.4 Thorax
1.4.1 Describe the structure of the thoracic wall K L2 L2 L2 L2
Describe course, relations & branches of ascending aorta,

1.4.2 K L2 L2 L2
arch & descending thoracic aorta
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Code ILO OSCE
Describe course, relations & tributaries of superior &
1.4.3 K L2 L2 L2 L2
inferior vena cava
Describe the anatomy of the thoracic cavity including
1.4.4 superior & inferior mediastinum, heart & pericardium, K L2 L2 L2 L2
lungs & pleurae, trachea & esophagus
Describe the development, relations, blood & nerve
1.4.5 K L2 L2 L2 L2
supplies of the diaphragm
Explain the development of heart, great vessels, fetal
1.4.6 K L2 L2 L2 L2
circulation & esophagus
1.4.7 Identify the dermatomes of the thorax K L3 L3 L3 L3
Identify the surface anatomy of heart, heart valves,
1.4.8 auscultation sites, lungs & pleurae & plane of sternal K L3 L3 L3 L3
angel
1.4.9 Interpret the findings of chest X-Ray, CT & MRI IS √ √
1.5 Abdomen, Pelvis & Perineum
1.5.1 branches of Aorta, common, external & internal iliac K L3 L3 L3 L3
arteries
1.5.2 K L3 L3 L3 L3
tributaries of common iliac veins & inferior vena cava
1.5.3 Define the preaortic & para aortic lymph nodes K L2 L2 L2 L2
1.5.4 Describe the anatomy of lumbar & sacral plexuses K L2 L2 L2 L2
Describe the origin, insertion, relations, nerve supply &
1.5.5 function of psoas major, quadratus lumborum, & anterior K L3 L3 L3 L3
abdominal wall muscles
1.5.6 Describe the structure & contents of the inguinal canal K L3 L3 L3 L3
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Code ILO OSCE
Discuss the anatomical location, relations, blood supply,
lymphatic drainage & nerve supply of: stomach,
duodenum, small bowel, large bowel, appendix, rectum,
anal canal, liver, gall bladder, biliary system, pancreas,
1.5.7 K L3 L3 L3 L3
spleen, adrenal glands, kidneys, ureters, urinary bladder,
seminal vesicles, prostate, uterus, uterine tubes, ovaries,
urethra, penis, scrotum, testis, epididymis, vagina &
vulva
1.5.8 Describe the peritoneal cavity & intra-abdominal spaces K L3 L3 L3 L3
Explain the development of foregut, midgut, hindgut, gut
1.5.9 rotation, anal canal, kidneys & ureters, bladder & K L2 L2 L2 L2
urethra, & testis
Identify the nine quadrants of the abdomen & the
1.5.10 different planes (subcostal - transpyloric - K L3 L3 L3 L3
transtubercular)
1.5.11 Identify the dermatomes of the abdomen K L3 L3 L3 L3
1.5.12 Explain the abdominal incisions of surgical interest K L3 L3 L3 L3

Interpret the imaging appearance of gastrointestinal,
1.5.13
biliary & urinary tracts
IS √ √
Interpret the imaging appearance of CT, MRI,
1.5.14
ultrasound & arteriography of the abdomen
IS √ √
25
May 2020
2- SURGICAL PHYSIOLOGY
Code ILO OSCE
2.1 General physiological principles
Discuss homeostasis & physiological response to
2.1.1 K L3 L3 L3 L3
stress
2.1.2 Discuss thermoregulation K L3 L3 L3 L3
Explain water & electrolyte balance, its disorders &
2.1.3 fluid replacement therapy (including colloid & K L3 L3 L3 L3
crystalloid solutions)
2.1.4 Explain acid base balance & its disorders K L3 L3 L3 L3
2.1.5 Discuss metabolic pathways K L3 L3 L3 L3
Define primary & secondary hemostasis, their
2.1.6 K L3 L3 L3 L3
disorders & fibrinolysis
Describe the metabolism in normal situation,
2.1.7 K L3 L3 L3 L3
starvation & hypercatabolic status
Assess malnutrition & indentify its sequelae, &
2.1.8 K L3 L3 L3 L3
discuss enteral & parenteral feeding
2.1.9 Discuss blood transfusion & blood products K L3 L3 L3 L3
2.2 Physiology of Respiratory system
2.2.1 Understand the central nervous control of ventilation K L3 L3 L3 L3
Understand the normal ventilatory cycle & the
2.2.2 K L3 L3 L3 L3
intermittent positive pressure ventilation
2.2.3 Identify causes of post operative respiratory failure K L3 L3 L3 L3
Describe the adult respiratory distress syndrome
2.2.4 K L3 L3 L3 L3
(ARDS)
26
May 2020

Code ILO OSCE
2.3 Physiology of Gastrointestinal tract
2.3.1 Describe the motility of pharynx & esophagus K L3 L3 L3 L3
2.3.2 Discuss gastric acid secretion K L3 L3 L3 L3
2.3.3 Describe gastro-duodenal motility K L3 L3 L3 L3
2.3.4 Discuss pancreatic secretion K L3 L3 L3 L3
2.3.5 Discuss bile secretion & enterohepatic circulation K L3 L3 L3 L3
2.3.6 Describe gall bladder motility K L3 L3 L3 L3
Explain the functions of the small bowel including
2.3.7 K L3 L3 L3 L3
digestion & absorption
2.3.8 Describe small bowel motility K L3 L3 L3 L3
2.3.9 Describe large bowel motility K L3 L3 L3 L3
2.3.10 Discuss the mechanism of anal continence K L3 L3 L3 L3
2.4 Physiology of Cardiovascular system
Understand cardiac pressure cycle & control of cardiac
2.4.1 K L3 L3 L3 L3
output
2.4.2 Explain blood pressure & its control mechanisms K L3 L3 L3 L3
2.4.3 Discuss hemorrhagic shock K L3 L3 L3 L3
2.5 Physiology of Endocrine system
Describe the functions of pituitary, adrenal. Thyroid &
2.5.1 K L3 L3 L3 L3
parathyroid glands
Explain calcium metabolism, calcium homeostasis &
2.5.2 K L3 L3 L3 L3
parathyroid hormone disorders
27
May 2020

Code ILO OSCE
2.5.3 Discuss thyroid hormones disorders K L3 L3 L3 L3
2.5.4 Discuss the origin & role of erythropoietin K L3 L3 L3 L3
Discuss the exocrine & endocrine functions of the
2.5.5 K L3 L3 L3 L3
pancreas
2.5.6 Discuss glucose homeostasis K L3 L3 L3 L3
2.6 Physiology of Renal system
Describe the function of the nephron, renal
2.6.1 K L3 L3 L3 L3
autoregulation & renin-angiotensin system
Discuss causes of poor urine output & types of renal
2.6.2 K L3 L3 L3 L3
failure
2.7 Physiology of central nervous system
2.7.1 Identify causes of postoperative confusion K L3 L3 L3 L3
2.7.2 Explain the physiology of space occupying lesion K L3 L3 L3 L3
2.7.3 Discuss cerebral autoregulation K L3 L3 L3 L3
28
May 2020
3- SURGICAL PATHOLOGY

Code ILO OSCE
3.1 Inflammation
3.1.1 Classify inflammation K L3 L3 L3 L3
Describe acute inflammation with an infective organism
3.1.2 as the primary agent, & microscopic & macroscopic K L3 L3 L3 L3
features
Describe chronic inflammation with an infective organism
as the primary agent, nonspecific & specific, microscopic
3.1.3 K L3 L3 L3 L3
& macroscopic features, mechanisms & local & systemic
effects
Discuss abscess, sinus & fistula, their definitions &
3.1.4 K L3 L3 L3 L3
complications
Discuss cellular injury other than infection: chemical,
3.1.5 physical & radiation injuries, & injury as a consequence K L3 L3 L3 L3
of genetic abnormalities
3.2 Wound healing
3.2.1 Explain the stages of wound healing K L3 L3 L3 L3
Discuss the types of wound healing (primary, secondary
3.2.2 K L3 L3 L3 L3
& tertiary)
3.2.3 Discuss general & local factors affecting wound healing K L3 L3 L3 L3
Discuss healing of central nervous system, fractures &
3.2.4 K L3 L3 L3 L3
pathological fractures
3.2.5 Discuss the management of different types of wounds K L3 L3 L3 L3
3.2.6 Discuss complications of wounds K L3 L3 L3 L3
Identify different types of suture materials & meshes used
3.2.7 K L3 L3 L3 L3
in surgical practice
3.2.8 Assess different types of wounds IS √ √ √
29
May 2020

Code ILO OSCE
3.2.9 Examine & deal with different types of wounds TS F5 F5 F5
3.3 Shock
Define shock, mention different types of shock & Discuss
3.3.1 the pathophysiology including the neuroendocrine K L3 L3 L3 L3
response to shock
Discuss the clinical picture & management of the
3.3.2 K L3 L3 L3 L3
different types of shock
3.3.3 Insert a central venous line TS F4
3.3.4 Introduce an endotracheal tube TS F4
3.3.5 Interpret blood gas reports IS √ √ √ √ √
Define hyperplasia, metaplasia, dysplasia, carcinoma in
3.4.1 K L3 L3 L3 L3
situ, & benign & malignant neoplasms
Classify tumors (carcinoma, sarcoma, blastoma, teratoma
3.4.2 K L3 L3 L3 L3
…..)
3.4.3 Discuss complications of benign tumors K L3 L3 L3 L3
3.4.4 Differentiate between benign & malignant neoplasms K L3 L3 L3 L3
Understand the behavior of cancer cell & the difference
3.4.5 between normal & distorted cell replication K L3 L3 L3 L3
(carcinogenesis)
Understand the molecular biology of cancer: cell cycle &
3.4.6 human genome, mechanisms of tumor genesis, K L1 L1
classification & uses of tumor markers
Describe the different methods of spread of malignant
3.4.7 K L3 L3 L3 L3
neoplasms
3.4.8 Discuss typing, grading & staging of cancer K L3 L3 L3 L3
30
May 2020

Code ILO OSCE
3.4.9 Discuss the etiology of malignant neoplasms K L3 L3 L3 L1
Discuss the different investigations used for the diagnosis
3.4.10 K L3 L3 L3 L3
of neoplasms
Discuss the different modalities for treating malignant
3.4.11 neoplasms (surgery - radiotherapy - chemotherapy - K L3 L3 L3 L3
hormonal therapy - immunotherapy …)
3.4.12 Diagnose all types of neoplasms IS √ √ √
Prescribe the appropriate investigations in cases of
3.4.13
neoplasms
IS √ √ √ √ √
3.4.14 Plan the appropriate treatment of neoplasms IS √ √ √ √
3.4.15 Discuss paraneoplastic syndromes K L3 L3 L3
3.4.16 Describe the different types of biopsies K L3 L3 L3 L3
3.4.17 Perform common types of biopsy TS F5
3.4.18 Perform surgical excision of benign tumors TS F5
3.4.19 Describe major surgical procedures for malignancy K L3 L3 L3 L3
Perform & assist in major surgical procedures for
3.4.20 TS F4
malignancy
Communicate bad news to patients/relatives in a proper
3.4.21
& ethical way
B √ √ √
Understand the epidemiology of common cancers &
3.4.22 K L2 L2
cancer registration
Discuss palliative care for pain & other symptoms &
3.4.23 K L2 L2
Identify the palliative care team
Discuss the screening programs for breast, cervical,
3.4.24 K L3 L3 L3
prostate & colorectal cancers
3.4.25 Discuss oncological emergencies
31
May 2020

Code ILO OSCE
3.5 Vascular disorders & surgical hematology
Discuss thrombosis, clot formation & hypercoagulable
3.5.1 K L3 L3 L3 L3
states
Describe the etiology of embolus formation & its
3.5.2 K L3 L3 L3 L3
complications
3.5.3 Describe atheroma K L3 L3
3.5.4 Discuss ischemia, infarction, aneurysms & varicosities K L3 L3 L3 L3
Discuss edema & ascites & differentiate between
3.5.5 K L3 L3 L3 L3
transudate & exudate
Discuss bleeding disorders including coagulation deficits,
3.5.6 K L3 L3
& the tests & complications of such conditions
3.5.7 Discuss hypercoagulable states K L3 L3
Describe risk factors, clinical picture, investigations,
3.5.8 K L3 L3 L3 L3
complications & treatment of deep vein thrombosis
Describe risk factors, pathophysiology, clinical picture,
3.5.9 K L3 L3 L3 L3
investigations & treatment of pulmonary embolism
Adjust the doses of anticoagulant therapy in case of deep
3.5.10
vein thrombosis & pulmonary embolism
IS √ √ √ √ √
3.5.11 Correct overdoses of anticoagulants IS √
Use Doppler ultrasound to examine the venous flow of
3.5.12 TS F4 F4
lower limbs & pelvis
Discuss blood transfusion: components of stored blood,
3.5.13 group-and-save & cross-matching, large volumes K L3 L3 L3 L3
transfusion, & alternatives to blood transfusion
32
May 2020

Code ILO OSCE
Discuss types, mechanism of action, indication, doses,
monitoring, overdoses & its management,
3.5.14 K L3 L3 L3 L3
contraindications & complications of
ANTICOAGULANTS & ANTIPLATLETS therapy.
3.6 Surgical infections & Antibiotics
Understand the pathophysiology & bacteriology of
3.6.1 K L3 L3 L3 L3
surgical infections & sepsis
Discuss endotoxins, exotoxins, immunization, commensals
3.6.2 K L3 L3 L3 L3
& nosocomial infection
Discuss acute non specific surgical infections (cellulitis -
3.6.3 boil - abscess - carbuncle - necrotizing fasciitis - K L3 L3 L3 L3
bacteremia - septicemia)
Discuss acute specific surgical infections (tetanus - gas
3.6.4 K L3 L3 L3 L3
gangrene)
Discuss chronic surgical infections (tuberculosis -
3.6.5 K L3 L3 L3
amoebiasis - filariasis - Bilharziasis)
3.6.6 Discuss disinfection & sterilization K L3 L3
Classify antibiotics & describe their mode of action &
3.6.7 K L3 L3 L3 L3
complications
3.6.8 Diagnose all types of surgical infections IS √ √ √ √ √
Drain an abscess, débride wounds & do amputation if
3.6.9 TS F5
necessary
3.7 Disorders of growth, differentiation & morphogenesis
Describe failure of growth: agenesis, aplasia, hypoplasia,
3.7.1 K L3 L3
atrophy, apoptosis & necrosis
Discuss overgrowth with normal cell differentiation:
3.7.2 hyperplasia, hypertrophy, metaplasia, hamartoma K L3 L3 L3 L3
formation
33
May 2020

Code ILO OSCE
Discuss growth & overgrowth with abnormal cell
3.7.3 K L3 L3
differentiation
Define amyloid disease & mention its causes, diagnosis &
3.7.4 K L2 L2
effects
3.7.5 Discuss hemosiderosis & hemochromatosis K L2 L2
Discuss calcification, & mention the causes of calculi
3.7.6 K L2 L2 L2 L2
formation & their complications
3.8 Surgical Immunology & Organ Transplantation
Discuss hypersensitivity reactions, immunoglobulins,
3.8.1 K L3 L3
chemotaxis & cytokines
Describe diseases mediated by immunological
3.8.2 mechanisms: Graves' disease, pernicious anemia & K L3 L3
rheumatoid arthritis
3.8.3 Discuss immunodeficiency K L3 L3
Understand transplantation immunology, major
3.8.4 K L3 L3
histocompatibility testing & rejection process
Discuss the principles of immunotherapy: steroids,
3.8.5 K L3 L3
cyclosporine, azathioprine ….
Mention the indications, technique & complications of
3.8.6 organ transplantation (kidney, liver, bone marrow, K L3 L3
pancreas & heart)
3.8.7 Discuss Graft-versus-host reaction K L3 L3
3.9.1 Discuss hypercalcemia K L3 L3
3.9.2 Discuss hyperuricemia K L3 L3
3.9.3 Discuss Plasma proteins, hepatic function & jaundice K L3 L3
34
May 2020
4- PRINCIPLES OF SURGERY

Code ILO OSCE
4.1 Perioperative Care
Discuss the preoperative assessment of fitness for surgery
4.1.1 K L3 L3 L3 L3
& risk scoring systems
Describe laboratory testing & imaging in assessment of
4.1.2 K L3 L3 L3 L3
fitness for surgery
Discuss the management of associated organ specific
4.1.3 K L2 L2
diseases
Discuss the management of associated issues related to
4.1.4 K L2 L2
medications
4.1.5 Discuss the management of associated general factors K L2 L2
4.1.6 Describe the informed consent before surgery K L3 L3
4.1.7 Explain the premedication in preparation for surgery K L3 L3 L3 L3
4.1.8 Discuss risk management in preparation for surgery K L2 L2
Understand the principles of general, local & regional
4.1.9 K L3 L3 L3
anesthesia
Discuss non-invasive & invasive monitoring of the
4.1.10 K L2 L2 L2
anaesthetized patient
Describe the positioning of patients in surgery and how to
4.1.11 K L3 L3 L3
avoid nerve injuries in patients under anesthesia
4.2 Postoperative management & Critical Care
Understand postoperative anesthesia management
4.2.1 (postoperative monitoring - ventilatory support - pain K L2 L2 L2
control - intravenous drug delivery)
35
May 2020

Code ILO OSCE
4.2.2 Discuss fluid & electrolyte balance K L3 L3
4.2.3 Discuss nutrition in the surgical patient K L3 L3 L3
4.2.4 Discuss general postoperative complications K L3 L3 L3 L3
Discuss postoperative respiratory failure & acute renal
4.2.5 K L3 L3 L3 L3
failure
Describe Systemic Inflammatory Response Syndrome &
4.2.6 K L3 L3 L2
Multiple Organ Dysfunction Syndrome
4.3 Surgical technique & technology
4.3.1 Discuss principles of safe surgery K L3 L3 L3
4.3.2 Discuss incisions & wound closure K L3 L3 L3
4.3.3 Explain the use of diathermy & laser in surgery K L3 L3 L3
4.3.4 Classify sutures & ligature materials K L3 L3 L3
4.3.5 Identify the basic surgical instruments K L3
4.3.6 Describe minor surgical procedures K L3 L3 L3
4.3.7 Understand day care surgery K L3 L3 L3
Discuss principles of anastomosis, endoscopic surgery &
4.3.8 K L3 L3 L3 L3
laparoscopy
Discuss indications, application, effects & complications
4.3.9 K L3 L3 L3
of tourniquet in the operating room
4.4 Management & legal issues in surgery
4.4.1 Discuss evidence based surgical practice K L3 L3
4.4.2 Define clinical audit & clinical governance K L3 L3
36
May 2020

Code ILO OSCE
4.4.3 Discuss medicolegal aspects of surgery K L3 L3 L3 L3
Understand the following communication skills subjects
(psychological effects of surgery - communication skills in
4.4.4
medicine & surgery - working in teams - breaking bad
IS √ √ √ √
news - dealing with conflict - management of crisis)
4.4.5 Discuss avoidance & management of errors K L2 L2
4.4.6 Discuss ethics & medical negligence K L2 L2 L2
4.5.1 Identify the sources of surgical infections K L3 L3 L3 L3
4.5.2 Understand principles of asepsis & antisepsis K L3 L3 L3 L3
4.5.3 Discuss surgery in Hepatitis & HIV carriers K L3 L3 L3
4.6 Emergency medicine & management of trauma
4.6.1 Understand pathophysiology of trauma K L3 L3 L3
4.6.2 Discuss initial assessment of trauma patient K L3 L3 L3
4.6.3 Discuss management of unconscious patient K L3 L3 L3
Discuss traumatic wounds (gunshot & blast injuries - stab
4.6.4 K L3 L3 L3
wounds - human & animal bites)
4.6.5 Discuss management of skin loss K L3 L3 L3 L3
understand pathogenesis, physiology, diagnosis &
4.6.6 K L3 L3 L3 L3
treatment of traumatic edema & compartment syndrome
Discuss environmental emergencies (hypothermia - heat
4.6.7 K L2 L2
exhaustion - radiation incident)
4.6.8 Describe acute loss of vision & causes of red eye K L2 L2
4.6.9 Discuss needle stick injuries K L3 L3
5- TRAUMATIC SURGICAL EMERGENCIES
37
May 2020

Code ILO OSCE
5.1 Discuss pathophysiology of trauma K L3 L3 L3
Describe assessment and resuscitation of the comatosed
5.2 K L3 L3 L3 L3
patient
5.3 Describe management of human & animal bites K L2 L2
Discuss environmental emergencies (hypothermia, heat
5.4 K L2 L2
exhaustion and radiation incident)
Describe the mechanism of traumatic injuries either
5.5 K L3 L3 L3
blunt ,penetrating or blast injuries
Discuss injuries of the head, face, neck, thoracic and
5.6 K L3 L3 L3
abdominal injuries
5.7 Discuss soft tissues, vascular and nerve injuries K L3 L3 L3
5.8 Describe prehospital care in case of traumatized patients K L3 L3 L3
Describe hospital care in traumatized patients
5.9 including(immediate care"ABCDE",initial hospital care K L3 L3 L3
,triage and major incidents
5.10. Define trauma safety scoring K L3 L3 L3
5.11 Describe primary and secondary surveys K L3 L3 L3
Discuss trauma in special situations (pediatric and
5.12 K L3 L3 L3
pregnancy)
5.13 Define post traumatic stress disorders K L3 L3 L3
Evaluate the necessary investigations needed in different
5.14
cases of trauma patient
IS √ √ √ √ √
Discuss the definitive treatment of different types of
5.15 K L3 L3 L3
trauma
38
May 2020

Code ILO OSCE
Describe how to introduce an endotracheal tube, perform
5.16 K L2 L2 L2
DPL & how to insert an intercostal tube
Introduce an endotracheal tube, perform DPL & insert
5.17 TS F5
an intercostal tube
Perform Exploratory laparotomy & repair injured
5.18 TS F4
vessels
39
May 2020
6- THE NECK

Code ILO OSCE
Identify the anatomy of the neck (triangles of the neck,
6.1 K L3 L3 L3 L3
fascia of the neck)
6.2 Enumerate congenital anomalies of the neck K L3 L3 L3 L3
6.3 Describe the levels of cervical lymph nodes. K L3 L3 L3 L3
Discuss etiology, pathology, clinical picture &
6.4 K L3 L3 L3 L3
management of branchial cyst & fistula
Discuss etiology, pathology, clinical picture and
6.5 K L3 L3 L3 L3
management of thyroglossal cyst and fistula
Discuss the etiology , pathology ,clinical picture and
6.6 K L3 L3 L3 L3
management of sternomastoid tumor
6.7 Discuss blunt and penetrating injuries of the neck K L3 L3 L3 L3
Differentiate cystic and solid swellings of different
6.8
triangles of the neck
IS √ √ √ √
Discuss etiology, pathology, clinical picture and
6.9 K L3 L3 L3 L3
management of thoracic outlet syndrome
Discuss indications, techniques & complications of
6.10. K L3 L3 L3
block neck dissection
6.11 Perform lymph node biopsy TS F5
6.12 Excise thyroglossal cyst and fistula TS F5
6.13 Excise branchial cyst and fistula TS F5
6.14 Excise cystic hygroma TS F4
40
May 2020
7- SALIVARY GLANDS

Code ILO OSCE
Describe the anatomy of the parotid, submandibular
7.1 K L3 L3 L3 L3
and sublingual salivary glands
Describe the anatomy of the infratemporal fossa and
7.2 its contents including maxillary artery and mandibular K L3 L3 L3
nerve
7.3 Discuss physiology of salivation K L3 L3
7.4 Enumerate the salivary gland disorders K L3 L3 L3 L3
7.5 Discuss salivary gland neoplasms. K L3 L3 L3 L3
7.6 Discuss inflammatory conditions of the salivary glands K L3 L3 L3 L3
7.7 Discuss calcular diseases of the salivary glands K L2 L3 L3 L3
7.8 Discuss sialectasis and its management K L3 L3 L3 L3
Describe parotidectomy & submandibular
7.9 K L3 L3 L3
sialadenectomy
7.10. Perform submandibular sialadenectomy TS F5
7.11 Perform parotidectomy operations TS F3
41
May 2020
8- BREAST
Code ILO OSCE
8.1 Describe embryology of the breast K L3 L3 L3
8.2 Describe anatomy of the breast K L3 L3 L3 L3
8.3 Discuss physiology of the breast K L3 L3
8.4 Assess clinical disorders of the breast. IS √ √ √ √ √
Explain etiology, pathology and treatment of
8.5 K L3 L3 L3 L3
gynecomastia
8.6 Discuss different investigations of the breast disorders K L3 L3 L3 L3
8.7 Discuss nipple abnormalities and discharges K L3 L3 L3 L3
8.8 Evaluate causes, types and management of mastalgia K L3 L3
8.9 Discuss inflammatory disorders of the breast K L3 L3 L3
Discuss the pathology, clinical picture and treatment of
8.10. K L3 L3 L3
duct ectasia.
8.11 Discuss clinical picture and treatment of ANDI. K L3 L3 L3 L3
Discuss the pathology, clinical picture and management
8.12 K L3 L3 L3 L3
of benign lesions of the breast.
Describe epidemiology, risk factors and genetics of
8.13 K L3 L3 L3 L3
breast cancer
Discuss the pathology of malignant neoplasms of the
8.14 K L3 L3 L3 L3
breast.
8.15 Describe clinical presentations of breast cancer K L3 L3 L3
8.16 Recognize different stages of breast cancer IS √ √ √ √
42
May 2020

Code ILO OSCE
8.17 Mention screening programs of breast cancer. K L3 L3 L3
Discuss management of breast cancer; surgical,
8.18 K L3 L3 L3
chemotherapy, radiotherapy and hormonal therapy
8.19 Perform drainage of breast abscess TS F5
8.20. Perform FNAC and true cut biopsy TS F5
8.21 Excise benign lesions of the breast TS F5
8.22 Perform different types of mastectomy. TS F5
8.23 Perform axillary node dissection TS F5
8.24 Discuss sentinel lymph node in breast cancer K L2 L2 L2 L2
Communicate with patient & relatives about breast
8.25
cancer
B √ √ √
43
May 2020
9- THE VASCULAR SYSTEM

Code ILO OSCE
9.1 Describe anatomy of the arterial and venous system K L2 L2 L2
Discuss etiology, clinical picture and management of
9.2 K L3 L3 L3 L3
common vascular injuries
9.3 K L3 L3 L3 L3
acute limb ischemia
9.4 K L3 L3 L3 L3
chronic limb ischemia
9.5 Explain diabetic foot problems and their management K L3 L3 L3 L3
9.6 K L3 L3 L3 L3
arterial aneurysms (aortic, popliteal,)
9.7 K L3 L3 L3
arteriovenous fistulae
Discuss etiology, pathology, clinical picture,
9.8 K L2 L2 L2
investigations & treatment of carotid artery disease
Discuss vasospastic disorders (Raynaud's disease &
9.9 K L2 L2 L2
phenomenon)
Explain etiology, clinical picture and management of
9.10. K L3 L3 L3
deep vein thrombosis
Explain etiology, clinical picture and management of
9.11 venous insufficiency (varicose veins and postphlebitic K L3 L3 L3 L3
limb)
Recognize endovascular diagnostic and therapeutic
9.12 K L3 L3
options
Evaluate cases of acute and chronic ischemia, analyze
9.13
clinical picture & criticize management
IS √ √ √
44
May 2020

Code ILO OSCE
9.14 Assess cases of arterial aneurysms IS √ √ √ √
9.15 Assess cases of arteriovenous fistulae IS √ √ √
9.16 Evaluate cases of varicose veins IS √ √ √
9.17 Perform vascular Doppler examination TS F5 F5 F5
9.18 Interpret vascular imaging studies IS √ √ √ √
9.19 Perform arterial embolectomy TS F3
9.20. Perform varicose veins surgery TS F5
9.21 Perform surgeries for diabetic foot infection TS F5
Perform surgeries for chronic limb ischemia and arterial
9.22 TS F3
aneurysms
45
May 2020
10- THE LYMPHATIC SYSTEM

Code ILO OSCE
Describe anatomy of cervical, axillary, inguinal,
10.1 K L3 L3 L3 L3
mediastinal, and abdominal lymph nodes
Describe etiology, clinical picture and management of
10.2 K L3 L3 L3 L3
acute lymphadenitis
10.3 K L3 L3 L3 L3
chronic lymphadenitis
10.4 K L3 L3 L3 L3
lymphedema
Describe pathology, etiology, clinical picture and
10.5 K L3 L3 L3 L3
management of lymphomas
Recognize etiology, clinical picture and management
10.6 K L3 L3 L3
of metastatic lymph node diseases
10.7 Examine cases of lymphatic diseases TS F5 F5 F5
10.8 Perform lymph node biopsy TS F5
10.9 Perform axillary lymph node dissection TS F4
10.10. Perform cervical lymph node block dissection TS F3
46
May 2020
11- PLASTIC SURGERY

Code ILO OSCE
Discuss skin grafts, skin flaps, myocutaneous flaps,
11.1 K L3 L3 L3
fasciocutaneous flaps, and microvascular skin flaps
11.2 Perform skin grafts and simple skin flaps TS F5
Explain etiology, pathology, clinical picture, and
11.3 K L3 L3 L3 L3
treatment of nerve injuries
Describe individual nerve injuries including cranial
11.4 nerves, brachial plexus, radial, ulnar, median, sciatic, K L3 L3 L3 L3
femoral and popliteal nerves
Recognize pathology, clinical picture and management
11.5 K L2 L2 L2
of nerve tumors
11.6 Explain indications and techniques of sympathectomy K L3 L3 L3 L3
11.7 Perform with assistance operations for nerve repair TS F3
Explain etiology, clinical picture, and treatment of
11.8 K L3 L3 L3 L3
carpal tunnel syndrome
Describe etiology, clinical picture, and treatment of
11.9 K L3 L3 L3 L3
Dupuytren's contracture
Describe etiology, clinical picture, and treatment of
11.10. K L3 L3 L3
Volkmann’s ischemic contracture
Define etiology, clinical picture, and treatment of soft
11.11 K L3 L3 L3 L3
tissue sarcomas
Perform surgeries for carpal tunnel, Dupuytren’s
11.12 TS F4
contracture and tendon repair
11.13 Describe development of the face and the palate K L3 L3 L3
Discuss congenital anomalies of the lip and the palate
11.14 K L3 L3 L3 L3
(Cleft lip, and cleft palate)
47
May 2020

Code ILO OSCE
Distinguish maxillofacial injuries (soft tissue and bony
11.15
fractures)
IS √ √ √ √
Describe pathology and treatment of carcinoma of the
11.16 K L3 L3 L3 L3
lip
Evaluate and decide how to deal with maxillofacial
11.17
injuries
IS √ √ √ √
11.18 Perform operations for cleft lip and cleft palate TS F3
Differentiate cysts of the floor of the mouth
11.19 K L3 L3 L3 L3
(sublingual, dermoid cysts, and ranula)
Identify the clinical picture and treatment of injuries of
11.20. K L3 L3 L3
the tongue
11.21 K L3 L3 L3 L3
of ulcers of the tongue
11.22 of precancerous lesions and carcinoma of the tongue & K L3 L3 L3 L3
oral cavity
11.23 K L3 L3 L3 L3
of carcinoma of the cheek
48
May 2020
12- SKIN AND SUBCUTANEOUS TISSUE

Code ILO OSCE
Differentiate cysts of skin and subcutaneous tissue (eg:
12.1 dermoid, sebaceous cysts) regarding etiology, clinical IS √ √ √ √ √
picture and treatment
Identify etiology, clinical picture and treatment of
benign skin and subcutaneous lesions (e.g.:
12.2 K L3 L3 L3 L3
hemangioma, lymphangioma, lipoma, benign
melanoma and neurofibromata)
Identify etiology, clinical picture and treatment of
malignant skin and subcutaneous lesions ( basal cell
12.3 K L3 L3 L3 L3
Ca, squamous cell Ca, malignant melanoma,
neurofibrosarcoma, and soft tissue sarcoma)
12.4 Perform excision biopsy for various skin lesions TS F5
Perform with assistance reconstruction for major skin
12.5 TS F3
defects
49
May 2020
13- BURNS

Code ILO OSCE
Identify the etiology of burns: scalds, flame burns,
13.1 K L3 L3 L3
electric burns, and chemical burns
13.2 Explain pathophysiology of burns K L3 L3
13.3 Classify burns according to surface area, and depth IS √ √ √ √
13.4 Recognize complications of burns (General, and local) K L3 L3 L3
Explain management of burns ( first aid,
13.5 K L3 L3 L3
resuscitative, nutritional support and local treatment)
Demonstrate how to assess surface area and depth of
13.6
burn
IS √ √ √ √
Calculate the necessary volume of fluids needed for
13.7
resuscitation and assess the adequacy of resuscitation
IS √ √ √ √
Demonstrate the principles of local management of
13.8
burns
IS √ √ √ √
13.9 Perform skin grafts TS F4
Perform with assistance various procedures of closure
13.10. TS F4
of skin defects
50
May 2020
14- ENDOCRINE SURGERY

Code ILO OSCE
14.1 Thyroid gland
Explain the synthesis and functions of thyroid
14.1.1 K L3 L3
hormones.
Discuss the pathology, clinical picture and treatment
14.1.2 K L3 L3
of thyroiditis (subacute and autoimmune)
Define the etiology and clinical picture of various
14.1.3 K L3 L3 L3 L3
types of simple enlargement of the thyroid gland
14.1.4 Enumerate the various causes of thyrotoxicosis. K L3 L3 L3 L3
Explain the clinical picture, investigations and
14.1.5 K L3 L3 L3 L3
different lines of treatment of thyrotoxicosis
Discuss the etiology, pathology, clinical picture,
14.1.6 investigations and treatment of neoplasms of the K L3 L3 L3 L3
thyroid gland.
14.1.7 Explain the management of a solitary thyroid nodule K L3 L3 L3 L3
14.1.8 Perform thyroidectomy operations. TS F4
14.1.9 Enumerate Indications for surgery in thyroid disease K L3 L3
14.1.10 Mention Complications of thyroidectomy K L2 L3 L3 L3
Discuss the clinical picture and treatment of
14.1.11 K L3 L3 L3
hypothyroidism
14.2 Parathyroid glands:
14.2.1 Discuss the metabolism of calcium. K L3 L3
51
May 2020

Code ILO OSCE
14.2.2 Enumerate various causes of hypercalcemia. K L3 L3
14.2.3 Discuss the clinical picture of hypercalcemia K L3 L3
Discuss the etiology, clinical picture, investigations and
14.2.4 K L3 L3 L3 L3
treatment of hyperparathyroidism
14.2.5 Perform operations for the parathyroid gland TS F3
14.3 Adrenal Gland:
14.3.1 Explain the functions of the adrenal cortex and medulla K L3 L3
Discuss the clinical picture, investigations and
14.3.2 treatment of Conn's syndrome, Cushing's syndrome, K L3 L3 L3 L3
adrenogenital syndrome and Pheochromocytoma
Assess the preoperative preparation of patients with
14.3.3
pheochromocytoma
IS √ √ √ √ √
14.3.4 Perform adrenalectomy operation TS F2
14.4 Endocrine disorders of the pancreas:
Discuss the clinical picture and investigations of
14.4.1 K L3 L3
insulinoma and gastrinoma
14.5 Carcinoid syndrome
14.5.1 Discuss Carcinoid syndrome K L2 L2 L2
14.6 Multiple endocrine neoplasia
14.6.1 Discuss multiple endocrine neoplasia K L3 L3
52
May 2020
15- CARDIOTHORACIC SURGERY

Code ILO OSCE
Discuss the etiology, clinical picture and treatment of
thoracic injuries including rib fractures, flail chest,
15.1 K L3 L3 L3
hemothorax, pneumothorax, cardiac injuries & cardiac
tamponade
Explain surgical disorders of the heart vessels and
15.2 K L2 L2
heart valves
15.3 Explain the principle of cardiopulmonary bypass K L2 L2
Discuss the etiology, pathology, clinical picture and
15.4 K L3 L3 L3
treatment of cancer of the lung & pleura
15.5 K L2 L2 L2
empyema
15.6 Enumerate the indications for thoracotomy K L1 L1
Perform pleural aspiration, insertion of an intercostal
15.7 TS F4
tube and pericardiocentesis
15.8 Perform a thoracotomy TS F2
Define the general and specific complications of
15.9 K L2 L2
thoracic operations
post-operative respiratory complications including
15.10. K L3 L3 L3
atelectasis, bronchopneumonia, pulmonary embolism
and ARDS
Explain the etiology, diagnosis and treatment of cardiac
15.11 K L3 L3 L3
arrest
53
May 2020
16- NEUROSURGERY, SCALP, SKULL & BRAIN

Code ILO OSCE
16.1 Discuss the types of scalp injuries and hematomas K L3 L3 L3
Explain the etiology, clinical picture and treatment of
16.2 K L3 L3 L3
fractures of the vault and base of the skull
treatment of brain concussion, acute extradural
16.3 K L3 L3 L3
hematoma, subdural hematoma, subarachnoid
hemorrhage and intracerebral hemorrhage
Apply the Glasgow coma scale for neurological
16.4
evaluation
IS √ √ √ √
Enumerate and explain the complications of head
16.5 K L3 L3
injuries
16.6 K L3 L3 L3
hydrocephalus in children and adults
Explain the etiology, pathology, investigations and
16.7 K L3 L3
treatment of brain abscess and meningitis
16.8 K L3 L3
intracranial tumors
Explain the etiology and clinical picture of congenital
16.9 K L2 L2
cerebral aneurysms & vascular malformations
Mention the diagnosis and testing for brain stem death
16.10. K L3 L3
and the principles of organ donation
54
May 2020
17- PHARYNX AND OESOPHGUS

Code ILO OSCE
17.1 injuries of the pharynx and oesophagus including K L3 L3 L3
corrosive injuries
treatment of neuromuscular problems of the pharynx
17.2 K L3 L3 L3 L3
and oesophagus including pharyngeal diverticulum and
achalasia of the cardia
17.3 investigations and treatment of neoplasms of the K L3 L3 L3 L3
pharynx and oesophagus
Explain the etiology, clinical picture, investigations and
17.4 K L3 L3 L3 L3
treatment of sliding and paraesophageal hernias
17.5 Observe esophagoscopy TS F1
17.6 Assist in operations of the pharynx and oesophagus TS F2
55
May 2020
18- STOMACH AND DUODENUM

Code ILO OSCE
Discuss the etiology, clinical picture & treatment of acute
18.1 K L3 L3 L3
peptic ulcers & stress ulcers
18.2 K L3 L3 L3 L3
treatment of chronic peptic ulcer
Explain the complications of peptic ulcer disease
18.3 K L3 L3 L3 L3
(perforation, hemorrhage and obstruction)
18.4 K L3 L3 L3 L3
investigations and treatment of gastric neoplasms
18.5 Perform vagotomy operation TS F4
18.6 Perform surgery for perforated or bleeding peptic ulcer TS F5
18.7 Assist in gastrectomy operation TS F3
56
May 2020
19- HEPATOBILIARY

Code ILO OSCE
19.1 Define congenital malformations of the biliary apparatus K L3 L3 L3 L3
Discuss the etiology, types, clinical picture, investigations and
19.2 K L3 L3 L3
treatment of liver injuries
19.3 K L3 L3 L3 L3
treatment of inflammatory problems of the liver
Discuss the etiology, clinical picture, investigations & treatment
19.4 K L3 L3 L3 L3
of Pyogenic liver abscess
Discuss the etiology, clinical picture, investigations & treatment
19.5 K L3 L3 L3 L3
of Amoebic liver abscess
19.6 K L3 L3 L3 L3
treatment of Hydatid cyst
Explain the etiology, types, complications and treatment of
19.7 K L3 L3 L3 L3
gallstones
Discuss the etiology, pathology, sequelae and management of
19.8 K L3 L3 L3 L3
liver cirrhosis
19.9 K L3 L3 L3 L3
treatment of jaundice
Define the etiology, clinical picture and treatment of biliary
19.10. K L3 L3 L3 L3
stricture
Discuss the etiology, pathology, clinical picture, investigations
19.11 & treatment of benign & malignant neoplasms of the liver & K L3 L3 L3 L3
biliary system
57
May 2020

Code ILO OSCE
Interpret the results of liver functions and radiological
19.12 investigations including ultrasound, CT, ERCP, MRCP and IS √ √ √
PTC
19.13 Aspirate a liver abscess TS F2
19.14 Perform an open or laparoscopic cholecystectomy TS F4

Assist in operations for exploration of common bile duct and
19.15 TS F3
liver resection
58
May 2020
20- THE PANCREAS

Code ILO OSCE
20.1 K L3 L3 L3 L3
investigations of acute pancreatitis
Discuss the etiology, clinical picture, investigations
20.2 K L3 L3 L3 L3
and treatment of chronic pancreatitis
20.3 treatment of benign and malignant neoplasms of the K L3 L3 L3 L3
pancreas
Explain the clinical picture, investigations and
20.4 treatment of functional tumors of the pancreas K L3 L3 L3 L3
(gastrinoma, insulinoma)
Distinguish the clinical picture of acute pancreatitis
20.5
and assess the severity of the case
IS √ √ √ √
Assist in operations for acute pancreatitis and
20.6 TS F2
pancreatic neoplasms
59
May 2020
21- THE PERITONEUM, OMENTUM AND MESENTRY

Code ILO OSCE
21.1 K L3 L3 L3 L3
treatment of acute septic peritonitis
Explain the etiology, clinical picture, investigations of
21.2 K L3 L3 L3 L3
an intraperitoneal abscess (pelvic, subphrenic)
Discuss the clinical picture and management of
21.3 K L3 L3 L3
tuberculous peritonitis
Define the etiology, investigations and treatment of
21.4 K L3 L3 L3
ascites
21.5 mesenteric cysts and non-specific mesenteric K L3 L3 L3 L3
lymphadenitis
Discuss the pathology, clinical picture, investigations
21.6 K L3 L3 L3 L3
and treatment of retroperitoneal sarcoma
21.7 Aspirate ascites TS F5
Operate upon a patient with generalized peritonitis and
21.8 TS F4
manage the cause.
Understand & attend ultrasound guided aspiration of
21.9 TS F1
an intra-peritoneal abscess
60
May 2020
22- THE SPLEEN

Code ILO OSCE
Discuss the etiology, clinical picture, investigations of
22.1 K L3 L3 L3
splenic injuries
Classify infections of the spleen (Viral, Bacterial,
22.2 K L3 L3 L3
Protozoal and Parasitic)
Classify causes of splenic enlargement and discuss the
22.3 K L3 L3 L3 L3
clinical picture, investigations and treatment
22.4 Perform splenectomy TS F4
Know prophylaxis and treatment of post-splenectomy
22.5 K L3 L3 L3
sepsis
61
May 2020
23- SMALL AND LAREG INTESTINE

Code ILO OSCE
23.1 K L3 L3 L3
injuries of the intestines
Explain the etiology, clinical picture, investigations &
23.2 K L3 L3 L3 L3
treatment of intestinal obstruction
23.3 investigations and treatment of inflammatory bowel disease K L3 L3 L3 L3
(Crohn's disease, and Ulcerative colitis)
23.4 K L3 L3 L3 L3
intestinal fistulae
Explain the etiology, clinical picture and treatment of acute
23.5 K L3 L3 L3
and chronic intestinal ischemia
Discuss the etiology, clinical picture, and treatment of
23.6 K L3 L3 L3 L3
diverticular disease of the colon
Discuss the etiology, pathology, clinical picture, staging
23.7 investigations and treatment of neoplasms of the small and K L3 L3 L3 L3
large intestines
23.8 Discuss intestinal complications of irradiation K L1 L1
Discuss etiology, clinical picture & management of short
23.9 K L1 L1
bowel syndrome
Discuss the indications and management of gastrointestinal
23.10 K L3 L3 L3 L3
stomas (gastrostomy – Ileostomy – Colostomy)
23.11 Assess patients with intestinal obstruction IS √ √ √ √ √
Perform an exploration for intestinal obstruction and deal
23.12 TS F4
with the cause
Assist in operations for intestinal ischemia and colorectal
23.13 TS F4
malignancy
Discuss the classification, etiology and complications of
23.14 K L3 L3 L3
colonic polyps
62
May 2020
24- THE APPENDIX

Code ILO OSCE
Enumerate the various anatomical positions of the
24.1 K L2 L2 l2
appendix
24.2 K L3 L3 L3 L3
investigations and treatment of acute appendicitis
24.3 Explain the complications of acute appendicitis K L2 L2 L2
24.4 Assess the differential diagnosis of lower abdominal pain IS √ √ √ √
Perform appendectomy operation and deal with the
24.5 TS F5
possible post-operative complications
Discuss the etiology, pathology, clinical picture, staging
24.6 investigations and treatment of neoplasms of the K L3 L3 L3 L3
appendix
25- THE ANAL CANAL

Code ILO OSCE
Discuss the etiology, clinical picture, complications and
treatment of hemorrhoids, anal fissure, anorectal
25.1 K L3 L3 L3
suppuration, perianal fistulae, pilonidal sinus, and anal
carcinoma
Perform operations for hemorrhoids, anal fissure,
25.2 TS F5
perianal abscess, perianal fistula, and pilonidal sinus
25.3 Discuss etiology & management of rectal prolapsed K L2 L2 L2 L2
25.4 Explain etiology & management of fecal incontinence K L2 L2 L2 L2
25.5 Mention sexually transmitted anorectal diseases K L2 L2 L2 L2
63
May 2020
26- ABDOMINAL WALL AND HERNIAS

Code ILO OSCE
Discuss the complications liable to occur in abdominal
26.1 K L3 L3 L3 L3
incisions
26.2 inguinal, umbilical, para-umbilical, femoral and K L3 L3 L3 L3
incisional hernias
26.3 Assess patients with complicated hernias TS F5 F5 F5
Perform operations for inguinal, umbilical, para-
26.4 TS F4
umbilical and femoral hernias
26.5 Perform operations for incisional hernia TS F4
27- PEDIATRIC SURGERY

Code ILO OSCE
Explain the physiological considerations in infants and
27.1 K L2 L2
children regarding Maintenance of body temperature.
27.2 children regarding Assessment of respiratory and K L2 L2
cardiovascular function
27.3 K L2 L2
children regarding Fluid and electrolytes.
Explain the physiological considerations in infants &
27.4 K L2 L2
children regarding Metabolic response
64
May 2020

Code ILO OSCE

correctable congenital abnormalities including: esophageal
atresia, intestinal atresia, , anorectal anomalies,
27.5 K L3 L3 L3
Hirschsprung ‘s disease, abdominal wall defects,
diaphragmatic hernias, neural tube defects and urological
abnormalities
Explain the etiology, clinical picture and treatment of
27.6 congenital hypertrophic pyloric stenosis and infantile K L2 L2 L2
intussusceptions
27.7 inguinal hernia, hydrocele, undescended testes and torsion K L3 L3 L3
of the testis
27.8 Discuss disorders of the hip, knee and foot joints K L2 L2 L2
27.9 Assess the fluid and electrolyte balance of infants IS √ √
27.10 Expect intestinal obstruction in newly borne IS √ √ √
Assist in operations for congenital hypertrophic pyloric
27.11 TS F2
stenosis & neonatal intestinal obstruction
27.12 K L3 L3 L3
neoplasms which occur in infants and children
65
May 2020
28- ACUTE ABDOMEN

Code ILO OSCE
Enumerate and discuss the various causes of acute
28.1 K L3 L3 L3
abdomen
Assess the various laboratory and radiological
28.2 investigations utilized for the diagnosis of acute IS √ √ √ √
abdomen
29- SURGICAL UROLOGY

Code ILO OSCE
Explain the embryological development of the urinary
29.1 K L1 L1 L1
system
29.2 Mention symptoms & signs of urinary tract disorders K L1 L1 L1
Discuss different tools of investigations of the urinary
29.3 K L3 L3 L3
tract disorders
Discuss Congenital anomalies of the kidney, bladder &
29.4 K L3 L3 L3 L3
urethra
29.5 Discuss hypospadias and epispadias K L3 L3 L3 L3
Discuss injuries of the kidney, ureter ,urinary bladder
29.6 and urethra etiology, clinical presentation, K L3 L3 L3
investigations and treatment
Discuss acute inflammatory problems of the urogenital
29.7 K L3 L3
system
29.8 Discuss bilharziasis of the urinary bladder K L3 L3
66
May 2020

Code ILO OSCE
Discuss obstructive uropathy: etiology pathology,
29.9 K L3 L3 L3 L3
clinical presentation, investigations and treatment
Discuss etiology, pathology, clinical presentations and
29.10. K L3 L3 L3 L3
management of urinary tract stones
29.11 Discuss stricture of the ureter and urethra K L2 L2 L2
29.12 Discuss benign prostatic hyperplasia K L3 L3 L3
29.13 Explain idiopathic retroperitoneal fibrosis K L3 L3 L3 L3
29.14 Discuss neoplasms of the kidney K L3 L3 L3 L3
Discuss pathology, clinical pictures, investigations,
29.15 K L3 L3 L3 L3
screening & treatment of prostatic carcinoma
29.16 Describe bladder diverticula K L3 L3 L3
29.17 Discuss acute and chronic urine retention K L3 L3
29.18 Discuss bladder dysfunction and incontinence K L3 L3
Enumerate causes of hematuria & discuss the
29.19 K L2 L2 L2
management
67
May 2020
30- TESTIS AND SCROTUM

Code ILO OSCE
30.1 Discuss congenital anomalies of the testis K L3 L3 L3 L3
Discuss torsion of the testis; etiology, clinical picture,
30.2 K L3 L3 L3 L3
investigations and treatment
Describe inflammatory conditions, acute non specific
30.3 epidydmoorchitis, & filariasis, tuberculosis and K L3 L3 L3
bilharziasis of the cord and testicle.
30.4 Discuss Inflammation of the prepuce & penis K L1 L1 L1 L1
30.5 Discuss neoplasms of the testis K L3 L3 L3 L3

30.6 Discuss carcinoma of penis & scrotum K L1 L1 L1 L1
Discuss etiology, pathology, clinical picture
30.7 K L3 L3 L3 L3
investigations and treatment of hydrocele
Discuss etiology, clinical picture, investigations and
30.8 K L3 L3 L3 L3
treatment of varicocele
30.9 Explain principles of renal transplantation K L2 L2
Discuss etiology, clinical picture & management of
30.10. K L2 L2 L2 L2
torsion of the testis
30.11 Perform operation for torsion testis TS F5
30.12 Perform operations for hydrocele TS F5
30.13 Perform operation for varicocele TS F5
30.14 Perform ureterolithotomy and cystolithotomy TS F3
30.15 Perform orchidectomy TS F4
30.16 Perform cystoscopy TS F3
68
May 2020

Code ILO OSCE
30.17 Discuss Extracorporeal Shock Wave lithotripsy K L2 L2
30.18 Perform percutaneous nephrolithotomy TS F2
30.19 Explain operations for undescended testis K L3 L3 L3 L3
30.20. Explain nephrolithotomy K L3 L1
30.21 Discuss types of prostatectomy K L2 L2 L2
30.22 Discuss cystectomy K L2 L2 L2
69
May 2020
31- ORTHOPEDIC SURGERY

Code ILO OSCE
31.1 Discuss pathophysiology of fracture healing K L3 L3
31.2 Enumerate classification of fractures K L3 L3 L3
31.3 Describe principles of management of fractures K L2 L2 L3
31.4 Discuss general & local complications of fractures K L3 L3 L3
31.5 Discuss management of joint injuries K L2 L2
31.6 Discuss fracture of the clavicle K L2 L2 L2
31.7 Discuss shoulder dislocation K L3 L3 L3
31.8 Discuss humeral, radial and ulnar shaft fractures K L2 L2 L2
Discuss fractures of neck of humerus (conservative and
31.9 K L2 L2 L2
operative)
31.10. Describe internal fixation of olecranon fracture K L2 L2
Discuss management of supracondylar fracture of
31.11 K L2 L2 L2
elbow
31.12 Describe aspiration of elbow K L2 L2
31.13 Recognize scaphoid fracture IS √ √ √ √
31.14 Describe pharyngeal fractures K L3 L3 L3
31.15 Discuss femoral, tibial and fibula shaft fractures K L2 L2 L2
31.16 Describe dislocated hip K L2 L2 L2
Discuss fractures of neck of femur including fixation

31.17 K L2 L2 L2
and hip replacement
70
May 2020

Code ILO OSCE
31.18 Recognize tibial plateau fractures IS √ √ √
31.19 Describe aspiration of knee K L3 L3
Discuss common fractures and joint injuries: trunk,
31.20. K L2 L2 L2
pelvis and vertebral column
Describe disorders of the hand ,including trigger finger,
31.21 ganglion, carpal tunnel syndrome and Dupuytren’s K L3 L3
disease
31.22 Discuss disorders of the foot K L3 L3 L3
31.23 Discuss osteomyelitis K L3 L3 L3 L3
31.24 Describe other bone infections K L3 L3
31.25 Evaluate low back pain and sciatica IS √ √ √
31.26 Evaluate pain in the neck and upper limb IS √ √ √
31.27 Discuss tuberculosis of the joints K L3 L3
31.28 Describe generalized disorders of bones and joints K L3 L3 L3
31.29 Discuss osteoporosis K L3 L3 L3
31.3o. Discuss rickets and osteomalacia K L3 L3
31.31 Discuss osteoarthrosis K L3 L3
31.32 Discuss rheumatoid arthritis K L3 L3
31.33 Discuss gout K L3 L3 L3
31.34 Describe Charcot osteoarthritis K L3 L3 L3
Discuss etiology, pathology, clinical pictures,
31.35 investigations and treatment of benign and malignant K L3 L3 L3 L3
tumors of bones
71
May 2020

Code ILO OSCE
Discuss indications, techniques and complications of
31.36 K L2 L2 L2
amputation of the upper and lower limb
31.37 Discuss pathological fractures K L2 L2 L2
31.38 Discuss traumatic edema and compartmental syndrome K L2 L2
Interpret imaging techniques, MRI, CT, Bone scan &
31.39
Ultrasonography
IS √ √ √ √ √
31.40. Discuss neuro physiological investigations K L2 L2
32- THE SPINE AND SPINAL CORD

Code ILO OSCE
Describe congenital anomalies of the spine and the
32.1 K L3 L3 L3 L3
spinal cord
32.2 Discuss fracture and dislocation of the spine K L3 L3 L3
Discuss etiology & management of traumatic
32.3 K L2 L2 L2
paraplegia
32.4 Discuss tuberculosis of the spine K L3 L3 L3
32.5 Describe intervertebral disc prolapse K L3 L3 L3
32.6 Discuss tumors of the spine K L3 L3 L3
32.7 Describe internal fixation of the spine K L3 L3 L3
32.8 Discuss neck & low back pain K L2 L2 L2
72
May 2020
33- HISTORY TAKING & PHYSICAL EXAMINATIONS

Code ILO Level 1st Part 2nd Part
OSCE
Case Assessment
Take history of the different surgical conditions

(thyroid - breast - abdomen - peripheral vascular -
varicose veins - lymphatics - neurological -
33.1 TS F5 F5 F5
urological …) that includes; personal history,
complaint, history of the present illness, past
history & family history
33.2 Perform general examination TS F5 F5 F5
33.3 Perform relevant local examination TS F5 F5 F5
34- Surgical Radiology

Code ILO OSCE
Demonstrate knowledge, clinical and technical skills

and decision-making capabilities with respect to K
34.1
diagnostic imaging pertinent of the practice of IS √ √ √
General Surgery
Understand and appreciate the role of the radiologist
34.2 as a member of an interprofessional healthcare team K √
in the practice of general surgery
Describe the role of interventional radiology in the
34.3
practice of general surgery
TS √ √
73
May 2020
CURRICULUM CONTENTS
74
May 2020
Curriculum Contents
1. Applied Surgical Anatomy

o Upper limb
o Lower limb
o Head, neck and spine
o Thorax
o Abdomen, pelvis and perineum
2. Surgical Physiology
o General physiological principles
o Physiology of the respiratory system
o Physiology of the GIT
o Physiology f the CVS
o Physiology of endocrine system
o Physiology of the renal system
3. Surgical Pathology
o Inflammation
o Wound healing
o Shock
o Surgical oncology
o Vascular disorders and surgical hematology
o Surgical infections and antibiotics
o Disorders of growth and differentiation
o Surgical immunology and organ transplantation
o Surgical biochemistry
4. Principles of surgery
o Peri-operative care
o Postoperative management
o Surgical technique and technology
o Management of legal issues in surgery
o Clinical microbiology
5. Surgical Trauma
6. The Neck
7. The Salivary Glands
8. The Breast
9. The Vascular System
10. The Lymphatic System
11. Plastic Surgery
12. Skin and Subcutaneous Tissues
13. Burns
14. Endocrine Surgery
15. Cardiothoracic Surgery
16. Neurosurgery
17. The Pharynx and Esophagus
18. The Stomach and Duodenum
19. The Hepatobiliary Surgery
20. The Pancreas
21. The Peritoneum, Omentum and Mesentery
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22. The Spleen

23. The Small and Large Intestines
24. The Appendix
25. The Anal Canal
26. Abdominal Wall and Hernia
27. Pediatric Surgery
28. Abdominal Trauma and Acute Abdomen
29. Surgical Urology
30. The Testis and Scrotum
31. Orthopedic Surgery
32. The Spine and Spinal Cord
33. Surgical Radiology
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1. APPLIED SURGICAL ANATOMY
▪ Knowledge of arteries and veins entails description of the course, relations, branches,
collateral circulation and surface anatomy of the individual vessel.
▪ Knowledge of nerves entails description of the course, relations and branches of the
individual nerves. The motor and sensory supply of each nerve is studied.
▪ Knowledge of muscles entails description of the origin, insertion, nerve supply and
actions of the individual muscle.
1.1 Upper Limb

▪ Arteries: Subclavian, axillary, branchial, radial, ulnar arteries and collateral circulation.
▪ Veins: Cephalic, basilic, brachial, axillary and subclavian veins.
▪ Nerves: The brachial plexus, musculocutaneous, radial, ulnar, median and circumflex
nerves.
▪ Axillary lymph nodes.
▪ Muscles of the upper limb.
▪ Bones of the pectoral girdle, arm, forearm and hands.
▪ Anatomy of cubital fossa.
▪ Plain x-ray, arteriography and venography of the upper limb bones and vessels.
▪ Dermatomes of the upper limb.
1.2 Lower Limb

▪ Arteries: Femoral, popliteal, anterior tibial, posterior tibial, peroneal and dorsalis pedis
arteries.
▪ Veins: Long and short saphenous, popliteal and femoral veins.
▪ Nerves: Femoral, obturator, sciatic, common peroneal, superficial peroneal, deep peroneal
and tibial nerves.
▪ Inguinal lymph nodes.
▪ Muscles of the lower limb.
▪ The anatomy of the femoral triangle and adductor canal.
▪ The popliteal fossa.
▪ The bones of the thigh leg and foot.
▪ The dermatomes and tendon reflexes of the lower limb.
▪ Plain x-ray, arteriography and venography of lower limb bones and vessels.
1.3 Head, Neck and Spine

▪ Arteries: Common, external and internal carotid and middle meningeal arteries.
▪ Veins: Anterior, external and internal jugular veins.
▪ Nerves: Cranial nerves and cervical plexus.
▪ The anatomy and levels of cervical lymph nodes.
▪ Muscles of the head and neck.
▪ The anatomy of the triangles of the neck.
▪ The anatomical position, relations and blood and nerve supply of salivary glands.
▪ The anatomical position, relations and blood and nerve supply of thyroid and parathyroid
glands.
▪ The relations and blood and nerve supply of the larynx, trachea, pharynx and esophagus.
▪ Contents and relations of the carotid sheath.
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▪ The anatomy of the skull, mandible, temporo-mandibular joint, vertebral column &
vertebral canal.
▪ The anatomy of the eye, orbit, ear, nose and paranasal sinuses.
▪ The anatomy of the mouth and tongue.
▪ The anatomy of the cranial cavity, dural sinuses and pituitary gland.
▪ The development of branchial arches, face, palate, thyroid, parathyroid glands and the
spine.
▪ The anatomical structure of the cerebral hemispheres, ventricles, cerebellum, brain stem,
spinal cord and meninges.
▪ The findings of plain x-ray, arteriography, CT, MRI and arteriography of head and neck.
1.4 Thorax
▪ The structure of the thoracic wall.
▪ Arteries: Ascending aorta, arch of the aorta and descending thoracic aorta.
▪ Veins: Superior and inferior vena cava.
▪ The anatomy of the thoracic cavity including superior, inferior mediastinum, heart,
pericardium, lungs, pleurae, trachea and esophagus.
▪ The development, relations, blood and nerve supply of the diaphragm.
▪ The development of heart, great vessels and esophagus.
▪ Fetal circulation.
▪ The dermatomes of the thorax.
▪ The surface anatomy of hear, heart valves, auscultation sites, lungs and pleurae.
▪ The findings of chest x-ray, CT and MRI of the chest.
1.5 Abdomen, Pelvis and Perineum

▪ Arteries: Abdominal aorta and common, external and internal iliac arteries.
▪ Veins: Iliac veins and inferior vena cava.
▪ The intra-abdominal lymph nodes.
▪ Nerves: The lumbar and sacral plexuses.
▪ Muscles: Anterior abdominal wall muscles, psoas major and quadratus lumborum.
▪ The structure and contents of the inguinal canal.
▪ The anatomical location, relations, blood supply, lymphatic drainage and nerve supply of
the abdominal viscera.
▪ The anatomy of the peritoneal cavity and intra-abdominal spaces.
▪ The development of the abdominal viscera.
▪ Quadrants of the abdomen and the different planes.
▪ The dermatomes of the abdomen.
▪ The abdominal incisions of surgical interest.
▪ The imaging appearance of gastrointestinal, biliary and urinary tracts.
▪ Imaging appearance of CT, MRI, ultrasound and arteriography of the abdomen.
2. SURGICAL PHYSIOLOGY
2.1 General Physiological Principles

▪ Homeostasis and physiological response to stress.
▪ Thermoregulation.
▪ Water and electrolyte balance.
▪ Acid base balance.
▪ Metabolic pathways.
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▪ Primary and secondary hemostasis.

▪ Enteral and parenteral nutrition.
▪ The metabolism in normal situation, starvation and hypercatabolic status.
▪ Nutrition and its disorders.
▪ Transfusion of blood and its products.
2.2 Physiology of Respiratory System
▪ The central nervous control of ventilation.
▪ The normal ventilatory cycle and the intermittent positive pressure ventilation.
▪ Causes of postoperative respiratory failure.
▪ Adult respiratory distress syndrome (ARDS).
2.3 Physiology of Gastrointestinal Tract
▪ Motility of the pharynx and esophagus.
▪ Gastric acid secretion.
▪ Gastroduodenal motility.
▪ Pancreatic secretion.
▪ Bile secretion and entero-hepatic circulation.
▪ Gallbladder motility.
▪ The functions of the small bowel including digestion and absorption.
▪ Motility of the small bowel.
▪ Motility of the large bowel.
▪ The mechanism of anal continence.
2.4 Physiology of the Cardiovascular System

▪ Cardiac pressure cycle and control of cardiac output.
▪ Blood pressure and its control mechanisms.
▪ Hemorrhagic shock: Etiology, neuroendocrine response, and clinical picture.
2.5 Physiology of the Endocrine System

▪ The functions of pituitary, adrenal, thyroid and parathyroid glands.
▪ Calcium metabolism.
▪ The origin and role of erythropoietin.
▪ The exocrine and endocrine functions of the pancreas.
▪ Glucose homeostasis.
2.6 Physiology of Renal System

▪ The function of the nephron, renal autoregulation and renin-angiotensin system.
▪ Causes of poor urine output and types of renal failure.
2.7 Physiology of the Central Nervous System:

▪ Causes of postoperative confusion.
▪ The physiology of space occupying lesion.
▪ Cerebral autoregulation.
3. SURGICAL PATHOLOGY
3.1 Inflammation
3.2 Wound Healing
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▪ Stages of wound healing.

▪ Types of wound healing: Primary, secondary and tertiary.
▪ Classification of surgical wounds.
▪ Factors affecting wound healing: General and local.
▪ Healing in specialized tissues: Central nervous system, gastrointestinal tract and fractures.
▪ Management of wounds.
▪ Complications of wounds.
▪ Suture materials and meshes used in surgical practice.
3.3 Shock
▪ Definition of shock.
▪ Pathophysiology of different types of shock: Hypovolemic neurogenic, cardiogenic,
anaphylactic and septic.
▪ Clinical picture and management of different types of shock.

▪ Definition of hyperplasia, metaplasia, dysplasia and carcinoma in situ.
▪ Differences between benign and malignant neoplasms.
▪ The molecular basis of cancer:
o Normal cell growth
o Disorders of cell growth.
o Carcinogenesis.
o Abnormalities in neoplastic cell behavior.
o Neoplastic progression, invasion and metastasis.
o The immune system and neoplasia.
▪ Etiology of malignant neoplasms: Genetics, viral, physical and chemical agents.
▪ The epidemiology of common cancers.
▪ Investigations for the diagnosis of neoplasms: Tumor markers, Radiology, Biopsy.
▪ Different modalities for the treatment of neoplasms: Surgery, Radiotherapy,
Chemotherapy, Hormonal and Immunotherapy.
▪ Paraneoplastic syndromes.
▪ Management of oncological emergencies.
▪ Palliative care for advanced cancer.
3.5 Vascular Disorders and Surgical Hematology

▪ Etiology and pathology of thrombosis.
▪ Etiology and complications of embolism.
▪ Pathology of atherosclerosis.
▪ Disorders of hemostasis and hypercoagulable states.
▪ Risk factors, clinical picture, investigations, complications and treatment of deep vein
thrombosis.
▪ Risk factors, Pathophysiology, clinical picture, investigations & treatment of pulmonary
embolism.
▪ Transfusion of blood and components of stored blood – complications of blood
transfusion.
3.6 Surgical Infections and Antibiotics

▪ Bacteriology and Pathophysiology of surgical infections.
▪ Endotoxins and exotoxins.
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▪ Nosocomial infections.
▪ Acute non-specific surgical infections: Cellulitis, boil, carbuncle, necrotizing fasciitis,
bacteremia, septicemia.
▪ Acute specific surgical infections (tetanus gas gangrene).
▪ Common chronic surgical infections (tuberculosis amoebiasis, filariasis, Bilharziasis).
▪ Principles of disinfection and sterilization.
▪ Antibiotics: Classification, mode of action, proper choice, complications, antibiotic
prophylaxis, microbial resistance.
3.7 Disorders of growth, differentiation and morphogenesis

▪ Failure of growth: Agenesis, aplasia, hypoplasia, atrophy, apoptosis and necrosis.
▪ Overgrowth with normal cellular differentiation, hyperplasia hypertrophy, metaplasia and
hamartoma.
▪ Amyloid disease: Causes, diagnosis and effects.
▪ Hemosiderosis and hemochromatosis.
▪ Calcification: Metastatic and dystrophic.
▪ Calculi: Etiology and complications.
3.8 Surgical Immunology and Organ Transplantation

▪ Types of hypersensitivity reactions.
▪ Immunoglobulins and cytokines.
▪ Common surgical problems mediated by immunological mechanisms; Graves' disease,
hemolytic anemia, essential thrombocytopenic purpura, myasthenia graves and
rheumatoid arthritis.
▪ Immunodeficiency syndromes.
▪ Transplantation immunology, major histocompatibility testing and the mechanism of
rejection.
▪ Principles of immunosuppression: steroids, Azathioprine, cyclosporine, monoclonal
antibodies.
▪ Indications, technique and complications of renal, hepatic, pancreatic, cardiac, lung and
bone marrow transplantation.

▪ Hypercalcemia: Etiology, clinical picture, investigations and treatment.
▪ Hyperuricemia: Etiology, clinical picture and treatment.
▪ Plasma proteins: Synthesis and functions.
▪ Metabolism of bile pigments and interpretation of their levels in jaundiced patients.
4. PRINCIPLES OF SURGERY
4.1 Preoperative assessment for fitness for surgery: Assessment of the cardiovascular,
respiratory, hepatic and renal functions. Enquiry about drug intake.
▪ Getting an informed consent before surgery.
▪ Prescription of premedications.
▪ Principles of all types of anesthesia.
▪ Monitoring of anesthetized patient.
4.2 Postoperative management
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▪ Postoperative monitoring and ventilatory support.

▪ Intravenous fluids.
▪ Nutrition.
▪ Postoperative complications.
4.3 Surgical Techniques

▪ Principles of the use of diathermy and laser.
▪ Types of suture materials.
▪ Principles of endoscopic and laparoscopic surgery.
▪ Tourniquet.
4.4 Medical ethics and Medicolegal Aspects

▪ Sources of surgical infection.
▪ Principles of antisepsis.
▪ Surgery in hepatitis and HIV carries.
5. SURGICAL TRAUMA
▪ The Etiology of traumatic injury; blunt, penetrating and blast injuries.

▪ Prehospital care.
▪ Triage.
▪ Primary survey of traumatized patients ABCDE:
o Airway and cervical spine support.
o Breathing.
o Circulation stoppage of hemorrhage and resuscitation.
o Disability.
o Exposure.
▪ Monitoring and important investigation.
▪ Secondary survey (patient overview):
o Head and facial injuries.
o Chest injuries.
o Abdominal and pelvic injuries.
o Limb injuries: skin injury, vascular injury, nerve injury and fractures.
o Spinal injuries.
o Management of individual injuries.
▪ Trauma scoring system.
▪ Special situations of trauma: Pediatric trauma and trauma in pregnancy.
▪ Post-traumatic stress disorders.
▪ Damage Control Surgery*
▪ Trimodal distribution of trauma death (immediate – early – late).
*Damage Control Surgery is a technique of surgery used to care for critically ill patients to provide limited
surgical intervention in order to control hemorrhage and contamination. This technique places emphasis on
preventing the lethal triad (hypothermia – acidosis – coagulopathy) rather than correcting the anatomy, as a
measure that saves lives. It can be divided into three phases: initial laparotomy, ICU resuscitation &
definitive reconstruction.
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6. THE NECK
▪ Anatomy of the neck: Triangles and fascia of the neck. Cervical lymph nodes and their
levels.
▪ Congenital anomalies of the neck: Branchial and thyroglossal cyst and fistula.
▪ Sternomastoid tumor.
▪ Blunt and penetrating injuries of the neck.
▪ Thoracic outlet syndrome: Etiology, pathology, clinical picture, investigations and
treatment.
▪ Cervical block neck dissection: indications, types and complications.
7. SALIVARY GLANDS
▪ Anatomy of the parotid, submandibular and sublingual salivary glands.

▪ Physiology of salivation.
▪ Salivary glands neoplasms: Benign and malignant.
▪ Inflammatory problems: acute and chronic.
▪ Calcular disease.
▪ Sialectasis: Etiology, clinical picture and treatment.
8. THE BREAST
▪ Embryology and anatomy of the breast.

▪ Physiology of the breast.
▪ Abnormalities of the nipple and nipple discharge.
▪ Inflammatory problems of the breast: Acute mastitis, acute breast, abscess – chronic breast
abscess.
▪ Duct ectasia: Pathology, clinical picture and treatment.
▪ Aberrations of normal development and involution (ANDI): Etiology, pathology,
investigations and treatment.
▪ Benign breast neoplasms: Pathology, clinical picture, investigations and treatment.
▪ Breast cancer: Epidemiology, Etiology, pathology, clinical picture, investigations,
treatment and screening programs.
▪ Gynecomastia: Etiology, investigations and treatment.
9. THE VASCULAR SYSTEM
▪ The anatomy of the arterial and venous systems.

▪ Etiology, clinical picture, and management of common vascular injuries.
▪ Acute limb ischemia: Etiology, clinical picture and management.
▪ Chronic limb ischemia: Etiology, clinical picture and management.
▪ Carotid artery disease:
o Physiology of cerebral circulation.
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o Carotid artery stenosis: Etiology, clinical picture, investigations and treatment.

▪ Diabetic foot infection: Etiology, clinical picture and management.
▪ Arterial aneurysms: Etiology, pathology, clinical picture, investigations and treatment.
▪ Arteriovenous fistula: Etiology, pathology, clinical picture, investigations and treatment.
▪ Vasospastic arterial disease: Raynaud's disease and phenomenon.
▪ Deep vein thrombosis: Etiology, pathology, clinical picture, investigations, treatment and
complications.
▪ Varicose veins of the lower limb: Clinical picture, investigations and treatment.
▪ Endovascular surgery: Indications, technique, and complications.
10. THE LYMPHATIC SYSTEM
▪ The anatomy of the cervical, axillary, inguinal mediastinal and abdominal lymph nodes.
▪ Acute lymphadenitis: Etiology, clinical picture and treatment.
▪ Chronic lymphadenitis: Non-specific, specific (T.R), Etiology, pathology, clinical picture
and treatment.
▪ Lymphomas (Hodgkin's – Non-Hodgkin's): Pathology, clinical picture, investigations and
treatment.
▪ Metastatic lymph nodes: Pathology, clinical picture, and treatment.
▪ Lymphedema: Etiology, pathology, clinical picture and treatment.
11. PLASTIC SURGERY
11.1 Principles of skin coverage: Skin grafts, various types of skin flap (myocutaneous –
fasciocutaneous – microvascular free flaps).
11.2 Surgery of Nerves

▪ Nerve injuries: etiology, pathology, clinical picture and treatment.
▪ Clinical picture of individual nerve injuries.
▪ Sympathectomy: Indications, Technique.
▪ Nerve tumors: Clinical picture, treatment.
11.3 Surgery of muscles, tendons and fascia

▪ Carpal tunnel syndrome: Etiology, clinical picture, investigations and treatment.
▪ Dupuytren’s contracture: Etiology, clinical picture and treatment.
▪ Volkmann’s ischemic contracture: Etiology, clinical picture and treatment.
▪ Soft tissue sarcoma: Etiology, pathology, clinical picture, investigations and
treatment.
11.4 Surgery of face, lips and palate

▪ Cleft lip and cleft palate: Embryologic background, clinical picture and treatment.
▪ Maxillofacial injuries: Bones and soft tissues:
▪ Carcinoma of the lip: Etiology, pathology, treatment.
11.5 Surgery of the mouth, cheek and tongue:

▪ Cysts of floor of the mouth: Ranula, sublingual dermoid cyst.
▪ Injuries of the tongue.
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▪ Inflammation of the tongue.

▪ Ulcers of the tongue.
▪ Carcinoma of the tongue, cheek and floor of the mouth: Etiology, pathology,
clinical picture and treatment.
12. SKIN AND SUBCUTANEOUS TISSUES
▪ Cysts of the skin and subcutaneous tissues: Dermoid cysts and sebaceous cysts.
▪ Benign lesions of the skin and subcutaneous tissues: Hemangioma, lymphangioma,
lipoma, neurofibromata and benign melanoma.
▪ Malignant lesions of the skin: Basal cell carcinoma, squamous cells carcinoma, malignant
melanoma.
▪ Etiology, pathology, clinical picture and treatment.
13. BURNS
▪ Etiology of burns: Scalds-Flame burns-Electric burns-chemical burns.

▪ Pathophysiology of burns.
▪ Classification of burns:
o Surface area.
o Depth of burn.
▪ Complications of burns:
o General.
o Local.
▪ Management of burns:
o First and treatment.
o Resuscitative fluid therapy.
o Nutritional support.
o Local treatment.
o Surgical correction of skin defects.
14. ENDOCRINE SURGERY
14.1 Surgery of the Thyroid Gland:

▪ Anatomy of the thyroid gland.
▪ Physiology of the thyroid gland.
▪ Simple enlargement of the thyroid gland: Physiological, colloid and nodular goitre.
▪ Retrosternal goitre.
▪ Thyrotoxicosis: Graves' disease, Plummer's disease: Autonomous nodule-Miscellaneous.
▪ Thyroiditis: subacute (De Quervain's disease and Hashimoto's thyroiditis)
▪ Solitary nodule of the thyroid gland: Etiology, investigations and management.
▪ Neoplasms of the thyroid gland: Differentiated, undifferentiated carcinoma. Medullary
carcinoma-Lymphoma.
▪ Investigations of the thyroid gland: Laboratory-radiology-biopsy.
▪ Indications, technique and complications of thyroidectomy operation.
14.2 Surgery of the Parathyroid Glands:

▪ Anatomy of the parathyroid glands.
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▪ Physiology of the parathyroid glands. Calcium metabolism.

▪ Hyperparathyroidism:
o Primary
o Secondary
o Tertiary
▪ Hypoparathyroidism.
14.3 Surgery of the Adrenal Glands:

▪ Anatomy of the adrenal glands.
▪ Physiology of the adrenal glands: Cortex and medulla.
▪ Etiology, clinical picture, investigations and treatment of Conn's syndrome, Cushing’s
syndrome. Adrenogenital syndrome and Pheochromocytoma.
14.4 Endocrine disorders of the pancreas: The clinical picture, investigations and
treatment of insulinoma and gastrinoma.
14.5 Carcinoid syndrome: Etiology, clinical picture, investigations and treatment.
14.6 Multiple endocrine neoplasias.
o MEN I
o MEN IIA
o MEN IIB
15. CARDIOTHORACIC SURGERY
▪ Chest injuries: Mechanism of injury, possible consequences, first aid treatment.

▪ Rib fractures: Simple fracture-flail chest.
▪ Hemothorax: Etiology, clinical picture, investigations and treatment.
▪ Pneumothorax: Simple, open, and tension. For each the clinical picture and treatment.
▪ Cardiac injuries: Etiology, clinical picture, treatment.
▪ Empyema: Acute, chronic and tuberculous.
▪ Bronchogenic carcinoma: Etiology, pathology, clinical picture and treatment.
▪ Post-operative pulmonary complications: Atelectasis, broncho-pneumonia, ARDS.
▪ Pulmonary embolism: Etiology, clinical picture and treatment.
▪ Cardiac arrest: Etiology, diagnosis, treatment.
▪ Principles of surgery for congenital and acquired cardiac diseases.
▪ Principles of cardiopulmonary bypass.
▪ Indications for thoracotomy.
▪ The general and specific complications of thoracic operations.
16. NEUROSURGERY, SCALP, SKULL AND BRAIN
▪ Anatomy of the scalp, skull and brain.

▪ Scalp injuries: Types of scalp hematomas.
▪ Fractures of the skull:
o Vault: simple and compound.
o Base: anterior, middle and posterior cranial fossa.
▪ Intracranial injuries:
o Mechanism of injury.
o Pathology: primary and secondary pathological sequelae.
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o Clinical picture of brain concussion, extradural hematoma and subdural

hematoma.
o Investigations and treatment.
o Complications of head injuries.
▪ Hydrocephalus:
o Normal CSF circulation.
o Hydrocephalus in children.
o Hydrocephalus in adults.
▪ Brain abscess: Etiology, pathology, investigations and treatment.
▪ Intracranial tumors: Pathology, clinical picture, investigations and treatment.
▪ The Etiology and clinical picture of congenital aneurysms.
▪ The diagnosis and testing for brain stem death and the principles of organ donation.
17. PHARYNX AND ESOPHAGUS
▪ Anatomy of the pharynx and esophagus: Course, structure, blood supply, lymphatic
drainage and nerve supply.
▪ Injuries of the pharynx and esophagus: Penetrating injuries, corrosive injuries.
▪ Neuromuscular problems of the pharynx and esophagus:
o Pharyngeal
o Achalasia of the cardia.
o Diffuse esophageal spasm.
▪ Neoplasms of the pharynx and esophagus:
o Benign lesions.
o Carcinoma of the pharynx. Nasopharynx, oropharynx, epi laryngeal and post-
cricoid cancer.
o Carcinoma of the oesphagus: Etiology, pathology, clinical picture,
▪ Sliding and paraesophageal hiatus hernia: Etiology, pathology, clinical picture,
18. THE STOMACH AND DUODENUM
▪ Anatomy of the stomach and duodenum: Relations, blood supply, lymphatic drainage,
nerve supply.
▪ Physiology of the stomach and duodenum:
o Mechanism of secretion of gastric juice.
o Mechanism of gastric emptying.
▪ Congenital hypertrophic pyloric stenosis: Clinical picture and management.
▪ Acute peptic ulcer: Acute gastric ulcer, stress gastric ulceration.
▪ Peptic ulcer disease: Etiology, clinical picture, medical and surgical treatment.
▪ Complications of peptic ulcer disease: Hemorrhage, perforation, obstruction.
▪ Neoplasms of the stomach and duodenum: Etiology, pathology, clinical picture,
▪ Principles of bariatric surgery.
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19. HEPATOBILIARY SURGERY
▪ Anatomy of the liver and biliary system:

o Surgical anatomy.
o Blood supply.
o Lymphatic drainage.
▪ Physiology of secretion bile salts and bile pigments. Physiology of gall bladder functions.
▪ Congenital malformations of the biliary apparatus.
▪ Liver injuries: Type of trauma, types of injuries, clinical picture, investigations and
treatment.
▪ Inflammatory problems of the liver and biliary apparatus:
o Etiology, clinical picture investigations and treatment of: Pyogenic liver
abscess.
o Amoebic hepatitis.
o Hydatid cyst of the liver.
o Acute cholecystitis.
o Acute cholangitis.
▪ Gallstones: Mechanism of formation, types, complications, and treatment.
▪ Liver cirrhosis and portal hypertension:
o Pathology of liver cirrhosis.
o Sequelae of liver cirrhosis.
o Management of portal hypertension during an attack of bleeding and in between
the attacks.
▪ Jaundice: Definition, Etiology, clinical picture, investigations and treatment.
▪ Neoplasms of the liver and biliary system: Pathology, clinical picture and management of
benign and malignant neoplasms of the liver and biliary system.
▪ Stricture of the bile duct: Etiology, clinical picture, investigations and treatment.
20. THE PANCREAS
▪ Anatomy of the pancreas: Relations, blood supply, lymphatic drainage.

▪ Physiology of the pancreas: Exocrine and endocrine functions.
▪ Acute pancreatitis: Etiology, pathology, clinical picture, investigations, treatment and
complications.
▪ Chronic pancreatitis: Etiology, clinical picture, investigations and treatment.
▪ Neoplasms of the pancreas:
o Pathology; benign and malignant.
o Clinical picture.
o Investigations.
o Treatment.
▪ Endocrine tumors of the pancreas: Gastrinoma and insulinoma.
21. THE PERITONEUM, OMENTUM AND MESENTERY
▪ Anatomy of the subphrenic spaces.

▪ Acute septic peritonitis: Etiology, clinical picture, investigations and treatment.
▪ Intraperitoneal abscess: Pelvic, iliac and subphrenic abscess: Etiology, clinical picture and
management.
▪ Tuberculous peritonitis: Pathology, clinical picture and management.
▪ Ascites: Etiology, investigations and treatment.
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▪ Mesenteric cysts and non-specific mesenteric adenitis: clinical picture and treatment.
▪ Retroperitoneal sarcoma: Pathology, clinical picture, investigations and treatment.
22. THE SPLEEN

▪ Anatomy of the spleen: Relations, ligaments related to the spleen, blood supply.
▪ Physiology of the spleen: Emphasis on the role of the spleen in immunity.
▪ Trauma to the spleen: Etiology, clinical picture, investigations and treatment.
▪ Infections of the spleen: Viral, bacterial, protozoal and parasitic.
▪ Splenomegaly: Etiology, clinical picture, investigations and treatment.
▪ Splenectomy operation: Indications, technique and complications.
23. THE SMALL AND LARGE INTESTINES
▪ Anatomy of the small & large intestine: Histological picture, blood supply, lymphatic
drainage.
▪ Physiology of the small and large intestine: Secretion, absorption, motility.
▪ Injuries of the small and large intestine: Etiology, clinical picture and management.
▪ Intestinal obstruction: Etiology, clinical picture, investigations, treatment and special
types.
▪ Intestinal fistulae: Etiology, clinical picture, management.
▪ Intestinal ischemia: Etiology, clinical picture and treatment of acute and chronic intestinal
ischemia.
▪ Inflammatory bowel disease: Pathology, clinical picture and treatment.
▪ Diverticular disease of the colon: Etiology, clinical picture and management.
▪ Neoplasms of the small and large bowel: Pathology, clinical picture, investigations,
treatment and screening for cancer.
▪ Radiation enteritis.
▪ Short bowel syndrome: Etiology, clinical picture and treatment.
▪ Gastrointestinal stomas: The indications and management of gastrointestinal stomas
(gastrostomy, ileostomy, colostomy).
24. THE APPENDIX

▪ Anatomy of the appendix.
▪ Acute appendicitis: Etiology, pathology, clinical picture, investigations and treatment.
▪ Complications of acute appendicitis, appendicular mass, appendicular abscess and
generalized peritonitis.
▪ Differential diagnosis of abdominal pain.
▪ Appendicular tumors.
25. THE ANAL CANAL
▪ Anatomy of the anal canal and the factors responsible for maintenance of aria! Continence.
▪ Hemorrhoids: Etiology, clinical picture, complications and management.
▪ Anal fissure: Etiology, clinical picture and management of acute and chronic anal fissure.
▪ Perianal abscesses and fistulae: Etiology, clinical picture and management.
▪ Pilonidal sinus: Etiology, clinical picture and treatment.
▪ Rectal prolapse: Etiology and treatment.
▪ Fecal incontinence: Etiology, investigations, and treatment.
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▪ Carcinoma of the anal canal: Pathology, clinical picture and treatment.

▪ Sexually transmitted anorectal diseases.
26. ABDOMINAL WALL AND HERNIAS

▪ Anatomy of: Muscles of the anterior abdominal wall, inguinal canal and femoral canal.
▪ Abdominal incisions: Vertical, Transverse, Oblique.
▪ Complications of abdominal wall incisions: Dehiscence, infection, incisional hernia.
▪ The Etiology, clinical picture and treatment of inguinal, umbilical, epigastric para-
umbilical, femoral and incisional hernias.
▪ Complications of a hernia: Irreducibility, Strangulation, Obstruction and Inflammation.
27. PEDIATRIC SURGERY
▪ The physiological considerations in infants and children regarding.
o Maintenance of body temperature.
o Assessment of respiratory and cardiovascular function.
o Fluid and electrolytes.
o Metabolic response.
▪ The etiology, clinical picture and treatment of correctable congenital abnormalities
including: esophageal atresia, diaphragmatic hernia, intestinal atresia, anorectal
malformations and Hirschsprung‘s disease.
▪ The Etiology, clinical picture and treatment of congenital hypertrophic pyloric stenosis
and infantile intussusception.
▪ The Etiology, clinical picture and treatment of inguinal hernia, hydrocele, undescended
testes and torsion of the testis.
▪ Disorders of the hip, knee and foot joints.
▪ The pathology, clinical picture and treatment of neoplasms which occur in infants and
children.
28. ABDOMINAL TRAUMA AND ACUTE ABDOMEN

▪ The Etiology, clinical picture and management of blunt and penetrating abdominal
injuries.
▪ The various causes of acute abdomen.
▪ The various laboratory and radiological investigations utilized for the diagnosis of acute
abdomen.
29. SURGICAL UROLOGY

▪ Anatomy of the kidney, ureter, urinary bladder and urethra.
▪ Embryological development of the urinary system.
▪ Symptoms and signs of urinary tract problems.
▪ Investigations for the urinary tract: Laboratory, radiology, endoscopic.
▪ Congenital anomalies of the urinary tract:
o Congenital anomalies of the kidney.
o Ectopia vesica.
o Hypospadias and epispadias.
▪ Injuries of the urinary tract: Etiology, clinical picture, investigations and treatment of
injuries to the kidney, ureter, urinary bladder and urethra.
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▪ Inflammations of the urinary tract:

o Acute pyelonephritis, acute cystitis and acute prostatitis.
o Bilharziasis of the urinary bladder.
▪ Obstructive uropathy: Etiology, clinical presentation, investigations and treatment of:
o Urinary tract stones.
o Stricture of the ureter and urethra.
o Benign prostatic hyperplasia.
o Idiopathic retroperitoneal fibrosis.
▪ Neoplasms of the urinary tract: Pathology, clinical picture, investigations and treatment of
neoplasms of the kidney urinary bladder and prostate.
▪ Differential diagnosis and investigations for hematuria.
▪ Neurogenic bladder: Etiology, investigations and treatment.
▪ Urinary incontinence: Etiology, investigations and treatment.
30. THE TESTIS AND SCROTUM

▪ Development of the testis.
▪ Torsion of the testis: Etiology, clinical picture and treatment.
▪ Inflammatory problems of the testicle, epididymis and spermatic cord:
o Acute: Acute epidydmoorchitis.
o Chronic: Tuberculosis, Bilharziasis, and Filariasis.
▪ Neoplasms of the testis: Seminoma, teratoma, interstitial cell tumor lymphoma, pathology,
clinical picture, investigations and treatment.
▪ Hydrocele: Etiology, clinical picture and treatment.
▪ Varicocele: Etiology, clinical picture, investigations and treatment.
▪ Inflammatory problems of the penis: balanitis and psoitis.
▪ Carcinoma of the scrotum and penis.
31. ORTHOPAEDIC SURGERY

▪ Fractures and dislocations: Etiology, mechanism of healing, clinical picture, principles
of management, complications of fractures (general and location).
▪ Fractures and dislocations of the upper limb.
▪ Fractures and dislocations of the lower limb.
▪ Infections of bones and joints:
o Acute hematogenous osteomyelitis.
o Chronic non-specific osteomyelitis.
o T.B. of bones.
o Septic arthritis.
o T.B. of joints.
▪ Generalized disorders of bones and joints:
o Osteoporosis.
o Rickets and osteomalacia.
o Hyperparathyroidism.
o Osteoarthrosis.
o Rheumatoid arthritis.
o Gout.
o Paget's disease of bones.
91
May 2020
o Charcot’s osteoarthropathy.
▪ Bone tumors: Etiology, pathology, clinical picture and treatment of benign and malignant
bone tumors.
▪ Amputations: Indications, technique & complications of amputations of the upper & lower
limbs.
▪ Assessment and surgical approaches to the shoulder elbow, wrist, hip, knee and ankle
joints.
32. THE SPINE AND SPINAL CORD

▪ Congenital anomalies.
▪ Fractures and dislocations of the spine.
▪ Traumatic paraplegia: Etiology, and management.
▪ T.B. of the spine.
▪ Intervertebral disc prolapse.
▪ Tumors of the spine.
▪ Neck pain and low back pain.
33. Surgical Radiology

▪ Diagnostic Imaging in the practice of General Surgery
▪ Interventional Radiology in the practice of General Surgery
92
May 2020
Teaching and Training Methods:
1. Clinical Rounds and Bed Side teaching
2. Grand round
3. Teaching clinical skills in Outpatient clinic
4. Teaching clinical and technical skills in emergency room
5. Teaching surgical skills in Operating room
6. Small group discussions
7. Lectures & Seminars
8. Skills lab (models, simulators, …..)
9. Self-directed learning
10. Problem Based learning
11. Case Based Discussion (CBD)
12. Attending scientific meetings as Journal club, morbidity &
mortality meeting, grand round, conferences, workshops…
13. Assignments
14. E-learning: lectures, webinars, training courses, …
93
May 2020
ASSESSMENT METHODS & BLUE PRINTING
1. FIRST PART EXAM
Candidates are allowed to sit for the first part exam at a minimum of six months after
the start date of training. This exam is a written one and is divided into two papers on
the same day:
a. Paper 1: 100 MCQs for 100 marks,
b. Paper 2: short essay questions for 100 marks or 100 MCQs for 100 marks,
The candidate is allowed to re-sit this exam two times, while a third one only allowed
after the approval of the scientific council.
Candidate has to pass this exam to sit for the second part.
The pass mark will be determined by Standard setting method.
First part exam covers the following items:
Average Percentage to the
whole exam
▪ Surgical Anatomy 20%
▪ Surgical Pathology 17%
▪ Surgical Physiology (includes homeostasis,
hemostasis and endocrinology) 25%
▪ Surgical microbiology 17%
▪ Surgical Immunology and
transplantations 8%
▪ Surgical Oncology 8%
▪ Principles of Surgery 5%
Candidates are exempted of this exam if they successfully complete the Master degree
in general surgery or the final MRCS exam.
2. SECOND PART EXAM:

Candidate is only allowed to sit for the second part exam after acceptance of the log
book. Logbook will be assessed 6 months before the second part exam.
This is a written exam. This exam is divided into 4 papers on 4 separate sessions over
2 days, 2 sessions every day:
a. Paper 1 100 MCQs for 100 marks
b. Paper 2 short essay questions for 100 marks or 100 MCQs for 100 marks,
c. Paper 3 MCQs for 100 marks
d. Paper 4 short essay questions for 100 marks. or 100 MCQs for 100 marks,
The candidate is allowed to enter this exam after the end of a five years training
program and is allowed for re-sit exam 3 times maximum.
Candidate has to pass the written exam to be eligible to sit for the third part. The
pass mark will be determined by Standard Setting method.
94
May 2020
Paper 1 and 2 cover the following items:

Average Percentage to the whole exam
▪ Plastic surgery, skin and burns 8%
▪ Neck and salivary glands 6%
▪ Vascular and lymphatic surgery 7%
▪ Endocrine surgery 9%
▪ Breast 8%
▪ Cardiothoracic surgery 7%
▪ Neurosurgery 5%
Paper 3 and 4 cover the following items:

• Gastrointestinal tract 36%
• Pediatric surgery 4%
• Urogenital surgery 5%
• Orthopedics and spine 5%
Total 100%
3. Third part examination:

This entails 3 separate examinations on 2-3 separate days:
First Exam:
Ten to fifteen OSCE stations each lasts for 7 - 10 minutes. The stations
cover focused history taking, focused general examination, local
examination, interpretation of medical reports, radiological pictures,
pathology specimens, communication skills, surgical skills, Emergency
station and operative station.
The pass mark will be determined by standard setting method.
Second Exam
Data OSCE slides, presenting different clinical situations including
patient photographs, surgical radiology, pathological specimens and
surgical instruments. The candidates have to answer the questions
written for each slide in the answer sheet, all the answer sheets will be
corrected according to structured model answers.
The pass mark will be determined by Standard Setting method.
Third Exam
Long case exam: is a clinical examination including one long case
lasting 30 - 40 minutes
The pass mark will be determined by Standard Setting method.
Candidates should fulfill the pass mark of each of the three exams of the third part.
Candidates who fail to pass the third part exam are allowed to re-sit for only 3 times
maximum.
95
May 2020
4. Workplace based assessment: The surgical skills will be assessed through:

a. The log book (LB), in which 80% of all its items concerning the clinical
attendance, the observation, assistance or performance of surgical procedures
should be fulfilled.
b. Training Assessment Forms: Trainer monthly reports – Educational supervisor
reports - Trainee assessment form
c. Annual Review Process (ARP)
d. Procedure based assessment
e. Multisource feedback (360-degree feedback)
f. Clinical evaluation exercise (CEX / Mini CEX)
g. Case Based Discussion (CBD)
h. Direct observation of procedural skills (DOPS)
All gathered and assessed in the Annual Review Meeting.
96
May 2020
GUIDE TO THE FINAL EXAMINATION
INSTRUCTIONS TO THE CANDIDATES
Each candidate is going to sit for 3 examinations on 2 - 3 separate days.
FIRST Exam:
Data OSCE Slides exam:
All candidates at the same time are going to see pictures presented to them on a
screen. The pictures illustrate photographs of patients, radiology films and
pathology specimens. Look meticulously at the pictures and then answer the
questions of the station in your answer sheet.
Second Exam:
OSCE exam (stations):
Each candidate will be examined in 10 - 15 OSCE stations which may require
focused history taking, focused general exam, local exam, reading a radiology
picture, testing communication skills or testing certain surgical skills. At the front
door of each station, please read the required instructions and stick to them. Each
station lasts for 7 - 10 minutes
Third Exam:
Long clinical case:
This exam lasts for 30 - 40 minutes and you will be examined by two examiners
who will be observing you all through the exam. You are supposed to take a full
history relevant to the case in about 10 minutes. Then do a complete general and
a meticulous local exam relevant to the case in about 10 minutes. Then you are
going to present a summary of the history and the clinical findings to the
examiners. You are supposed to make a sensible provisional clinical diagnosis.
You should mention the possible differential diagnosis. Prioritize the
investigations you would like to do. Finally explain your plan of treatment.
During the remaining time of the session. Remember that your attitude to the
patient is taken into consideration.
97
TRAINING ASSESSMENT FORMS
1- Learning Agreement Record
2- Training Monthly Report
3- Educational Supervisor Report
4- Trainee Assessment Form
5- Training Post Assessment form
6- Annual Review Process (ARP)
98
1- Learning Trainee
Agreement Record Name:
Training
Specialty:
Number:
‫إتفاق بين المدرب و المتدرب على خطة التدريب أثناء الدورة يتم كتابته فى لقاءات دورية بين المدرب و المتدرب فى‬
‫بداية و منتصف ونهاية الدورة لتحديد األهداف التدريبية و مراجعة ما تم و عمل توصية للدورة التالية‬
Hospital Year of training Start date
Trainer Subspecialty End date
Practicalities
a. Review timetable & on-call rota
b. Explore practicalities of post
(planned absences, conferences etc.
for both trainer & trainee)
c. Agree dates for future meetings i. Mid-point
(Mid-point review applies in rotations > 6 review
months) ii. End of post
review
Educational objectives
2. Mid- 3. End of
1. Start of post
Objectives point post
Meeting date: Date: Date:
Knowledge
& Courses
(e.g. Basic
sciences
relevant to
sub-specialty,
see
curriculum)
Clinical
Skills
(e.g. History,
consent,
examination
of …)
99
Operative /
Procedural
Skills
(Guided by
curriculum and
PBAs)
TRAINEE’S TIMETABLE
Sat Sun Mon Tue Wed Thu
Morning
Afternoo
n
On-Call
Rota
Agreement Summary (to be filled at the end of post)

Have the targets set in
the learning agreement
been achieved? Y/N
(please specify any
actions or
recommendations for
future attachments)
Signatures
Trainer: Trainee: Date:
100
2- Trainer Monthly Hospital /

Report Specialty
Trainer Name Month covered
:‫عدد المتدربين لهذا الشهر‬ ‫بيانات المدرب‬

‫المحمول‬ ‫الوظيفة‬
‫ يكتب بمعرفة المدرب و يتم تسيلمه من أصل و صورة فى‬.‫تقرير شهرى عن المتدربين و نشاط المدرب‬
‫األسبوع األول من كل شهر لمنسق التخصص‬
Trainee’s report
Attenda Presentati
Performanc
Trainee’s Name YIT1 nce ons PBA4
e5
percent2 / Lectures3
Guidelines for Trainer:

1 Year in Training 2 Recorded as attendance %
during this month

3 Number of Presentations or Lectures given by the Trainee 4 Number of operative competencies
assessed
5 It is expected that the majority of trainees would fall into the “satisfactory” category 3. Please enter
your mark (scored 1-5) in the column provided; which best reflects your assessment using the prompts
as a guide.
POOR = 1 DEFICIENT = 2 SATISFACTORY = 3 ABOVE AVERAGE = 4 EXCELLENT =5
Clinical activities (by the trainer)

Activity Cases Discussed / Examination or Procedures Demonstrated
Out
patients
101
Ward
Rounds
Procedur
es /
Operative
Lists
Departmental Teaching Activities

Audienc
Present
Activity Date Format Title e
er
number
e.g.
Clinical Lecture,
Video,
Meeting Discussion,
etc.
s/
Teachin
g
Morbidi
ty/
Mortalit
y
Patholo
gy/
Radiolo
gy
Journal
Review
Trainer’s timetable
Sat. Sun. Mon. Tue Wed Thu
102
Morning
Afternoon
Total No. of Doctors

On-Call
in unit (training & non-
Rota
training)
Comments from trainer: (please extend to an attached sheet if necessary –

each attached sheet must be signed and dated by trainer)
Signatures
Trainer’s Trainer’s Hospital Signature Date
Name Signature Director
103
3- Educational Hospital
Supervisor’s Report
Visit date &
Specialty period
covered
This monthly report should be filled by the educational supervisor & passed to the
Specialty Coordinator who will collate and scrutinize all reports, before making them
available to the HARP committee. A copy of the report shall be posted to the respective
trainer/s and the hospital director / administration.
Trainers’ & program assessment
Please indicate each trainer’s contribution to the training and teaching activities of the
department, using the following abbreviations: D = Deficient, S = Satisfactory or G =
Good. Evidence could be collected from meeting with trainers and trainees (together and
separately), as well as reviewing trainer’s monthly reports and trainees’ logbooks.
Proce Emer
dures genci Multi-
Clinic Morbi Journ
Out Ward / es/ Discip Overa
Trainer’s al dity / al Teach
patie Roun Oper Emer linary ll
Name Meeti Mort Revie ing
nts ds ating gency meeti rating
ngs ality w
Theat Opera ngs
re ting
Strengths of unit/department:
Weaknesses of unit/department:
104
Trainees’ assessment
Attend
Logboo
Previou ance at Rotatio
k
s HARP scientif n plan
Trainee’s Name YIT1 Checke Remarks
outcom ic followe
d & Up-
e2 activiti d
to-date
es 3
Guidelines for Supervisor:

1
Year in Training
2
HARP= Half Annual Review Process HARP1 = Satisfactory to progress
HARP2 = Targeted Training HARP3 = Official warning HARP4 =
Unsatisfactory
3
Recorded as percentage of attendance at teaching activities during the report period (both
local & Central Teaching Days + Conferences & other scientific events)
Suggestions for improvement:
Signatures
Educational supervisor Signature Date:
Name:
105
4- Trainee Assessment Trainee Name:

Form
Fellowship
Specialty:
Number:

‫تقرير من المدرب عن المتدرب فى نهاية فترة التدريب و به جزء خاص بالمتدرب إلبداء رأيه و يتم توقيع التقرير من‬
.‫ ) بثالث أسابيع‬HARP( ‫المدرب و المتدرب وتسليمه لمنسق التخصص قبل التقييم النصف سنوى‬
Guidelines for trainer: Please enter your mark (scored 1-5) in the column provided; which
POOR = DEFICIENT = SATISFACTORY = ABOVE EXCELLENT
1 2 3 AVERAGE = 4 =5
reflects your assessment using the guide. Each row must contain a number.
Aspect of
Mar
performan Poor Satisfactory Excellent
ks
ce
Knowledge
General ▪ Below the level of ▪ At the level of ▪ Knowledge on
Knowledge basic textbook basic textbook scientific basis,
▪ Fail to apply ▪ Apply knowledge current
Subspecialt
knowledge in in practice under consensus;
y practice supervision controversies
Knowledge ▪ Apply knowledge
in practice
Clinical ▪ No interest in any ▪ Join in research ▪ Full of research
Research research activity as co-workers initiatives
▪ Poor only ▪ Lively, interesting
and
presentation skill ▪ Clear presentation skill
Presentatio
presentation skill
n
Skills
Clinical ▪ Improper history ▪ Satisfactory ▪ Excellent analytic
Judgment and physical history & physical power
exam. exam. ▪ Spot out the
▪ Illogical ▪ Appropriate unusual and
conclusion from clinical rarity.
clinical data judgement
Procedural ▪ Rough handling ▪ Safe handling of ▪ Always plans
/ Surgical of soft tissue sharp instrument before surgery
▪ Improper use of ▪ Knows one’s
Skill
instruments limitation
106
▪ Reacts to
unexpected
situations
Attitude & Behaviour
Doctor ▪ Poor listener ▪ Trusted by ▪ Inspires
Patient ▪ Increase patient patient confidence for
anxiety ▪ Explains patient
Relationshi
treatment plan ▪ Patient delighted
p
properly to be under his
care
Accuracy in ▪ Poor and illogical ▪ Adequate and ▪ Documents full
Documenta clinical notes clear clinical management
▪ Multiple mistakes notes plan
tion
in medical ▪ Minor mistakes in ▪ Excellent medical
reports reporting only report
Motivation ▪ Lack of ▪ Keen to learn ▪ Pays extra effort
and motivation / under protected to learn
energy environment ▪ Performance
Determinat
▪ Ignorant of his more than
ion
weaknesses required
Teamwork ▪ Poor ▪ Helps colleagues ▪ Constructive and
communication when needed innovative
skill ▪ Follows team ▪ Initiative for
▪ Considered as a rules and team
burden on the regulations improvement
team
Reliability ▪ Improper ▪ carry out duty as ▪ Good sense of
response to instructed risk management
pager call ▪ separate routine ▪ Proactive
▪ Frequent wrong from emergency thinking
priority setting
Departmen ▪ Attend < 50% of ▪ Attend 60% of ▪ Attend > 75% of
tal academic activity academic activity academic activity
▪ Not keen on ▪ Participates in ▪ Competent/consc
Academic
teaching juniors. teaching & ientious/good
Activities
training style
TOTAL
Logbook summary (where applicable) Special
Factors
Surgeon / Surgeon / Assistant Total (Any factor
Unsupervised Supervised such as ill-
health,
Advanced personal or
107
Major family
Intermediate problems
that may
Minor have
Total affected the
performance
)
Comments from trainer: (please extend to an attached sheet if necessary –

each attached sheet must be signed and dated by trainer and trainee)
Summary conclusion
Satisfactory in all respects to proceed
Satisfactory to proceed, but the following areas for improvement have been
identified and must be addressed in the next placement (detail areas for
improvement - please extend to an attached sheet if necessary –attached sheets
must be signed and dated by trainer and trainee)
Official warning, may be expelled if problems not rectified during next placement
Unsatisfactory and should be referred for advice about choosing an alternative
career pathway
Comments from Trainee: (please extend to an attached sheet if necessary –
Signatures
Trainer: Trainee: Date:
108
5- TRAINING POST
ASSESSMENT Trainee Name:
FORM
Fellowship
Specialty:
Number:
‫يسلم‬ .‫تقرير سرى من المتدرب فى نهاية فترة التدريب إلبداء رأيه عن اإليجابيات وأقتراحاته لتطوير التدريب‬
. ‫( بثالث أسابيع‬HARP ) ‫لمنسق التخصص قبل التقييم النصف سنوى‬
Please insert your rating against each criterion using the following abbreviations: D =
Deficient, S = Satisfactory & G = Good. The accompanying guidelines are offered for
use in rating criteria. Please add your comments at the end if desired.
RAT DEFICIENT SATISFA GOOD
ING CTORY
CLINICAL TRAINING
Outpat ▪ Do not see new patients. ▪ See new & old patients.
ients No time to discuss with Time for discussion with
trainer. trainer.
▪ Large number of patients. ▪ Adequate time with
Poor organisation. patient. Well organised.
Ward ▪ Rarely led by consultant. ▪ Usually consultant led. In-
Rounds Rapid decisions, little depth presentation /
discussion. Consultant discussion of patients.
does not listen to junior Adequate time allowed.
views.
PROCEDURES / OPERATIVE TEACHING
Opport ▪ Usually left to do minor ▪ Mix of major & minor
unity surgery. Less than 3 elective surgery. At least 3
sessions / week. Only sessions / week. Exposure
assists and rarely performs to day surgery.
major cases.
Teachi ▪ Works on own. Poor senior ▪ Taken through procedures.
ng support. Not shown / Shares cases with
taught new or more consultant. New technique
advanced techniques. workshops, Videos or
courses.
109
Supervi ▪ Consultant rarely present ▪ Consultant usually present

sion in same or adjoining in same or adjoining
theatre. Cannot get senior theatre. Assistance at
assistance if in difficulty. senior level available.
No clear guidelines. Given clear guidelines as to
when to call / inform /
discuss with consultant.
CLINICAL MANAGEMENT
Patient ▪ Consultant does not ▪ Consultant supports
Manag support trainee. No trainee & offers advice.
ement guidelines & no trust. Trainee given guidelines &
Consultant criticizes all trusted to use own
decisions. judgement.
Emerg ▪ Advice / help not easy to ▪ Advice / help readily
ency / obtain. Consultant difficult available. Consultant
Operat to find / contact. Also, not always happy to be
keen to come in / assist. phoned / consulted / give
ing
advice.
Feedba ▪ Poor or absent appraisal. ▪ Regular appraisals sessions
ck No protected time to in specified time.
discuss performance. Consultants open about
Consultant not frank / strengths / areas for
mainly critical. improvement.
Career ▪ Consultant not interested ▪ Consultant offers advice.
Advice in trainee or his career. Directs trainee to source of
advice / help.
SCIENTIFIC ACTIVITIES
Clinical ▪ Poor consultant support / ▪ Consultant led. Well
Meetin input. Badly attended. attended by all grades.
gs Rigid non innovative Varied programme. Often
programme. Not multi- multidisciplinary. Held in
disciplinary. Held outside normal working time.
normal working hours. Juniors encouraged to
present / take part.
Audit ▪ Morbidity / mortality only. ▪ Proper audit cycle, leads to
No in-depth review of change in clinical practice.
problems. Does not lead to ▪ Juniors assisted with data
change in clinical practice. collection. Friendly, non-
▪ Juniors collect all data. confrontational
Threatening atmosphere. atmosphere.
110
Journal ▪ Juniors expected to do all ▪ Equal consultant / junior

Review reviewing. Poor consultant participation. Articles
attendance. Didactic reviewed and discussed.
discussion.
Resear ▪ No fixed time allowed. ▪ Fixed session / protected
ch Clinical work precludes time allocated.
time for research. ▪ Able to discuss / plan ideas
▪ No interest or stimulation with consultants. Directed
shown by consultants. to appropriate sources for
information / funding.
GENE ▪ No objectives. All clinical ▪ Clear objectives for
work. Poor education / trainee. Good balance /
RAL
learning. clinical / teaching /
learning / research.
Strengths of unit/department:
Weaknesses of unit/department:
Suggestions for improvement:
Signatures
Trainee: Date:
6- Annual Review Trainee

Process (ARP) Name:
Training
Number /
Specialty:
End of
Training:
This is an official document. A separate form is to be completed at each HARP meeting

indication the evidence for and outcome of the review process. The original is the property of
the Egyptian Fellowship Board. Signed and completed forms are to be returned to the Board
offices.
Date of Period Covered Year in Training (tick as
Review appropriate)
111
From To 3, 4, 5, First
review, Second review
Previous HARP 1 HARP 2 HARP 3 HARP 4
HARP
outcome
Posts under review

Hospital Period Subspecialty Trainer
(from –
to)
Documentation taken into account during the HARP meeting and

known by trainee
1 Log book
2 Trainee assessment forms
3 Curriculum vitae
4 Summary of courses/meetings attended and summary of research
undertaken.
5 Training portfolio
6 Educational supervisors report Form
7 Others
Summary conclusion
HARP 1: Satisfactory in all respects to proceed
HARP 2: Satisfactory to proceed, but the following areas for improvement have
been identified and must be addressed in the next placement (detail areas for
improvement - please extend to an attached sheet if necessary –attached sheets
must be signed and dated by Council director and trainee)
112
HARP 3: Official warning, may be expelled if problems not rectified during next
placement
HARP 4: Unsatisfactory and should be referred for advice about choosing an

alternative career pathway
HARP 5: Successfully completed training, Eligible to sit final exam
Comments from Trainee: (please extend to an attached sheet if necessary –
Signatures
Council Director: Trainee: Date:
113
“Training Manual
makes an Amateur a Pro.”
Best Wishes
114

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Ministry of Health & Population

High Committee of Health Specialties

Egyptian Fellowship Board

Postgraduate medical education worldwide is governed by academic standards that

Prof. Magdy El-Serafy

Our Dear Candidate

Trainees should document all activities, comments and reflections in the

Head of the Scientific Council

The High Committee of Medical Specialties would like to acknowledge the

Sincere thanks and appreciation go to the following esteemed members of

Prof. Samir Galal

STRUCTURE OF THE TRAINING PROGRAM 5

TRAINEE'S DUTIES AND RESPONSIBILITIES 7

REQUIRED SURGICAL PROCEDURES 10

INTENDED LEARNING OUTCOMES (ILOs) 16

TEACHING & TRAINING METHODS 93

ASSESSMENT METHODS & BLUE PRINTING 94

GUIDE TO THE FINAL EXAMINATION 97

TRAINING ASSESSMENT FORMS 98

The Structure of the General Surgery

Weekly Activities (as minimum requirements)

1- Basic Surgical Skills (including intestinal & vascular anastomoses)

3- Basic Life Support

7- Research methodology & EBM

Trainees Duties & Responsibilities

1st, 2nd & 3rd Years

4th & 5th Years

N.B. Trainees should document all activities, comments and reflections

I- JOB DESCRIPTION OF THE TRAINER

II- JOB DESCRIPTION OF THE EDUCATIONAL SUPERVISOR

Surgical Procedures distributed over the Five Years

4th & 5th

3 Vascular & Lymphatic Surgery

9 GIT & Abdominal Surgery

INTENDED LEARNING OUTCOMES

INTENDED LEARNING OUTCOMES

Level of knowledge Code

ILO Written Written Long WPB

1.1.10 Describe the anatomy of cubital fossa K L3 L3 L3 L3

1.1.11 Describe the structures around the wrist K L3 L3 L3 L3

1.1.12 Understand the movements of the thumb IS √ √ √ √

ILO Written Written Long WPB

1.2.7 Describe the anatomy of the popliteal fossa K L3 L3 L3 L3

Describe the origin, insertion, nerve supply & function of

1.3.6 Describe the anatomy of the triangles of the neck K L3 L3 L3 L3

Identify the anatomical position, relations & blood &

ILO Written Written Long WPB

1.3.10 Describe contents & relations of the carotid sheath K L3 L3 L3 L3

1.4.1 Describe the structure of the thoracic wall K L2 L2 L2 L2

Describe course, relations & branches of ascending aorta,

ILO Written Written Long WPB

ILO Written Written Long WPB

1.5.12 Explain the abdominal incisions of surgical interest K L3 L3 L3 L3

ILO Written Written Long WPB

ILO Written Written Long WPB

ILO Written Written Long WPB

ILO Written Written Long WPB

ILO Written Written Long WPB

ILO Written Written Long WPB