The Tamil Nadu Dr. MGR Medical University Madras

The Tamil Nadu 

Dr. M.G.R. Medical University 

Madras 

Regulations For The 

Higher Speciality Courses

THE TAMIL NADU Dr- M-G.R. MEDICAL UNIVERSITY 

MADRAS - 32. 

D. M. 

HIGHER SPECIALITY COURSES 

Branches of Study Page No. 

BRANCH 1 Neurology 13 

BRANCH I! Cardiology 17 

BRANCH Ml Nephrology 27 

BRANCH IV Gastroenterology 38 

BRANCH VII Oncology (Medical) 44 

BRANCH IX Rheumatology 50 

M. Ch. 

BRANCH I Cardio-Thoracic Surgery 63 

BRANCH II Neuro Surgery 69 

BRANCH III Plastic Surgery 77 

BRANCH IV Genito-Urinary Surgery 82 

BRANCH V Paediatric Surgery 90 

BRANCH VI Surgical Gastro - Enterology 

and Proctology 95 

BRANCH VII Oncology (Surgical) 99 

BRANCH VIII Vascular Surgery 104 

N.B. :—The core-Syllabus furnished in this Book let is only 

an "Out - line". The Post - Graduate students 

should read exhaustively the Standard Text - Books, 

Reference Books, Journals etc. for a thorough 

understanding of the subject.

The Tamil Nadu 

Dr. M. G. R. Medical University 

MADRAS 

Regulations of the University 

In exercise of the powers conferred by Section 44 of the 

Tamil Nadu Dr. M. G. R. Medical University, Madras, Act, 1987 

(Tamil Nadu Act 37 of 1987), the Standing Academic Board 

of the Tamil Nadu Dr. M. G. R. Medical University, Madras hereby 

makes ttie following regulations I—- 

SHORT TITLE AND COMMENCEMENT:— 

These regulations shall be called "THE REGULATIONS FOR 

THE HIGHER SPECIALITY COURSES OF THE TAMIL NADU 

DR. M. G. R. MEDICAL UNIVERSITY, MADRAS", 

They shall come into force from the academic year 1994-95 

The regulations and the Syllabus are subject to modification 

by the Standing Academic Board from time to time.

REGULATfONS 

D.ft/L/M.Ch. POST-GRADUATE HIGHER 

DEGREE COURSES 

ftEGISTRATION 

A candidate admitted into D,iVi. / IVT.Ch. Post-graduate Higher 

Speciality Degree Courses in any of trie affiliated institutions of 

The Tamil Nadu Dr. M. G. R. Medical University, Madras, shall 

register with the University by remitting the prescribed fees 

along with the application form for registration du!y filled in 

and forwarded to the Controller of Examinations of this University 

through the Head of the affiliated institution within the stipulated 

date. 

BRANCH OF STUDY 

Candidates shall be examined in one of the following branches; 

D.IVT 

Branch 

Branch 

Branch 

Branch 

Branch 

Branch 

M.Ch, 

Branch 

Branch 

Branch 

Branch 

Branch 

Branch 

Branch 

Branch 

r 

ll 

III 

IV 

VII 

IX 

! 

H 

ill 

!V 

V 

VI 

vn 

Vlil 

Neurology 

Cardiology 

Nephrology 

Gastroenteroiog'y 

Oncology (Medical) 

Rheumatology 

Cardio-Thoracic Surgery 

Neuro Surgery 

Plastic Surgery 

Genito-Urinary Surgery 

Paediatric Surgery 

Surgical Gastro-Enterology 

and Proctology 

Oncology (Surgical) 

Vascular Surgery

1. ELIGIBILITY 

Candidates for admission to the first year D.M. / Wl.Ch "Postgraduate 

Higher Speciality Degree Courses shall be required to 

have any one of the following qualifications as detailed ' 

D.M. 

Branch I Neurology 

Branch il Cardiology 

Branch 

Branch IX 

M.OK 

Branch ! 

Nephrology 

Branch SV dastroenteroiogy 

Branch VII Oncology 

(Medical) 

Qualification ^requirements 

M.O. - General Medicine 

M.D. - Paediatrics 

M.D. - General Medicine 

IV!. D. - Paediatrics 


M.D, - Paediatrics 


M,D, - Paediatrics 

M.D, - Genera! Medicine 


M.D. - Radio - Therapy -" 

Rheumatology M.D. - Genera! Medicine 

Cardjo 

Thoracic 

Surgery 

Branch II Neuro Surgery 


M.S. - General Surgery 


M.S. - Orthopaedic Surgery

Branch HI 

Branch VF 

iransh Vlt 

Flastfc 

Surgery 

Branch IV Genfto- 

Surgery 

Branch VIH 

Paetffatrfe 

Surgery 

Sargicaf 

Gastroenterofogy 

& 

Proctofogy 

Oncology 

Surgical 

Vascular 

Surgery 

M.S. - Genera? 

Surgery 

M.S. - Orthopaedic Surgery 

M,S. - E,N.T. 

M-S. - Generaf Surgery 

iVi.D. -Obstetrics & 

Gynaecology 

M.S. - Gerrera-r 

Surgery 

M,S. - Orthopaedic 

Surgery 

M.S, - Generaf 

Surgery 

M.S. - General 

Surgery 

M.S. - Orthopaedic Surgery 

M.S. - E.N.T- 

M.D, - Obstetrics & 

Gynaecology 

M.D. - Radio Therapy 


I.S. - Orthopaedic

a) He / She having qualified for the Post-graduate degree 

of this University or any other University recorrgnised as 

equivalent thereto by the authority of this University and the 

Indian Medical Council and obtained permanent registration 

from any of the State Medical Councils. 

b) The admitting authorities of the Institutions will strictly 

ensure that every candidate admitted to the D.M, / M.Gh. Post- 

Graduate Higher Spsciality Degree Courses has obtained 

permanent registration certificate (M.B.B.S., Post-Graduate 

Degree) from any one of the State Medical Councils. 

Candidates who have passed any qualifying examination 

other than the Tamil Nadu Dr. M.G,R Medical University shall 

obtain an eligibility Certificate from this University by remitting 

the prescribed fees along with the application form before seeking 

admission to any one of the affiiiated medical institutions, 

4. RECOGNITION FEE 

Candidates who have passed the M.B.B.S. Degree / Postgraduate 

Degree from any other University shall remit a recognition 

fee as prescribed along with the stipulated registration fees. 

5. DURATION OF THE COURSE 

a) The duration of certified study and training for the D.M./ 

M.Ch. Post-graduate Higher Speciality Degree Courses shaM be 

of two years. 

(b) No exemption shall be given from this period of study 

and training for any other experience gained prior to the admission 

of the course. 

6. COMMENCEMENT OF THE COURSE 

The academic year for D.M, / M.Ch. Post-graduate Higher 

Speciality Degree Courses shall commence from April 1st of the 

academic year.

7. CUT-OFF DATES 

The candidates admitted from 1st April to 30th June shall be 

registered for that acodemic year and shali take up their regular 

examination in March. 

The candidate admitted from 1st July to 31st December shall 

be registered^for that academic year and shall take up their exam. 

in September, 

The candidate admitted from 1st January to 31st March 

shall be registered for the academic year of the selection, but they 

shall undergo the course along with the subsequent year batch of 

students. 

8. COMMENCEMENT OF EXAMINATIONS 

There shall be two University examinations in an academic 

year. 

March 1st / September 1st 

If the date of commencement of the examination fails on 

Saturdays, Sundays or declared Public Holidays, the examination 

shall bagin on the next working day. 

9. WORKING DAYS IN AN ACADEMIC YEAR 

Each academic year shall consist of not less than 200 working 

days. 

10. ATTENDANCE REQUIREMENTS FOR ADMISSION TO 

EXAMINATION 

No candidate shall be permitted to appear for the examination 

unless he/she has put in 80% attendance during his/her period 

of study and training in the affiliated institution recognised by 

this University and produces the necessary certificate of study, 

attendance and progress from the Head of the institution.

11. CONDONATION OF ATTENDANCE Q. .: 

There shall be no condonation of attendance. 

12. REVALUATION OF ANSWER PAPERS ? : 

There shall be no revaluation of answer papers. 

7 

13. TRAINING IN OUTSIDE CENTRES •' ' 

The Head of the Post-graduate Departments should make 

necessary arrangements for their post-graduate candidates to 

undergo training in various skills in other centres within and outside 

the State if facilities are not available in their own institution 

or hospitals. 

14. NUMBER OF APPEARANCES 

Candidates who do not pass their final examination within 

three appearances shall undergo a further period of study and 

training of minimum 3 months duration in a recognised Postgraduate 

Department in the speciality in an institution approved 

by Medical Council of India for every subsequent appearances. 

The candidate should submit a certificate of "study 'and 

training from the Head of the Institution to Controller of Examination 

of this University along with his/her application for 

admission to every subsequent examinations (applicable for 

candidates who have failed more than 3 times) : : . 

The failed candidates will be, permitted to appear for a 

maximum of 8 attempts within 6 years from the date of-completion 

of the course and shall be discharged from the course if 

he / she faNs to fulfil this provision. V'.i. ~ 

15. MAINTENANCE OF LOG BOOK 

(a) Every post-graduate candidate shall maintain a record of 

skills he has acquired during the training period certified by the 

various Heads of Departments he has undergone training.

3 

(b) The candidate should also be required to participate in 

the teaching and training programme of post-graduate and intern 

students. 

(c) In addition, the Head of the Department shall involve 

their post-graduate candidates in Seminars, Journal Clubs, Group 

Discussions and participation in clinical, clinico-pathological 

conferences. 

(d) Every post-graduate candidate should be encouraged to 

present short title papers in conferences and improve on it and 

submit them for publication in reputed medical journals. Motivation 

by the Heads of Departments is essential in this area to 

sharpen the research skills of the post-graduate candidates. 

(e) The Head of the Department shall scrutinise the Log Book 

every three months. 

(f) At the end of the course, the candidate should summarise 

the contents and get the Log Book certified by the Head of the 

Department. 

(g) The Log Book should be submitted at the time of practical 

examination for the scrutiny of the Board of Examiners. 

16. DISSERTATION 

(a) Ail candidates admitted to undergo D.M. / M.Ch. Postgraduate 

Higher Speciality degree courses shall be assigned a topic 

for dissertation / thesis within 3 months of his / her admission to 

the course and the title of the topics assigned to the candidates 

be intimated to the Controller of Examinations of this University 

by the Head of the Department through the Head of the Institution, 

failing which the candidate will not be registered. 

(b) The candidate shall have the option in lieu of dissertation 

/ thesis to submit 3 short papers of standard acceptable for 

publication by any National Medical Journal declared by the 

examiners.

c) The dissertation / thesis shall be a bound volume of 

minimum 50 pages and not exceeding 75 pages of type matter 

(Double line spacing and one side only) excluding certification, 

acknowledgements, annexures and Bibliography. 

d) 4 copies of dissertation shall be submitted 4 months prior 

to the commencement of the examinations on the prescribed date 

to the Controller of Examinations of this University. 

17. EVALUATION OF DISSERTATION 

a) The dissertation shall be evaluated by two external 

examiners prior to the commencement of the University theory 

examinations. 

b) Two copies of statement of marks for dissertation shall 

be sent by the Examiners to the Controller of Examinations of 

this University. The Controller of Examinations shall forward a 

copy of the statement of marks to the Chairman of the Board of 

Examiners who will consolidate the marks at the tims of Clinical 

examinations. 

c) If the dissertation is approved but the Examiners suggest 

minor corrections and resubnvssion of the d ssertation, the 

candidate's results shall be withheld. The Chairman, Board of 

Examiners, shall submit a detailed report to the Controller of 

Examinations of this University the corrections that the candidate 

has to carry-out and the dissertation shall be resubmitted within 

a month of publication of the results by the candidate. The 

dissertation should be revalued by the same set of examiners and 

on receipt of approval the results of the candidate shall be 

declared. ; . _ . . . . " 

d) If the candidate fails in the written / practial examination 

but his dessertatiou is approved, the marks awarded for dissertation 

shall be carried over for the subsequent examination(s).

10 

e) If the dissertation is rejected by any one examiners, the 

candidate is not permitted to appear for the written / practical 

examinations and shall resubmit a fresh dissertation one month 

prior to the commencement of the subsequent theory examination. 

18. MIGRATION /TRANSFER OF CANDIDATES 

a) Migration / Transfer of candidates from one recognised 

Medical College to another recognised Medical College of this 

University or from another University shall not be granted unless 

a No Objection Certificate is obtained from the Medical Council 

of India. 

b) The provision of combination of attendance shall be 

granted to a transferee for admission to the examinations of this 

University on satisfactory fulfilment of the regulations of this 

University. 

19. RE-ADMISSION AFTER BREAK OF STUDY 

a) Candidates having a break of study of 5 years and above 

from the date of admission and more than two spells of break 

will not be considered for re-admission. 

b) The five years period of break of study shall be calculated 

from the date of first admission of the candidate .to the course 

for the subsequent spells of break of studies. 

c) A candidate having a break of study shall be re-admitted 

after satisfactory fulfilment of the regulations of the University at 

the commencement of an academic year only and shall undergo 

the full duration of the course with no exemption in the period of 

study and will be permitted to appear for the examinations as 

prescribed in the regulations.

DISTRIBUTION OF MARKS: 

11 

Scheme of Examination 

Theory Title of the Papers Duration Maximum 

in Hours Marks 

Paper 1 

3 

100 

Paper 11 

Paper III 

Paper IV 

CLINICAL EXAMlNATiIONS: 

Long Case 

Short Cases 

Ward Rounds 

DISSERTATION : 

Marks for Dissertation 

Marks for Oral on Dissertation 

ORAL : 

3 

3 

3 

Total : 

No. Of cases Duration 

One One hour 

Two (Minimum) One hour 

(30 mts. each) 

Three 45 mts. 

(15 mts. each) 

Total : 

Total 

MARKS QUALIFYING FOR A PASS 

50% of marks in the University written examination 

50% of marks in the University clinical examination 

50% aggregate in Theory/Ciinical/Oral/Dissertation 

100 

100 

100 

400 

Marks 

70 

70 

60 

200 

100 

100 

200/400 

100/200 

400/800 

Maximum Number of Candidates to be Examined Per day: 3

12 

Model Question Paper 

Time: 3 Hours Maximum: 100 Marks 

1. Essay Question 

2. Essay Question 

3. WRITE BRIEFLY ON: 

(A) 

(B) 

(C) 

(D) 

(E) 

25 Marks 

25 Marks 

(5 x 10 •= 50 Marks)

13 

D.M. BRANCH-I NEUROLOGY 

STRUCTURED TRAINING PROGRAMME: 

DEPARTMENTS INVOLVED IN THE TRAINING PROGRAMME ; 

—Clinical neurology and orientation to the course. 

Selection of the topic for dissertation. Research 

methodology including biostatistics to be finalised 

with appropriate department. 

—Clinical Neurology 

Behavioural Neurology and Cognitive Neurology,. 

—Neuropsychology and clinical psychiatry 

— Neurosurgery 

—Neuropathology 

—Electro-neurophysiology 

—Neuroradiology 

—Acute Neurology 

—Posting in Clinical Neurology

4, SYLLABUS : 

1. History of Neurology 

14 

BASIC SCIENCES 

2. Neuro anatomy including neuro - embtyology and applied 

neuroanatomy 

3. Neurophysiology - a) Electro - neurcphysiology 

b) Applied neurophysiology 

4. Neurochemistry 

5. Neuropathology 

6. Genetics, experimental neurology, neuroimmunology, neuropharmacology, 

statistics, research methodology. 

NEUROLOGY 

1. Clinical neurology including neurological examination 

including peediatric neurology, neuro-ophthalmology, neurootology, 

neuro-psychiatry, neuropsychology, behavioural 

and cognitive neurology, neurological manifestation in 

general medicine and tropical neurology. 

2. Orientation to neurological surgery. 

3. Electrophysiology which includes EEG, EMG, Evoked Potentials, 

brain mapping and quantitative and analytical electroneuro-physiology. 

4. Neuro-imaging which includes neuroradiology, CT scan, 

MRI, PET etc. 

5- Neuro-therapeutics. 

6. Acquantanus with world literature and recent advances.

15 

ANNEXURE B 

Scheme of Examination of Post-Graduate 

Higher Speciality Degree Examination 

O.M. BRANCH I NEUROLOGY 

Paper I —Basic Sciences .„. 100 

(Consisting of Neuroanatomy,Neuro-Physioiogy, 

Neuro pathology, 

Neuro-Chemistry & 

Electro Neuro Physiology) 

Paper II—Clinical Neurology 

Basic Sciences 100 

Paper III—Recent advances in 

Neurology m 100 

Papar IV—Ancillary Subjects _„ 100 

Clinical _ 200 

Oral — 100 

Dissertation ,„ 100 

800

16 

Minimum marks requirement for pass in the Examination :- 

Totai marks Separate minimum marks 

< required. 

Paper 1 

Paper M 

Paper III 

Paper IV 

400 200 

Clinical 200 100 

Oral 100 

Dissertation 75 

Oral on \- 100 

Dissertation '25 

800 4°° Marks 

required 

for awarding 

a pass,

1? 

D.M. - BRANCH-H - CARDIOLOGY 

• - 


(a) FIRST SIX MONTHS : 

The candidate will work in the Departments of Anatomy 

Physiology, Biochemistry and Pathology where he wili devote his 

attention to Physiology and Applied Physiology of cardiac cycle. 

Waemodynamics, Pharmacology of relevant drugs, Pathology of 

the heart at autopsy. Anatomy and surgical anatomy of cardiac 

chambers and valves. Pulmonary Physiology, Electro-physiology, 

Physiology of hypothermia and perfusion for open heart surgery. 

Cardiac biochemistry and electrolytes, 

'(C) THIRD SIX MONTHS: 

IS 

Clinics in Clinical Cardiology, [preluding the subjects 

mentioned above with particular reference to tho clinical findings, 

correlation with cardiac physiology and instrumental cardiology. 

(d) FOURTH SIX MONTHS ; 

The candidate must spend enough time in the following 

departments: 

(a) Cardiac catheterisation, 

(b) Pathology, histopathology and cardiac biochemistry. 

(c) Operation theatres along with the cardiac Surgeons.

19 

POST GRADUATE HIGHER SPECIALITY DEGREE 

D, M, BRANCH II—CARDIOLOGY 

PAPER SUBJECT MARKS 

MAX 

Paper J — Basic Sciences - Cardiolegy- - 100 

Paper H — Applied Cardiology including Heomodynamics 100 

Paper 111 — Clinical Cardiology including recent advances 100 

Paper IV — Special Cardiac investigation snd therapeutic 

procedures . TOO 

- CiinicaJ .- 200 

Oral 100 

Dissertation ICO 

Total 800 

. MINIMUM MARKS REQUIRMENT FOR YAWARDING 

PASS IN THE EXAMINATION 

Paper I I 

Paper II j 

Paper 111 

Paper IV 

Total Marks Separate minimum 

Marks required 

400 2CO 

Clinical 200 100 ... 

Oral 100 '_ 

•Dissertation 75] ...... 

. j 100 

Oral on Dissertation 25 J 

800 •" • : 4°° Aggregate marks 

—— -—- required for a 

pass.

20 

SYLLABUS FOR D.M. (CARDIOLOGY; 

1. Development of the heart - arrests in the development of 

the heart and predisposing factors-comparative anatomy. 

2. Methods of diagnosis - clinicaf examination right and left 

ventricular hypertrophy importance of the first and second 

sound - appreciation of cardiac murmurs. 

3. Diagnostic methods of precision - X-ray fluo copy 

kymography - angiography selective angiography cardiac 

catheterisation - electrocardiography ^ Vector Cardiography, 

4. Determination of vital capacity - Cardiac output by Pick 

Principle-dilution methods determination of circulation 

time - blood volume venous pressure determination of 

, pulmonary blood flow, pulmonary resistance and place of 

radioactive isotopes in the investigation of both congenital 

acquired heart disease and blood gas analysis. 

5. Concept of Cardiac failure - forward failure - backward 

failure - high output failure- low output failure • Pathogenesis 

of symptoms like oedema, dyspneea, pulmonary 

oedema, cyanosis, effusion, asctise, jaundice, gallop 

rhythm and ulsus alternans.. 

6. Treatment of Cardiac failure - genera! principle - diet - 

drugs - digitalis, various preparations, physiological and 

pharmacological ascsion, indications, drug toxicity - 

quinidin - diuretics like mersalyl and cholorothiazide 

anticoagulants - xanthino derivatives-morphine pottasium 

salts - sedatives. 

7. Circulatory failure - shock and symcope - mechanism of 

shock causes of shock - various types of syncope and 

treatment.

• 

21 

8. Cardiac arrhythaias and various types of heart block. 

9. Coronary circulation - coronary blood flow and its control, 

problem of coronary atherosclerosis - angina pactories - 

clinical features - electrocardiographic" findings - treatment. 

10. Acute coronary occlusion and myocardial Infarction - 

symptoms signs - diagnosis - complications - treatment - 

prevention - prognosis changes in the enzymes of the 

heart. 

11. Pericorditis - classification - clinical features1- cardiac 

tamponEue - pericardia! aspiration. 

12. Constrictive pericarditis - signs - symptoms relationship 

to tuberculosis - diagnosis - treatment, including surgery. 

13. Myocardits and cardio - myopathis - signs - symptoms - 

diagnosis. 

14. Rheumatic fever - aetiology - course - seroligical tests - 

diagnosis treatment. 

15. Valvular lesions - mineral valvular disease - mitral steno- 

, sis and insufficiency • aortic stenosis aortic fnsufficency - 

aetiology, pathology - signs - symptoms diagnosis complications 

treatment including surgery tricuspid stenosis. 

16. Congenital heart disease - classification - symptomatology 

common congenital heart disease- methods of investigation- 

surgery of congenital heart disease, with and without 

cardiopulmonary bypass - medical aspects of extra - 

corporal circulation detailed knowleuge of atrial septal 

defect ventricular septal defect, patient ductus arteriosus, 

commontruncous. Pallet's tetralogy, aortic septal defect, 

co-aretation of the aorta and pulmonary stenosis.

22 

17. Bacterial endocarditis-bacteriology pathogenesis clinical 

features treatment detailed knowledge of the antibiotics 

indicated in the treatment of this disease. 

18. Cardio - aortic syphilis - pathology - gumma of the 

myocardium aortic incompetence - syphilitic - aortitis - 

aneurysms - diagnosis - complications and treatment. 

19. Heart in acute infection like pneumonia, typhoid 

diphtheria. 

20. Hypertension and hypertensive heart disease-investigation 

of a case of hypertension - estimation of renal functionendocrine 

factors in hypertension-pathological physiology 

of hypertension signs, symptoms place of nyperte.nsive 

drugs, and management of hypertension. 

21. Pulmonary embolisum - predisposing factors - types of 

emboli - clinical classification - acute, sub - acute and 

chronic - physical findings and treatment. 

22. Extrinsic heart disease.- haart in anaemia,, in beri beri in 

Page'rs disease - hyperthyriodism - hypothyrodism. 

23. Tarumatrc heart disease - penetrating injuries of the heart 

haemopericardium. 

24. Cardiac tumours. 

25. Functional heart disease - including neuro - circulatory 

asthenia and cardiac neurosis. 

26. Pregnancy and heart disease - pathological physiology - 

circulatory adaptations - management of a case of heart 

disease through pregnancy indications for therapeutic 

abortion.

27. Surgery in : 

23 

On the cardio vascular system-assessing surgical risks 

choice of hypothermia and extra-corporal circulation in 

the treatment of both congenial and -acquired heart 

disease and aneurysms and other vascular defects. 

(b) Surgical management of patients with heart disease. 

IN ADDITION TO THE ABOVE SYLLABI, CANDIDATES SHOULD 

HAVE WORKING KNOWLEDGE OF CARDIOLOGY IN ALL ITS 

ASPECTS EVEN THOUGH NOT COVERED BY THE SYLLABUS 

OUTLINED. 

A student in the course of his training should devote sometime 

for experimental cardiology in animal house and conduct 

minor pharmacological experiments in relation to Cardiology. 

Throughout the entire three years course the student should 

attend autopsis of cardiac cases and maintain a complete record 

of the case including the histopathological study and bacteriological 

data. 

While working in the Anatomy department it is advised that 

the student will devote time to reconstruct the development of the 

heart.

24 

List of Books and Journals 

AUTHOR TITLE PUBLISHER 

1. Adams, F H. etc. 

2. Braunwatd, E 

3, Feigenbaum, H, 

4. Grossman 

5. Hurst, J.W, 

& 

Schlant 

6. Lakshmikanhan, C,L. 

7, Lakshmikanthan, C.L 

.8, Lip Man, B. etc. 

Moss Heart Disease 

in infants - children 

Adolescents Vols. 1 

and Vol.—2 Ed. 4 

Heart Disease ; A 

Text book of Cardio* 

vascular Medicine 

Ed 4/1992 

Echocardiography, 

Ed. 4 

Williams 

WMkin3 

F.A.Davis 

Lea & Fobiger 

Cardiac Catheter!zationAnglography 

and intervention 

Ed, 4/1991 Lea & Febiger 

The Heart '. Arteries 

and veins - 

Ed. 7 

Illustrative Echocardiography 

1980 

Illustrative Color 

Doppler Echocardiography 

1989 

Clinical Electro* 

cardigraphy 

Ed. 8 

IVtcgraw - Hilf 

T, Saravana 

Perumat 

Madras 

T, Saravana 

Perumal, 

Ivladras. 

Year book 

Medical 

Pub.

9. Nanda, N.C, 

, Schamroth, 

25 

Atlas of Color 

Doppler Echo* 

teardiography 1985 

The Electro*, 

cardiology of 

Coronary artery 

disease Ed. 2 

Lea & febiger 

Slack well 

Scientific 

foundation 

11. Schiant, R. Year book of C.V Mosby 

Cardiology 1992 

12, Vogel, 1C Jnterventional 

Cardiology :- 

Future directions 

1992 .: - : C.V,

1» American Heart Journal 

26 

JOURNALS 

2. American Journal of Cacdiotogy 

3. British Heart Journal 

4. Cardiology Clinics 

5. Cardiovascular Clinics of North America 

6. Circulation 

7. British Journal of Diseases of the chest 

8. Chest 

9. Circulation Research 

tO. European Heart Journal 

11. Indian Heart Journal 

12. Journal of American College of Cardiology 

13. Progress in Cardiovascular Diseases 

14. Recent Advances in Cardiology

27 : 

D.M. BRANCH III - NEPHROLOGY 

STRUCTURED TRAINING PROGRAMME-IN D.M. NEPHROLOGY 

OBJECTIVE TRAINING: ;: 

1. To develop skills in the diagnosis and treatment of kidney 

diseases. ... . 

2. To impart knowledge in the physiology, pathology of 

kidney in health and disease. 

3. To train in preventive Nephrology.. 

4. To develop ability and application for research and the 

capacity to disseminate the knowledge so acquired. 

B. To improve teaching skill. Knowledge of new methods of 

teaching and teaching aids. 

6, To have a basic understanding of interpersonal relation-ship 

to develop compassion and aptitude for service. 

METHODS OF TRAINING 

1. Inservice training. 

2. Syllabus as given already. 

3. Procedure to learn. Renal biopsy 

Starting and closing of peritoneal dialysis 

Starting and closing of haemdialysis 

Vascular access for haemodialysis

TRAINING PROGRAMME 

TEACHING PROGRAMME : 

28 

- Duration 2 years 

Monday 5pm to 7pm Case presentation 

Tuesday Transplant Meeting 

Teaching rounds 

Wednesday 

Thursday 

Friday 

T pm—2 pm Topic 

discussion 

Article discussion 

Review 

Saturday Dialysis meeting 

Journal club 5 pm 

5 pm Case discussion 

5 pm Case discussion 

Group discussion 

Problem discussion CPC 

Nephrology grand rounds

29 

P.G. Higher Speciality Degree Examination 

D.M. BRANCH 111 NEPHROLOGY; -.£ 

Marks 

Paper I — Nephrology - Basic Sciences ,. ; 100 

Paper II — Clinical Nephrology, Dialysis, _ . 

Transplantation 100 

Paper III — Recent advances '100 

Paper IV — Essay Questions 100 

Clinical 200 

Oral 100 


Minimum marks requirements for awarding 

pass in theExaminations :- 

Paper I 

Paper I! 

Paper III 

Paper IV 

Total 800 

Total Separate minimum 

Marks marks required. 

400 200 


Oral 100 

Dissertation 751 1fi 

Oral on Dissertation 25 J IUU 

800 ^DO Marks 

• required 

for a pass

30 

Every postgraduate is expected to pressnt atleast one paper in 

National Society and publish in National / International Journal. 

Lecture: 

—Physiology - Department of Physiology 

—Visiting professors.

31 

D.M. (NEPHROLOGY} SYLLABUS 

1. STRUCTURE OF KIDNEY: - 

Anatomy of human kidney comparative Anatomy - Electron 

microscope as a tool for study of kidney structure. Eesctron 

microscopy of the kidney. 

2. OUTLINE OF KIDNEY PHYSIOLOGY : 

Renal circulation - kidney and oedema. Glomular filtration - 

tubular reabsorption - Tubular Secretion - Reabsorption and 

exeretion of Water Excretion of Sodium and Chloride-Excretion of 

Urea Non ionic diffeston. Hydrogen Ion and kidney, '. Mechanism 

of urinary concentration. 

3. WATER AND ELECTROLYTE BALANCES : 

Renal effects of Water and electrolyte imbalances. Potassium 

and kidney. Acid base disturbance and the kidney. 

4. CLINICAL EXAMINATION OF RENAL FUNCTION : 

Proteinuria. Urine sediment, clinical tests of renal function - 

Tests of concentration and dilution -co - relation of clinical 

function tests - Potopes and renegrams and renal function relation 

to age - Percutaneous renal biopsy. 

5. RENAL RADIOGRAPHY: 

Examination and Principles - Examination methods - stones. 

Tumour, Cysts, Urinary tract dilation, Trauma, Renal carbuncle, 

abscess, perinephritis, Primary vascular Changes, medullary 

spenge kidney. Gas in Urinary Pathways. Failure of renal 

function. Electrolyte derangements Uremia. Treatment of renal 

insulficiency and renal failure. 

6. SYMPTOMATOLOGY OF RENAL DISORDERS : 

7. TECHNIQUES OF EXAMINATION IN NEPHROLOGY:

32 

8. Consequences of Renal Failure and their Management ; 

Renal effects of acute Hypotension. 

9. Dialytic Methods of Treatment : 

Principles and mechanisms (i) Haemeodialysis (ii) Peritonial 

dialysis (iii) other methods of dialysis (iv) Acute dialysis 

(a) Renal failure (b) Poison (v) Chromic Dialysis, (vi) Methods 

of shunts complications (vii) Institutional Dialysis - Planning 

Central (viii) Home Dialysis (ix) Complications of Dialysis 

(x) Dialisable toxins and other substances- ; 

10. Pathogenosis of Glomerulonephritis : 

.Terminology, Pathology, Pathology of tubules, progression of 

acute glomerulonephritis Experimental glomerulonephritis. 

Foreign protein nephritis. Microbiologic aspects of nephritis. 

Complement and immune mechanism in tissue damage- Immune 

phenomena in human nephritis. 

11. Clinical Aspects of Acute Glomerulonephritis : 

Epidemiology, site of proceeding infection. Clinical immunology 

I aten : period Renal function and electrolyic disturbances, 

laboratory data, renal histology in relation to clinical course. 

Clinical course and prognosis recurrences. Differentia! diagnosis 

prophylaxis and treatment. 

12. Focal Gfomerulonephritis : 

As a complication of other diseases. Renal biopsy studies irt 

local glomerulonephritis, clinical feature Pathology, Treatment, 

Nature of local glomerulonephritis. 

" - ' - - . - - 

13. Clinical Aspects of-Chronic Glomerulonephritis *< , 

Incidence. Pathogenesis and classification, symptoms and 

signs, laboratory findings, prognosis, natural history, differential 

diagnosis treatment.

14. The Nephroeic Syndrome : 

33 

Renal amyloidosis Thrombosis of real artery and vein. Haemoglobinuria, 

Myoglobinon in Porphyria, Nature of the lesion, renal 

biopsy, immunology, Pathology, Pnysiology, clinical features, 

special forms, Experimental Nephrosis treatement and prognosis. 

15. Acute Renal Failure : 

Pre-renal, renal, post-renal failure. Clinical course and treatment, 

caloric intake, fluids. Cardio various system, Central 

nervous system, infection. 

16. Pediatric Nephrology : 

Acute renal failure of new boms and infants. Hacmolytic 

Ureamic syndrome. 

17. Pyelonephritis and Urinary Tract Infection : 

Pathways of renal infection Bladder infection, Ascending 

infection, predisposing factors, clinical manifestations, lafao'atory 

diagnosis, hypertention and chronic pyelonephritis. Renal 

papillary necrosis, bacteruria obstruction and stasis, intrumentatlon, 

diabetes, gout, analgesic abuse. 

18. Viral Infection of the Kidney. 

19. Nephrosclerosis. 

20. Hypertension: 

Renal causes. Malignant Nephrosclerosis Reflovascula? 

hypertention. Renin-angiotensin- aldosterone in renal circulation. 

21. Polyuria : 

(a) causes (b) Mechanism. 

22. Renal Cortilae Necrosis : 

R«nal infarction and Hypertension to Renal vascular disease.

34 

23. Renal involvement in Myeloma : 

Amayloidosis, systematic lupus Frythematosus and other 

disorders of connective tissue. Kidney and Heart failure. 

24. Diabetic Nephropathy : 

Causes and prevention. Treatment. 

25. The kidney in Gout, 

26. Nephropathy of Hypercalcemia : 

Effects of Calcium on renal function clinical features. 

Hyperparathyriodism. 

27. Nephropathy of Potassium Deplection : 

Pathogenes's structural changes. Pyelonephritis. 

28. Nephrolethiasis and Nephrocaicinosis : 

Aetiology and genesis of calculi. Different types. Renal 

tabular acidosis. Collagen diseases involving kidney Angitis 

(Angiopathy) and Kidney. 

29. Obstructive Nephropathy : 

Evaluation, mechanism of nephron destruction. Pathogenesis 

of hydronephrosis. Clinical manifestation. 

30. Effects of urethra! transplantation : 

31. Effects of Irradiation on the Kidney : 

32. Renal Tubular Dysfunction : 

Selective defects of tubular function. 

33. The Kidney in Liver Diseases 

Renal failure in cirrhosis. 

34. The Kidney in Pregnancy. 

35. The Kidney in Sickle Cell Anaemia.

36. Genetics in Renal Disease. 

35 

37. Polycystic Disease of the Kidneys. 

38. Cystic Disease of Renal Medulla. 

39. Herditary Nephropathies. 

40. Vasopressin—Ressistant Diabates Insipidus. 

41. Congenital Malformation of the Kidney. 

42. Renal Tuberculosis, Modern Treatment. 

43. Tumours of the Kidney and Kidney complication associated 

with other Malignancies. 

44. Kidney and Sarcoidiosis. Kidney and IMeurofibromatosis 

Kidney and Angiokeratoma. Kidney and allergic Puspura. Kidney 

and Multiple myeloma and marcoglobulinemia, kidney and 

scteroderma. Progressive Lipodystrophy and kidney. 

45. Nephrotaxins and Kidney : 

Analgesic nepropathy, 

46. Diuretic and Kidney. 

47. Transplantation of the Kidney : 

(i) Introduction : Immunnological considerations of 

transplants. The genetic basis of transplantation. 

- ; 

(ii) Organ transplantation—moral and ethical problems. 

The World wide status. The clinical transplant kit. The 

Medical management of transplant patient. Maintenance dialysis. 

Kidney transplantation. The early diagnosis of renal allograft 

rejections. The Pathlogy of Human renal transplantation. Functional 

and Morphologic alterations in long term kidney transplants. 

Transplants of other organs. Hecrotransplants. Histocompatibility 

tissue.. Various experimental approaches. Immunological 

biopsy. Organ preservation. Perfusion rechniques. 

•

36 

48. Bony complications of Renal Diseases 

49. Diets in Kidney Disease 

Nitrogen Metabolism in Uraemia : 

50. Antibiotics in Renai Diseases. 

51. Immuno Suppressives in Renal Diseases. 

52. Experimental Renal Diseases. 

Immunologically induced Nephritis, experimental 

pyelonephritis. 

53. Pulmonary Involvement in Renal Diseases —Good 

Pasture Syndrome. 

54. Cardiac manifestations secondary to renal diseases. 

55. Colagen diseases affecting cardio-renal systems. 

56. Pediatric Nephrology. 

Practical Works : 

The course must stress on-the practical training that the candidate 

must undergo during the period of training with emphasis on. 

(!) Precutaneous renal biopsy—techniques, implication and 

management. 

(2) Dialysis: Haemo and peritoneal, implication and 

management. 

(3) A. V. Shunts—Insertion, care and declotting methods 

techniques of A.V. fistulae. 

(4) Transplantation : Perfusion techniques. 

(5) Renal Histology : Posting in Pathology Department for 

a period of 4—8 weeks in addition to weekly regular sessions on 

renal histology. 

•

37 

(6), Renal Biochemistry: Must be capable of handling all 

routine renal biochemical investigations—Posting in Biochemistry 

Departments for 2—4 weeks. 

(7) Uroiogical Procedures : Must be familiar with all procedures 

such as cystoscope, urethral catheterization etc. 

, - 

(8) Training in Technic of Dialytic methods.

38 

D-.M. BRANCH-IV-GASTROENTEROLOGY 

STRUCTURED TRAINING PROGRAMME : 

Departments involved in the 

Training Programme and 

duration of Training 

(1) Entire Programme in the 

Department Gastroenterology 

apart from visit to 

another centre for one 

month. 

(2) Surgical Gasteroenteroiogy 

(3) Paediatric Medical Surgical 

Gastroenterology. 

(4) Department of Radiology 

(5) Pathology 

(6) Haematology 

(7) Biochemistry 

(8) Special Preventive Medicine 

(9) Other Basic Sciences

39 

Post-Graduate Higher Speciality Degree Examination 

D. M. BRANCH IV-GASTROENTEROLOGY 

PAPER SUBJECT MARKS 

Paper I — Basic Sciences applied to 

the speciality 100 

Paper II — General Gastroenterology 

including Paediatric and 

preventive Gastroenterology. 100 

Paper ill — Heptobiiiary, Pancreatic 

Diseases. 100 

Paper IV — Recent advances in the 

Speciality. 100 

Clinical 200 

Oral 100 


Total 800

40 

Minimum IVIarks requirements for a pass in the Examination 

Total Separate minimum 

marks required. 

for each. 

Paper 1 

Paper !! 

Paper HI 

Paper IV 

Clinical 

Oral 

Dissertation 

Oral on Dissertation 75 

25 

400 

200 

100 

100 

200 

100 

800 400 Total 

— Marks 

required for a pass

41 

Syllabus 

Indepth knowledge of Digestive Health and Diseases, Diagnosis 

: Prevention and development anamolies of digestive system ; 

physiological functions and changes of organs in ill health; 

histopathology of normal structures and changes in diseases ; 

acquired diseases due to varying causes including Functional 

disorders; all current investigative procedures to assess both 

normalcy as also disease states; and treatment by all the 

available modalities including surgery and therapeutic endoscopy 

etc.. Preventive aspects must be studied in detail. Knowledge of 

systemic diseases affecting digestive system must also be 

imparted.

42 

SUGGESTED TEXT BOOKS 

1. Sherlock S. Diseases of the Liver and Biliary system. 

2. Morson B.C. and Davidson. Gastrointestinal Pathology. 

3. Koff, R.S.—Liver diseases in Primary care Medicine, 

4. Wilfred Sircus and Smith (A) Ed. Scientific foundations 

and Gastroenterology. 

5. Topics in Gastroenterology (upto date series). 

6. Sir Francis Avery Jono and J.E. Sennard Jones - Clinical 

Gastroenterology. 

7. Shearman, D.J.C. and Finalayson, N.D.C. Diseases of the 

Gastrointestinal tract and liver. 

8. Word (WJ) and Brady, P.G. Critical care Gastroenterology, 

9. Sleisenger M. H. and Fordtran, Gastrointestinal diseases 

Pathophysiology Diagnosis, Management. 

10. Bouchier I.A.D. Recent Advances in Gastroenterology. 

11. Spiro H.M. Clinical Gastroenterology. 

12. Gillespic, I.E. and Thompson T.J. Gastroenterology. 

13. Bayless T.M. Current therapy in Gastroenterology and Liver 

diseases. 

14. Bouchier, I.A.D., Text book of Gastroenterology, a 1984. 

15. Berk, J.E. ed. Bockus. Gastroenterology. 

16. Thomas HC. and James (EA). Recent advances in 

Hepatology No. 2, 1986. 

17. & 18. Modern Trends and Recent advances in Gastroenterology. 

All series upto date. 

19. Schiff (L) and Schiff (E). Diseases of the Liver. 

20. Peter B. Cotton, Practical G.I. Endoscopy.

Gastroenterotogy 

GUT 

43 

JOURNALS 

American Journals of Gasteroenterology. 

Hepatology. 

Journal of Clinical Gasteroenterology. 

Tropical Gasteroenterology. 

European Journal of Gasteroenterology. 

" 

'

44 

D.M. BRAIMCH-VII -ONCOLOGY 


Departments: Medical, Surgical and Radiation Oncology, 

Pathology including clinical pathology. 

Cytology, 

Cytogenetics, 

Molecular Biology. 

Biochemistry, 

Tumour microbiology including immunology 

Clinical Microbiology 

Physics as applied to medicine. 

Nuclear Medicine 

Tumour Registry 

Biostatistics 

Epidemiology 

Clinical Pharmacology 

Anaesthesia 

Radio diagnosis and imaging and 

Out-patient departments. 

Duration of: 1 Clinical Physics 6 months in the first year 

training J 

Biochemistry -do- 

Clinical Pharmacology -do- 

Biostatistics ~do- 

All the other subjects are taught over the entire 24 months 

of the course.

45 

P.G. Higher Speciality Degree Examination 

D.M. BRANCH-VII ONCOLOGY (Medical) 

Paper I — Basic Sciences (Radiation Physics, 

Turner B'oiogy, 

Biochemistry, 

Biometry, Immunology & 

Pharmacology 

Paper II — General—Oncology, Turner 

pathology, Radiology & 

nuclear Medicine 

Paper Eil - Mgdical Oncology including 

Therapy Epidemiology and 

Rehabilitation 

Marks 

100 

100 

100 

Paper IV — Recent Advances in Medical 

Oncology 100 

* Clinical 200 

Ora! 100 

Dissertation- 75) -nn 


Total 800

46 

4. Minimum Marks requirements for a pass in the Examination 

Total Marks Separate minimum 

Marks required 

Paper I 400 200 

Paper II 

Paper III 

Paper IV 

Clinical 

Oral 

Dissertation 

*Clinical Examinations 

200 

100 

100 

800 

100 

400 Marks 

required 

for pass 

Examinations No. of Cases Duration Marks 

Long Cases 

Short Cases 

1 80 Minutes 

2 2x20=40 

No. of Candidates to be examined per day-3 

100 

100 

200

47 

SYLLABUS 

1) Basic sciences of Oncology 

PATHOLOGY 

Modern pathology consists of many laboratory sciences 

including histopathoiogy, cytology, medical mircrobiology and 

virology, immunology, haematology and clinical chemistry. 

The general pathology of tumours, their functional properties 

and modes of spread, w=th a knowledge of their effects and 

metabolic, micro-biological and defect systems of the body are 

areas of particular value. 

This knowledge and experience is gained through an integrated 

teaching programme of regular clinico - pathological 

conferences, seminars, and demonstrations of biopsy and cytological 

material and biochemical data. Trainees should spend, 

if possible, an elective period of several months in one or more 

branches of pathology. This would allow an introduction to 

laboratory research and its related technology. 

HAEMATOLOGY 

Studies of abnormalities of the haemopoitic system are 

essential. Experience should be gained in performing and interpreting 

laboratory investigations. 

BIOCHEMISTRY 

The increasing importance of Biochemisty in the investigation 

and monitoring of patients and the development of immunodiagnosis 

must be recognised. The oncologist must be familiar 

with alterations in the general body metabolism caused by neoplastic 

disease and with biochemical disturbances from individual 

tumours. The mechanism of carcinogenesis including transplacental 

and intrautcrine carcinogenesis, the activation and 

binding of carcinogens is of profound interest.

48 

ENDOCRINOLOGY AND METABOLIC MEDICINE 

This is an expanding subject including the endocrine manifestations 

of tumours and ectopic hormones. Significant results 

are not obtained by manipulation of the hormonal control systems, 

especially incarcinoma of the breast and prostate. 

TUMOUR BIOLOGY AND IMMUNOLOGY 

Tumour immunology and molecular biology subjects with 

important potential value. 

RADIOBIOLOGY 

The collaboration of radiation oncologists with radiobiologists 

is essential and to a lesser extent for medical oncologists. 

Knowledge is required of cell kinetics, including the characterisation 

of normal and neoplastic cells the cell cycle and cell 

division,, cell loss and multiplication and cellular repair. 

RADIATION PHYSICS 

This including the physics of ionizing radiation and their 

interaction with cells, tissues and materials which is essential 

for the safe, accurate and effective radiotherapy Radiation 

Oncologists require more knowledge in depth than other specialists. 

CLINICAL PHARMACOLOGY 

An understanding of the pharmacology of the wide range of 

chemicals used in therapy is essential, especially for medical 

oncologist. This includes the use of different chemical combinations, 

dosage schedules, metabolism and elimination. An understanding 

of their limitations, toxicity and chemical interactions is 

necessary, for they are being used increasingly alone or in combin 

ation with surgery and radiationr 

EPIDEMIOLOGY 

This subjects is of great interest to all oncologists. The 

search for more clues in radiology must continue so that prevention 

can expand. The oncologist should be familiar with epidemiological 

methodology, tumour registries and population surveys.

GENETICS 

49 

Genetic mechanisms in enoplastic diseases are being more 

clearly understood and immunogenetics cytogenitics are established 

disciplines. Genetic counselling may be needed. 

MEDICAL STATISTICS 

A working knowledge is necessary for design of clinical trials, 

data recording and sampling and the use of controls Different 

techniques should be learnt for presenting data measuring mortality 

and the use of life tables: in addition to the assesment of 

therapy with surviva Irates. 

CLINICAL ONCOLOGY 

The objective to develop clinical judgement and technical 

skills in the total management of patients with neoplastic diseases 

The special technical skills are concerned with rnedical surgical 

and radiation treatment. Combination treatment with medicine. 

Surgery and radiation is being used increasingly which makes 

periods of interdisciplinary training advisable.

50 

DM. BRANCH IX - RHEUMATOLOGY 

STRUCTURED TRAINING PROGRAMME 

The selected candidates will get their training in the Dept. of 

Rheumatology during the first 3 months of first year and the 

entire second year. 

The teaching programme for the above period is enclosed. 

Teaching Programme for the 9 months of first year will be 

done as follows : 

Time - 8-00 a.m. to 1-00 p m.—On all Working Days 

DEPARTMENTS : 

Dermatology 4 Weeks 

Nephrology 8 Weeks 

Microbiology 4 Weeks 

Pathology 4 Weeks 

Rehabilitation 6 Weeks 

Orthopaedics 6 Weeks 

Radiology 4 Weeks

51 

TIME TABLE 

(Last 3 months of 1st year & full period of 2nd year) 

Days 8 to 10 am 10 to 12 Noon 

Monday 

Tuesday 

General Ward 

rounds and 

detailed 

discussion of 

in patients. 

Splinting 

Arthroscope 

Ward rounds 

Wednesday General Ward 

rounds and 

datailed 

discussion of 

in patients 

Thursday Splinting 

Arthroscope 

Ward rounds 

Outpatients 

Ward clinics 

SLE Clinic 

Outpatients 

Ward clinics 

R.A. JRA Clinics 

Outpatients 

Ward clinics 

PSS & Vasculitis 

Clinic 

Outpatients 

Ward Clinics 

SNSA Clinic 

Friday General Ward . Outpatients 

rounds and Ward clinics 

detailed DJD Clinics 

discussion 

about in patients 

Saturday Splinting 

Arthroscope 

Ward rounds 

Outpatients 

Ward clinics 

Other diseases

52 

TIME TABLE—AFTERNOON 

(ENTIRE COURSE) 

Days 1 to 2 pm 2 to 4 pm 

Monday Journal club Individual Project work 

Drug trials microbiology 

Immunology Lab / work 

Tuesday Lecture 

Case sheet 

branding 

Wednesday Topic 

discussion 

Articles 

writing 

Thursday Lecture, 

Discussion on 

diagnosis 

Friday Group discussion 

Ortho rheumatology 

conference, 

Radiology review. 

Saturday Lecture, Slidss 

review. 

Physiotherapy 

Occupational Therapy 8t 

patient education 

Group discussions with 

laboratory wing regarding 

the abnormal Laboratory 

parameters and their 

clinical correlation. 

Appliances clinic. 

Individual lab. project 

works and drug trials. 

Physicians conference 

Review of week's 

programme, Immunology 

Microbiology Lab. work.

53 

Post Graduate-Higher Speciality Degree Exam. 

D.M. BRANCH IX RHEUMATOLOGY 

Paper Subject Duration 3 Hrs. 

Paper I Basic Sciences & Diagnostic Procedures 

Rheumatology snd Clinical Immunology 

Paper II Clinical Rheumatology and .MOO 

Clinical Immunology 

Paper 111 CMnical Pharmacology, Rehabilitation .100 

Surgery, Special problems ralated to - -"; 

Rheumatic diseases-Paediatric 

Rheumatology, Pregnancy and Rheumatic 

diseases. 

Paper IV Recent Advances in Rheumatology and 100 

Immunology 

Clinical (Morning Session) 200 

Oral (Evening Session) 100 


TOTAL 800

54 

Minimum Marks Requirements For a Pass ir> the Examination 

Paper f 

Paper II 

Paper Ml i 

Paper IV [ 

Clinical 

Orar 

Total 

Marks - 

Dissertation 75) 

Oral on 25 > 

nicoartattnn 1 

400 

200 

100 

100 

Separate minimum 

marks required 

200 

100 

800 400

55 

Scheme For Clinical Examination-D.M. Rheumatology 

(One Day) 

Examination No. of 

Cases 

MORNING SESSION 

Short Cases 4 

Lab. Procedure 1 

AFTERNOON SESSION 

ORAL 

1. Pathology Slides 

2. X-Ray Interpretation 

3. Lab. Result Interpretation 

4. Clinical oriented Problems 

5. Topic Discussion 

Duration 

of Exam 

Marks 

200 

100

56 

SYLLABUS-UP DATED 

D..M. BRANCH IX-RHEUMATOLOGY 

1. BASIC PRINCIPLES IN RHEUMATOLOGY 

a. Biology of the joints 

b. Articular Structures. 

Hands-Wrists-Elbows-Shoulders-Neck-Lowback-Hip Joint 

and Pelvic Girdle-Knees-Ankles-Feet 

c. Connective Tissues 

Normal and Pathologic Synovia! tissue-Collagen-Collagenases 

- Proteogiycans - Mediators derived from polyinsaturated 

fatty acid - Prostaglandins - Thromboxanes- 

Leukotrienes-Mediators of acute and chronic inflamma 

tion-Vascular Endotheliem-Interfeukins-Free Radicals. 

d. Formation and resorption of bone-Bone as a tissue and an 

organ. 

e. Muscle 

Anatomy-Ccncractife proteins-Scaffold proteins-UItrastructure 

of the muscle fiber-Neuromuscular junction-Physioology 

of the Motor Unit-Excitation-Contraction coupling- 

The Biochemistry of contraction Muscle energy Motaboli 

sm-Pnarmacol.ogy of the Motor Unit. 

f. Nerve 

Neuropathies of special interest to Rheumatoiogy-Labora 

lory investigations. 

g. Synovial Physiology 

h. Col!*agen in normal and diseased connective tissue.

57 

i Chondrocyte Structure and Function-Articular cartilage, 

|. Elastin 

k. Fibroblast function and fibrosis. 

1. Biology of connective tissue-Biochemistry of protenaces, 

Product of arachidonic metabolism and other au toco ids. 

m. Ceil biology under-lying inflammatory and proliferate 

responses in human tissues. 

2. Functional assessment of Joints 

3. DIAGNOSTIC PROCEDURES 

a. Synovlal Fiuid 

b Aspiration and Injection of joints and soft tissue 

c Rheumatoid Factor 

d. Antinuclear antibodies and L E, Ce!! Phenomenon 

e. Antiphospholpid antibodies 

f. Acute Phase reactants 

g. Synovial biopsy 

h Radiology of joints 

i. Radioisotopic assessment of joints and bones 

]. CT & MR! in rheumatic diseases 

k. Arthrography 

1. Arthroscopy 

m. Thermography

.n. Neuromuscular testing 

58 

o. Lsb evaluation of inflammation 

p. Methods available for evaluating bone mineral content.: 

4. DIFFERENTIAL APPROACH TO MAJOR RHEUMATIC ". 

SYNDROME: , 

Acute and chronic monoarticular arthritis - Polyarthritis - 

Shoulder and neck pain-low backpain-foot pain-the fibromyalgia 

syndrome - skin and theumatic diseases - Eye and rheumatic 

diseases-Cardiac manifestations. Pulmonary manifestations of 

connective tissue diseases - Arthritis and Liver diseases-Nutrition 

and rheumatic diseases - Psychosdcial aspects of rheumatic 

diseases. 

5 CLINICAL PHARMACOLOGY IN RHEUMATIC DISEASES : 

Salicylates - Nonsteroidal ants inflammatory drugs - anti 

maiariais Gold compounds-D. Pencillamine - Methotrexate - Giucocorticoids 

- Suifasalezine - Immunoregulatory agents - Cytotoxic 

agents-Therapeutic Apheresis-lonizing radiation - Antilymphocyte 

antibodies-Cyciosporin A and other agents-NSAID gastropathy- 

Antihyper uricemic drugs-Opioid peptides-Drug toxicity of anti 

rheumatoid drugs. 

6. SPECIFIC ARTICULAR AND CONNECTIVE TISSUE DISEASES : 

Rheumatoid Arthritis - Felty's syndrome Sjogren's syndrome- 

Spordyla-arthropathies-Ankylosing spondylitis-Reiter's syndrome- 

Psoriattc arthritis - Enteropathic arthritis - Systemic Lupus 

Erythematosus - Mixed connective _ tissue disease - Overlap 

syndromes-VascuIitic syndromes Vasculitis and related disorders- 

Polyarthritis - Vascultitis associated with rheumatic diseases- 

Hypersensitivity vasculitis - Churg - Strauss Vasculitis - Wegener's 

Granulomatosis • Takayasu's Arteritis, Cogan's syndrome - 

Kawasaki's disease-Giant cell Arteritis-Polymyalgia Rheumatica- 

Behcet's disease-Scleoderma-Localised fibrotic disorders-Eosinophilic 

fascitis - Sclerodema - Inflammatory disease of muscle- 

Polymyositis - dermatomyositis - Gout and related disorders of

59 

Purine Metabolism Diseases associated with the deposition of 

Calcium Pyrophosphate or Hydroxyapatite - Osteoarthritis-Polychondritis-Amyloldosis 

- Sarcoidosis-lron storage disease-Multicentric 

Reticulohistiocytosis - Oahronosis - infectious arthritis - 

Bacteria! arthritis • Myocobacterial and fungal infections - Lyrrie 

disease-Viral arthritis. 

Hemophilic arthropathy - Hemoglobinopathies and Arthritis- 

Arthropathies Associated with Endocrine disorders-Hypertrophic 

Osteoarthropathy - neuropathic joint disease - Musculoskeletai 

syndrome associated with Malignancy - hetitable disorders of 

structural proteins-Metabolic Bone disease - Osteoporosis - Osteomalacia-Paget's 

disease - Osteonecrosis-Tumours and Tumour-like 

lesions involving joints-Rheumatic diseases of c'niidhood-Juvonile 

Rheumatoid arthritis - Rheumatic fever - Childhood S. L. E, and 

dermatomyositis. " 

Hypermobility syndrome (Hyper Laxity), Raynaud's phenomenon-Soft 

tissue rheumatism-Anaemia in systemic connective 

tissue diseases. 

7. MEDICAL ORTHOPAEDICS AND REHABILITATION :" 

Sports medicine - Entrapment Neuropathies.- Chronic pain 

syndromes-Rehabilitation of patients with rheumatic diseases. 

Footwear and orthoses - Local carticosteroid injections- 

Rheumatic complaints in performing arts (Rheumatic problems in 

artists) Acute soft tissue injuries in spotrs-Work related rheumatic 

syndromes. 

8. RECONSTRUCTIVE SURGERY IN RHEUMATIC DISEASES : 

Preoperative evaluatioivChoice of Procedure-Post operative 

management and follow-up. 

Newer surgical techniques in the management of rheumatic 

problems.

60 

9. SPECIAL PROBLEMS IN RHEUMATIC DISEASES : 

Development of new Anti rheumatic drugs-Management of 

Rheumatic disability - Pain and Rheumatic disease - Rheumatic 

diseases in the aged-Diet and arthritis-Sexuality and arthritis- 

Problems of Pregnancy and delivery. 

10. IMMUNOLOGY-CONCEPTS AND DIAGNOSTIC PROCEDURES 

Immunoglobulins-St'ucture, function and molecular genetics - 

Cellular basis of the immune response-Structure and function of 

monocytes and macrophages - mechanisms of inflammation - 

complement-Immune compIexes-Immunogenetics-Autoimmunity. 

Adaptive and innate immunity - Celfs involved in Immune 

response-The Lymphoid system-Major histocompatibility complex 

(H.L.A. System) - Molecules which recongnize antigen - The generation 

of Diversity - Antigen recognition - Cell cooperation 

in the Immune response - Cell Me diated Immune responses- 

Regulation of the immune response - Genetic control of immunity- 

Immunological tolerance - Immunologica! techniques. Monoclonal 

antibodies - Mast cells and mediators. - Immunology in Rheu - 

matic diseases. 

11. Role of Microbial infection in Rheumatic diseases-Reactive 

arthritis-HLA B27 related and non related arthritis-Animal models 

of arthritis. Immunotherapy-antineutrophilic cytoplasmic antibodies-Autoimmunity 

to cartilage collagens. 

12. SPECIFIC IMMUNOLOGIC DISEASES : 

AIDS-Primary immunodeficiency diseases—AiDS and rheumatological 

manifestations—Compliment deficiencies and Rheumatic 

diseases 

13. Recent advances in Rheumatology and Immunology.

BOOKS 

61 

D. M. BRANCH IX - RHEUMATOLOGY 

Recommended List of Books and Journals 

1. Text Book of Rheumatofogy - Kelly, Harris, Ruddy Sledge 

2. Arthritis and Allied Conditions - McCarty 

3. Copeman's Text Book Rheumatic Diseases - Scott 

4. Diagnostic & Management of Rheumatic Diseases - Katz 

(Lippincot) 

5. Paediatric Rheumatology Update - Woo, White & Ansell. 

(Oxford) 

6. Text Book of Paedialric Rheumatology-Cassidy & Petty 

(Churchill Livingstone) 

7. Arthritis in Black & White - Brower (Saunders) 

8. Rheumatology & Immunology - Cohen & Bennett (Grune 

Stratton) 

9. Immunology - Roitt 

10 Basic & Clinical Immunology - Fudenberg (Lange) 

11. Rheumatological Medicine-Dieppe, Doherty, Macearlane 

Maddison (Churchill Livingstone) 

JOURNALS 

1. Arthritis and Rheumatism 

2. Annals of Rheumatic Diseases 

3. British Journal of Rheumatology 

4. Seminars in Arthritis and Rheumatism 

5 Scandinavian Journal of Rheumatology

6, British Medical Journal 

7. New England Journal of Medicine 

8, Lancet 

9. Rheumatic Disease Clinics of North America (Sauncfers) 

10. Bailliere's Clinical Rheumatology (BailHere Tincfalfc) 

11. Immunology Today 

12. Journal of Immunology 

13. Journal of AlFergy and Clinical Emmunotogy .". [ ' .' 

14. Journal of the Association of Physicians of India 

15. Arthritis and Rheumatism council-reports on Rh-eurnatu 

Diseases,

63 

IVI.Ch.— Branch I Cardio Thoracic Surgery 

STRUCTURED TRAIN-ING PROGRAMME FOR TWO YEARS: 

Paediatric Cardio Thoracic Surgery Department — 3 Months 

Department of Cardiology — 1J „ 

Accident Services — 1£ 

Cardio Thoracic Units and 

C.A.B.G. Unit — 18 „ 

Total 24

64 


M.Ch. Branch I - Cardio Thoracic Surgery 

Papers Subjects Marks 

Paper I _ — Basic Science 100 

Paper II — Thoracic and Cardio Vascular Surgery 100 

Paper til — Thoracic and Cardio Vascular Surgery 100 

Paper IV — Recent advances in Thoracic and 

Cardiovascular Surgery. 100 

Clinical 200 

Oral 100 


800 

2. Minimum marks requirements for awarding pass in the 

Examination :- 

Total Marks Separate minimum marks 

required 

Paper I 

Paper II 

Paper HI 

Paper IV 

Clinical 

Oral 



400 

200 

100 

100 

800 

*Clinica! No. of Cases 

Long cases 1. 

Short cases (Minimum) 2 

200 

100 

- Marks 

••'.400 required 

"-- — "• for a 

pass 

Marks

65 

Syllabus 

Applied Anatomy and Developmental Anatomy of the Chest 

wall Diaphram: Pleura, Lungs, Mediastinum, Oesophagus, Heart, 

Pericadium, Great Vessels and its branches, Congential Cardiovascular 

and Thoracic Anomalies 

Applied Physiology-Respiration. Pulmonary function tests 

Blood Pressure, Cardiac cycle, cardiac output, production of 

Heart Sounds and murmurs, Physiology of Extracorporal 

Circulation and Hypothermis, Cardiac Metabolism. Acid base 

balance. Fluid and Electrolyte Balance, Physiology of Oesophagus, 

Gastro Oesophangeal reflux. 

Applied Pathology Thoracic injuries. Chest wall tumours : 

Emphysema, Pleural tumours. Pulmonary suppuration. Congenital 

and great Vassels, Henign strictures of Oesopagus, Cancer of 

Oesophagus. Cardia-spasm, Reflux Oesophagus, Diaphragmatic 

hernia. 

Applied Bacteriology-Thoracic infections, Pulmonary infections 

Bacterial and Fungai Endocarditis, Infections during open 

heart surgery, Intra-Thoracic Infections. 

Clinical Examination and Management including Chest injuries 

Chest deformities and tumours of the chest wall. 

Infections of the Pleura and tumours of the Pleura 

Pulmonary tuberculosis, lung abscesses Bronchiectasis lung 

cysts and lung tumours. Techniques and complication of 

pulmonary resections, Mediastinal tumours. 

Congenital anomalies of Oesophagus.

66 

Foreign body in oesophagus, cardiospasm, Beningn structures 

of Oesophagus , Peptic Oesophagitis : Hitatus Hernia, Corrosive 

structures of the Oesophagus, Cancer of Oesophagus and Diaphragnatic 

hernia. 

Diseases of the Pericardium, myocardium and endocardign, 

Rheumetic heart diseases Diseases of the conducting system of 

the heart, coronary diseases. 

Detailed knowledge of the treatment of all Cardiac Surgery 

problems. 

Detailed knowledge of extra corporeal circulation.

67 

Detailed Knowledge of Open heart surgery, 

and infant Cardiology 

Recommended list of books and Journals : 

The candidate is expected to read all the literatures available 

on the subject. However, the following books are recommended. 

1. Cooley, D. A. Surgical treatment of Aortic Aneurysm 

1986-W.B S. 

2. Cooley, D.A. Techniques in cardiac surgery 

S. 2/1984-W.B.S. 

3. Crawford G.B. & Diseases of Aorta including and 

Crawford J. L, atlas of angiographic pathology 

and surgical techniques - 1989- 

Williams and Wilkins. 

4. Donald Doto Update in cardie surgery 

5. Ebert, P. A. Atlas congenital cardiac surgery 1989 

Churchil Livingstone 

6. Gay Atlas of adult cardiac surgery 1980 

Churchill Livingstone 

7. Ebert P.A. Atlas of congenital cardiac surgery 

& Churchil Livingstone 

Scholass Berg, L 

8. Gay W.A. Atlas of adult cardiac surgery 1990 

Churchill Livingstone 

9. Hood, R. M. Techniques in general thoracic 

Surgery 1985 Churchill Livingstone 

10. Monro J L. & A colour atlas of cardiac surgery 1989 

Shove G. Wolfe publisher

11. Moreno-cabral 

C. E. et a] 

12. Sabiston D.C. 

& Specer; 

Manual of postoperative management 

in adult cardiac surgery 1988 

Williams and Wilkins 

Surgery of the chest ed. 5/1990 

W. B.S. 

13. Baumgarler et al Heart and heart lung transplantation 

1990 W. B. S. 

14. Barret Boyes 

15. Hood, R M. 

16. Kittle C. F. 

17. Pickard, L, R. 

18. Ravitch & 

Steichen 

Cardiac surgery 1986-Churchil 

Livingstone 

Thoracic Trauma 1989 - 

Churchil Livingstone 

Current Contraversies in Thoracic 

Surgery 1986 W.B.S. 

Decision making in surgery of the 

chest 1989 -W.B.S. 

Atlas of general thoracic Surgery 

1988-W. B. S.

69 

M.Ch. Branch—II - Neuro Surgery 


Neuro- Neuro- Neuroanatomy. 

Pathology, Surgery and 

Clinical 

Neurology 

SPECIAL TRAINING PROGRAMME: 

A period of four weeks in one or more of the following neuro- 

surgical departments before taking of examination is 

recommended. 

A. Department of Neurosurgery—Christian Madical College,, 

Vellore. 

B. Department of Neurosurgery—NIMHANS, Bangalore. 

C. Department of Neurosurgery -ANMS, Delhi. 

D. Department of Neurosurgery—PGI, Chandigarh. 

E. Department of Neurosurgery—SCIMST, Trivandrum, ;

70 

M Ch. Branch II - Neurosurgery 

Scheme of Examinations 

Total marks Separate Minimum Marks 

required for pass 

Paper I : Neuro Basic Sciences 100 

Paper II : Clinical Neurology and Neuro 

radiology 100 

Paper lit : isteuro Surgery 100 

Paper IV : Recent Advances in Neuro Surgery 100 

Clinical Examination 200 

Oral Examination 100 


Theory 

Minimum marks requirements for awarding pass in the 

examination ;- 

Paper I 

Paper II 

Paper 11 

Paper WE 

Total Marks Separate Minimum 

Marks Required 

400 

Clinical 200 

Oral 100 

Dissertation 75] tnf> 

Oral on dissertation 25 } uu 

200 

100 

800 400

71 

M.Ch. Branch-ll-Neuro Surgery 

The Syllabus will include Basic General Science such as 

Physics, Chemistry, Electricity and Electronics, Computer 

Sciencts, Statistics etc. In addition to Baîc Neurosciences 

such as Neuroanatomy, Neurophysiology, Neuropathology, Neurochermstry 

ancf Weuropharmacoiogy. 

a) The Candidates should have a working knowledge of 

Basic General Sciences with a view to enable them in handling 

various neuro - investigative and neurosurgical instrumentation 

and equipment effectively and also to prepare and assess papers 

and publications in the field, A minimum working knowledge of 

A/C electricity, D/C electricity. Physics of light and sound. 

Electromagnetism, ultrasound, LASER etc. As applicable to 

neurosciences will form the General Science content of Part I. 

The knowledge in these areas will be assessed both in the theorypapers 

as will as by Viva Voce. 

b) Knowledge of Basic NEUROANATOMY will include 

development of the nervous system including genetics malformations 

of the nervous system, conventional descriptive anatomy, 

Systematic anatomy. Regional anatomy, Cross sectional anatomy 

(relevant to X-ray Tomography C.T. Scan, Magnetic Resenance 

Imaging etc) and also three dimentional anatomy of various 

operative approaches to the Central Nervous System, including 

Microsurgical anatomy also will form the content of the Neuroanatomy, 

(c) Neurophysiology - The Neurophysiological content of 

Part 1 will include a detailed knowledge of Physiology of the 

nervous system including cerebral blood flow and CSF dynamic 

electrophysiology (EEC, Nerve Conduction Studies, EMG, Evoked 

Potentials) including all the recent advances such as Brain 

Mapping and multi - modality Evoked potentials such as VER, AER

72 

(Cortical Brainstem) SSER, MEP, Cranial and peripheral nerve 

stimulation - Preoperatively and intraoperatively, A minimum 

working knowledge of handling the instrumentation and interpretation 

of different results will be insisted upon. 

(d) NEUROCHEM1STRY - The neurochemistry content 

will include a detailed General Principles ef Neurochemistry with 

special reference to normal tissue constituents, neurotransmitter, 

Neuroreceptology and Neuroenzymology. Neurochemical aspects 

of Neurological and Neurosurgical illinesses, Biochemistry of 

tumours of the central nervous system including tumour markers, 

Neuro chemical aspects of head injuries and spinal cord injury, 

MR and ESR spectroscopy etc. a minimum working knowledge of 

interpretation of common laboratory results will be "insisted 

upon. 

(e) NEUROPATHOLOGY-The Neuropalhology will include 

Genera! Pathology of nerve cells, Neuro glia. Blood vessels, 

Granial and peripheral nerves and their mechanisms, Patho- 

Physiology of birth injuries concussion, contusion, Intracranial 

haematomas, Hhemorrhages, Cerebral oedema. Intracranial 

hypertension Vascular injuries infective complications, sequlae of 

head injuries etc., Pathology of infections disease of the nervous 

system with special reference to Postmeningitic sequlae. Vascular, 

Nutritional and Metabolic toxic disorders of the nervous system, 

Aneurysms and Angiomatqus (arterivenous) malformation. 

Pathology of brain and spinal cord tumours and peripheral nerve 

tumours including tumours of pituitary. Pineal cranium and spinal 

celumn in detail with special reference to histogenesis, gross 

pathology, Micropathoiogic aspects, Mircoscopic appearances, 

tissue culture, special diagnostic procedures including cytology 

techniques. Immunology of brain tumours including current 

consepts in monoclonal antibodies and targetting for diagnosis 

and therapy. The pathology content will include also minimum 

bacteriology minimum Microbiology, including virology and 

parashoiogy with special reference to agents that effects the 

nervous system in our area/country.

73 

(f) NEUROPHARMACOLOGY: The candidate should have 

adetailed pharmaceutical knowledge of the various aspects of the 

drugs and Pharmaceuticals commonly used in Neurosurgery 

including nutritives diagnostic Pharmaceuticals antiseptics and 

disinfectants, antibiotics, Anticonvulsants, Antioedema measures 

such as diuritics, Antidepressants, Analgesics, Antipyretics, and 

Antiparkinsons. Antipsychiatics, Cardio Vasoactive respiratary 

supportive drugs including drug assay Monitoring drug inneraction 

protocals of clinical trials etc.

74 

Syllabus for "Neurodiagnostics" Including Clinical 

Neurology 

The candidate should have a detailed working knowledge of 

clinical examination of the neurological / neurosurgicsl Patient 

including neonates and infants and unconscious patients: A 

^thorough knowledge of the Physical signs including their neuroanatomical 

and neuro Physiological Basis, brief historical vignette, 

methods of elicetation, interpretation and inference including 

fallacies knowledge of various coma scales and their relative 

merits and deficits, a detailed knowledge of the evolution of the 

Physical signs during various developmental stages, details 

regarding Brain Death (Cerebral Death and Brainstem Death) etc., 

are all essential. 

A detailed knowledge of the differensiation of some common 

medical neurological disorders which can closely mimic neuiosurgical 

conditions is essential Microcephaly Vs. Craniosynostosis; 

cervical spondyiosis Vs Anterior Horn Cells Disease, 

Medical Dementia Vs N.P.H. etc. 

A working knowledge of the various medical neuroiogica! 

disorders. Particularly more Prevalent in our region, is also 

required. A minimum working knowledge of neurodegenerative 

disorders, neuro-muscular disease, genetic disease Paroxysmal 

disorders etc. is a must. 

A detailed working knowledge of the various diagnostic 

Procedures including a historical vignette, the instrumentation / 

equipment, methodology, documentation and interpretation of 

results will be required. A thorough knowledge of choice of the 

investigative procedure in a given Patient - Decision making in 

Neurodiagnostics - is also essential. The candidate should have 

a reasonable understanding of the risks, complications, fallacies, 

cost-effectiveness etc. of the various neurodiagnostic procedures.

75 

The neurodiagnostic procedures in this context would include 

access to various parts of the CNS including ventricles, 

subarachnoid space, neurovasculature, neural parenchyma etc. 

in the course of Neuro-op^halmologica!, neurootological workup, 

L.P., V P., cisternal Tap, EEG, Nerve conduction studies, EMG, 

eletrocorticography, neuroradiology including plain x-rays. X-ray 

sonography, angiography including venography and venous 

sinography, Pneumoence phalography, ventriculography, 

myography, cisternography, cyscography orbitography, interventional 

radiology, radionucleide angiography, encephalography, 

and neuroscimigraphy uitrasonography (neunates, infants, transcranials 

intraoperative and interventional). C T. scanning, MR 

Imaging including MR angiography and cisternography etc. The 

candidate should have adequate experience with the various 

investigative procedures of day-to-day use. 

The candidate is expected to have a thorough knowledge of 

the (a) main historical landmarks (b) theoretical aspects, 

practical ward procedures, special investigatory methods, clinical 

features, diagnosis and differential diagnosis, preoperative and 

Postoperative assessment and care, and details of operative techni 

ques of all surgical diseases or the nervous system and (c) recent 

advances and basic research methods in neurosurgery and all 

special surgical tools involving optics. LASER, ultrasonics, 

cryogenics, RE current, endoscopy etc. 

A broad acquaintance of the classical monograph in neurosurgery 

and recent neurosurgical literature will be expected. 

The candidate is expected to attain a-high degree of clinical 

judgement, operative skill and efficiency in postoperative 

management and to conduct diagnostic and operative procedures 

independantly. 

The examiners shall also bear in mind in the evaluation of 

the results of the examination whether the candidate is of such 

high merit as to be able to teach and train other neurosurgeons

76 

in course of time and whether his skill, knowledge, clinical acumen 

and surgical judgement is of such high order that decisions and 

management regarding neurosurgically ill Patients can be entrus 

ted safely to him.

77 

M.Ch. BRANCH III - PLASTIC SURGERY 


Departments involved in the Plastic Surgery: 22| Months 

training Programme and Microsurgery : 2 weeks 

duration of training in months, : Burns : 2 ,, 

Departments 

I Year 

II Year 

Dental Sciences 

including Orthodontia. 

Oral Surgery 

and Prosthetics i 1 Week 

Audiometry & speech 

Therapy. : 1 Week 

Plastic Burns Micro Dental Speech 

Surgery Surgery Sciences Therapy 

11 Months 2 Weeks 2 Weeks 

11* ,. 

1 Week 1 week

Paper Ft 

Paper I 

Gl in real 

Dissertation 

Total 

Mode of examinations 

Theory 

Paper r 

Paper I'l 

Paper HI 

Paper IV J 

Clinical 

Oral 

Dissertation 

Oral on dissertation 

78 

Scheme of Examination' 

M. ch. Branch Ill-Plastic Surgery 

— Basic Sciences and General Principles in 

Plastic Surgery. 100 

— Plastic Surgery — Regional 100 

— Plastic Surgery — Applied 100 

— Plastic Surgery as applied to a Hied sciences 

and Recent advan-ces in Plasti© Surgery. 100 

Minfmun Marks Requirements 

for awarding PASS in the Examination 

75 | 

25 t 

Maximum Marks 

100 

100 

200 

100 

10O 

eoo 

Marks 

200 

100 

400

79 

SYLLABUS 

M Ch. BRANCH lll-PLASTIC SURGERY 

Course of study and syllabus ; 

Preliminary Training—3 months 

Wound heating 

Atraumatic operating technique 

Dressing Technique and control of wound infection 

Anaesthesia for MaxiHofacJal Surgery 

Fractures of the Face and Jaws 

Free grafting of skin Heading of Grafts; Results Closure of 

wounds with Skin loss. 

Defects of covering. Lining and Supporting Tissues General 

Principles and simple methods of restoration Limitations of 

Plastic Surgery; Safety precautions. 

Advanced Training—21 months : 

The trainee will work as a full time assistant in the Unit* He 

will maintain a Case Day and submit detailed records of at least 

20 cases he himseJf has treated. There will be Discussion 

Sessions and postgraduate Seminars. The trainee will be put to 

tests from time to time, the training shall emphasies the application 

of Basic Sciences to Plastic Surgery at all stages. 

The scope of training is indicated in broad outline in the 

following syllabus ;

80 

Principles of diagnosis of tissue loss and distortion. 

General Problems of tissue transplantation 

Principles of restoration of skin lining and supporting tissue 

loss. 

Auto, home and hetero transplants. 

Synthetic substitutes. 

Avulsion injuries. 

Reanimation procedures-tendons, nerves, slings etc. 

Principles of Rehabilitation-e. g. physiotherapy, occupational 

therapy, speech therapy etc. 

Wound healing and scars. 

Surgical care of infants and children. 

Anaesthesia for Plastic Surgery. 

Congenital malformations of the face - cleft lip and plate, 

nose, ear, orbit and eyelids etc. 

Orthodontia and growth disorders of the jaws Injuries of the 

face. 

Corrective ond reconstructive surgery of the Jaws. 

Destructive lesions of the face and jaws-lupus, cancrum oris, 

syphilis. 

Oro facial malignancy. 

Plastic Surgery of the eyelids and eye. 

Plastic Surgery of the ear. 

Plastic Surgery of Nose. 

Cosmetic procedures.

81 

Neck - Burn constractures, reconstruction of defects of 

Pharynx, Larynx, trachea and oesophagus. 

Pressure sores. 

Reconstructive surgery of the breast. 

Genito-urinary malformations. 

Hand - Functional anatomy, congenital malformations injuries 

(Primay repair) - reconstructive procedures and tendonsurgery. 

The burnt hand. 

Skin blemishes and tumours - Naevi, Leucoderma rodent ulcer, 

epithelioma etc. 

Lymphoedema 

Burns - General considerations, immediate early and late 

problems. 

Special regional problems in burns. 

Organisation of a burns unit. 

Research in burns. 

Principles of skin culture 

LEPROSY - Reconstructive problems in leprosy face, hands 

and feet. 

Rehabilitation and Research in leprosy. 

Transplantation of organs - special problems.

82 

M.Ch. Branch IV Genito Urinary Surgery 


INVESTIGATIVE UROLOGY : Ascending Urethrograms / 

Micturiting cystourethrograms / 

Nephrostogram, Interpretation 

Intravenous Program (IVU) 

Retrograde Pyelogram (RGP) 

OPERATIVE UROLOGY 

OPEN & ENDOSCOPIC 

SURGERY 

To assist routine 

Open Urological major procedures 

To independently perform minor 

Urological procedures 

(1) Orchidectomy 

(2) Circumcision 

(3) Meatoplasty 

(4) Biopsy of Prostate 

(5) Trocar cystostomy 

(6) SPC 

(7) Urethral dilatation 

(8) Testicular biopsy 

(9) Surgery for Varicocele 

(10) Hydrocelectomy 

(11) To observe the cystoscopy 

findings 

(12) Learn about endoscopic instruments 

& Principles of 

Diathermy. 

of

83 

Interpretation of Ultrasound of findings, Renography and 

other radio nuclide studies renal angiograph, Venography. 

Vasoseminovesiculography. 

URODYNAMICS 

To independently perform 

1, Endoscopy of lower urinary tract under supervision 

and interpretation of findings. RGC & Bladder biopsy- 

2. Open surgeries like 

Angio Access (AV shunts, fistulae) 

Total and partial amputation 

Penis, 

Open Prostatectomy 

Nephrostomy 

Ureterolithotomy 

Pyelolithotomy 

Urethroplasty for stricture 

Excision of filarial scrotum & Penis 

(a) Oroflowmetry 

(b) Cystometry 

(c) UPP 

(d) EMG 

(e) Sexual dysfunction Studies. 

ENDOSCOPIC PROCEDURES 

To be performed under Supervision. 

(1) Internal Urethrotomy for structures 

(2) Bladder neck incision

(3) Cysto litholripsy 

84 

(4) Insertion & retrieval of ureteral stents. 

OPEN SURGICAL PROCEDURES 

(1) Simple nephrectomy 

(2) Extended Pyeiotithotomy 

(3) Pyeloplasty 

(4) Urethroplasty 

(5J Hypospadias Surgery 

(6) VVF repair 

(7) Donor nephrectomy 

(8) Orchiopexy. 

ENDOSCOPY: 

(1) Cystolithotripsy 

(2) TUR Prostate 

(3) TUR —Bladder tumour 

(4) Percutaneous Nephrolithotomy 

(5) Ureteric stone samnipulation & disintegration by 

Ureterorenoscopy 

(6) Endoscopic bladder neck suspension for stress incon 

tinence. 

OPEN SURGERY; 

(1) Radical Nephrectomy & Nephro Ureterectbmy 

(2) Anatrophic nephrolithotomy 

(3) Ureteroneocystostomy

(4) Boari flap 

(5) Urinary diversion 

(6) Augmentation cystoplasty & Neobladders 

(7) Severe forms of Hypospadies repair 

(8) Microswrgical Vaso VasaJ

86 

M-Ch BRANCH IV - GENITO-URINARY SURGERY 

Paper I — 

Paper II — 

Paper ill — 

Paper IV — 

Final Examinations Marks 

Basic Sciences applied tc Genito Urinary 

Surgery 

Urology 

Urology 

Recent Advances in Urology 

Clinical 

Oral 

Dissertation 

Total 

100 

Minimum marks requirement for pass in the Examination :- 

Paper 

Paper 

Paper 

Paper 

I > 

If 

III 

IV 

Total marks 

400 

'Clinical 200 

Oral 100 


Oral on 


100 

800 

100 

100 

100 

200 

100 

100 

800 

Separate minimum marks 

required. 

200 

100 

400 Marks 

required 

for a pass.

* Clinical Examination 

Long Case 1 

Short Cases 2 

Ward Round 

87 

Note : Not more than 3 Candidates shall be examined per 

day.

Syllabus : 

88 

It will cover wide spectrum of the diseases of urogemtal 

system and retroperitoneum. Apart from the clinical aspect of 

these subjects, candidate has to acquire indepth knowledge of 

the related basic subjects like applied anatomy, embryology, 

physiology, Biochemistry, Pharmacology, Pathology, Genetics 

and Immunology. 

1. Anatomy and Embryology of GU tracts, adrenals & 

reiroperitoneum. 

2. Applied physio to gy and biochemistry. Immunology, 

Microbiology, & Genetics pertaining to Urology. 

3. Investigative Urotogy and Genito-Urinary radiology and 

imaging / including nuctear medicine. 

4. Male Infertility, Andrology, Microsurgery and Urological 

endocrinology. 

5. Sexual dysfunction - investigations and management. 

6. Perioperative care, management of urologica! complications 

and care of the critically ill patients. 

7. Urodynamics and Neurogenics vesico - urethral dysfunction. 

8 Genito-Urinary trauma. 

9. Urolithiasis - Medical, Biochemical & Surgical aspects - 

Open surgical and Endourologicat procedures. 

10. Uro - Oncology - Adult & Paediatric. 

11. Reconstructive Urology. 

12. Paediatric Urology - congenital malformations and 

acquired diseases.

89 

13. Urinary tract infections and sexually transmitted diseases. 

14. Obstructive Uropathy. 

15. Renal transplantation (including transplant immunology, 

medical & surgical aspects). 

16. Renovascular hypertension. . : 

17. Gynaecological Urology. 

18. Operative Urology - Open and endoscopic. 

19. Endourology - Establishment of PCN, stents - Antegrade 

Ureterorenoscopy, PCNL - retrograde. 

20. Diathermy, lasers, fibre optics, instruments, catheters, 

endoscopy etc. 

21. Retroperitoneal diseases and management. 

22. Medical aspects of the kidney diseases - Nephrology as 

applied to Urology. 

23. Newer modalities in management of Urological disease. 

24. STD/AIDS.

90 

M.Ch. Branch V—Paediatric Surgery 

STRUCTURED TRAINING PROGRAMME 

The Post - Graduates will undergo training for Paediatric 

Surgery (M.Ch.) as follows ; 

General Paediatric Surgery — 18 Months 

Paediatric Urology — 3 „ 

Neonatal Surgery • . — 2 

Paediatric Radiology — 1 Month 

Total 24 Months

91 

SYLLABUS 

The syllabus shall consist of (A) Detailed knowledge in 

certain areas ; and (B) General knowledge in other areas as 

specified below : 

(A) DETAILED KNOWLEDGE IS EXPECTED IN THE FOLLOWING 

AREAS: 

(1) Normal development and developmental malformations 

of the (a) Gastro Intestinal (b) Respiratory (c) Genito 

Urinary systems (d) The body wall including the 

Diaphragm (e) Central Nervous system. 

(2) Neonatal Surgery 

The surgical pathology, diagnostic modalities and 

management of above regions. 

(3) Infections peculiar to Neonatal Surgery Example : 

Necrotising Enterocolitis. 

(4) Anti Microbial Therapy. 

(5) Tumours in child-hood and their management. 

(6) Burns, Trauma, and critical care in childhood including 

ventilatory support. 

(7) Minimally invasive surgery in childhood. 

(8) Endoscopy in child-hood. 

(B) GENERAL KNOWLEDGE IN FOLLOWING AREAS : 

I. AIDS 

II. Use of Prosthetic material 

Ml. Micro Surgery 

IV. Common orthopeadic deformities 

V. Other surgical diseases of children commonly prevalent in 

India.

92 


M.Ch. Branch V—Paediatric Surgery (Surgery) 

Part I Examination 

Paper I — Basic Sciences as applied 

to Paediatric Surgery 

Paper II — Neonatai Surgery 

Paper III — Regional and Systemic 

Paediatric Surgery 

Paper IV — Recent Advances in Paediatric 

Surgery 

•Clinical 

Oral 

Dissertation 

Total 

Marks 

100 

100 

100 

100 

200 

100 

100 

800 

Minimum Marks Requirements For a Pass in the Examination 

Paper I 

Paper II 

Paper III 

Paper IV 

Clinical 

Oral 

Dissertation 

Oral on 

Dissertation 

Total 

75 

25 

Total 

Marks 

400 

200 

100 

100 

800 

Separate minimum 

marks required 

200 

100 

400

*Cllnical Examinations 

93 

Examinations No, of cases Duration Marks 

Long Cases 1 

Short Cases 3 

No. of candidates to be examined per day «= 3

94 

Recommended List of Books and Journals 

TEXT BOOKS 

1. Paediatric Surgery 

Year Book Medical Publishers, Chicago, 

2. Swenson's Paediatric Surgery - Edition HI 

3. Operative Surgery, Paediatric Surgery ROB & SMITH - 

Consultant Editor Nixon - H. Butter Worths. 

4. Paediatric Urology By Ashcroft, Saunders and London / 

Philadelphia. 

5. Neonatal Surgery Rickkham PP. and others 

(Butter Worths) 

6. Adult & Paediatric Urology by Grayhack. 

7. Plastic Surgery in infancy & Childhood MUSTARDE 

(Livingstone), 

8. Paediatric Urology - Campbell Volume Hi (Butter Worths) 

9. Clinical Paediatric Urology Kelalis & King W. B. Saunders 

JOURNALS 

(1) Paediatric Surgery International (Springer International) 

(2) Journal of Paediatric Surgery (W. B. Saunders) 

(3) Seminars in Paediatric Surgery - W. B. Saunders.

95 

M.Ch. Branch VI—Surgical Gasteroenterology 


Departments involved in the training programme and duration 

of training (in months) : 

Department of Surgical Gastroenterology ] One year and 

and Proctology, Government General [ Eleven months 

Hospital, Madras - 600003. J 

Department of Medical Gastroenterology 

Government General Hospital, 

Madras - 600003. 

Department of Gastrpenterology, AH "1 Fifteen days 

' India Institute of Medical Sciences, > each in Second 

New Delhi and J year, 

Postgraduat Institute of Medical 1 

Sciences. Chandigarh. J

96 

M.Ch, Branch VI—Surgical Gastroenterology 

SCHEME OF EXAMINATIONS 

Paper Subjects Marks 

Paper I — Basic Sciences as applied to 

Gastroenterology in TOO 

(applied anatomy, applied Physiology, 

Microbiology and Clinical Pharmacology) 

Paper tl — Surgical Gastroenterology & Proctology 

Clinical problem Current Concepts. 100 

Paper \\\ Surgical Gastroenterology & Proctology 

Controversies and Current concepts. 100 

Paper IV — Recent advances in surgical Gastroenterology 

and Proctology., 100 

Clinical 200 

Oral 100 


Total 800 

2. Minimum Marks requirement for pass in the Examinations. 

Total marks Separate minimum 

Marks required. 

Paper I \r 11 

Paper HI f 400 200 

Paper IV , 


Oral 100 


Oral on Dissertation 25 \ 

800 400 Marks 

required 

for pass

M-Ch. Branch VI—Surgical Gastroenterology 

UPDATED CORE SYLLABUS : 

BASIC SCIENCES : PERTAINING TO GASTROENTEROLOGY 

Surgical Anatomy 

Endoscopic Anatomy 

Ultrasonographic and CT Anatomy 

Clinical Physiology including critical care physiology 

Clinical Pathology 

Clinical Biochemistry and pharmacology 

GASTROINTESTINAL SURGERY 

Oesophagus 

Stomach and Duodenum 

Small Intestine 

Diagnostic techniques, eongt 

anamolies, benign strictures, 

oesophagitis (a) corrosive 

(b) reflux, motility disorders, 

perforations, diverticula, 

tumours and reconstructive 

surgery. 

Congenital disorders* diverticula, 

volvulus, ileus, foreign 

bodies, ulcers, fistulas, neoplasms, 

stomach, reconstructive 

surgery, complications following 

surgery. 

Congenital disorders. Intestinal 

obstruction, tumours of small 

intestine, fistulae, ulcers, strictures, 

reconstructive surgery.

98 

Appendix, Colon Congenital disorders, diverticulum, 

colitis, tumours, surgical 

aspects, rectal prolapse, anal 

incontinence, fissure, fistula 

and haemorrhoids, proctitis, 

strictures. 

Hepato Biliary system 

Pancreatic diseases Spleen 

Investigative procedures : 

Diagnostic and interventional radiology 

Imaging modalities 

Nuclear medicine 

Endoscopy including laproscopy 

in relation to 

Gastroenterology 

Trauma to gastrointestinal system 

Emergency surgery (eg) for intestinal Obstruction, Gl Bleed etc. 

Recent advances in Gastroenterology.

99 

M.Ch Branch VII - Surgical Oncology 


Departments involved in the training programme and duration 

of training (in months) year wise : 

Departments: Surgical, Medical and Radiation Oncology, 

Pathology including clinical pathology. 

Cytology, 

Cytogenetics, 

Molecular Biology, 

Biochemistry 

Tumour microbiology including immunology 

Clinical Microbiology, 

Physics as applied to medicine, 

Nuclear Medicine, 

Tumour Registry 

Bi ©statistics, 

Epidemiology, 

Clinical pharmacology, 

Anaesthesia, 

Radio diagnosis and imaging and Out • patient 

departments. 

Duration of : Clinical physics 6 months 

Biochemistry -do- 

Clinical pharmacology *do* 

Biostatisties -do- 

Syllabus : AM the other subjects are taught over the 

entire 24 months of the course.

100 

Branch VII - M.Ch. Surgical Oncology 

1. Part 1 Examination Marks 

Paper I — Basic Sciences as applied to 

Surgical oncology 100 

Paper H — Surgical oncology - I 100 

Paper Ml — Surgical oncology - I? 100 

Paper IV — Recent advances in Surgical 

oncology 100 

Clinical; 200 

Orai 100 


800 

2. Minimum marks requirements for awarding pass in the 

Part II Examination :- 

Total Marks Separate minimum marks 

required 

Paper ! 

Paper II 

Paper III 

Paper IV 

400 200 


Oral 100 

Dissertation 75 \ 


— „ * - Marks 

800 400 required 

pass

PATHOLOGY 

101 

Syllabus for M. Ch. Surgical Oncology 

BASIC SCIENCES 

Modern pathology consists of many laboratory sciences including 

histopathology, Cytology, Medical Microbiology and Virology, 

Immunology, Haematology and Clinical Chemistry. 

The general pathology of tumours, their functional properties 

and. modes of spread, with a knowledge of their effects and 

metabolic, Micro-Biological and defence system of the body are 

areas of particular value. 

This knowledge and experience is gained through an integrated 

teaching programme of regular clinico - pathological conferences, 

Seminars and demonstrations of biopsy and Cytdlbgical material 

and Biochemical data. Trainees should spend, if possible, an 

electrive period of several months in one or more branches of 

pathology. This would allow an introduction to laboratory 

research and its related technology. 

HAEMATOLOGY 

Studies of abnormalities of the haemopoietic system are 

essential experience should be gained in performing and interprating 

laboratory investigations. 

BIOCHEMISTRY 

The increasing importance of Biochemistry in the investigation 

and monitoring of patients and the development of imrnunodiagnosis 

is recognised. The oncologist must be familiar with 

alterations in the general body metabolism cused by neoplastic 

disease and with biochemical disturbances from individual 

tumours. The mechanism of carcinogenesis including transplacental 

and intrauterine carcinogenesis, the activation and 

binding of carcinogenes is of profound interest.

102 

ENDOCRINOLOGY AND METABOLIC MEDICINE 

This is an expanding subject including the endocrine 

manifestations of tumours and actopic hormones. Significant 

results are not obtained by manipulation of the harmona! control 

systems, especially incarcinoma of the area and prostate. 

TUMOUR BIOLOGY AND IMMUNOLOGY 

Tumour immunology and molecular biology are subjects with 

important potential value. 

RADIOBIOLOGY 

The coltoborati'on of radiation oncologists with radiobiologists 

is essential, and to a lesser extent for medical oncologists, 

knowledge is required of cell kinetics, including the character! 

zation of normal and neoplastic ceUa; the cell cycle and cell 

divison ; cell loss and multiplication and cellular repair. 

RADIATION PHYSICS 

This includes the physics of ionizing radiation and their interaction 

with cells, tissues and materials which is essential for the 

safe, accurate and effectiv^ radiotherapy Radiation oncologists 

require more knowledge in depth than other specialists. 

CLINICAL PHARMACOLOGY 

An understanding of the Pharmacology of the wide range of 

chemicals used in therapy is essential, especially for medical 

oncologists. This incluHos the use of different chemical combinations, 

desage schedules, metabolism and elimination. An 

understanding of the'r limitations, toxicity and chemical interactions 

is necessary for they are being used increasingly, alone or 

in combination with surgery and radiation. 

EPIDEMIOLOGY 

This subject is of great interest to all oncologists. The search 

for more clues in a etiology must continue so that prevention 

can expand. The oncologists should be familiar with epidemiclogical, 

methodology, tumour registries and population surveys.

GENETICS 

103 

Genetic mechanism in neoplastic diseases are being more 

clearly understood and immunogenetics cytogenetics are 

established disciplines. Genetic counselling may be needed. 

MEDICAL STATISTICS 

A working knowledge is necessary for the design of clinical 

trials, data recording and sampling and the use of controls. 

Different techniques should be learnt for presenting data measuring 

mortality and the use of life tables, in addition to the assessment 

of therapy with survival rates.

104 

M.Ch. Branch VIII—Vascular Surgery 


THE DEPARMENTS INVOLVED fN THE TRAINING PROGRAMME : 

I Year — 12 Months — Vascular Surgery Department 

II Year — 9 „ — -do- 

— 1| „ — Radiology Department 

— 1| „ — Cardiothoracic Surgery. 

1. The period of training programme leading to Degree of 

M.Ch, in Vascular Surgery shall not be less than 2 years. 

2. During the training period, the candidate shall work on a 

full time basis in the Vascular Surgery Department under the 

Professor and Head of the Department of Vascular Surgery. He 

shall take part in all activities of the department including participating 

in seminars and conferences, teaching assignments and 

other duties that may be assigned to him by the Head of the 

Department. 

3. The scope of training is indicated in a broad outline. 

(a) Clinical Vascular Surgery, both out patient and in-patient 

work up and follow up of cases. 

(b) Diagnostic procedures including (i) angiography and 

other Radiological procedures used in Vascular Surgery 

(ii) Bio-Chemistry (iii) Physio-pathoiogy (iv) Pathology. 

Candidates shall be posted for a minimum period of 

1-|- months to Radiology Department to get training in 

angiography and other Radiological investigations 

pertaining to Vascular Surgery and 1| months in Cardiothoracic 

Surgery department.

105 

(c) Operative - Vascular Surgery : 

Broadly stated that the candidate shall work as a full 

time Assistant to the Head of the Department and carry 

out all clinical work, diagnostic and Operative procedures, 

teaching and other duties assigned to him by 

the Head of the Department to the full satisfaction of 

the Head of the Department.

106 

M.Ch. Branch Vlll-Vascular Surgery 

FINAL EXAMINATIONS 

PAPER .SUBJECTS MARKRS 

Paper I Basic Sciences applied to Vascular 

Surgery 100 

Paper II Vascular Surgery I 100 

Paper III Vascular Surgery II 100 

Paper IV Recent advances in Vascular Surgery 100 

Clinical 200 

Oral 100 


Total 800 

2, Minimum Marks requirments for awarding pass in the 

Examination :- 

Paper Total Marks Separate minimum 

marks required. 

Paper I 

Paper II 

Paper III 400 200 

Paper IV 


Oral 100 

Dissertation 751 ..«« 


800 400 Marks 

required 

for pass

107 

VASCULAR SURGERY 

•1-1 

CORE SYLLABUS 

1, Surgical approach to Vascular problems. 

2. Haemodynamics & diagnosis of Arterial and Venous 

diseases - Basic Techniques & application and vascular 

laboratory. 

3. ARTERIAL DISEASES: 

Arterial wall pathology in atherosclerosis. Burger's disease, 

Atherogenesis Non - specific aorto - arteritis Arterial anurysms, 

Fibrpclyspjasia, uncommon arteriopathies, etc,. 

etc., 

(a) ACUTE LIMB ISCHEMIA 

Arterial Thromboemfaolism, Drug abuse. Vascular injuries 

(b) CHRONIC LIMB ISCHEMIA 

Management & reconstructive Surgeries for occuluive 

arterial disease, Extra - anatomic by pass. Lumbar & cervical 

sympathectomies. Diabetic foot & Management, etc., 

4. VENOUS DISEASES : 

Chronic venous insufficiency - diagnosis Management, Postphlebitic 

sequalae, varicose veins, perforator incompetence. Deep 

venous valuelar incompetence etc. 

5. Management of Extracranial cerebrovascular diseases. 

6. Surgical Management of Portal hypertension. 

7. Surgical Management of Reno - Vascular hypertension. 

8. Management of viseral ischemic syndromes.

108 

9. Arterio - venous Malformations - Congenital & Acquired. 

10. Neuro-vascular conditions involving upper extremity. 

11. Fundamental Therapeutic & Technical considerations. 

12. Vascular Grafts. 

13. Complications or vascular Surgery and its prevention & 

Management. 

14. Management of Lymphoedema. 

15. Extremity amputations for vascular diseases. 

16. InterventwnaJ Radiological techniques & its application in 

vascular disease. 

17. Non - invasive Vascular Laboratory. 

18. Endo vascular Surgeries & Recent advances.

109 

List of Recommended Books & Journals 

1. Text Book of Vascular Surgery—By Robert B. Rutherford- 

Vol I & II. 

2 Text Book of Vascular Surgery—By Henry Haimovici. 

3. Text Book of Vascular Emergencies —By Henry Haimovici. 

4. Text Book of Vascular Surgical Emergencies—John 

J. Bergan & James S. I. Yao. 

5. Investigation of Vascular Diseases —By Andrew 

N. Nicolaides & James Yao. 

6. Vascular Surgical Techniques —By R.M. Greenhalgh. 

7. Rob & Smith Operative Surgery Text Book of Vascular 

Surgery—Jemes Deeweese, 

JOURNALS: 

1. Journal of Vascular Surgery. 

2, American Journal of Surgery.

UNIVERSITY of CAMBRIDGE 

ESOL Examinations 

English for Speakers of Other Languages 

Cambridge ESOL Entry Level Certificate in ESOL 

International (Entry 3)* 

is to: certify • that 

KARTHIK BASUMANI 

has beer) -.awardedI. '_•{ 

Pass with Merit 

the" 

Preliminary English Test 

Council of Europe Level B1 

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:Date "of Examination 

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DECEMBER (A) 2009 

CHENNAI 

-Referehce'Number" 09CIN0015098 

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•Accreditation Number. 500/2414/0 . • . 

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Date of Issue 22/01/10 

Certificate Number 0025883398 

OfquQl 

Michael Milanovic 

Chief Executive 

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The Tamil Nadu Dr. MGR Medical University Madras

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