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INTERMEDIATE MODULEINPAEDIATRICSREQUIREMENTS FOR TRAINING & EXAMINATION2012;GDD=?= G>H@QKA;A9FK 9F

Composed by:Syed Faisal BabarDepartment of Medical EducationPublished: August, 2012COLLEGE OF PHYSICIANS AND SURGEONS PAKISTAN7th Central Street, Defence Housing Authority, Karachi-75500.Phone No. 99207100-10 UAN: 111-606-606 Fax No. 99266432B

CONTENTS1ABOUT THE COLLEGE4TRAINING AND EXAMINATION7ASSESSMENT9COURSE FOR BASIC PAEDIATRICS TRAINING34USEFUL ADDRESSES AND TELEPHONE NUMBERSC

About theCOLLEGEThe College was established in 1962 through an ordinance of theFederal Government. The objectives/functions of the College includepromoting specialist practice of Medicine, Obstetrics & Gynaecology,Surgery and other specialties by securing improvement of teachingand training, arranging postgraduate medical, surgical and otherspecialists training, providing opportunities for research, holding andconducting examinations for awarding College diplomas andadmission to the Fellowship of the College.Since its inception, the College has taken great strides in improvingpostgraduate medical and dental education in Pakistan.Competency-based structured Residency Programs have now beendeveloped, along with criteria for accreditation of training institutions,and for the appointment of supervisors and examiners. The formatof examinations has evolved over the years to achieve greaterobjectivity and reliability in methods of assessment. The recognitionof the standards of College qualifications nationally andinternationally, particularly of its Fellowship, has enormouslyincreased the number of trainees and consequently the number oftraining institutions and the supervisors.The rapid increase in knowledge base of medical sciences andconsequent emergence of new subspecialties have graduallyincreased the number of CPSP fellowship disciplines to sixty fourAfter completing two years of core training during IMM, the traineesare allowed to proceed to the advanced phase of FCPS training in thespecific specialty of choice for 2-3 years. However, it is mandatory toqualify IMM examinations before taking the FCPS-II exitexaminations including specialties in dentistry.The work performed by the trainee is to be recorded in the e-Iogbookon daily basis. The purpose of the e-Iog is to ensure that the entriesare made on a regular basis and to avoid belated and fabricatedentries. It will hence promote accuracy, authenticity and vigilance onthe part of trainees and the supervisors.Intermediate Module in Paediatrics 20121

The average number of candidates taking CPSP examinations eachyear is to a minimum of 25,000. The College conducts examinations forFCPS I (11 groups of disciplines), IMM, FCPS II (64 disciplines), MCPS20 disciplines, including MCPS in HPE and also Diploma in HealthCare System Management (DCPS-HCSM). A large number of Fellowsand senior medical teachers from within the country and overseas areinvolved at various levels of examinations of the College.The College, in its endeavor to decrease inter-rater variability andincrease fairness and transparency, is using TOACS (Task OrientedAssessment of Clinical Skills) in IMM and FCPS-II Clinicalexaminations. Inclusion of foreign examiners adds to the credibility ofits qualifications at an international level.It is important to note that in the overall scenario of health delivery over85% of the total functioning and registered health care specialists ofthe country have been provided by the CPSP. To coordinate trainingand examination, and provide assistance to the candidates stationedin cities other than Karachi, the College has established 14 RegionalCenters (including five Provincial Headquarter Centers) in the country.The five Provincial Headquarter Centers, in addition to organizing thecapacity building workshops/short courses also have facilities of libraries,I.T, and evaluation of synopses and dissertations along with providingguidance to the candidates in conducting their research work. Thetraining towards Fellowship can be undertaken in more than 159accredited medical institutions throughout the country and 44accredited institutions abroad. The total number of trainees in theseinstitutions exceeds 16000.Intermediate Module in Paediatrics 2012These continuous efforts of the College have even more importantlydeveloped a credible system of postgraduate medical education forthe country. The College strives to make its courses and trainingprograms 'evidence' and need 'based' so as to meet internationalstandards as well as to cater to the specialist healthcare needs notonly for this country but also for the entire region.Prof. Zafar Ullah ChaudhryPresidentCollege of Physiciansand Surgeons Pakistan2

INTERMEDIATE MODULETo ensure better training, the CPSP introduced an intermediatemodule examination in several disciplines in 2001. This mid-trainingassessment strengthens the monitoring and in-training assessmentsystems by providing trainees with an estimate of mid-training corecompetencies. It also serves as a diagnostic tool for trainees andsupervisors, provides a curricular link between basic and advancedtraining, and an opportunity for sampling a wider domain ofknowledge and skillsVide Notifications No. 6-1 / Exam-04 / CPS / 1438 S and R, dated July21, 2004, the Intermediate Module (IMM) examination is mandatoryeligibility requirement for all specified FCPS II examination as fromSeptember 2007. Trainees who passed FCPS I in 2001 and onwardsare required to complete two years training in Paediatrics, and takethe Intermediate Module (IMM) examination.Even if they do not appear in the IMM examination, the trainees arepermitted to continue their training in the chosen discipline but mustpass the IMM examination prior to taking the final FCPS IIexamination.Intermediate Module in Paediatrics 20123

TRAINING ANDEXAMINATIONGENERAL REGULATIONSCandidate will be admitted to the examination in the name (surnameand other names) as given in the MBBS degree. CPSP will notentertain application for change of name on the basis ofmarriage/divorce/deed.REGISTRATION AND SUPERVISIONAll trainings must be supervised, and trainees are required to registerwith the Research and Training Monitoring Cell (RTMC) within 30 daysof starting their training for the Intermediate Module. In case of delay inregistration, the start of training will be considered from the date ofreceipt of application by the RTMC. Registration forms are availablein RTMC and in the Regional Centers. They can also be downloadedfrom the CPSP Website. They must submit the name of theirsupervisor by the date indicated on the registration form. Training iscompulsorily monitored by an approved supervisor who is a CPSPfellow or a specialist with relevant postgraduate qualificationsregistered at the RTMC. The trainees are not allowed to worksimultaneously in any other department/institutions for financial benefitand/or for other academic qualifications.Intermediate Module in Paediatrics 2012APPROVED TRAINING CENTERSTraining must be undertaken in units, departments and institutionsapproved by the College. A current list of approved institutions isavailable from the College and its Regional Centres as well as onthe College website: www.cpsp.edu.pkDURATIONThe duration of training for the Intermediate Module (IMM) istwo years; the Intermediate Module examination is taken oncompletion of the basic training.4

BASIC PAEDIATRICS TRAININGPROGRAM FOR INTERMEDIATEMODULECOMPONENTS OF TRAININGThe two (2) years of core training in Paediatrics consist of:●●Eighteen (18) months of approved residency training inPaediatrics, andThree (3) months rotation in two of the following:- Casualty / Emergency- NeonatologyMANDATORY WORKSHOPSIt is mandatory for all Intermediate Module trainees to attendthe following CPSP certified workshops in the two years ofIntermediate Module training:1. Computer and Internet Orientation2. Research Methodology and Dissertation Writing3. Communication Skills4. BLS/ NALS/PALS/NRAny other workshop/s as may be made available by the CPSP.E-logbookThe CPSP council has introduced an E-logbook system for allresidency programs. Upon registration with RTMC each trainee isallotted a registration number and a password to log on to the e-logbook on the CPSP website. The trainee is required to enter allwork performed and the academic activities undertaken in thelogbook on a daily basis. The concerned supervisor is required toverify the entries made by the trainee. This system ensures timelyentries by the trainee and prompt verification by the supervisor. Italso helps in monitoring the progress of trainees and the vigilanceof the supervisors. The College has enforced the e-logbook sinceJuly, 2011Intermediate Module in Paediatrics 20125

Research (Dissertation / Two Papers)One of the training requirements for fellowship trainees is adissertation or two research papers on the topic related to the fieldof specialization published/accepted for publication in CPSPapproved journals. For trainees in Paediatrics the dissertationsynopsis or abstracts of the research papers must be submitted forapproval to the Research and Evaluation Unit (REU) by the end offirst year of the Intermediate Module.General RequirementsTraining should incorporate the principle of gradually increasingresponsibility, and provide each trainee with a sufficient scope,volume and variety of experience in a range of settings that includeinpatients, outpatients, emergency and intensive care, rehabilitationcenter, or other.Instructional MethodologyTeaching occurs using several methods that range from formaldidactic lectures to planned clinical experiences. Aspectscovered will include knowledge, skills and practices relevant tothe discipline in order to achieve specific learning outcomes andcompetencies.Intermediate Module in Paediatrics 2012The theoretical part of the curriculum represents the currentbody of knowledge necessary for practice. This can beimparted through lectures, grand teaching rounds, clinicopathologicalmeetings, morbidity/mortality review meetings,literature reviews and presentations, journal clubs, self directedlearning, conferences and seminars.Clinical learning is to be organized to provide appropriateexpertise and competence necessary to evaluate and managecommon clinical problems. Demonstration in outpatient andinpatient clinics, and procedural skills training on simulators,mannequins and patients are all practical training modalities.6

ASSESSMENTELIGIBILITY REQUIREMENTSFor appearing in Intermediate Module examination a candidateshould have:● Passed FCPS I in Medicine or granted exemption● Registered with Registration and Training Monitoring Cell (RTMC).● Completed two years of RTMC registered training under anapproved supervisor in an institution recognized by the CPSP.A certificate of completion of training must be submitted.● Completion of entries in e-logbook along with validation by thesupervisor.● Submitted certificates of attendance of mandatory workshops.EXAMINATION SCHEDULEThe Intermediate Module theory examination are held twice a year.● Theory examinations are held in various cities of the countryusually at Abbottabad, Bahawalpur, Faisalabad, Hyderabad,Islamabad, Karachi, Nawabshah, Larkana, Lahore, Multan,Peshawar Quetta and Rawalpindi centers. The College shalldecide where to hold TOACS examinations depending on thenumber of candidates in a city and shall inform the candidatesaccordingly.● English is the medium of all examinations for theory andTOACS.● The College will notify of any change in the centres, the datesand format of the examination.● A competent authority appointed by the College has the powerto debar any candidate from any examination; if it is satisfiedthat such a candidate is not a suitable person to take theCollege examination because of using unfair means in theexamination, misconduct or other disciplinary reasons.EXAMINATION FEE● Applications along with the prescribed examination fee andrequired documents must be submitted by the last date notifiedfor this purpose before each examination.● The details of examination fee and fee for change of centre,subject, etc shall be notified before each examination.● Fee deposited for a particular examination shall not be carriedover to the next examination in case of withdrawal, absence orexclusion.Intermediate Module in Paediatrics 20127

COURSE FOR BASIC PAEDIATRICSTRAININGGENERAL OBJECTIVESUpon completion of specified training in the chosen discipline, aresident must acquire the knowledge, skills and attitudes requiredfor practice of the discipline, including its foundations in the basicmedical sciences and research scholarship in order to:● Be a competent specialist able to provide appropriate andcost-effective care to patients at all levels● Promote health and prevent disease in patients, families andcommunities● Practice continuing professional developmentTo attain competency the trainee must achieve:●●●●Knowledge and expertise in clinical and procedural managementof relevant diseasesMastery of relevant skillsEffective clinical judgment and decision making in dealingwith health problems using evidence based medicineTrainees must demonstrate the knowledge, skills and attitudesrelating to gender, culture and ethnicity pertinent to paediatricsand researchIntermediate Module in Paediatrics 20129

TRAINING FOR INTERMEDIATE MODULEThe curriculum of first two years in Paediatrics involves balancedand objective integration of basic medical sciences and essentialcore clinical knowledge in general. The trainee should be able todiagnose and manage uncomplicated conditions prevalent in theregion and recognize, stabilize and refer complicated cases.The coverage that each discipline receives below is not indicativeof the relative importance placed on each discipline in the trainingprogram, or in the examination. These are guidelines and notcomprehensive definitive lists. Only minimum levels of expectedcompetence have been identified but sufficient scope, volume andvariety of experience are desirable.BASIC CLINICAL KNOWLEDGEIntermediate Module in Paediatrics 2012The trainee should be able to:● Take good history● Examine the patient physically● Write correct medical records which are clear, concise andaccurate● Write referral for consultation to other specialists● Demonstrate the ability to communicate clearly, consideratelyand sensitively with patients, relatives, other healthprofessionals and the public● Use evidence based medicine and evidence based guidelines● Demonstrate awareness of bio-psycho-social factors in theassessment and management of a patient10

SPECIFIC CLINICAL KNOWLEDGEBy the end of second year of training in Paediatrics the traineeshould be able to independently manage children with the followingproblems / diseases:GROWTH AND DEVELOPMENTAnthropometric values■■■■■■Normal valuesRates of increment of weight, height and headcircumferenceType of measurements used in assessment of growthRates of increments in height, weight and headcircumferences in term and preterm infantsMicrocephaly and hydrocephalus identificationDysmorphology assessment and related measurementsNutrition - IYCF (Infant and young child feeding)■■■Normal nutritional requirements in term infants andchildren- Understand total nutrient requirement for a childand its calculation- Failure to thriveBreast feeding- Advantages of breast feeding- Contraindications of breast feeding- Contents of breast milk, colostrum- Contents of cow milk, goat milk, formula milks andspecialized formuls in special circumstances- Understands qualitative and quantitativedifferences between breast milk and non-human milkComplementary feeding issuesIntermediate Module in Paediatrics 201211

Child Development■■■Recognizes the normal developmental milestones ofinfants and children- Identify delays in developmentPreschool Child DevelopmentSchool- Normal cognitive functions- Knows school related issues- Age appropriate readiness and ability to separatefrom parents- Identify appropriate age at which child is able tofollow directions- School screening programmes and their valuePREVENTIVE PAEDIATRICSVaccinationIntermediate Module in Paediatrics 2012■■■■Knowledge of the basic schedule of EPIIndications and contraindications of vaccinesTypes/ Modes of AdministrationComponents of vaccines and newer vaccines■ Global polio eradication initiative and AFPsurveillance program■ Risks and complications of vaccine, Egg allergies -understands egg based vaccinesScreening■■■■■■Principles of screeningBlood Pressure - when to screen and normsHematocrit - when to screen and normsHearing - when to screen and normsVision - when to screen and normsTools for all12

FLUID & ELECTROLYTES■ Normal composition of body fluids and electrolytes■ Normal fluid requirements in term and preterm infantsand children at different ages■ Acid base physiology■ Dehydration - types, management■ Fluid and electrolyte derangements and itsmanagements i.e Na K Bicarbonate, identification ofelectrolyte abnormalities on ECG rhythm strips■ Metabolic acidosis and metabolic alkalosis - types andetiology, identification and management■ Evaluation of readings of pH, HCO 3 PCO 2 and PO 2■ SIADH - Causes Management■ Calculation of Anion gap■ Recognize compensated and uncompensated metabolicacidosis and alkalosisNEONATOLOGY■ Normal newborns■ Delivery room management and neonatal resuscitation■ Fluid and Electrolyte in newborn■ Knowledge of components of APGAR scores and itssignificance■ Differentiation between low birth weight and preterm infantsand their management■ Birth Asphyxia■ Neonatal infections, sepsis, TORCH infection■ Neonatal issues i.e. hemorrhagic diseases of newborn, respiratory distress syndrome, meconiumaspiration syndrome, hyperbilirubinemia types causesand treatment, exchange transfusions■ Infant of diabetic mothers, monitoring andmanagement■ Neonatal seizures■ Incubator careIntermediate Module in Paediatrics 201213

EMERGENCY AND INTENSIVE CARE MANAGEMENTCommon Accidental Paediatric Emergencies■ Poisoning■ Knowledge on the availability of poison controlcenters and access of Poison control centers■ Online resources■ Emetics, ipeacac, charcoal, indications andcontraindications■ Management of specific poisons i.e acids, alkali,kerosene oil, coins, iron, Paracetamol, NSAIDS,Organophosphorus compoumnds, Hydrocarbons,Theophylline and Anticholinergics■ Hyperpyrexia■ Coma: causes, types, classifications, management,level of coma indentification on GCS■ Animal and insect bites and its managements■ Near Drowning■ Electrocution■ BurnsCOMMON MEDICAL EMERGENCIES■■■■ShockSeizuresAcute Respiratory distressComa: causes, types, classifications, managementIntermediate Module in Paediatrics 2012INFECTIOUS DISEASES■■■■■■Common viral exanthemas and Dengue feverMalariaTyphoid (Enteric fever)HelminthiasisMeningitis / encephalitisCommon Bacterial Infections14

GASTROINTESTINAL AND LIVER DISORDERS■ Diarrhea■ Hepatitis - Viral (acute and chronic)■ Chronic liver disease■ Malabsorption■ Constipation■ Approach to abdominal painHEMATOLOGICAL AND ONCOLOGICAL DISORDERS■ Anemia - nutritional■ Hemolytic anemia, Etiology, differentials, initialinvestigations■ Transfusion of blood products, indications and itscomplications■ Bleeding disorders like ITP, Hemophilias■ Common childhood malignancies■ Leukemia and lymphomaCARDIOVASCULAR DISORDERS■ Congenital HD recognition, common ones like VSD,ASD, PDA, TOF, TGA, Co Ao, PS and AS■ Causes of CCF and basic principles of management ofCCF■ Rheumatic fever and heart diseases■ Clinical skills of cardiovascular exam, interpretation ofmurmurs■ Basics of ECG interpretation■ Radiological diagnosis of cardiac diseasesNEUROLOGICAL DISORDERS■ Febrile seizures and its management■ Epilepsy■ Acute flaccid paralysis■ Cerebral palsyNEPHROUROLOGY■ Acute kidney injury■ Chronic kidney disease■ Obstructuve Uropathies■ Acute Glomerulo- nephritis■ Nephrotic syndrome■ Urinary tract infectionsIntermediate Module in Paediatrics 201215

PULMONOLOGY■■■AsthmaPneumonia and its compicationsUpper respiratory tract infections, otitis media, tonsillitisstridorENDOCRINAL DISORDERS■ Hypothyroidism■ Short stature approach■ Diabetes■ Ambiguous genitaliaMUSCULOSKELETAL DISORDERS■ Arthritis: septic arthritis, rheumatoid arthritis■ Osteomyelitis■ CDH and TEVGENETIC AND RELATED DISORDERS■ Basics■ Pedigree■ Common disorders of medelian transmission■ Chromosomal defects like Downs, TurnerSOCIAL AND PREVENTIVE PAEDIATRICS■ Child abuse and neglect:, definition, detection andmanagementIntermediate Module in Paediatrics 2012NATIONAL PROGRAMS RELATED TO CHILD CARE■■■■IMNCIMaternal and child healthMillennium Development goalsNational tuberculosis control programMISCELLANEOUS1616

BASIC SKILLSPsychomotor and technical skillsDemonstrate assessment, diagnostic and procedural skills for ethicaland effective patient care at minimum levels of competenciesidentified. Tables below identify only minimum levels of competencehowever, sufficient scope, volume and variety of experience aredesirable.Key for assessing competencies:1. Observer status2. Assistant status3. Performed under supervision4. Performed independentlyIntermediate Module in Paediatrics 201217

Intermediate Module in Paediatrics 2012COMPETENCIES3 Months 6 MonthsLevel Cases Level CasesFirst Year9 Months 12 MonthsLevel Cases Level CasesTotal Cases1st YearBasicsGeneral Paediatrics(Familarity with Principles of General Paeds) 3 20 4 20 - - - - 40ER/ Emergency 2 20 3 20 3 20 3 20 80Neonatal Paediatrics (including perinatal care) 1,2 20 2 20 3 20 3 20 80PICU/Semi intensive 1 5 1 5 2 5 2 5 20Preventive/Ambulatory Care 1 10 2 10 3 10 3 10 40Paediatrics Surgery - - - - - - - - -A: Patient ManagementHistory taking 4 40 4 40 4 40 4 40 160Physical Examination 4 40 4 40 4 40 4 40 160Ordering & Interpreting Investigations 2 40 3 40 4 40 4 40 160Deciding and implementing treatment 1 40 2 40 3 40 3,4 40 160Maintaining follow-up records 4 40 4 40 4 40 4 40 160Teaching/ Training/ Supervision of research(Acquisition of training in Research Methodology)Prepare and submitSynopsisParticipation in research for object learningcritique of research paper1818

COMPETENCIES3 Months 6 MonthsLevel Cases Level CasesFirst Year9 Months 12 MonthsLevel Cases Level CasesTotal Cases1st YearB: Preventive PaediatricsNutrition, evaluation and management 2 5 2 5 3 5 3 5 20Assessment, monitoring and promotion ofgrowth and development 2 3 2 3 3 3 3 3 12Vaccination 3 3 3 3 4 3 4 3 12Special education programs for handicappedand deprived children - - - - - - - - -School health service - - - - - - - - -Genetic counseling 1 1 1 1 2 1 2 1 4Intermediate Module in Paediatrics 201219

Intermediate Module in Paediatrics 2012COMPETENCIES3 Months 6 MonthsLevel Cases Level CasesFirst Year9 Months 12 MonthsLevel Cases Level CasesTotal Cases1st YearC: ProceduresVenous cannulation 4 10 4 10 4 10 4 10 40Venesection 2 1 2 1 2 1 2 1 4umbilical artery cannulation 2 2 2 2 3 2 3 2 8peripheral artery cannulation 2 1 2 1 2 1 3 1 4Lumbar puncture 3 5 3 5 4 5 4 5 20Subdural tap 1 1 1 1 2 1 2 1 4Pleural tap 1 1 1 1 2 1 2 1 4Pericardial tap - - - - - - - - -Peritoneal tap 1 1 1 1 2 1 2 1 4Suprapubic aspirate 2 1 2 1 3 1 3 1 4Bone marrow aspirate 1 1 1 1 2 1 2 1 4Bone marrow trephine 1 1 1 1 2 1 2 1 42020

COMPETENCIES3 Months 6 MonthsLevel Cases Level CasesFirst Year9 Months 12 MonthsLevel Cases Level CasesTotal Cases1st YearC: ProceduresDirect larynogoscopy and endotracheal intubation 2 3 3 3 3 3 3 3 12Cardio pulmonary resuscitation CPR 2,3 3 3 3 3 3 3 3 12Mechanical ventilation 1 1 1 1 2 1 2 1 4Defibrillation 1 1 1 1 2 1 2 1 4Exchange transfusion 1 2 2 2 2 2 3 2 8Needle biopsy of liver 1 1 2 1 2 1 3 1 4Proctosigmoidoscopy - - - - - - - - -Chest drain insertion (Pneumothorax/ Empyema) 1 1 1 1 2 1 2 1 4Emergency pneumothorax drainage (needle insertion) 1 1 1 1 2 1 2 1 4Peritoneal dialysis 1 1 1 1 2 1 2 1 4Gl endoscopy 1 1 1 1 1 1 1 1 4Renal Biopsy 1 1 1 1 2 1 2 1 4Intermediate Module in Paediatrics 201221

Intermediate Module in Paediatrics 2012COMPETENCIES3 Months 6 MonthsLevel Cases Level CasesFirst Year9 Months 12 MonthsLevel Cases Level CasesTotal Cases1st YearCommon Paediatric DiseasesMalnutrition and micronutrient deficiencies 2 5 2 5 3 5 3 5 20Malaria 2 1 2 1 3 1 3 1 4A.R.I. 2 5 2 5 3 5 3 5 20Acute diarrhea 2,3 15 2,3 15 3 15 3 15 60Bronchial asthma 2 5 2 5 3 5 3 5 20Rheumatic fever 2 2 2 2 3 2 3 2 8Meningitis / Encephalitis 2 5 2 5 3 5 3 5 20Enteric fever 2 2 2 2 3 2 3 2 8Measles and other exanthemata 2 2 2 2 3 2 3 2 8Worm infestation 2 1 2 1 3 1 3 1 4Acute and chronic diarrhea 2 2 2 2 3 2 3 2 8Malabsorption syndromes 2 1 2 1 3 1 3 1 4Anemias including haemolytic Anemias 2 3 2 3 3 3 3 3 122222

COMPETENCIES3 Months 6 MonthsLevel Cases Level CasesFirst Year9 Months 12 MonthsLevel Cases Level CasesTotal Cases1st YearCommon Paediatric DiseasesMetabolic disorders 1 2 2 2 3 2 3 2 8Jaundice 1 5 2 5 3 5 3 5 20Sepsis 1 3 2 5 3 5 3 5 18Birth trauma /asphyxia 1 2 2 2 3 2 3 2 8Congenital malformation 1 1 2 1 3 1 3 2 5Congenital heart disease 1 1 2 1 3 2 3 2 6Respiratory distress 1 3 2 3 3 3 3 3 12Bleeding disorders 1 1 2 1 3 1 3 1 4Seizures 1 2 2 2 3 2 3 2 8Prematurity/low birth weight 1 2 2 2 3 3 3 4 11Antenatal screening 1 1 2 1 3 1 3 1 4Intermediate Module in Paediatrics 201223

Intermediate Module in Paediatrics 2012COMPETENCIES3 Months 6 MonthsLevel Cases Level CasesFirst Year9 Months 12 MonthsLevel Cases Level CasesTotal Cases1st YearManagement of emergenciesShock 1 1 2 2 3 2 3 2 7Convulsions/status epilepticus 1 1 2 2 3 2 3 2 7Hyperpyrexia 1 1 2 1 3 1 3 1 4Poisoning 1 1 2 1 3 1 3 1 4Dehydration 2 5 2 5 3 5 3 5 20Coma 1 1 2 2 3 2 3 3 8Status asthamaticus 1 2 2 2 3 3 3 3 10Cardiac failure 1 1 2 2 3 2 3 2 7Renal failure 1 1 2 1 3 1 3 1 4Hepatic failure 1 1 2 1 3 1 3 1 4Respiratory failure 1 1 2 1 3 1 3 1 4Hypertensive conditions 1 1 2 1 3 1 3 1 42424

COMPETENCIES3 Months 6 MonthsLevel Cases Level CasesFirst Year9 Months 12 MonthsLevel Cases Level CasesTotal Cases1st YearLeukemias 1 1 1 1 2 1 2 1 4Hodgkin's disease. 1 1 1 1 2 1 2 1 4UTI. 2 2 2 2 3 2 3 2 8AGN and Nephrotic Syndrome. 2 2 2 2 3 2 3 2 8ARF and CRF 2 2 2 2 3 2 3 2 8Hypothyroidism 2 1 2 1 3 1 3 1 4Congenital adrenal hyperplasia. - - 2 2 3 2 3 2 6Diabetes mellitus and diabetic ketoacidosis 2 1 2 1 3 1 3 1 4Seizure disorders 2 2 2 2 3 2 3 2 8Osteomyelitis and septic arthritis 2 1 2 1 3 1 3 1 4Common skin problems 2 1 2 1 3 1 3 1 4Metabolic and storage disorders - - - - 1 1 1 1 2Genetic disorders 2 1 2 1 3 1 3 1 4Intermediate Module in Paediatrics 201225

Intermediate Module in Paediatrics 2012COMPETENCIES15 Months 18 MonthsLevel Cases Level CasesSecond Year21 Months 24 MonthsLevel Cases Level CasesTotal Cases2nd YearBasicsGeneral Paediatrics(Familarity with Principles of General Paediatrics) - - - - - - - - -ER/ Emergency 4 20 4 20 4 20 4 20 80Neonatal Paediatrics (including perinatal care) 4 20 4 20 4 20 4 20 80PICU/Semi intensive 3 5 3 5 3 5 3 5 20Preventive/Ambulatory Care 3 10 3 10 3 10 3 10 40Paediatrics Surgery - - 1 5 1 5 1 5 15A: Patient ManagementHistory taking 4 40 4 40 4 40 4 40 160Physical Examination 4 40 4 40 4 40 4 40 160Ordering & Interpreting Investigations 4 40 4 40 4 40 4 40 160Deciding and implementing treatment 3,4 40 3,4 40 3,4 40 3,4 40 160Maintaining follow-up records 4 40 4 40 4 40 4 40 160Teaching/Training/ Supervision of research(Acquisition of training in Research Methodology)Participation in research for object learning critique of research paper2626

COMPETENCIES15 Months 18 MonthsLevel Cases Level CasesSecond Year21 Months 24 MonthsLevel Cases Level CasesTotal Cases2nd YearB: Preventive PaediatricsNutrition, evaluation and management 4 5 4 5 4 5 4 5 20Assessment, monitoring and promotion ofgrowth and development 4 3 4 3 4 3 4 3 12Vaccination 4 3 4 3 4 3 4 3 12Special education programs for handicappedand deprived children 1 3 2 3 3 3 4 3 12School health service 1 3 2 3 3 3 4 3 12Genetic counseling 3 1 3 1 4 1 4 1 4Intermediate Module in Paediatrics 201227

Intermediate Module in Paediatrics 2012COMPETENCIES15 Months 18 MonthsLevel Cases Level CasesSecond Year21 Months 24 MonthsLevel Cases Level CasesTotal Cases2nd YearC: ProceduresVenous cannulation 4 10 4 10 4 10 4 10 40Venesection 3 1 3 1 4 1 4 1 4umbilical artery cannulation 3 2 3 2 4 2 4 2 8peripheral artery cannulation 3 1 3 1 4 1 4 1 4Lumbar puncture 4 5 4 5 4 5 4 5 20Subdural tap 3 1 3 1 4 1 4 1 4Pleural tap 3 1 3 1 4 1 4 1 4Pericardial tap - - - - - - 1 1 1Peritoneal tap 3 1 3 1 4 1 4 1 4Suprapubic aspirate 4 1 4 1 4 1 4 1 4Bone marrow aspirate 2 1 2 1 3 1 3 1 4Bone marrow trephine 2 1 2 1 3 1 3 1 42828

COMPETENCIES15 Months 18 MonthsLevel Cases Level CasesSecond Year21 Months 24 MonthsLevel Cases Level CasesTotal Cases2nd YearCont-2C: ProceduresDirect larynogoscopy and endotracheal intubation 4 3 4 3 4 3 4 3 12Cardio pulmonary resuscitation CPR 4 3 4 3 4 3 4 3 12Mechanical ventilation 3 1 3 1 3 1 3 1 4Defibrillation 3 1 3 1 4 1 4 1 4Exchange transfusion 3 2 4 2 4 2 4 2 8Needle biopsy of liver 3 1 3 1 4 1 4 1 4Proctosigmoidoscopy - - - - - - 1 1 1Chest drain insertion (Pneumothorax/ Empyema) 3 1 3 1 3 1 3 1 4Emergency pneumothorax drainage (needle insertion) 3 1 3 1 4 1 4 1 4Peritoneal dialysis 3 1 3 1 4 1 4 1 4Gl endoscopy 2 1 2 1 2 1 2 1 4Renal Biopsy 2 1 2 1 2 1 2 1 4Intermediate Module in Paediatrics 201229

Intermediate Module in Paediatrics 2012COMPETENCIES15 Months 18 MonthsLevel Cases Level CasesSecond Year21 Months 24 MonthsLevel Cases Level CasesTotal Cases2nd YearCommon Paediatric DiseasesMalnutrition and micronutrient deficiencies 4 5 4 5 4 5 4 5 20Malaria 4 1 4 1 4 1 4 1 4A.R.I. 4 5 4 5 4 5 4 5 20Acute diarrhea 4 15 4 15 4 15 4 15 60Bronchial asthma 4 5 4 5 4 5 4 5 20Rheumatic fever 4 2 4 2 4 2 4 2 8Meningitis / Encephalitis 4 5 4 5 4 5 4 5 20Enteric fever 4 2 4 2 4 2 4 2 8Measles and other exanthemata 4 2 4 2 4 2 4 2 8Worm infestation 4 1 4 1 4 1 4 1 4Acute and chronic diarrhea 4 2 4 2 4 2 4 2 8Malabsorption syndromes 4 1 4 1 4 1 4 1 4Anemias including haemolytic Anemias 4 3 4 3 4 3 4 3 123030

COMPETENCIES15 Months 18 MonthsLevel Cases Level CasesSecond Year21 Months 24 MonthsLevel Cases Level CasesTotal Cases2nd YearCommon Paediatric DiseasesMetabolic disorders 3 2 3 2 3 2 4 2 8Jaundice 3 5 3 5 4 5 4 5 20Sepsis 3 5 3 5 4 5 4 5 20Birth trauma /asphyxia 3 2 3 2 3 2 4 2 8Congenital malformation 3 1 3 1 3 1 4 2 5Congenital heart disease 3 1 3 1 3 2 4 2 6Respiratory distress 3 3 3 3 3 3 4 3 12Bleeding disorders 3 1 3 1 3 1 4 1 4Seizures 3 2 3 2 4 2 4 2 8Prematurity/low birth weight 3 2 3 2 3 3 4 3 10Antenatal screening 3 1 3 1 3 1 4 1 4Intermediate Module in Paediatrics 201231

Intermediate Module in Paediatrics 2012COMPETENCIES15 Months 18 MonthsLevel Cases Level CasesSecond Year21 Months 24 MonthsLevel Cases Level CasesTotal Cases2nd YearManagement of emergenciesShock 3 2 3 2 3 2 4 2 8Convulsions/status epilepticus 3 2 3 2 4 2 4 2 8Hyperpyrexia 3 2 4 2 4 2 4 2 8Poisoning 3 1 3 1 3 1 3 1 4Dehydration 4 5 4 5 4 5 4 5 20Coma 3 1 3 2 3 2 3 3 8Status asthamaticus 3 2 3 2 4 3 4 3 10Cardiac failure 3 2 3 2 3 2 4 2 8Renal failure 3 1 3 1 3 1 4 1 4Hepatic failure 3 1 3 1 3 1 4 1 4Respiratory failure 3 1 3 1 3 1 3 1 4Hypertensive conditions 3 1 3 1 3 1 4 1 43232

COMPETENCIES15 Months 18 MonthsLevel Cases Level CasesSecond Year21 Months 24 MonthsLevel Cases Level CasesTotal Cases2nd YearLeukemias 3 1 3 1 3 1 4 1 4Hodgkin's disease. 3 1 3 1 3 1 4 1 4UTI 4 2 4 2 4 2 4 2 8AGN and Nephrotic Syndrome. 4 2 4 2 4 2 4 2 8ARF and CRF 4 2 4 2 4 2 4 2 8Hypothyroidism 4 1 4 1 4 1 4 1 4Congenital adrenal hyperplasia. 4 2 4 2 4 2 4 2 8Diabetes mellitus and diabetic ketoacidosis 4 1 4 1 4 1 4 1 4Seizure disorders 4 2 4 2 4 2 4 2 8Osteomyelitis and septic arthritis 4 1 4 1 4 1 4 1 4Common skin problems 4 1 4 1 4 1 4 1 4Metabolic and storage disorders 2 1 3 1 3 1 4 1 4Genetic disorders 4 1 4 1 4 1 4 1 4Intermediate Module in Paediatrics 201233

USEFUL ADDRESSESAND TELEPHONENUMBERS1. Regional Offices of the CPSPIntermediate Module in Paediatrics 201234MUZAFFARABADCMH MuzaffarabadAzad KashmirTEL: 05822-920998Email:rc_muzaffarabad@cpsp.edu.pkABBOTTABADAyub Hospital ComplexAbbottabadTEL: 0992-383330Email: rc_abbottabad@cpsp.edu.pkPESHAWARHayatabad Medical ComplexPhase IV, Hayatabad,PeshawarUAN: 091-111-666-666TEL: 091-9217011, 091-9217320-1FAX: 091-9217062Email: rc_peshawar@cpsp.edu.pkISLAMABADP.I.M.S, Ravi Road, Sector G- 8/ 3Islamabad.UAN: 051-111-666-666TEL: 051-9262590-1,FAX: 051-9262592Email: rc_islamabad@cpsp.edu.pkFAISALABADPunjab Medical CollegeFaisalabadUAN: 041-111-666-666TEL: 041-9210131, 9210366-8FAX: 041-9210224Email: rc_faisalabad@cpsp.edu.pkLAHORENext to INMOL, HospitalNew Muslim Town, Block-DLahore.UAN: 042-111-666-666TEL: 042- 9231320-8FAX: 042- 9231327Email: rc_lahore@cpsp.edu.pkMULTANNishtar Medical College,Distt. Jail Road, Opp Circuit House,Multan.UAN: 061-111-666-666TEL: 061-9200946, 9200952Email: rc_multan@cpsp.edu.pkBAHAWALPURQuaid-e-Azam Medical CollegeBahawalpurTEL: 062- 9250461Email: rc_bahawalpur@cpsp.edu.pkNAWABSHAHPeoples Medical College for GirlsNawabshahTEL: 0244-9370271, 9370479FAX: 0244-9370478Email: rc_nawabshah@cpsp.edu.pkLARKANAChandka Medical CollegeLarkanaTEL: 074 – 9410726Email: rc_larkana@cpsp.edu.pk34

HYDERABADAdjacent to Sir Cowasji JehangirInstitute of Psychiatry,Hyderabad, Sindh.TEL: 022-3860056FAX: 022-3860057Email: rc_hyderabad@cpsp.edu.pkQUETTANear Cenar Hospital,Off: Brewery Road, QuettaTEL: 081-9213434 & 081-2913435FAX: 081-2853326Email: rc_quetta@cpsp.edu.pk2.KARACHIDepartments of CPSP KarachiOVERSEAS CPSP CENTRES●UAN – 021-111-606-606Department of MedicalEducation99207100 -10 Ext: 235/240● Examination (FCPS Part I)99207100 -10 Ext: 311●●Examination (FCPS Part II)99207100 -10 Ext: 215Registration, Training &Monitoring Cell99207100 -10 Ext: 345 & 324For further Information:Phone: 99207100-10UAN 111-606-606Facsimile: 99266450Website: www.cpsp.edu.pk3. Saudi ArabiaRIYADHSaudi Council for Health SpecialitiesDiplomatic Quartre P.O.Box 94656,Riyadh - 11614.Kingdom of Saudi ArabiaCity: RiyadhCountry: Kingdom of Saudi ArabiaTEL: 966-1-4822415 ext:156/141FAX: 966-1-48841464. NepalKATHMANDUInstitute of Medicine, Maharajgunj,Kathmandu, NepalCity: KathmanduCountry: NepalTEL: 00977-1-4416224FAX: 00977-1-4416224Email: cpsp_kathmandu@yahoo.comIntermediate Module in Paediatrics 201235