Medical Doctorate in Clinical Toxicology ةيكينيلكلأا مومسلا ىف ...med.asu.edu.eg/uploads/med/Toxicology_MD_201508168513.pdf · 2018-11-26 · 6- Disasters and General

FFaaccuullttyy ooff MMeeddiicciinnee AAiinn SShhaammss UUnniivveerrssiittyy

PPoossttggrraadduuaattee SSttuuddiieess

Medical Doctorate in Clinical Toxicology درجة الدكتوراه فى السموم األكلينيكية

Program Code: FFTT771100

Program Guide and

Logbook

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C a n d i d a t e C u r r i c u l u m v i t a e

[Name] :

[telephone no] :

[mobile no] :

[mailing address] :

[email address] :

[postcode] :

Please attach your recent photo

photo here.

Experience

[organization] [your present job title] [start date] [location] [responsibilities]

[organization] [previous job title] [start and end date] [location] [responsibilities]

[organization] [previous job title] [start and end date] [location] [responsibilities]

3

Education

[certificates] [start and end date] [school or college]

Training

[any other training that will be useful in your job]

Filled by post graduate authorities

Date of Registration

First semester

Second semester

Third semester

Fourth semester

Fifth semester

Sixth semester

4

TABLE OF CONTENTS:

Page

I- Welcome Statement 5

II- Mission Statement 5

III- Senior supervisor and affiliated departments and Hospitals 5

IV- Program specifications 6

1- Basic Information 6

2- Professional Information 6

3- Academic standards 9

4- Curriculum structure and contents 9

5- Program courses: 10

6- Program admission requirements: 14

7- Regulation for progression and program completion. 14

8- Course specifications 17

a. First Part (Medical Ethics, Law and Medical Responsibilities, Critical Care of Poisoned Patients, Toxicological and Biological Analysis, Human and Patient Rights, Management of disasters)

b. Second Part (General Poisoning, Systemic Toxicology, Resuscitative measures in Clinical Toxicology, Treatment of Drug Dependence, Chronic Toxicological Complications )

c. Elective Courses

V- General information

VI- Your log book

1 – Introduction

2 – Supervisors

3 - Tables for training records

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4 – Log book preview

VII- Head of department approval for the exam entry

Detachable forms:

VIII- Thesis follow up

IX- Evaluation forms

I- Welcome Statement: The Department of Forensic Medicine and Clinical Toxicology welcomes you to the Medical Doctorate in Clinical Toxicology. As a department we are committed to medical student education and continuously strive to improve your educational experience. This handbook presents information guide and logbook activity of the Medical Doctorate in Clinical Toxicology administered by the Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Ain Shams University.

II- Mission Statement: The mission of the Faculty of Medicine, Ain Shams University is “The

preparation of a competent graduate, who is able to compete on both national

and regional levels, capable of lifelong learning, training and tutoring, while

adhering to the codes of practice of medical health services and ethics. The

college as well, seeks continuous development of programs and courses. It also

enhances expansion of applied scientific research and health programs for

community services and environmental development. Moreover, through

providing distinguished academic and research cadres of teaching staff,

supporting the administrative system and sustainability of own resources, the

college is able to achieve goals and objectives”.

The mission of this degree is to prepare an outstanding expert consultant in clinical toxicology who is competent with all the possible toxicological health problems in his community, recognize and predict the basics, types, mechanisms and varied toxic effects in clinical toxicology. It

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will develop enough skills in interpreting diagnostic tools and in management methods, talents to distinguish poisoning from different disease entities, and competence in operating toxicological disasters and developing preventive measures to protect the community in an ethical way using the current and advanced guidelines. It helps the applicant to get his way in his career by self- developed array of continued medical education.

III- Senior Supervisor and Affiliated Departments and Hospitals

Senior Supervisor Prof. ------------------------------- ------------------------------- ------------------------------- E-mail:

Affiliated Departments and Hospitals Poison Control Center – Ain Shams University Hospitals.

Other hospitals

IV- Program Specifications

1 - B A S I C I N F O R M A T I O N

1. Program title: Medical Doctorate in Clinical Toxicology 2. Program type: Single Double Multiple 3. Faculty: Ain Shams University – Faculty of medicine 4. Department: Forensic Medicine and Clinical Toxicology Department

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5. Assistant co-coordinator Write the name ……………………………………………… 6. Co-coordinator Write the name……………………………………………… 7. Last date of program approval:

2 - P R O F E S S I O N A L I N F O R M A T I O N 1. Program aims: 1- Implementation and reinforcement of the rules of both medical

practice and research ethics. 2- Acquisition of basic and updated theoretical knowledge in the field

of clinical toxicology with special regards to evidence-based rules as well as international and local medical guidelines.

3- Enhancement of self-education abilities and adopting it as a way of continued medical education.

4- Refining the clinical skills based on a systematic approach to diagnose toxicological diseases and to manage them efficiently and accurately.

5- Development of practical and procedural skill that is necessary in clinical toxicology practice. Awareness of the new tools and how to utilize and analyze their results to help the profession.

6- Improvement of the analytical skills and performance to the state of the art.

7- Adoption of rationalized and ideal management of medical emergency states.

8- Understanding the basics of well designed research that aims at the community benefit.

9- Improvement of communication and expression skills of candidates.

10- Development of leadership skills in the field of clinical toxicology. 11- Improvement of teaching and training abilities.

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2. Intended learning outcomes (ILOs): 1- Knowledge and understanding (K):

By the end of this program the candidate will be able to know the basic and updated knowledge of: a1. Recognize clinical toxicology basic knowledge

(pathophysiology, factors necessary to predict poisoning types and intensity in a community, pathology of the general disease entities)

a2. Recognize clinical presentations and complications of poisoning a3. Be acquainted with tools necessary for the diagnosis of

poisoning. a4. Discover skills for basic procedures. a5. Recognize medical emergencies and critical care in toxicology. a6. List toxicology related disorders. a7. Recognize therapeutic guidelines of different protocols a8. Recognize the skills of preventive toxicology a9. Be familiar with guidance outlines of toxicological disasters

2- Intellectual skills (IS): By the end of the program the candidate will be able to: b.1 Specify medical dilemmas and complexities and how to solve

them. b.2 Make conclusions and be able to conduct scientific discussion. b.3 Select different choices based on multiple determining factors

as social, scientific, economic etc... b.4 Prioritize and tailor the different guidelines to individual

situations.

3- Professional and practical skills (PS): By the end of the program, the candidate will be able to: c.1 Obtain a focused medical history guided by proper analytical

thinking and be able to draw conclusions.

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c.2 Examine properly and systematically to identify different toxidromes and other clinical syndromes unsupported by laboratory evidence.

c.3 Perform and modify analytical procedures according to given clinical data.

c.4 Interpret toxicological results to reach an accurate diagnosis and design a treatment plan in reference to therapeutic guidelines and protocols.

c.5 Interpret general medical investigations and use their findings in diagnosis and therapy.

c.6 Put a diagnosis and differential diagnosis of different cases. c.7 Design a treatment prescription for a given medical problem

within a multidisciplinary management plan if needed. c.8 Identify patients needing hospitalization and emergency

intervention by predicting clinical evolution. c.9 Identifying patients in need for higher specialization. c.10 Master the different emergency and routine procedures

necessary in the Clinical Toxicology specialty.

4- General and transferable skills (GS): By the end of this program the candidate will be able to: d.1 Gain communication skills with workers, nurses, juniors,

professors, peers, patients and their care givers. d.2 Master computer skills in research, data base filing and

preparation of presentation. d.3 Use computer efficiently in solving medical problems. d.4 Work in team. d.5 Acquire managerial skills.

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3 - A C A D E M I C S T A N D A R D S : ( B E N C H M A R K S )

Programs preparing The American Board of Toxicology and Diplome d’Etudes Superieures de Toxicologie Clinique

4 - C U R R I C U L U M S T R U C T U R E A N D C O N T E N T S : 4a- Program duration: minimum of 36 months on six semesters

اناهح

انكىد انقزراخ انذراسحانساعاخ

انعرذج

دورج أساساخ انثحس انعه يرطهثاخ انكهح

FT7101 1 اخالقاخ يارسح انه انطثح اندزء األول

FT7102 1 انقاى و انسؤنح انطثح

FT7103 1 انزعاح انزكزج نزض انرسى

انسح و انثىنىخحانرحانم FT7104 1

حقىق اإلسا و حقىق انزض -

-يىاخهح انكىارز و انرسى انعاوFT7105 FT7106

2

15 انزسانح

FT7107 5 انسىو انعايح اندزء انثا

FT7108 5 األسعاف األون

FT7109 6 انسىو انخاصح و عالخها

FT7110 4 عالج حاالخ األديا

ضاعفاخ انسح انزيحان FT7111 2

االخرارح انقزراخ

خرار انطانة واحذ ي ت:

2 E7024 دورج احصاء طث -1

E7026 اسرخذاو انكثىذز -2

E7012 انثىنىخا اندزئح -3

15 كزاسح األشطح

60 اندىع

5- PROGRAM COURSES 5.1- Program: Medical Doctorate in Clinical Toxicology (FT710): Semester 1 a. Compulsory= 6 CH

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Course Part

Code No.

No. of Units: 6 No of hours

L /SDL C/P

1st Part FT7101 1- Ethics of Medical Practice 12 6

FT7102 2- Law and Medical Responsibilities 12 6

FT7103 3- Critical Care of Poisoned patients 5 22

FT7104 4- Toxicological and Biological Analysis 5 20

FT7105 FT7106

5- Human and Patients rights 6- Disasters and General Poisoning Management

24 12

5.2- Program: Medical Doctorate in Clinical Toxicology (FT710) Semester 2 a. Compulsory= 5CH Course Part

Code No No. of Units : 1 – Title No of hours

L /SDL C/P

2nd Part FT7107 General Toxicology 45 30

FT7108 Resuscitative and First aid Measures 10 10

5.3- Program: Medical Doctorate in Clinical Toxicology (FT710) Semester 3 a. Compulsory= 5 CH Course Part

Code No.

No. of Units : 3 – Title No of hours

L SDL C/P

2nd Part FT7107 General Toxicology 15

FT7108 Resuscitative and First aid Measures 5 20

FT7109 Specific Toxicology and Management 20 20

FT7110 Dependence Treatment 10 10


Code No.


L SDL C/P

2nd Part FT7108 Resuscitative and First aid Measures 5 20



12


Code No.


L SDL C/P

2nd Part FT7108 Resuscitative and First aid Measures 10 40



5.6- Program: Medical Doctorate in Clinical Toxicology (FT710) Semester 6 a. Compulsory = 2 CH b. Elective = 2 CH. Total = 4 CH Course Title

Code No.

No. of Units:2 – Title No of hours per semester

L SDL C/P

2nd Part FT7110 Chronic Toxicological Complications

20 20

On

e o

f th

e fo

llow

ing

E7024 دورج احصاء طث

E7026 اسرخذاو انكثىذز

E7012 انثىنىخا اندزئح

6 . P R O G R A M A D M I S S I O N R E Q U I R E M E N T S -(: شرزط نقذ انطانة نهحصىل عه درخح انذكرىرا :7انادج )

يا أ ك داصال ػه دسجة اناجغحش ف يادة انحخصص أ إدذ اناد األعاعية انحصيهة -1

ي إدذ انجايؼات انصشة أ ػه دسجة يؼادنة نا .

جغييذذ انشعييو يصيياسر انحييذسك إعييحال - .يافقيية جيية انؼييم ػهيي يحدهاييات انذساعيية -2

األجضة إعحفاء انغحذات انده ة ف انهذق

كي أ انحفشؽ نهذساعة نذة خظ فصل دساعة ػه األقم قام دخل ايحذيا انجيضء اننيا. -3

حى انحذسك نفظ انذة ػه األقم ف ادذ انغحشفات أ انشاكض انؼهة انؼحيذة يي انكهية ؼيذ

أعحفاء انششط انح جذذدا األقغاو انخحصة.

7- R E G U L A T I O N F O R P R O G R E S S I O N A N D P R O G R A M

C O M P L E T I O N ن ي أل ن دح آخش أغغدظ انناية حى انحغجم نذسجات انذكحسا يشج ف انؼاو : األ(: 8يادج )

0آخش دغاش ي أل فاش دح

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جصع انذساعة ف كم ػاو جايؼ ػه فصه دساع يذة كم ييا خغية ػشيش اعياػا . ايذا (: 9يادج )

غ . االل ف أل أكح ش اذا اننا ف يصر فاشاش. يغ جظى فصم دساع صف يكنر نذة عيحة اعيا

انذساعي قايم اعياػ يي ذاحي ػهي االقيم ؼيذ إعيحفاء انشيشط دغيك انقيشسات يحى انحغيجم نهفصيم

عياػات يؼحيذة. جيص نهدانيك جؼيذم 6انغجهة. الاغ أ ضذ انؼكء انذساع ف انفصم انادذ ػ

(. كيا جيص ني االغيذال خيالل انقشسات خالل اعاػ ي ذاية انفصيم انذساعي ل انذيز ا اال يافة

عح اعا غ ي ادذ انقشاست د ادحغا ساعاا ف.

يذة انذساعة نهذصل ػه انذكحسا عحة ثالثي هيشا لعيث فصيل دساعية( جحياص خالنيى (: 17يادج )

انخييايظ غيحف خالنييا اندانيك شايجيا جييذساا يحكيايال انقغيى طاقييا نهغياػات انؼحييذة ان يذة انايال

ي ال غخ ن يذخل اميحذيا قايم إعيحفاء ثالثية أس ياع اندهيل ي األشدة اندهل ي ف كحك يحا ؼة

. ي انغاػات انؼحذة

فصيم دساعي اديذ جحياص ؼيذ اندانيك إيحذايا إ جيذ يذة انذساعة ف انجضء األل نهذكحسا (: 18يادج )

ف انكايم نإلحقال نهذساعة ف انجضء اننا شحشط خالنا انحيذسك حديذ انغحشيفات ال شحشط انجاح

ػهي أ يحى انؼحذة يي انقغيى نجية انذساعيات انؼهيا انكهية عياء انيذاخم أ انخياس أ انشاكض انجايؼة

. إعحكال انذساعة طاقا نهغاػات انؼحذة

جييص ياقشيية جنهذسجيية ال يييغ انقييذ انييذكحسا حغييجم ي ييع انشعييانة قييو انييذاسط نذسجيية(: 19يااادج )

انشعانة قام يشس ػاي ػه انحغجم نهذسجة ال خصص نا دسجات.

ياقشية قو انذاسط نذسجة انذكحسا حعحفاء يحدهاات انجايؼة قام انحغجم يحدهايات انكهية (: 22يادج )

يحدهاييات انجايؼيية يي انذصييل ػهيي هييادة انحفييم فيي انهغيية .ء اننيياقاييم دخييل إيحذييا انجييضانشعييانة

دسجيية( يحدهاييات انكهيية يي دتييس دسات يؼحييذة ييي نجيية انذساعييات انؼهييا 550امجهضيية ليجييع

انكهة ف يجال انحخدط انذساعات انداة امدصاء اندا أ إجحاص إخحااسات خاصة جذذدا انهجة.

عييث جغييؼ عيياػة يييا عييث ثالثيي عيياػة جييث انغيياػات انؼحييذة نذساعيية انييذكحسا (: 21يااادج )

ػه األقم خصص يا خيظ ػشيشة عياػة نكحيك يؼحذة عاػة دساعحى اثاء اناجغحش تا عح

. إ جذخظ ػششة عاػة نهشعانة عث عاػات ػه األقم نهجضء األل األشدة يحا ؼة

يذة انقذ نذسجة انذكحسا خظ عيات جيص نجهيظ انجايؼية ياءا ػهي طهيك يجهيظ انكهية (: 22يادج )

ؼييذ يافقيية نجيية انذساعييات انؼهييا انكهيية ؼييذ طهييك يجهييظ انقغييى إعييحادا إنيي جقيياسش عيية ييي جييغ

قيذ نهذصيل ػهي ذيذ أقصي ثيا عيات يي جياس انانششف ػه اندانك انغياح ح يافة ػياو اديذ

دسجة انذكحسا.

يغ إيحذايات ي يػة جشيم القغاو انؼية األهيحشا ييغ أقغياو انياد انشجادية هحضو اج(: 23يادج )

عييا م انحقييى انخحهفيية ييي أعييوهة طهيية قصييشة يحؼييذدة امخحيياسات ك إخحايياسات إكهكيية يقيية جقييظ

اعة اناج جفاصم رنك جؼحذ ي نجة انذساعات انؼها انكهة . اناسات انخحهفة ػه أ جشم كش

دسجيية نهجييضء األل إ 300دسجيية يييا 1500يجييع دسجييات االيحذييا انييا نهييذكحسا (: 24يااادج )

. 400ه انحشاك ا اص صجذ. تا انا انؼذل انففاش ي كيم ػياو ؼقيذ إيحذيا انيذس اننيا في أ شيم ؼقذ إيحذا انذس األل ف أكح ش (: 25يادج )

يا ي كم ػاو.

انحذشييش انؼهيي % ييي دسجيية60كيي انجيياح فيي ييياد انييذكحسا ؼييذ انذصييل ػهيي (:26يااادج )

االكهك انشف كم ػه دذة.

14

Assessment Schedule and Weighing of

Assessments

Item Mark

Po

ints

GP

A

sco

re

ةانط

انح

انح

Stu

den

t

stat

e

During

semester End of

semester Total

First semester (If present) 80 300 380

Second semester 80 80

Third semester 80 80

Fourth semester 80 80

Fifth semester 80 80

Sixth semester Final exam

Written

1200* 1200*

Oral

Practical /Clinical

Total 400 1500 1900

NB: * 1500 if there is no end of first semester exam

عمى الوجو التالي: ممحوظة: تعادل درجات الطالب طبقا لمنقاط قاط 4 : % فأكثز 92 -1 A

قاط 3667 : % 92% حر أقم ي 85ي -2 A-

قاط 3633 : %85% حر أقم ي 82ي - 3 B+

قاط 3622 : %82% حر أقم ي 75ي - 4 B

قاط 2667 : %75% حر أقم ي 72ي - 5 B-

قاط 2633 : %72% حر أقم ي 65ي - 6 C+

قاط 2622 : %65% حر أقم ي 62ي -7 C

15

قاط 1667 : %62% حر أقم ي 62ي - 8 C-

F صفز : %62أقم ي - 9

درجة لمجزء األول إن وجد. 011درجة منها 0011مجموع درجات االمتحان النهائي لمدكتوراه درجة 011درجة لمدبموم العالي والماجستير و 011بما يوازى مي التراكميصويضاف إليها المعدل ألف

.لمدكتوراه

عمى أساس مجموع حاصل ضرب نقاط كلل مقلرر مضلروبا لي (GPAلويتم حساب المعدل الفصمي عدد ساعاتو المعتمدة مقسوما عمى الساعات المعتمدة لممقلررات التلي درسلها الطاللب لي الفصلل الدراسلي. كملا

عملى أسللاس مجمللوع حاصلل ضللرب النقللاط التلي حصللل عميهللا (CGPAلمعلدل التراكمللي لمطالللب ال يلتم حسللاب الطالب ي كل مقرر مضروبا ي عدد ساعاتو المعتمدة مقسوما عمى مجموع الساعات المعتمدة الكمية.

دة يلتم اععلاأو اللدكتوراه والماجسلتير لي اللدبموم أمقلررات ال ي حالة الرسوب ي مادة أو مجموعة من ويلتم حسلاب التقلدير الفعملي اللصي يحصلل عميلو لي أول إعلادة قلط أملا إصا تكلرر ي المادة أو المجموعلة قلط.

.(C-نقاط اى 0.01% قط )اى01رسوب يحسب لو عند النجاح تقدير

16

C O U R S E S S P E C I F I C A T I O N S

ET HI CS O F MEDI CA L PRA C TIC E ثحاخالقاخ يارسح انه انط

(FT7101)

1- COURSE SPECIFICATIONS

University Ain Shams Faculty of Medicine Program on which the course is given

Medical Doctorate in Clinical Toxicology (FT710)

Major or minor element of programs Minor Department offering the program Department of Forensic Medicine

and Clinical Toxicology Department offering the course Department of Forensic Medicine

and Clinical Toxicology Academic level Medical Doctorate – 1st semester Date of Specification Approval

2- BASIC INFORMATION

Title Ethics of Medical Code FT7101

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practice

Credit Hours 1 Lectures: 10 h Tutorials: 4 h

Clinical: 6 h Total contact: 20 h

Coordinator

3 . P R O F E S S I O N A L I N F O R M A T I O N

1 C O U R S E A I M S

The aim of the course is to assure that the students obtain a thorough comprehension of the basic principles of ethics during medical practice in order to assume his tasks in a context of safe, respectful, satisfactory and successful relation with the patient and his relatives

2 - I N T E N D E D L E A R N I N G O U T C O M E S ( I L O S ) F R O M

T H E C O U R S E :

1- KNOWLEDGE AND UNDERSTANDING (K): By the end of the course the candidate will be able to:

a1. Describe the aspects playing the fundamental parts of medical ethics. a2. Portray the circumstances where the ethics might be violated a3. Describe the different problems during medical practice that create

ethical concern

a4. Recognize the ethics rules governing medical practice and issued by the Egyptian Medical Syndicate.

a5. Identify the ethical concern in emergency, critical care, during transfer, on referral of patients in general and intoxicated cases in particular

a6. Identify the ethical concern during medical, surgical manipulations, gynecologic, pediatric and neurological examination practice,

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a7. Identify the ethical concern during emergency situations as acute poisoning for patients unable to give their consent

a8. Recognize the ethical principles of emergency medicine practice and the challenges to apply them

a9. To list different types and limitations of consent in clinical toxicology. a10. Recognize the medico-legal importance of informed consent and its

limitations. a11. Describe the confidentiality, fairness and the respect of privacy and

dignity of acutely intoxicated patients and their limitations. a12. Know how to make full documentations for toxicological patients

presented in emergency room, in-patient unit, intensive care unit and out-patient units.

a13. Describe procedure and limitations to restrain the patients at ICU. a14. Know the patient rights referring to human rights and lawful

legalizations.

2- INTELLECTUAL SKILLS (IS): By the end of the course the candidate will be able to: 1b Interpret the most important challenge situations 2b Correlate the Egyptian ethical regulations to the basic principles of

medical ethics 3b Integrate the medical ethics principles with different clinical situations

and specialties and recognize ethical principles in medical interventions and procedures e.g. Mechanical Ventilation

4b Select the ethical rules suiting our community according to the governing legislations

5b Incorporate ethical considerations during nursing care, home care, geriatric care, critical care, dying situations.

6b Conceive the concept of ever-changing profile of medical ethics in a society and correlate it to advances in biotechnology and regulations

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7b Estimate the medical procedures and treatment modalities breaking the concept of medical ethics and recognize causes of ethical concern in Emergency and critical care

8b Practice of Emergency and Critical care Medicine in cost conscious manner

3. PROFESSIONAL SKILLS: By the end of the course the candidate will be able to: c1 Demonstrate the procedure and formalities to restrain a patient in ICU. c2 Write full documentation as regard medical charts; follow up charts for

different intoxicated patients in ER, in-patient unit, out-patient and ICU. c3 Write a valid consent in different situations and consent needed for

discharge a patient against medical advice. c4 Write medico-legal reports of acute intoxicated patient. c5 Practice the ethics principles autonomy, fairness, confidentiality,

beneficence and non maleficence

4. GENERAL AND TRANSFERABLE SKILLS (GS): By the end of the course the candidate will be able to: d.1. Maintain honesty and integrity in all interactions with teachers,

colleagues and others with whom physicians must interact in their professional lives.

d.2. Recognize the scope and limits of their role as students as well as the necessity to seek and apply collaboration with other workers.

d.3. Use database to collect material needed for research. d.4. Gather and organize material from various sources (including library,

electronic and online resources). d.5. Understand the importance of continuing professional development. d.6. Demonstrate knowledge of the importance of ethical approval and

patient consent for clinical research. d.7. Work cooperatively and show respect for other opinions.

20

d.8. Appraise responsibility towards work..

3 - C O U R S E C O N T E N T :

Topics No of hours

L T C/P SDL

Medical Ethics 1 Credit Hour

1) Concept of medical ethics 1

2) Ethical principles 3 1

3) Ethical principles and limitations in critical care.

3 2 1

4) Procedures posing special concern in breaking the ethical principles in emergency and clinical toxicology practice

2 2

2

5) Rules governing medical ethics in Egypt 2 1

6) Ethical rules in use of drugs and research

1 1

Total 10 4 6

L: Lecture, T: Tutorial, C/P: Clinical or Practical and SDL: Self directed learning.

4 - S T U D E N T A S S E S S M E N T M E T H O D S 4.1 Short essays to assess knowledge 4.2 MCQs to assess knowledge and intellectual skills 4.3 Practical/ Clinical exam to assess professional skills and general skills 4.3 Oral exam to assess intellectual, professional and general skills

21

4 - Student Assessment Methods 4.1 Short essays to assess knowledge 4.2 MCQs to assess knowledge and intellectual skills 4.3 Oral examination to assess intellectual, professional and general skills 4.4 Practical examination

Weighing of assessments

1 Written examination: 30 2 Practical examination 10 3 Oral examination 10 4 Clinical examination -- Total 50

5 - List of References 5.1- Course Notes (paper and / or electronic) 5.2- Essential Books (Textbooks) 5.3- Recommended Books 5.4- Periodicals, Web Sites, etc

22

ME D I C A L RE S P O N S I B I L I T I E S A N D

MA L P R A C T I C E I N C L I N I C A L

T O X I C O L O G Y (FT7102) األطثاء أخطاء و انرسى نحاالخ انطثح انسؤنح


Medical Doctorate of Clinical Toxicology (FT7102)



and Clinical Toxicology Academic level First Semester Date of Specification Approval

A - B A S I C I N F O R M A T I O N

Title Medical Malpractice and responsibilities

Code FT6104

Credit Hours 1 Lectures: 8 h Tutorials: 10 h Clinical: 6 h Total contact: 24 h

Coordinator

23

C . P R O F E S S I O N A L I N F O R M A T I O N


Acquire an appropriate background of basics of standards of care in

medicine disease actionable in toxicology.

Identify and manage medical complications in the context of poisoning malpractice

Recognize the inappropriate procedures, drugs, antidotes and other supportive management

Acquire the talent and experience of rapid accurate management of medical emergencies.


T H E C O U R S E :

1. KNOWLEDGE AND UNDERSTANDING (K): By the end of the course the candidate will be able to:

a1. Determine malpractice points in reference to therapeutic guidelines and protocols that could be done for acute intoxicated patients in emergency room, in-patient unit, ICU, out-patient unit and laboratory.

a2. Know how to write medico-legal report in acute intoxicated patients. a3. Enumerate the medico-legal responsibilities towards answering a

patient telephone asking a medical advice. a4. Recognize different forms of negligence in acutely intoxicated

patient. a5. Recognize the medico-legal aspects of transfer and referral a6. Recognize negligence in providing efforts of diagnosis and

management in toxicology practice a7. Requirements for Negligence to be Actionable

24

2. INTELLECTUAL SKILLS (IS): By the end of the course the candidate will be able to:

b1. Acquire the skill to avoid malpractice claim in all activities of toxicology practice.

b2. Express wisdom to negate the elements of a claim. b3. Express skill to depict inappropriate management and solve it. b4. Avoid breach of duty by sticking to therapeutic guidelines and

protocols that consider basic standards of care. b5. Depict dangerous signs that endanger patient life and correlate

them to medical or toxicological pathology.

3. PROFESSIONAL SKILLS (PS):

By the end of the course the candidate will be able to: c.1. Acquire Communication skills to harmonize patient toxicologist

interrelation. c.2. Acquire communication skills with health care providers to achieve

the goal to cure the patient without commission a breach of duty. c.3. Arrange teaching sessions aiming at avoiding inappropriate

management from the part of physicians (non toxicologist) and other health care providers

2. GENERAL AND TRANSFERABLE SKILLS (GS):

By the end of the course the candidate will be able to: d.1. Maintain honesty and integrity in all interactions with patients. d.2. Assume responsibility towards the patient related to the toxicologist

by a duty d.3. Work cooperatively and show respect for other opinions.

25


Topics No of hours

L T C/P SDL Medical Responsibilities and Malpractice in

Clinical Toxicology 1 Credit Hour

Ideal and basics standards of Care 1 1

Types of malpractice 1 1

Deviation from standards of care by ignorance

2 2 1

Deviation from standards of care by negligence

2 2

1

Elements of negligence claim 1 1

Factors enhancing claim 1

The most common causes of claims and health care providers

1

Malpractice versus assault 1

Types of informed consent and contribution of patient in negligence

1

Case studies of common malpractice 4

Total Contact hours = 24 8 10 6

Total Credit hours = 1

Student assessment methods: MCQ and written : to assess knowledge


1 Written examination: 30 2 Practical examination -- 3 Oral examination 20 4 Clinical examination -- Total 50

26

C R I T I C A L CA R E O F PO I S O N I N G

PA T I E N T S (FT7103)

C O U R S E S P E C I F I C A T I O N S



Major or minor element of programs Major Department offering the program Department of Forensic Medicine


and Clinical Toxicology Academic level First semester Date of Specification Approval

A- BASIC INFORMATION

Title Critical care of poisoning patient

Code FT7103

Credit Hours 1 Lectures: 5 h Tutorials: 11h Clinical and Practical: 11h

Total contact hours : 27 h

Coordinator

27

B - PROFESSIONAL INFORMATION

1 - C O U R S E A I M S :

a) To be competent in the emergency clinical evaluation and management of an acutely intoxicated patient, and in immediate general and specific emergency management b) To identify and manage acute systemic disturbances and failure and properly manage all complications due to acute intoxication c) To demonstrate skills and competence in dealing with resuscitative measures as antidotes administration, oxygenation, monitoring, and mechanical ventilation adjustments suitable for acutely intoxicated patient based on the recognized clinical toxic effects of poisons.


T H E C O U R S E :

A- KNOWLEDGE AND UNDERSTANDING

By the end of the course the candidate will be able to: a1. Describe the critical care modalities in patients with acute or chronic

intoxications complicated with system failure. a2. Explain the usual evolution of poisoning. Depict the prognostic signs

and interpret their significance using the investigative tools and toxicology laboratory results.

a3. Understand the basis of the critical care antidotes and drugs, equipment and their functioning, use indications, values, complications and limitations according to type of poisons.

a4. Comprehend the preset parameters of mechanical ventilation, adjustments, meaning of monitoring value for all types of intoxication, stage of the disease and circumstances.

28

a5. Realize the monitoring value of electrocardiographic changes, significance in different intoxication and emergency management.

a6. Understand the basis of elimination and detoxification procedures, their potential values and risks and their indications.

a7. Understand the basis and indications of hemodialysis and recommend specific prescriptions for every poison and other circumstances.

a8. Outline the required emergency investigational procedures that help in diagnosis of acute and chronic intoxications.

a9. Discuss the details of management of the acute intoxicated patient.

B- INTELLECTUAL SKILLS

By the end of the course the candidate will be able to: b1. Provide skills to diagnose acute intoxications and their vital

complications on emergency basis interpret the clinical data and select immediate intervention.

b2. Interpret the monitoring values and significance of clinical changes for rapid and immediate therapeutic intervention using antidotes, drugs or resuscitative equipment.

b3. Modify the therapeutic modalities of equipment according to the values and calculations of clinical and machine data.

b4. Express competence in interpreting arterial blood gas, other laboratory parameters of significance and monitoring values of cardiac monitor, electrocardiography, imaging, ventilation, central venous pressure, response of antidotes and elimination procedures.

b5. Evaluate the patient clinical condition by selecting the proper modality. b6. Decide promptly the required management procedure and clearly

design the proper pathway of care of acute of intoxications. b7. Show competency in solving problems related to critical care tools

used in the management of the intoxicated patient. Recognize troubleshooting of every equipment and express competence in dealing and correcting it

29

b8. Understand the value of documentation and cumulative critical care observation for subsequent decision making concerning the management of acute intoxications

b9. Formulate questions on research points that require evidence based research.

b10. Apply basic toxicological sciences in the prevention of acute intoxicated cases.

C- PROFESSIONAL SKILLS

By the end of the course the candidate will be able to: c1. Perform full and informative general and systemic clinical examination

of an intoxicated patient. c2. Select the investigational approach on emergency basis for

clarification of the detailed diagnosis, severity and possible systemic affection.

c3. Choose the required intervention and procedure, and express competence in performing them, including elimination procedures as emesis, gastric lavage, assuring airway and endotracheal intubation, AMBU resuscitation and mechanical ventilation, assessment of central venous pressure, humidification of airway, oxygenation, nebulizer, use of special modality ventilation, using cardiac monitoring for starting or terminating antidotes or drugs or for other decision making therapeutic modality, defibrillation and other minor and major procedures

c4. Undergo efficiently all procedures used for detoxification and elimination of poisoning

c5. Demonstrate skill in applying protocols for specific and antidotal management of acute intoxicated cases.

c6. Demonstrate skill in emergency management of acute life threatening conditions as arrest, treatment of shock, seizures, respiratory failure

D- GENERAL AND TRANSFERABLE SKILLS

30

By the end of the course the candidate will be able to: d1. Communicate with colleagues and seniors for the sake of a more

accurate diagnosis and effective treatment d2. Present cases and discuss clinical data with peers. d3. Practice emergency medicine with referral to medical ethics and

medico-legal responsibilities d4. Self education and collect data from the net and the marketed

products d5. Work within a team in preparing research articles


Topics No. of hours

L T C/P SDL

MANAGEMENT OF SPECIFIC PRESENTATIONS

Cardiopulmonary Resuscitation - Basic Life Support (BLS), and Advance Life Support (ALS)

1 1

Evaluation, causes and management of shock in poisoning: CVP, ECG,

0.5 2 2

Arrhythmias: Management in different intoxication states

0.5 1 1

Assessment of respiratory function: imaging, ABG, clinical data

0.5 1 1

Respiratory presentations in poisoning: Respiratory failure, Pulmonary edema (CPE – NCPE), ARDS,

0.5 1 2

Clinical approach to the comatose patient. Differential diagnosis of metabolic, structural versus toxic coma.

0.5 1.5 1.5

Seizures, agitation, delirium and 0.5 0.5 0.5

31

confusional states: Causes and management in Toxicology

Acid base, electrolytes and fluid imbalance

0.5 1 1

Assessment and Monitoring of renal function in critical care intoxicated patient

0.5 1 1

Toxic and fulminant hepatitis and failure in acute poisoning

0.5 0.5

Coagulopathy (DIC). Monitoring and management

0.5 0.5

TOTAL Contact Hours = 23 hours 5 11 11

TOTAL Credit Hours = 1 hours 0.3 0.35 0.35

L: Lecture, T: Tutorial, C/P: Clinical or Practical and SDL: Self directed learning

4 - S T U D E N T A S S E S S M E N T M E T H O D S

4.1Essay written … to assess a1 – a10 4.2Practical exam to assess b1 – b7 4.3Clinical exam and check list application to assess c1 – c6 and d1 - d3 4.4 MCQ exam to assess a1 - a10, b1 - b7

4.4 Research article presentation to assess b8-9, d1, d2, d4.


1 Written examination: 30 2 Practical examination -- 3 Oral examination -- 4 Clinical examination 20 Total 50

32

5 - L I S T O F R E F E R E N C E S 5.1- Course Notes (paper and / or electronic) …Provided by staff members 5.2- Essential Books (Text Books)

Handbook of medical toxicology, Peter Viccellio, Little ,Brown and company 5.3- Recommended Books

Goldfrank Toxicologic emergencies,

Clinical Toxicology of commercial products

Haddad

Ellenhorn Medical Toxicology

The ICU Book, by Paul L. Marino

Guidelines for the administration of enteral and Parenteral nutrition in pediatrics. Mark Bedford et al. Toronto Canada

Clinical Electrocardiography by Ary L. Goldberger 5.4- Periodicals, Web Sites, etc

1. Canadian Journal of Emergency Medicine. http://www.cma.ca/index.php/ci_id/15639/la_id/1.htm

2. The Internet Journal of Emergency and Intensive Care Medicine. http://www.ispub.com/journal/the_internet_journal_of_emergency_and_intensive_care_medicine.html

3. BMC Emergency Medicine. http://www.biomedcentral.com/bmcemergmed

4. International Journal of Emergency Medicine

http://www.ncbi.nlm.nih.gov/pmc/journals/594/ 5. Urgence Pratique. http://www.urgence-pratique.com/ 6. Journal of Critical Care

http://www.elsevier.com/wps/find/journaldescription. 7. Latest news, updates and guidelines for emergency physicians.

http://www.acep.org/ 8. A cluster of databases on toxicology, hazardous chemicals and

related areas. http://toxnet.nlm.nih.gov/

33

9. Discussions, classes and reviews sponsored by The University of Illinois at Chicago. http://www.uic.edu/com/er/toxikon

10. Database of photos, botanical information, and health information on poisonous plants. http://www.ansci.cornell.edu/plants/index.html

11. Hunter Area Toxicology Service’s modules on approximately 25 common toxic drugs and environmental agents, including information on pharmacology, toxicology, and treatment. http://www.hypertox.com/

12. AAPCC is a nationwide organization of poison centers and interested individuals. http://www.aapcc.org/

13. Extensive menu of links to data on pharmaceuticals, biotechnology, and pharmaceutical companies. http://pharminfo.com/phrmlink.html

14. Search engine for commonly prescribed drugs with; dosages, indications, interactions, pharmacokinetics, costs and more. http://www.clinicalpharmacology.com/

15. Comprehensive collection of drugs of abuse. http://www.streetdrugs.org/

16. Access to Martindale's pharmacy center for drug information. http://www.martindalecenter.com/Pharmacy.html

17. http://www.ecglibrary.com/ ECG library

34

T O X I C O L O G I C A L A N D B I O L O G I C A L

A N A L Y S I S (FT7104)








Title Toxicological and Biological Analysis

Code FT7104



Coordinator

35



a. To identify the laboratory capabilities essential in differentiating and

assisting in the evaluation of the severity of poisoning as confident guides for subsequent management of intoxicated patients.

b. To demonstrate skills and competence in collecting samples in a proper way and time and to conceive the principles of the tests

c. To demonstrate skills and competence in performing simple laboratory procedures and bedside tests

d. To be competent in interpreting the values of biological and toxicological testing for the diagnosis and management of poisoning


T H E C O U R S E :


By the end of the course the candidate will be able to: a1. List the toxicological tests required for proper diagnosis and

management a2. Describe the required laboratory tests in patients with acute or chronic

intoxications especially in acute emergency situations. a3. Identify the different biological tests that point and indicate to the

nature of poisoning and or intensity. a4. Recognize the normal values of the biological and toxicological results

36

a5. Understand the basis of indirect toxicological markers and their significance

a6. Identify the proper sample collection procedures for each test based on kinetics of the drug / poison, time delay and sensitivity of the test requested

a7. Be aware of the limitations and benefits of each toxicological method. a8. Understand the value of drug and poison monitoring in biological fluids a9. Assimilate the principles of toxicological sampling a10. Assimilate the kinetic and dynamic of different poisons and rules

governing their biotransformation, redistribution and elimination a11. Understand the principles and theories of each technique used in

toxicological analysis a12. Describe the steps of each method of analysis a13. Comprehend the mechanism of sample extraction methods a14. Recognize the reliability, reproducibility, specificity and sensitivity and

the basic requirements of each methodology. a15. Be familiar with trouble shooting of each method of analysis a16. Recognize indications, medico-legal implications and cost of each

method of analysis.


By the end of the course the candidate will be able to: b1. Provide skills to interpret laboratory results in emergency situations

according to the clinical data and select immediate intervention. b2. Correlate the laboratory result with the clinical data available, with time

delay and with the body fluid tested b3. Express competence in interpreting arterial blood gas, electrolytes and

other laboratory parameters

37

b4. Express competence in interpreting toxic blood levels and drug screen and detect false negative or positive results and falsely high or low levels

b5. Be able to recognize trouble shooting during laboratory procedures. b6. Reject a sample not valid for toxicological analysis b7. Prioritize analytical methods according to the requirement, to the given

clinical data and situation as emergency, medico-legal or therapeutic; as for the most economic, rapid reliable or sensitive.

b8. Modify steps according to the required poison to be analyzed, chemicals availability and cost

b9. Expect a certain method and selected body fluid for analysis according the general rules of biotransformation of a given poison with a specific structure.

b10. Review the literature and references to reach suitable method of toxicological analysis according to the available resources

b11. Design a toxicological analysis for an unknown poison of potential hazards to the community using the basics of research

b12. Comprehend the values and limitations of poisoning markers b13. Comprehend the problems and difficulties of delay, misinterpretation

or ignoring an important step of toxicological analysis b14. Accurately interpret results of toxicological analysis according to the

used methods, situation and other factors as timing, body fluid and based on the toxicological information given by the patient and physician.

b15. Comprehend the medico-legal aspects and limitations of each result.


By the end of the course the candidate will be able to: c1. Perform bedside toxicological tests correctly.

38

c2. Select the toxicological analytical method and approach for each test according to the nature of suspected poison

c3. Perform urgent laboratory analysis as arterial blood gas and electrolytes and blood glucose.

c4. Perform colorimetric toxicological tests on qualitative and quantitative basis.

c5. Demonstrate skill in discussing the nature and characteristics of the poisons according to clinical data in order to choose the proper analytical instrument as gas liquid chromatography or high performance liquid chromatography.

c6. Perform extraction procedures of different groups of poisons c7. Prepare in a safe and accurate way the reagents to be used for the

toxicological analysis c8. Perform spectrophotometric analysis of acetaminophen, salicylates,

trichlorinated compounds and others in a sound manner c9. Perform thin layer chromatographic testing for acidic, basic groups of

poisons, benzodiazepines, cannabis, and tramadol in a safe approach and correct manner

c10. Execute chromatographic analysis on GC and HPLC and interpret results

c11. Carry out immunoassay laboratory tests on automated equipment after performing calibration quality control tests

c12. Perform drug screening and therapeutic drug monitoring using a multitude of equipments to achieve the best results suiting the requested goal

c13. Demonstrate skill in interpreting the results according to the collected patient data after confirming the analysis to comply with international standards of toxicological analysis..

c14. Demonstrate skill in releasing results of medico-legal importance


39

By the end of the course the candidate will be able to: d1. Communicate with colleagues and seniors for the sake of a more

accurate diagnosis and effective treatment d2. Present cases and discuss clinical in correlation to laboratory data. d3. Self education and collect data from the net and the marketed

products d4. Work within a team in preparing research articles


Topics No. of hours

L T C/P SDL

INDICATIONS FOR TOXICOLOGICAL ANALYSIS 1

SAMPLE COLLECTION PROCEDURES, TRANSPORT AND STORAGE

0.5 0.5 1

TYPE OF SAMPLES, DRUGS IN SALIVA OR

HAIR ANALYSIS

0.5

EXTRACTION PROCEDURES (ACIDIC, BASIC

AND SPECIAL) 0.5 0.5 1

DRUGS OF ABUSE , ADULTERATION

TESTING, AND PROBLEMS ENCOUNTERED

IN SCREENING FOR DOA

0.5 1 1

ALCOHOL, AND TOXIC ALCOHOLS 0.5

DRUG ABUSE IN SPORT 0.25 0.25

PESTICIDES, RODENTICIDES 0.25 0.5 0.5

THERAPEUTIC DRUG MONITORING 0.5 0.5

DRUG SCREEN 1 1

VOLATILE SUBSTANCES 0.25 0.5

METALS 0.25

40

GASES 0.5

ANIONS 0.25 0.25

TECHNIQUES OF ANALYTICAL TOXICOLOGY

COLOR TESTS AND BED SIDE TESTS 0.5

IMMUNOASSAYS 0.5 0.5

ULTRAVIOLET, VISIBLE AND

FLUORESCENCE SPECTROPHOTOMETRY 0.25 0.5

THIN–LAYER CHROMATOGRAPHY 2

GAS CHROMATOGRAPHY 1

HIGH PERFORMANCE LIQUID

CHROMATOGRAPHY 1

MASS SPECTROMETRY 0.25

EMERGING TECHNIQUES 0.25

BIOLOGICAL SAMPLING (BLOOD, URINE..) 0.25 0.5

TOXICOLOGICAL INDICES IN BIOLOG. TESTS

ARTERIAL BLOOD GAS 0.5 0.5

ELECTROLYTES (NA – K – CA – MG..) 0.5 0.5

TRANSAMINASES AND LIVER FUNCTION T 0.5

KIDNEY FUNCTION TESTS (SERUM- URINE) 0.5

CPK AND CARDIAC & MUSCLE ENZYMES 0.5

COAGULATION STUDIES AND CBC -RBS 0.5

URINE 0.25


TOTAL Credit Hours = 1 hours 0.3 0.2 0.5



4.1Essay written … to assess a1 – a10 and b1 - b2

41

4.2Practical exam to assess b1 – b5 and c1 – c8 4.3Clinical exam and check list application to assess c1 – c7 and d1 - d3 4.4 MCQ exam to assess a1 - a10, b1 – b5, c1 – c8

4.5 Research article presentation to assess b8-9, d1, d2, d4. Weighing of assessment

1 Written examination: 30 marks 2 Practical examination -- 3 Oral examination 20 Total 50 marks


Clark's Analysis of Drugs and Poisons by Moffat et al 5.3- Recommended Books

Handbook of Basic Tables for Chemical Analysis Second Edition. Bruno and Svoronos, 2003

Basic Analytical Toxicology by Flanagan R

Volatile Substance Abuse by Flanagan et al

Physician guide to laboratory diagnosis of Metabolic diseases .Blau, Duran, Blaskovics and Gibson. 2nd Edition Springer-Verlag Berlin

Fiche de données toxicologiques et environnementales des substances chimiques (Institut National de l'Environnement Industriel et des Risques)

TIAFT Proceedings and meetings

Handbook of medical toxicology, Peter Viccellio, Little ,Brown and company

Drug Abuse Handbook: Steven Karch. CRC Press. 5.4 Journals

42

ODCCP Bulletin on Narcotics

Journal of analytical Toxicology

Annales de Toxicologie Analytique

human rights principles (FT 7105)

FT7)105(يثاديء حقـىق اسـا





and Clinical Toxicology Academic level First Semester Date of Specification Approval

B - B A S I C I N F O R M A T I O N


Code FT6105

Credit Hours 1 Lectures: 7 h Tutorials: 5 h practical: 12 h Total contact: 24 h

Coordinator

D . P R O F E S S I O N A L I N F O R M A T I O N

43

B - Professional Information

1- Course Aims:

The aims of this course are to enable students to:

1. Describe the main articles of universal declaration of human

rights.

2. Recognize that human dignity of all people is the foundation of

justice and peace in the world.

3. Identify justice, tolerance, and dignity as public moral

imperatives.

4. Foster attitude of tolerance, respect, solidarity, and responsibility.

5. Develop awareness of how human rights can be translated into

social and political reality.

6. Understand the components of patient rights charter governing

medical and medicolegal practice.

7. Apply human rights and patients rights during medicolegal

investigation of cases.

2- Intended Learning Outcomes (ILOs) from the

Course:

44

a- Knowledge and understanding

By the end of the course the candidate will be able to:

a1. List the main components of the universal declaration of human

rights. a2. State the main principles of patient rights charter.a3. Recognize

that all persons have the rights to a secure, healthy, ecologically

sound environment.

a4. Understand that all persons shall be free from any discrimination

in regard to actions and decisions that affect the environment, the

faculty, and health practice.

a5. Realize that freedom of speech, belief, fear, and want are the the

highest aspiration of the people.

a6. Discriminate between justice, dignity and respect applications in

medical practice.

a7. Identify that everyone has the rights to an effective access to

health services without discrimination due to age, race, religions,

beliefs and thoughts.

a8. Recognize the laws and legal protections that regulate human

rights.

b- Intellectual skills By the end of the course the candidate will be able to: b1. Provide

intellectual approaches in respecting persons and patients.

b2. Respect moral and cultural beliefs, and religious and

philosophical conviction.

b3. Demonstrate efficiency to detect violation of human rights

during medicolegal investigtaion.

b4. Provide evidences of effective applications of patient rights

principles during examination of child abuse and sexual

harassment litigation cases.

45

b5. Perform an organized intellectual respect to privacy and

confidentiality in preparation of expert reports and case analysis.

c- Professional skills

By the end of the course the candidate will be able to c1. Apply basic human right principles in forensic medicolegal

practice.

c2. Manifest competency in application of patient rights in aspectsof

court litigations.

c3. Identify or eliminate persons as victims of human rights violation

in medical malpractice claims.

c4. Strengthen respect for human personality and its dignity.

c5. Build programs and capacities for human rights education at his

working hospitals and institutions

c6. Adopt equality before law, nondiscrimination on ground of

religion, race, caste, sex, and beliefs.

c7. Prepare accurate medicolegal report that follow up the principles

of human and patient principles.

c8. Write reports or give testimony, when needed, to aid the court in

applying justice in crimes.

d- General and transferable skills


d1. Maintain honesty and integrity in all communication activities

with colleagues and others with whom forensic pathologist must

interact during their practical lives.

d2. Utilize problem solving skills in varieties of practical situation.

d3. Manages time, prioritaires workloads and Recognizes and

manages personal emotions.

46

d4. Communicates the medico-legal information in written, oral or

electronic forms.


Topics No of hours

L T C/P SDL

1) Universal declaration of

human rights: History

- Precursors

- Drafting

- Adoption

Structure

Permeable

Human rights set out in

declaration

Commemration

Significance and legal effect

Praise and criticism

3 2 3

2) The Patients' Rights

Charter: Definitions

Main patient's rights principle

2 2 5

3)Medicolegal implications 1 1 2

4)Patient responsibilities 1

2

47

L: Lecture, T: Tutorial, C/P: Clinical or Practical and SDL: Self

directed learning

3 - Student Assessment Methods: Written, oral and MCQ to assess knowledge Practical examination to assess intellectual skills Weighing of assessments

1 Written examination: 30 2 Practical examination 10 3 Oral examination 10 4 Clinical examination -- Total 50

48

T O X I C O L O G I C A L D I S A S T E R

M A N A G E M E N T (FT7106) انعـــاو وانرســــى نكـىارزا يىاخهـــح


Medical doctorate in Clinical Toxicology (FT7106)






Code FT 7106

Credit Hours 1 Lectures: 10 Tutorials(POS):10 h Total contact:20 h

Coordinator

49

B . P R O F E S S I O N A L I N F O R M A T I O N

1 . C O U R S E A I M S

Provides an appropriate background of types and hazards of

toxicological disasters. And elaborate the prediction of its occurrence

Provides experience in the proper preparedness and management of toxicological disasters in contexts of probable toxicological disasters in Egypt.


T H E C O U R S E :

1. KNOWLEDGE AND UNDERSTANDING (K): By the end of the course the candidate will be able to:

K.1.Define types of toxicological disasters (natural and man-made). K.2 List activities to carry out for the preparedness for the disaster K.3 Define how to predict the occurrence of toxicological disaster. K.4 List factors to be considered in the planning of response to toxicological disasters. K.5 Define hazardous materials and delineate priorities and vulnerability in toxicological disasters K.6 Describe some toxicological disasters probably occurring in Egypt regarding diagnosis, response, treatment and prevention. K.7 List and describe toxicological disasters in the world. K.8 Describe the general approach to the poisoned patient within the disaster.

2.INTELLECTUAL SKILLS (IS): By the end of the course the candidate will be able to:

50

IS.1 Demonstrate the skill of solving problems in predicting of, prioritizing responses to, and toxicological disasters.

IS.2 Demonstrate competency in proposing a disaster management protocols

IS.3 Demonstrate professionalism in solving problems about the general approach of a poisoned patient in the case of disaster.

3. PROFESSIONAL SKILLS (PS):

By the end of the course the candidate will be able to: PS.1 . Demonstrate professionalism in the general approach of a poisoned patient in the case of disaster.

4.GENERAL AND TRANSFERABLE SKILLS (GS):

By the end of the course the candidate will be able to: GS1. Maintain honesty and integrity in all interactions with patients. GS2. Assume responsibility towards the patient related to the toxicologist by a duty GS3. Work cooperatively and show respect for team work


Topics No of hours

L POS C/P SDL

Definition and types of toxicological disasters

1

Disaster preparedness(basic goals, priorities and vulnerabilities)

1 2

Disaster preparedness(prediction, planning 2 2

51

response)

Toxicological disasters in Egypt 1

Toxicological disasters in the world 1 o √

Chemical warfare 1

Radiation 1

Biological weapons 1

Disaster management protocol 2 2

General approach to a poisoned patient in a disaster

1 2

Total Contact hours = 20 10 10

Total Credit hours = 1

L: lecture-POS: problem oriented session, C/P : clinical and practical, SDL: self-directed learning

4 - Student Assessment Methods 4.1 - Essay written … to assess from K1-K5 4.2 - MCQ exam to assess from K1-K5

4.3-OSPE exam to assess IS1,IS2,IS3,PS 1

Weighing of assessments (combined with FT 7105)

1 Written examination: 30 marks 2 Practical examination 10 3 Oral examination 10 Total 50 marks

52


Title General toxicology Code FT6105

Credit Hours 5 Lectures: 46h Tutorials: 45 h Practical: 15 h Total contact: 106 h Coordinator

B - P R O F E S S I O N A L I N F O R M A T I O N


a) To provide competency in the general approach to a poisoned patient regarding diagnosis and treatment b) To implement guidelines for proper management of complications due to acute intoxication





and Clinical Toxicology Academic level Semester2,3 Date of Specification Approval

G E N E R A L T O X I C O L O G Y FT7107

نسىو يح ا عا ن ا

53

c) To apply background knowledge of the basic toxicology sciences in explaining special toxicological systemic insults and atypical pictures in extremes of age , pregnancy and diseases.

D)To provide knowledge about common general toxicological problems as environmental, occupational and genetic subjects


T H E C O U R S E :


By the end of the course the candidate will be able to: a1. Describes the pathophysiology, toxic causes, clinical picture and diagnosis of

complications of poisoning (respiratory, neurological, cardiovascular and metabolic) a2. Describe, in details, the steps of the general management of acutely intoxicated

patients. a3. Discuss how the different body systems respond to poisoning a4. Describes the atypical pictures acute poisoning due to pregnancy, extremes of age and

multiple overdoses.


By the end of the course the candidate will be able to: b1. Interpret and diagnose critical life threatening complications of acute intoxications

and identify conditions needing immediate intervention. b2. Decide promptly the required management procedure and clearly design the proper

pathway of care of and acutely intoxicated patient. b3. Relate the atypical clinical pictures to special conditions as extremes of age and

pregnancy.


54

By the end of the course the candidate will be able to: c1. Perform full and informative general and systemic clinical examination

of an intoxicated patient. c2. Choose the proper required investigational procedure for the general

evaluation of the patient condition c3. Undergo efficiently all procedures used for detoxification and

elimination of poisoning



d1 –Present cases and discusses clinical data with peers. d2 – Self education and collect data from the net and other sources d3 – Communicate properly with patients, peers and seniors ………. d4 – Work, within a team, in preparing research articles.

3 - C O U R S E C O N T E N T

Topic No. of hours

L T C/P SDL

General clinical examination of poisoning cases and role of the lab.

2 1 4

Toxidromes 1 1 2

Management of acute poisoning

Detoxification (Gastric lavage, emesis, catharsis, whole bowel irrigation)

2 1 1

Elimination procedures (Diuresis, dialysis and others)

2 1 1

Extracorporeal methods of enhancing elimination.

1 1

Toxic causes, diagnosis of specific clinical

55

complications:

Neurological complications of poisoning and Management

Coma , Seizures, tremors, fasciculation 2 2 1

Agitation, Hallucinations and delusions and Behavioral changes

1 1 1

Encephalopathy, Cranial nerve toxicity - Peripheral neuropathy

1 1 1

Cardiovascular complications

Hypotension, Shock – Hypertensive crises

1 1 1

Myocarditis, Myocardial, and peripheral ischemia

1 1 1

Respiratory complications

Respiratory failure - Pneumonitis – ARDS

1 1 1

Pulmonary edema (Cardiogenic and non-cardiogenic)and Acute bronchospastic conditions

1 1 1

Acid Base and Electrolytes imbalance 1 1

Topics No. of hours

L T C/P SDL

Evidence based medicine and toxicology 1

Geriatric toxicology 1 1

Pediatric toxicology 1 1

Pregnancy and poisoning 1 1

Multiple overdoses 1 1

Developmental toxicology 1 1

Industrial toxicology 1 1

Carcinogenesis –mutagenesis&teratogenesis 1

Environmental toxicology &pollution 2 1

Genomics and new genetics in toxicology 1

56

Experimental toxicology 1

Nephrotoxicity 2 2

Hepatotoxicity 2 2

Toxicity of hematological system 1 2

Immunotoxicity 1 1

Dermatotoxicology 1 1

Ophthalmic toxc\icology 1 1

Otolaryngeal toxicology 1 1

Reproductive toxicology 1 1

Gasterointestinal toxicology 1 1

Genitourinary toxicology 1 1

Biochemical &molecular basis of toxicology 2

Toxicokinetic &t toxicokinetic basis of toxicology

1

Antidotes 2 1


4.1 - Essay written … to assess a1, a2, a3 a4 4.2 - Practical exam to assess b5…….………. 4.3 - Clinical exam and check list application to assess c1, c2, c3, c4 and d3 4.4 - MCQ exam to assess a1, a2, a3, a4, c1, c2, c3, c4 4.4 - Research article presentation to assess d1, d2, d4.

5 - W E I G H I N G O F A S S E S S M E N T :

1 Written examination: 120 marks 2 Practical examination 20 Clinical examination 80 3 Oral examination 30 Total 50 marks

6 - L I S T O F R E F E R E N C E S

57

5.1- Course Notes (paper and / or electronic) …Provided by staff members 5.2- Essential Books (Text Books)

Handbook of medical toxicology, Peter Viccellio, Little, Brown and company

Recommendations and Perspectives. Gullo and Lumbs


5.3- Recommended Books


Ellenhorn's Medical Toxicology

Dreisbach's handbook of poisoning

Toxicologie Clinique: Bismuth Chantal


Haddad,

Ellenhorn Medical Toxicology. Williams and Wilkins

Textbook of Healthcare Ethics. 2nd Edition. Loewy, and Roberta Springer. Kluwer Academic Publishers

5.4- Periodicals, Web Sites, etc 1. A cluster of databases on toxicology, hazardous chemicals and

related areas. http://toxnet.nlm.nih.gov/ Canadian Journal of Emergency Medicine. http://www.cma.ca/index.php/ci_id/15639/la_id/1.htm


3. Discussions, classes and reviews sponsored by The University of Illinois at Chicago. http://www.uic.edu/com/er/toxikon

4. Database of photos, botanical information, and health information on poisonous plants. Contains links to other related sites http://www.ansci.cornell.edu/plants/index.html

58


6. Journal of Intensive Care Medicine. Tufts University school of Medicine. University of Massasuchetts. Medical School

7. Very extensive menu of links to data on pharmaceuticals, biotechnology, and pharmaceutical companies. http://pharminfo.com/phrmlink.html

8. Latest news, updates and guidelines for emergency physicians. http://www.acep.org/



R E S U S C I T A T I V E A N D F I R S T A I D

ME A S U R E S (FT7108)




Major or minor element of programs Major

59

Department offering the program Department of Forensic Medicine and Clinical Toxicology

Department offering the course Department of Forensic Medicine and Clinical Toxicology

Academic level Semesters 3, 4 and 5 Date of Specification Approval


Title Resuscitative and First aid Measures

Code FT7108



Coordinator



a) To be competent in the emergency clinical evaluation and management of an acutely intoxicated patient b) To identify and manage acute systemic disturbances and failure and properly manage all complications due to acute intoxication c) To express skills and competence in dealing with resuscitative measures as antidotes administration, oxygenation, monitoring, and mechanical ventilation adjustments suitable for acutely intoxicated patient based on the recognized clinical toxic effects of poisons.

60


T H E C O U R S E :


By the end of the course the candidate will be able to: a1. Describe the resuscitative measures and critical care modalities in

patients with acute or chronic intoxications complicated with system failure.

a2. Explain the usual evolution of poisoning. Depict the prognostic signs and interpret their significance using the investigative tools and toxicology laboratory results.

a3. Understand the basis of the critical care antidotes and drugs, equipment and their functioning, use indications, values, complications and limitations according to type of poisons.

a4. Comprehend the preset parameters of mechanical ventilation, adjustments, meaning of monitoring value for all types of intoxication, stage of the disease and circumstances.

a5. Realize the monitoring value of electrocardiographic changes, significance in different intoxication and emergency management.

a6. Understand the basis of elimination and detoxification procedures, their potential values and risks and their indications.

a7. Understand the basis and indications of hemodialysis and recommend specific prescriptions for every poison and other circumstances.

a8. Understand the basis of other procedures helping the eliminations of poison as peritoneal dialysis, hemofiltration and hemoperfusion.

a9. Outline the required emergency investigational procedures that help in diagnosis of acute and chronic intoxications.

a10. Discuss the details of management of the acute intoxicated patient.

61


By the end of the course the candidate will be able to: b1. Provide skills to diagnose acute intoxications and their vital

complications on emergency basis interpret the clinical data and select immediate intervention.

b2. Interpret the monitoring values and significance of clinical changes for rapid and immediate therapeutic intervention using antidotes, drugs or resuscitative equipment.

b3. Modify the therapeutic modalities of equipment according to the values and calculations of clinical and machine data.

b4. Express competence in interpreting arterial blood gas, other laboratory parameters of significance and monitoring values of cardiac monitor, electrocardiography, imaging, ventilation, central venous pressure, response of antidotes and elimination procedures.

b5. Evaluate the patient clinical condition by selecting the proper modality.

b6. Decide promptly the required management procedure and clearly design the proper pathway of care of acute of intoxications.

b7. Show competency in solving problems related to critical care tools used in the management of the intoxicated patient. Recognize troubleshooting of every equipment and express competence in dealing and correcting it

b8. Understand the value of documentation and cumulative critical care observation for subsequent decision making concerning the management of acute intoxications

b9. Formulate questions on research points that require evidence based research. Apply basic toxicological sciences in the prevention of acute intoxicated

cases.


62

By the end of the course the candidate will be able to: c1. Perform full and informative general and systemic clinical examination of

an intoxicated patient. c2. Select the investigational approach on emergency basis for clarification

of the detailed diagnosis, severity and possible systemic affection. c3. Choose the required intervention and procedure, and express

competence in performing them, including elimination procedures as emesis, gastric lavage, assuring airway and endotracheal intubation, AMBU resuscitation and mechanical ventilation, assessment of central venous pressure, humidification of airway, oxygenation, nebulizer, use of special modality ventilation, using cardiac monitoring for starting or terminating antidotes or drugs or for other decision making therapeutic modality, defibrillation and other minor and major procedures

c4. Undergo efficiently all procedures used for detoxification and elimination of poisoning

c5. Demonstrate skill in applying protocols for specific and antidotal management of acute intoxicated cases.

c6. Demonstrate skill in emergency management of acute life threatening conditions as arrest, treatment of shock, seizures, respiratory failure



d1. Communicate with colleagues and seniors for the sake of a more accurate diagnosis and effective treatment

d2. Present cases and discuss clinical data with peers. d3. Practice emergency medicine with referral to medical ethics and

medico-legal responsibilities d4. Self education and collect data from the net and other sources

63

d5. Work within a team in preparing research articles


Topics No. of hours

L T C/P SDL

CLINICAL EXAMINATION OF ACUTELY ILL

INTOXICATED PATIENT 1 4

TOXIDROMES 1 1 2

CRITERIA FOR ADMISSION OF POISONING

CASES IN ICU 1

ROLE OF ANALYTICAL TOXICOLOGY, AND

IMAGING IN ICU MANAGEMENT. 1 1

ELIMINATION PROCEDURES: EMESIS AND

GASTRIC LAVAGE AND OTHER ELIMINATION

PROCEDURES (TYPES OF DIALYSIS..)

2 2 6

ANTIDOTE ADMINISTRATION AND MONITORING 0.5 1 1

MANAGEMENT OF SPECIFIC PRESENTATIONS

Cardiopulmonary Resuscitation - Basic Life Support (BLS), and Advance Life Support (ALS)

1 1

Evaluation, causes and management of shock in poisoning: CVP, ECG,

1 2 6

Arrhythmias: Management in different intoxication states

1 2 2

Evaluation significance and management of ischemic heart and myocarditis in poisoning

0.5 1 1

Assessment of respiratory function: imaging, ABG, clinical data

1 4 2

64

Oxygenation and aerosol therapy in acute poisoning states

0.5 1 0.5

Respiratory presentations in poisoning: Respiratory failure, Pneumonitis, bronchospastic conditions, Pulmonary edema (CPE – NCPE), ARDS,

1 2 3

Mechanical Ventilation: setting ventilation in different indication, different modalities, as PEEP, monitoring, calculations, weaning and troubleshooting in specific intoxication (Hydrocarbon, methanol, CO, Heroin lung, botulism etc…..)

2 4 6

Clinical approach to the comatose patient. Differential diagnosis of metabolic, structural versus toxic coma.

1.5 2 3

Seizures, agitation, delirium and confusional states: Causes and management in Toxicology

1 1 1

Acid base, electrolytes and fluid imbalance

1 2 2

Assessment and Monitoring of renal function in critical care intoxicated patient

1 1 1

Toxic and fulminant hepatitis and failure in acute poisoning

0.5 1 1

Coagulopathy (DIC). Monitoring and management

0.5 0.5 1

Acute hemorrhagic crises, and acute toxic bone marrow failure

0.5 0.5 0.5

Neutropenia, thrombocytopenia: Significance and management

0.5 0.5

Rhabdomyolysis 0.5 1

SPECIFIC PROCEDURES IN ACUTE

65

INTOXICATION

Oxygenation, aerosol 0.5 1 1

Endotracheal Intubation 2 1

Gastric Lavage 2 2

Emesis 0.5 0.5

Catharsis 0.5 0.5

Access of central venous line 1 2

Enteral and Total Parenteral Nutrition 1 2 1

Endoscopy of upper GIT in corrosives 1

ECG interpretation in Toxicology 1 3 2

Other emergency procedures: tracheotomy, insertion of chest tube in barotraumas or corroded lung lesions

2 1

Inappropriate pre-hospital management 1 1

HOSPITAL ACQUIRED INFECTION IN ICU 0.5

TRANSPORTATION OF CRITICALLY ILL PATIENT 1 0.5

EMERGENCY RESUSCITATION IN DISASTERS 1

WORK ORGANIZATION IN AN ICU 0.5


TOTAL Credit Hours = 5 hours 1.3 1 2



4.1Essay written … to assess a1 – a10 4.2Practical exam to assess b1 – b7 4.3Clinical exam and check list application to assess c1 – c6 and d1 - d3 4.4 MCQ exam to assess a1 - a10, b1 - b7

4.4 Research article presentation to assess b8-9, d1, d2, d4.

66


Handbook of medical toxicology, Peter Viccellio, Little, Brown and company

Fundamentals of Mechanical Ventilation. Chatburn RL. Cleveland Ohio. Mandu Press

Handbook of Drugs in Intensive Care:An A-Z Guide 3rd ed

Intensive and Critical Care Medicine. Reflections, Recommendations and Perspectives. Gullo and Lumbs

The ICU Book, by Paul L. Marino

5.3- Recommended Books



Haddad,

Ellenhorn Medical Toxicology. Williams and Wilkins

Clinical Electrocardiography by Ary L. Goldberger

Textbook of Healthcare Ethics. 2nd Edition. Loewy, and Roberta Springer. Kluwer Academic Publishers

5.4- Periodicals, Web Sites, etc 11. A cluster of databases on toxicology, hazardous chemicals and

related areas. http://toxnet.nlm.nih.gov/ Canadian Journal of Emergency Medicine. http://www.cma.ca/index.php/ci_id/15639/la_id/1.htm


13. BMC Emergency Medicine. http://www.biomedcentral.com/bmcemergmed

67

14. International Journal of Emergency Medicine

http://www.ncbi.nlm.nih.gov/pmc/journals/594/ 15. Urgence Pratique. http://www.urgence-pratique.com/ 16. Journal of Critical Care

http://www.elsevier.com/wps/find/journaldescription. 17. Discussions, classes and reviews sponsored by The University of

Illinois at Chicago. http://www.uic.edu/com/er/toxikon 18. Database of photos, botanical information, and health information on

poisonous plants. Contains links to other related sites http://www.ansci.cornell.edu/plants/index.html

19. The European Society of intensive care Medicine journal. http://icmjournal.esicm.org/index.html

20. The Internet Journal of Emergency and intensive Care Medicine. http://www.isppub.com


22. Journal of Intensive Care Medicine. Tufts University school of Medicine. University of Massasuchetts. Medical School

23. Very extensive menu of links to data on pharmaceuticals, biotechnology, and pharmaceutical companies. http://pharminfo.com/phrmlink.html

24. latest news, updates and guidelines for emergency physicians. http://www.acep.org/



27. ECG library. http://www.ecglibrary.com/

68

S P E C I F I C T O X I C O L O G Y A N D

M A N A G E M E N T ( F T 7 1 0 9 )


A- BASIC INFORMATION University AinShams Faculty of medicine

Program on which the course is given


Major or minor element of programs Major

Department offering the program Department of Forensic Medicine and Clinical Toxicology

Department offering the course Department of Forensic Medicine and Clinical Toxicology

Academic level (2nd Year)

Date of Specification Approval

Title Special toxicology. Code FT7109



Coordinator

69



a) To prepare a specialist who is competent in clinical evaluation of acutely and chronically intoxicated patient and provide immediate and correct general and specific management b) To provide knowledge and skills of the management of all complications due to acute intoxication c) To give guidelines in preparing protocols of prevention emergency and outpatient management of acute and chronic intoxication.


T H E C O U R S E :



a1 Discuss the pathophysiology of common acute and chronic intoxications with drugs and chemicals a2 Describe clinical picture and complications of common drugs and chemical acute and chronic intoxications. a3 – Outlines and interpret the required investigational procedures that help in diagnosis of acute and chronic intoxications.

a4 –Discusses the details of management of the acute and chronic intoxicated patient a5- Relates available knowledge with evidence based medicine practice


70

By the end of the course the candidate will be able to: b1- Interpret and diagnose acute intoxications, and identify conditions needing immediate intervention. b2 – Decide promptly the required management procedure and clearly design the proper pathway of care of acute and chronic intoxications. b3 – Show competency in solving problems revolving around acute and chronic intoxications with referral to medical ethics and medico-legal responsibilities

b4- Apply basic toxicological sciences in the prevention of acute and chronic intoxicated cases. b5 – Formulate questions on research points that require evidence based research.



c1- Perform full and informative general and systemic clinical examination of an intoxicated patient. c2 - Choose the proper required investigational procedure that helps in diagnosis and interpret correctly. c3 - Undergo efficiently all procedures used for detoxification and elimination of poisoning c4 - Show competency in applying protocols for specific and antidotal management of acute intoxicated cases.



d1 –Present cases and discusses clinical data with peers. d2 – Self education and collect data from the net and other sources d3 – Communicate properly with patients, peers and seniors ………. d4 – Work within a team in preparing research articles

71


Topics No. of hours

L T C/P SDL

Over the Counter drugs

Acetaminophen 1 1 1

Salicylates 1 1 1

Non Steroidal Anti-Inflammatory Drugs 1

Anorexigenic drugs, Obesity Drugs 1 1 CNS stimulants and common cold medications 1 Drugs That Affect Sexual Function. 1 Antimicrobials Cephalosporins and Penicillins 1 Macrolides 1

1

Quinolones Aminoglycosides 1 Antituberculous drugs 1 Antiviral drugs 1

Antiprotozoal drugs (Antimalarials, Antiamebics and others)

Antifungal drugs 1

Topics No. of hours

L T C/P SDL

Central Nervous System Drugs

Antidepressants (TCA – SSRI) 1 1 1

Neuroleptics 1 1

Lithium 1 1

Sedatives hypnotics (Benzodiazepines, Barbiturates, Meprobamate, Zopiclone, zolpidem, Melatonin receptor,

1 1 2

72

bromides, plant origin sedatives.)

Anxiolytics Others (Buspirone…) 1*

Muscle relaxants Others (Baclofen, Carisoprodol, …)

1* 1

Antiepileptics 1* 1

Respiratory Drugs

Theophylline and Xanthines 1* 1 1

Beta2-adrenergic receptor agonist 1* 1 1

Topic No. of hours

L T C/P SDL

Cardiovascular Drugs

Digitalis preparations 1 1 1

Beta blockers 1 1 1

Diuretics 1

Calcium Channel Blockers 1 1 1

Antiarrhytmics 1 1

Antihypertensives 1 1

Nitrates 1 1 Hyperlipidemia drugs

1

Anti-platelets

Endocrine Drugs) Oral hypoglycemic drugs and Insulin 1 1 1 Steroids

1

Metals and salts Lead 1 1 1 Mercury 1

1

Arsenic 1 Iron 1 1 1

73

Corrosives (Acids, Alkalis, chlorine) Chemicals

Toxic Gases (Carbon monoxide, cyanide, chlorine, hydrogen sulfide…)

2 1 2

Toxic Alcohols and Glycols 2 1 3

Rodenticides (Phosphides, anticoagulants, Boron, Carbamates)

1 1 1

Insecticides (Organophosphates, Organochlorines, Carbamates, Pyrethroids, Others)

2 2 3

Herbicides (Paraquat, diquat, atrazine) 1 1

Petroleum distillates and hydrocarbons

2 1 2

Detergents, Dyes, food colors and preservatives

1

Food Poisoning (Bacterial, viral, chemical, endogenous…)

Botulism 1 1 2

Ciguatera, Paralytic shellfish. Scombroid,

1 1 2 *

Food allergy versus poisoning 1 *

Animal Envenomation

Scorpion 1 1 3

Snakes 1 1 3

Spider Bees and wasps and Marine(jelly fish ……etc)

1 1

Toxic Plants

Mushrooms 1

Mycotoxins, Houseplant

74

Atropine, Hyoscine (atropa belladonna & related plants) Other hallucinogenic psychoactive plants (Nutmeg, khat, supari, valerian.)

1 1

L: Lecture, T: Tutorial, C/P: Clinical or Practical and SDL: Self-directed learning


4.1Essay written … to assess a1, a2, a3 a4 4.2Practical exam to assess b5 4.3Clinical exam and check list application to assess c1, c2, c3, c4 and d3 4.4 MCQ exam to assess a1, a2, a3, a4, b1, b2, b3, b4, b5

4.4 research article presentation to assess b6, d1, d2, d4.

5 - W E I G H I N G O F A S S E S S M E N T 1 Written examination: 150 marks 2 Practical examination 20 Clinical examination 100 3 Oral examination 30 Total 300 marks


Handbook of medical toxicology,Peter Viccellio,Little ,Brown and company 5.3- Recommended Books


Haddad Ellenhorn's Medical Toxicology

75

5.4- Periodicals, Web Sites, etc …………………………………………

T R E A T M E N T O F DR U G D E P E N D E N C E

(FT7110) اإلديــــا عالج

76





and Clinical Toxicology Academic level Semester 3, 4 and 5 Date of Specification Approval

A . B A S I C I N F O R M A T I O N

Title Internal Medicine Code FT7110

Credit Hours 4 Lectures: 30 h Tutorials: 28 h Clinical and Practical: 32 h


Coordinator

B . P R O F E S S I O N A L I N F O R M A T I O N


1. Acquire an appropriate background of drug dependence and methods of

diagnosis using clinical methods, challenge tests and analytical techniques.

77

2. Identify and manage medical complications of drug dependence including overdose

3. Acquire skills in detoxification maneuvers using internationally approved techniques and in ethical way

4. Practice and be competent in general medical examination and develop skills in differentiating diseases by proper integration of assembled clinical data.

5. Develop the skills to predict and manage possible signs of ominous system failure and diseases of organs targeted by poisons.

6. Acquire the talent and experience of rapid management of medical emergencies.


T H E C O U R S E :

1- Knowledge and understanding (K):

By the end of the course the candidate will be able to: a.1 Recognize the drugs used in dependence and drugs in current use. a.2 Describe the pathophysiological changes of drugs of dependence

including central neurotransmitter changes. a.3 Describe the general complications of drug abuse and those of each

particular drug. a.4 Explain the clinical picture of overdose by drugs of abuse and their

complications. a.5 Elucidate the clinical picture of chronic use for every drug and their

complications. a.6 Understand the mechanisms employed for different detoxification

procedures. a.7 Specify the rules, including ethical regulations, governing the different

methods of detoxification procedures in different parts of the world.

78

a.8 Recognize the value, dangers and limitations of detoxification in every drug, multi-drug use, patient's clinical status, chronicity and intensity of addiction.

a.9 Describe the role of toxicological analysis in the follow up of ex-addicts

2- Intellectual skills (IS):

By the end of the course, the candidate will be able to: b.1. Depict the clinical and pathological changes of drug abusers and

clarify them and their correlation. b.2. Acquire a prudent approach to get history and examine patients

requesting treatment. b.3. Apply the rules of ethics to avoid malpractice. b.4. Manifest intellectual conduct and attitude to encourage the patient to

submit to requirements of the examination and subsequently to treatment.

b.5. Expresses skills in dealing with patients on follow up and patients hiding their relapse.

b.6. Express skills in diagnosis of multi drug abuse in modified clinical picture due to polymedication with drugs of abuse.

b.7. Design a detailed toxicological analysis and treatment protocol based on patient's particular factors.

3- Professional and practical skills (PS): By the end of the course the candidate will be able to:

c.1. Competently carry out clinical examination to accomplish accurate and detailed diagnosis of drug abuse with its medical complications.

c.2. Request investigations and challenge tests pertinent to the clinical data and preliminary diagnosis.

79

c.3. Perform decontamination procedures in a safe and appropriate technique according to the standards of care.

c.4. Effectively perform procedures and therapeutic actions in agreement with the emerging complications of drug of abuse as special devices oxygenation, special mode ventilation, arrhythmia correction.

c.5. Safely detoxify the concerned toxic substance and avoid life threatening unethical and unapproved withdrawal methods.

c.6. Detect relapses using the clinical challenge tests and confirmatory analytical methods

4- General and transferable skills (GS): By the end of the course the candidate will be able to: d.1. Communicate the experience of your results and gain on the other

hand that of other centers d.2. Achieve the best results through discussion and communication with

colleagues and superiors d.3. Demonstrate respect, honesty and confidentiality for the patient

under your care and persons for which screening are performed. d.4. Acquire communication skills with prosecutor, police officers and

other family members or work managers requesting the toxicological test.


Topics No of hours

L T C/P SDL

Treatment of Drug Dependence (FT7110) 4 Credit Hours

Mechanisms and theory of drug abuse: receptor toxicology

2 1

80

General basics of drug abuse 2 1 1

Opiates, narcotics and tramadol 2 2 3

Benzodiazepines and sedatives hypnotics (Zopiclone, barbiturates, meprobamate and myorelaxants)

2 2 3

Alcohol abuse 1 1 1

Central stimulants: Cocaine, amphetamine, designer drugs, sympathomimetic and others

2 2 1

Cannabis 2 2 2

Solvent abuse 1 1 1

Potentially dependence producing drugs on the market

1 2 2

Other drugs of abuse: Research spirit 1 2 1

General examination of dependent patient in overdose and other dependence emergencies

2 2 2

Tailoring analytical toxicology for diagnosis and shaping profile of drug abuse and its role in relapses

1 1 1

Detoxification procedures 4 3 8

Monitoring ex drug abuser 3 1 2

Medical and Surgical Complications of drug dependence practice

1 1 2

New concepts in management 1 2 2

Medicolegal aspects of dependence 1 1

Ethical Considerations 1 1

Total 30 28 32

81

L: Lecture, T: Tutorial, C/P: Clinical or Practical and SDL: Self directed learning.


4.1 Short essays to assess knowledge 4.2 MCQs to assess knowledge and intellectual skills 4.3 Practical exam to assess professional, intellectual and general skills 4.3 Oral exam to assess intellectual, professional and general skills


1 Written examination: 100 marks

2 Practical examination 20 marks

3 Oral examination 30marks

4 Clinical examination 50 marks

Total 200 marks

5 - L I S T O F R E F E R E N C E S Clarke's analysis of drugs and poisons

Goldfrank Clinical Toxicologic Emergencies

Drug Abuse Handbook: Steven Karch. CRC Press.

C O M P L I C A T I O N S O F C H R O N I C

T O X I C I T Y ( F T 7 1 1 1 ) انزيح انسح انضاعفاخ

University Ain Shams Faculty of Medicine

82

Program on which the course is given




and Clinical Toxicology Academic level (6th Semester) Date of Specification Approval 18 -10- 2009


Title Chronic toxicity Code FT7111

Credit Hours 2 Lectures: 15 Tutorials: 21 Practical: 9 Total contact: 30

Coordinator

B - P R O F E S S I O N A L I N F O R M A T I O N


a) To prepare a specialist who is competent in clinical evaluation and diagnosis of chronically intoxicated patient and provide immediate and correct general and specific management b) To provide knowledge and skills of the management of all complications due to chronic intoxication c) To give guidelines in preparing protocols of prevention emergency and outpatient management of chronic intoxication.

83


T H E C O U R S E :



a1 Recognize and diagnose the cases of common chronic intoxications with drugs and chemicals a2 Discuss the pathophysiology of common chronic intoxications with drugs and chemicals a3 Describe clinical picture and complications of common chronic drugs and chemical intoxications. a4 – Outlines and interpret the required investigational procedures that help in diagnosis of chronic intoxications.

a5 –Discusses the details of management of the chronic intoxicated patient a6- Relates available knowledge with evidence based medicine practice


By the end of the course the candidate will be able to: b1-Discover and diagnose chronic intoxications, and identify conditions needing immediate intervention. b2 – Decide promptly the required management procedure and clearly design the proper pathway of care of chronic intoxications. b3 – Show competency in solving problems revolving chronic intoxications with referral to medical ethics and medico-legal responsibilities

b4- Apply basic toxicological sciences in the prevention of chronic intoxicated cases. b5 – Formulate questions on research points that require evidence based research.

84



c1- Taking competent history and perform full and informative general and systemic clinical examination of an intoxicated patient. c2 - Choose the proper required investigational procedure that helps in diagnosis and interpret the data correctly. c3 - Undergo efficiently all procedures used for elimination and management of poisoning c4 - Show competency in applying protocols for specific and antidotal management of chronic intoxicated cases.



d1 –Present cases and discusses clinical data with peers. d2 – Self education and collect data from the net and other sources d3 – Communicate properly with patients, peers and seniors ………. d4 – Work within a team in preparing research articles


Topics No. of hours

L T C/P SDL

Analgesics

85

Acetaminophen 0.5 1 1

Salicylates 0.5 1 1

Non Steroidal Anti-Inflammatory Drugs 0.5 1

Colchicine 0.5

Topics No. of hours

L T C/P SDL

Central Nervous System Drugs

Neuroleptics 0.5 1 1

Lithium 1 1 1

Antiepileptics 0.5 1

Respiratory Drugs

Theophylline and Xanthines 1 1 1

Topic No. of hours

L T C/P SDL

Cardiovascular Drugs

Digitalis preparations 1 1 1 Endocrine Drugs

Oral contraceptives, Male sex hormones and anabolic steroids

0.5 1

Antithyroid drugs 0.5 1 Antiestrogen drugs

Occupational and Environmental Toxicology

Metals Lead 0.5 1 1 Mercury, Arsenic 0.5 1 Iron, ,Aluminum

0.5 1 1

Antimony, Thallium ,Chromium 1

86

Cadmium, Barium, Manganese, Phosphorus, Copper

Hydrocarbons (aromatic, halogenated), Toxic Alcohols and Glycols

0.5 1

Insecticides (Organophosphates, Organochlorines, Carbamates, Pyrethroids, Others)

0.5 1

Fumigants (methylbromide, phosphine)

0.5 1

Dioxins 0.5 1

Halogens (chlorine, iodine, bromine) 0.5

Carbon monoxide 0.5 1 1

Vitamins A, D, K 1 1

Immunosupressants

Cyclosporin 0.5

1

Chemotherapeutics 1 1



4.1Essay written … to assess a1, a2, a3 a4 4.2Practical exam to assess b1, b2, b3, and b4 4.3Clinical exam and check list application to assess c1, c2, c3, c4 and d1 4.4 MCQ exam to assess a1, a2, a3, a4, b1, b2, b3, b4, b5

87

4.4 research article presentation to assess d1, d2, d3, d4.


1 Written examination: 50 marks

2 Practical examination 20 marks

3 Oral examination 10-

4 Clinical examination 20 marks

Total 100marks


Handbook of medical toxicology,Peter Viccellio,Little ,Brown and company 5.3- Recommended Books


Clinical management of poisoning and drug overdose. Ellenhorn's Medical Toxicology

5.4- Periodicals, Web Sites, etc …………………………………………

Elective Courses

M E D I C A L S T A T I S T I C S C O U R S E (E7024 ) انطث حصاءاإل دورج

88

University: Ain Shams University Faculty: of Medicine

Course specifications Program on which the course is given: Medical Doctorate in Clinical Toxicology Major or minor element of programs: Minor Department offering the program: Forensic and Clinical Toxicology Department offering the course: Community Medicine Academic Level: 6th semester of Medical Doctorate in Clinical Toxicology Date of specification approval: ……………………….…………….

1- Basic Information Title: Medical statistics course Code: E7024 Credit Hours: 2 hour

2- Coordinator: Community Medicine Department

3- Year/Level: sixth semester

4- Professional Information 1- Course Aim: To enable the doctorate candidate to plan, conduct, analyze and interpret the results of a research in his specific field. This course unit introduces the application of statistical ideas and methodology to medical research.

2- Intended Learning Outcomes (ILOs) from the Course:

a- Knowledge and understanding By the end of the course the candidate will be able to:

89

a.1. Define medical statistics and identify uses and importance of medical statistics in medical research

a.2. Define:

Types of variables.

Descriptive statistics.

Presentation and summarization of data.

Measures of central tendency and scatter.

Principles of probability and probability distributions.

Concepts of inferential statistics: confidence interval and hypothesis testing.

Different tests of statistical significance.

Difference between parametric and nonparametric tests of significance.

Correlation and regression

Concept of statistical modeling using multivariable and multivariate statistical methods.

Combining evidence from different studies and meta-analysis

Importance and methods of sampling and how to determinate the suitable sample size.

Different types of research methodology: observational and intervention studies and the different statistical issues related to the design, conduct, analysis and interpretation of the results of each study type.

Ethical aspects of medical research including those specifically applied to clinical trials.

b- Intellectual skills By the end of the course the candidate will be able to:

b.1. Interpret correctly the results of statistical analyses and critically evaluate the use of statistics in the medical literature.

b.2. Integrate and evaluate information from a variety of sources.

90

c- Professional skills By the end of the course the candidate will be able to:

c.1. Select appropriate study designs to address questions of medical relevance

c.2. Select and apply appropriate statistical methods for analyzing data typically encountered in medical applications.

c.3. Use selected software packages for statistical analysis and data management.

d- General and transferable skills By the end of the course the candidate will be able to:

d.1. Work effectively in a group from different backgrounds. d.2. Respects the role of staff and co-staff members regardless of degree

or occupation. d.3. Communicate effectively with professional statisticians and the wider

medical community, including the ability to present results of statistical analyses through written and oral presentations

d.4. Use of computer data bases and other computer skills. d.5. Handle data appropriately and analyze them through: decision

processes, objective criteria, problem definition, project design and evaluation, risk management, teamwork and coordination.

d.6. Learn independently with open-mindedness and critical enquiry.

3- Course content:

Topics

T C/P

Introduction to medical statistics and its uses X x

Types of variables and Descriptive statistics X X

Graphic presentation of data X X

Introduction to probability theory and rules X X

91

Sample and population: sampling distribution of mean and proportion

X X

Confidence interval of a mean and a proportion X X

Confidence interval of a difference between two mean /proportion

X X

Testing a hypothesis about population mean/proportion X X

Testing a hypothesis about the difference between two means/proportion

X X

Comparing between more than two means-Introduction to factorial analysis

X X

Cross-tabulation and introduction to categorical data analysis

X X

Simple correlation and simple regression X X

Introduction to multivariable and multivariate analysis X X

Study designs: observational studies X X

Study designs: Intervention studies: clinical trials X X

Study designs: Experimental animal studies X X

Study designs: Bias and Confounding X X

Ethical issues in medical research X X

Sample size estimation for continuous and binary outcome measures.

X X

Meta-analysis and publication bias. X X

T: Tutorial and C/P: Clinical or Practical and SDL: Self directed learning

4- Student Assessment Methods 4-1 Written exam to assess knowledge and understanding and will

concentrate on problem solving questions 4-2 Weighing of assessment Written exam 100 Total 100

92

5- List of References

5.1- Course Notes (paper and / or electronic): Student Notes on Medical Statistics and Research Methods. Prof. Mohsen Abdel Hamid and Dr Moustafa El Houssinie. Department of Community, Environmental and Occupational Medicine.

5.2- Essential Books (Text Books): Statistics in Clinical Practice. avid Coggon. BMJ Books. 2nd edition 2003

5.3- Recommended Books: Handbook of Epidemiology. Springer 2005 5.4- Periodicals, Web Sites, etc

www.brettscaife.net/statistics/introstat/

onlinestatbook.com/rvls/

www. Epidemiolog.net

http://www.shef.ac.uk/scharr/spss/

C O M P U T E R C O U R S E ( E7026 ) دورج انكثىذز

93

V- General Information

1 – Monitoring Of Training and Submission of Training Reports

You must keep proper and updated records in your logbook to reflect the activities encountered in your training. Your logbook must be duly endorsed by an authorized signatory at the end of each semester.

You will be continuously assessed by your supervisors, in consultation with head of department. An assessment will be submitted within 2 weeks of completion of each semester.

2 - Miscellaneous Information:

Injury and/or Blood or Body Fluid Exposure: During regular working hours, you should immediately report an exposure incident to coordinator of your program. If exposure occurs after regular working hours or during a weekend or holiday; please call the -----------------------------

-------------------------. For injury, please report to the Emergency Department. Please also be sure to inform the supervisors of any exposure incident and/or injury.

3 - Action Completion of Clinical Training Once all training sessions are completed the log book should be

signed by the senior supervisor and the head of the department and then should be submitted to the post graduate secretariat.

4- Reference The Training Guide is available at the post graduate secretariat and could be downloaded from the following website is ---------------------------------------------------------------------

94

Your log book 1- Introduction

The aim of this book is to give you a guide to the expectations for each item. It will be a guide for both you and your teachers to what you should be seeing and doing.

It will give you a list of the important topics that you should think about and should be covered in:

1. Clinical or practical sessions 2. Tutorials 3. Self-directed learning (SDL)

For each item there is also a list of 1. Clinical conditions or Practical sessions to be seen or attended 2. Practical procedures to be seen and done

Remember

This document is only a guide. It is not an exhaustive list. It is not just a checklist to score points. It is a guide to encourage you to read and learn more. This book is for your benefit. It will form a record of your clinical training and experience. 2 - Supervisors Nominated Staff members for each unit and activity to sign the logbook items 3–Tables for Training Records The candidate will record the details and date of each activity, and the authorized staff member signature.

95

Candidates are required to fulfill 75% of the listed activities in order to be eligible for the exam entry. The minimum number required for each activity = 75% (it is listed for each activity). You are free to attend more and record your extra attendance.

WE E K L Y DE P A R T M E N T PL A N

LECTURE WARD )يزور

انذرس

وانىاب(

GRAND

ROUND

)يزور

( االساذذج

SEMINAR

TOXICOLOGY

LAB CASE

PRESENTA

TION

Saturday 8 – 9 11 – 12

9 – 11 12 - 14 14 -15

Sunday 8 – 9 11 – 12

9 – 11

12-15

Monday 8 – 9 11 – 12

9 – 11 12 - 14 14 - 15

Tuesday 8 – 9 11 – 12

9 – 11 12 - 14

14-15

Wednesday

8 – 9 11 – 12

9 – 11 12 - 14 14 - 15

Thursday 8 – 9 11 – 12

9 – 11

12 - 15

Department Seminar attendance

(NB. Minimum number required is 20)

No

Dat

e

Pla

ce

Topics Supervisor signature

1

96

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

Case Studies (Special topics are compulsory) (NB. Minimum number required is 30)

.

No

Dat

e

Pla

ce

Topics Supervisor signature

1

2

3

4

5

97

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

98

Case presentation with review article (NB. Minimum presented is 6 - Attendance minimum required is 24)

No Date Place Diagnosis Supervisor signature

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

99

Thesis attendance

(NB. Minimum number required is attending 6)

No Date Place Name of the thesis Supervisor signature

1

2

3

4

5

6

On the Job Training (24 hours attendance in the Poison Control Center)


No Total Number & / New poisons seen Date Supervisor signature

1

2

3

4

5

6

7

8

100

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

101

Analytical Toxicology attendance

1. Colorimetric analysis (min 15)

No Number & Types of analysis Date Supervisor signature

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

102

2.Thin Layer Chromatography (min 5)

No Number & Types of cases Date Supervisor signature

1

2

3

4

5

6

7

8

9

10

3. Gas Chromatography (min 5)

No Number & Types of cases Date Supervisor signature

1

2

3

4

5

6

7

8

103

9

5. Immunoassay technique ( number is 20)

No Number of cases Date Supervisor signature

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

104

Attending Emergency Resuscitation in ER / ICU


No Date Place Case(s) Supervisor signature

1

2

3

4

5

6

7

8

9

10

11

12

Grand round attendance (Minimum number is 36)

No Number / Selected cases Date Supervisor signature

1

2

105

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

106

29

30

31

32

33

34

35

36

Attendance of Mechanical Ventilation Setting, Follow up, Weaning and discussion for a Minimum number of 18 cases

No Toxic cause Date Supervisor signature

1

2

3

4

5

6

7

8

9

10

107

11

12

13

14

15

16

17

18

Gastric Lavage Procedure (Minimum number is 20)

No Type of poisons Date Supervisor signature

1

2

3

4

5

6

7

8

9

10

11

12

13

14

108

15

16

17

18

19

20

Malpractice – Inappropriate Management Case Study (NB. Minimum number required is 6)

No Date Type of Management / Poison Supervisor

1

2

3

4

5

6

109

P R A C T I C A L S K I L L S (A G R E E M E N T S C A L E ) Requirements Candidates are required to fulfill 75% of the listed activities in order to be eligible for the exam entry. The minimum number required for each activity = 75%. You are free to attend more and record your extra attendance.

a-Poor b- Satisfactory c- Excellent

A. Clinical Procedures and Evaluation Each of the following procedure should be observed, then assisted then

performed independently

Item

No

Obs

erve

d

Dat

e an

d si

gn

Ass

iste

d

Dat

e an

d si

gn

Don

e in

depe

nden

tly

(A, B

, C)

Dat

e an

d si

gn

Coma examination

1

2

3

4

5

Control of Toxic seizures

1

2

3

4

5

Intubation 1

110

2

3

4

5

Testing for Brain Stem Death (5X3)

1

2

3

4

5

Challenge tests (Antidotes) (5x3)

1

2

3

4

5

Basic general neurological examination (5x3)

1

2

3

4

5

Respiratory assessment (imaging, ABG)

1

2

3

4

5

Management and evaluation of Pulmonary Edema (5x3)

1

2

3

4

111

5

Management and evaluation of Shock

1

2

3

4

5

TPN

1

2

3

4

5

Management and evaluation of agitation, confusion and delirium

1

2

3

4

5

Endotracheal Intubation

1

2

3

4

5

Gastric lavage

1

2

3

4

5

Central Vein Catheterization

1

2

112

3

4

5

Renal Function Assessment

1

2

3

4

5

Coma of undetermined cause examination and workup

1

2

3

4

5

Arrhythmia evaluation and management (including DC Shock)

1

2

3

4

5

Performing and interpreting abnormal ECG of toxic etiology

1

2

3

4

5

113

5 - Log book preview

The candidate logbook will be reviewed and patients seen/ skills performed summarized by diagnosis groups during the semester evaluation and at the end of the course in the table below. This reflects the number of activity done by category. (According to each degree) The results of this review will be totaled in the summary chart below.

VI- Head of Department Approval for the Exam Entry ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

114

_Thesis Follow up(a report for each of the 6 semesters)

التقرير النصف السنوي لعام / التاريخ/ -1 عن الطالب /

نهسىو األكهكح (الدكتوراهالمقيد لدرجة ) الطب الشرعى و السموم األكمينيكيةبقسم /

تقرير السادة األساتذة المشرفين

تذأ خع انادج انعهح و كراتح انقذيح

ع شىطا يحذوداقط

أوشك عه االرهاء

اره ي اندع

تذأ اندزء انعه

قطع شىطا يحذودا


اره ي انرحهم

تذأ ياقشح انرائح



اره ي انرحزز

تذأ عح انهائح يع انشزفانزاخ



ارهد ذايا

اسرزار قذ انطانة رأي انسادج انشزف

يذ انقذ

شطة قذ انطانة

عى ذى ذشكم ندح اناقشح

ال

رخ انرشكم ذا

/ /

يذ / شطة انقذ

وكم انكهح ذىقع انسادج انشزف

115

116

انرقزز انصف انسى نعاو / انرارخ/ -2

ع انطانة /

نهسىو األكهكح (انذكرىراانقذ نذرخح )

انشزع و انسىو األكهكحطة انتقسى

ذقزز انسادج األساذذج انشزف




اره ي اندع









تذأ انزاخعح انهائح يع انشزف



ارهد ذايا


يذ انقذ

ة قذ انطانة شط


ال

ذارخ انرشكم

/ /



117

انرارخ/ انرقزز انصف انسى نعاو / -3

ع انطانة /


انسىو األكهكحو انشزع طةانتقسى /




رهاءأوشك عه اال

اره ي اندع










شىطا يحذودا قطع


ارهد ذايا


يذ انقذ



ال


/ /



118


ع انطانة /







اره ي اندع












ارهد ذايا


يذ انقذ



ال


/ /



119

انرارخ/ انرقزز انصف انسى نعاو / -5

ع انطانة /







اره ي اندع











هاءأوشك عه االر

ارهد ذايا


يذ انقذ



ال


/ /

120

ذ يذ / شطة انق



ع انطانة /

نهسىو األكهكح( انذكرىراانقذ نذرخح )






اره ي اندع







الرهاءأوشك عه ا





ارهد ذايا


يذ انقذ


عى ندح اناقشح ذى ذشكم

ال


/ /

ذ / شطة انقذ ي


121

122

VII- Evaluation Forms Evaluation Form (at the end of each semester) To be completed at -------------------------------------

Candidate Supervisor Location

Aim of training ______________________________________________________________________________________________________________________________________________________________________________________________________

Agreed educational objectives and timescale in which objectives should be achieved. ______________________________________________________________________________________________________________________________________________________________________________________________________

Comments by Candidate ______________________________________________________________________________________________________________________________________________________________________________________________________

Comments by Supervisor ______________________________________________________________________________________________________________________________________________________________________________________________________ __________________________________________________________________

Date of next meeting Signed by candidate Signed by Supervisor Date

123

Degree Program Evaluation Form by the Candidate To be completed at the end of your degree.

Please consider each pair of statements and decide which most

clearly reflects your view and tick one box or answer the question.

I. Individual Information 1. Are you a graduate of ASU?

Yes no to some degree 2. Year and semester when studies began: II. General Questions 1. What are the advantages/disadvantages of the general study environment at the University ASU? 2. What were your expectations when you applied to the degree? 3. Do you feel that the degree program prepares you well for your future studies or employment according to the demands and expectations of those institutions?

Yes no to some degree 4. Has the time limit of the program (two or three academic years) caused you any difficulties or inconveniences?

Yes no to some degree III. Structure of Degree Program 1. Did you receive enough guidance in planning your study schedule in the beginning of the program?

yes no to some degree 2. What were the main difficulties in the planning of your study schedule? 3. What is your general opinion on the structure of the degree program?

124

4. In your opinion, does the degree program offer a good balance of lectures, seminars, conferences, and book exams?

yes no to some degree a) General Studies i) Do you feel that you have received enough guidance on academic writing?

yes no to some degree ii) Do you feel that you have acquired sufficient knowledge on research skills (eg. quantitative and qualitative research methods)?

yes no to some degree b) Courses i) Have you had some special difficulties in completing some of the courses? Please specify. ii) Has there been a sufficient variety of courses offered for your optional studies?

yes no to some degree iii) Have you received enough guidance for the preparation of your thesis?

yes no to some degree IV. Concluding Points 1. Did the degree program meet your expectations?

yes no to some degree 2. What aspects of the degree program do you particularly like? 3. What aspects of the degree program do you particularly dislike? 4. What are your suggestions on how to improve the program?

125

THANK YOU

Documents

Medical Doctorate in Clinical Toxicology ةيكينيلكلأا مومسلا ىف ...med.asu.edu.eg/uploads/med/Toxicology_MD_201508168513.pdf · 2018-11-26 · 6- Disasters and General