Training program for clinical master of Internal Medicine 2 Training program for clinical master of Surgery 26



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        1. Clinical skills requirements:

Skill

Case no.(≥)

Sampling of arterial blood

5

Thoracocentesis (aspiration of air / fluid)

10

Chest closed drainage

5

Non-invasive mechanical ventilation

5




      1. Further requirements

        1. Diseases to be learned and case number requirements:

Disease

Case no.(≥)

Lung abscess

1

Pneumocystis carinii pneumonia

1

Pulmonary neoplasm

2

Interstitial pulmonary disease

2

Sleep apnea syndrome

1




        1. Clinical knowledge and skills requirements:

Skill

Case no.(≥)

Pulmonary function test

2

Pulmonary thrombolysis

2

Bronchoscopy (observation)

2

Bronchoalveolar lavage (observation)

2




    1. Cardiovascular Medicine / CCU

      1. Aim of rotation

        1. Master: The etiology, pathophysiology, clinical presentation, diagnosis, differential diagnosis and treatment of acute coronary syndrome, heart failure, primary hypertension, arrhythmia, acute myocarditis and acute pericarditis;master the indication and application method of common cardiovascular medications; master ECG examination and diagnosis; master antithrombotic and thrombolysis; master defibrillation and cardioversion.

        2. Be familiar with: The etiology, pathophysiology, clinical presentation, diagnosis, and treatment of infective endocarditis, valvular heart diseases, constrictive pericarditis, congenital heart diseases, and peripheral vascular diseases, etc.; be familiar with the indications and principles of emergent percutaneous coronary angioplasty (PTCA) and other interventional therapies; be familiar with dynamic ECG; be familiar with pericardial puncture; be familiar with cardiac pacing.

        3. Understand: The diagnosis and treatment of secondary hypertension, endocarditis due to prosthetic heart valves and intravenous drug abuse, cardiomyopathy, and cardiac neurosis, etc.; understand echocardiography; understand radiofrequency catheter ablation.

      2. Basic requirements

        1. Diseases to be learned and case number requirements as listed below; complete at least 5 admission notes.

Diseases

Case no.(≥)

Acute myocarditis

2

Acute coronary syndrome

10

Acute pericarditis

2

Primary hypertension

5

Arrhythmia

5

Heart failure

5




        1. Basic skills requirements:

Skill

Case no.(≥)

ECG examination

20

Emergent thrombolysis

4

Defibrillation and Cardioversion

5




      1. Further requirements

        1. Diseases to be learned and case number requirements:

Disease

Case no.(≥)

Valvular heart disease

2

Infective endocarditis

1

Constrictive pericarditis

1

Congenital heart disease

2

Peripheral vascular disease

2

Secondary hypertension

2

Endocarditis due to prosthetic heart valves and intravenous drug abuse

1




        1. Clinical knowledge and skills requirements:

Skill

Case no.(≥)

Pericardial puncture

2

Cardiac pacing

2

Cardiac interventional therapy (observation)

2

Radiofrequency catheter ablation (observation)

2




    1. Neurology

      1. Aim of rotation

        1. Master: The etiology, pathophysiology, clinical presentation, diagnosis, differential diagnosis and treatment of cerebrovascular accident, increased intracranial pressure, epilepsy, polyradiculitis, and myasthenia gravis, etc.; master systemic neurological physical examinations; master diagnosis of cerebrospinal fluid and neurologic imaging (such as CT); master lumbar puncture.

        2. Be familiar with the etiology, clinical presentation, diagnosis, and treatment of infection of central nervous system, cranial nerve diseases, and demyelinating disease, etc.; be familiar with the clinical application and results analysis of MRI and transcranial Doppler (TCD).

        3. Understand: Diagnosis and treatment of brain tumor; understand interventional therapies of cerebrovascular diseases.

      2. Basic requirements

        1. Diseases to be learned and case number requirements as listed below; complete at least 5 admission notes.

Disease

Case no.(≥)

Cerebral infarction

5

Cerebral hemorrhage

5

Subarachnoid hemorrhage

2

Increased intracranial pressure

4

Infection of CNS

2

Polyradiculitis

1

Myasthenia gravis

1

Epilepsy

1




        1. Basic skills requirements:

Skill

Case no.(≥)

Systemic neurologic physical examinations (Localization of neuropathy)

10

Lumbar puncture

2




      1. Further requirements

        1. Diseases to be learned and case number requirements:

Disease

Case no.(≥)

Headache

5

Cranial nerve disease

1

Demyelinating disease

1

Brain tumor

2




        1. Clinical knowledge and skills requirements:

Skill

Case no.(≥)

Interventional therapy (observation)

2

Thrombolysis

3




    1. Other Internal Medicine Sections (gastroenterology, hematology, endocrinology, nephrology, etc.)

      1. Aim of rotation

        1. Master: The etiology, pathophysiology, clinical presentation, diagnosis, differential diagnosis and treatment of gastrointestinal bleeding, hepatic encephalopathy, acute pancreatitis, DIC, hemorrhagic diseases, diabetes mellitus, hyperthyroidism, and renal failure, etc.; master the methods of abdominal paracentesis and application of Sengstaken-Blakemore tube; master indications, contraindications and operation methods of lumbar puncture.

        2. Be familiar with: The clinical presentation, diagnosis and treatment of peptic ulcer, infectious diarrhea, cirrhosis, anemia, urinary tract infection, SLE, endocrine adenoma, hypersplenism, and thrombocytopenic purpura, etc.; be familiar with the indications, contraindications and complications of gastroscopy and liver biopsy.

        3. Understand: The diagnosis and treatment principles of leukemia, aplastic anemia, glomerulonephritis, various tumors and gout; understand he bone marrow image of hematologic diseases; understand the principles and method of various laboratory examinations for bleeding and coagulation function; understand the requirements of the preservation of endocrine specimens.

      2. Basic requirements

        1. Diseases to be learned and case number requirements as listed below; complete at least 5 admission notes.

Disease

Case no.(≥)

Gastrointestinal bleeding

2

Cirrhosis and hepatic encephalopathy

1

Acute pancreatitis

2

Anemia

1

Hemorrhagic disease

1

Diabetes mellitus

2

Hyperthyroidism

1

Acute renal failure

2

DIC

1




        1. Clinical skills requirements:

Skill

Case no.(≥)

Abdominal paracentesis

5

Bone marrow aspiration

2

Hemostasis by Sengstaken-Blakemore tube

2

Gastroscopy (as an assistant)

2

Liver biopsy (observation)

1




      1. Further requirements

        1. Diseases to be learned and case number requirements:

Disease

Case no.(≥)

Peptic ulcer

1

Infectious diarrhea

2

Glomerulonephritis

1

Urinary tract infection

2

Thrombocytopenic purpura

1

Leukemia

1

Hypersplenism

1

Endocrine adenoma

1




        1. Clinical knowledge and skills requirements:

Skill

Case no.(≥)

Gastroscopy

2

Liver biopsy (observation)

1




    1. General Surgery(mainly abdominal surgery)

      1. Aim of rotation

        1. Master: The etiology, clinical presentation, diagnosis, differential diagnosis and surgical treatment of common abdominal trauma, acute abdomen (appendicitis, inguinal hernia, hollow organ perforation, intestinal obstruction, acute hemorrhagic necrotizing pancreatitis, acute obstructive suppurative cholangitis, peritonitis, etc.), and gastrointestinal bleeding, etc.; master basic surgical procedures (incision, hemostasis, ligation, debridement and suturing, etc.); master the methods to estimate the area and depth and emergent management of burn injury; master the cut-down of peripheral vein and artery; master aseptic techniques; master the method of wound dressing; master urinary catheterization; master diagnostic abdominal paracentesis, etc.

        2. Be familiar with: The diagnosis and surgical management of acute cholecystitis, cholelithiasis, peptic ulcer, and urolithiasis; be familiar with exploratory laparotomy; be familiar with the interpretation of abdominal imaging studies (plain X-ray film, ultrasonography, CT, etc.).

        3. Understand: Diagnosis and principles of management of abdominal neoplasms.

      2. Basic requirements

        1. Diseases to be learned and case number requirements as listed below; complete at least 5 admission notes.

Disease

Case no.(≥)

Abdominal trauma

5

Burn injury

2

Acute appendicitis

5

Inguinal hernia

1

Acute cholecystitis

2

Acute intestinal obstruction

2

Hollow organ perforation

2

Acute hemorrhagic necrotizing pancreatitis

2

Acute obstructive suppurative cholangitis

2

Acute peritonitis

2

Acute massive upper GI bleeding

2




        1. Clinical skills requirements:

Skill or Operation

Case no.(≥)

Appendectomy (operator or first assistant)

5

Inguinal hernia repair (operator or first assistant)

5

Cut-down of vein or artery (operator)

5

Diagnostic abdominal paracentesis

5

Urinary catheterization

15

Exploratory laparotomy (first assistant)

2

Repair of gastrointestinal perforation (first assistant)

5


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