Anatomic Pathology Haematology Medical Microbiology Chemical Pathology Forensic Pathology Medical Immunology Medical Genetics 1 CONTENT PAGE NUMBER INTRODUCTION TO THE PROGRAM 3 ANATOMIC PATHOLOGY 9 HAEMATOLOGY 19 MEDICAL MICROBIOLOGY 30 CHEMICAL PATHOLOGY 40 FORENSIC PATHOLOGY 48 MEDICAL IMMUNOLOGY 54 MEDICAL GENETICS 64 EXAMINATION 74 APPENDIX Master of Pathology; Revised- October 2016 2 1. MASTER OF PATHOLOGY PROGRAMME 1.1 INTRODUCTION The Master of Pathology is a 4 year post-graduate programme with the primary objective of producing a competent specialist who will lead the laboratory and provide the diagnostic and consultation services to the clinicians. The programme is comprised of stage 1 of one year duration and stage 2 of three years duration. The training centers include public universities’ teaching hospitals (closed system) and the accredited hospital of Ministry of Health (open system). 1.1.1. VISION The Master of Pathology strives to be the academic programme for local and international students, providing the highest standard of pathology education and training to produce a competent pathologist. 1.1.2. MISSION a. To meet the requirements of the nation in the field of pathology. b. To create an environment that is conducive for achieving academic, service and research excellence in pathology. c. To produce competent pathologists who will provide quality clinical services and laboratory management. d. To consolidate and improve training programme for the development of quality human resources in the field of pathology. e. To promote internationalisation of academic, research and service activities related to pathology. 1.1.3. ENTRY REQUIREMENTS Candidates who wish to pursue Master of Pathology need to a. have a valid medical Degree from a university recognized by Malaysian Medical Council (MMC). b. be registered with the MMC. c. complete at least 3 years of medical service. d. pass the entrance examination and/or e. pass an interview. All candidates must pass the entrance examination before he or she can be eligible for the interview for selection into the programme. For foreign candidates, requirements a-e above are applied, plus a. Possess a Temporary Practicing Certificate issued by the MMC before starting practice. b. Undergo clinical or laboratory attachment at a minimum of 3 months before joining the programme with satisfactory supervisor report. c. Proof of proficiency in the English language. Candidates must obtain a minimum score of 6.0 in IELTS or 550 in TOEFL (obtained within 2 years prior to date of enrolment) Master of Pathology; Revised- October 2016 3 The Entrance Examination: a. The examination consists of TWO True-False Multiple Choice Question papers. Each paper consists of 60 questions with 5 responses.The first paper consists of basic anatomic pathology, forensic pathology, microbiology and immunology questions. The second paper consists of basic haematology, chemical pathology and genetic questions. b. Marking system: A computerised marking system will be used. There will be minus marking of 0.5 marks for wrong answer. The minimum mark for each question is 0 (no carryover of negative marks). c. The pass mark is 50% and the candidate will be called for an interview. Those who obtain a mark between 45 -49% may be considered for interview. d. The result of the entrance exam is validfor 2 years. e. The examination will be conducted annually by one of the conjoint universities. 1.1.4. INTAKE SCHEDULE Once a year usually in June. 1.1.5. STAGES OF THE PROGRAMME The 4-year course will be divided into two Stages: Stage 1 and Stage 2. The Stage 1 course is of one year duration of General Pathology in four major disciplines of pathology i.e. Anatomic Pathology, Haematology, Medical Microbiology and Chemical Pathology with some input from immunology, genetics and forensic pathology. Stage 1 training is only done in universities. At the end of the Stage 1 course the candidate will sit for an examination in General Pathology (Part 1 examination) and must pass this examination in order to proceed to the Stage 2 course. The Stage 2 course is of three years duration. The candidate can opt for one of the following disciplines: Anatomic Pathology, Haematology, Medical Microbiology, Forensic Pathology, Chemical Pathology, Immunology and Medical Genetics. During the Stage 2 course the candidate shall undertake a research project and submit a research project report. At the end of the Stage 2 course the candidate must sit and pass an examination (Part 2 examination) in order to be awarded the degree of Master of Pathology. Stage 2 training may be undertaken in the universities (Closed System) or in accredited training centers under Ministry of Health or public hospitals (Open System). However, candidates in the Open System will do the last year of training in the respective university. Master of Pathology; Revised- October 2016 4 1.1.6 DURATION The maximum duration permitted to complete the course is seven years. The maximum duration permitted to complete the Stage 1 course is two years and the maximum duration permitted to complete the Stage 2 course is five years. 1.2. TRAINING PROGRAMME 1.2.1. IN-SERVICE TRAINING PROGRAM This is an in-service training program and candidates are expected to be responsible for their own learning. Nevertheless, all candidates are also required to attend orientation and intensive courses as well as distance learning programs conducted by the universities. Lecturers from the universities will monitor the candidates in Ministry of Health laboratories on a regular basis. 1.2.2. SUPERVISORS The supervising pathologist at the center of training is required to check on the progress of the candidate, keep track of the candidate's practical skills through the maintenance of a log book and conduct regular sessions with the candidate. Supervising pathologist is required to submit progress report to the university at least at the end of a posting but not less than once every six months. All supervisors shall be formally appointed by the university concerned. For the Open System, academic staff from university will be appointed as the main supervisor and those from Ministry of Health will be appointed as co-supervisor by the respective university. 1.2.3. LEVELS OF COMPETENCE The candidate is expected to acquire a range of skills during the period of training. For each specific skill, the level of competence expected will be determined. For this purpose, a uniform scale of measurement of competence is adopted as stated below; Level 1: Observer status only Level 2: Assistant status Level 3: Able to perform under close and direct supervision Level 4: Able to perform under indirect supervision Level 5: Able to perform unsupervised 1.2.4. RESEARCH For the Stage 2, the candidate shall plan and undertake a research project and write up a dissertation. This is to introduce the candidate to research methodology, data analysis and report writing. To facilitate this task all candidates are required to undergo training in research methodology conducted by the university concerned. Master of Pathology; Revised- October 2016 5 Supervisor and co-supervisors for the dissertation shall be appointed by the university. The dissertation supervisor and co-supervisor can also be from the training supervisors. The candidate must present the research proposal at the departmental level prior to submission to the post graduate committee in the second semester of Year 2. The dissertation is to be submitted 6 months before the start of Part II Professional Examination. Each dissertation will be assessed by an external or internal examiner appointed by the university. The dissertation will be marked either as: 1. acceptable unconditionally 2. acceptable subject to minor corrections 3. resubmission due to major corrections and re-examination 4. not acceptable A satisfactory report of the dissertation is a prerequisite for sitting the Part II Professional Examination. Candidates are encouraged to publish their dissertation in scientific journals before graduating from the programme. 1.2.5. ELECTIVE POSTINGS Elective postings can be undertaken when deemed necessary by the individual discipline. Where the posting is essential in order for the candidate to acquire necessary skills, the posting should be considered a compulsory posting even if it is done outside the primary center of training. Overseas postings may be considered if it is consistent with the individual university's regulations. 1.2.6. READING MATERIALS A list of required reading materials will be given to all candidates. A list of required journals will be prepared by each discipline. All Ministry of Health hospitals undertaking training should facilitate the availability of these journals. 1.2.7. ACCREDITATION OF TRAINING CENTERS a. All centers of training should have facility for electronic communication for effective and efficient communication between students and teachers. b. Details on the guidelines on accrediting the training centers are published in a separate book. (Master of Pathology – Guidelines for accreditation of training centers) Master of Pathology; Revised- October 2016 6 1.2.8. COURSE STRUCTURE STAGE 1 STAGE 2 YEAR 1 YEAR 2 YEAR 3 YEAR 4 2 semesters 2 semesters 2 semesters 2 semesters (48 weeks of T&L,log book) (48 weeksT&L,in-service (48 weeks T&L, in-service (48 weeks T&L, in-service training, log book, and research activity) training, log book, and research activity) training, log book, and research activity) Semester 1 Semester 3 Semester 5 TCL: Lectures SCL: in-service training in SCL: in-service training in SCL: in-service training in laboratory/ward/clinic/mortuary at University laboratory/ward/clinic/mortuary at University laboratory/ward/clinic/mortuary at University SCL: Practical, Seminar, Case Hospital or MOH Hospital. Hospital or MOH Hospital. Hospital or MOH Hospital. Study, Journal Critique. TCL: Research methodology and preparation SCL: Practical, Seminar, Case Study, Journal SDL : Carrying out research activity / writing SDL: Writing case book. of research proposal. Critique case book Rotation: SCL: Practical, Seminar, Case Study, Journal ** Submission and assessment of dissertation, -10 weeks in every discipline of Critique log book and case book to examiner(s). Pathology. - Orientation week (1 week) SDL: Case book writing / research proposal SDL : Carrying out research activity / writing - Intensive course (2 weeks) writing case book - Study leave (3 weeks) . Semester 2 Semester 4 Semester 6 Total= 46 weeks SCL: in-service training in SCL: in-service training in SCL: in-service training in laboratory/ward/clinic/mortuary at University laboratory/ward/clinic/mortuary at University laboratory/ward/clinic/mortuary at University Hospital or MOH Hospital. Hospital or MOH Hospital. Hospital or MOH Hospital. PART 1 PROFESSIONAL EXAMINATION SDL : Carrying out research activity / writing SDL : Carrying out research activity / writing ASSESSMENT of dissertation, log book and (2 weeks) case book case book case book and PART 2 PROFESSIONAL EXAMINATION (2 weeks) *T& L = Teaching and Learning; TCL = Teacher-centered Learning; SCL = Student-centered Learning; SDL = Self-directed Learning; MOH = Ministry of Health 7 1.3. STAGE 1 MASTER OF PATHOLOGY PROGRAMME 1.3.1. OBJECTIVES a. Primary objective The primary objective of the Stage 1 course is for the candidate to attain basic knowledge and practical competence in Pathology. b. Specific objectives i. To acquire basic theoretical knowledge in Pathology. ii. To acquire basic practical competence in the performance and interpretation of common laboratory tests including autopsies. iii. To acquire basic knowledge in laboratory management including laboratory organization, quality control and laboratory safety. 1.3.2. COURSE STRUCTURE The candidate shall undergo a rotation posting in the 4 major disciplines of 10 weeks duration each. An orientation course will be held at the beginning of the academic year and an intensive course during the academic year. Both these courses will be conducted in the universities. During the postings, the candidate shall maintain a log book and perform to the supervisor's satisfaction a list of procedures. FRAMEWORK OF STAGE 1 COURSE Orientation 1 week Rotational postings 40 weeks (10 weeks X 4) Intensive course 3 weeks Self-study 2 weeks Examinations 2 weeks Posting breaks 4 weeks TOTAL 52 weeks 8 2. ANATOMIC PATHOLOGY MODULE 2.1. GENERAL INTRODUCTION Anatomic pathology is a medical specialty that is concerned with the diagnosis of diseases based on their macroscopic, microscopic and ancillary studies. The ultimate aim is for the trainees to be able to recognize pathological changes that leads to the diagnosis of diseases, its clinical correlation and pathogenesis. 2.2. VISION To produce competent, ethical, highly motivated anatomic pathologist of international standing. 2.3. MISSION To inspire lifelong learning, advance knowledge and skillful anatomic pathology diagnosticians and laboratory consultants 2.4. PROGRAMME DESCRIPTION This is a four-year programme comprising stages 1 (year 1) and 2 (years 2, 3 and 4) .Stage 1 is an in-campus training. It is a foundation year during which the trainees are exposed to all four major disciplines namely Anatomic Pathology, Hematology, Chemical Pathology and Medical Microbiology, incorporating elements of immunology, forensic, molecular pathology, medical genetics and transfusion medicine. Upon successful completion of the first stage, the trainees continue to be trained in Anatomic Pathology and Laboratory Management. 2.5. LEARNING OUTCOMES At the end of the programme, the trainee shall be able to: a. Apply the theoretical and practical knowledge in the fields of Anatomic Pathology. b. Perform and interpret diagnostic pathology tests in the fields of Anatomic Pathology. c. Display communication and teamwork skills in the provision of pathology patient care services 2.6. STAGE 1: ANATOMIC PATHOLOGY MODULE 2.6.1 INTRODUCTION Phase 1 training focuses on understanding general pathology with some input on common systemic pathology. The competency technical requirement is generally at level 3 (mainly) and level 4 (for simple common diseases). Master of Pathology; Revised- October 2016 9 2.6.2 LEARNING OUTCOMES At the end of the programme, the trainee shall be able to: a. Apply the basic theoretical and practical knowledge in the fields of Anatomic Pathology, Haematology, Medical Microbiology and Chemical Pathology. b. Perform and interpret basic diagnostic pathology tests in the fields of Anatomic Pathology. c. Display communication and teamwork skills in the provision of pathology patient care services Apply the professional values, attitude and ethics while working in the hospital’s diagnostic laboratories d. Apply the professional values, attitude and ethics while working in the hospital’s diagnostic laboratories. 2.6.3 LEARNING OBJECTIVES a. General objective i. To attain level 3 competence in the gross and microscopic examination, interpretation and reporting of tissue specimens. ii. To acquire knowledge of the principles of techniques involved in the preparation and staining of paraffin and frozen sections. b. Specific objectives i. To recognize pathological changes by macroscopic and microscopic examination (Competence level 3) ii. To be able to identify common artifacts and their causes. (Competence level 3) iii. To diagnose and report on surgical pathology specimens. (Competence level 3) iv. To recognize the circumstances where ancillary tests are necessary. (Competence level 3) v. To understand the medico-legal implications of Anatomic Pathology reports. (Competence level 5) vi. To inculcate good and safe laboratory practice. (Competence level 3). vii. To perform and report on clinical and forensic autopsies. (Competence level 3) 2.6.4. COURSE CONTENT a. THEORY i. Pre-requisite knowledge: • Anatomy and histology of the human body. • Applied physiology of all organ-systems. • Basic cellular biology in various organ systems. ii. Knowledge to be acquired Master of Pathology; Revised- October 2016 10