IntermedIAte module

In
obstetrIcs & GynAecoloGy

REQUIREMENTS FOR TRAINING & EXAMINATION

PY
CO
2010 E
IC
FF
O Addendum
Basic Life Support (BLS) is a mandatory course for
CoLLege oF
all postgraduate trainees
PhySICIAnS And
(FCPS and MCPS). All Fellowship residents are
SurgeonS
required to attend BLS course before they can
PAkIStAn
appear in Intermediate Module (IMM) examination.

I
ADDENDUM
The College of PhysiCians and surgeons PakisTan
would appreciate any criticism, suggestions,
advice from the readers and users of this document.
Comments may be sent in writing or by
e-mail to the CPSP at:

national directorate residency Program (ndrP)

College of Physicians and Surgeons Pakistan (CPSP)
7th Central Street, Defence Housing Authority, Karachi-75500.
ndrp@cpsp.edu.pk

II
 Contact Details:
College of Physicians and Surgeons, Pakistan.
7th Central Street, Phase II, D.H.A. Karachi - 75500.
Phone: 99207100-10, UAN 111-606-606
Facsimile: 99266450
Website: www.cpsp.edu.pk

Contents

1 INTRODUCTION

4 TRAINING AND EXAMINATION

7 ASSESSMENT

10 TRAINING FOR INTERMEDIATE MODULE

23 USEFUL ADDRESSES AND TELEPHONE NUMBERS

III
 INTRODUCTION
The College was established in 1962 through an ordinance of the
Federal Government. The objectives and functions of the College
include: promotion of specialist practice by securing improvement of
teaching and training; arranging postgraduate medical, surgical and
other specialist training; holding and conducting examinations for
awarding College diplomas and admission to the Fellowships of the
College; and promotion of research.

Since its inception the College has actively pursued improvements in

postgraduate medical education in Pakistan. Currently, the College
offers Fellowships in fifty three disciplines compared to the initial few
in Medicine, Surgery, Paediatrics and Obstetrics and Gynecology in
1963. Structured training programs have been developed, criteria for
recognition of training institutes have been laid down, and format of
examinations has been improved with unbiased objective, reliable
Intermediate Module in Obstetrics & Gynaecology 2010

and candidate friendly methods of assessment. Fellowship training

can be undertaken in over 130 accredited medical institutions
throughout the country and 106 accredited institutions abroad. Over
2000 supervisors are involved in the CPSP training programs.

The College has established 12 Regional Centers including five

Provincial Headquarter Centres in the country to coordinate the
training and examination, and facilitate the candidates of these areas.

1
 Constant efforts are made to improve the standards of examinations
and make them relevant, transparent, objective and fair to the
candidates. In its endeavor to decrease inter-rater variability, and
increase fairness and transparency, the College has introduced the
use of assessment forms for scoring of all the components of clinical
and oral examinations. Another step in this direction is the
introduction of Task Oriented Assessment of Clinical Skills (TOACS)
in the FCPS II Clinical Examinations in a number of disciplines from
September 2001.
Intermediate Module in Obstetrics & Gynaecology 2010

2
INTERMEDIATE MODULE
To ensure better training, the CPSP introduced an Intermediate
Module Examination in several disciplines in 2001. This mid-training
assessment strengthens the monitoring and in-training assessment
systems by providing trainees with an estimate of mid-training
competence. It also serves as a diagnostic tool for trainees and
supervisors, provides a curricular link between basic and advanced
training, and an opportunity for sampling a wider domain of
knowledge and skills.

Vide Notification No. 6-1 / Exam-04 / CPS / 1438 S and R, the

Intermediate Module (IMM) examination is mandatory eligibility
requirement for all FCPS II examination as from September 2007 and
onward. Candidates are required to complete two years training in
Obstetrics and Gynaecology, attend all mandatory workshops and
take the Intermediate Module examination.

In case of failure in the Intermediate Module examination, the trainees

are permitted to continue their training in the chosen specialty but
must pass the Intermediate Module examination prior to appearing in
the final FCPS II examination.
Intermediate Module in Obstetrics & Gynaecology 2010

3
 TRAINING AND
EXAMINATION
GENERAL REGULATIONS
Candidate will be admitted to the examination in the name (surname
and other names) as given in the MBBS degree and PMDC
certificate. CPSP will not entertain any application for change of
name on the basis of marriage / divorce /deed.

REGISTRATION AND SUPERVISION

All training must be supervised, and trainees are required to register
with the Research and Training Monitoring Cell (RTMC) within 30
days of starting their training for Intermediate Module. In case of
delay in registration, the start of training will be considered from the
date of receipt of application by the RTMC. Registration forms are
available in RTMC and in the Regional Centers. They can also be
downloaded from the CPSP Website. Training is compulsorily
monitored by an approved supervisor who is a CPSP fellow or a
specialist with relevant postgraduate qualifications registered at the
Intermediate Module in Obstetrics & Gynaecology 2010

RTMC.

APPROVED TRAINING CENTRES

Training must be undertaken in units, departments and institutions
approved by the College. A current list of approved institutions is
available from the College and its Regional Centres as well as on the
College website: www.cpsp.edu.pk

4
BASIC MEDICAL TRAINING
PROGRAM FOR INTERMEDIATE
MODULE
DURATION
The duration of training for the Intermediate Module (IMM) is
two years; the Intermediate Module examination is taken on
completion of the basic training.

ROTATIONS
Three months of rotation in any two of the following disciplines,
one of which is mandatory before appearing in the Intermediate
Module examination. Second rotation may be completed in next
two years:
- Medicine
- Neonatology
- Diagnostic imaging

COMPONENTS OF TRAINING
Mandatory Workshops
It is mandatory for all Intermediate Module trainees to attend
the following CPSP certified workshops in the two year of
training:
1. Introduction to Computer and Internet
Intermediate Module in Obstetrics & Gynaecology 2010

2. Research Methodology and Dissertation Writing

3. Surgical Skills
4. Communication Skills
Any other workshop/s as may be introduced (e.g. ACLS and ATLS)
by CPSP.
noTe: No candidate will be allowed to appear in IMM
examination without attending the abovementioned
workshops including BLS.
Logbook
Trainees are required to maintain a logbook in which entries of
academic/ professional work done during the period of training
should be made on a daily basis, and signed by the supervisor.
Completed and duly certified logbook will form a part of the
application for appearing in IMM examination.

5
 E-logbook
The CPSP council has decided to introduce E-logbook system for
all trainees in FCPS from January 2009. Upon registration with
RTMC each trainee is allotted a registration number and a
password to log on to the e-logbook on the CPSP website. The
trainee is required to enter all work performed and the academic
activities undertaken in the logbook on daily basis. The concerned
supervisor is required to verify the entries made by the trainee.
This system ensures timely entries by the trainee and prompt
verification by the supervisor. It also helps in monitoring the
progress of trainees and vigilance of supervisors.

Research (Dissertation/Two Papers)

One of the training requirements for fellowship trainees is a
dissertation or two research papers on a topic related to the
field of specialization. For trainees in Obstetrics & Gynaecology
the dissertation synopsis or abstracts of the research papers
must be submitted for approval to the Research and Evaluation
Unit (REU) by the end of first year of the Intermediate Module.

General Requirements
Training should incorporate the principle of gradually increasing
responsibility, and provide each trainee with a sufficient scope,
volume and variety of experience in a range of settings that include
inpatients, outpatients, emergency and intensive care.
Intermediate Module in Obstetrics & Gynaecology 2010

Instructional Methodology
Teaching occurs using several methods that range from formal
lectures to planned clinical experiences. Aspects covered will
include knowledge, skills and attitudes relevant to the discipline in
order to achieve specific learning outcomes and competencies.

The theoretical part of the curriculum presents the current body of

knowledge necessary for practice. This can be imparted using
lectures, grand teaching rounds, clinico-pathological meetings,
literature reviews and presentations, journal clubs, self directed
learning, conferences and seminars. Clinical learning is organized
to provide appropriate expertise and competence necessary to
evaluate and manage common clinical problems. Demonstration in
outpatient and in patient clinics and procedural skill trainings on
simulators, mannequins and patients are all practical training
modalities.

6
ASSESSMENT
ELIGIBILITY REQUIREMENTS
For appearing in Intermediate Module examination a candidate
should have:
● Passed FCPS-I in Obstetrics and Gynaecology or granted
exemption by CPSP.
● Registered with the Research and Training Monitoring Cell
(RTMC).
● Completed two years of training under an approved supervisor
in an institution recognized by the CPSP. A certificate of
completion of training must be submitted.
● Submitted attested logbook.
● Submitted certificates of attendance of mandatory workshops.
● Synopsis for dissertation/abstracts of two research papers must
be submitted.

It is important to note that all applicants must undertake IMM

examination before taking Fellowship examination of the relevant
specialty.
Intermediate Module in Obstetrics & Gynaecology 2010

EXAMINATION SCHEDULE
● The Intermediate Module theory examination will be held twice
a year.
● Theory examinations are held in various cities of the country
usually at Abbottabad, Bahawalpur, Faisalabad, Hyderabad,
Islamabad, Karachi, Nawabshah, Larkana, Lahore, Multan,
Peshawar and Quetta centres. The College shall decide
where to hold TOACS examinations depending on the number
of candidates in a city and shall inform the candidates
accordingly.

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 ● English is the medium of all examinations for theory, practical
and viva.
● The College will notify of any change in the centres, the dates
and format of the examination.
● A competent authority appointed by the College has the power
to debar any candidate from any examination if it is satisfied
that such a candidate is not a fit person to take the College
examination because of using unfair means in the examination,
misconduct or other disciplinary reasons.

EXAMINATION FEE
● Fee deposited for a particular examination shall not be
carried over to the next examination in case of withdrawal,
absence or exclusion.
● Applications along with the prescribed examination fee and
required documents must be submitted by the last date
notified for this purpose before each examination.
● The details of examination fee and fee for change of centre,
subject, etc shall be notified before each examination.

FORMAT OF EXAMINATION
Intermediate Module examination consists of the following two
Intermediate Module in Obstetrics & Gynaecology 2010

components:
● Theory examination:

It consists of:
Paper i
Paper ii } 100 One best type of MCQs in each paper.
(70 Obs. 30 Gynae)
● Clinical examination:
TOACS (Task Oriented Assessment of Clinical Skills).

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TOACS

TOACS will comprise of 12 to 20 stations with a change time of

one minute for the candidate to move from one station to the
other. The stations may have an examiner, a patient or both.
Structured clinical tasks will be set at each station. At stations
where no examiner is present the candidates will have to
submit written responses to short answer questions/ MCQs on
a response sheet.

There will be two types of stations: static and interactive. On

static stations the candidate will be presented with patient
data, a clinical problem or a research study and will be asked
to give written responses about the questions asked. At the
interactive stations the candidate will have to demonstrate a
competency, for example, taking history, performing a clinical
examination, counseling, assembling an instrument, etc. One
examiner will be present at each interactive station and will
either rate the performance of the candidate or ask questions
testing reasoning and problem-solving skills.

Pass/Fail Criteria
Intermediate Module in Obstetrics & Gynaecology 2010

Candidates have to pass the theory to be eligible to take the

TOACS examination.

9
 TRAINING FOR INTERMEDIATE
MODULE
GIO (GENERAL INSTRUCTIONAL OBJECTIVES):
By the end of 2nd year in Obstetrics and Gynaecology, a trainee
shall be able to:

KNOWLEDGE:
1. Discuss etiology, pathogenesis, epidemiology and management
of disorders in Obstetrics and Gynaecology, as given in the
section on Specific Learning Outcomes (SLO).
2. Show initiative to become life long self-directed learners
tapping on resources including clinical material, faculty,
Internet and on-line learning programs and library.
3. Discuss principles of basic sciences as applied to Obstetrics
and Gynaecology like hemorrhage, blood transfusion, shock,
sterilization of instruments, infection, antibiotics, inflammation,
repair, and healing.

SKILLS:
1. Take a comprehensive and pertinent history of a patient
Intermediate Module in Obstetrics & Gynaecology 2010

presenting with Obstetrical and Gynaecological complaints.

2. Perform detailed Physical examination in a rational sequence
that is both technically correct as well as methodical.
3. Elicit Physical signs without discomfort to the patient.
4. Evaluate patient in the setting of Outpatients Department,
Hospital wards, Labour Room, Day care surgery, Emergency
Department and attending calls in other departments for
problems related to Obstetrics and Gynaecology.
5. Formulate a working diagnosis and consider relevant
differential diagnosis.
6. Order a set of relevant investigations considering availability,
diagnostic yield, cost-effectiveness, side effects, and
implications for management.

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7. Decide and implement suitable effective treatment considering
safety, cost factors, complications and side effects.
8. Practice proper procedures in operating theatres and labor
wards including gowning, gloving, use of various sutures,
surgical principles, and use and working of electro medical
equipment.
9. Assist at major surgeries and perform minor procedures under
supervision.
10. Maintain follow-up of patients at appropriate intervals,
recognizing new developments and/or complications and
offering sensible management protocols.

ATTITUDES:
1. Counsel patients and relatives in patient's preferred language
exhibiting good communication skills, empathy and
empowerment to patients.
2. Exhibit emotional maturity and stability, integrity, ethical values
and professional approach, sense of responsibility in day-to-
day professional activities.
3. Take proper informed consent for physical examination and
ensure confidentiality and appropriate environment for intimate
physical examination.
4. Call for help judiciously in emergency situations and referral as
required. Intermediate Module in Obstetrics & Gynaecology 2010

5. Maintain detailed and accurate documentation regarding

patient management and procedures.

PROCEDURES:
The level of competence to be achieved each year is specified
according to the key, as follows:
1. Observer status.
2. Assistant status.
3. Performed under direct supervision.
4. Performed under indirect supervision.
5. Performed independently

note: Levels 4 and 5 for practical purposes are almost

synonymous

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 Intermediate Module in Obstetrics & Gynaecology 2010

First Year
COMPETENCIES 3 Months 6 Months 9 Months 12 Months Total Cases
Level Cases Level Cases Level Cases Level Cases 1st Year

obstetrics Antenatal ( OPD & WARD)

Eliciting Pertinent history 4 30 5 30 5 30 5 30 120
Performing physical examination 4 30 5 30 5 30 5 30 120
Requesting appropriate investigations 3 30 3 30 4 30 5 30 120
Interpreting the results of investigations 3 30 3 30 4 30 5 30 120

12
Deciding and implementing appropriate treatment 2 30 2 30 3 30 4 30 120
Managing immediate complications 1 30 2 30 3 30 4 30 120
Maintaining follow-up 3 30 4 30 5 30 5 30 120
Using ultrasound (basic) 1 5 1 5 2 5 2 10 25
Fetal monitoring (including CTG) 3 30 4 30 5 30 5 30 120
Actual or demonstration on
Amniocentesis - - - - - - 1 video models

Management of medical disorders in pregnancy 1 10 2 10 3 10 3 10 40

 First Year
COMPETENCIES 3 Months 6 Months 9 Months 12 Months Total Cases
Level Cases Level Cases Level Cases Level Cases 1st Year

obstetrics Intrapartum (Labour Room)

Assessment on admission 2 30 3 30 4 30 4 30 120
Medical induction of labour 2 5 2 5 3 5 4 5 20
Surgical induction of labour 2 5 2 5 3 5 4 5 20
Management of normal labour 2 30 2 30 3 30 4 30 120
Performing and repairing episiotomy 2 5 2 10 3 10 4 10 35
Repair of vaginal and perineal tears 2 2 2 2 3 3 4 3 10
(excluding third degree tears)
Repair of third degree tears 1 - 1 - 2 - 2 - -
Repair of cervical tears 1 2 2 2 3 3 4 3 10
Immediate management of 2 3 3 3 4 3 5 3 12
post-partum haemorrhage

13
Outlet forceps delivery 1 2 2 2 3 2 4 2 8
Vacuum extraction 1 2 2 3 3 3 4 3 11
Caesarean section 1 10 2 10 3 10 4 10 40
Repair of ruptured uterus (cases distributed in 12 months) 1 - 1 - 2 - 2 - 5
Obstetric hysterectomy (as above) 1 - 1 - 2 - 2 - 3
Correction of (acute) inverted uterus (as above) 1 - 1 - 1 - 2 - 2
Breech, twin delivery, 1 3 1 3 2 3 2 3 12
destructive operations, craniotomy etc.

obstetrics Postnatal

Resuscitation of neonate 1 20 2 20 3 20 3 20 80
Contraception counseling / advice 2 50 3 50 3 50 4 50 200
Insertion of IUCD 1 5 2 5 3 5 3 5 20

Intermediate Module in Obstetrics & Gynaecology, 2010

 Intermediate Module in Obstetrics & Gynaecology 2010

First Year
COMPETENCIES 3 Months 6 Months 9 Months 12 Months Total Cases
Level Cases Level Cases Level Cases Level Cases 1st Year

gynaecology OPD & Ward (number of cases distributed in 12 months)

Eliciting Pertinent history 4 20 - - - - - - 20
Performing physical examination 4 20 - - - - - - 20
Requesting appropriate investigations 3 20 - - - - - - 20
Interpreting the results of investigations 3 20 - - - - - - 20

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Deciding and implementing appropriate treatment 2 20 - - - - - - 20
Managing immediate complications 1 20 - - - - - - 20
Maintaining follow-up 3 20 - - - - - - 20
Taking Pap smears 2 10 - - - - - - 10
Arranging assessment by an anesthetist 2 15 - - - - - - 15
Colposcopy 1 5 - - - - - - 5
Hystero-salpingography (injection of dye) 2 5 - - - - - - 5
LLETZ / Cauterization of cervix /cryosurgery 1 2 - - - - - - 2
 First Year
COMPETENCIES 3 Months 6 Months 9 Months 12 Months Total Cases
Level Cases Level Cases Level Cases Level Cases 1st Year

gynaecology Operative Skills (B1 General Skills) (number of cases distributed in 12 months)
Scrubbing 3 10 - - - - - - 10
Opening & Closing abdomen 1,2 5 - - - - - - 5

gynaecology Operative Skills (B2 Operations) (number of cases distributed in 12 months)

Evacuation of Retained products of conception 2 5 - - - - - - 5

Dilatation & Curettage 2 5 - - - - - - 5
Cervical Biopsy 2 2 - - - - - - 2
Polypectomy 2 2 - - - - - - 2
Marsupilization of Bartholin’s Cyst 2 2 - - - - - - 2

15
Minilaparotomy (for tubal ligation) 2 5 - - - - - - 5
Drainage of abscess 2 2 - - - - - - 2
Post-partum tubal ligation 2 5 - - - - - - 5
Diagnostic laparascopy 1 5 - - - - - - 5
Hysteroscopy 1 5 - - - - - - 5
Ovarian cystectomy 1 3 - - - - - - 3
Laparotomy for ectopic pregnancy 1 5 - - - - - - 5
Myomectomy 1 1 - - - - - - 1
Abdominal hysterectomy 1 5 - - - - - - 5
Vaginal hysterectomy 1 2 - - - - - - 2
Repair of prolapse 1 2 - - - - - - 2

Intermediate Module in Obstetrics & Gynaecology 2010

 Intermediate Module in Obstetrics & Gynaecology 2010

Second Year
COMPETENCIES 15 Months 18 Months 21 Months Total Cases
Level Cases Level Cases Level Cases 2nd Year

obstetrics Antenatal (OPD & WARD)

Eliciting Pertinent history 5 30 5 30 5 30 90
Performing physical examination 5 30 5 30 5 30 90
Requesting appropriate investigations 5 30 5 30 5 30 90
Interpreting the results of investigations 5 30 5 30 5 30 90

16
Deciding and implementing appropriate treatment 5 30 5 30 5 30 90
Managing immediate complications 5 30 5 30 5 30 90
Maintaining follow-up 5 30 5 30 5 30 90
Using ultrasound (basic) 3 10 4 10 5 10 30
Fetal monitoring (including CTG) 5 30 5 30 5 30 90
Amniocentesis Actual or demonstration on video models
Management of medical disorders in pregnancy 4 15 5 15 5 15 45
 Second Year
COMPETENCIES 15 Months 18 Months 21 Months Total Cases
Level Cases Level Cases Level Cases 2nd Year

obstetrics Intrapartum (Labour Room)

Assessment on admission 5 30 5 30 5 30 90
Medical induction of labour 5 5 5 5 5 5 15
Surgical induction of labour 5 5 5 5 5 5 15
Management of normal labour 5 30 5 25 5 25 80
Performing and repairing episiotomy 5 10 5 10 5 10 30
Repair of vaginal & perineal tears (excluding third degree tears) 5 2 5 2 5 2 6
Repair of third degree tears 3 - 3 - 4 - 8
Repair of cervical tears 4 3 5 3 5 4 10
Immediate management of post-partum haemorrhage 5 4 5 4 5 4 12

17
Outlet forceps delivery 4 2 5 4 5 4 10
Vacuum extraction 5 3 5 3 5 3 9
Caesarean section 4 15 5 15 5 15 45
Repair of ruptured uterus 3 - 3 - 4 5 5
Obstetric hysterectomy 3 - 3 - 4 3 3
Correction of inverted uterus (acute) 3 - 3 - 4 2 2
Breech, twin delivery, destructive operations, craniotomy etc. 4 3 4 3 4 2 8

obstetrics Postnatal
Resuscitation of neonate 4 20 5 20 5 20 60
Contraception counseling / advice 5 50 5 50 5 50 150
Insertion of IUCD 5 10 5 10 5 10 30

Intermediate Module in Obstetrics & Gynaecology 2010

 Intermediate Module in Obstetrics & Gynaecology 2010

Second Year
COMPETENCIES 15 Months 18 Months 21 Months Total Cases
Level Cases Level Cases Level Cases 2nd Year

gynaecology OPD & Ward (number of cases distributed in 12 months)

Eliciting Pertinent history 4 20 - - - - 20
Performing physical examination 4 20 - - - - 20
Requesting appropriate investigations 3 20 - - - - 20
Interpreting the results of investigations 3 20 - - - - 20

18
Deciding and implementing appropriate treatment 2 20 - - - - 20
Managing immediate complications 2 20 - - - - 20
Maintaining follow-up 4 20 - - - - 20
Taking Pap smears 3 10 - - - - 10
Arranging assessment by an anesthetist 3 15 - - - - 15
Colposcopy 2 10 - - - - 10
Hystero-salpingography (injection of dye) 3 5 - - - - 5
LLETZ / Cauterization of cervix /cryosurgery 2 2 - - - - 2
 Second Year
COMPETENCIES 15 Months 18 Months 21 Months Total Cases
Level Cases Level Cases Level Cases 2nd Year

gynaecology Operative Skills (B1 General Skills) (number of cases distributed in 12 months)
Scrubbing 4 15 - - - - 15
Opening and Closing abdomen 3,4 5 - - - - 5

gynaecology Operative Skills (B2 Operations) (number of cases distributed in 12 months)

Evacuation of Retained products of conception 3 5 - - - - 5

Dilatation and Curettage 3 5 - - - - 5
Cervical Biopsy 3 3 - - - - 3
Polypectomy 3 3 - - - - 3
Marsupilization of Bartholin’s Cyst 3 2 - - - - 2

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Minilaparotomy (for tubal ligation) 3 5 - - - - 5
Drainage of abscess 3 3 - - - - 3
Post-partum tubal ligation 3 5 - - - - 5
Diagnostic laparascopy 2 5 - - - - 5
Hysteroscopy 2 5 - - - - 5
Ovarian cystectomy 2 3 - - - - 3
Laparotomy for ectopic pregnancy 2 5 - - - - 5
Myomectomy 2 2 - - - - 2
Abdominal hysterectomy 2 5 - - - - 5
Vaginal hysterectomy 2 3 - - - - 3
Repair of prolapse 2 3 - - - - 3

Intermediate Module in Obstetrics & Gynaecology, 2010

 Intermediate Module in Obstetrics & Gynaecology 2010

ROTATIONS
Level Cases

NEONATOLOGY (Three Month Rotation)

Neonatal Examination 1,2,3,4 10 each
Neonatal Resuscitation 1,2,3,4 10 each
Emergency drug dosage and side effects 1,2,3,4 5 each
I / V fluids in first seven days 1,2,3,4 5 each
Management of LBW 1,2,3,4 5 each
Recognition of Sepsis & emergency care 1,2,3,4 5 each

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IMCI (Integrated management of Childhood illness) 1,2,3,4 5 each
Vaccination 1,2,3,4 5 each
ROTATIONAL TRAINING

recognition and emergency management of danger signs like:

i. Jaundice 1,2,3,4 10 each
ii. Respiratory distress 1,2,3,4 10 each
iii. Convulsions 1,2,3,4 10 each
iv. CCT 1,2,3,4 10 each
v. Anaemia 1,2,3,4 10 each
vi. Peripheral Circulatory Failure 1,2,3,4 10 each
 ROTATIONS
Level Cases

MEDICINE (Three Month Rotation)

Medical problems relevant to oBg / gyn like….
Diabetes Mellitus 1,2,3,4,5 10 each
Hypertension 1,2,3,4,5 10 each
Liver Disease 1,2,3,4,5 10 each
Anaemia 1,2,3,4 10 each
Renal Diseases 1,2,3,4 10 each

21
Thyroid Diseases 1,2,3,4 10 each
Epilepsy 1,2,3,4 10 each
Viral Diseases 1,2,3,4,5 10 each
Preventive Management 1,2,3,4,5 10 each
history, examination, appropriate investigation and treatment of …
Paracentesis 1,2,3 5 each
Aspiration 1,2,3 5 each
Liver Biopsy 1 5 each
Case Presentation/ Journal Club 5 3

Intermediate Module in Obstetrics & Gynaecology 2010

 Intermediate Module in Obstetrics & Gynaecology 2010

ROTATIONS
Level Cases

DIAGNOSTIC IMAGING (Three Months Rotation)

Basics of Ultra Sound Scan 1,2,3,4 10 each
Diagnosis of IUT Pregnancy 1,2,3,4 10 each
Fetal Biometry 1,2,3 10 each
Placental Localisation 1,2,3 10 each
BPP 1,2,3 10 each

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Diagnosis of Ectopic pregnancy 1,2 10 each
Identification of normal ovary & Uterus 1,2 10 each
Ovarian Follicle 1,2,3 10 each
Ovarian Cyst alongwith its characteristics 1,2,3 10 each
Interpertation of X-Ray Chest 1,2,3,4 15 each
Interpertation of HSG 1,2,3,4 10 each
Interpertation of CT 1,2 5 each
Interpertation of MRI 1,2 5 each
 USEFUL ADDRESSES
AND TELEPHONE
NUMBERS

1. Regional Offices of the CPSP

MUZAFFARABAD LAHORE
CMH Muzaffarabad Next to INMOL, Hospital
Azad Kashmir New Muslim Town, Block-D
TEL: 058810 - 43307 Lahore.
FAX: 058810 - 43902 UAN: 042-111-666-666
Email: ssgr-brehman@cpsp.edu.pk TEL: 042- 9231320-8
FAX: 042- 9231327
ABBOTTABAD Email: rc_lahore@cpsp.edu.pk
Ayub Hospital Complex
Abbottabad
MULTAN
TEL: 0992-383330
Nishtar Medical College,
Email: rc_abbottabad@cpsp.edu.pk
Distt. Jail Road, Opp Circuit House,
Multan.
PESHAWAR
Hayatabad Medical Complex UAN: 061-111-666-666
Phase IV, Hayatabad,  TEL: 061-9200946, 9200952
Peshawar Email: rc_multan@cpsp.edu.pk
UAN: 091-111-666-666
TEL: 091-9217011, 091-9217320-1 BAHAWALPUR
FAX: 091-9217062 Quaid-e-Azam Medical College
Email: rc_peshawar@cpsp.edu.pk Bahawalpur
Intermediate Module in Obstetrics & Gynaecology 2010

TEL: 062- 9250461

ISLAMABAD Email: rc_bahawalpur@cpsp.edu.pk
P.I.M.S, Ravi Road, Sector G- 8/ 3
Islamabad. NAWABSHAH
UAN: 051-111-666-666
Peoples Medical College for Girls
TEL: 051-9262590-1,
Nawabshah
FAX: 051-9262592
TEL: 0244-9370271, 9370479
Email: rc_islamabad@cpsp.edu.pk
FAX: 0244-9370478
FAISALABAD Email: rc_nawabshah@cpsp.edu.pk
Punjab Medical College
Faisalabad LARKANA
UAN: 041-111-666-666 Chandka Medical College
TEL: 041-9210131, 9210366-8 Larkana
FAX: 041-9210224 TEL: 074 – 9410726
il:rc_faisalabad@cpsp.edu.pk Email: rc_larkana@cpsp.edu.pk

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 HYDERABAD QUETTA
Liaquat University Hospital, Jamshoro CPSP Bolan Medical College
Hyderabad Sandeman Civil Hospital
TEL: 022-3877393 TEL: 081- 9202424
Email: rc_hyderabad@cpsp.edu.pk Email: rc_quetta@cpsp.edu.pk

KARACHI

2. Departments of CPSP Karachi OVERSEAS CPSP CENTRES

UAN – 021-111-606-606 3. Saudi Arabia
RIYADH
● Examination (FCPS Part I) Saudi Commission for Health
9207100 -10 Ext: 311
Specialities,
● Examination (FCPS Part II) Diplomatic Quarter, P.O. Box 94656
9207100 -10 Ext: 215 Riyadh -11614, KSA.
TEL: 966-1-4822415 Ext: 156/141
● Department of Medical 966-2-6401000 Ext: 25843
Education
Email: medexam5@scfhs.org
9207100 -10 Ext: 305

● Registration, Training & 4. Nepal

Monitoring Cell KATHMANDU
9207100 -10 Ext: 320 T.U. Institute of Medicine
For further Information visit the Maharajganj, Kathmandu, Nepal
College website at : TEL: 977-1- 416224
www.cpsp.edu.pk Email: cpsp@iomdit.org.np
Intermediate Module in Obstetrics & Gynaecology 2010

24
ADDENDUM IMM PROSPECTUS
OBSTETRICS AND GYNECOLOGY
This addendum is to be read after Page 22 of the prospectus

The course during IMM covers following areas of Gynaecology &

Obstetrics:

1. GYNAECOLOGY (Weightage 30%):

■ Development of Female Genital organs-normal and
abnormal, especialy intersexes, obstruction of outflow tract
and urogenital maldevelopment
■ Amenorrhoea
■ Gynaecological Endocrinology, especialy Hirsutism and Virilism,
PCO
■ Endometriosis, Perineal and Pelvic infections, especialy
Bartholin gland problems, Vaginal discharge, STIs, PID
■ Menstrual disorders, especialy Menorrhagia, Dysmenorrhoea,
PMS, DUB
■ Disorders of early pregnancy, especialy Abortion, Ectopic
Pregnancy, GTD and their management
■ Menopause, Hormone Replacement Therapy
Pelvic Floor Disorders and UV Prolapse
Intermediate Module in Obstetrics & Gynaecology 2010

■ Infertility
■ Contraception and Sterilization
■ Pre and Postoperative assessment, preparation and
management. Gynaecological procedures, e.g. cervical
smear, insertion of pesseries, Hysterosalpingography,
Ultrasonography. Minor Operative Gynaecological surgery

Topics where low level of knowledge (up to diagnosis) is

required:
■ Radiotherapy
■ Oncology
■ Endoscopy
■ Urinary Fistulas

A
 2. OBSTETRICS (weightage 70%):
1. normal Pregnancy, labour and Puerperium
- Antenatal Care
- Intrapartum care, Maternal and fetal monitoring
- Postpartum care
- Analgesia / Anaesthesia during labour
- Normal Puerperium
- Breast feeding / complications
- Prenatal diagnosis

2. abnormal Pregnancy, labour and Puerperium

- Malpresentation
- Malposition
- In-coordinate uterine action
- CPD
- Obstructed labour
- 3rd stage complications
- Induction of labour
- Pre Term Labour
- Surgical complications (Appendicitis, Perforated peptic
ulcer, Pancreatitis cholethiasis / cholecystitis, renal colic).
- Neonatal care / Resuscitation
Intermediate Module in Obstetrics & Gynaecology 2010

3. Medical complications of Pregnancy

- Cardio vascular diseases
- Renal and urinary tract disorders
- Diabetes in pregnancy
- Endocrine disorders
- Hepatic and G.I.T disorders
- Haemotological disorders of pregnancy
- Thromboembolic disorders
- Psychiatric and neurological disorders
- Dermatological disorders
- Neoplastic diseases

B
4. operative / instrumental interventions
- Forceps delivery
- Vacuum delivery
- Breech extraction
- Shoulder dystocia
- Ceasarian section / Ceasarian Hysterectomy
- Episiotomy
- Perineal tears, cervical tear
- Rupture uterus, inversion of uterus
- Manual removal of placenta
- Cephalocentesis

5. epidemiology
- Maternal mortality / morbidity
- Biostatistics
- Reproductive Health
- Domestic Violence

Intermediate Module in Obstetrics & Gynaecology 2010