Download An Introduction to and an Overview of MEDICAL COURSE

MEDICAL COURSE
-- Introduction and Overview
HP Kedilaya
Professor & Head, Dept. of Biochemistry,
Contents
1. Why Introduction and Overview for the
Newly Joined Students?
2. Introduction and Overview of the Medical
Course
Why Introduction and Overview for the
Newly Joined Students?

Teachers Often Observe –
Students are Academically Disoriented
Don’t Know What and Why Exactly
they are Doing When They are Studying
Not Focused While Studying
Possible Reasons for Disorientation
in Students




Attitude Towards Academics
-- cultural
-- previous experience with academics
Academic Quality of Students
Quality of Teaching
No Proper Introduction to the Course
Importance of
Introduction and Overview
 Everyone
Knows it for a Topic
in Textbooks
in a Lecture Class
 Then Why not for an Entire Course
Imagine a Task of
A Trekking Expedition
 Take
an Overview ………
……………. A Helicopter View
What is a Proper Introduction and
Overview of the Medical Course?
 Introduction and Overview of the Medical
Course
Concerned With All the Teachers of a
Medical College Irrespective of the Their
Specialty.
 Opinion about What is Proper or
Appropriate May Differ from Teacher to
Teacher

MEDICAL COURSE
-- Introduction and Overview
Medical science is one of the most
interesting subjects.
Medical profession is the noblest of all
professions.
Medical Science is One of the
Most Interesting Subjects.

Working of the Human Body -Sophisticated,
Intriguing
More
and
Exciting
Than that of any Existing Machine
Medical Profession is the Noblest
of all Professions…..
……Because

it Deals with –


-- Pains and Pleasures of the Body
-- The Comforts and Discomforts of the Body
-- Life and Death of the Patients
More Customer (patient) Satisfaction
and
No other Field of Science is Facing Real-life
Challenges that are as Large and Formidable
as those of Medical Science
CONTENTS

Meanings of Basic Concepts

Study Of Medicine
Meanings of Basic Concepts



The Living Organism
The Machine and the Body
(A Mechanistic View)
Health, Disease and the Doctor
The Living Organism






All Living Organisms are made up of Matter --- Just like the Non-living Matter.
Therefore, the Living Organisms Obey all the Laws of Physics
and Chemistry –
-- Just like the Non-living Matter.
The Ultimate Property of all Living Organisms –
-- Reproduction
Other Unique Properties are --- Growth and Self-maintenance.
These Properties can also be Conceived as their --- Functions
Thus, Reproduction is their Ultimate Function
and
All other Processes or Functions Sub-serve the Function of
Reproduction.
The Living Organism (Cont’d)
Living Beings are Open Systems
-- Exchanging Energy, Matter and Information
with the Environment
-- For Reproduction, Growth and Maintenance



They Ingest Food (Nutrients) --- For Input of Energy and Matter
They Interact with the Surrounding --- For Input of Information.
The Machine and the Body
(A Mechanistic View)
The Machine



Has certain FUNCTIONS and
Requires a proper STRUCTURE (and/or
Composition – composition in case of liquid state) for
its proper Performance.
Any Change in the Structure of the Machine,
therefore, can Cause –

-- Loss of its Functions.
Therefore, all that a Mechanic Needs to do when a
Machine is not Working is to –
-- Repair the Machine in such a way
that its Normal Structure is Restored.
The Machine and the Body
(A Mechanistic View)
(Cont’d…..
The Body
The Body of an Organism, including Human, is like
–
-- a Machine
 The Body has Functions and to Perform these
Functions it should have --- a Proper Structure (and/or Composition).
A Normal or Healthy Body has a Proper or Normal
Structure

And Therefore,
-- All its Functions are Intact
Health, Disease and the Doctor


What is Health?
Health is a State of the Body –
-- When all its Functions are Intact
 Since Function depends on Structure, to be Healthy a Body
Should have –
-- a Proper or Normal Structure.
What is Disease?
Disease or Disorder is a State of the Body –
-- When there is Loss of One or More of its Functions.
 Since Function depends on Structure –
-- Only a Change in the Structure of the Body can
cause Disease.
Health is Normal and Disease is Abnormal
Who is a Doctor ?




Ills
Pills
Kills
Bills
Health, Disease and the Doctor
 Who
is a Doctor ?
A Doctor is One Who Helps to –
– Cure and Prevent Diseases.
 He
is Like a Mechanic Who Helps to
– Repair and Maintain a Machine.
Health, Disease and the Doctor
How Does a Doctor Cure a Disease?
Since Disease is Caused by an Abnormality
in the Structure of the Body –
Only Helping to
Restore the Normal Structure of the Body --- Can Cure a Disease.
An Important Difference between the Body
and the Machine is that –
The Body has the Property of Self-repair,
which the Machine has not

Study of Medicine
What Knowledge and Skill should one Acquire
to be a Doctor and How to Acquire it ?
Practical Knowledge of –
How to Cure and Prevent Diseases
Theoretical Knowledge of –
All Aspects of Diseases
Theoretical Knowledge of –
All Aspects of the Normal /Healthy Body
OR
Normal Structure and Function.
The Order for Study of
Medicine

From the Above Argument, it Follows that–
The Order of the Study of Subjects of
the Medical Course
Will be as Follows:
The Order for Study of Medicine
I. Theoretical Study of the Normal Body
– The Pre-Clinical Phase of the Medical Course
II. Theoretical Study of Diseases
– The Para-Clinical Phase of the Medical
Course
III. Practical, Hospital-based, Patient
Centered Learning of Diagnosis,
Treatment or Management and
Prevention of Diseases
– The Clinical Phase of the Medical Course
I. Study of the Normal Body
(Pre-Clinical Phase)

Study of any Organism involves nothing
but –
-- The Study of the Function
And
-- The Study of the Structure
(Because the Function depends on the Structure)
I. Study of the Normal Body
(Pre-Clinical Phase)

The Structure and Function of the Human Body,
like those of other Organisms, are Hierarchical.
Structural and Functional Hierarchy of the Body
The Body
Organs and Organs- Systems
Tissues
Cells and Intercellular Substances
Sub-cellular Organelles
Molecules
I. Study of the Normal Body
(Pre-Clinical Phase)
(Cont’d…..
Scales/Levels of Size in the Study
 For the Convenience of Distributing the
Subject Matter of Study of the Normal Body
among the Disciplines –
-- Two Scales of Size are adopted
1) The Lower, Molecular Level
And
2) The Higher, Micro and the Macro Levels
(Or the Supra-molecular Level)
I. Study of the Normal Body
(Pre-clinical Phase)
(Cont’d…..
Distribution of Subject Matter among the Disciplines
Studying the Normal Body
-- Based on whether the study is of –
1) Structure or Function
and whether it is at the
2) Molecular level or Micro & Macro level
Subject Matter is Distributed among Three Disciplines —
 Biochemistry
 Anatomy
and
 Physiology
I. Study of the Normal Body
(Pre-Clinical Phase)
(Cont’d…..
Subject Matter of Biochemistry, Anatomy and
Physiology
STUDY OF THE
NORMAL BODY
I. Study of the Normal Body
(Pre-Clinical Phase)
(Cont’d…..
Subject Matter of Biochemistry, Anatomy and
Physiology
STUDY OF THE
NORMAL BODY
Study of Structure
I. Study of the Normal Body
(Pre-Clinical Phase)
(Cont’d…..
Subject Matter of Biochemistry, Anatomy and
Physiology
STUDY OF THE
NORMAL BODY
Study of Structure
Study of Function
I. Study of the Normal Body
(Pre-Clinical Phase)
(Cont’d…..
Subject Matter of Biochemistry, Anatomy and
Physiology
STUDY OF THE
NORMAL BODY
At the
Molecular level
Study of Structure
Study of Function
I. Study of the Normal Body
(Pre-Clinical Phase)
(Cont’d
Subject Matter of Biochemistry, Anatomy and
Physiology
STUDY OF THE
NORMAL BODY
At the
Molecular level
At the
Micro & Macro
level
Study of Structure
Study of Function
I. Study of the Normal Body
(Pre-Clinical Phase)
(Cont’d…..
Subject Matter of Biochemistry, Anatomy and Physiology
STUDY OF THE
NORMAL BODY
Study of Structure
At the
Molecular level
At the
Micro & Macro
level
Anatomy
Study of Function
I. Study of the Normal Body
(Pre-Clinical Phase)
(Cont’d…..
Subject Matter of Biochemistry, Anatomy and Physiology
STUDY OF THE
NORMAL BODY
Study of Structure
Study of Function
Anatomy
Physiology
At the
Molecular level
At the
Micro & Macro
level
I. Study of the Normal Body
(Pre-Clinical Phase)
(Cont’d…..
Subject Matter of Biochemistry, Anatomy and Physiology
STUDY OF THE
NORMAL BODY
At the
Molecular level
At the
Micro & Macro
level
Study of Structure
Study of Function
Biochemistry
Anatomy
Physiology
I.
Study of the Normal Body:
(Pre-clinical Phase)
(Cont’d…..
Energy and Matter (Food/Nutrients)
Nutrition
INPUTS
(Biochemistry)
Behavior Science
(Physiology)
Information
II. Study of Diseases: (Para-Clinical Phase)
Disease or Disorder is a State of the Body
when there is Loss of One or More of its
Functions.
Since Function Depends on Structure --- Only a Change in the
Structure of the Body
can Cause Disease.
II. Study of Diseases:
(Para-Clinical Phase)
ASPECTS OF DISEASE






Cause (Etiology),
Mechanism of Disease (Pathogenesis),
Disease Manifestations (Clinical Manifestations)
Detection/Identification and Assessment (Diagnosis)
Treatment/Management
And
Prevention
II. Study of Diseases: (Para-clinical Phase)
(Cont’d…….
Cause of Diseases ( Etiology)
• There is always a Cause for the Process of
Disease
i.e.. Causes that can Create an Abnormality in the
Structure of the Body
• Sometimes a Disease may have More than
One Cause -- Multifactor Etiology
2 Types of Causes
1. Genetic and
2. Acquired/Environmental
II. Study of Diseases: (Para-Clinical Phase)
(Cont’d…….
Cause of Diseases ( Etiology)
 Genetic
(Cont’d….
Diseases
-- Due to Inborn Errors
in the Genetic Make-up of the Body
-- Inherited from One or Both the
Parents
-- Like Manufactural Defects in
II. Study of Diseases: (Para-Clinical Phase)
(Cont’d…….
Cause of Diseases ( Etiology)



(Cont’d……….
Acquired Diseases
--Due to Several Kinds of Agents –
Physical Agents, Chemical Agents and Biological Agents
-- Even Lack or Excess Intake of Food or Nutrients
– Nutritional Disorders
-- And Lack of Proper Social Environment
(Abnormal Informational Input)
--Behavioral or Psychological Disorders
Subjects :
Clinical Biochemistry, Pathology, Microbiology and
Psychiatry
II. Study of Diseases: (Para-Clinical Phase)
(Cont’d…….
Mechanism of the Disease Process
(Pathogenesis)

Tracing the Cause and Effect Sequence --- From Etiology to Manifestation (loss of
function)
Subjects:
Clinical Biochemistry, Pathology and
Psychiatry
II. Study of Diseases: (Para-Clinical Phase)
(Cont’d…….
Clinical Manifestation

Clinical Manifestation includes Signs and Symptoms.
Symptoms
– What the Patients Complain or Report to the Doctor
about the Abnormal Sensations they Feel (e.g. Pain).
Signs
– What the Doctor Makes out on Physically Examining the
Patient.
Subjects:
Clinical Biochemistry, Pathology, and all Clinical
Subjects
II. Study of Diseases: (Para-Clinical Phase)
(Cont’d…….
Diagnosis
 Identification and Assessment of a Disease
and also its Outcome (Prognosis).
It is Done by Undertaking Tasks in the Order
Given Below.
 History Taking

Physical Examination

Special Investigation
Diagnosis
 History
Taking
Collecting Information from the
Patient regarding his Complaint or
Symptoms
 Physical Examination:
Visual Examination,
Examination by Hands (Palpation) and
Examination of Sound and Smell.
Diagnosis
Investigation:
-- Investigations or Tests Using
Special Instruments
Determination of Levels of
Certain Substances in Blood,
Imaging Techniques (Like X-ray,
Ultrasound, Etc),
Microscopic Examination of Body Fluids
and Tissues, Etc]
 Special
Diagnosis
Subjects:
All Clinical Subjects
Para-clinical Subjects – Clinical
Biochemistry, Pathology and Microbiology
– Radiology, is Involved in the Actual
Performance of Imaging Techniques.
II. Study of Diseases: (Para-Clinical Phase)
(Cont’d…….
Treatment and Management



Aim is to
Cure
Prevent
Manage
Decrease the Suffering
Rehabilitate
Many Diseases are Self-limiting
The First Line of Strategy –
-- Remove the Cause whenever Possible.
II. Study of Diseases: (Para-Clinical Phase)
(Cont’d…….
Types of Treatment (Therapy) and Management
Options
 Reassurance and Patient Education:
 Physical Rest:
 Diet:
 Pharmacotherapy (Use of Drugs for Treatment):
– To Reduce Unpleasant Symptoms Like Pain, Fever,
etc
– To Act Against Disease Causing Bacteria (Antibiotics),
Virus, Worms, etc;
– Replacement of Essential Molecules, Such as
Hormones, in the Body.
 Surgery
– Removal of Unwanted Parts of the Body
– Correction/Replacement of Defective or Lost Parts
II. Study of Diseases: (Para-Clinical Phase)
(Cont’d…….
Types of Treatment (Therapy) and Management Options
(Cont’d....




Physiotherapy: Special Exercises, Application of Pressure,
Massage, Heat, etc
Rehabilitation
Counseling
-- For Behavioral or Psychiatric Disorders
Other Types of Treatments –
Radiotherapy, Heat Therapy, Phototherapy, etc.
Subjects:
All Clinical Subjects
and
Pharmacology, Dietics and Nutrition (Under Clinical
Biochemistry)
II. Study of Diseases: (Para-Clinical Phase)
Prevention of Disease
(Cont’d…….
Prevention is Better than Cure.
 Done by --- Identifying and Removing the Cause
-- Improving the Bodily Defense
 Done at the –
-- Individual Level (e.g. Vaccination)
-- Community Level (e.g. Sanitation)
Subject:

Community Medicine
Medico Legal Aspects
--To Solve Crimes
-- Ascertaining the Cause of Death, etc.
Subject:
Forensic Medicine
III. Learning Clinical Skills
(Clinical Phase)

The Clinical Phase Involves –
--Practical, Hospital-Based, Community-Based
and
Patient-Oriented Learning of –
– Diagnosis
– Treatment/Management
– and Prevention


of Diseases
During this Phase Students Apply the Knowledge and Skills
Learnt during the Pre- and Para-Clinical Phase
SUBJECTS –
Medicine, Surgery, Obstetrics & Gynecology, Pediatrics,
Ophthalmology, Otolaryngology (E.N.T), Orthopedics,
Psychiatry, etc.