Petronas Twin Tower

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Petronas Twin Tower K.L.C.C
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School of Medical Sciences - USM
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School of Medical Sciences - USM

• Established in 1979
• The main activities are
• Teaching
• Patient care
• Research

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Hospital USM

• The Medical School is serviced by a 716-
• bed teaching hospital functioning at
• tertiary care level with international
• standard facilities.

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School of Medical Sciences USMCourses Offered

• MD
• M.Med (16 specialities)
• M.Sc Ph.D
• M.Sc (Sports Science), (Sports Medicine)
• Postgraduate Diploma in Medical Therapeutics

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MD Program

• In general this program is taught with an
  integrated multidisciplinary approach, based on
  organ and system with emphasis on problem solving.

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Curriculum

• The program runs for 5 years and is
• divided into 3 phases (with professional
  examinations at the end
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  of each phase)
• Phase I - First year
• Phase II - Second year
• Third year
• Phase III - Fourth year
• Fifth year

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Phase I

• Bioethics and Nursing 1 week
• General Block 5 weeks
• Haemopoeitic and lymphoid system 2 weeks
• Musculo-skeletal system 4 weeks
• Nervous system 4 weeks
• Reproductive system 1 week
• Gastrointestinal and nutrition 4 weeks
• Endocrine system and metabolism 3 weeks
• Cardiovascular system 3 weeks
• Respiratory system 2 weeks
• Urinary system 2 weeks
• Host and environment 4 weeks
• First aid 1 week

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Phase II

• General Block
• Haemopoeitic and lymphoid system
• Reproductive system
• Musculo-skeletal system
• Psychological medicine
• Infectious disease
• Cardiovascular system
• Respiratory system
• Genito-urinary system
• Gastrointestinal system
• Endocrine system
• Nervous system

In phase II students are introduced to clinical
clerkship, community and family case studies and
will undergo 6 weeks of elective posting.
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Phase III

• General block lectures and Interdisciplinary
  activities
• Clinical postings Rotation through all clinical
  disciplines
• Community and family case studies
• Elective (year 4)

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Mode of teaching

• Formal lectures
• Small group discussions
• Problem-based learning
• Fixed learning module
• Self-study
• Seminars
• Interdisciplinary activities (symposium-like
  presentations presented by students)
• Therapeutic ward round (problem-based)
• Clinical ward rounds

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Co-curriculum

• Wednesday afternoons are reserved for
• co-curricular activities whereby students
• are required to participate in uniformed
• brigades like military cadets, sports or
• socio-cultural activities and self-defence
• art.

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Teaching of pharmacology and therapeutics

• Phase I
• Introduction
• Autonomic pharmacology
• Pharmacokinetics anf pharmacodynamics
• Phase II
• Pharmacology teaching follows the blocks
  according to system
• Phase III
• - Pharmacology teaching is given in the general
  block lectures, interdisciplinary activities,
  seminars and therapeutic ward rounds.

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2nd P-Drug workshop 1999 - Hieizan
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Rational Use of Drugs - what are the Issues?
Assoc. Professor Haji Abd Rahman Noor Departments
of Pharmacology and Paediatrics School of Medical
Sciences Universiti Sains Malaysia, Health
Campus, Kubang Kerian, Kelantan, MALAYSIA
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No. of physicians in the U.S. 70,000 Accidental
death caused by physicians per year
120,000 ð     accidental death per physicians
0.171 (source U.S. Dept. of Health and Human
Services) cf. No. of gun owners in the U.S.
80,000,000 No. of accidental gun death per year
1500 No. of accidental gun death per gun owner
0.0000188 Statistically doctors are approximately
9000 more dangerous than gun owners.
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Instrument left by a surgeon removed
from patients abdomen
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Rational Use of Drugs

• Are there any issues? Yes!
• Evidence literature reference
• Activities by WHO
• Activities by individual countries

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In Australia National Medicines Policy is well
established, which includes Quality Use of
Medicines Quality Use of Medicines achieved by
partnership approach with medication team
concept involving doctors, pharmacists, nurses
and consumers, based on the following
principles  
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R. Kausal et al JAMA 2001285162114-2120 Condu
cted a study in 2 teaching hospitals in Boston to
assess the rates of medication errors, adverse
drug events and potential ADEs in paediatric
patients
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• Kausal R. (cont).
• 10778 medication orders were reviewed
• 616 (5.7) showed medication errors
• 115 (1.1) showed potential ADEs
• 26 (0.24) showed ADEs ( 19 were preventable
  ).
• The preventable ADEs were similar to a previous
  study in adults but the potential ADEs rate was
  3 times higher.

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Netherlands Medications that are initiated by
specialists are continued by G.Ps. G.Ps admit
that their prescribing behaviour partly results
from repeat prescriptions by specialists.   Commun
ications between specialists and G.Ps are
crucial.