Course outline

COURSE OUTLINE

Welcome to the Clinical Medicine Courses !!!

You are to study one of the fundamental courses in clinical medicine. Clinical medicine is important in the sense that nearly more than 75% of clinical cases you see in a hospital practice are medical cases and it requires in-depth physical examination skills, diagnostic and therapeutic skills and upto date knowledge and clinical management strategies. Moreover, without a clinical examination skill, you cannot investigate a clinical case in other clinical areas like gynaecology or surgery. Therefore this course is of atmost importance to your every day practice in the future.

Instructional Goals

Students will begin identifying and accumulating the specialized knowledge, skills and resources needed for the practice of Veterinary Medicine. This course examines the causes and effects of important diseases of food animals and companion animals in India, with an emphasis on ruminant animal medicine. Elements of physiology, pathology, epidemiology, microbiology, nutrition, and production management are integrated into a health management approach emphasizing disease prevention. The course is directed at undergraduate clinical students with interest in, and knowledge of, farm animal medicine and companion animal medicine.

Course Objectives

At the end of the course, students should be able to:

  • Describe health and disease in the context of health management
  • Describe the association of common diseases with sub-optimal productivity or welfare
  • Identify the relative importance of common diseases of common farm and companion animals
  • At a basic level, explain the risk factors, etiology, clinical signs, interrelationships, and approaches to clinical and preventive management of common diseases of common farm and companion animals prevalent in Indian veterinary practice situations.
  • To independently undertake physical examination, diagnostic investigations, diagnosis and prognosis and clinical management.

Clinical Course Practicals are an important component of your veterinary training. This is where you develop the clinical skills you will need in practice and the vast majority of you will work to a greater degree in farm animal practice and a lesser degree in small animal practice. The Clinical Practicals will be oriented with the activities of the Teaching Veterinary Hospitals and you would get a thorough grounding in farm and small animal medicine. The success of the practical learning, however, depends on your attitude; the more you contribute the more you will learn. It is worth emphasising that there is a wealth of material, case records etc, for you to use in the Teaching Veterinary Hospitals and what you get from the clinical practicals is very much a function of you.

Expectations

  • You are expected to be familiar with these guidelines before you start each clinical practical.
  • You should behave as, particularly to clients, an ‘almost veterinarian’ instead of simply a clinical veterinary student. A clean white coat and appropriate name badge (stating your name and that you are a veterinary student) are mandatory. Reasonable personal discretion in your dress is fine but casual clothes, e.g. jeans, sandals, trainers etc. are NOT acceptable. Our clients’ first impressions are all important and you must, therefore, appear and behave in a professional manner at all times.

Equipment Required

  • Clean white coat
  • Name badge
  • Digital thermometer
  • Stethoscope
  • Scissors (blunt ended preferably curved)
  • Watch with second hand
  • Pen and note book
  • Pen torch and artery forceps

DESIRED LEARNING OUTCOMES

General Objectives

  • Professional conduct and appearance.
  • Competent history taking and clinical examination.
  • Problem orientated approach.
  • Record keeping (case reports, lab records, case summaries).
  • Communication skills (clients, clinicians, nurses, office staff, fellow students).
  • Presentation skills – daily rounds.
  • Case diaries of cases seen in hospitals.

Laboratory Objectives

  • Perform PCV, TP, & Staining.
  • Basic cytology – make and read blood smear and pull slide of needle aspirate, ear swab slide, rectal scrape slide, skin scrapes and cytology etc.
  • Know how to interpret haematology, serum chemistry and urinalysis reports.
  • Have some understanding of “special tests” – e.g., indications and performance of bedside diagnostic tests like white side test, California mastitis tests, etc.

CLINICAL MEDICINE SPECIFIC OBJECTIVES

Knowledge

We expect you to be familiar with your lecture notes from the preclinically taught course before you start the clinical practicals and rotations. The clinical practicals and rotations are an opportunity to apply this knowledge to problem solving in clinical cases.

  • Medical ‘problems’ – be able to discuss the approach to the following problems:
    • Weight loss Pruritus
    • Pyrexia of unknown origin Alopecia
    • Seizures/syncope Scaling
    • Coughing Ulceration and crusting
    • Nasal discharge PU/PD
    • Ascites Urinary ‘incontinence’
    • Diarrhoea Heart murmur
    • Ataxia/paresis/paralysis Masses and neoplastic lesions
    • NB – this is not an exclusive list
  • Be able to decide on appropriate drugs and calculate dosages for infectious diseases, immune mediated diseases, gastrointestinal, urinary, respiratory, reproductive, dermatological, endocrine and cardiac disorders. Understand the concepts of chemotherapy.
  • Be able to select an appropriate fluid therapy regime and rate.
  • Be able to decide on an appropriate diet/nutritional supplementation, route and quantity. Understand the use of parenteral and enteral nutrition. d. Understand basic concepts of and indications for diagnostic imaging techniques.

Skills

  • Be able to carry out:
    • Physical examination including neurological, otic and basic ophthalmological examinations
    • Venipuncture: jugular and cephalic (and saphenous)
    • Subcutaneous and intramuscular injections
    • Venous catheterisation
    • Cystocentesis
    • Urinary catheterisation
    • Rectal examination – recognise normal/abnormal
    • Enema administration
  • Understand how (or be able to):
    • Nasogastric tube placement
    • Thoracocentesis and chest drain
    • Transtracheal wash
    • Joint tap
    • CSF collection
    • Fine needle aspirate
    • Abdominocentesis
    • Blood transfusion
    • Perform and read ECG
  • Understand the indications for and concepts of:
    • Radiology, including contrast studies
    • Endoscopy and colonoscopy
    • Ultrasound examination
    • Know when to refer a medicine patient to surgery
Last modified: Monday, 28 May 2012, 6:02 AM