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Medicine Final Year MBBS Assessment

Method · December 2022

DOI: 10.13140/RG.2.2.17750.73286

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 2022-2023
Medicine Final Year MBBS
Assessment
Rawalpindi Medical University, Rawalpindi

Dean Medicine & Allied, RMU

This booklet has been extracted after modification from the various documents focusing

Rawalpindi medical University, Rawalpindi curriculum of Final Year MBBS. The assessment

methodology tailored to intuitional strategy is provided in details.

Professor Muhammad Khurram

 Final Professional MBBS Examination

Rawalpindi Medical University Scheme

Theory Clinical & Practical Internal Total

28% of total marks 42% of total marks Assessment
40% of Theory + Clinical & Practical Uniform, standardized (30%)
60 % of Theory + Clinical & Practical

140 210 150 500

Paper I Paper II Structured Clinical Evaluation
70 70
MCQs SEQs MCQs SEQs Long Case Short Cases Practical
45 5 45 5 3 stations 4 stations 5 stations
(1 number (5 number (1 number (5 (20 numbers (20 numbers (14 numbers
each) each each) number each) each) each)
each
Numbers Number
45 25 45 25 60 80 70
 Final Professional MBBS Examination
Written Component- Table of Specification
Paper I
Topic Distribution MCQs- 45 SAQs- 5
1 Respiratory Medicine 7 1
2 Cardiovascular Diseases 7 1
3 Gastroenterology and Hepatobillary Diseases 7 1
4 Neurology 6 1
5 Rheumatology 6 1
6 Hematology 6
7 Poisoning 6

Paper II
Topic Distribution MCQs- 45 SAQs- 5
1 Infectious Diseases 7 1
2 Endocrinology including Diabetes Mellitus 7 1
3 Nephrology 7 1
4 Acid Base, Water and Electrolytes Disorders 6 1
5 Psychiatry and Behavioral Sciences 6 1
6 Dermatology 6
7 Critical Care 6

Both Papers
MCQS 90= 90 numbers SAQs 10= 50 numbers 140 numbers
 Clinical & Practical Component Breakup

1 Long Case History 20

2 Long Case Examination 20
3 Long Case Discussion/Management 20
4 Short Case Respiratory 20
5 Short Case CVS 20
6 Short Case CNS 20
7 Short Case GIT 20
8 Work Book, Log Book 14
9 ECG, Instrument, Medication 14
10 X-Ray and CT Scan 14
11 Counseling 14
12 BLS 14

 All candidates will take history, examine a clinical system or component, do counseling, perform BLS related activity, and get review of Work and
Log Book etc with reference to uniform written command in specified time,
 Information to Examiner/Key based assessment of each student will be done e.g., evaluation of clinical examination general demeanor,
examination technique, examination findings, likely differential diagnosis based on the finding, probable causes and severity of the condition etc
will be focused keeping in mind clinical scenario.
Clinical and Practical Component Cycle

1 2 3
Long Case Long Case Long Case
History Taking Examination Discussion/Viva Voce

12 OSCE 4
BLS related Short Case- Respiratory
Final Year MBBS

11 5 minutes/station 5
60 minutes’ minimum cycle,
Counseling Short Case- CVS
can be increased with Rest
Stations
Total Marks 210
Station 1-7= 20 numbers each
Station 8-12= 14 numbers
each

10 6
X-Ray & CT scan Station Short Case- CNS

9 8 7
ECG, Instrument/Medication Log Book, Work Book Short Case- GIT
 Internal Assessment- RMU
Details and marks distribution
Clerkship- Unit/Ward Wise 1st Medical Unit 2nd Medical Unit Cardiology Psychiatry Dermatology Radiology

Assessment 20 20 5 5 5 5 60

A- Work Place Based (WPBA)-

50%
+
B- Ward Test (WT)- 50%
EBE
It will comprise clinical (40 marks-50% of total EBE marks and MCQ (40 marks- 50% of total EBE marks similar to framework of 80
Final Professional Examination in Medicine
CPC
Attended≥75% 10marks 10
Attended >75% Zero mark
Total 150
*Unit/Ward assessment will be rounded.
 A student having publication (Medicine & Allied related) in non-predator Journal during Final Year MBBS
period will get extra 7.5 marks. Addition of these numbers will not be over and above total 150 numbers.
Credit of these marks cannot be taken in other subjects.
 There is no compensation for attendance for missed period(s) of clerkship. Remedial learning can only
be used to make up for compensation of clerkship objectives not attendance.
 Internal Assessment 150 Marks
% Wise Breakup

Component % of Internal Assessment

EBE- 80/150 53.3%

Clerkship- Unit/Ward assessment- 40%

Work Place Based (WPBA) and Ward Test (WT)

Assessment 60/150

CPC 10/150 6.7%

*Publication- 7.5/150 5%

 Details have been provided in previous page

 CLERKSHIP- UNIT/WARD WORK BASED ASSESSMENT (WBA) AND WARD TEST (WT)

MARKING DETAIS IN ONE MEDICAL UNIT (20 Marks)

WBA- 10 marks (50%) WT - 10 marks (50%)

2 Case Clinical Work Book assessment 6 Evening duties in in Ward/ER

Presentation/morni (5 Case Write Ups on Work Book)

ng report

4 3 3 10

5 Complete Case Write ups Attended all

Yes -3 Yes -3

No, <5- Zero No, <6 – Zero

20% 15% 15% 50%

Subspecialties will reduce components to 5 keeping in mind 1 week duration compared to 4 weeks of one Medical Unit
 End Block Examination (EBE)

 End Block Examination (EBE) has been devised for assessment of three months

Rotation/Clerkship. It has undergone a number of modifications over last few years. A lot of

effort has been done to make it uniform and standardized keeping in mind attachment of

Medical Students to more than one hospital and Ten Departments.

 It will be held at the end of each Block (after 12 weeks) on last working days.

 It will include theory (MCQs and SAQs- 40 numbers) and clinical (OSCE- 40numbers).

 MCQ and SAQs component will be according to Final RMU Examination pattern.

 OSCE will be the same as RMU Final professional Examination Clinical and Practical

Component as given in next component.

 Pass marks are 50%. Both theory and clinical components have to be passed separately
 End Block Examination (EBE) - 80 numbers
Written Component- 40 Numbers
It will include 40 MCQS, each of 1 number

It will be held after CPC on Wednesday in last working week.

Table of Specification
Topic Distribution MCQs-40 each SAQs- 5
of 0.5 numbers Each of 4
numbers
1 Respiratory Medicine 4 1
2 Cardiovascular Diseases 4 1
3 Gastroenterology and Hepatobillary Diseases 4 1
4 Neurology 4 1
6 Psychiatry and Behavioral Sciences 3 1
8 Dermatology 3
5 Endocrinology including Diabetes Mellitus 3
7 Infectious Diseases 3
9 Critical Care 2
10 Acid Base, Water and Electrolytes Disorders 2
11 Poisoning 2
12 Rheumatology 2
13 Hematology 2
14 Nephrology 2

MCQS 40= 20 numbers SAQs 5= 20 numbers Total Theory- 40 numbers

Clinical Component Stations
It will include 12 Stations. It will be of 40 marks

COMPONENT Numbers
1 Long Case History 3
2 Long Case Examination 3
3 Long Case Discussion/Management 3
4 Short Case Respiratory 3
5 Short Case CVS 3
6 Short Case CNS 3
7 Short Case GIT 3
8 Work Book, Log Book 3
9 ECG, Instrument, Medication etc 4
10 X-Ray and CT Scan 4
11 Counseling 4
12 BLS 4
Total 40
Clinical and Practical Component Cycle

1 2 3
Long Case Long Case Long Case
History Taking Examination Discussion/Viva Voce

12 EBE 4
BLS related Short Case- Respiratory
Final Year MBBS

11 5 minutes/station 5
60 minutes’ minimum cycle,
Counseling Short Case- CVS
can be increased with Rest
Stations
Total Marks = 40
Station1-8 = 3 marks each
Station 9- 12 =4 marks

10 6
X-Ray & CT scan Station Short Case- CNS

9 8 7
ECG, Instrument/Medication Log Book, Work Book Short Case- GIT
 Final Year MBBS Clerkship- Unit/Ward Work Based Assessment (WBA)
10 Marks- (MU-II HFH Template)

Name Roll No
Batch Dates of Session

A- Clinical Work Book Assessment- 3 Marks

3 marks for 5 Complete Clinical Write ups according to Work Book components, Zero for any incomplete and<5
S No Case Diagnosis Assessed by Assessment Signature

1 Dr Faramarz Khan Complete

Incomplete

2 Dr. Noreen/Dr. Asif Complete

Incomplete

3 Dir. Madeeha Nazar Complete

Incomplete

4 Dir. Mudasar Complete

Incomplete
 5 Dir. Nida Anjum Complete

Incomplete

6 Dir. Suleman Complete

Mushtaq
Incomplete

B- 2 Case Presentations- 4 Marks

4 marks for 2 satisfactory Case Presentation/Morning Reports,
Zero for any unsatisfactory or <2 Case Presentations

S No Case Presentation/Morning Assessed by Assessment Signature

Report (Consultant Name)

1 Satisfactory

Unsatisfactory

2 Satisfactory

Unsatisfactory
C- 6 Evening Duties in Ward/ER- 3 Marks
3 marks for all attended and documented,
Zero for <6 attended and documented

Date Patient Documentation Assessed by Assessment Signature

 Composite Marks

Case Presentations Work Book 6 Evening Duties Total

Assessment
-----/4 ----/3 ----/3 ----/10

Consultant Incharge Final Year MU-II HFH Signature, Date, Stamp

Dir. Suleman Mushtaq

 Ward Test- 10 Numbers
HFH MU-I or MU-II HFH

Station Topic Topic description LOS Marks

%
1 Long case Respiratory system Able to introduce
History taking  COPD, Pneumonia, himself and polite
Tuberculosis, Asthma, with the patient
10
Thromboembolic disease,
Pleural disease, ILD Able to extract (10%)
&Sarcoidosis, Lung relevant
Cancer information
GIT
 Gastro-esophageal reflux Takes informed
(GERD), Peptic ulcer consent
disease (PUD), Acute and
chronic diarrhea, Celiac Takes detailed
disease, Inflammatory history
bowel disease, Irritable
bowel syndrome,
Colorectal carcinoma
 Acute Hepatitis, Chronic
Liver Disease(CLD),Liver
Cirrhosis, ascites & PH,
Gastric &Esophageal
Carcinoma,
Hepatocellular Carcinoma
 Nephrology
 Renal Failure (ARF),
Chronic Kidney Disease
(CKD), Urinary Tract
Infection (UTI) Water &
Electrolyte disorders,
Acid- Base disorders

2 Long case Respiratory system, GIT and Takes informed 10

Examination Nephrology consent (10%)
(same as above)
Uses correct
clinical methods
systemically
including
appropriate
exposure and
redrape

Able to pick
clinical sign
present in the
patient
3 Long case Respiratory system, GIT and Presents skillfully
Discussion/viva- Nephrology
voce (same as above) Gives correct
10
findings
(10%)
Gives logical
interpretation of
 findings and
differential
diagnosis

Enumerate and
justify relevant
investigation

Outline the
treatment plan
4 Short case Pleural effusion, Consolidation, Perform proper 10
Respiratory system lung collapse, COPD, and concerned (10%)
Bronchogenic CA, relevant clinical
Bronchiectasis, Lung fibrosis, examination
Pneumothorax according to
instructions given
in professional
manner

Systematic and
appropriate
application of
clinical methods

Able to pick
correct signs

Logically
interprets the
clinical findings
 Justifies diagnosis

Make an
appropriate
management plan
5 Short case Hepatomegaly, Splenomegaly, Perform proper 10
GIT hepatosplenomegaly, Ascites, and concerned (10%)
Jaundice, Cirrhosis relevant clinical
examination
according to
instructions given
in professional
manner

Systematic and
appropriate
application of
clinical methods

Able to pick
correct signs

Logically
interprets the
clinical findings

Justifies diagnosis

Make an
appropriate
management plan
6 Logbook/workbook Complete logbook with all 10
columns filled including daily (10%)
topic discussed, long case
presented, morning report,
procedures, investigations

Complete workbook with five

histories and morning reports
checked and signed

7 Instruments ETT, Ambu bag, LP needle, BMB Able to identify 10

needle, oropharyngeal airway, the instrument, (10%)
NG tube, Foleys catheter, IV describes
cannulas, Central venous line, indications,
Laryngoscope, chest tube contraindications
and complications
8 X-ray CXR of consolidation, pleural Able to identify 10
effusion, fibrosis, cavitation, findings, give (10%)
cardiac failure, mediastinal and diagnosis and
hilar lymphadenopathy differential
diagnosis,
enumerate
complications and
briefly describes
Treatment
9 Counseling Breaking bad news, Needle prick Able to counsel 10
injuries, Initiation of ATT, the patient (10%)
Initiation of ATT and other drugs focusing on
in pregnancy, Counseling autonomy,
regarding pregnancy related confidentiality,
medical issues beneficence,
 justice, no harm
and safety net etc
10 BLS Performance of BLS steps on Able to perform 10
simulator and related viva BLS according to (10%)
recent AHA
Guidelines
Total marks100

WT marks will be rounded to 10 for inclusion in Internal Assessment

Similar Framework will be utilized by Other Medical and Specialty Units

 MCQs

MCQ papers will include Single Best Answer (SBA) question with following distribution;
 Establishing a diagnosis (25–40%)
 Understanding the mechanisms of disease (20–35%) Applying principles of management (15–
25%)
 Promoting preventive medicine and health maintenance (15–25%)

Substantial amount of extraneous information may be given, or a clinical scenario may be followed by
a question that could be answered without actually requiring that you read the case. It is student’s job
to determine which information is superfluous and which is pertinent to the case at hand.
There are a few stems that are consistently addressed throughout the examination:
• What is the most likely diagnosis? (40%)
• Which of the following is the most appropriate initial step in management? (20%)
• Which of the following is the most appropriate next step in management? (20%)
• Which of the following is the most likely cause of . . . ? (5%)
• Which of the following is the most likely pathogen . . . ? (3%)
• Which of the following would most likely prevent . . . ? (2%)
• Other (10%)
 SAQs

Questions in this component will mostly contain a description of a patient history and examination
with or without some investigation reports e.g. CBC, Chemistry, X-Rays/ ECG etc, followed by two or
three questions.

• These require short, structured answers

• Consider bulleted points or headings and lists
• Do not attempt to put down everything you know about the subject – stick to answering the
question being asked and give common answers first before unusual or unlikely answers
• Keep a close eye on the time- it is easy to get carried away and spend far too much time on a
single part of a question

EXAMPLE

A 66-year-old man presents with chest pain. This started suddenly 2 hours previously. The pain is
central and radiates to both shoulders. He is sweaty and feels very unwell. On examination, he is
apyrexial and tachycardic with a blood pressure of 110/60.
 1. What is the most likely diagnosis?
Answer: Acute myocardial infarction
2. What two investigations would be of immediate use?
Answer: ECG and troponin
3.
4. State four immediate therapeutic steps you would institute.
Answer: High-flow oxygen, i.v diamorphine, morphine, aspirin and consider thrombolysis or
angioplasty
5. Suggest three possible complications of the therapies you suggest.
Answer: Hemorrhage, gastrointestinal ulceration, respiratory depression

When answering these questions, remember that although your answers may be correct, there may
be a better way of answering in order to show off your knowledge.

• Give a full answer to secure full marks – Acute myocardial infarction rather than Heart attack
(incomplete answer would be eligible for similarly stunted score)
• Give investigations of different modalities – ECG and troponin rather than Troponin and creatine
kinase
• Give specific rather than general treatments with differing aims – High flow oxygen rather than
Oxygen or i.v.

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