SYLLABUS
You should have an understanding of the structure and function of
chromosomes and genes and a knowledge of the principles of inheritance of
chromosomal and genetic disorders.
Examples of question topics might include:
• Inherited diseases • Chromosome structure • Common chromosome abnormalities
The cell is the fundamental unit of the structure of organs. It is important
that you understand the structure and function of the components of the
cell and its membrane. You should understand how cells communicate
internally and with each other by means of chemical substances and
membrane receptors.
Examples of question topics might include:
• Function of intracellular organelles • Cellular communication
GENETICS
CELL, MOLECULAR AND MEMBRANE BIOLOGY
Clinically relevant anatomy will be tested, including neuroanatomy.
Examples of question topics might include:
• Peripheral nerve lesions • Cranial nerve abnormalities • Dermatomes,myotomes and reflexes
It is essential that you understand the structure and function of the different
organs which make up the body and how these organs interact, such as
through hormonal and neural influences. You should know the broad
principles of metabolism such as the production of energy and the pathways
of carbohydrate, protein and lipid metabolism, but a detailed knowledge of
the chemical processes in the steps of the metabolic pathways is not
necessary. You should have an understanding of the principles of nutrition,
water, electrolyte and acid-base balance. Knowledge of the physiology and
biochemistry of each organ system is examined under that specialty.
Examples of question topics might include:
• The mechanism of blood pressure control • Acid-base balance
ANATOMY
PHYSIOLOGY, BIOCHEMISTRY AND METABOLISM
Although a detailed knowledge of basic immunology and immunological
diseases is not required, you should have a sound working knowledge of the
principles of immunomechanisms.
Examples of question topics might include:
• Humoral and cell-mediated immunity • Immunodeficiency syndromes • Phagocytic dysfunction diseases • Complement deficiencies • Hypersensitivities including allergies and autoimmune diseases
Immunology and immunological tests
You should have a basic knowledge of the immune system in health and
disease.
Examples of question topics might include:
• Common immunological laboratory tests • Evaluation of patients with immune disease • Intercellular communication and signal transduction • Lymphocyte and phagocytic cell biology • Antigen presentation • Humoral, cellular and mucosal immunity including TH1 and TH2
responses • Inflammation • Complement system and cytokines • Hypersensitivity and autoimmunity
Clinical conditions
You should be able to answer questions on the various immunodeficiency
syndromes.
IMMUNOLOGY
Examples of question topics might include:
• Mechanisms of immunodeficiency • Antibody immunodeficiency disorders • T-cell immunodeficiency disorders • Combined antibody and cellular immunodeficiency disorders • Phagocytic dysfunction diseases • Complement deficiencies
You should know the main clinical characteristics and immediate
management of acute allergic emergencies.
Examples of question topics might include:
• Anaphylaxis • Angio-oedema • Urticaria
You should be familiar with immunology as applied to other medical
diseases.
Examples of question topics might include immunomechanisms in:
• Rheumatic diseases (connective tissue diseases) • Endocrine diseases (thyroid autoimmune diseases, diabetes mellitus,
Addison's disease) • Haematological diseases (pernicious anaemia, autoimmune haemolytic
anaemia, idiopathic thrombocytopenic purpura) • Gastrointestinal diseases (Coeliac disease, inflammatory bowel disease,
hepatobiliary diseases) • Renal diseases (Goodpasture's syndrome, immune-complex
glomerulonephritis) • Dermatological diseases (discoid lupus, pemphigus, pemphigoid) • Neurological diseases (demyelinating diseases,myasthenic syndromes)
Management
You should be able to answer questions on the principles of
immunosuppressive therapy including major indications and side-effects.
Examples of question topics might include:
• Immunosuppressive drug therapy (corticosteroids, cytotoxic agents, and
cyclosporin) • Intravenous immunoglobulin • Monoclonal antibodies • Cytokine therapy • Bone marrow transplantation
You should know about the principles of immunisation and be familiar with
vaccines currently in use.
Microbiology
You should understand the major taxonomy of bacteria in terms of
Gram-staining and aerobic/anaerobic metabolism. Virus classification is
not important except for members and characteristics of the herpes group.
Virus replication with reference to retroviruses should be understood. Major
pathogenic protozoa and helminths should be known.
Examples of question topics might include:
• Aerobic or anaerobic bacteria • Gram-staining characteristics of bacteria
Immunology of infectious diseases
You should understand immune deficiency states linked with types of
opportunistic infections. Principles of immunisation and knowledge of
vaccines currently used should also be known.
Examples of question topics might include:
• Opportunistic infections • Immunisation policy
Pathophysiology
You should have a basic understanding of:
• Septic shock • ARDS • Role of cytokines in infection
Epidemiology
You should have knowledge of the principles of epidemiology relevant to
infectious diseases.
INFECTIOUS DISEASES AND TROPICAL MEDICINE
Examples of question topics might include:
• Mechanisms of transmission of pathogens • How epidemics happen • Knowledge of carrier states, reservoirs, vectors and zoonoses • Elementary concepts of the control of communicable diseases (including
immunisation, isolation, contact tracing, chemoprophylaxis of close
contacts) • Broad awareness of geographical variation in disease including TB, HIV,
Hepatitis B, malaria
Treatment
You should know the broad indications for, and major adverse effects of,
commonly employed antimicrobial agents.
Examples of question topics might include:
• B-lactams • Tetracyclines • Macrolides • Aminoglycosides • Quinolines • Trimethoprim • Metronidazole • Antituberculous drugs • Antimalarial drugs • Antiviral agents
Specific infections
Knowledge of the characteristics, recognition, prevention, eradication and
pathological effects of all commonly encountered bacteria, viruses, rickettsia,
fungi, protozoa, parasites and toxins, including an understanding of the
principles of infection control, will be required. Special attention to
differential diagnosis, appropriate investigations and awareness of when
presumptive therapy is indicated is essential.
Examples of question topics might include:
• Septicaemia • Meningitis and encephalitis • Endocarditis • Pneumonia (community-acquired, hospital-acquired, lung abscess,
empyema) • Tuberculosis • PUO (appropriate investigations, when empirical therapy might be
indicated) • Soft-tissue infection and osteomyelitis • Streptococcal infection, rheumatic fever, nephritis • Intra-abdominal sepsis • Food-poisoning (especially salmonellosis, campylo-bacter, verocytotoxin
producing E coli) • Tropical infections (especially malaria, bilharzia, amoebiasis, filariasis,
leishmaniasis, hookworm and viral haemorrhagic fevers) • Viral hepatitis • HIV/AIDS (course of typical infection; CD4 count and HIV viral load as
markers of progression; main opportunistic infections including
Pneumocystis pneumonia, CNS toxoplasmosis, cryptococcal meningitis,
tuberculosis) • Glandular fever syndrome and its differentiation from HIV
seroconversion illness • Spirochaetosis - syphilis, leptospirosis, borrelia • Toxic shock syndrome and staphylococcal infections
You should have a basic understanding of the usage and limitations of the
common statistical tests used in reporting the results of research in clinical
journals. The following lists of terms should give some idea of the range of
terms and techniques which you should understand, all of which can be
found regularly in journals such as The Lancet, British Medical Journal and
New England Journal of Medicine.
You are not expected to have any knowledge of computer packages for
carrying out statistical calculations. You may be expected to carry out simple
calculations that do not require the use of a calculator. You are not expected
to memorise formulae for statistical tests, but should understand their
conceptual basis.
The following lists are not intended to be inclusive but as illustrative of the
type of knowledge that you need to possess.
Descriptive statistics
Examples of question topics might include:
• Mean, median, mode • Standard deviation, standard error • Confidence interval • Variance • Range, quartile, inter-quartile range • Percentile • Skewness • Contingency table • Population • Missing values • Outliers
Graphical techniques
Examples of question topics might include:
• Histogram • Box-plot • Scattergram
STATISTICS, EPIDEMIOLOGY AND
EVIDENCE-BASED MEDICINE
Inferential techniques
Examples of question topics might include:
• Null hypothesis • Alternative hypothesis • Parametric and non-parametric tests • Normal distribution • Type 1 and Type 2 errors • False positive and false negative • Statistical power • One and two-tailed tests • Statistical significance, P value • T-test • Mann-Whitney and Wilcoxon test • Chi-square test for 2 x 2 contingency table • Correlation (Pearson's and Spearman's) • Linear regression • Study design
Evidence-based medicine
You are expected to have an understanding of evidence-based medicine and
an ability to apply this understanding in the management of patients.
Clinical trials
Examples of question topics might include:
• Interpretation of simple clinical trial data • Randomisation • Placebo-controlled trial • Open trial • Single-blind trial • Double-blind trial • Intention-to-treat • Bias
You will be expected to have knowledge of the following:
• Physiology, control and function of formed blood elements • Bone marrow structure and function • Applications of biochemistry, genetics, immunology, and virology to
blood disorders • Effects of age and pregnancy on blood disease • Splenomegaly, lymphadenopathy, and their causes • Principles and hazards of blood and blood product replacement therapy • Principles, but not detail, of anti-tumour chemotherapy • Principles of marrow transplantation • Adverse effects of drugs on the blood
Iron metabolism
You should have an understanding of:
• Physiology of iron, including its absorption • Iron overload • Iron deficiency states including diagnosis, causes and treatment • Iron metabolism, including anaemias of chronic disorders and
sideroblastic anaemias
Megaloblastic anaemias
You should understand the physiology of vitamin B12 and folic acid and the
mechanisms and investigation of deficiencies and their management.
Examples of question topics might include:
•B12 deficiency •Folate deficiency
Haemolytic anaemias
You should understand:
• Mechanisms of shortened red cell survival • Features and management of congenital and acquired haemolytic states
CLINICAL HAEMATOLOGY
• Molecular pathology of thalassaemia and common
haemoglobinopathies
Examples of question topics might include:
• Causes of haemolysis • Diagnosis of haemolytic anaemia
Other anaemias
Examples of question topics might include:
• Anaemias complicating systemic disease • Aplastic anaemia • Myelodysplastic syndromes
Polycythaemia and myeloproliferative disorders
You should know the causes, investigation and management of
polycythaemia and myeloproliferative disorders.
White cell disorders
You should understand the:
• Physiology of leucocytes • Leucocytosis and leucopenia • Acute and chronic leukaemias, including diagnosis, management and
prognosis • Lymphoproliferative diseases including Hodgkin's disease, non-Hodgkin’s
lymphomas, and plasma cell dyscrasias
Disorders of haemostasis
You should possess knowledge of:
• Platelet function and coagulation • Thrombocytopenia and impaired platelet function • Thrombocytosis • Common congenital and acquired disorders of coagulation (especially
anticoagulant therapy and disseminated intravascular coagulation)
You are expected to have a good knowledge and understanding of the
principles of clinical pharmacology, therapeutics and clinical toxicology.
Pharmacology
You should understand the:
• Mechanisms by which drugs produce their pharmacological effects • Basic principles of agonism and antagonism • Clinical implication of drugs that act at different receptor sites • Links between the pharmacological effects of drugs at the molecular
level, the cellular level, and the tissue/organ level, and how these are
affected by disease processes and other drugs • Principles by which both therapeutic and adverse effects occur
Clinical pharmacokinetics
You should understand the principles that underlie:
• Processes of drug absorption and distribution • Biotransformation and excretion • Concepts of drug half-life and clearance • First order and zero order kinetics
Application of this knowledge to clinical situations is necessary but detailed
kinetic calculations will not be required.
Monitoring drug therapy
You should understand the principles that underlie the monitoring of drug
therapy including:
• Direct measurement of therapeutic response • Measurement of plasma drug concentrations • Knowledge of the scientific basis for the measurement of drug
concentration and its link to the principles of pharmacokinetics
CLINICAL PHARMACOLOGY, THERAPEUTICS AND
CLINICAL TOXICOLOGY
Emphasis will be given to the areas of clinical practice and therapeutics
where the narrow therapeutic range of particular pharmacokinetic
properties of the drug make this approach important.
Adverse drug reactions
You should have an understanding of the epidemiology of adverse drug
reactions and know how to recognise and avoid them. You must also be
aware of important adverse effects of commonly used drugs and have an
understanding of the importance of adverse drug reaction reporting
schemes.
Drug interactions
You should have an understanding of the epidemiology of adverse drug
interactions, and of the mechanisms by which interactions may occur. You
should also have a knowledge of common drug interactions and their clinical
consequences.
Pharmacogenetics
You should understand the principles of pharmacogenetics and its
importance in determining variations in response to drugs in man, both in
terms of efficacy and toxicity. You should have knowledge of the clinical
consequences of the common pharmacogenetic variations relevant to
clinical practice.
Therapeutics for specific patient groups
You should understand the principles of therapeutics as they apply in the
following circumstances:
• The elderly • Pregnancy and breast feeding • Patients with renal disease • Patients with hepatic disease
You should understand that the altered physiology in these patient groups
may affect the pharmacokinetics and pharmacodynamics of drugs. You
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should know the principles underlying drug choice, in pregnancy and breast
feeding, and have an understanding of the teratogenic effects of drugs that
may be used in pregnancy. In the case of renal and hepatic disease it is also
necessary for you to have an understanding of drugs that may produce
toxicity of these organs and whose use is particularly affected by disease of
these organs.
Clinical toxicology
You should understand the principles of management of patients who have
been poisoned with drugs or other toxic substances. This should include
assessment, recognition of common symptom patterns, principles of
removal of toxic substances, and their antidotes where these approaches
may be appropriate.
Examples of question topics might include:
• Paracetamol poisoning • Salicylate poisoning • Tricyclic antidepressant poisoning • Lithium poisoning • Iron poisoning • Digoxin poisoning • Intoxication due to drugs of abuse
Criteria for selecting drugs in a therapeutic class
You should understand the criteria that may be used to select a drug from
among drugs in a popular therapeutic class. This would include:
• Differences in pharmacokinetics and pharmacodynamics • The approved indications of the drug • Possible adverse effects or drug interactions • Cost effectiveness
You should also be aware of the nomenclature used in describing studies
that may be used to underpin drug selection.
Drug formulations and routes of administration
You should be aware of the various formulations of medicines available, and
of the routes by which medicines may be administered. You should also
understand the advantages and disadvantages of various routes and
preparations. From this knowledge, you would be expected to be able to
select the most appropriate formulation and route of drug administration in
common clinical scenarios.
Detailed knowledge of all the rheumatic conditions is not required.However,
you should have a sound working knowledge of the basic principles of the
common musculoskeletal conditions.
Examples of question topics might include:
• Inflammatory arthritis • Back pain • Periarticular disorders • Osteoarthritis • Connective tissue diseases • Bone diseases
Clinical science
Basic physiology, biochemistry, anatomy and pathology relating to
musculoskeletal disease should be known.
Examples of questions topics might include:
• Physiology of pain • Physiology of inflammation • Urate metabolism • Bone metabolism • Applied anatomy, particularly of cervical and lumbar nerve roots, and of
peripheral nerves commonly involved in disease
The pathology of the common rheumatic conditions should be known.
Examples of question topics might include pathological findings in:
• Rheumatoid arthritis • Osteoarthritis • Connective tissue diseases • Bone diseases
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