Syllabus for FCPS - Paediatrics
ThBIObJective of FCPS- Paediatrics will be to ﬁnd out person who :
— Isfafle and w‘umg to take responsibility for the management
0 a 1 range of acute and chronic condition in paediatrics,
_ h,as the ability to adopt a problem-solving approach to clinical
_ ls able .to plan and interpret a program of investigation
aPpi‘opriate to the clinical situation with due regards to
patients Comfort, safety and economic capability,
_ ha_s the up to Slate knowledge on the recent developments in
allied branches and the skill of using the available technology
for the betterment of the sick child,
-— is aware of the role of the paediatrician in health/welfare
professmnal team and the society and has the willingness to
work co-operatively within such team,
' —- has acceptable communication skill for patient-doctor,
relation-doctor, nurse-doctor and doctor-doctor relation,
— has the intention for maintenance and further development of
own knowledge and skill through continuing education.
Evaluation of the necessary knowledge and skill will be assessed
through two stages: .
Part-I : This part will assess the basic knowledge and skill
appropriate for the subject. This will include applied basic science
as detailed below in the course content together with behavior,
attitude and communication skill. These aspect will be assessed
Part-II : This part will assess advanced skill of data collection
(both clinical and laboratory), interpretation, judgement and
decision making. This will be evaluated through:
‘ Clinical examination
Structured oral examination/ OSCE
The Part-I examination will comprise 0f fonowing three written
- paperJ; Anatomy, Behavioral Science, Medical Statistics and
_ PaperJI; Physiology, Clinical Biochemistry and Clinical
- Paper-III: Pathology (Microbiology, Immunology, Virology,
Genetics, Molecular biology and Histopathology)
In the following section the course content for each paper is
elaborated sometimes showing the functional aspect of it. Each of
the paper ends with a table showing distribution of question for
theory paper on each section.
Paper - I .' Anatomy, Behavioral Science, Medical Statistics and
Points to remember :
0 Following are the course content for FCPS part-I in
Paediatrics in paper-l. The contents should be approached
which is relevant to Paediatrics discipline and not for surgical
or other true basic science discipline. ' ,
o In the study of different parts/organs blood supply, 13$~ phatic
drainage, structural relations are excluded (except in places
clearly mentioned in the content). However, nervous and
endocrine controls are retained.
0 Identification of viscera and body parts are excluded from the
Cell biology : structural details of a cell with functional
implications, cell cycle, cell division and its anomalies.
Recommended reading: Basic Histology - Junqueira; Basic
Histology -Ross; Gray '3 Anatomy
Developmental anatomy (general): Anatomical relevance of
the followmg phySiological aspects~ period of life, teratogenesis,
sensitive period of life, fetal circulation and changes at birth,
placental function, multiple pregnancy and general and
proportional growth and development of body features from birth
(as differentiated from adulthood) with emphasis on sexual
maturity. , '
Recommended reading: Embryology - Langman's and Moore '8
_ Developmental anatomy (Special) : development of important"
parts and organs, specially the gonads, vital organs and bones;
mechanism of developmental anomalies of different organs.
Recommended reading: Embryology - Langman's and Moore's
General anatomy (systemic approach to the body
Basic ideas on tissues
Osteology- histology, development and its anomalies, important
Angiology including lymphoid system- circulation through special
organs like brain, heart, kidney, liver, spleen, gut and lungs.
General plan of the lymphatic drainage, and important groups of
clinically 1mportant lymph nodes and there drainage region.
Recommended reading: Basic Histology - Junqueira; Gray's
Topographic anatomy (including surface anatomy) :
General body features including secondary sex characteristics;
‘ topographic anatomy of different parts and organs of a child
including the variation in a newborn (in practical examination
relevant topics will be assessed by using bones, viscera, model and
Recommended reading: Gray '3 Anatomy
Histology : Light, dissecting and electron microscopic features
and their functional implications of following structures - liver,
kidney, GI tract, pancreas, respiratory passages and alveoli,
endocrine glands, heart, blood vessel, muscles, lymphoid organs
(the learning objective of this chapter will be to learn the general
histology covering the functional principle of the 4 basic tissue. In
practical examination these parts will be assessed using projected
photomicrograph and printed photographs).
Recommended reading: Basic Histology - Junqueira; Basic
Histology - Ross.
Clinical Neuroanatomy: Central and peripheral nervous
system with special importance on the development and related
anomalies; anatomy of the common injury including birth injuries,
clinical neuroanatomy in relation to joint movement.
Recommended reading: Snell and book of NMS series.
Sectional anatomy and anatomy of imaging : basic of
sectional anatomy of different parts/organs relevant to paediatrics
helping to identify the normal appearance leading to
identiﬁcation of organ or its parts and the abnormal situations
(Radiograph, USG, CT and MRI materials are to be used for
relevant anatomy ofimag'ing).
Recommended reading: Caffey's Paediatric Radiology, relevant
introductory section in Nelson/Forfar textbook ofPaediatrics
Basic anatomy of relevant physiological processes and
related disorders : respiration, sucking, swallowing, vomiting,
nasal regurgitation, peristalsis, defecation, micturition, walking,
vision, hearing, equilibration, olfaction, taste, reﬂexes. V
Recommended reading: Moore Clinical Anatomy, Ganong's
Anatomy relevant to clinical procedures and related
problems : lumbar puncture, tracheostomy, laryngoscopy,
otoscopy, venepuncture, liver biopsy, renal biopsy, I
peritoniocentesis and thoracocentesis. '
Recommended reading: Moore Clinical Anatomy, Hutchison's
Behavior science, medical ethics and communication
There has to be some brief introduction of the' topic initially and
elaborated in the second part. Later on most ofit shall be covered
in ﬁrst part. Communication skill to cover both patient-doctor,
doctor-attendant, doctor-doctor and doctor to other professionals
in the ﬁeld.
Medical statistics : Definition of different terms commonly used
in the practice, basic concepts, fundamentals of biostatistics and
epidemiology, sampling, data, analysis, frequency tables, central
tendency and measure of dispersion, distribution probability, test
of probability, signiﬁcance, confidence interval, data presentation,
Recommended reading: Essential of Medical Statistics, By Betty
Kirkwood, by Bradford-Hill
Format of examination :
It will comprises of
W 'tt ' ' . . .
CO::3retrl::xam:n::0n ' The Questions 1n general anatomy should
d.“ par 5 at are relevant to paediatrics. Distribution of
l erent parts of anatomy to be represented in the written
question are as follows ;
1. Cell biology 34
2 Developmental (general and special) anatomy 6-8
3. General anatomy and Topographic anatomy 6-8
4. Histology 3_5
5. Clinical neuro-anatomy 5
6. Sectional anatomy and anatomy ofimaging 4-6
7. Anatomical basis of procedure and related problems 4-6
8. Anatomy of physiologic processes and disorders 4-6
9. Behavioral science, medical ethics, code of conduct 3
10. Medical Statistics 3
Paper-II: Physiology, Clinical Biochemistry and Clinical
Points to remember:
Cl Following are the course content for FCPS part-I in
Paediatrics in paper-II. The contents should be approached
which is relevant to Paediatrics discipline and not for true
basic science discipline.
C] The study shonld be directed in understanding of the 'baSIC
physiological processes in relation to speciﬁc clinical entity so
that one understand the pathophySiOIOgy 0f the dlsease
process clearly in later part.
A. PhySiOIOgy . . - ' leCt lar b' l v ~
Cell/membrane Physmlogy "winding mo 1 '1 1110‘ 0g? T
F t. 18 of each organelle mcludmg t ieir re ationship;
unc 101 ~ . ‘
Intercellular communication and receptor diseases,
Recommended reading .' Ganong “31040”
Pathophysiology of body fluid, electrolytes and there
derangement: _ . _ _
Body fluid compartments and its relevance in clinical practice.
Physiology of important solutes (sodium, potassium, chloride,
phosphate, calcium) and impact of there derangement.
Buffering system including acidosis and alkalosis and their
Consequences of fluid, electrolytes and acid/base disturbances on
Recommended reading: Ganong/Guyton, Nelson/Forfar
Physiology of Growth and Development :
Period of life including puberty, teratogenesis, sensitive period of
foetal life, theory of growth and development, factors influencing
growth/development, concept of growth curve, measuring growth,
fetal circulation and changes at birth, placental function,
physiological derangements in specific growth and developmental
- disorders, multiple pregnancy and development of general body
features and proportion.
Recommended reading: Nelson /Forfar
Physiological processes and there clinical application
0 Respiratory system- respiration including its regulation,
surfactant, respiratory membrane, types of respiration,
production of breath sound and there variants, lung function
test and its interpretation in different situation, cough,
acidbase balance and respiratory system, principles of oxygen
therapy, pathophysmlogy of hypox1a and respiratory failure.
0 Gastrointestinal system - physiology and disorder of gut
motility, mucosal protection of stomach, digestion and
absorption of different food components, liver function, bile
production and metabolism, iaundice, liver function test and
there. interpretation 111 different situation, pancreatic
function, gut hormones, mechanism of abdominal pain.
. Cardiovascular system - properties of Cardiac muscle, cardiac
cycle, conduction pathways, ECG, blood pressure, pulse,
cardiac arrhythmia, hemodynamics and correlation with
' Doppler/ECHO, peripheral circulation, circulation of brain,
kidney, liver, lungs and GI tract, pathophysiology of heart
failure, oedema, shock and dyspnoea.
. Hemopoietic system - constituents of blood and there
importance, hemoglobin formation and metabolism,
hemopoiesis, factors controlling hemopoiesis, iron kinetics,
pathophysiology of anemia, hemolytic disorder, bleeding
disorder and coagulation disorders.
0 Nutrition - micro and macronutrients-deﬁnition, function,
deﬁciency, physiological derangement in malnutrition of
different nutrient, measuring nutrition, dietetics
0 Renal System -- glomerular and tubular functions, water-g
electrolyte balance, formation of urine, micturition and its
0 Musculoskeletal system - muscle contraction, physiology of
bone formation, factor influencing it and its disorder.
, 0 Endocrinology - physiological role, control of secretion,
_ metabolism, feature of hypo and hyper function, test for
functioning status of— thyroid gland, pituitory gland, adrenal
gland, parathyroid gland, pancreas and gonads. Also includes
I physiology of pregnancy, parturition, breast milk and breast
feeding, diabetes mellitus and puberty.
I Recommended reading: Ganong/Guyton, Nelson /Forfar
Physiology of imaging:
Principles of X-ray, CT, MRI, PET, USG, ECHO, Doppler, Isotope
' and other scanning of thyroid, kidney, liver, brain, bone, etc.
Recommended reading: Relevant section, in the introductory chapters
in different systems in Nelson/Forfar
Physiology of speech, disorders of speech - mechanism, tests.
Physiology of smell and tests of smell function.
Physiology of vision- visual path, light and accommodation reﬂex,
visual ﬁeld, color vision, and tests for above functions and their
Hearing and eQUilibrium- tests and interpretation of their
Physiology of taste and the tests for taste.
Motor neurone- upper and lower, physiology of deep tendon
TeﬂexeS, superﬁcial reflexes, primitive reﬂexes and withdrawal
supeFﬁCial and deep pain, visceral sensations, referred pain,
taCtile localisation, two point discrimination, steriognosis.
Functions of basal ganglia and cerebellum - posture, balance and
111115619 tone, physiologic principle of coordination, ataxia.
Hypothalamus - secretion, functions and there control, physiology
0f hunger, thiFSt, bOdy temperature. Physiologic basis of tests to
measure the different functions.
CSF .— production, control, function, circulation and physiological ‘
consequences of abnormalities. Physiological basis of EEG. ‘
Recommended reading: Ganong/Guyton, Nelson/Forfar ‘
B. Clinical Biochemistry 1
Physiologic and clinical signiﬁcance of important steps and I:
regulation of glycolysis, citric acid cycle, gluconeogenesis, ‘
glycogenesis, glycogenolysis and HMP shunt.
_ Physiologic and clinical significance of important steps and '
regulation of lipogenesis, lipolysis, ketogenesis, cholesterol
Physiologic and clinical significance of important steps and ‘
metabolism of phenylalanine, tyrosine, methionine, tryptophan. ‘
Folic acid and vit B 12
Purine metabolism and formation of uric acid 4
Glycoproteins proteoglycan and mucopolysaccharoidoses
Metabolism - Basal metabolic rate and factor inﬂuencing it
Collagen — types and principles of synthesis
. . . . I1
Prmc1ples of commonly used biochemical tests and factors (both l
physiological and procedural) that may affect the test. '
Recommended reading: Harpers textbook of Biochemistry an"
relevant section in the introductory chapters on different system
V Basic pharmacology:
tion, di t 'b ' . .
Drug absorp s n ution, e] . I
tion half life. peak and t ‘mma‘m’ mechanism of drug
‘ ac _, . rough level, dose r ,
, principle of therapeutics, esponse relation,
Pharmmongy of some Commonly used drugs -
pharmacological effects, classiﬁcations, me'chanism f ,
side greets fand Clrug interaction of the follow'0 acuons’
analgesmé/antlpyretlcw antimicrobials and antihelm‘mgl drugs.-
°h°1‘“‘?’g‘°’ Smathémimmeucs, drugs used in p13“? ‘2”
diuretics' antlhlStammesv brOIIChOdilatorS, laxativesp vitdliifijs
and mmerals, hormones’ hypOglycaemic agents, anticohvulsant
Recommended reading: Basic d ' 4
Katzung an Clinical Pharmawlogy by BG
Format of examination : ‘
It will comprise of
The written part will be assessed with MCQ. Questions shall be '
mostly clinical use of basic science knowledge rather than true,
physiological processes or biochemical reaction etc. Distribution of
different parts to be represented in the written questions are ;
1. Cell physiology and molecular biology 4-5
2. Pathophysiology of body fluid, electrolytes
and there derangement 3-5
3. Physiology of growth and development 4-5
4. Endocrinology 4-6
5. Physiological processes & its clinical application 10—15
6. Physology ofimaging 2‘3
7. Neurophysiology 6‘7
8. Clinical biochemistry 5'6
9- Clinical pharmacology 6‘8
Paper-III: Pathology (Microbiology, Immunology, Virology, '
Genetics, MOICCular biology and Histopathology) Points to
0 Following are the course content for Paediatrics FCPS part-1
in paper-III. The contents should be approached which is .
relevant to Paediatrics discipline and not for true basic science
discipline or other clinical subjects.
General pathology : The following conception are to be
correlated with different clinical entity- cellular injury and death,
inﬂammation and repair, granulomatous disorder, neoplasm,
thrombosis, embolism, oedema.
Principles of commonly used cytological and histopathological ,
investigations, factors affecting the quality of specimen and
reporting scope and limitations of such investigations
Immunology : basic principles, concept of host-agent- ‘-
environment, mechanisms of immunity and auto-immunity, .
immune mediated diseases including graft versus host and tumor ‘
immunity, pathological basis of different investigative tools ‘
available based on immunological principles. ‘
Genetics and molecular biology : basic concept, molecular
- basis of diseases, genetical basis of diseases, investigative tools
available for these, their uses and limitations, pedegree analysis, ’
genetic counseling principles.
Special pathology : A student will be expected to know the _‘
following of the individual pathological situation enumerated J
0 Site of lesion including the microstructure
0 General pathological description of the type of lesion I
0 Functional derangement following the lesion I2;
0 Micro-structural and chemical changes of the lesion
0 Pathological explanation of presenting feature
Respiratory system .' Pneumonia, bronchiolitis, tonsillitis, :
bronchial asthma, lung abscess, bronchiecstasis, pleural effusion.
Haematology and Oncology .' Anaemia (nutritional, hemolytic,
haemorrhagic and others), bleedng disorder (ITP, hemophilia»
- ' leb ' .
Von W11 rands disease), Hodgkins and non_H0d kins
Lymphoma, leukaemia Wilm t i g
neuroblastoma ’ S UmOI‘, retmoblastoma,
Cal‘dm‘fascuza".Systefn .' Rheumatic heart diseases, congenital
heart diseases, infective endocarditis. _
Central nervous System I Meningitis, encephalitis, GB syndrome,
Gastrointestinal system ; Hirschsprung diseases, appendicitis,
hepatltls ' acute & Chronic, cirrhosis ofliver, portal hypertension.
Gen‘m'urmar)’ ' system .' Urinary tract infection, acute
glome'rulonephnusi nePhrotic syndrome, acute renal failure,
chronic renal failure.
Collagen disorder : Acute rheumatic fever, JCA.
NUtritional diforC-Zer .‘ PEM, macro and micro nutrient deficiency
syndromes, iodine deficiency disorder, rickets, scurvy,
Neonatology .' Low birth weight, respiratory distress syndrome,
TORCH infection, neonatal 'aundice, birth as h xia, hemorrhagic
. J p y
disease of newborn.
Inborn error ofmetabolism : Phenylketonuria, Galactossaemia
Endocrinology: Thyroid - hypo and hyper function, pituitory
,anterior and posterior - hypo and hyper function, Pancreas -
diabetes, adrenal gland — adrenal hyperplasia,
Recommended boo/es: Relevant section in Robbin's Pat/lologic
Basis of Diseases, Jawetz, Melnick and Adelberg's Medical
Microbiology and Nelsons/Forfar Textbook ofPaediatrics.
B. Bacteriology '
0 Basic bacteriology: Classification of microbial agents, normal
microbial ﬂora in human body, infection, sepsis, septicemia,
bacteraemia, spread ofinfection, control of infection.
0 Bacterial culture, principles of bacterial grthh, CUltUFe
media, principles of serological techniques used . in
bacteriology, scope and limitation of bacteriological studies,
collection and preservation of sampleS.
O Pathogenesis and laboratory diagnosis of-
Typical/atypical mycobacteria, diphtheria, pertusis, tetanus,
pneumonia, enteric fever, meningitis, tetanus, gangrene, 'I
gonorrhoea. dengue, syphilis including congenital infection, 1
staphylococcal and streptococcal infection, secretary and =
. . _ I
0 Infection and immunosuppression :
Recommended books: Relevant section in Nelsons/Forfar Textbook
of Paediatrics and Jawetz, Melnick and Adelberg's Medical
0 Basic virology : viral structure, classiﬁcation, replication,
mode of transmission, pathogenesis and diagnosis of viral
0 Pathogenesis and diagnosis of diseases cause by-
Adenoviruses, Herpesvirus, Hepatitis virus, Rotavirus, Rabies
virus, Slow virus, Reovirus, Arbovirus, HIV, Measles and
rubella, mumps, poliornyelitis
0 Viral infection in congenital or acquired immuno-
Recommended books: Relevant section in Nelsons/Forfar
Textbook ofPaediatrics, Medical Microbiology.
0 General parasitology: classification of parasites, transmission,
infestation, body response to infestation, pathological basis of
different laboratory diagnosis.
0 General features of rhizopodes, ﬂagellates, nematodes,
cestodes and trematodes.
0 Life cycle of parasites, pathogenesis and diagnosis of diseases
caused by- malaria, leishmaniasis, toxoplasmosis,
pneumocystosis, ascariasis, ankylostomiasis, strongyloidiasis,
enterobiasis, ﬁlariasis, taeniasis, echinococcosis, sarcoptes
Recommended books: Relevant section in Parasitology by
Chatterjee and Nelsons/ F orfar Textbook of Paediatrics.
r - -W
E. Mycology ‘ ~
0 General mycology : properties of fungus, claSSlﬁcatlon 0‘
fungi, laboratory diagnosis of fungal diseaSCS-
° Pathogenesis, clinical consequences and laboratory diagHOSlS
of superﬁcial and cutaneous mycosiS, deep IDYCOSIS
Recommended books: Relevant section in Nelsons/Forfar Tc-TtbOOk
Format of examination in pathology:
It will comprise of
The written part will be assessed through MCQ assessing the
clinical use of basic science knowledge rather than true
Distribution of different parts in the written questions.
Cigarts No. of question
1. General pathology 8-10
2. Immunology 4-6
3. Systemic pathology 12-15
4. Genetics and molecular biology 3-5
5. Bacteriology 6-8
6. Virology 3-5
7. Parasitology 2-3
8. Mycology 2-3
9. Pathological procedures, sterilisation/disinfection g