MMED orientation template malaysia medic

Orientation

1. MASTER OF
INTERNAL MEDICINE
(MMED)
DEPARTMENT ORIENTATION

Assoc Prof Dr Mohamed Faisal
MMED Coordinator – Internal Medicine (UKM)

2. National Postgraduate
Medical Curriculum
(NPMC)

3. Starting 1
st
December 2022


In campus (UKM) – 11
Outcampus – 16

Each lecturer/specialist/consultant will
be assigned 1-2 candidate as mentee
from Day 1

4. National Curriculum for Internal Medicine
•Aims to produce Internal Medicine specialists who will:
•deliver highly competent person-centred care by applying
state-of-the-art medical knowledge and excellent clinical skills

•demonstrate ethical conduct, professionalism, and commitment
towards personal development and lifelong learning

•be leaders in the field contributing to education, research, quality
improvement, strategic development, and the promotion and
improvement of health in local, national, and international settings

5. •All candidate selected this intake,
•have successfully taken the Internal Medicine Entrance Examination (IMEE) & has
achieved the required entrance grade

•Consist of 2 types of assessment:
•Formative assessment
•Summative assessment

•Still 4 years program

6. Kurikulum
Baru vs
lama
Fasa1Fasa 2Fasa 3
Tahun 1 Tahun 2-3 Tahun 4
Exam Exam Exam
2 LC
8 SC
TP
24 bulan

7. Year of
Study
Phase of Training
Duration of
training
Year 1
Training in General Internal
Medicine
12 months
Year 2 - 3 Rotation through subspecialties 24 months
Year 4 Registrar post 12 months

9. Minimum
3 months rotation
Minimum
1 month rotation
Cardiology Infectious Diseases (ID)
Respiratory Haematology
Nephrology Palliative Medicine
Endocrinology Dermatology
Neurology Geriatric Medicine
Gastroenterology Rheumatology
Rotation

11. Formative Assessment

12. Portfolio
•Each candidate is required to have INDIVIDUAL
Portfolio
•Record all training activities over the year
•Will form an integral part of evidence of your
professional development
•Need to be present to mentor 5-6 monthly
•Will be a core assessment for your annual
report
•Will be assessed for progress to next stage of
training

•Will be compiled over 4 years of training

14. Certificate Trainer
•Latest statistics (28.11.2022) from Department of
Medicine UKM

•Total Lecturers (December 2022)
(Faculty and Hospital Post) : 51

•Total lecturers without certificate: 7

15. Mentor’s Report
•Mentor is someone who monitor the trainee for the whole of 4-year
programme

•Student will be assigned at the start of the training

•Should meet trainees at regular interval
•Recommended min of 3x (start , mid and end of the year before
annual review)

•Mentor can be the supervisor/posting trainer at certain point

16. Mentor’s
Report

17. Responsibility of the mentor
to ensure candidate/s submit
the forms on time

18. Workplace
Based
Assessment
(WPBA)
WPBA will be used in Internal Medicine
training assessment:
1)Mini-Clinical Evaluation Exercise (MiniCEX)
2)Case-Based Discussion (CBD)
3)Directly Observed Procedural Skill (DOPS)
4)Multisource Feedback (MSF)
5)Discharge summary/referral letter

•Discharge summaries and referral letters will
also be assessed periodically during training.
Sample forms and examples will be
provided.

19. •It is the responsibility of both trainees and trainers to ensure that WPBAs are done
and completed.

•Trainees must be responsible for learning and request that trainers to carry out
these assessments.

•If they are consistently refused, evidence of the proposed requests and dates must
be forwarded to Coordinators/Training Programme Directors.

•These assessments are an essential part of the trainee’s Portfolio.

•It is highly recommended that the trainee keeps backup scans/copies of all
assessments.

•Loss of documents or failure to submit or provide them as part of the Portfolio may
have a significant impact on training and assessment.

20. Mini CEX
•Assessment will review one or more of the followings:
•History taking
•Physical examination
•Decision making skills
•Counseling of patients and relatives
•Discussion on management plans
•Rationale for decision making
•Communication skills

21. Summary of minimum MiniCEX required
Year of training No. of Mini CEX Required
(Satisfactory)
1 4
2 4
3 4
4 2

22. Important
•The MiniCEX may be conducted during ward rounds, outpatient clinics,
family conferences or potentially any clinical setting where an interaction
takes place between the trainee and a patient/relative. Trainee leads the
clinical encounter

•Each trainee can do as many Mini CEX as possible. However, of the
minimum number required, should have assessed on different components
(HX, PE, MDT etc) and done by different trainers.

•The MiniCEX should take approximately 30-60 minutes to complete
(10-30 minutes for encounter and 20-30 minutes for reflections,
questions, feedback and documentation)

23. Assessment
•Year 1– 3 :
•Address core general medical, subspecialty knowledge
and skills

•Year 4 :
•Focus on overall management strategies as expected from
a specialist

24. Mini CEX

25. Mini CEX

26. Case Based Discussion
•Case based discussion is a discussion on actual
case managed by trainee

•Occurring in a focused and scheduled manner
and constructive feedback takes place.

•Similar to a long case discussion, however case
discusses involved unique patient with currently
acute event.

27. Summary of minimum CBD required
Year of training No. of CBD Required
(Satisfactory)
1 3
2 3
3 3
4 3

28. Important
•Each trainee can do as many CBD as possible.

•However, of the minimum number required, should
have assessed on different Rotation / Specialty and
done by different trainers.

29. CBD

30. CBD

31. Directly Observed Procedural Skills (DOPS)
•Structured checklist for assessing procedural skills

•Assessing trainee’s interaction with patient when performing
a procedure

•Procedures : Lumbar puncture, ECHO, EST, Abdominal
paracentesis, BMA, Chest tube insertion, Double Lumen
Catheter, Knee Joint aspiration, Thoracentesis

32. Summary of minimum DOPS required
Year of training No. of DOPS Required
1 4
2 4
3 4
4 2

33. Important
•Each trainee can do as many DOPS as possible.

•All DOPS must be done at least once.

•However, of the minimum number required, should
have assessed on different DOPS and assessed by
different trainers/assessor.

34. DOP

35. DOP

36. Multi-source Feedback (MSF)
•360
o
formative assessment on learning attitude and
professional conduct
•A reflection on performance and planning for
ongoing development/ improvement
•To help identify areas to focus on for student
development

•To drive behaviour change and helps on performance:
•provide insight and awareness of trainee practice
and performance

37. The process of selection…
1) How to nominate the assessors?
- across all levels
- must have professional interactions with the trainee

2) A minimum of 20 assessors (throughout the year);
- 10-12 Peer colleague/ MO
- 6-8 Nurses/Ward sisters/ Matron/Nurse Supervisor
- 1-2 Consultant / Specialist
- 1 Pharmacist – optional
- 1 Ward clerk –optional
- 1 Healthcare assistant –optional
- 1 Dietician/physiotherapist -optional

3) Selection must be from the clinical posting/ location the
student have worked with.

38. MSF form
send to the
trainer via
email by
each
university
coordinator
Trainer &
mentor to
decide on the
numbers of
assessors
(minimum
20)
Nominating
assessors for
the MSF -
identified by
the trainee and
agreed by the
supervisor/
mentor
(vice-versa)
Assessors to
response within
1-2 week once
nominated, If
assessors
rejected the
request, new
assessor should
be assigned.
MSF process
should be
completed in
one month from
the request date
The steps..

39. Assessment – MSF
Year of training MSF Required
1 Yes (20)
2 (re-evaluation if poor)
3 Yes (20)
4 (re-evaluation if poor)

40. MSF

41. Referral
letter

42. Posting & Mentor Report

43. Posting Trainer Report
•Summary of progress through postings
•Need/required to achieve satisfactory completion

•Year 1:
•To be filled by supervisor after discussion by all academic staff
•Frequency : 3monthly

•Year 2-3:
•To be filled by each posting supervisor
•Major posting: 3 monthly (Cardiology/ Respiratory/ Gastroenterology/
Neurology/ Nephrology/ Endocrinology)
•Minor posting: Minimum of 1 month (Rheumatology/ ID/ Dermatology/
Hematology/ Geriatric/ Palliative)

46. Thesis Proposal
Assessment
•Only applicable for UKM
candidates

47. Research Progress Report
•Only applicable for UKM candidates
•6 monthly assessment (starting after proposal presentation)
• Signed by thesis supervisor starting after

48. Research
progress

49. Summative Assessment

50. Internal
Medicine
Qualifying
Assessment

51. ASSESSMENT
IMQA
20%
20%
25%
10%
25%

52. Year 4
•Thesis / Audit / Research Project

53. Exit Requirements to Successfully Complete Training
•Satisfactory Progress Reviews and recommendation by the Assessment
Committee of the NPMC
•Pass Summative Assessment - IMQA
•Successful completion of;
•A minimum of 4 years rotations/placements, Portfolio
•Workplace based assessments (WPBA)
•Research, Audit and Quality Improvement (RAQI)

54. Timeline

57. Thank you and Good Luck