A NEW DIMENSION TO MD BIOCHEMISTRY CURRICULUM DR. SANGAPPA V. KASHINAKUNTI, ASSO. PROF., DEPT OF BIOCHEMISTRY, S.N.MEDICAL COLLEGE, BAGALKOT, KARNATAKA. DR. GURUPADAPPA S. KALLAGANAD, PROF AND HOD., DEPT OF BIOCHEMISTRY, SIMS, SHIMOGA, KARNATAKA . RESULTS: ABSTRACT: METHODS : The present study is still in hypothetic and preliminary stage, it requires the data collection, analysis of the data, discussion with experts and senior biochemists. But still, these methodologies seem attractive to young biochemists, who can contribute to these ideas a lot. Any advises, healthy critics, comments and suggestions are accepted along with the feedback. Introduction :The present MD (Biochemistry) curriculum is more of chemistry oriented rather than clinical oriented. How do we make this more clinical oriented ? Aim and Objective: To make MD (Biochemistry) curriculum more clinical oriented. Material and Methods : We can conduct case presentations, discussions on molecular medicine and postgraduate examination pattern which will emphasize on the biochemical diagnosis of a patient’s disease. Results: Implementation of such methods will result in better training of postgraduates. Discussion : The comparison between the present mode of MD (Biochemistry) Course training and examination pattern with our new concept is discussed below, The curriculum can be modified to a more clinical oriented one by introducing the following methods: In theory, we can introduce Systemic Biochemistry viz, Respiratory system, Cardiovascular System, Gastrointestinal, genitourinary ,Hematology, Skeletal system, Biochemistry of pregnancy, Pediatric biochemistry, biochemistry of lens and eye, Biochemistry of nerve and muscle, Endocrinology and CNS. The main objective in teaching would be to discuss the normal biochemistry of individual system, biochemical-pathogenesis and biochemistry of its disorders, laboratory investigations and to arrive at a probable biochemical diagnosis. In the practical training of the postgraduate student, we can introduce- 1.Case Presentations- Which would cover history, examination, sample collection, estimation using both conventional methods and Automated methods, interpretation of results,and biochemical diagnosis. Discussion should include biochemistry of signs and symptoms, biochemical variations, interpretation, mechanism of action of drugs,molecular medicine. 2. Clinical Procedures like Lumbar puncture, Pleural tap, Bone marrow aspiration, Collection of blood and Serum separation should be learnt with expertise which will help in proper interpretation of the biochemical data. 3. In the laboratory- All clinical parameters done in diagnostic laboratory including hormones, markers etc by Semi automated analyzer, Fully automated analyzer, ABG analyzer, Electrolyte analyzer should be learnt which would include programming, standardizing, and running of the instrument. 4. Molecular biology techniques useful for diagnostic and research purpose should be learnt. Scheme of Examination Proposed– Theory Paper 1 – chemistry, techniques, metabolism , genetics. Paper 2 – nutrition , vitamins, energy metabolism, mineral metabolism. Paper 3 – clinical chemistry- I Paper 4 – clinical chemistry- II Scheme of examination Proposed - Practical Major case – history , examination, sample collection, processing of sample, estimation of parameters ( using suitable automated analyzers), interpretation of the results and biochemical diagnosis. Ex – Cirrhosis, Myocardial Infarction, Nephrotic Syndrome, Renal Failure, thyroid, etc. Minor case 1 and 2 - history , examination, sample collection, processing of sample, detection of limited parameters. Ex – Diabetic Ketoacidosis, Inborn errors of metabolism, Anemia etc. DISCUSSION: The proposed curriculum mainly involves the incorporation of systemic biochemistry, case presentation, discussion on molecular medicine, bed side procedures etc , during training of MD course. In the theory examination increasing the marks for clinical biochemistry and in practical examination, instead of conventional methods we can introduce case presentation and biochemical diagnosis using automated techniques. Some of the universities have introduced the case presentation during regular course and in examination also like RGUHS, Karnataka has separate marks of 25 for history and examination of patient,and Baba Farid university of health sciences, Punjab introduced case presentation during training and examination also. “However the teacher teaches, the way in which the student studies is largely influenced by the examinations” Flexner- 1925, Reformer of American medical education. Even though some of the universities might have involved the above mentioned changes or methods but how much importance is given to them in the examination also matters. Many of the faculty members all over India may be ignorant of such good changes that are being brought up. Therefore, a need for an uniform curriculum all over India has to be emphasized. It is a well known fact that our curriculum basically originated from science faculty, even now we are not daring to cross the lines drawn by non- medical professionals. However to know the advantages and disadvantages of this concept, statistical data analysis and expert’s comment in this regard are required. INTRODUCTION: The present MD (Biochemistry) theory curriculum consists of Chemistry of biomolecules, Metabolisms (carbohydrates, lipids, proteins, nucleic acids, minerals, etc. ) , Nutrition, Genetics, Molecular biology, Enzymes , Specialized tissues etc. The clinical biochemistry involves mainly the organ function tests, endocrinology, basic immunology, diagnostic enzymology etc. Practical curriculum mainly covers methods of estimation of substances in blood, CSF , body fluids by chemical methods. In theory examination, most of the universities give equal weightage to chemistry, techniques and clinical biochemistry in terms of marks distribution. As far as practical examination is concerned, it involves the qualitative / quantitative analysis by chemical Methods (using conventional methods) and electrophoresis/ chromatography. This glance of the MD Biochemistry curriculum appears more of a curriculum for chemistry degree rather than medical degree. If you look into MSc (medical biochemistry) curriculum , there is no much difference as compared to MD curriculum. In this context, the present concept was considered for presentation and to think- 1.How the current curriculum can be made more clinical oriented? 2.Is our curriculum oriented towards the physician’s need ? 3.To learn more practically applicable techniques. To concentrate more on molecular medicine. 5.A clinical oriented approach to the exams. 6.How MD biochemistry curriculum can be made different from MSc medical biochemistry curriculum. CONCLUSION: The present MD (Biochemistry ) curriculum needs a metamorphosis, and in future MD (Biochemistry) can become a clinical course rather than a more clinical oriented course or pre-clinical course. REFERENCES: RGUHS Syllabus Baba Farid UHS, Punjab MCI Regulations for MD Biochemistry