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THE TAMILNADU Dr.M.G.R. MEDICAL UNIVERSITY,

No.69, Anna Salai, Guindy, Chennai – 600 032.

D.M/ M.Ch
SUPER SPECIALTY DEGREE COURSE

SYLLABUS AND CURRICULUM

2017-2018

M.Ch - UROLOGY
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THE TAMIL NADU Dr. M.G.R. MEDICAL UNIVERSITY, CHENNAI

Syllabus - M.Ch - UROLOGY

1. AIMS & OBJECTIVES

The syllabus for M.Ch., Urology course should comprehensively

cover all the subjects in urology and renal transplantation during 3 years of
study period. The student who undergoes the course should have an
exposure to all the facets of urology and transplantation and develop
adequate knowledge and skill to treat the patients competently after
acquiring the degree.

2. THEORY SYLLABUS

It will cover a wide spectrum of the diseases of the urogenital

system, retroperitoneum and renal transplantation

Apart from the clinical aspect of these subjects, the candidate has
to acquire in depth knowledge of the related basic subjects like applied
anatomy, physiology, biochemistry, pharmacology, pathology,
microbiology, epidemiology, immunology etc.

1. Anatomy and embryology of GU tract, adrenal & retroperitoneum.

2. Applied physiology and biochemistry pertaining to Urology, Nephrology,

renal transplantation and renovascular hypertension.

3. Investigative urology & Genito-urinary radiology and imaging including

nuclear medicine.

4. Male Infertility, Andrology and Urological endocrinology.

5. Sexual dysfunction-investigation and management

6. Perioperative care, management of urological complications and care of

the critically ill patients.

7. Urodynamics and Neurology.

8. Genito-Urinary trauma.

9. Urolithiasis-Medical, Biochemical & Surgical aspects.

10. Uro-Oncology-Adult & Paediatric.

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11. Reconstructive Urology.

12. Paediatric Urology-congenital malformations and acquired diseases.

13. Urinary tract infections and sexually transmitted diseases.

14. Obstructive Uropathy.

15. Renal transplantation (including transplant immunology medical &

surgical aspects)

16. Renovascular Hypertension.

17. Gynaecological urology.

18. Newer developments in Urology.

19. Operative Urology – Open and endoscopic.

20. Endourology.

21. Behavioural and social aspects of urology.

22. Neonatal problems in urology.

23. Electrocoagulation, lasers, fibre optics, instruments, Catheters,

endoscopes etc.

24. Retroperitoneal Diseases & Management.

25. Medical aspects of the kidney diseases.

26. Laparoscopic Urologic Surgery.

27. Robotic Urologic Surgery

Apart from the above mentioned subjects, each candidate should

have basic knowledge of the following :

1.Biostatistics & Epidemiology.

2.Computer Sciences.

3. Experimental and Research methodology and Evidence Based

Medicine.
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4. Scientific presentation.

5. Cardio-pulmonary resuscitation.

6.Ethics in medicine.

Bioethics
1. Respect human life and the dignity of every individual.
2. Refrain from supporting or committing crimes against humanity and
condemn all such acts.
3. Treat the sick and injured with competence and compassion and
without prejudice and apply the knowledge and skills when needed.
4. Protect the privacy and confidentiality of those for whom we care and
breach that confidence only when keeping it would seriously threaten their
health and safety or that of others.
5. Work freely with colleagues to discover,develop, and promote advances
in medicine and public health that ameliorate suffering and contribute to
human well being.
6. Educate the public about present and future threats to the health of
humanity.
7. Advocate for social, economic, educational and political changes that
ameliorate suffering and contribute to human well being.
8. Teach and mentor those who follow us, for they are the future of our
caring profession.

Urological Jurisprudence

Comprehensive knowledge of urological jurisprudence including informed

consent consumer protection act, organ transplantation act, medical
record keeping laws relating male and female sterilization etc.

3.CLINICAL TRAINING

The Students will be clinically trained in parent department during

the 3 years course.

0-6 Months

A candidate is required to perform the following procedures.

1. Cystourethroscopy, dilatation, retrograde uretero - pyelography,

interpretation of normal and abnormal findings in relation to gross
inflammation, obstructive and neoplastic changes in the lower urinary
tract.
Interpretation of flow rate.
Optical urethrotomy, insertion and retrieval of ureteric stents.
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2. Minor Urological Procedures :

Needle biopsy of the prostate, dilatation, trocar cystostomy, open

cystostomy, orchiectomy, circumcision, meatotomy / meatoplasty.

3. Uro -Radiological & Imaging Techniques :

During this period a candidate should perform various uroradiological and

Imaging procedures like Retrograde Urethrograms & Micturating
cystourethrogram, cystogram, nephrostogram, sonogram, antegrade
pyelography.
Learn interpretation of intra venous urogram, Ultrasound & Computerized
tomography’ scans and Isotope renogram and, renal angiography.

Attain familiarity with Shock wave Lithotripsy, perform and interpret

urodynamic studies.

Various tests of sexual dysfunction such as pharmacologically induced

penile erection and dynamic cavernosography.

6 – 23 Months

The candidate shall assist and perform following procedures.

(a)Endoscopic Surgery :

Bladder Neck Incision, Litholopaxy, cystolithotripsy, ureteral meatotomy,

endoscopic suspension of bladder neck, Transurethral resection of
Prostate and bladder tumour; ureteroscopy.

(b) Open surgical procedures :

Simple nephrectomy, radical nephrectomy, cystolithotomy,
ureterolithotomy, Pyelolithotomy, extended pyelolithotomy, pyeloplasty,
retropubic and transvesical prostatectomy,orchieopexy, partial and total
amputation of penis, ureteric reimplantationVVF repair, A.V. Fistula
(radial), harvesting Buccal mucosa, , Inguinal lymph node dissection,
Blandy’s urethroplasty. Bed preparation Renal Transplanation.

(c) All Urological Emergencies:

Percutaneous Nephrostomy, Cystoscopy and double DJ stenting, Trocar
SPC diversion, open supra pubic cystostomy, Renal injuries, Ureteric
injuries, bladder injuries, urethral injuries, penile injuries, torsion testis,
fracture penis.
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24 – 36 Months

a)Endoscopic surgery

PCNL

Laparoscopic procedures

Simple nephrectomy, radical nephrectomy, pyeloplasty,

ureterolithotomy

b) Open Surgery

Perform
Subsitution urethroplasty, progressive perineal urethroplasty. Hypospadias
repair, ,Boari flap,augmentation cystoplasty, Urinary diversion,
ureteroneocystostomy, radical cystectomy, nephroureterectomy, brachial
AV fistulae

Assist
Exstrophy closure,epispadias repair, posterior urethral valve fulgration,
Penile prosthesis, artificial urinary sphincter, Microsurgical
vasoepididymostomy, and vasovasostomy.
Post chemotherapy retroperitoneal lymphadenectomy, nephron sparing
surgery, radical prostatectomy, neobladder.
Renal transplantation.
Laproscopic pyeloplasty,laparoscopic partial nephrectomy.
RIRS.

During II year, students are encouraged to undergo special postings

for learning new advanced techniques / Procedure / Skills in institutions of
higher repute where the requisite facilities are available without affecting
the duties of the parent department.

4.SKILL TRAINING REQUIREMENTS

ENDOSCOPIC SURGERY
1. Endoscopies 100
2. Optical Urethrotomy 30
3. TURP 20
4. TURBT 10
5. Ureteroscopy 30
6. PCNL 5
7. Laparoscopic Urological Procedures 10
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OPEN SURGERY

1. Nephrectomy 5
2. Pyelolithotomy 5
3. Pyeloplasty 5
4. Radical Nephrectomy 5
5. VVF Repair 4
6. Radical Cystectomy 1
7. Ileal conduit 3
8. Partial Penectomy 5
9. Total Penectomy 3
10. Varicocele Ligation 5
11. Ileo inguinal block dissection 2
12. Substitution Urethroplasty 5
13. Anastamotc Urethroplasty 2
14. Meatoplasty 10
15. Ureteric reimplantation 5
16. Assisting Transplant Surgey 5
17. Hypospadias repair 2

5. TEACHING METHODOLOGY

Besides didactic lectures (delivered by the faculty members, national and

international visiting teachers,) seminar, symposium and journal clubs
have to be organized.
Problem oriented training to be given in the form of case discussions,
ward rounds, inter-disciplinary meetings and department statistical
meetings, Practical training is to be imparted by full time residency
training programme, where a trainee will be given full responsibility of the
patients.
Course Training

As it is a fulltime residency programme the candidate will be

responsible for the total care of the patients. The candidate will be
encouraged to improve and develop his decision-making ability under
supervision to make independent decisions.

Every day, there will be at least one hour academic activity to a

maximum of 10 hours/week in which all the faculty members and residents
will participate. Case discussions will take place weekly with a final year
resident as a moderator.

Other academic activities like journal clubs, seminars, group

discussions statistical meetings , will be a fortnightly feature. Morbidity and
mortality meetings where operations, complications, deaths will be carried
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out monthly. Emergency will only be attended by the on call residents.

Consultations given to other departments should also be discussed

every morning with the respective consultants. In OPD a candidate will
see the cases independently and will make all the pertinent notes. In
problematic cases and a special referral, it is mandatory to show the case
to the respective consultant.

A candidate will have to attend all postmortem examinations done

for the department.

Interdepartmental meetings like uroradiology, uronephrology,

uroradiotherapy & medical oncology, uro pathology, uroimaging will
provide an opportunity for open discussion on a common subject and it will
also provide an opportunity to learn views of the specialists on these
subjects.

Theory examination will be conducted once in six months from first

year onwards.

Model practical examinations will be conducted at the end of the

course.

6. RESEARCH WORK

Mandatory attendance of manuscript writing workshops.

1. Basic knowledge of clinical research methods, biostatistics,

epidemiology and ethics.
2. Basic knowledge of cell biology, molecular biology, molecular
genetics and immunology
3. Critical analysis of current literature, ability to formulate research
questions, make a study design, calculate sample size, data
management, ways to avoid bias etc.
4. Preparation of proposals for funding and evaluation by
institutional review boards
5. Presentation of work in written/oral form at conferences
6. Publication of the work in peer review journals.

Students should compulsorily attend Research Methodology

workshop conducted by the University within first six months of M.Ch
Course.

It is desirable that the candidate should spend time for basic

research in collaboration with a basic science department i.e.
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biochemistry, and pathology.

7. LOG BOOK:

The Postgraduate student of a Postgraduate Degree Course in

Super specialties shall maintain Log Book of the work carried out by them
and the training programme undergone during the period of training
including details of surgical operations assisted or done independently.

The Log Book shall be checked and assessed by the faculty

members imparting the training.
Periodical evaluation of Log Book to be done by the Head of the
Department as per 52nd SAB.
The Evaluation of the candidates in both theory and practical aspects will
help the candidate in the improvement of his/her knowledge skills & attitude.

8. COMPETENCY ASSESSMENT:
Overall:

1. Communication / Commitment / Contribution /

Compassion towards patients and Innovation - 10 Marks

2. Implementation of Newly learnt techniques - 10 Marks

3. Documentation of case sheets / discharge

Summary / Review - 10 Marks

4. Number of cases presented in Clinical Meetings/

Journal Clubs / Seminars / Papers presented in
Conference. - 10 Marks

5. No. Of Medals/ Certificates won in the conference /

Quiz competitions and other academic meetings with
Details. - 10 Marks

Total 50 Marks

Assessment I - February - First Year

II - August - First Year
III - February - Second Year
IV - August - Second Year
V - February - Third Year
VI - May - Third Year
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VIVA INCLUDING COMPETENCY ASSESSMENT – 100 Marks (50+50)

9. THEORY EXAMINATION

Paper I - Basic Sciences Applied to Urology

Paper II - General Adult and Pediatric Urology
Paper III - Regional Systemic Urology
Paper IV - Recent Advances in Urology

Each paper will contain:

1. Essay questions (2) - 2 X 15 = 30 Marks

2. Short Notes (10) - 10 X 7 = 70 Marks

Total 100 Marks

10. CLINICAL EXAMINATION:

Particulars Time for candidate to Time for examiners to Maximum
examine the cases question the Marks
candidates
Long Case 1 Case x 60 Minutes 60 Minutes 100
Short Case 2 Cases x 15 Minutes 30 Minutes 100
Ward Rounds 3 Patients x 10 Minutes 30 Minutes 100
OSCE 5 Stations x 3 Minutes 15 Minutes 50
Viva Voce 15 Minutes 100
Log Book 50
500

As per Medical Council of India Post Graduate Medical Education

Regulations 2000 (amended upto 10th August 2016)clause 13.9 A
Postgraduate student of a Postgraduate degree Course in broad
specialties/Super Specialties would be required to present one
poster presentation to read one paper at a National/State conference
and to present one Research paper which should be
published/accepted for publication/sent for publication during the
period of his Postgraduate studies so as to make him eligible to
appear at the Postgraduate Degree Examination.

Apart from Poster/Oral paper presentation in National/State

conferences, the Research paper published by the candidate in the
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University Journal of Medical Sciences will be considered as equivalent

to the Research Paper as mentioned in 13.9. clause. Case Reports can
also be published in University Journal of Medical Sciences but case
reports will not be considered as Research Paper.

The candidate can also present Research Paper as per Clause 13.9
of Post Graduate Education Regulation 2000, and if the article sent for
publication by the candidate as primary author or corresponding author
which has not yet been published/accepted for publication, the candidate
should submit a letter from the HOD, stating that the article sent for
publication is of publishable merit and the proof of the Research Article
submitted to the Journal for publication should be sent to the university
forwarded through the HOD [as per 53rd SAB]

The student can submit articles for the University journal anytime from the
time of registration till 6 months prior to theory examination.

11. OSCE:
1. Clinical Scenario - 2 stations
2. Operative Surgery - Video/Photograph
3. Clinical Photograph
4. Endoscopic Photograph
5. Pathology slide

12. REFERENCE BOOKS

General Urology
1. Campbell urology-3 Volumes Edited by Walgh, et al
2.Scientific Basis of Urology Mundy
3.Current Urological Therapy Kaufman
4.Obstructive Uropathy O’Reilly
5.Urogenital trauma Mcannich
7.Adult & Paediatric Urology Gillenwater et al

Paediatric Urology
Pediatric Urology Kelalis & King – 2 vol.
Urodynamics
Urodynamics principle & practice Mundy
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Endourology
Endourology Arthur Smith

Renal Transplantation
Kidney transplantation Peter Morris

Operative Urology
1 Glen’s operative urology
2 Atlas of urological surgery Hinman

**Note: The editions are as applicable and the latest editions shall be the
part of the syllabi.

13. JOURNALS
 Indian J. Urology
 European Urology
 Journal of Urology
 BJU international
 Urology (Gold Journal)
 Transplantation

Periodicals
1 Urological clinics of North America
2 Seminars in Urology
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