COURSE DETAILS - CMC Vellore
Transcription
COURSE DETAILS - CMC Vellore
COURSE DETAILS Master in Medicine in Family Medicine (M. Med in Fam. Med.) (2-Year Distance Education Course for MBBS & Postgraduate Doctors) This course is provisionally accredited by the Tamil Nadu Dr. M G R Medical University, Chennai, Tamil Nadu. 1|Page I. PREAMBLE There are close to 2, 50,000 General Practitioners (GPs) in India who have no access to postgraduate education. Since the government has not mandated continuous education for physicians, most of the GPs do not make much effort to remain up-to-date with the developments in medical education. The lack of continuous updating of the knowledge and skills by these GPs has led to a situation where there are excessive referrals because they are not confident in handling cases even with the slightest complication. Many patients, therefore, end up visiting multispecialty hospitals where the health care costs are very high. No wonder, in a World Bank study done in the year 2004, it was found that the private healthcare sector was responsible for drowning many below the poverty line! A ‘Family Physician’ is a multi-competent specialist who not only provides the point of first contact, but also provides the continuum of care in a patient-centric way. The number of ‘Family Physicians’ – doctors satisfying the above definition – in the Indian sub-continent is grossly inadequate to cater to the huge population. II. THE OVERALL OBJECTIVE The overall objective of the M.MED (FAM. MED.) program is to build the capacity of GPs and enable them to manage more cases so that referrals become less necessary – hence the motto: REFER LESS, RESOLVE MORE III. SPECIFIC COURSE OBJECTIVES: A graduate of the course should be able to perform the following functions, with a high level of integrity, commitment and competency: 1. Develop a strong base in the core Family Medicine principles such as patient centeredness, comprehensiveness, whole person care etc. 2. Diagnose and treat effectively the common diseases occurring in all age groups, across a wide spectrum of disciplines including medicine, surgery, pediatrics, obstetrics and gynecology, orthopedics, dermatology, ENT and ophthalmology. 3. Detect at an early stage, life, limb and vision-threatening potential emergencies, so that urgent treatment and prompt referral to tertiary care hospital is made. 4. Promptly treat common emergencies that present to a general outpatient set up and refer patient after initial stabilization. 5. Develop a broad comprehensive approach to health problems affecting all age groups. 6. Discuss the relevant and up-to-date basic science, etio-pathogenesis of diseases in the context of diseases presenting in undifferentiated forms or in the background of chronic diseases. 7. Use a syndromic and algorithmic approach to management of health problems without the use of sophisticated investigations. 2|Page 8. Incorporate the role of cost-effective holistic management. 9. Develop an ethical and compassionate approach to patients under their care. 10. Practice focused clinical history-taking and physical examination in specific clinical settings 11. Network with the specialists such that they can continue the care of patients undergoing sophisticated tertiary level care, between appointments. 12. Implement recognized protocols for health promotion in all age groups. 13. Organize and promote rehabilitation of the disabled. 14. Participate in community health programs especially those which are components of national health policies. 15. Be motivated to improvise and problem-solve in resource-poor settings. 16. Generate enthusiasm in the health team, so that they can provide high quality, appropriate, ethical and comprehensive care. 17. Ensure a therapeutic environment for patients and relatives, to enhance confidence in the health system and the health care professionals. 18. Competent in medical record-keeping and data management. 19. Develop as teachers who can communicate and train team members, community members and other medical fraternity IV. COURSE FORMAT This is a Diploma level course delivered in a blended learning format (distance learning plus faceto-face contact programs). No of Seats: 100 Course Duration: 2 Years V. ELIGIBILITY CRITERIA 1. Candidates must possess a valid MBBS degree 2. Candidates must possess a valid MCI/State Medical Council registration 3. The course is open to Indian Citizens currently residing in India only. 4. The course is open only to doctors who are currently in active clinical practice Note: Those who have enrolled previously for the PGDFM (Post Graduate Diploma in Family Medicine) offered by CMC are not eligible to apply for this course (M.MED in Family Medicine), irrespective of their completion status. VI. COURSE COMPONENTS 1. 100 Self-Learning Modules 2. 60 Video-lectures 3. 33 days of Contact Programs – Hands on training for developing Core Clinical Skills 4. 100 Assignments to be worked-through and submitted 5. Project Work 3|Page 6. Mandatory 1 month Residency for Skills Training 7. Online discussion forums 8. Work-based assessments by local mentors VI.1. SELF LEARNING MODULES This course is designed in the form of 15 booklets which comprises of 100 self-learning modules. Each booklet contains 6 to 8 modules. An average of 1.5 hours per day (10 hours a week) will be needed to complete the booklets in the above time period. The modules are problem-based and are designed to challenge you to give answers to problems posed, think of options, and to apply the material just learned. The problems are chosen and designed such that as a practicing physician, you are familiar with them, and are therefore motivated to respond out of your individual prior experience. The teaching module is followed by answers to the questions asked during the module. The modules are written in a self-learning format and we have tried to make them interesting and easy to read. We know you are busy, but unless you set apart time to read regularly, you will lose out much on this course. The algorithms and protocols given in these modules need to be internalised if you want to practice good, responsible, ethical and evidence-based Family Medicine confidently and that can happen only through regular reading! The table below indicates how the topics are organized in the various booklets. Table 1: List of Self Learning modules HANDBOOK 1 Basics of Family Medicine 2 Medicine – I Neurological Problems , Mental Health 4|Page TOPICS – YEAR MODULE 1 2 3 Principles of Family medicine Promotion & Prevention in Family Practice Communication & Consultation in FM 4 Medical Documentation 5 Referrals in Family Practice 6 Family Practice Management 7 Head Ache 8 Seizures 9 Stroke 10 11 12 Movement Disorders Sleep Disorders Mental Health Problems 13 Substance Abuse 3 Womens Health Part I 4 Child Health Part I 5 Surgical topics for a Family Physician Part I 6 Medicine–II Cardiovascular Problems 7 Medicine – III Respiratory/ Gastro-intestinal Problems HANDBOOK 8 Becoming a Family Physician – Roles, responsibilities, Attitudes 5|Page 14 Antenatal Care 15 Antepartum Problems 16 Medical Diseases in Pregnancy 17 Intra-partum Problems 18 Postnatal Care 19 Contraception 20 Violence in Women 21 Neonatal Screening 22 Neonatal Resuscitation 23 Neonatal Problems 24 Breastfeeding and Weaning 25 Immunisation 26 Developmental Delay 27 Neck Swellings 28 Leg Ulcers 29 Acute Abdomen 30 Gastrointestinal Bleeding 31 Common ENT problems 32 BLS,ACLS, Shifting of a critically ill patient 33 Orthopedic problems Part 1 34 Chest Pain 35 Dyspnea Part 1 36 Palpitations 37 Syncope 38 Oedema Part 1 39 Hypertension 40 Shock 41 Dyspnea Part 2 42 Approach to Cough 43 Nausea and Vomiting 44 Dyspepsia 45 Loose Stools 46 Constipation 47 Approach to Jaundice MODULE TOPICS – YEAR 2 48 Roles & Responsibilities of a Family Physician 49 Chronic Disease Followup 50 National Health Programs 51 Health Advocacy 52 Bio-medical Ethics 53 Team Concept & Leadership 9 Medicine– IV Infections & Genito-Urinary Problems 10 Womens Health Part II 11 Child Health Part II 12 Surgical topics for a Family Physician Part II 13 Medicine – V Musculo-skeletal Problems & Life Style Medicine 14 Skin/Blood Problems & Emergencies 6|Page 54 Family Physician and Community Health 55 Medico-legal Aspects 56 Health Informatics 57 Fever Part 1 58 Fever Part 2 59 Sexually Transmitted Diseases 60 HIV 61 Haematuria 62 Lower Urinary Tract Symptoms (LUTS) 63 Edema Part 2 64 Menstrual Irregularities – Part 1 65 Menstrual Irregularities – Part 2 66 Vaginal Discharge 67 Breast Problems 68 Infertility 69 Menopause 70 Growth Monitoring & Malnutrition 71 Common Paediatric Problems Part 1 72 Common Paediatric Problems Part 2 73 Common Paediatric Problems Part 3 74 Child Abuse 75 Groin Swellings 76 Head Injury 77 Oral Health 78 Red Eye 79 Diminished Vision 80 Anesthesia for a Family Physician 81 Orthopedic Problems Part 2 82 Joint pains 83 Backache 84 Aches and Pains (Body ache) 85 Weight Loss 86 Obesity 87 Diabetes 88 Lifestyle Modifications 89 Common Infectious skin condition 90 Common Non-infectious skin conditions 91 Anemia 92 Bleeding Disorders 93 Emergencies for a Family Physician Part 1 94 Emergencies for a Family Physician Part 2 15 Occupational Health & Age specific Health Problems 95 Occupational Health 96 Adolescent Health Problems 97 Men’s Health 98 Geriatric Problems 99 Palliative care – Part 1 100 Palliative care - Part 2 101 Supplementary Module - Miscellaneous VI.2. VIDEO-LECTURES There are some pre-recorded video-lectures which are part of the course curriculum. Some of them, you will be watching during the contact programs. Some will be end-of-day assignments during contact programs where you will have to watch them in the evenings as preparation for the next class. Some will be assigned to be watched at home. These will be intimated to you from time to time. VI.3. CONTACT PROGRAMS The contact programs form a very important part of the course components. You will be required to attend 3 compulsory Contact Programs of 11 days each, during the course period of 2 years. These are intensive sessions of 33 X 8= 264 hours duration. Objectives of the contact program 1. To impart in this short time ● a vision to practice ethical, rational and evidence-based medicine ● a strong overview of the principles of Family Medicine ● motivation to practice caring and compassionate health care 2. To augment your theory knowledge base 3. To help you hone some of your skills 4. To discuss broad clinical approach to various health problems with a Family Medicine focus 5. To assess you through face-to face interactions with them as well as through the log books, which goes into your formative assessment Contact Centers: You will be assigned to any one of the below listed centers for your contact programs. ● Christian Medical College Vellore, Tamil Nadu ● St. Stephens Hospital, New Delhi, ● Christian Fellowship Hospital, Oddanchatram, Tamil Nadu ● Christian Institute of Health Sciences & Research, Dimapur, Nagaland Allotment of contact centers is strictly under the purview of CMC. 7|Page Table 2: List of Core Clinical skills taught during the contact programs: M.MED IN FAMILY MEDICINE –CORE COMPETENCIES GENERAL CORE SKILLS FAMILY MEDICINE SKILLS 1.Consultation & Communication skills 2.Core Family Medicine Skills (see – Table 3) 3.Team Management & Leadership skills 4. Management skills for all common Health problems and emergencies (with problem-based, algorithmic, protocol -based approach and rational prescription and investigations (See List of modules in Table 1) 5. Chronic Disease management and follow-up skills 6. Skills for Prevention, Promotion and Counseling activities 7. Community-based approach and management skills SPECIFIC CORE SKILLS Examination & Assessment Skills SKILLS IN MEDICINE & ALLIED SPECIALTI ES GENERAL MEDICINE Cardiovascular exam Respiratory exam C-V risk assessment Wells score- DVT decision tool CHADS2- AF decision tool CRB 65- respiratory severity score Abdominal exam Quick Neuro exam Foot exam MENTAL HEALTH Alcohol abuse screening tool dementia screening tool Depression and anxiety screening tool Triaging Assessing & managing shock Assessing & managing all common emergencies Elderly exam Frailty assessment EMERGENC Y MEDICINE GERIATRIC S DERMATOL OGY PALLIATIV E CARE 8|Page Skin examination Breaking Bad News Pain Scoring Instrumental & Procedural skills Peak flow meter Spirometry BP measurement Use of Glucometer Nebulization therapy IV Access Ascitic tap Bladder catheterization BLS/ ACLS Stabilising and transfer of a trauma patient Skin Scraping & smears Interpretative skills ECG interpretation Chest X-ray interpretation Examination & Assessment Skills GENERAL SURGERY ORTHOPEDI CS SKILLS IN SURGERY & ALLIED SPECIALT ENT IES ANAESTHES IA MATERNA L& CHILD HEALTH OBS & GYNAE Fundoscopy Examination of the eye Eye pads and dressings Epley & Halpike Manouvre Use of tuning fork Otoscopy Syringing of ear Placing an ear-wick Pre-op assessment of patient Use of Bag and mask Local Anaesthesia PAEDIATRI CS PoP application Splints and slings Eye exam- anterior chamber & ocular movements Visual Acuity and fields Digital Tonometry Examination & Assessment Skills SKILLS IN Interpretative skills OPHTHALM OLOGY Breast exam Neck exam for lumps Rectal exam Examination of Genitalia Back exam Joint exam e.g. knee Instrumental & Procedural skills Proctoscopy Dressings Stitchcraft Incision & Drainage Antenatal exam Postnatal exam Vaginal exam Newborn exam Paediatric Examination IMNCI Assessments& management APGAR scoring Developmental Assessment Instrumental & Procedural skills Speculum exam IUCD insertion Pap smear Limb X-rays interpretation Basic CT/MRI interpretation Interpretative skills Metrogram Partogram Hearing test Paed Otoscopy Neonatal Resuscitation Table 3: Core Family Medicine Skills Broad Concepts Understanding normality Family – Oriented Care Specific features Understanding illness behaviour Understanding help-seeking behaviour Understanding culture Understanding quality of life Understanding risks of medicalisation Understanding behaviour and relationship theory Importance + Influence of Family Importance Assessment Family Conference 9|Page Broad Concepts Problem -solving approach Community Specific features Problem-based Vs. disease based Clinical reasoning Screening, assessment &decision tools Use of resources Integrating doctor and patient agenda Local epidemiology Community profile approach Influence of poverty, ethnicity, resources Knowledge and skills sharing Family Therapy Family-at-risk + Thinking Family Prioritisation Managing multiple problems Information management Effective medical care Quality assurance Screening and prevention Treatment and care Working in teams Knowing professional boundaries Using patient record for management Maintaining patient record Registers; call and recall systems Access on line tools Confidentiality Evidence based medicine Guidelines Formularies Critical thinking Research Audit Significant event analysis What's worth screening for and what's not Doctor as 'drug'; placebo effects; Iatrogenic illness Alternative therapies Carers Auxiliary health care professionals Empowering patients, carers and staff Co-ordination of care The Consultation Health Service Structure Values and beliefs Personal , episodic, 24 hour Comprehensive care Cradle to grave Learning disability Coping with uncertainty Rational investigations Managing risk Knowing referral thresholds Knowing own competence Proper use of time 10 | P a g e Home nursing Rehabilitation Teaching 'skill mix' Referral procedures Lead role in complex care Consultation models Therapeutic environment Doctor / patient relationship Specific communication skills Telephone consultations Government programs Legal framework Health beliefs Patient centred care Doctor and society Ethics Understanding yourself Consent and capacity to consent Continuity of care Encouraging self-care Behaviour change Self care Values, attitudes, feelings, beliefs Reflective practice Lifelong learning 'Professional' behaviour, skills& attitudes Leadership Doctor as professional Teamwork Conflict resolution Managing a busy clinic Quality improvement Advocacy: patient; self; staff, community VI.4. ASSIGNMENTS TO BE WORKED-THROUGH AND SUBMITTED There are a total of 100 modules in 15 volumes of the books. Each module will have a set of 10 assignment questions based on MCQ/EMQs. These assignments are to be submitted periodically as per the due dates, as partial fulfillment of the course work. VI.5. PROJECT WORK The candidates are also required to complete a project work. Different topics will be allotted for students belonging to different batches. Project Work is a course requirement and can be carried during the 2nd year. Project work requires some fact finding, applied learning and basic research methodology and paper writing skills. Details about the project will be intimated to you later. VI.6. MANDATORY 1 MONTH RESIDENCY FOR SKILLS TRAINING All Candidates should undergo mandatory residential training for a minimum period of 1 month which can be divided into two 15 day periods. This training will be at one of mission hospitals affiliated to CMC Vellore. Details of this rotation will be made available later in the course. VI.7. ONLINE DISCUSSION FORUM Candidates will be part of online groups and they are expected to participate in the discussion forums. This is aimed at keeping our students linked to the faculty and other students throughout the course period. The facilitators from CMC will initiate and moderate the online discussions. The contributions to these discussions will be observed and will count toward the internal assessment. VI.8. WORK-BASED ASSESSMENTS BY LOCAL MENTORS Each student will have to nominate a local mentor who will be involved in their work based assessment process. Details of this will be provided during the course. VII. EXAMINATIONS: 1. First Year Exam – This exam which includes theory and practical exams, will be conducted at the contact centers during the contact programs 2. Second year Exam – This is the University exit exam which includes theory and practical exams and will be conducted at CMC Vellore VIII. CRITERIA FOR THE AWARD OF DEGREE: A candidate should fulfill following criteria for successful completion of the course. 50% MARK IN 50% MARK IN MINIMUM 30 DAYS OF FORMATIVE SUMMATIVE CONTACT PROGRAM ASSESSMENTS ASSESSMENTS ATTENDANCE The course should be completed with a maximum period of 4 years. 11 | P a g e IX. COURSE FEES The Course Fee for the M. Med in Family Medicine is Rs. 76,500. This fee can be paid in 2 installments. Installment I Installment II Installment Fees Per Installment Rs. 50,000 Rs. 26,500 Deadline to receive each Installment th 6 July 2015 2nd September 2015 As per the University norms, candidates who have completed MBBS abroad will have to pay an additional fee of Rs.12, 000 toward University Registration. X. ADMISSION PROCESS You can download the admission bulletin by clicking on the link: http://admissions.cmcvellore.ac.in/program.php?programid=11 XI. CONTACT DETAILS: EMAIL ID: [email protected] PHONE NO: 0416-2283433, 09003461291, 09790311199. 09790311188 ADDRESS: The Coordinator Department of Distance Education, 2nd Floor, Main Block, CMC Hospital, Ida Scudder Road, Vellore – 632 004. Tamil Nadu, India. 12 | P a g e FEEDBACK FROM ALUMNI OF THIS COURSE... I was blessed in many ways to be born and brought up in the small border State of Nagaland in the far flung Northeast India…After graduation in 2005, I felt I was ready to be of help with what I learnt then and so felt post-graduation could wait. When I joined Dimapur District Hospital as M.O in-charge of the Antiretroviral Unit, I realized that I needed to be more equipped if I wanted to offer my patients my best. Everything I had in mind and more were being covered in the content of the 12 modules. The flexibility of the course was a big attraction. I could go to work, attend to my kids, manage my home and also at the same time, I was learning every day and getting more and more confident in my practice. Thank you. Sungiggü shwen! Dr. Victoria Seb Khing, Dimapur, Nagaland The problem based approach makes it very practical and the knowledge gained can be easily applied. The course is unique as it covers topics like consultation skills, ethical issues, breaking bad news and palliative care which are new grounds to many. Dr. Moses Jayachander Kantipudi, Awali, Bahrain It is through NRHM that I enrolled in the PGDFM course with CMC Vellore. Learning at this old age has been a fascinating experience for us. After this course the referral has come down drastically, I feel proud to state that I have been able to save a few lives through proper management. This course has proved to be a boon for a poor state like Bihar and it may to some extent help the economy of the state. Dr.Sanjay Jhun Jhun Walla, Samastipur, Bihar This is the finest example of the selfless and dedicated efforts of a devoted group of people – the outcome being this ever growing yearly batch of fine family medicine Physicians. Dr. Sara Susan Maveli, Sharjah, UAE Holistic and continuing care for an entire family was one of the key learning points I obtained from this course… Dr. Saira Nooreen K, Chennai This course was like a ‘stick stretched out to a sinking man’.The books etch out the vision of a team, committed to making a difference to the health care of this nation. The vision is now an integral part of us & will be as long as we practice. 13 | P a g e I believe that one drop at a time, will eventually make an ocean of responsible and committed doctors, in service to this nation. Dr. Maria S Denzil, Bangalore This course enriches our clinical knowledge and enables us to treat the patients more confidently. Dr. Rinku Ghosh, Bangalore The practical sessions of otoscopy & fundoscopy helped in improving my clinical skills. Dr. Preetha S.R, Trivandrum The problem approach which the modules contained stimulated my reading Dr. Devavaram Prathipaty, Guntur, Andhra Pradesh The two year program has been an enlightening one and has brought about in us a positive attitude and confidence to carry on our profession to the best of our capabilities. Wishing CMC and the Distance Education Dept success in all their future endeavors. God bless. Dr. Julie Jose, Oman The entire prospectus and the study material has been designed in a very interesting manner I am a much more confident Doctor now. Dr. Mitaly Pathak Agarwal, Bangalore The algorithms provided in the course booklets served as useful guides. Dr.M.Thulasimani, Pondichery The course has added tremendous value to the way I manage co-morbidities in my patients. The central office at Vellore has been exemplary in its support and flexibility to me and I understand to many others, to help complete the course. Dr. Nandini Vallath, Bangalore It is very useful for medical practitioners who are practising in rural areas and cannot attend regular courses leaving their practice. The modules are very attractive and make the students to read it and complete the assignments also. It empowers the medical practitioners with knowledge. I strongly feel “FAMILY MEDICINE” is the specialty which is needed for the community at present. Dr. R.Parimala, Coimbatore When I joined the course, I had the desire to know something about everything. During these past 2 years, my views and thoughts about the medical profession have changed. Dr. Suryakanthi C, Ernakulam, Kerala 14 | P a g e It gave me the necessary confidence and a new paradigm “Refer less and resolve more” … Dr. Renu Saraogi, Bangalore Now I serve as the patients’ advocate, explaining the causes and implications of illness to the patients and their families, and I serve as an advisor and confidant to the family. Thank you. Dr Pragati Kumar, Ghazipur, UP This course, not only changed my approach towards health concerns but also helped in extending continuing care of varied medical conditions which are not limited to a diagnosis or organ system. Dr. Kaushik Chatterjee, Mohanpur, Nadia, WB I am working as medical officer at the ESI Dispensary. By this course I have gained confidence, patience and good communication skills. Dr. Sushama Mary, Kollam, Kerala The course has given me confidence in dealing with patients with the limited resources Dr. Jennifer Shullai, Shillong, Meghalaya It has taught me to listen to my valuable patients patiently and to listen to their spoken and unspoken problems and to address them in a broader way, and thus establish a good doctor- patient relationship… I used to avoid pediatric patients before, but now I don’t…. Dr. Debasish Sinha, Kolkata I have come to realization that most cases presenting to our out patients are primary care problems. The algorithmic style of approach to diagnosis leads to institution of early proper treatment and better outcome. Dr. Tshiani.K. Nigeria The whole concept of “Refer less and resolve more”, is a wonderful concept, which will actually resolve 3/4th of our country’s health problems, and THIS is what the whole PGDFM course has conveyed, in words and in action in the last two years. For a Radiologist like me, who purely took up this course due to my own unquenchable love for Clinical Medicine, in spite of branching off into Radiology for the last 20 years, it was pure bliss to recapitulate and even unlearn and relearn so many things. The contact programs were delightful with the instructors so very dedicated and passionate about Family Medicine. I enjoyed the journey more than the Destination, and the Journey will go on life long,….. Dr. Akhilandeswari Prasad, New Delhi. 15 | P a g e Well crafted, concise, updated, evidence based, tailored to Indian standards, easy to study even for busy doctors, is what I can say in a line about the course. Now I feel that a Family Medicine is itself a speciality which requires the same or even higher level of clinical skill than my consultant colleagues for which no substitute exist or is in no way inferior. Now I know the healing power of a properly done personalized consultation. Dr. K.J.Anoop, Kerala. This is one course I would advocate for all who are struggling in their specialties and super specialties and have forgotten the art of dealing with the general O.P.D. Dr. Beatrice Madhavan, Aligarh. Each and every subject in the modules are written so nicely and are helpful for our practice. Dr. Dilip Kumar Phukan, Dangari, Tinsukia, Assam. I imbibed the concepts of Family Medicine and changed my practice from patient care to FAMILY ORIENTED PATIENT CARE. Now, health education and training paramedical staff has become part of my practice. I feel happy to be part of this great concept of changing Indian health scenario and encouraging & incorporating the practice of Family Medicine in our healthcare system. Dr. Chilaka Rajesh, Visakhapatnam. … made me feel like a real learner. Dr. Lal Mohan Ho, Bhubaneswar, Odisha. Being posted in remote and inaccessible areas since I graduated in 2008, this course has become a blessing to many a patient, who do not have to go too far off towns for treating their ailments any more, and made me a likeable person. Dr. P. Hegin Tungdim, Churachandpur, Manipur. It enabled me to look at the whole person Most importantly this course has prompted me to dig deeper into the world of Medicine and seek more knowledge. Dr. Moanarola Ao, New Delhi. …it will be a feather in my cap and a great value addition to my career. Dr. Narendra Kumar Gupta, Patna. My approach to the patients has completely changed for the better; I learnt the importance of a Family Physician in the community. Apart from the medical aspect I got to meet many doctors from different places and got into a professional network of friends. Dr. M.Porselvi, Bangalore. 16 | P a g e I have learnt the art of breaking bad news to my patients and their relatives’ based on my encounter in this program- Above all the course has taught me, Christian Values, imbibed at CMC. DR. Sokowo Allagwoni Jacob, Nigeria. an excellent, informative and enlightening journey. I was wondering whether I would be able to remember everything. But the flow of the chapters made learning easy and enjoyable. Doing this course is helping me in my practice and also in advising and treating my own family. Dr.Prathiba Janardhanan, Dhrishti Eye Care, Chennai. I thank God for the training, my life is so blessed. I learnt about the correct attitude to have towards the profession seeing it as a vocation and not a carrier. In short my patients are enjoying better services. . Dr. Vincent Baba Abaya, Nigeria. These books are going to be of great value, as a ready reckoner during daily practice. One remarkable fact I would like to point out, is the openness and acceptance of each other that prevailed. There was a perfect camaraderie and I am thankful for this experience which transformed us from busy hard core professionals, to students willing to learn from each other. Dr. Rukhsana Dutt, Muscat, Oman. From the first module itself I understood there were a huge amount of things which a General Practitioner should learn. This course really gave me immense amount of confidence in dealing from paediatric to geriatric. I don’t consider myself as a great physician, but know that I’m a better physician than I was before. Dr. Sunil Vijayakumar, Sharjah, UAE. 17 | P a g e And Jesus, when He came out, saw a great multitude and was moved with compassion for them, because they were like sheep not having a shepherd. So He began to teach them many things. When the day was now far spent, His disciples came to Him and said, “This is a deserted place, and already the hour is late. Send them away, that they may go into the surrounding country and villages and buy themselves bread; for they have nothing to eat.” But He answered and said to them, “You give them something to eat.” And they said to Him, “Shall we go and buy two hundred denarii worth of bread and give them something to eat?” But He said to them, “How many loaves do you have? Go and see.” And when they found out they said, “Five, and two fish.” Then He commanded them to make them all sit down in groups on the green grass. So they sat down in ranks, in hundreds and in fifties. And when He had taken the five loaves and the two fish, He looked up to heaven, blessed and broke the loaves, and gave them to His disciples to set before them; and the two fish He divided among them all. So they all ate and were filled. And they took up twelve baskets full of fragments and of the fish. Now those who had eaten the loaves were about five thousand men. Mark 6:30-44 (Bible) Anything given in the Lord’s hands multiplies! 18 | P a g e 19 | P a g e