ADOPTION OF THE SYLLABI FOR THE SUBJECTS OF THE LICENSURE EXAMINATION FOR PHYSICIANS WHEREAS, Sec.

8, Article III R.A. No. 2382, as amended, otherwise known as The Medical Act of 1959, provides that no person shall engage in the practice of medicine in the Philippines unless he x x x has satisfactory passed the corresponding board Examination and Certificate of Registration duly issued to him by the Board of Medicine WHEREAS, Sec. 21, Article II of the same Act provides the various subjects of the licensure examination of physicians; WHEREAS, the primary objective of said examination is to test the over-all knowledge and proficiency of the applicant for registration for the practice of medicine; WHEREAS, the syllabi of the subjects for examination containing the concepts/topics shall be the basis of the test questions which members of the board shall input in the test questions data bank, WHEREAS, under Sec. 9(h) of R.A. No. 8981 (the PRC Modernization Act of 2000), the Board is empowered to prepare, adopt and issue the syllabi or tables of specifications of each of the subject for examination, and WHEREAS, the Board evaluated the solicited comments and suggestions from the Deans of the different schools, faculties or institutes of medicine of colleges and universities, public and private and considered the said suggestions in the formulation of the syllabi. WHEREAS, the Board RESOLVED, as it hereby resolves, to prescribe and adopt the syllabi of the subjects in Licensure Examination for Physicians contained in the document denominated as syllabi of the Subjects in the Licensure Examination for Physician marked as Annex A and appended as an integral part of this Resolution. The syllabi adopted herein shall be used starting with the August 2002 Physicians Licensure Examination. This Resolution shall take effect after fifteen (15) days following the completion of this publication in the official Gazette or newspaper of general circulation, whichever comes earlier. Let copies of this resolution be furnished all schools, Institutes of Medicine or colleges and universities, public or private offering the course of Doctor of Medicine for dissemination to their graduates. Done in the City of Manila, this 24th day of April, 2002. RODOLFO P. DE GUZMAN, M.D. Chairman JOSE S. RAMIREZ, M.D. Member EDGARDO T. FERNANDO, M.D Member ATTESTED : CARLOS G. ALMELOR Secretary Professional Regulatory boards JUANITO B. BILLOTE, M.D. member RICARDO D. FULGENCIO II, MD Member

APPROVED : ANTONIETA FORTUNA-IBE Chairperson ALFONSO G. ABAD Commissioner AVELINA DELA REA-TAN Commissioner

Date of Publication in the Official Gazette July 8, 2002 Date of Effectivity July 24, 2002

SYLLABUS FOR THE PHYSICIAN LICENSUE EXAMINATION The syllabus is essentially a listing of all topics which may be the basis for formulating questions in the subjects indicated. The preparation took sometime as we requested the different medical schools to submit to the board their syllabi. The board reviewed this and had a syllabi prepared and sent to the Association of the Philippine Medical Colleges, Inc. (APMC) for comments. The current syllabi is an integration of all these efforts. We want to emphasize that the listing of topics do not reflect the relative importance or frequency of questions in these areas. Neither is it intended to influence the different schools to change their curriculum. The licensure examinations require achievement of standard terminal competencies and instructional objectives which should guide the medical educational process, whether traditional or the Problem Based Learning (PBL) in form. To the extent possible comments coming from the different medical schools will be given due course when these are reasonable or significant. Effort is expanded so that the bio-medical science can be applied to actual clinical abnormalities or disorders so that at least some of the items are case based problem-solving in nature. To the extent possible, disease process which are encountered locally or the understanding of which is of particular importance in illustrating fundamental biological mechanism will be given due prominence. There is no intention to make all questions must know. We have shifted to the criterion referenced grading from the previous norm criterion reference system. We utilized the Nedelsky Method of Setting the Minimum Passing Level (MPL) per item and compute from thereon the MPL of the subject. The Board acknowledge receipt of the Pediatric Undergraduate Curriculum as prepared by a special committee of the Philippine Pediatric Society. This is a landmark project and the Board member assigned to this subject will have the opportunity to review this for possible inclusion in the syllabi.

BIOCHEMISTRY I. Introduction to Biochemistry A. The Living World B. Biomolecules C. Biochemical Process Living Cells Water Structure, characteristics and importance Bioenergetics A. Thermodynamics B. Redox Reactions C. The Role of ATP Peptides and proteins Classifications, Characteristics and Properties Protein Synthesis Enzymes, Coenzymes, Vitamins and Hormones Characteristics and Functions Carbohydrates A. Monosaccharides B. Disacharides, Oligosacchrides, Polysaccharides and Complex Carbohydrates Carbohydrates Metabolism A. Glycogen Metabolism B. Glycogenesis C. Metabolism and Other Sugars Lipids and Membranes Classifications, Characteristics and Functions Lipid Metabolism Aerobic Metabolism Nitrogen Metabolism Integration of Metabolism Nucleic Acids Nucleotide Metabolism Genetic Information

II. III. IV.

V. VI. VII. VIII.

IX.

X. XI. XII. XIII. XIV. XV. XVI. XVII.

References : 1. 2. 3. Harpers Biochemistry (Murray, Granner, Mayes and Rodwell) Biochemistry (Mckee and Mckee) biochemistry (Mathews and VanHolde)

ANATOMY AND HISTOLOGY I. Morphology and Function A. Bones and Joints B. Muscular system C. Cardiovascular System

D. E. F. G. H. I.

Lymphatic System Respiratory System Gastrointestinal System Urogenital System Central Nervous System and Peripheral System Endocrine System APPLIED ANATOMY

I.

Anatomic Basis for Clinical Signs and Symptoms A. Infarcts 1. Cerebro-spinal 2. Myocardial 3. Pulmonary 4. Digestive System 5. Extremities 6. Placenta B. Traumatic/Surgical Transactions 1. Cranio Spinal Nerves 2. Peripheral Vascular and Lymphatic Vessels C. Space-Occupying Lesions D. Foreign bodies/substance

II.

Anatomic Correlations of Common Surgical and Diagnostic Procedures A. Cerebro-spinal B. Vascular Ligaments/Transection C. Tumor surgeries and lymph node dissection D. Fluid Aspiration from Body Cavities - common treatment procedures regimens References : 1. 2. 3. Clemente, C.D. Edition; Anatomy, A. Regional Atlas of the Human Body, 4th Edition, Williams and Wilkins, Philadelphia 1977. Snell, R.S.; Clinical Anatomy for Medical Students, 5th Edition, Little Brown and Company, Boston 1995 Cormack, D.H.L. Clinical Integrated Histology, LippincottRaven, Philadelphia 1977.

MICROBIOLOGY AND PARASITOLOGY I. Basic Principles of Microbiology and Parasitology II. Principles of Immunology; Classifications of Diagnosis and Management III. Pathogenic Organisms; Classification A. Gram Positive Bacteria B. Gram Negative Bacteria C. Chlamydia, Rickettsia, Coxiella Burnetti D. Spirochetes E. Mycobacterium F. Mycoplasma G. Fungi H. Viruses I. Slow viruses and Prions J. Parasitologic organisms IV. Special Problems

A. Water and Food Bacteriology B. Environmental problems References : 1. Zinzzer Microbiology, Current Edition 2. Beaver Clinical Parasitology, current Edition 3. Jawetz Medical Microbiology, current Edition

PHYSIOLOGY I. General Physiology A. Cell Physiology Extra Cellular Fluid 1. Types and Functions of Cells 2. Cell Membranes 3. Distribution of Body Waters 4. Cellular Transport System B. Nerve Physiology 1. Characteristics of nervous and functions of Nerve Fibers C. Muscle Physiology 1. Characteristics and Functions of muscle fiver D. E. F. G. H. I. Hypothalamus and the autonomic nervous system Cutaneous, deep and visceral sensation Physiology and function of the brain Sleep Pattern RAS EEG Basic and Functions

II. Physiology of Blood Cells, Blood Coagulation and Immunology Mechanism III. Cardiovascular System A. Physiology of the Cardiovascular system B. Disorders IV. Respiration A. Physiology of the Respiratory system B. Disorders V. Renal Physiology A. Physiology of the Renal system B. Disorders VI. Gastro-Intestinal Tract A. Physiology of GIT B. Disorders VII. Endocrinology and Reproduction A. Physiology of Endocrine gland B. Disorders VIII. Special Senses A. Physiology B. Disorders

XXI. Aviation, space, Deep Sea and sports Physiology References : 1. Textbook of Medical Physiology by Guyton Lamb, Ingram Johnson and Pitman: 2. Essentials of Physiology 3. Review of medical Physiology by William f. Ganong 4. Human Physiology and mechanism of Disease by Arthur C. Guyton and John E. Hall

LEGAL MEDICINE I. Legal Medicine, Medical Jurisprudence and Ethics A. Legal Medicine 1. Application of Relevant Laws to the Practice of Medicine 1.1 Definition and Determination of the Cause of Death 1.2 Determination of the Causes of Death in the adjudication of cases 1.3 Medico legal implication in relation mechanism and its correlations of the body injury and the causes 1.3.1 Laceration 1.3.2 Hematoma 1.3.3 Penetrating and non-penetrating wound 1.3.4 Perforating wound 1.3.5 Stab wound 1.3.6 Incise wound 2. The Battered Child 2.1 Recognition 2.2 Child and Welfare code 2.3 Classification of Child Abuse, Causes and Implications 2.4 Management 3. Crimes Against Chastity 3.1 Definition, classifications of Crimes against Chastity 3.2 Recognition, diagnosis and management 4. Medico Legal Implication of Pregnancy as a Consequence of Crimes against Chastity 4.1 Medical Evidence of Pregnancy by laboratory List 4.2 Proof of Delivery - anti mortem and post mortem 5. Abortion and Miscarriage 5.1 types 5.2 complication 6. Determination of the Causes of Death 7. Post Mortem Charges 8. Determination of paternity and Filiations 9. Medico Legal Importance and Sterility 10. Medico Legal Importance of mental and Psychological Disorder 11. Substance Abuse B. Medical Jurisprudence 1. Legal Aspects of Medical Practice 2. Licensure and Regulatory laws 3. Physician-patient relationship

4. Different doctrine applicable in the determination as to whether the physician and hospital in cases of medical practice 5. Life threatening medical emergencies 6. Delegation of responsibilities of attending Physicians 7. Medico Legal problems in Human Organ Transplantation 8. Fertility 9. Phil. Health Insurance 10. Physicians or expert witness in court 10.1 Ordinary and expert witness 10.2 Privilege communication 10.3 Hearsay Evidence/dying Declaration References : Legal Medicine by Pedro Solis, MD, LlB. Medical Jurisprudence (The Practice of Medicine and the Law) by Pedro Solis, MD, LlB.

PATHOLOGY I. Cell Injury, Necrosis and Apoptosis A. Morphology, Gross and Microscopic B. Pathogenesis and Pathophysiology C. Clinical Consequences Inflammation A. Morphology, Gross and Microscopic B. Pathogenesis and Pathophysiology C. Clinical Consequences Repair and Regeneration A. Morphology, Gross and Microscopic B. Pathogenesis and Pathophysiology C. Clinical Consequences Developmental Pathology A. Morphology, Gross and Microscopic B. Pathogenesis and Pathophysiology C. Clinical Consequences Circulating Disturbancy A. Morphology, Gross and Microscopic B. Pathogenesis and Pathophysiology C. Clinical Consequences Radiation Injury A. Morphology, Gross and Microscopic B. Pathogenesis and Pathophysiology C. Clinical Consequences Neoplasia A. Eteogenesis B. Classification of neoplasm C. Tumor Markers D. Ploidy Immunopathology A. B-cells and T-cells and Lymphocyte subpopulations

II.

III.

IV.

V.

VI.

VII.

VIII.

B. Immune Deficiency diseases C. Immune-Mediated Diseases IX. X. XI. XII. XIII. Cross-Reacting Antibodies Immune complex Anti-Receptors Prions Amyloidosis A. Transplantation Pathology B. Tissue typing and DNA Fingerprinting Infectious Diseases A. Bacterial B. Rickettsial C. Viral D. Parasitic E. Mycosis F. Slow Viruses and Prions Diseases of the Digestive Systems Diseases of the heart and Lungs Diseases of the Endocrine Diseases of the Urologic and Reproductive system Diseases of the Skin and Connective Tissues Diseases of the Central and Peripheral Nervous System and special Sense Organs

XIV.

XV. XVI. XVII. XVIII. XIX. XX.

References : 1. 2. Cotran, R.s., Kumar, V. & Collins, T: Robins pathologic Basis of disease; 6th Edition; W.B. Saunders company, Philadelphia 1999. Danjanor, I. And Linden, J.: Andersons pathology, 10th Edition, Volume 1 and 2, Mosby, Boston 1996. PHARMACOLOGY I. Definition, Principles and Application A. Pharmacokinetics B. Pharmacodynamics C. Pharmacotherapeutics D. Adverse Reactions and Drug-Interactions E. Toxicity Pharmacological Agents Based in the Management of Disorders A. Synaptic and neuro effector junction sites B. Central nervous system C. Cardiovascular system D. Genitourinary system E. Reproductive system F. Respiratory System G. Blood and blood forming organs H. Special Organs Pharmacological Agents use for specific Indications A. Autocoids; Anti-inflammatory Drugs B. Anti-Microbials and anti-helmintics C. Anti-neoplastic Drug D. Hormones and Hormone antagosits E. Vitamins F. Immunomodulators

II.

III.

IV. V.

Heavy Metal, Heavy Metal Antagonists and Environmental Planning The Clinical Applications of the Principles of Pharmacodynamics, Kinetics, Adverse Reactions, Drug Interactions and toxicity for Rational Drug use in Patient-Problems

References : Goodman & Gilmans the Pharmacological Basis of Therapeutics, Ninth Edition Basic and Clinical Pharmacology by Bertram G. Katzung, MD, PhD.

SURGERY, OPTHALMOLOGY, OTORHINOLARYNGOLOGY I. Surgical Basic Principles I A. Fluid and Electrolyte Balance B. Mechanisms of water and electrolyte flux C. Acid-base balance D. Normal water and electrolyte requirements response to trauma; SIRS E. Oncotic and osmotic pressure F. Trauma G. Shock H. General Principles of Critical Care Surgical Basic Principles II A. Wounds and wound healing B. Surgical Bacteriology C. Surgical Infections D. Sepsis and antisepsis E. Antimicrobial agents Surgical Basic Principles III A. Burns B. Surgical Nutrition C. Blood and blood transfusions D. Hematologic diseases E. Molecular biology F. Immunology and Transplantation Head and neck surgery, Ophthalmology, Otorhinolaryngology A. Classification and Etiology of disorders/diseases B. Principles of diagnosis and management Thoracic and Cardiovascular Surgery A. Etiology and Classification of TCVS disorder B. Diagnosis and Management of Common Disorders Peripheral Vascular Surgery A. Classification, Diagnosis and Management Abdomen I A. Disorders of the upper Gastrointestinal Tract B. The Pancreas C. The Spleen D. Retroperitoneal Disorders

II.

III.

IV.

V.

VI. VII.

VIII.

Abdomen II A. Disorders of the Liver B. Disorders of the Gallbladder and the Biliary Tract Abdomen III A. Disorders of the small Intestines B. Disorders of the Caecum, Rectum and Anorectum; perineum C. Vermiform Appendix

IX.

X. XI.

Disorders of the Skin and Soft Tissues The Breast A. Classification and diagnosis of the Benign and Malignant lesions of the Breast B. Management of Benign and Malignant lesions of the Breast Hernias and Abdominal Wall Disorders Surgical Specialties I A. Neurosurgery - Diagnosis and management of common neurosurgical disorders B. Endocrine Surgery - Diagnosis and Management of Disorders of the Endocrine Glands C. Urology - Diagnosis and Management of Urologic Disorders D. Gynecologic disorders of Importance in Surgery E. Principles of Plastic and Reconstructive Surgery

XII. XIII.

XIV.

Surgical specialties II A. Classification, characteristics and Indications of Anesthetic Agents B. Orthopedic disorders C. Pediatric surgery - classification, characteristics, diagnosis and Management of Common problems References : 1. 2. 3. 4. 5. 6. Basic surgery (Poll, Gardnesr and Stone) Textbook of Surgery (Sabiston) Textbook of Surgery (Schwartz) Ophthalmology, Principles and concepts (Dewell) Ophthalmology,, Secrets (Vander and Gault) Fundamental of Otorlaryngology (Adams, Boies and Hilger)

MEDICINE I. II. Principles of Physical Diagnosis Infectious Diseases A. Etiologic Agents 1. Bacteria 2. Virus 3. Fungus 4. STD 5. HIV 6. AIDS B. Diagnosis and Recognition

10

1. Clinical Signs and Symptoms, Diagnostic and Procedures C. Management III. 1. 2. 3. 4. 5. 6. IV. Immunologic disorders Overview of the Immune System Pathogenesis of Immuno disorders Allergy : Allergic Reactions, allergic Rhinitis; Urticaria Angioedemas, Anaphylaxis Drug Reactions Immunodeficiency disorders Rheumatic Disease

Cardiovascular Disorder 1. Classification, Etiology, Diagnosis and Management of Cardiovascular disorder 2. Special procedures in the Diagnosis and Management Respiratory Disorders 1. Classification, Etiology, Diagnosis and Management 2. Special procedures in the Diagnosis and Management Kidney and urinary Tract disorders 1. Classification, Etiology, Diagnosis and Management 2. Special procedures in the Diagnosis and Management Gastrointestinal Tract Disorders 1. Classification, Etiology, Diagnosis and Management 2. Special procedures in the Diagnosis and Management Endocrine and Metabolic Disorder 1. Classification, Etiology, Diagnosis and Management 2. Special procedures in the Diagnosis and Management Oncology 1. Principles of Neoplasia 2. Principles of Cancer Therapy and Treatment Modalities Hematologic Disorder Neurology Psychiatry - Diagnosis and Management Special Problems a. Substance Abuse b. HIV/AIDS c. Problems of the Environment

V.

VI.

VII.

VIII. . IX.

X. XI. XII. XIII.

References : Cecile, Textbook of Medicine, current Edition Harrison, Textbook of Medicine, Current Edition OBSTETRICS AND GYNECOLOGY OBSTETRICS I. Normal Pregnancy, labor and Delivery A. Anatomy of the Reproductive Tract B. Physiology of Pregnancy 1. Endometrium

11

2. 3. 4. 5. C. D. E. F. G. H. II.

Placenta Placental Hormones Morphological and Physiological Development of Fetus Maternal Adaptations to Pregnancy

Diagnostic of Pregnancy Prenatal Care Mechanism of Normal Labor in Occiput Presentation Conduct of Normal Labor and Delivery Obstetrics Analgesia and Anesthesia Care of the Newborn

Abnormal Pregnancy, Labor and Delivery of Puerperium A. Fetal Positions and Related Problems B. Abortions C. Ectopic Pregnancy D. Preterm birth E. Post Term birth F. Multifetal Pregnancy G. Pregnancy at Extremes of Reproductive Life H. Complications; Diagnostic Investigation and Management of Abnormal Pregnancy 1. Techniques used to assess fetal health 2. Non-invasive and invasive techniques to monitor the fetus 3. Operative Obstetrics 3.1 Operative vaginal surgery 3.2 Technique of brush delivery 3.3 Cesarean delivery and cesarean hysterectomy Family Planning A. Methods of contraception 1. Medical contraception 2. Mechanical Methods of Contraception surgical contraception 3. Natural Planning Method

III.

GYNECOLOGY I. Female Reproductive Tract A. Anatomy and Embryology B. Molecular biology and Genetics C. Reproductive Physiology Diseases and disorder affecting the Female Reproductive System A. Pelvic Pain and Dysmenorrhea, Premenstrual syndrome B. Non-Neoplastic Diseases of the Female C. Benign and Malignant diseases of the Female Reproductive Tract D. Intraephethelial disease of the Cervix Vagina and Vulva E. Changes in the Breast associated with Menstruation, Pregnancy and Delivery F. Special problems in Reproductive Health 1. Adolescent gynecology 2. Menstrual disorders 3. Endometriosis 4. Infertility 5. Recurrent Spontaneous Early Pregnancy Loss 6. Menopause 7. Immulogic Disorders

II.

References :

12

William Obstetrics, 20th Edition Textbook of Obstetrics, 1st Edition By : Bajon, Panlilio, Baltazar, Garcia, Sumpaico, Tomacruz Novaks Gynecology, 12th Edition comprehensive Gynecology, 3rd Edition

PEDIATRICS AND NUTRITION

I. II. III. IV. Growth and Development Nutrition Preventive and Promotive Pediatrics Disease and Disorders of Childhood A. B. C. D. E. F. G. H. I. J. K. L. Immunology, Allergy and Genetic Infectious Disease Cardiovascular System Respiratory Hematology Digestive System Genito Urinary Disorders Nervous System Musculo Skeletal System Metabolic and Endocrine Disorders Dermatologic Disorders Special Problems 1. 2. 3. 4. 5. References: 1. Textbook of Pediatric by Waldo Nelson 2. Textbook of Pediatric and Child Health Fe Del Mundo, Felix Estrada, Perla D. Santos-Ocampo, Xerxes Navarro 3. Red-Book Committee on Infectious Diseases, American Academy of Pediatrics, 24th Edition, George Peter-Editor Poisoning Substance Abuse Child Abuse Trauma Perinatology

PREVENTIVE MEDICINE I. II. Epidemiology and Biostatistics Public Health and Preventive Medicine A. B. C. D. III. IV. Family and Community Health Care Environmental Sanitation Occupational Health Practice Herbal Medicine and Nutrition

Research Methodology Special Problems A. HIV and AIDS B. Transmissible Spongiform Encephelopathy 13

C. Hepatitis D. Bioengineering Genetic Disorders E. Foot and Mouth Disease References: 1. Foundations of Statistical Analysis for Health Sciences Ophelia Mendoza, Maridel Borja, Caridad Ancheta. Ofelia Saniel. Jesus Sarol 2. Research Methods in Health and Medicine (Philippine Council for Health Research and Development), Department of Science and Technology, Volume I F.S. Sanchez, S.I. Morelos, J.C. Baltazar 3. Reading in Preventive Medicine II (UST, Dept. of Preventive and Social Medicine) 4. Bioethics A. Angles Tan-Alora, MD 5. The Implementing Rules And Regulations of the National Health and Insurance Act of 1995. 6. Epidemiology Manual by Dr. Rosa Santos-Carreon (UST) 7. Lectures and manuals on Preventive Medicine from different Philippine Medical Schools.

14