Checklist of infrastructure and equipment



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PART X

ACADEMICS
43. Educational Program Objectives: Every institution shall have a defined objective and public health objectives.
44. Curriculum Management: The curriculum shall be as laid down by the PM&DC. The institution shall be governed by the statutes, regulations, rules framed by the PM&DC from time to time including general scheme of studies , duration of courses, the medium of instructions and examinations, detailed syllabi for examinations, and the condition under which students shall be admitted to examinations.
45. Roles and Responsibilities: There is integrated institutional responsibility for the overall management, delivery and evaluation of the curriculum. The Principal and the faculty need to ensure the effective delivery and implementation of the components of the curriculum. The Principal or Dean need to have sufficient resources and authority to fulfill this responsibility.
46. Evaluation of examinations: The statutes, regulations, rules framed by the PM&DC on evaluation and inspection of examination, shall govern the institution and the responsibility to comply shall be that of the Principal and the Vice Chancellor. No formal invitation to inspect examination is required to be extended to PM&DC.PM&DC shall inspect any or all examinations and the institution shall provide schedules of examinations to PM&DC well in time. The university shall not declare result of the examination unless cleared by PM&DC.

47. Confidentiality of student record

It is the responsibility of the institution concerned to keep the student records to be confidential and available only to members of the faculty and administration on a need to know basis. Laws concerning confidentiality of record need to be kept in view. Students are to be allowed to review and challenge their records if there is a valid reason for it.

48. Requirements and Guidelines about the Learning



Environment in the Institution
(a) Academic atmosphere

The institution shall create an environment where graduate and continuing medical and dental education programs are present. The program of medical and dental education leading to the M.BBS/BDS degree are to be conducted in an environment that fosters the intellectual challenge and spirit of inquiry appropriate to a community of scholars. Medical and dental institutions shall make available sufficient opportunities for medical and dental students to participate in research and other scholarly activities and the faculty shall encourage and support student participation.


(b) Behaviour & Discipline

(i) Medical and dental institutions have to ensure that the learning environment for medical and dental students promotes the development of explicit and appropriate professional attributes (attitudes, behaviors, and identity) in their medical and dental students.


(ii) Each medical and dental institution shall define and publicize the standards of conduct for the teacher-learner relationship, and develop written policies for addressing violations of those standards. The medical and dental institution are to publicize to all faculty and students its standards and procedures for the evaluation, advancement, and graduation of its students and for disciplinary action. There has to be a fair and formal process for taking any action that adversely affects the status of a student.
(iii) No political activity, in any form is to be undertaken by a student or a faculty member. PM&DC will take serious action including debarring him/her from medical education anywhere in Pakistan against perpetrators.
(c) Co-Curricular Activities The institution shall promote the extra curricular and recreational activates of the students. Indoor and outdoor sports facilities are to be arranged.
49. Evaluation of Program Effectiveness: (i) To judge student achievement a medical and dental institution has to collect and use a variety of outcome data, including national norms of accomplishment, to demonstrate the extent to which its educational program objectives are being met, how many students are successful in joining postgraduate courses and then achieving post graduation.
(ii) In assessing program quality, institutions are to consider student evaluations of their courses and teachers, as well as a variety of other measures.
(iii) A system for the evaluation of student achievement shall be in place throughout medical and dental college life and shall employ a variety of measures of knowledge, skills.
(iv) There is to be ongoing assessment that assures students have acquired and can demonstrate on direct observation the core clinical skills, behaviors, and attitudes that have been specified in the institution’s educational objectives. There is to be evaluation of problem solving, clinical reasoning, and communication skills.
(v) The faculty of each discipline shall set the standards of achievement in these disciplines. The directors of all courses and clerkships are to design and implement a system of formative (40%) and summative (60%) evaluation of student achievement in each course and clerkship. Each student shall be evaluated early enough during a unit of study to allow time for remediation.
( vi) All institutions shall adopt a process by which they shall maintain a record of achievements of each and every one of their students before and after graduation. Each medical and dental college are to engage in a planning process that sets the direction for the institution and results in measurable student achievement outcomes.
(vii) Narrative descriptions of student performance and of no cognitive achievement shall be included as part of evaluations in all required courses and clerkships where teacher-student interaction permits this form of assessment.

50. Information Resources and Library Services (i) The medical and dental institutions are to have a well-maintained library and information facilities, sufficient in size, breadth of holdings, and information technology to support its education and other missions. There shall be physical or electronic access to leading biomedical, clinical, and other relevant periodicals, sufficient current numbers of which shall be readily available. The library and other learning resource centers are to be equipped in such a manner so as to allow students to access information electronically, as well as to use self-instructional materials.


(ii) The library and information services staff are to be responsive to the needs of the faculty and students of the medical and dental institution. A professional staff shall supervise the library and information services, and provide instruction in accessing resource to the users. The library and information services staff shall be proficient in accessing current international, regional and national information resources and data systems, and know contemporary information technology. Moreover

      1. The library shall be a 100% lending library with adequate copies of text books (20% of admission strength) and 10 sets of at least 5 reference books in each subject.

      2. The library shall have seating facility for 20% of the total number of students on roll.

      3. The library shall have very extended timings.

      4. The institution shall have Internet connectivity and e-books. At least 1 computer per 10 students' admission with access to PERN and its subject related journals.



PART XI

TEACHING HOSPITAL

(CREDIT POINTS 250)
51. To train 100 MBBS students the institution shall establish one or more teaching hospital with ratio of minimum of 5 beds to a student admission per year and will be required to have a minimum total capacity of 500 beds in all or one hospitals and with the prescribed composition of departments and units. At first inspection the requirement is of 250 bed and which shall be increased to 500 beds by the time the students reach third year.
52. No two colleges shall share a teaching hospital irrespective of its bed strength.
53. Clinical resources in the attached teaching hospitals shall be sufficient to ensure breadth and quality of ambulatory and bedside teaching. They include adequate numbers and types of patients (acuity, case mix, age, gender, etc.) as well as physical resources. The hospital must have appropriate instructional facilities and information resources, appropriate instructional facilities include areas for individual student study, for conferences, and for large group presentations (lectures).
54. Sufficient information resources, including library holdings and access to other library systems at site. A sufficient number of computers are needed that allow access to the Internet and to other educational software. Call rooms and lockers, or other secure space to store personal belongings, shall be available for student use.

55. A teaching hospital affiliated with a private institution / University shall have 50% of the total prescribed beds available at no profit basis to the patients as already laid down in regulation 24 supra.

56. There shall be a major role of the medical and dental institution in appointment/assignment of faculty members in the affiliated teaching hospital responsible for medical and dental student teaching. If department heads of the institution are not also the clinical service chiefs at affiliated institutions, the affiliation agreement has to confirm the authority of the department head of the college to ensure faculty and student access to appropriate resources for medical and dental student education.

57. The prescribed number of beds in teaching hospital be distributed among the specialties as shown in table 2.



(Table 2 a)

Number of Beds

(Medical College)

Total Marks 40% 100 marks.


Department

Required Up to 100 Admissions

Required Up to 150 Admissions

Required for 151 to 200 Admissions

Required for 201 to 250 Admissions

Required for 251 to 300 Admissions




500 Beds

600 Beds

700 Beds

800 Beds

900 Beds

Essential Specialties
















Medicine

75

120

120

160

200

Surgery

75

120

120

160

200

Gynecology & Obstetrics

80

80

120

120

130

Paediatrics

40

40

80

80

80

Eye

15

20

20

20

20

ENT

15

20

20

20

20

Orthopedic / Trauma

40

40

40

40

50

Optional Specialties
















Medicine and Allied Specialties

80

80

80

80

80

Surgery and Allied Specialties (10 Bed in maxillofacial Surgery)

80 (1 unit on OMFS)

80 (1 unit on OMFS)

100 (1 unit on OMFS)

120 Floating (depending upon need and faculty)

120

Floating (depending upon need and faculty)




Out of 250 marks, 40% maybe given to the mandatory hospital facilities, listed below and 60% to the bed strength.
Hospital Facilities includes: 40% (100 marks)
Out-patient Department. 10%

Resuscitation area with facilities

Separate cubicles for teaching medical students

Dressing area

Basic instruments according to different specialities

Faculty room

Provision of wheel chairs and stretchers

Hospital Pharmacy. 05%

Both for indoor and outdoor patients

Trained pharmacists

Emergency room 10%

10 beds with monitoring facilities

Minor OT

Facilities for resuscitation esp. Defibrillator

Cubicles for patients with central oxygen and suction and monitoring facilities

Anaesthesia machines with ventilator 2



Operating Rooms 10%

Pre-anaesthesia area

Recovery area with central oxygen and suction and monitoring facilities

5 fully equipped operating rooms

Monitoring facilities in all theatres

Image intensifier (1)

Facilities for resuscitation

5 Anaesthesia machines with ventilators

Capnograph (Optional)

Diathermy machines in each theatre, both mono polar and bipolar

Protocol for Hep B/C
Critical care beds e.g intensive care, coronary care and neonatal care. 15%

Separate Medical & Surgical ICU beds

Separate Paediatric & Neonatal intensive care beds

Coronary care beds

15% of the total bed strength will be intensive care beds

Ventilatory facilities Atleast 15 Ventilators

Facilities for blood gas analysis


CSSD. 10%

Washing area

Washer disinfector 1

Steam Autoclaves with 134 C Temp. 500 ltrs. 2

Ethylene di-oxide/Formaldehyde gas steriolizer 1

Sealing Machines

Chemical Sterilization facilities

Storage & Distribution Counter


Radiology Services with all imaging modalities. 15%

X-ray Machines

500 mA Fluoroscopy/Image Intensifier 1

300 mA Stationary Bucky Table 2

300 mA Stationary Bucky Stand 2

100 mA Portable 2

Ultrasound Machines

3.5 mHz probe Gray Scale 2

3.5 mHz probe portable Gray Scale 2

Color Doppler Multifrequency probes 2

Biopsy probes 2

CT scan


Multislice (4/16/64) 1

MRI scan Optional

Mammography

Preferably with magnifier/spot film/compression 1

Safety Equipment

Lead Aprons 3

TLD 1

Lead Shield/Partitions 4



Film Badge/Radiation detector & thyroid shields

Optional equipments

OPG

Angiography Suites (compulsory)



PACS

Computed/Digital radiography



Laboratory Services (Haematology, Histopathology, Microbiology, Chemical Pathology and Blood Bank). 15%

Histopathology

Microtome facilities 1

Facilities for tissue processing 1

Embedding Stations 1

Basic Staining Station 1

Microscope with multiple heads 1

Frozen section facilities (Optional)

Haematology

3/5 part automated differential counter 1

Microscopes 1 with teaching head 2

*New Baur Chambers 5

Basic Staining Facilities inc Reticulocytes

Fridge to keep samples 1

Blood Bank

Serofuge 1

Agglutination Viewer 1

Water bath/Heat Block 1

Microscope 1

Platelet rotator with incubator 1

Blood Bank Fridge 1

-30 C Freezer for storage 1

Chemical pathology

Centrifuges 2

Semi automated chemistry analyzer 1

Automated chemistry analyzer 1

Immuno-assay analyzer 1

Refractometer 1

Ion selective electrode 1

Blood gas analyzer (Either in Deptt. Or ICU) 1

Fridge 1

Freezer -30 or -70 C 1

Microbiology

Incubator 37 C 1

Basic Staining facilities

Fridge 1


Microscope with teaching head 2

Safety Hood 1



Day Care Facilities. 05%

Food Service.

Proper Waste Disposal System (Incenirators). 05%
The total marks for hospital services will be 150. The above mentioned % can be calculated from 150 marks.
It is also recommended that the hospital should have at least 4 tutorial rooms, to be shared by different departments for teaching of students. Each tutorial room should have at least 25 seats.

Note

1. The total no. of beds required for 100 students is 500. The hospital shall have 500 beds of which at least 150 beds should be owned by the hospital and the rest 350 beds maybe contracted through Memorandum of understanding from other other government or nongovernmental organizations.

2. The hospital will have the liberty of either demarcate the no. of beds according to the specialties mentioned above or they can allocate beds according to floors or demarcated areas. It is recommended that under this scenario Medicine & Allied will have 200 beds, Surgery & Allied will have 150 beds and Mother & Child Health will have 150 beds. The total no. of beds will remain 500.

3. It is also recommended that out of 500 beds, 10% should be beds with monitoring facilities e.g ICU, CCU, NICU, HDU or in Emergency room.

4. There should be minimum of 2 outreach clinics dedicated for Community Health Services.

5. Since most of the Surgeries/Procedures done in Ophthalmology is carried out as an outpatient or day care the no. of beds in this speciality is reduced to 15.

6. The scoring will be done according to the no. of beds, and allocation of beds in different specialties or floors, as mentioned above, e.g if the total strength of beds is 400, then 20% marks will be deducted, or if the hospital does not have beds with monitoring facilities, although the total no. is 500, still 10% marks will be deducted.

7. Bed occupancy annual average shall not be below 60%.
8. For Dental College, the requirement of Dental Hospital for admissions in BDS, if it is a stand alone dental hospital, shall be equal to their annual intake of students in the following proportion it shall have 20 general surgery and 20 general medicine and 10 beds for oral & Maxillofacial surgery. For the Dental College with Medical College no extra beds are required.

58. A dental institution in public sector shall not have more than 100 students annually and a dental institution in private sector shall not have more than 80 students annually if it is a stand alone college and 75 students annually if it is with a medical college irrespective of facilities. A medical institution in public sector shall not have more than 350 students annually and a medical institution in private sector shall not have more than 150 students annually irrespective of facilities.


59. Dropouts in the first two years shall be adjusted in subsequent admissions so as to maintain total admission strength in the first two years. All dropouts shall be reported to the Executive Committee and permission for admission shall be sought.
60. Dissection of the bodies and the mortuary is optional.


PART XII

FACULTY

CREDIT POINTS 350
61 The strength, qualification and experience of teaching faculty and other staff and the terms and condition of their service shall be according to PM&DC requirements. The faculty shall have to be registered with PM&DC as only registered faculty shall be acceptable as faculty.The faculty shall display his valid faculty registration and PM&DC registration at his place of duty.
62. Faculty Objectives: (i) The medical and dental institution faculty has to define the objectives of the educational program according to the PM&DC curriculum. The objectives are to serve as guide for delivery of the curriculum content and provide the basis for evaluating the effectiveness of the educational program in order to achieve the defined competencies of the graduate as laid down by the PM&DC.
(ii) The objectives of the educational program are to be stated in outcome-based terms that allow assessment of student progress in developing the competencies that the PM&DC and the public expects out of a physician. There shall be a system with central oversight to assure that the faculty defines the types of patients and clinical conditions that students have to encounter, the appropriate clinical setting for the educational experiences, and the expected level of student responsibility. The faculty has to monitor student experience and modify it as necessary to ensure that the objectives of the clinical education program are met. The objectives of the educational program have to be made known to all medical and dental students and to the faculty and others with direct responsibilities for medical and dental student education.
63. Service Policies and career planning and progression. No faculty shall be over the age of seventy years, unless granted status of Professor Emiratus by the affiliating University.There shall be clear policies and terms and conditions of service for faculty appointment, renewal of appointment, promotion and progress, granting of tenure, and dismissal. These shall be clearly told to the faculty at the time of appointment. A medical and dental institution shall have policies that deal with circumstances in which the private interests of faculty members or staff may be in conflict with their official responsibilities. On regular intervals, faculty members shall receive written information about their terms of appointment, responsibilities, lines of communication, privileges and benefits, if relevant, and the policy on practice earnings. Career progression policies shall be laid down and shall safeguard the interest of the faculty.

64. Faculty shall receive regularly scheduled feedback on their academic performance and their progress toward promotion. Feedback shall be provided by students, departmental leadership or, if relevant, other institutional leadership. Opportunities for professional development are to be provided to enhance faculty members’ capacity and skills and leadership abilities in education and research.










The institution / University shall submit the details of available teaching staff with documentary evidence of their appointment, Income Tax deduction certificate and place of previous appointment and resignation(in case he has been in any other institution previously).Female faculty shall have flexible timings, which they will communicate to the administration from time to time .


65. Number, Qualifications, and Functions of the faculty The recruitment and development of a medical and dental institution’s faculty shall take into account its mission, the diversity of its student body, and the population that it serves. There has to be a sufficient number of faculty members in the subjects basic to medicine and in the clinical disciplines to meet the needs of the educational program and the other missions of the medical institution. In determining the number of faculty needed for the educational program, medical institutions shall consider that faculty may have educational and other responsibilities in academic programs besides medicine. In the clinical sciences, the number and kind of faculty appointed shall also relate to the amount of patient care activities required to conduct meaningful clinical teaching across the continuum of medical and dental education. Persons appointed to a faculty position have to demonstrate achievements commensurate with their academic rank. Members of the faculty must have the capability and continued commitment to be effective teachers. A faculty member/consultant who attends duty after 2400hrs shall not be required on duty next day before 1200hrs.
66. Effective Teaching: requires knowledge of the discipline and an understanding of curriculum design and development, curriculum evaluation, and methods of instruction. Faculty members involved in teaching, course planning and curricular evaluation shall possess or have ready access to expertise in teaching methods, curriculum development, program evaluation, and student evaluation. Such expertise may be supplied by a department of medical and dental education or by faculty/staff members with backgrounds in educational science. Faculty involved in the development and implementation of a course, clerkship, or larger curricular unit shall be able to design the learning activities and corresponding evaluation methods (student and program) in a manner consistent with the institution’s stated educational objectives and sound educational principles. Community physicians appointed to the faculty, on a part-time basis or as volunteers, shall be effective teachers, serve as role models for students, and provide insight into contemporary methods of providing patient care.
Faculty members shall have a commitment to continuing scholarly productivity characteristic of an institution of higher learning. Among the lines of evidence indicating compliance with these standards are the following:


    1. Documented participation of the faculty in professional development activities related specifically to teaching and evaluation.

(ii) Attendance at international, regional or national meetings on medical or dental educational affairs.



    1. Evidence that faculty members’ knowledge of their discipline is current.

67. The minimum required faculty and ancillary staff for the number of students is as under and the marks assigned to each category are displayed for convenience and reference in the inspection reports and information Performa of the Council for each category.

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