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DIPLOMA IN TUBERCULOSIS AND CHEST DISEASES (D.T.C.D) First 6 months (Orientation Programme)
1. Attending PG orientation programme (covering the main teaching methods issues relating to establishing support with the patients. Ethical issues involved in rendering the patient care services) 2. Care of indoor patients under guidance of seniors. 3. Taking case-history, working up indoor cases, writing admission and discharge 4. Performing Minor –OT procedures in OPD. 5. Attending emergency ad referral calls under the supervision of Senior Resident/Assistant Professor/ Associate Professor/Professor. 6. Attending ward rounds and assisting in carrying out the instructions by senior 7. Attending Our Patient Department patients under the supervision of seniors. 8. Keeping records and maintenance of ward, OPD and emergency statistics. After 6 months to the end of the course:
1. Presenting indoor patients in ward rounds. 2. Attending OPD patients. 3. Doing emergency duties of 24hr duration by rotation among all residents. 4. Presenting seminars, journal articles cases on rotation basis. 5. Attending Inter-departmental meetings and planning the management. 6. Ensuring proper management of indoor patients and proper record keeping by 7. Attending medical care review meetings. Central Academic Programmes and other guest-lectures organized by Institute. 8. Taking clinical classes for undergraduate students posted in TB & CD. 9. Maintaining a Log Book. TEACHING SCHEDULE
CLINICAL POSTINGS:
™ Tuberculosis Research Center (TRC) Chennai ™ National Tuberculosis Institute (NTI) Bangalore Afternoon Lectures/ Demonstration Classes in Pre and Para Clinical Sciences The following skill should be possessed by candidate appearing for Diploma In Tuberculosis and Chest Diseases (DTCD).
Communication skills:

a) Communication with peer Group by way of: b) Communication with students and colleagues: ƒ Undergraduate teaching ƒ Demonstrations ƒ Gathering and compiling data, analysis and presentation, designing a ƒ Knowledge about requirements, estimation of cost and expenditure of b) Knowledge about essential National Health Programmes. a) General skills b) Specific skills in Respiratory Medicine GENERAL SKILLS
™ General Medicine: History taking Methodological clinical examination, fundus examination, liver biopsy, L. P. sternapuncture for bone-morrow examination, catheterization and bedside investigations. ™ Cardiology: Interpretation of ECG in relation to respiratory diseases, ECHO, Radiology: X-ray reading, positioning, fluoroscopy, bariumswallow, bronchography, CT scan and Ultra Sonography. ™ Optional: MRI Lung Scan and Pulmonary-angiography. ENT, Anaesthesiology: Intubation, Tracheostomy, Transtracheal aspiration, Sinus examination. o Paediatric Pulmonary diseases: Fluid and electrolyte balance in children. o Cardiovascular and Thoracic Surgery: Bronchoscopy, Pulmonary resection, post-operative care and pre-operative evaluation. ™ These skills are acquired by the candidates by working in parent and allied SPECIFIC SKILLS IN RESPIRATORY MEDICINE

• Sputum examination with ZN stain, examination of the body fluids for AFB • FNAC • Evaluation of diagnostic tests • Sleep lab and sleep clinic • Exercise • Respiratory muscle function tests • Pulmonary function test • BCG • Bronchoscopy aspiration and lavage • Pleural • Management issues and basic nursing and asepsis, cross infection and • Life support system management. • Principles of total parenteral (TPN) nutrition. Apart from these skills, the candidate should possess skill for rapid diagnosis and decision making which is useful in outpatient department and as a part of inpatient management he/she should have the following skills. • Case sheet writing, clinical examination, diagnosis, investigation and • Problem based approach towards day- to day management • Bedside diagnostic and therapeutic procedures • Minor surgical procedures • Rehabilitation EVALUATION
CONTINUOUS OR PERIODIC EVALUATION DURING THE COURSE
This evaluation of the candidate should be earned out every month and the • Short question and answer supplemented by viva-voce. • Ward round question answers practical skills • Direct supervision and observation of procedures like bronchoscopy, pleural • Checking the log book. • Regularity in attendance.
COMMUNICATION SKILLS

• Objective assessment of clinical presentation, seminars and case discussions’ • Dealing with patients, relatives and paramedicals • Feedback from patients CERTIFYING THE PROFICIENCY IN THE SKILLS
For Diploma in Tuberculosis and Chest Diseases (DTCD) This is done by theory examination consisting of 3 papers of 100 marks each. Theory question papers consist of short answer and long answer questions. This weight age is 50%. The other 50% will have 200 marks for clinical and 100 marks for viva/ practical. The candidate should pass independently all categories under the same set of examiners. Papers – I
Basic Sciences as applied to Pulmonary Medicine Format for paper – I
Applied Basic Sciences approximately 60% weight age on Anatomy and Physiology and 40% on other applied basic sciences related to Tuberculosis and Respiratory Diseases. Format for Paper II & III
• 2 Long questions of 25 marks each • 5 short answer questions of 10 marks each Tuberculosis (Pulmonary and extra pulmonary including recent
advances)
Paper III
Non-Tuberculosis chest Diseases including recent advances and air
pollution.

CLINICAL EXAMINATIONS
Practical examination 1. Spot slides and spotters 2. X-ray films 3. Specimen 4. ECG/ABG/Polysomnography 5. Instruments 6. PFT Interpretation 7. Bronchoscophy findings & Interpretation 1. Recent advances 2. Research work done 3. Image techniques 4. Acute emergencies Eligibility for Pass
• The candidate should obtain a minimum of 50% marks in theory, Clinical, Practical and Viva voce separately. (In addition, in each Theory paper a candidate has to secure minimum of 40% . If any candidate fails even under one head, he/she has to reappear for both Theory and Practical / clinical / Viva examinations. Examiners
1. There shall be four examiners (PG teachers) – Two internals and two externals. Two internal examiners shall be from the same University/Institution. One of the internal examiners will act as Chairman/convener as per instructions from University. Two external examiners shall be from different Universities. 2. All the examiners must be full-time PG teachers with requisite experience as per Annexure II – Model question papers for Diploma in Tuberculosis and Chest
Diseases(DTCD)
Annexure II – List of Recommended Books and Journals for both MD and DTCD
PAPER – I
1. An Architecture for Physiological Function • Development, ultra structure and Anatomy of Respiratory tract and Lungs. • Embryology of lungs, heart, mediastinum and diaphragm. • Development • Surgical and endoscopic and applied Anatomy of chest and neck including • Radiographic Anatomy (plain skiagram, CT, MRI, Ultrasound etc.) • Control of Ventilation and role of peripheral and central Chemoreceptors & • Ventilation, pulmonary Blood Flow, Gas Exchange, Blood Gas Transport • Inhalation kinetics and its implication in aerosol therapy, sputum induction 3. Approach to the Patient with Respiratory signs and symptoms • Basic signs and symptoms of lung diseases • Pathogenesis, evaluation of dysnoea and abnormal breathing patterns. • Pulmonary manifestations of systemic diseases. • Trache Bronchial Secretion/Transbronchial Aspirations • Bronchoscophy and related Procedures • Radiographic Evaluation of the Chest and Computer Tomography and MRI • Gram’s stain, Zeihl-Neelsen stain for AFB, Fluorescent Microscopy, fungus Stain, Gomori stain for p. carini. • Immunological Tests including Mantoux. • Polymerase chain reaction, D. N. A. probe, Bactec tests. • Thoracocentesis, Biopsy FNAC/FNAB • Spirometry, ABG, Diffusion studies PAPER – II
• Pathogenesis of Pulmonary Tuberculosis and clinical Manifestations and • Diseases caused by Mycobacteria other than Mycobacterium Tuberculosis • Treatment of Mycobacterial Diseases of the Lungs caused by • RNTCP • Treatmetn of pulmonary tuberculosis in hepatic renal and endocrine • Multidrug resistant tuberculosis • AIDS & tuberculosis • Chemoprephylaxes PAPER – III
• Immune defenses of the lung and Cellular Communication in Respiration • Sarcoidosis • Hypersensitivity Pneumonitis and Pulmonary Manifestations of Collagen • Granuloma like Wegener’s, Churg Strauss etc. • Occupatioonal and Environmental Pulmonary Diseases. 3. Non-infection disorders of the pulmonary Parenchyma • Aspiration and inhalational (non-Occupational) Disease of the Lung • Pulmonary • Pulmonary Hypertension and Cor Pulmonale • Pulmonary thromboembolic Disease. • Asthma Epidemology, General Features, Pathogenesis, Pathophysiology and therapeutic modalities Chronic Obstructive Pulmonary Diseases. • Immunotherapy • Long term Oxygen therapy • Inhalation • Pulmonary Rehabilitation • Acute Brochrolitis and Bronchiolitis Obliteran • Upper airway obstraction • Broncholitis Obliterans organizing Pneumonia (BOOP) 6. Hypoventilation Syndromes and sleep disorders • Disorders of Alveolar Ventalation • Sleep Apnea Syndrome • Obesity 7. Non - Tuberculosis Infections of the Lungs General aspects • Approach to patient with Pulmonary Infections • Nosocomal 8. Non – Tuberculosis infections of the lungs specific disorders • Pneumonias caused by Gram-Positive Bacteria, Gram Negative Aerobic- Organisms and Anaerobic Organisms and Anaerobic infections of the Pleura • Unusual Bacterial Pneumonia including viral or rickettsial • Community Acquired Pneumonia • Bronchectasis • Biology of the lung cancer, small cell and non small cell • Epidemiology, Pathology, Natural History and Clinical Picture of the • Diagnostic Approach of Pulmonary Nodules • Small Cell Lung Cancer • Medical Management and Surgical Treatment of Non-small Cell Lung • Radiation Therapy in the Management of the Carcinoma of the Lung • Benign and malignant Neoplasms of the Lung other than Bronchogenic Carcinoma and thymic and neuro fibromatous tumors, Neoplasms of the Pleura, Chest Wall and diaphragm • Primary Neoplasms and cysts of the Mediastinum • Pleural Dynamics and Effusions • Non neoplastic and Neoplastic Pleural Effusions • Pneumothorax • Pyothorax and Broncho-pleural; fistula • Pleural thickening, fibrosis and calcification • Acute Respiratory failure: Introduction and Overview • Adult Respiratory Distress Syndrome: Clinical Features, Pathogenesis, Sequential Morphological changes and Management • Acute Respiratory failure in the patient with Obstructive Airways Disease • Respiratory Muscles and clinical Implications of Respiratory Muscle • Pre – and Post – operative evaluation AND Management of Thoracic • Chest Trauma /Trauma related lung dysfunction • Lung 14. Practical Assessment of Pulmonary performance • Pulmonary function test and its Interpretations in Determining the • Spirometry, compliance , resistance, lung volume, diffusions • Blood gas analysis • Cardiopulmonary exercise testing • Bronchoprovocation • Organic and inorganic dust exposure and their effects • Environmental dust measurements, radiation and lung, occupational • Effects and Hazards of smoking and passive smoking and its prevention in • Demonstration and use of equipments (Ventilator, Bronchoscope, DIPLOMA IN TUBERCULOSIS AND CHEST DISEASSES (DTCD) EXAMINATION
Paper – 1 : BASIC SCIENCES AS APPLIED TO PULMONARY MEDICINE ANSWER ALL QUESTIONS: DRAW SUITABLE DIAGRAMS WHEREVER NECESSASRY b. High Altitude Pulmonary edema c. Deep Sulcus sign d. Clarithromycin e. Respiratory f. Preoperative Pulmonary evaluation. g. Dynamic DIPLOMA IN TUBERCULOSIS AND CHEST DISEASSES (DTCD) EXAMINATION
Paper II: PULMONARY AND EXTRAPULMONARY including RECENT ADFVANCES)
ANSWER ALL QUESTIONS: DRAW SUITABLE DIAGRAMS WHEREVER NECESSASRY Q!: Describe the clinical features and managaement of Tuberculosis meningitis. Q2: How will you diagnose MDR-TB ? Write recent Concepts in the treatment of MDR-TB. A) Runyan’s Classification. B) Wallgren’s Time Table C) Brocks’ syndrome D) Erythema Npdpsi, E) BCG Vaccination. DIPLOMA IN TUBERCULOSIS AND CHEST DISEASSES 9DTCD) EXAMINATION
Paper – III NONTUBERCULOUS CHEST DISEASES including RECENT ADFVANCES AND ANSWER ALL QUESTIONS: DRAW SUITABLE DIAGRAMS WHEREVER NECESSASRY Q1 Describe non-cardiogenic pulmonary oedema and its management. Q2: Classify pneumonia, Describe the clinical features and management of community acquired pneumonia 1. PIOPED 2. Modified Light’s criteria 3. Loffler’s 4. Eaton – Lambert syndrome 5. N-Acetyl Recommended Books
Name of the Books
Name of the Author &
Publication
5. Murray a Nadal Text Book of Respiratory 7. Respiratory Care Anatomy and Physiology 19. Atlas of procedures in Respiratory Medicine 20. Computerised Tomography and Magnetic 21. Principles and Practicals od Medicine 22. Harrisons Principles of Internal Medicine 23. Practical Approach to Critical Respiratory Print Journals
Name of the Books
Indian Journal of Lung Disease and Tuberculosis 3. International Journal of Lung Disease and Tuberculosis 4. On Line Journals
Name of the Books
Journal of Allergy and Clinical Immunology

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