Dnb-Pharmacology: Competency Based Training Programme
Dnb-Pharmacology: Competency Based Training Programme
Dnb-Pharmacology: Competency Based Training Programme
for
DNB- PHARMACOLOGY
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CONTENTS
I. OBJECTIVES OF THE PROGRAMME
a) Programme goal
b) Programme objective
IV. SYLLABUS
V. COMPETENCIES
IX. EXAMINATION –
a) FORMATIVE ASSESSMENT
b) FINAL THEORY & PRACTICAL
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PROGRAMME GOAL
PROGRAMME OBJECTIVES
(i) Knowledge:
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xiii) Major national health problems and programs
xiv) Drug regulations in India and abroad and National Drug Policy
xv) Teaching technology
xvi) Methods of communication and medical writing.
xvii) Plan and conduct lecture, demonstration, practical tutorial classes for
students of medical and allied disciplines.
xviii) Estimation of drug levels in blood and other biological fluids using
suitable chemical assay techniques and interpret the same in therapeutic /
toxicological context
xix) Would be able to participate in the team involved in the preclinical and
clinical drug discovery process in pharmaceutical / academic setup.
xx) Preparation of protocols to conduct experimental studies in animal and
human drug trials
(ii) Skills:
The student should acquire the skills that are commensurate with the expected
knowledge as outlined above. Some of the desirable skills are:
(i) Performing commonly employed experiments and clinical techniques in
Pharmacology and drug research
(ii) Plan and conduct toxicity studies and clinical trials
(iii)Formulate and undertake research projects independently including
statistical analyses
(iv)Perform a number of service activities e.g. therapeutic drug monitoring,
pharmacovigilance, pharmacoeconomics and pharmacoepidemiology
(v) Perform various teaching and training activities for undergraduate and
post- graduate medical students and others with a sound understanding of the
modern tools of teaching technology.
(vi) Be conversant with the adequate communication skills of both the
written and verbal nature (e.g. publishing scientific papers, training doctors,
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paramedics, patients and public regarding relevant aspects of
pharmacotherapy).
(vii) Be proficient in use of computers in various aspects of their day to day
work
(viii) Be able to analyze and evaluate a research paper
(ix) Be able to formulate and conduct problem based teaching/learning
exercises
(x) Be capable of various managerial skills e.g. Drug store management in
a hospital; organization of workshops/training programs etc.
(xi) Be aware of the legal and ethical issues involved in drug development
and research.
(xii) Be able to constitute and conduct the proceedings of various
committees e.g. IAEC, IEC, DTC etc.
1. Any medical graduate with MBBS qualification , who has qualified the
Entrance Examination conducted by NBE and fulfill the eligibility criteria
for admission to DNB Broad Specialty courses at various NBE accredited
Medical Colleges/ institutions/Hospitals in India is eligible to participate in
the Centralized counseling for allocation of DNB Pharmacology seats
purely on merit cum choice basis.
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Every candidate admitted to the training programme shall pursue a regular
course of study (on whole time basis) in the concerned recognized institution
under the guidance of recognized post graduate teacher for assigned period of
the course.
The rounds should include bedside sessions, file rounds & documentation of case
history and examination, progress notes, round discussions, investigations and
management plan) interesting and difficult case unit discussions.
The training program would focus on knowledge, skills and attitudes (behavior), all
essential components of education. It is being divided into theoretical, clinical and
practical in all aspects of the delivery of the rehabilitative care, including methodology of
research and teaching.
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Symposia: Trainees would be required to present a minimum of 20 topics based on the
curriculum in a period of three years to the combined class of teachers and students. A
free discussion would be encouraged in these symposia. The topics of the symposia
would be given to the trainees with the dates for presentation.
Clinical: The trainee would be attached to a faculty member to be able to pick up
methods of history taking, examination, prescription writing and management in
rehabilitation practice.
Bedside: The trainee would work up cases, learn management of cases by discussion
with faculty of the department.
Journal Clubs: This would be a weekly academic exercise. A list of suggested Journals
is given towards the end of this document. The candidate would summarize and discuss
the scientific article critically. A faculty member will suggest the article and moderate the
discussion, with participation by other faculty members and resident doctors. The
contributions made by the article in furtherance of the scientific knowledge and
limitations, if any, will be highlighted.
Research: The student would carry out the research project and write a thesis/
dissertation in accordance with NBE guidelines. He/ she would also be given exposure
to partake in the research projects going on in the departments to learn their planning,
methodology and execution so as to learn various aspects of research.
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SYLLABUS
THEORY
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29. Pharmacoepidemiology
30. Pharmacovigilance
31. Pharmacogenomics
32. Gene therapy
33. Stem cell research
34. Pharmacometrics-Methods of Evaluation
35. Medical education techniques and technology
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Qualitative testing, titrimetric analysis. Beer and Lambert’s law. Basis and working
principle of colorimeter, ultraviolet, atomic absorption spectrometers, Fluorescence
spectroscopy, NMR, and Mass Spectroscopy. Basics of Chromatography. Partition,
absorption and ion exchange chromatography.
Clinical Trials
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Therapeutic audit: Drug utilization studies, essential drug concept,
rational prescribing
Drug delivery systems: sustained release, enteric coated formulations
and liposome etc.
Pharmacovigilance, Pharmacoeconomics, Pharmacogenetics and Drug
Information
PRACTICALS
Clinical Pharmacology:
Experimental Pharmacology
1. General:
• Study of basic instruments used for isolated tissue experiments
• Study of basic animal techniques
• Techniques for injection of drugs and collection of blood samples,
feeding of animals, etc.
• Techniques of Euthanasia
• Different laboratory animals and their application in experimental
pharmacology, breeding data, housing and maintenance and animal feeds
• Preparation and administration of a drug solution in appropriate strength
and volume.
2. In vitro Experiments:
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• Isolated Guinea pig tracheal chain (histamine and histamine antagonists
on cumulative DRC)
• Langendorff’s heart preparation (Study of different drugs on isolated
perfused rabbit heart).
C) Bioassay (by using different methods):
• Adrenaline on Rabbit/Guinea-pig/Rat intestine/duodenum
• Histamine on Guinea-pig ileum / Tracheal chain
• Acetylcholine on rat colon
• Mepyramine on guinea pig ileum
• 5-HT on rat fundus strip / estrogen primed rat uterus
C) Demonstration of competitive antagonism using suitable in vitro methods
E) Determination of EC50, ED50, pD2 and pA2 values of drugs
3. In vivo Experiments:
• Study of drugs using various psychopharmacological techniques
• Effect of mydiatrics and miotics on rabbit eye
• Study of CNS stimulants and depressants using photoactometer
• Study of antiepileptic drugs by using animal models of epilepsy
• Study of analgesics using animal methods of analgesia
• Study of anti-inflammatory drugs using carageenin induced rat paw
edema and other methods if possible
• Study of histamine aerosol induced bronchospasm and its antagonism
by antihistamines
Biochemical Pharmacology
Clinical Pharmacology
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• Preparation of protocol for human experiments/clinical trials
a) Schedule Y
b) ICH-GCP Guidelines
c) ICMR GCP Guidelines
d) ICMR Genetic Guidelines
• Preparation of patient information sheet and Informed consent form for
human experiments
• Evaluation of promotional drug literature
• Preparation of “Drug Information Sheet” (WHO criteria)
• Preparing standard operative practice for Bioavailability and
bioequivalence studies
• Interpretation of bioavailability parameters with the help of given
pharmacokinetics data
Clinical Pharmacy
Computer Skills
Research Methodology:
Biostatistics
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• Statistical software
OTHERS
The P G students are to be encouraged to largely carry out self learning with the
help of libraries and teachers. Preponderance of didactic teaching is to be
avoided. They are expected to actively seek knowledge and skills on their own
initiative. Sound knowledge of general and systemic pharmacology including
therapeutics of graduate level is to be acquired by self-study and by participating
in the teaching of graduate students.
1. P.G. Lectures, Seminars & Journal Club: These are to be held once a week
and are to include talks delivered by qualified faculty members of Pharmacology
as well as allied disciplines. Topics of interest common to PGs of other basic
and/or clinical disciplines (e.g. statistics, educational science, communication
skills, information technology, biomedical ethics, and human behavior) could be
covered in programs drawn out jointly with other departments. Suggested topics
for multidisciplinary teaching (Appendix 1), PG lectures (Appendix 2) and PG
seminars, experimental methods discussion. A timetable of these programs
should be drawn every 6 months. Each PG student should present at least 4-6
seminars every year and actively participate in seminars presented by other PGs.
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4. Intradepartmental postings Every PG student should be posted by rotation
to the different sections/laboratories of the Pharmacology department, viz.
experimental pharmacology, chemical pharmacology and drug assay, clinical
pharmacology including ADR monitoring and drug information service,
toxicology. A two weeks part time posting to the hospital pharmacy should be
arranged so that the PG student could learn drug procurement, storage, record
keeping, dispensing and quality control. A record of the observations made and
lessons learnt should be maintained by the students in logbooks.
Ethics
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THESIS PROTOCOL & THESIS
The candidates are required to submit a thesis at the end of three years of
training as per the rules and regulations of NBE.
The protocol for a research proposal (including thesis) is a study plan, designed
to describe the background, research question, aim and objectives, and detailed
methodology of the study. In other words, the protocol is the ‘operating manual’
to refer to while conducting a particular study.
The candidate should refer to the NBE Guidelines for preparation and
submission of Thesis Protocol before the writing phase commences. The
minimum writing requirements are that the language should be clear, concise,
precise and consistent without excessive adjectives or adverbs and long
sentences. There should not be any redundancy in the presentation.
The development or preparation of the Thesis Protocol by the candidate will help
her/him in understanding the ongoing activities in the proposed area of research.
Further it helps in creating practical exposure to research and hence it bridges
the connectivity between clinical practice and biomedical research. Such
research exposure will be helpful in improving problem solving capacity, getting
updated with ongoing research and implementing these findings in clinical
practice.
Research Ethics: Ethical conduct during the conduct and publication of research
is an essential requirement for all candidates and guides, with the primary
responsibility of ensuring such conduct being on the thesis guide. Issues like
Plagiarism, not maintaining the confidentiality of data, or any other distortion of
the research process will be viewed seriously. The readers may refer to standard
documents for the purpose.
The NBE reserves the right to check the submitted protocol for plagiarism, and
will reject those having substantial duplication with published literature.
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PROTOCOL REQUIREMENTS
1. All of the following will have to be entered in the online template. The
thesis protocol should be restricted to the following word limits.
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3. Since most of the difficulties faced by the residents relate to the work in
clinical subject or clinically-oriented laboratory subjects, the following
steps are suggested:
a. The number of cases should be such that adequate material,
judged from the hospital attendance/records, will be available and
the candidate will be able to collect case material within the period
of data collection, i.e., around 6-12 months so that he/she is in a
position to complete the work within the stipulated time.
b. The aim and objectives of the study should be well defined.
c. As far as possible, only clinical/laboratory data of investigations of
patients or such other material easily accessible in the existing
facilities should be used for the study.
d. Technical assistance, wherever necessary, may be provided by the
department concerned. The resident of one specialty taking up
some problem related to some other specialty should have some
basic knowledge about the subject and he/she should be able to
perform the investigations independently, wherever some
specialized laboratory investigations are required a co-guide may
be co-opted from the concerned investigative department, the
quantum of laboratory work to be carried out by the candidate
should be decided by the guide & co-guide by mutual consultation.
Title- A good title should be brief, clear, and focus on the central theme of
the topic; it should avoid abbreviations. The Title should effectively
summarize the proposed research and should contain the PICO elements.
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Introduction- It should be focused on the research question and should
be directly relevant to the objectives of your study.
Aim and Objectives - The ‘Aim’ refers to what would be broadly achieved
by this study or how this study would address a bigger question / issue.
The ‘Objectives’ of the research stem from the research question
formulated and should at least include participants, intervention,
evaluation, design.
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Competencies
Bioassay
• Bioassay methods
• General & statistical considerations
• Methods of bioassay for: Acetylcholine, skeletal neuromuscular junction
blockers, adrenaline, noradrenaline, histamine, 5HT, hormones, insulin,
vasopressin/oxytocin, estrogen, progestins, ACTH
• Competitive antagonism-pA2 values
• Radio immunoassay: Basic Concepts & applications, ELISA
• Animal experiments – Legal and Ethical considerations
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Educational Science:
• Teaching learning concept
• Teaching learning methods including problem based learning (PBL)
• Learning resource materials
• Instructional aids
• Educational objectives and curriculum development
• Communication skills
• Evaluation methods (Essay type, SAQs, MCQs, item analysis etc.
1. DNB candidates are required to submit their thesis protocol within 90 days
of their joining DNB training.
1. As per NBE norms, writing a thesis is essential for all DNB candidates
towards partial fulfillment of eligibility for award of DNB degree.
2. DNB candidates are required to submit the thesis before the cut-off date
which shall be 30th June of the same year for candidates appearing for
their scheduled December final theory examination. Similarly, candidates
who are appearing in their scheduled June DNB final examination shall be
required to submit their thesis by 31st December of preceding year.
3. Candidates who fail to submit their thesis by the prescribed cutoff date
shall NOT be allowed to appear in DNB final examination.
4. Fee to be submitted for assessment (In INR): 3500/-
5. Fee can be deposited ONLY through pay-in-slip/challan at any of the
Indian bank branch across India. The challan can be downloaded from
NBE website www.natboard.edu.in
6. Thesis should be bound and the front cover page should be printed in the
standard format. A bound thesis should be accompanied with:
a. A Synopsis of thesis.
b. Form for submission of thesis, duly completed
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c. NBE copy of challan (in original) towards payment of fee as may be
applicable.
d. Soft copy of thesis in a CD duly labeled.
e. Copy of letter of registration with NBE.
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LOG BOOK
This log book shall be made available to the board of examiners for their perusal
at the time of the final examination.
The log book should show evidence that the before mentioned subjects were
covered (with dates and the name of teacher(s) The candidate will maintain the
record of all academic activities undertaken by him/her in log book .
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Leave Rules
1. DNB Trainees are entitled to leave during the course of DNB training as per the
Leave Rules prescribed by NBE.
2. A DNB candidate can avail a maximum of 20 days of leave in a year excluding
regular duty off/ Gazetted holidays as per hospital/institute calendar/policy.
3. MATERNITYLEAVE:
a. Afemale candidate is permitted a maternity leave of 90 days once during
the entire duration of DNB course.
b. The expected date of delivery (EDD) should fall within the duration of
maternity leave.
c. Extension of maternity leave is permissible only for genuine medical
reasons and after prior approval of NBE. The supporting medical
documents have to be certified by the Head of the Institute/hospital where
the candidate is undergoing DNB training. NBE reserves its rights to take
a final decision in such matters.
d. The training of the candidate shall be extended accordingly in case of any
extension of maternity leave being granted to the candidate.
e. Candidate shall be paid stipend during the period of maternity leave. No
stipend shall be paid for the period of extension of leave.
4. Male DNB candidates are entitled for paternity leave of maximum of one week
during the entire period of DNB training.
5. No kind of study leave is permissible to DNB candidates. However, candidates
may be allowed an academic leave as under across the entire duration of training
program to attend the conferences/CMEs/Academic programs/Examination
purposes.
DNB COURSE NO. OF ACADEMIC LEAVE
DNB 3 years Course (Broad & Super Specialty) 14 Days
DNB 2 years Course (Post Diploma) 10 Days
DNB Direct 6 years Course 28 days
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6. Under normal circumstances leave of one year should not be carried
forward to the next year. However, in exceptional cases such as
prolonged illness the leave across the DNB training program may be
clubbed together with prior approval of NBE.
7. Any other leave which is beyond the above stated leave is not permissible
and shall lead to extension/cancellation of DNB course.
8. Any extension of DNB training for more than 2 months beyond the
scheduled completion date of training is permissible only under extra-
ordinary circumstances with prior approval of NBE. Such extension is
neither automatic nor shall be granted as a matter of routine. NBE shall
consider such requests on merit provided the seat is not carried over and
compromise with training of existing trainees in the Department.
9. Unauthorized absence from DNB training for more than 7 days may lead
to cancellation of registration and discontinuation of the DNB training and
rejoining shall not be permitted.
10. Medical Leave
a. Leave on medical grounds is permissible only for genuine medical
reasons and NBE should be informed by the concerned
institute/hospital about the same immediately after the candidate
proceeds on leave on medical grounds.
b. The supporting medical documents have to be certified by the Head
of the Institute/hospital where the candidate is undergoing DNB
training and have to be sent to NBE.
c. The medical treatment should be taken from the institute/ hospital
where the candidate is undergoing DNB training. Any deviation
from this shall be supported with valid grounds and documentation.
d. In case of medical treatment being sought from some other
institute/hospital, the medical documents have to be certified by the
Head of the institute/hospital where the candidate is undergoing
DNB training.
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e. NBE reserves its rights to verify the authenticity of the documents
furnished by the candidate and the institute/hospital regarding
Medical illness of the candidate and to take a final decision in such
matters.
11.
a. Total leave period which can be availed by DNB candidates is
120+28 = 148 days for 6 years course, 60+14=74 days for 3 years
course and 40+10 = 50 days for 2 years course. This includes all
kinds of eligible leave including academic leave. Maternity /
Paternity leave can be availed separately by eligible candidates.
Any kind of leave including medical leave exceeding the
aforementioned limit shall lead to extension of DNB training. It is
clarified that prior approval of NBE is necessary for availing any
such leave.
b. The eligibility for DNB Final Examination shall be determined strictly
in accordance with the criteria prescribed in the respective
information bulletin.
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EXAMINATION
FORMATIVE ASSESSMENT
The performance of the resident during the training period should be monitored
throughout the course and duly recorded in the log books as evidence of the
ability and daily work of the student
1. Personal attributes:
Behavior and Emotional Stability: Dependable, disciplined, dedicated,
stable in emergency situations, shows positive approach.
Motivation and Initiative: Takes on responsibility, innovative,
enterprising, does not shirk duties or leave any work pending.
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Honesty and Integrity: Truthful, admits mistakes, does not cook up
information, has ethical conduct, exhibits good moral values, loyal to the
institution.
Interpersonal Skills and Leadership Quality: Has compassionate
attitude towards patients and attendants, gets on well with colleagues and
paramedical staff, is respectful to seniors, has good communication skills.
2. Clinical Work:
FINAL EXAMINATION
The summative assessment of competence will be done in the form of DNB Final
Examination leading to the award of the degree of Diplomate of National Board in
Pharmacology. The DNB final is a two-stage examination comprising the theory
and practical part. An eligible candidate who has qualified the theory exam is
permitted to appear in the practical examination.
Theory Examination
1. The theory examination comprises of Three/ Four papers, maximum
marks 100 each.
2. There are 10 short notes of 10 marks each, in each of the papers. The
number of short notes and their respective marks weightage may vary in
some subjects/some papers.
3. Maximum time permitted is 3 hours.
4. Candidate must score at least 50% in the aggregate of Three/ Four
papers to qualify the theory examination.
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5. Candidates who have qualified the theory examination are permitted to
take up the practical examination.
6. The paper wise distribution of the Theory Examination shall be as follows:
a) Practical Examination:
1. Maximum Marks: 300.
2. Comprises of Clinical Examination and Viva.
3. Candidate must obtain a minimum of 50% marks in the Clinical
Examination (including Viva) to qualify for the Practical Examination.
4. There are a maximum of three attempts that can be availed by a
candidate for Practical Examination.
5. First attempt is the practical examination following immediately after the
declaration of theory results.
6. Second and Third attempt in practical examination shall be permitted out
of the next three sessions of practical examinations placed alongwith the
next three successive theory examination sessions; after payment of full
examination fees as may be prescribed by NBE.
7. Absentation from Practical Examination is counted as an attempt.
8. Appearance in first practical examination is compulsory;
9. Requests for Change in center of examination are not entertained, as the
same is not permissible.
10. Candidates are required not to canvass with NBE for above.
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RECOMMENDED TEXT BOOKS AND JOURNALS
REFERRED JOURNALS
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