GUIDELINES FOR COMPETENCY BASED

POSTGRADUATE TRAINING PROGRAMME FOR MD

IN MICROBIOLOGY

Preamble:

The purpose of PG education is to create specialists who would provide high quality
health care and advance the cause of science through research & training.

The purpose of preparing these Guidelines is to standardize Microbiology teaching at

Post Graduate level throughout the country so that it will achieve uniformity in
undergraduate teaching as well.

This document is to provide teachers and learners illustrative guidelines to achieve

defined outcomes through learning and assessment. This document was prepared by
various subject-content specialists. The Reconciliation Board of the Academic
Committee has attempted to render uniformity without compromise to purpose and
content of the document. Compromise in purity of syntax has been made in order to
preserve the purpose and content. This has necessitated retention of “domains of
learning” under the heading “competencies”.

SUBJECT SPECIFIC OBJECTIVES

A post graduate student upon successfully qualifying in the MD (Microbiology)

examination should be able to:
1. Demonstrate competence as a clinical microbiologist
2. Interact effectively with the allied departments by rendering services in basic as
well as advanced laboratory investigations
3. Demonstrate application of microbiology in a variety of clinical settings to solve
diagnostic and therapeutic problems along with preventive measures.
4. Play a pivotal role in hospital infection control, including formulation of
antibiotic policy and management of biomedical waste.
5. Acquire skills in conducting collaborative research in the field of Microbiology
and allied sciences.
6. Conduct such clinical/experimental research as would have significant bearing
on human health and patient care
7. Demonstrate effective communication skills required for the practice of clinical
microbiology and while teaching undergraduate students
8. Establish good clinical microbiological services in a hospital and in the
community in the fields of bacteriology, virology, parasitology, immunology
and mycology.
9. Plan, execute and evaluate teaching assignments in Medical Microbiology.

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 10. Plan, execute, analyze and present the research work in medical microbiology.
11. To acquire various skills for collaborative research.
12. To participate is various workshops/seminars/journal clubs/demonstration in the
allied departments
13. Uphold the prestige of the discipline amongst the fraternity of doctors.

Post-graduate training

The post graduate training should include the following components for a holistic
approach.

a. Laboratory and Diagnostic skills in Clinical Microbiology

b. Teaching Skills
c. Research Methodology
d. Communication and attitudinal skills

a. Laboratory and Diagnostic skills in Clinical Microbiology:

Based on the available facilities, the department should prepare a list of Post Graduate
experiments pertaining to basic, diagnostic and applied Microbiology. Active learning
should form the mainstay of the postgraduate training. There should be lectures for
the postgraduate students (at least 20 per year) along with seminars/symposia/group
discussions and journal clubs. The postgraduate student should also attend a
minimum of 20 ward rounds, discuss with the faculty, and maintain a log book for the
same. They should be able to render consultative and investigative services in
microbiology.

b. Teaching Skills

The Medical Education Department/Unit of the institution should be able to sensitize

the postgraduate students in basic concepts of medical education like domains of
learning, teaching skills, teaching - learning methods, learning resource material,
evaluation techniques etc. The postgraduate students should attend all undergraduate
lectures in the subject of Microbiology and participate actively in the undergraduate
teaching programme including tutorials, demonstrations and practicals.

c. Research Methodology

The postgraduate students should be able to plan, design and conduct research in
microbiology, as well as collaborate with other departments, analyze data and become
familiar with basic biostatistics. They should also be able to write a research paper.
All this can be achieved by writing a thesis on a current and relevant topic in
Microbiology.

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 d. Communication and attitudinal skills
The post graduate student should be able to communicate effectively with patients,
their relatives, peers, and consultants for better clinical correlation of laboratory
findings as well as research. They should work as an effective team member and
leader. They should also demonstrate right kind of attitude while handling clinical
material and reports.

SUBJECT SPECIFIC COMPETENCIES

A) Cognitive Domain:
At the end of the course, the student should have acquired knowledge in the
following theoretical competencies:

General Microbiology
1. Important historical events and developments in microbiology
2. Basic as well as advanced knowledge in various microscopes and microscopic
techniques used in diagnostic microbiology
3. Various bio-safety issues including physical and biological containment,
universal containment, personal protective equipment for biological agents
4. Various isolation precautions including standard and transmission based
precautions
5. In-depth knowledge about various method of Sterilization, disinfection and
lyophilization
6. Nomenclature, classification and morphology of bacteria as well as other
microorganisms
7. Various types and significance of normal flora of human body in health and
disease states.
8. Requirements for growth and nutrition of bacteria along with bacterial
metabolism
9. Various types and role of bacterial toxins and bacteriocins
10. Microbiology of air, milk, water as well as hospital environment
11. Various types of host-parasite relationship and their significance
12. Various antimicrobial agents and mechanisms drug resistance
13. Bacterial genetics, bacteriophages and molecular genetics relevant for medical
microbiology
14. Applications of quality assurance, quality control in microbiology and
accreditation of laboratories

Immunology

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 1. Components of immune system, types of immunity (Innate, acquired, mucosal,
humoral and cell mediated immunity) and immune response
2. Describes and identifies uses of various antigens, immunoglobulins (antibodies)
and antigen and antibody reactions
3. Complement system and Cytokines
4. Various disorders like hypersensitivity, immunodeficiency and auto-immunity
involving immune system
5. MHC complex, Immune tolerance, Transplantation and Tumor immunity
6. Various types, techniques, advances, and applications of vaccines and
immunotherapy
7. Measurement of immunological parameters
8. Immunological techniques and their applications in diagnostic microbiology as
well as research
9. Mechanisms and significance of immune-potentiation and immune-modulation

Systemic bacteriology

1. Demonstrate knowledge and skills in various techniques for isolation and

identification of bacteria
2. Demonstrate knowledge about epidemiology, morphology, biochemical
properties, antigenic nature, pathogenesis, complications, laboratory diagnosis
treatment and prevention of major bacterial pathogens of medical importance
given below-
a. Gram positive cocci including Staphylococcus, Micrococcus,
Streptococcus, anaerobic cocci etc.
b. Gram negative cocci including Neisseria, Branhamella, Moraxella etc.
c. Gram positive bacilli including Lactobacillus, Coryneform bacteria,
Bacillus and aerobic bacilli, Actinomyces, Nocardia, Actinobacillus and
other actinomycetales, Erysipelothrix, Listeria, Clostridium and other
spore bearing anaerobic bacilli etc.
d. Gram negative bacilli including Vibrios, Aeromonas, Plesiomonas,
Haemophilus, Bordetella, Brucella, Gardnerella, Pseudomonas and other
non-fermenters, Pasteurella, Francisella, Bacteroides, Fusobacterium,
Leptotrichia and other anaerobic gram negative bacilli etc.
e. Helicobacter, Campylobacter, Calymmatobacterium, Streptobacillus,
Spirillum and miscellaneous bacteria
f. Enterobacteriaceae
g. Mycobacteria
h. Spirochaetes
i. Chlamydia
j. Mycoplasmatales; Mycoplasma, Ureaplasma, Acholeplasma and other
Mycoplasmas.

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 k. Rickettsiae, Coxiella, Bartonella etc.

Mycology

1. Explain general characteristics including morphology, reproduction and

classification of fungi
2. Demonstrate knowledge and skills for isolation and identification of fungi
3. Explain tissue reactions to fungi
4. Demonstrate knowledge about epidemiology, morphology, biochemical
properties, antigenic nature, pathogenesis, complications, laboratory diagnosis
treatment and prevention of major fungal pathogens of medical importance
given below-
a. Yeasts and yeast like fungi including Candida, Cryptococcus,
Malassezia, Trichosporon, Geotrichum, Saccharomyces etc.
b. Mycelial fungi including Aspergillus, Zygomycetes, Pseudallescheria,
Fusarium, Piedra, other dematiaceous hyphomycetes and other
hyalohyphomycetes etc.
c. Dimorphic fungi including Histoplasma, Blastomyces, Coccidioides,
Paracoccidioides, Sporothrix, Penicillium marneffei etc.
d. Dermatophytes
e. Fungi causing Mycetoma, Chromoblatomycosis, Occulomycosis and
Otomycosis.
f. Pneumocystis jirovecii infection
g. Rhinosporidium seeberi and Lacazia loboi (formerly named Loboa
loboi)
h. Pythium insidiosum
i. Prototheca

5. Able to identify laboratory contaminant fungi

6. Explain Mycetism and mycotoxicosis along with agents involved
7. Demonstrates knowledge about antifungal agents and perform in vitro
antifungal susceptibility tests.

Virology

1. Demonstrates knowledge about general properties, classification, morphology,

virus replication and genetics of viruses
2. Explain pathogenesis of viral infections
3. Demonstrates knowledge about isolation and identification of viruses
4. Demonstrate knowledge about epidemiology, morphology, genetics, antigenic
nature, pathogenesis, complications, laboratory diagnosis, treatment and
prevention of major DNA viruses of medical importance including Pox viruses,

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 Herpes viruses, Adeno viruses, Hepadna virus, Papova viruses and Parvo
viruses etc.
5. Demonstrate knowledge about epidemiology, morphology, genetics, antigenic
nature, pathogenesis, complications, laboratory diagnosis, treatment and
prevention of major RNA viruses of medical importance including Entero
viruses, Toga viruses, Flavi viruses, Orthomyxo viruses, Paramyxo viruses, Reo
viruses, Rhabdo viruses, Arena viruses, Bunya viruses, Retro viruses, Filo
viruses, Human Immunodeficiency Virus, Arbo viruses, Corona viruses, Calci
viruses etc.
6. Demonstrate knowledge about epidemiology, morphology, genetics, antigenic
nature, pathogenesis, complications, laboratory diagnosis, treatment and
prevention of major Hepatitis viruses
7. Demonstrate knowledge about epidemiology, morphology, genetics, antigenic
nature, pathogenesis, complications, laboratory diagnosis, treatment and
prevention of unclassified viruses and slow viruses including prions
8. Demonstrate knowledge about viral vaccines and anti-viral drugs.

Parasitology

1. Demonstrate knowledge about general characters, classification and methods of

identification of parasites.
2. Demonstrate knowledge about epidemiology, morphology, antigenic nature, life
cycle, pathogenesis, complications, laboratory diagnosis, treatment and
prevention of Protozoan parasites of medical importance including Entamoeba,
Free living amoebae, Giardia, Trichomonas, Leishmania, Trypanosoma,
Plasmodium, Toxoplasma, Sarcocystis, Cryptosporidium, Microsporidium,
Cyclospora Isospora, Babesia, Balantidium, etc.
3. Demonstrate knowledge about epidemiology, morphology, antigenic nature, life
cycle, pathogenesis, complications, laboratory diagnosis, treatment and
prevention of helminthes of medical importance including those belonging to
Cestoda (Diphyllobothrium, Taenia, Echinococcus, Hymenolepis, Dipyllidium,
Multiceps etc.), Trematoda (Schistosomes, Fasciola, Fasciolopsis,
Gastrodiscoides, Paragonimus, Clonorchis, Opisthorchis etc.) and Nematoda
(Trichiuris, Trichinella, Strongyloides, Ancylostoma, Necator, Ascaris,
Toxocara, Enterobius, Filarial worms, Dracunculus etc. )
4. Demonstrate knowledge about common arthropods and other vectors viz.
mosquito, sand fly, ticks, mite, cyclops, louse, myasis of medical importance.
5. Demonstrate knowledge about anti-parasitic vaccine and drugs.

Applied Microbiology

1. Demonstrate knowledge about epidemiology of infectious diseases

2. Demonstrate knowledge about antimicrobial prophylaxis and therapy

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 3. Demonstrate knowledge about hospital acquired infections
4. Demonstrate knowledge about management of biomedical waste
5. Effectively investigate an infectious outbreak in hospital and community
6. Demonstrate knowledge about infections of various organs and systems of
human body viz. respiratory tract infections, urinary tract infections, central
nervous system infections, congenital infections, reproductive tract infections,
gastrointestinal infections, hepatitis, pyrexia of unknown origin, infections of
eye, ear and nose, septicaemia, endocarditis, haemorrhagic fever etc.
7. Demonstrate knowledge about opportunistic infections
8. Demonstrate knowledge about various sexually transmitted diseases
9. Demonstrate knowledge about principles, methods of preparation,
administration and types of vaccines
10. Effectively use information technology (Computers) in microbiology
11. Demonstrate knowledge and applications of Automation in Microbiology
12. Demonstrate knowledge and applications about molecular techniques in the
laboratory diagnosis of infectious diseases
13. Demonstrate knowledge in statistical analysis of microbiological data and
research methodology
14. Demonstrate knowledge in animal and human ethics involved in microbiology
15. Demonstrate knowledge in safety in laboratory and Laboratory management

B) Affective Domain:
1. Should be able to function as a part of a team, develop an attitude of
cooperation with colleagues, and interact with the patient and the clinician or
other colleagues to provide the best possible diagnosis or opinion.
2. Always adopts ethical principles and maintain proper etiquette in dealings with
patients, relatives and other health personnel and to respect the rights of the
patient including the right to information and second opinion.
3. Develop communication skills to word reports and professional opinion as well
as to interact with patients, relatives, peers and paramedical staff, and students
for effective teaching.

C) Psychomotor domain:

1. Collection/transportation of specimens for microbiological investigations

2. Preparation, examination and interpretation of direct smears from clinical
specimens
3. Plating of clinical specimens on media for isolation, purification, identification
and quantification purposes.
4. Preparation of stains viz. Gram, Albert’s, Ziehl Neelsen (ZN), Silver
impregnation stain and special stains for capsule and spore etc.

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5. Preparation and pouring of media like Nutrient agar, Blood Agar, Mac-Conkey
agar, Sugars, Kligler iron agar/Triple sugar iron agar (TSI), Robertson’s cooked
meat broth, Lowenstein Jensens medium, Sabouraud’s dextrose agar etc.
6. Preparation of reagents-oxidase, Kovac etc.
7. Quality control of media, reagents etc.
8. Operation of autoclave, hot air oven, filters like Seitz and membrane filters etc
9. Care and operation of microscopes
10. Washing and sterilization of glassware (including plugging and packing)
11. Care, maintenance and use of common laboratory equipments like autoclave,
hot air oven, water bath, centrifuge, refrigerators, incubators etc.
12. Aseptic practices in laboratory and safety precautions. Selection of Personal
Protective Equipment according to task and donning (gloves, mask, eye
protection, gown etc).
13. Sterility tests
14. Identification of bacteria of medical importance up to species level (except
anaerobes which could be up to generic level).
15. Techniques of anaerobiosis
16. Tests for Motility: hanging drop, Cragie’s tube, dark ground microscopy for
spirochaetes
17. Routine and Special tests - Catalase test, Oxidase test, slide and tube coagulase
tests, niacin and catalase tests for Mycobacterium, bile solubility, chick cell
agglutination, sheep cell haemolysis, satellitism, CAMP test, and other
biochemical tests.
18. Preparation of antibiotic discs; performance of antimicrobial susceptibility
testing eg. Kirby-Bauer, Stoke’s method, Estimation of Minimal
Inhibitory/Bactericidal concentrations by tube/plate dilution methods.
19. Tests for ß-lactamase production.
20. Screening of gram negative isolates for ESBL and MBL
21. Screening of Staphylococci for Methicillin Resistance.
22. Screening of Enterococci for Vancomycin resistance.
23. Testing of disinfectants.
24. Quantitative analysis of urine by pour plate method and semi quantitative
analysis by standard loop tests for finding significant bacteriuria
25. Disposal of contaminated materials like cultures
26. Disposal of infectious waste
27. Bacteriological tests for water, air and milk
28. Maintenance and preservation of bacterial cultures

 Time frame to acquire knowledge & skills:

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 o Knowledge :

End of 1st year End of 2nd year End of 3rd year

GENERAL IMMUNOLOGY :Clinical GENERAL
MICROBIOLOGY: 1. Hypersensitivity MICROBIOLOGY
1. History and 2. Immunodeficiency & IMMUNOLOGY:
Pioneers in 3. Auto-immunity
Microbiology 4. Immune tolerance
2. Microscopy 5. Transplantation immunity All
3. Nomenclature 6. Tumour immunity
and classification 7. Immunoprophylaxis
of microbes and immunotherapy
4. Morphology of 8. Measurement of immunity
bacteria and other
micro-organisms
5. Growth and
Nutrition of
bacteria
6. Bacterial
metabolism
7. Sterilization and
disinfection
8. Culture media
and culture
methods
9. Identification of
bacteria
10. Bacterial toxins
11. Bacterial
antagonism :
Bacteriocins
12. Bacterial genetics
13. Gene cloning
14. Antibacterial
substances used
in the treatment
of infections and
drug resistance in
bacteria
15. Bacterial ecology
- Normal flora of
human body,
Hospital
environment, Air,
Water and Milk
16. Host-parasite
relationship
IMMUNOLOGY : SYSTEMATIC SYSTEMATIC
1. Innate and BACTERIOLOGY BACTERIOLOGY
acquired 1. Streptococcus and Lactobacillus (2nd year) :
immunity 2. Staphylococcus plus
2. Antigens and Micrococcus 1. Actinomycetes,
3. Immunoglobulins 3. Pseudomonas Nocardia and
4. Antigen and 4. The Enterobacteriaceae Actinobacillus
antibody 5. Mycobacteria 2. Erysipelothrix and
Reactions 6. Corynebacterium and other Listeria
5. Complement Coryneform bacteria 3. The
System 7. Vibrios, Aeromonas, Bacteroidaceae:
6. The normal Plesiomonas, Campylobacter & Bacteroides,
immune system: Spirillum Fusobacterium
structure and 8. Neisseria, Branhamella & and Leptotrichia
function Moraxella 4. Chromobacterium,
7. Immune 9. Haemophilus and Bordetella flavobacterium,
Response 10. Bacillus: the aerobic spore- Acinetobacter and

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 bearing bacilli Alkaligenes
11. Clostridium: the spore-bearing 5. Pasteurella,
anaerobic bacilli Francisella
12. Non-sporing anaerobe 6. Brucella
13. The Spirochaetes 7. Chlamydia
8. Rickettsiae
9. Mycoplasmatales:
Mycoplasma,
Ureaplasma and
Acholeplasma
10. Miscellaneous
bacteria

MICROBIOLOGY VIROLOGY: VIROLOGY (2nd

APPLIED TO 1. The nature of viruses year): plus
TROPICAL 2. Classification of viruses 1. Vaccines
MEDICINE AND 3. Morphology: virus structure 2. Pox viruses
RECENT 4. Virus replication 3. Vesicular viruses
ADVANCES 5. The genetics of viruses 4. Toga viruses
6. The pathogenicity & lab 5. Bunya viruses
1. Normal Microbial diagnosis of viruses 6. Arena viruses
flora 7. Epidemiology of viral infections7. Marburg and
2. Epidemiology of 8. Anti-viral drugs Ebola viruses
infectious 9. Bacteriophages 8. Rubella virus
diseases 10. Herpes viruses 9. Orbi viruses
3. Hospital acquired 11. Paramyxoviruses 10. Respiratory
infections & 12. Influenza virus diseases :
Hospital waste 13. Hepatitis viruses Rhinoviruses,
disposal 14. Rabies virus adenoviruses and
4. Bacteriology of 15. Human immunodeficiency corona viruses
water milk and viruses 11. Enteroviruses;
air Polio, Echo, and
Coxsackie viruses
12. Other enteric
viruses
13. Slow viruses
14. Oncogenic viruses
15. Teratogenic
viruses
PARASITOLOGY: PARASITOLOGY
1. General Parasitology (2nd year): plus
2. Protozoan parasites of medical 1. Protozoan
importance: parasites of
Entamoeba, medical
Giardia, importance:
Trichomonas, Toxoplasma,
Leishmania, Sarcocystis,
Trypanosoma, Cryptosporidium,
Plasmodium Babesia,
Balantidium etc.
2. Helminthology:
All those medically
important
helminthes
belonging to
Cestoda,
Trematoda and
Nematoda.
3. Cestodes:
Diphyllobothrium,
Taenia,
Echinococcus,
Hymenolepis,
Dipyllidium,

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 Multiceps etc.
4. Trematodes:
Schistosomes,
Fasciola,
Gastrodiscoides,
Paragonimus,
Clonorchis,
Opisthorchis etc.
5. Nematodes:
Trichuris,
Trichinella,
Strongyloides,
Ancylostoma,
Necator, Ascaris,
Toxocara,
Enterobius,
Filarial worms,
Dracunculus, etc.
6. Ecto-parasites:
Common
arthropods and
other vectors viz.,
Mosquito, Sand
fly, Ticks, Mite,
Cyclops
MYCOLOGY MYCOLOGY (2nd
1. The morphology and year): plus
reproduction in fungi 1. Contaminant and
2. Classification of fungi opportunistic
3. Dermatophytes fungi
4. Candida 2. Fungi causing
5. Aspergillus superficial
mycoses
3. Fungi causing
subcutaneous
mycoses
4. Fungi causing
systemic
infections
5. Anti-mycotic
agents
MICROBIOLOGY
APPLIED TO
TROPICAL
MEDICINE AND
RECENT
ADVANCES
1. Infections of
various organs and
systems of human
body
2. Molecular
genetics as
applicable to
microbiology
3. Vaccinology:
principle, methods
of preparation,
administration of
vaccines.
4. Bio-terrorism

ALLIED BASIC
SCIENCES

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(a) Biochemistry:
Basic
understanding of
biochemistry as
applied to
immunological/
molecular
methods for study
of microbial
diseases and
pathogenesis of
infections.
1. Protein
purification and
estimation
2. Protein estimation
3. Nucleic acid
purification and
characterization
4. Agarose and
polyacrylamide
gel electrophoresis
- principles
5. Ultracentrifugatio
n – principles
6. Column
chromatography –
principles

(b) Molecular
biology: Basic
knowledge as
applicable to
molecular
diagnostics and
molecular
epidemiology.
1. Recombinant DNA
technology
2. Southern, northern
and western
blotting
3. DNA amplification
techniques
4. Diagnostic PCR,
different methods
of PCR product
detection (liquid
hybridization,
ELISA).
5. Genotyping of
microbes and
viruses

(c) Pathology: (as

applied to
Microbiology)
Basic knowledge
of
1. Inflammation and
repair
2. Intercellular
substances and

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 reaction
3. Pathological
changes in the
body in bacterial,
viral, mycotic and
parasitic infections
4. Demonstration of
pathogen in tissue
section

o Skills:

1st year residency-skills list

Area Sr. no. Procedure Observed no. Assisted Performed
no./ independentl
practice on y no.(under
dummy supervision)
General 1. Microscopy for unstained 5 5 10
microbiology preparations/ wet mount
2. Microscopy for stained 5 5 10
preparation
3. Preparation of direct smears 5 5 10
from clinical specimens
4. Hanging drop preparation 5 5 10
5. Washing, sterilization and 10 sessions - -
packing of glassware
6. Infection control activities- 10 10 -
environmental sampling
7 Identification of HAI 5 5 --
8 Calculation of HAI quality 5 5 --
indicators
9 Bacteriology of water 5 5 -
10 Bacteriology of air 5 5 -
11 Antibiotic disc preparation - - -
12 Handling of laboratory animal - - -
13 Methods for preservation of 10 - -
bacteria
14 Maintenance of stock cultures 10 - -
Staining 1 Gram staining 10 20 30
2 Acid fast staining ( Ziehl- 10 20 30
Neelsen method)
3 Albert staining 5 10 10
4 Modified ZN staining for M. 5 5 5
leprae
5 Modified ZN staining for 5 5 5
Nocardia
6 IQC-staining 5 5 5
Media 1 Preparation of stains 4 4 4
preparation
2 Preparation of reagents 10 10 10
3 Preparation, plugging, pouring 20 20 30

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 & Quality Control (QC) of
culture media
4 Operation & maintenance of 10 10 20
autoclave
Bacteriology 1 Specimen collection for Blood 5 5 5
Culture
2 Inoculation of liquid & solid 20 20 30
media
3 Identification test 20 20 30
4 Antimicrobial sensitivity 10 20 30
testing- modified Kirby-bauer
technique
5 IQC- Antibiotic disc potency 5 5 -
6 Operation of BacT/ALERT 5 10 20
7 Operation of Vitek 2 compact 5 10 20
8 Petroff’s concentration 10 10 20
technique
9 AFB culture & sensitivity 5 10 20
Mycology 1 KOH Wet mount 5 10 20
2 Germ tube test 5 10 20
3 Slide culture 5 10 20
4 Negative staining for fungus 5 5 5
5 LPCB mount 10 10 10
Parasitology 1 Giemsa staining for thick & thin 5 - -
peripheral blood smear
2 Stool wet mount for R/M 10 20 30
3 Stool concentration techniques 5 10 5
4 Modified ZN staining for C. 2 2 2
parvum
Serology/ 1 Phlebotomy & separation of 10 10 5
Immunology serum
2 Operation & maintenance of 5 10 20
mini-VIDAS
3 Operation & maintenance of 5 10 --
ELISA reader & washer
Performance of serological
tests
1 Latex agglutination test(RA, 10 20 30
ASO)
2 RPR card test 10 20 30
3 Tube agglutination test 10 20 30
4 Gold conjugate Rapid card test 10 20 30
5 ANA by IF 5 5 --
6 ANA by Immunoblot 5 5 --
7 IQC-serology 5 5 5

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2nd year residency-skill list
Area Sr. no. Procedure Observed Assisted no./ Performed
no. practice on independently no.
dummy (under supervision)
General 1. Microscopy for unstained --- -- --
microbiology preparations/ wet mount
2. Microscopy for stained -- -- --
preparation
3. Preparation of direct smears -- -- --
from clinical specimens
4. Preparation of slit skin smear 5 5 5
for lepra bacilli
5. Hanging drop preparation -- -- 10
6. Washing, sterilization and 05 sessions - -
packing of glassware
7 Infection control activities- -- 10 10
environmental sampling
8 Identification of HAI -- 5 5
9 Calculation of HAI quality -- 5 5
indicators
10 Bacteriology of water -- 5 5
11 Bacteriology of air -- 5 5
12 Antibiotic disc preparation 05 lots - -
13 Handling of laboratory - - -
animal
14 Methods for preservation of -- 05 10
bacteria
15 Maintenance of stock -- 05 10
cultures
Staining 1 Gram staining -- -- 30
2 Acid fast staining ( Ziehl- -- -- 30
Neelsen method)
3 Albert staining -- -- 05
4 Modified ZN staining for M. -- -- 5
leprae
5 Modified ZN staining for -- -- 5
Nocardia
6 IQC-staining -- -- 5
Media 1 Preparation of stains -- -- 5
preparation
2 Preparation of reagents -- -- 15
3 Preparation, plugging, -- -- 50
pouring & Quality Control
(QC) of culture media
4 Operation & maintenance of -- -- 20
autoclave
Bacteriology 1 Specimen collection for -- -- 5
Blood Culture
2 Inoculation of liquid & solid -- -- 30
media
3 Identification test -- -- 30
4 Antimicrobial sensitivity -- -- 30
testing- modified Kirby-
bauer technique
5 IQC- Antibiotic disc potency -- 5 5
6 Operation of BacT/ALERT -- -- 20
7 Operation of Vitek 2 -- -- 20
compact
8 Petroff’s concentration -- -- 20
technique
9 AFB culture & sensitivity -- -- 20
Mycology 1 KOH Wet mount -- -- 20

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 2 Germ tube test -- -- 20
3 Slide culture -- -- 20
4 Negative staining for fungus -- -- 5
5 LPCB mount -- -- 10
Parasitology 1 Giemsa staining for thick & - 10 -
thin peripheral blood smear
2 Stool wet mount for R/M -- -- 30
3 Stool concentration -- -- 5
techniques
4 Modified ZN staining for C. -- -- 2
parvum
Serology/ 1 Phlebotomy & separation of -- -- 5
Immunology serum
2 Operation & maintenance of -- -- 20
mini-VIDAS
3 Operation & maintenance of -- -- 20
ELISA reader & washer
Performance of serological
tests
1 Latex agglutination test(RA, -- -- 30
ASO, CRP)
2 RPR card test -- -- 30
3 Tube agglutination test -- -- 30
4 Gold conjugate rapid card -- -- 30
test
5 ANA by IF -- -- 10
6 ANA by Immunoblot -- -- 10
7 IQC-serology -- -- 5

3rd year residency-skill list

Area Sr. no. Procedure Observed Assisted no./ Performed
no. practice on independently
dummy no.
(under
supervision)
General 1. Microscopy for unstained --- -- --
microbiology preparations/ wet mount
2. Microscopy for stained -- -- --
preparation
3. Preparation of slit skin -- -- --
smear for lepra bacilli
4. Hanging drop preparation -- -- --
5. Washing, sterilization and 05 - -
packing of glassware sessions
6. Infection control activities- -- -- 10
environmental sampling
7 Identification of HAI -- -- 5
8 Calculation of HAI quality -- -- 5
indicators
9 Bacteriology of water - - 5
10 Bacteriology of air - - 5
11 Antibiotic disc preparation - 5 lots 2 lots
12 Handling of laboratory - - 10
animal
13 Methods for preservation of - - 10
bacteria

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 14 Maintenance of stock - - 10
cultures
Staining 1 Gram staining -- -- 30
2 Acid fast staining ( Ziehl- -- -- 30
Neelsen method)
3 Albert staining -- -- 05
4 Modified ZN staining for M. -- -- 5
leprae
5 Modified ZN staining for -- -- 5
Nocardia
6 IQC-staining -- -- 5
Media 1 Preparation of stains -- -- 10
preparation
2 Preparation of reagents -- -- 15
3 Preparation, pouring & -- -- 50
Quality Control (QC) of
culture media
4 Operation & maintenance of -- -- 20
autoclave
Bacteriology 1 Specimen collection for -- -- 5
Blood Culture
2 Inoculation of liquid & solid -- -- 30
media
3 Identification test -- -- 30
4 Antimicrobial sensitivity -- -- 30
testing- modified Kirby-
bauer technique
5 IQC- Antibiotic disc -- -- 5
potency
6 Operation of BacT/ALERT -- -- 20
7 Operation of Vitek 2 -- -- 20
compact
8 Petroff’s concentration -- -- 20
technique
9 AFB culture & sensitivity -- -- 20
Mycology 1 KOH Wet mount -- -- 20
2 Germ tube test -- -- 20
3 Slide culture --- --- 20
4 Negative staining for fungus -- -- 5
5 LPCB mount -- -- 10
Parasitology 1 Giemsa staining for thick & -- -- -
thin peripheral blood smear
2 Stool wet mount for R/M -- -- 30
3 Stool concentration -- -- 5
techniques
4 Modified ZN staining for C. -- -- 2
parvum
Serology/ 1 Phlebotomy & separation of -- -- 5
Immunology serum
2 Operation & maintenance of -- -- 20
mini-VIDAS

17
 3 Operation & maintenance of -- -- 20
ELISA reader & washer
Performance of serological
tests
1 Latex agglutination test(RA, -- -- 30
ASO, CRP)
2 RPR card test -- -- 30
3 Tube agglutination test -- -- 30
4 Gold conjugate rapid card -- -- 30
test
5 ANA by IF -- -- 10
6 ANA by Immunoblot -- -- 10
7 IQC-serology -- -- 5

Syllabus
Course contents:

Paper I: General Microbiology

1. History of microbiology
2. Microscopy
3. Bio-safety including universal containment, personal protective equipment for
biological agents
4. Physical and biological containment
5. Isolation precautions including standard precautions and transmission based
precautions
6. Sterilization, disinfection and lyophilization
7. Morphology of bacteria and other microorganisms
8. Nomenclature and classification of microorganisms
9. Normal flora of human body
10. Growth and nutrition of bacteria
11. Bacterial metabolism
12. Bacterial toxins
13. Bacteriocins
14. Microbiology of hospital environment
15. Microbiology of air, milk and water
16. Host-parasite relationship
17. Antimicrobial agents and mechanisms drug resistance
18. Bacterial genetics and bacteriophages
19. Molecular genetics relevant for medical microbiology
20. Quality assurance and quality control in microbiology
21. Accreditation of laboratories

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Immunology

1. Components of immune system

2. Innate and acquired immunity
3. Cells involved in immune response
4. Antigens
5. Immunoglobulins
6. Mucosal immunity
7. Complement
8. Antigen and antibody reactions
9. Hypersensitivity
10. Cell mediated immunity
11. Cytokines
12. Immunodeficiency
13. Auto-immunity
14. Immune tolerance
15. MHC complex
16. Transplantation immunity
17. Tumor immunity
18. Vaccines and immunotherapy
19. Measurement of immunological parameters
20. Immunological techniques
21. Immunopotentiation and immunomodulation

Paper II: Systematic bacteriology

1. Isolation and identification of bacteria

2. Gram positive cocci of medical importance including Staphylococcus,
Micrococcus, Streptococcus, anaerobic cocci etc.
3. Gram negative cocci of medical importance including Neisseria, Branhamella,
Moraxella etc.
4. Gram positive bacilli of medical importance including Lactobacillus, Coryneform
organisms, Bacillus and aerobic bacilli, Actinomyces, Nocardia, Actinobacillus
and other actinomycetales, Erysipelothrix, Listeria, Clostridium and other
spore bearing anaerobic bacilli etc.
5. Gram negative bacilli of medical importance including Vibrios, Aeromonas,
Plesiomonas, Haemophilus, Bordetella, Brucella, Gardnerella, Pseudomonas and
other non-fermenters, Pasteurella, Francisella, Bacteroides, Fusobacterium,
Leptotrichia and other anaerobic gram negative bacilli etc.
6. Helicobacter, Campylobacter, Calymmatobacterium, Streptobacillus, Spirillum
and miscellaneous bacteria
7. Enterobacteriaceae

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 8. Mycobacteria
9. Spirochaetes
10. Chlamydia
11. Mycoplasmatales; Mycoplasma, Ureaplasma, Acholeplasma and other
Mycoplasmas.
12. Rickettsiae, Coxiella, Bartonella etc.

Mycology

1. General characteristics and classification of fungi

2. Morphology and reproduction of fungi
3. Isolation and identification of fungi
4. Tissue reactions to fungi
5. Yeasts and yeast like fungi of medical importance including Candida,
Cryptococcus, Malassezia, Trichosporon, Geotrichum, Saccharomyces etc.
6. Mycelial fungi of medical importance including Aspergillus, Zygomycetes,
Pseudallescheria, Fusarium, Piedra, other dematiaceous hyphomycetes and other
hyalohyphomycetes etc.
7. Dimorphic fungi including Histoplasma, Blastomyces, Coccidioides,
Paracoccidioides, Sporothrix, Penicillium marneffei etc.
8. Dermatophytes
9. Fungi causing Mycetoma, Chromoblatomycosis, Occulomycosis and Otomycosis.
10. Pythium insidiosum
11. Prototheca
12. Pneumocystis jirovecii infection
13. Rhinosporidium seeberi and Lacazia loboi (Loboa loboi)
14. Laboratory contaminant fungi
15. Mycetism and mycotoxicosis
16. Antifungal agents and in vitro antifungal susceptibility tests.

Paper III: Virology

1. General properties of viruses

2. Classification of viruses
3. Morphology: Virus structure
4. Virus replication
5. Isolation and identification of viruses
6. Pathogenesis of viral infections
7. Genetics of viruses
8. DNA viruses of medical importance including Pox viruses, Herpes viruses, Adeno
viruses, Hepadna virus, Papova and Parvo viruses etc.
9. RNA viruses of medical importance including Enteroviruses, Toga viruses, Flavi
viruses, Orthomyxo viruses, Paramyxo viruses, Reo viruses, Rhabdo viruses,

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 Arena viruses, Bunya viruses, Retro viruses, Filo viruses, Human
immunodeficiency virus, Arbo viruses, Corona viruses, Calci viruses etc.
10. Slow viruses including prions
11. Unclassified viruses
12. Hepatitis viruses
13. Viriods, prions
14. Vaccines and anti-viral drugs.

Parasitology

1. General characters and classification of parasites.

2. Methods of identification of parasites
3. Protozoan parasites of medical importance including Entamoeba, Free living
amoebae, Giardia, Trichomonas, Leishmania, Trypanosoma, Plasmodium,
Toxoplasma, Sarcocystis, Cryptosporidium, Microsporidium, Cyclospora
Isospora, Babesia, Balantidium, etc.
4. Helminthology of medical importance including those belonging to Cestoda
(Diphyllobothrium, Taenia, Echinococcus, Hymenolepis, Dipyllidium, Multiceps
etc.), Trematoda (Schistosomes, Fasciola, Fasciolopsis, Gastrodiscoides,
Paragonimus, Clonorchis, Opisthorchis etc.) and Nematoda (etc. )
5. Entomology: common arthropods and other vectors viz. mosquito, sand fly, ticks,
mite, cyclops, louse, myasis.
6. Anti-parasitic agents.

Paper IV: Applied Microbiology

1. Epidemiology of infectious diseases

2. Antimicrobial prophylaxis and therapy
3. Hospital acquired infections
4. Management of biomedical waste
5. Investigation of an infectious outbreak in hospital and community
6. Infections of various organs and systems of human body viz. respiratory tract
infections, urinary tract infections, central nervous system infections, congenital
infections, reproductive tract infections, gastrointestinal infections, hepatitis,
pyrexia of unknown origin, infections of eye, ear and nose, septicaemia,
endocarditis, haemorrhagic fever etc.
7. Opportunistic infections
8. Sexually transmitted diseases
9. Vaccinology: principles, methods of preparation, administration of vaccines,
types of vaccines
10. Information technology (Computers) in microbiology
11. Automation in Microbiology
12. Molecular techniques in the laboratory diagnosis of infectious diseases

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 13. Statistical analysis of microbiological data and research methodology
14. Animal and human ethics involved in microbiological work.
15. Safety in laboratory and Laboratory management

TEACHING AND LEARNING METHODS

The training programme should be designed to enable the student to acquire a capacity to
learn and investigate, to synthesize and integrate a set of facts and develop a faculty to
reason. The curricular programme and scheduling of postings must provide the student
with opportunities to achieve the above broad objectives. Much of the learning is to be
accomplished by the student himself. Interactive discussions are to be preferred over
didactic sessions. The student must blend as an integral part of the activities of an
academic department that usually revolves around three equally important basic functions
of teaching, research and service. As mentioned earlier, the emphasis recommended
under a residency programme is of learning while serving/working.

Post Graduate Training programme

Teaching methodology

Based on the available facilities, the Department can prepare a list of post graduate
experiments pertaining to basic and applied microbiology. Active learning should form
the mainstay of post graduate training; there should be lectures for post graduates (at least
20 per year), along with seminars, symposia, group-discussions and Journal clubs. The
post graduate students should regularly do the ward rounds of various clinical
departments and learn cases of interest for discussion with the clinical faculty. Each
college should have a Medical Education Unit to generate teaching resource material for
undergraduates and evolving of problem solving modules.

Rotation:
Postings to laboratories/assignments

The three-year training programme for the MD degree may be arranged in the form of
postings to different assignments/laboratories for specified periods as outlined below.
The period of such assignments/postings is recommended for 35 months. Posting
schedules may be modified depending on needs, feasibility and exigencies. For facilities
not available in the parent institution as well as for additional knowledge and skill,
extramural postings may be undertaken.

Suggested schedule of rotation:

Within Department
1. Bacteriology
2. Mycobacteriology
3. Serology/Immunology

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 4. Mycology
5. Virology
6. Parasitology
7. Media preparation
Other Departments
1. Clinical Pathology
2. Clinical Biochemistry
3. Skin & VD
4. ICTC & RNTCP

Practical training
Practical training should be imparted by posting the students in various sub-specialties
(sections) as detailed in the intrinsic and extrinsic rotation. The student should be actively
involved in day to day working of all the sections. He/she should be trained under the
guidance of teachers in all the aspects of Clinical Microbiology and applied aspects of
laboratory medicine including collection and transport of specimens, receiving of
samples, preparation of requisite reagents, chemicals, media and glassware, processing of
specimens, performing required antimicrobial susceptibility testing and reporting on the
specimens, interpretation of results, sterilization procedures, bio-safety precautions,
infection control practices, maintenance of equipments, record keeping and quality
control in Microbiology.

Skills & performance

The student should be given graded responsibility to enable learning by apprenticeship.

The faculty throughout the year should assess performance of the student in skills. Area
of improvement/remarks should be mentioned for the skill and student should be re-
assessed for the skills which are not acquired. To go to the next level, it should be
mandatory for the student to acquire lower level skills satisfactorily, i.e only on
satisfactory completion of assisted/performed with assistance skills should the student be
permitted to perform the skill independently.

Emergency duty
The student should be posted for managing emergency laboratory services in
Microbiology. He/she should deal with all the emergency investigations in Microbiology.

Training in research methodology

Training in research methodology should be imparted by planning of a research project
by the student under the guidance of a recognized guide to be executed and submitted in
the form of a thesis.

The thesis is aimed at training the post graduate student in research methods and
techniques. It should include identification of a research question, formulation of a
hypothesis, search and review of relevant literature, getting acquainted with recent

23
advances, designing of research study, collection of data, critical analysis of the results
and drawing conclusions. The thesis should be completed and submitted by the student
six months before appearing for the final university examination.

Communication and attitudinal skills

Post-graduate student is expected to imbibe professional attributes of honesty, integrity,
accountability, honour, humanism and excellence and demonstrate the same in the day-
by-day conduct and dealings with the teacher, peers, the nursing and paramedical staff
and most-importantly patients. To ensure that student is able to acquire these attributes,
their personal conduct should be keenly observed by the teachers and student should be
counselled as and when required. Personal attributes of the student should be regularly
assessed by peers, senior, and junior students and Head of the Unit/ In charge.

The following is a rough guideline to various teaching/learning activities that may be

employed.

• Collection of specimens, smear examination, culture and sensitivity analysis

• Discussion during routine activities such as during signing out of cases.
• Presentation and work-up of cases including the identification of special stains
and ancillary procedures needed.
• Clinico-microbiological conferences, active involvement with hospital infection
control committee
• Intradepartmental and interdepartmental conferences related to case discussions.
• Conferences, Seminars, Continuing Medical Education (CME) Programme.
• Journal Club.
• Research Presentation and review of research work.
• A postgraduate student of a postgraduate degree course in broad specialties/super
specialties would be required to present one poster presentation, to read one paper
at a national/state conference and to present one research paper which should be
published/accepted for publication/sent for publication during the period of his
postgraduate studies so as to make him eligible to appear at the postgraduate
degree examination.
• Participation in workshops, conferences and presentation of papers etc.
• Laboratory work.
• Use and maintenance of equipment.
• Maintenance of records. Log books should be maintained to record the work done
which shall be checked and assessed periodically by the faculty members
imparting the training.
• Postgraduate students shall be required to participate in the teaching and training
programme of undergraduate students and interns.
• Department should encourage e-learning activities.

24
 During the training programme, patient safety is of paramount importance,
therefore, skills are to be learnt initially on the models, later to be performed
under supervision followed by performing independently; for this purpose,
provision of skills laboratories in medical colleges is mandatory.

ASSESSMENT

FORMATIVE ASSESSMENT, i.e., assessment during the training

Formative assessment should be continual and should assess medical knowledge,

patient care, procedural & academic skills, interpersonal skills, professionalism, self
directed learning and ability to practice in the system.

General Principles

Internal Assessment should be frequent, cover all domains of learning and used to
provide feedback to improve learning; it should also cover professionalism and
communication skills. The Internal Assessment should be conducted in theory and
practical/clinical examination.

Quarterly assessment during the MD programme should be based on:

1. Journal based / recent advances learning

2. Patient based /Laboratory or Skill based learning
3. Self directed learning and teaching
4. Departmental and interdepartmental learning activity
5. External and Outreach Activities / CMEs

The student to be assessed periodically as per categories listed in postgraduate

student appraisal form (Annexure I).

SUMMATIVE ASSESSMENT, i.e., assessment at the end of training

The summative examination would be carried out as per the Rules given in
POSTGRADUATE MEDICAL EDUCATION REGULATIONS, 2000.

The post-graduate examinations should be in three parts:

1. Thesis.
Every post graduate student shall carry out work on an assigned research project
under the guidance of a recognized Post Graduate Teacher, the result of which shall
be written up and submitted in the form of a Thesis. Work for writing the Thesis is
aimed at contributing to the development of a spirit of enquiry, besides exposing the

25
 post graduate student to the techniques of research, critical analysis, acquaintance
with the latest advances in medical science and the manner of identifying and
consulting available literature.

Thesis shall be submitted at least six months before the Theory and Clinical /
Practical examination. The thesis shall be examined by a minimum of three
examiners; one internal and two external examiners, who shall not be the examiners
for Theory and Clinical examination. A post graduate student shall be allowed to
appear for the Theory and Practical/Clinical examination only after the acceptance of
the Thesis by the examiners.

2. Theory Examination

The examinations shall be organized on the basis of ‘Grading’ or ‘Marking system’

to evaluate and to certify post graduate student's level of knowledge, skill and
competence at the end of the training. Obtaining a minimum of 50% marks in
‘Theory’ as well as ‘Practical’ separately shall be mandatory for passing examination
as a whole. The examination for M.D./ MS shall be held at the end of 3rd academic
year. An academic term shall mean six month's training period.

There should be four theory papers:

Paper I: General Microbiology and Immunology

Paper II: Systematic Bacteriology
Paper III: Virology Parasitology and Mycology
Paper IV: Applied Microbiology and Recent advances

3. Practical and Oral/viva voce Examination

Practical should be spread over two days and include the following components:

• Bacteriology:

1. Identification of a pure culture.

2. Isolation and Identification of Bacteria from Clinical Samples

• Serology:

Common Serological Tests like ELISA/VDRL/Widal/Brucella Agglutination test etc.

• Virology:

1. Preparation of tissue cultures

2. Virus Titration
3. Haemagglutination and its inhibition test
4. Virus Neutralization Test
5. Other rapid tests for diagnosis of viral infections

26
 • Mycology

1. Identification of fungal cultures

2. Slide culture techniques
3. Examination of histopathology slides for fungi

• Parasitology

1. Processing and Identification of ova and cysts in stool samples

2. Amoebic Serology
3. Microscopic Slides
4. Examination of histopathology slides for parasites
5. Spots: 10 spots

Oral/Viva-Voce Examination:

This must include a component of teaching session of not more than 15 minutes duration.

Recommended Reading:
Books (Latest edition)

1. Forbes B, Sahm D, Weissfeld A. Bailey and Scott’s Diagnostic Microbiology,

Mosby, St. Louis.
2. Koneman EW, Allen SD, Janda WM, Schreckenberger PC, Winn WC. Color
Atlas and Textbook of Diagnostic Microbiology, J.B. Lippincott, Philadelphia.
3. Murray PR, Baron EJ, Pfaller MA, Tenover FC, Yolken RH. Manual of Clinical
Microbiology, American Society for Microbiology.
4. Garcia LS, Bruckner DA. Diagnostic Medical Parasitology, American Society for
Microbiology.
5. Wiedbrauk DL, Johnston SLG. Manual of Clinical Virology, New York, Raven
Press.
6. Bailey and Scott’s Diagnostic Microbiology.

Journals
03-05 international Journals and 02 national (all indexed) journals

27
 Annexure 1
Postgraduate Students Appraisal Form
Pre / Para /Clinical Disciplines
Name of the Department/Unit :
Name of the PG Student :
Period of Training : FROM…………………TO……………
Sr. PARTICULARS Not Satisfactory More Than Remarks
No. Satisfactory Satisfactory
1 2 3 4 5 6 7 8 9
1. Journal based / recent
advances learning
2. Patient based
/Laboratory or Skill
based learning
3. Self directed learning
and teaching
4. Departmental and
interdepartmental
learning activity
5. External and Outreach
Activities / CMEs
6. Thesis / Research work
7. Log Book Maintenance

Publications Yes/ No

Remarks*______________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
________________
*REMARKS: Any significant positive or negative attributes of a postgraduate student to be mentioned.
For score less than 4 in any category, remediation must be suggested. Individual feedback to
postgraduate student is strongly recommended.

SIGNATURE OF ASSESSEE SIGNATURE OF CONSULTANT SIGNATURE OF HOD

28