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Master of Medicine 2019/2020 PPSP/PG/OPH/CP2/IR1 MASTER OF MEDICINE OPHTHALMOLOGY Universiti Sains Malaysia 2019/2020 Malaysian Universities Conjoint Committee of Ophthalmology MASTER OF MEDICINE (OPHTHALMOLOGY) BY Professor Dr. Shatriah Ismail LIST OF CONTRIBUTORS Associate Professor Datin Dr. Zunaina Embong Professor Dr. Wan Hazabbah Wan Hitam Professor Dr. Liza Sharmini Ahmad Tajudin Dr. Evelyn Tai Li Min 1st Edition - May 2005 2nd Edition - May 2006 3rd Edition - May 2007 4th Edition - May 2008 5th Edition - May 2009 6th Edition - May 2010 7th Edition - May 2011 8th Edition - May 2012 9th Edition - May 2013 10th Edition - May 2014 11th Edition - May 2015 12th Edition - May 2016 13th Edition - May 2017 14th Edition - May 2018 15th Edition - May 2019 Preface Welcome to the Master of Medicine (Ophthalmology) program at Universiti Sains Malaysia (USM). As a prior graduate of this program, it is my privilege to write the preface for this guidebook. As with any course one elects to undertake, one requires at least an understanding of the course structure, the syllabus, and the requirements for each phase, in order to successfully complete the course within a reasonable time. First released in 2005, this guidebook aims to give you an overview of these things and more. As a student, I often referred to my guidebook when in doubt, and even now, still have that original guidebook, although it has undergone many revisions since my time. As goalposts may shift, particularly the pre-requisites for continuous assessment and the examination formats, it would be advisable to refer to a copy of the most recent version of this book. We hope you will find this book useful. If you note any areas for improvement, do let us know so these can be addressed in the next revision. Dr. Evelyn Tai MD (USM), MMed (Ophthal) (USM) Coordinator, Master of Medicine (Ophthalmology) Program May 2019 ii From the desk of the Head of Department Congratulations to our new Master of Medicine (Ophthalmology) trainees. Welcome to a new chapter of your life. Hope that it will be a smooth journey of learning. Master of Medicine (Ophthalmology) in USM started in 1997. The department has built our own strength and improved our weakness for the past 2 d e c a d e s in producing ophthalmologist for the country. To date, USM have already produced 159 ophthalmologists who are now working in Malaysia and abroad. Currently, our syllabus and examination format is based on Malaysian Universities Conjoint Committee of Ophthalmology (MUCCO). MUCCO was formed with representatives from USM, UKM, UM, Ministry of Health and Academy of Medicine. MUCCO has been successful in standardization of the curriculum, teaching program and assessment of training in ophthalmology in Malaysia since 2009. Our training program is aimed for excellence in academic and surgical skill expertise, appropriate attitude, teamwork, leadership quality and great personality in our future graduates. Everyone may have a different milestone in this journey. Be consistent, work smart and focus to your destination! Professor Dr. Shatriah Ismail MD (USM), MMed (Ophthal) (USM),Fellowship in Paediatric Ophthalmology and Strabismus (Singapore), AM (Malaysia) Coordinator of Master of Medicine (Ophthalmology) Program Professor, Consultant Paediatric Ophthalmologist & Strabismus Specialist May 2019 iii TABLE OF CONTENTS No Contents Page Preface ii From the desk of the Head of Department iii 1. Introduction 1 2. Objectives 5 2.1. Phase I (Year 1) 6 2.2. Phase II (Year 2 & 3) 6 2.3. Phase III (Year 4) 6 3. Program Structure 7 4. Syllabus 9 4.1. Phase I 10 4.2. Phase II and III 22 5. Text & References 29 6. Duties of a Trainee 35 6.1. Teaching Program 36 6.2. Schedule 37 6.2.1. General planner for assessment and courses 37 6.3. Dissertation 38 6.3.1. Writing a proposal 38 6.3.2. Ethical approval 39 6.3.3. Research grant 39 6.3.4. Data collection 39 6.3.5. Dissertation report 39 6.3.6. Submission of dissertation report 43 6.3.7. Assessment of thesis by examiners 44 6.3.8. Presentation and viva voce 44 6.3.9. Final submission of dissertation report 44 6.3.10. Publication 45 6.4. Summary of Dissertation Progress 46 6.5. Publication 47 6.5.1. Progress of publication 48 6.5.2. Format of a case report/case series 49 6.5.3. Format of letter to editor 49 6.5.4. Format of original article 50 iv 6.6. Summary of Surgery Done & Assisted 51 6.7. Summary of Merit Points 52 6.7.1. Overall 52 6.7.2. Presentation 54 6.8. Annual Leave 55 6.8.1. Annual leave 55 6.8.2. Leave application 55 6.8.3. Unrecorded leave 55 6.8.4. Medical/Emergency leave 55 6.8.5. Overseas leave 55 7. Assessment 56 7.1. Continuous Assessment 57 7.2 Progress Interview 60 7.3. Evaluation of the Dissertation Progress 60 7.4. Evaluation of the Program 60 8. Examination 65 8.1. Phase I Examination 66 8.2. Phase II Examination 67 8.3. Phase III Examination 68 8.4. Others 68 8.5. Grading Marks 69 8.6. Merit Points 69 8.7. Summary of Assessment 70 8.8. Evaluation of the Examination 71 8.9. Best Student Award 74 9. Department of Ophthalmology 75 9.1. Lecturers 76 9.2. Visiting Professors 77 9.3. Honorary Lecturers 77 9.4. Trainee Lecturers 78 9.5. Supporting Staffs 78 10. Clinical Services 79 10.1. Rotational Postings 80 10.2. Clinical Services 80 10.2.1. Prevention of blindness clinic 80 10.2.2. General clinic 81 10.2.3. Pre-operative clinic 82 v 10.2.4. Subspecialty clinics 83 10.3. Diagnostic Laboratory Services 84 10.4. Optometry Services 84 10.5. On-Call Responsibilities 84 10.6. Patients Requiring Admission 85 10.7. Ward Rounds 86 10.8. Operation Theatre 86 10.9. Specialist Visit to Hospital Tengku Anis, Pasir Putih, Kelantan 87 10.10. Community Engagement Program 87 11. Dissertation Projects 89 vi 1 Introduction 1 The Ophthalmology Unit started its existence in 1984, about a year after Hospital Universiti Sains Malaysia (Hospital USM) was first commissioned to offer ophthalmology services for the people of Kelantan. In response to the Ministry of Health’s requirement for more local specialists and the introduction of Masters Program in Malaysia, the university first started recruiting local medical officers for the trainee lecturer program in Ophthalmology in the 1986 – 1990 period, all of whom were sent for postgraduate training in UKM. The growing number of lecturers has finally appropriated the move from a Unit to Department status and the subsequent establishment of the Master of Medicine (Ophthalmology) program. The program kicked off in 1997 with its first intake of 10 trainees. The program is a mixed- module mode, and almost similarly structured compared to the programs offered by UKM and UM. However, being the youngest ‘sibling’ has its own unique advantages. Our program offers a two year in-campus placement for distance learning (PJJ) trainees which puts them under direct supervision and allows them a better exposure and access to facilities available in the campus including medical library, computer aided laboratory, clinical skill center and the highly acclaimed research backups. The postgraduate teaching courses are run by both local as well as international faculty members. Teaching staff strength now is 11 lecturers. The department is actively involved in serious research activities including collaborative research with other departments and national institutions. The procurement of the Humphrey visual field analyser, digital imaging system for anterior and posterior segments, and endothelial cell analyser, corneal topography, ocular ultrasound (A & B Scans) and IOLMaster®, have increased the department’s research potential tremendously. Frequency doubling perimetry, confocal scanning laser ophthalmoscopy (Heidelberg Retinal Tomography III), and scanning laser polarimetry (GDx) complemented the glaucoma service. The department has also acquired the HRA, optical coherent tomography and paediatric visual acuity Smart system. The procurement of a highly recommended phacoemulsification machine saw the department progressing to a new level in small incision cataract surgery with numerous research projects carried out on this new type of surgery. Argon and YAG lasers have complemented our clinical service and put our research output to a higher level. The planning of a well-equipped LASIK centre is the next natural course of action towards further progress very soon. One of the major achievements of the department was the organisation of the USM Ophthalmology Symposium which was first held in 2003 and then followed by another successful symposium in 2004. In 2005, we were host to the inaugural 1st USM-UM-UKM Ophthalmology Meeting held in conjunction with the annual Ophthalmology Symposium. It was organised in the spirit of the conjoint committee; to strengthen the solidarity between the three major universities 2 offering the ophthalmology training programme. In 2011, we were honoured once again to organise the 1st Annual MOH-USM-UKM-UM Ophthalmology Scientific Conference in conjunction with the 5th USM Ophthalmology Symposium on 2011. We are due again to host the esteem ophthalmology symposium in 2019. The collaboration between the universities in the field of ophthalmology was further strengthened with the formation of a new flagship of the Malaysian Universities Conjoint Committee of Ophthalmology (MUCCO). With this Committee, the syllabus and examination format have been standardised to ensure that the quality of graduates produced are of the highest calibre. The first conjoint examination was held in May 2008 and has continued since then. By May 2019, the USM Master of Medicine (Ophthalmology) program has produced 159 ophthalmologists, including four of our international trainees who graduated in 2008 and 2009.
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