Modules
- Year 1
- Year 2
- Introduction to Year 2 and Year Outcomes
- Cardiorespiratory 2
- Metabolism 2
- Brain and Behaviour 2
- Human Development 2
- Human Sciences and Public Health 2
- Locomotor 2
- Cancer Week
- Moving and Handling Training
- Year 2 Lifesaver Programme
- Clinical Communication Skills
- Medicine in Society 2
- Extended Patient Contact
- Student Selected Component (SSC)
- Year 3
- Introduction to Year 3 and Year Outcomes
- Clinical Science and Professionalism (Weeks 1-3)
- Cardiovascular, Respiratory and Haematology (CR3)
- Gastroenterology and Cancer (MET3A)
- Public Health
- Endocrinology and Renal Medicine (MET3B)
- General Practice and Community Care
- Student Selected Component (SSC)
- Clinical and Communication Skills
- Year 4
- Introduction and Year 4 Outcomes
- Obstetrics and Gynaecology
- Child Health
- HIV & Sexual Health
- Musculoskeletal
- Health Care of the Elderly
- Neuroscience
- Dermatology
- General Practice and Community Care
- Psychiatry
- Ear, Nose and Throat
- Global Health and Ethics
- Ophthalmology
- Clinical & Communication Skills
- Student Selected Component (SSC)
- Year 5
- Introduction to Year 5 and Year Outcomes
- Teaching Week 1
- Teaching Week 2
- Anaesthesia & ITU (AN & ITU)
- Breaking Bad News
- Clinical Pharmacology & Therapeutics
- Community Care
- Doctors as Teachers and Educators (DATE)
- Emergency Medicine (EMERG MED)
- General (Internal) Medicine (G(I)M)
- Immediate Life Support (ILS)
- Student Assistantship
- Simulation
- Surgery
- Student Selected Component (SSC)
- Year GEP 1
Year 1 FM1: Fundamentals of Medicine
- Dr Lesley Robson
- l.g.robson@qmul.ac.uk
Teaching Material for this Module
Introduction
The aims of the FunMed Module are:
- To develop independent learning and critical reasoning skills necessary for a University course
- To acquire basic Information Technology (IT) skills in accessing information and in word processing
- To develop time management skills in planning and scheduling work
- To work and communicate effectively in small groups
- To appreciate the development of modern medicine and its historical context
- To appreciate the historical, social and demographic characteristics of the East End of London, and the implications of these for the health of the local population
- To develop an understanding of normal biological structure and function, at the cellular and molecular level; and knowledge of cellular pathology and basic pharmacology sufficient to provide a foundation for subsequent stages
- To obtain a basic knowledge of anatomical terms and of the location of the main organs and structures, including the use of medical imaging
- To begin to understand the contribution of genetic, social, environmental, political, occupational and behavioural factors to health, illness and disease
- To begin to appreciate the effect of illness on people and their families
- To begin to understand the role of the doctor and other health professionals in society
- To prepare students for meeting patients in clinical settings, by addressing communication skills and ethical principles in the health professional - patient relationship
- To develop basic skills of resuscitation and emergency care
- To provide a broad overview of the entire MBBS course
Index
- General Outcomes for the Whole Person
- Medical knowledge: ANATOMY (TD 8.1)
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Bones and Joints
- Can describe the axial and appendicular skeleton
- Name the major parts of the axial and appendicular skeleton and describe their relative functions
- Name and describe the major bones of the skull and the important foramina
- Can classify the different types of joints
- Use the correct anatomical terms to describe movements at these joints
-
Skin and Tissues
- For each of the various types of epithelial tissue, can outline its structural characteristics, functional capabilities, cellular specialisations and be able to give an example of a body site where it would be located.
- Can name the various types of glands, relate their structure to their function, and give an example of where each might be found in the body.
- Can describe the basic structure of a mucosa and a serosa, and predict their functions from the different types of epithelial cell found on their surface.
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Epithelia and Glands
- For each of the various types of epithelial tissue, outline its structural characteristics, functional capabilities, cellular specialisations and be able to give an example of a body site where it would be located.
- Recognise the various epithelial cell types in photomicrographs and predict their function from their structure
- Understand and master the use of the system for classifying different types of lining epithelia based on number of layers and shape of cells on the surface
- Recognise glandular tissue in photomicrographs, identify the gland type and its likely function
- Name the various types of glands, relate their structure to their function, and give an example of where each might be found in the body.
- Describe the basic structure of a mucosa and a serosa, and predict their functions from the different types of epithelial cell found on their surface.
- Recognise the mucous and serous membranes in photomicrographs and be able to identify different structural components found in each of these complex tissues
- Recognise, name and understand the function of different components of the basement membrane.
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Blood and the Circulatory System
- Identify the structural difference between arteries and veins related to function. Name and locate the major arteries and veins in the systemic circulation.
- Describe the position of the heart and identify the great vessels
- Follow the main vessels to the viscera and to the periphery, identifying the main vessels
- Differentiate between systemic, portal and pulmonary circulation
- Describe the general location of lymph nodes.
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Anatomical Positions, Planes and Movements
- Describe the anatomical position and use correct anatomical terms to describe body directions, regions and body planes or sections.
- Locate and name the major body cavities and their subdivisions and list the major organs contained within them. Name the serous membranes and indicate their common function
- Identify the main components of the cardiovascular, respiratory, digestive, urinary, endocrine and reproductive systems of the body.
- Can describe the relevant, deep fascia, compartments
- Locate the major organs in cross section and on MRI and CT
- Can describe the relevant muscle groups and movements
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Muscles, Nerves and Connective Tissue
- Compare and contrast the structure, function and location of the three major types of muscle.
- Recognise the different types of connective tissue in photomicrographs
- Recognise nervous tissue and be able to distinguish neural and glial components
- Describe the major responses of muscle to use and disuse.
- Identify common cell types found in connective tissues
- Show understanding of how different cell types within nervous tissue and the organisation of the tissue contribute to its functions
- Relate the functional organisation of the neuromuscular synapse (junction) to the process of neuromuscular transmission.
- Understand differences in the make-up of the extracellular matrix between various connective tissues and how types are differently organised
- Relate organisation of different types of connective tissue to their function
- Outline the distinctive structural and functional characteristics of nervous tissue.
- Relate the structures of the neuronal cell body, dendrites, axon and synaptic terminal to their function.
- Recognise different types of muscle and different components of muscle tissue in photomicrographs
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Histology
- Describe the categorisation, main structural features and functions of the connective tissues.
- Describe the different cell types found in mature connective tissue.
- Relate the composition of extracellular matrix components to the functional requirements of the various connective tissues.
- Compare and contrast the structure and functions of the two types of adipose tissue.
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Autonomic Nervous System
- Compare and contrast the SNS and ANS
- Draw labelled diagrams to show the general arrangement of motor and somatic reflexes.
- Name the divisions of the ANS, and describe the segmental organisation of the sympathetic and parasympathetic nervous systems.
- Draw a series of labelled diagrams to show the arrangement of nerve fibres in the divisions of the ANS at the anatomical and neurochemical and receptor levels,
- Describe how the adrenal medulla acts as a modified post-ganglionic cell.
- Briefly describe how the enteric nervous system can control gut function.
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Anatomy of the Nervous System - General
- Explain the structural and the functional divisions of the nervous system
- Can explain the broad structure and function of the central nervous system
- Can explain the broad structure and function of the peripheral nervous system
- Can explain the broad structure and function of the somatic nervous system
- Can explain the broad structure and function of the autonomic nervous system
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Bones and Joints
- Medical knowledge: PHYSIOLOGY (TD 8.2)
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Homeostasis
- Be able to apply the principles of homeostasis to one human physiological system, from: body temperature; or blood glucose concentration; or body fluid volume.
- Be able to define homeostasis in relation to the physiological systems
- Be able to discuss the contribution of negative feedback, positive feedback and positive feedforward to the process of body homeostasis.
-
Body Fluids
- Be able to describe the distribution of body fluids within the body and the composition of intracellular and extracellular fluids.
- Be able to describe how water moves between different compartments of the body.
- Be able to discuss the contribution of ion pumps to the regulation of cell volume.
- Be able to discuss fluid balance and the role of the kidney in regulating blood osmolality and volume.
- State general disorders of fluid balance.
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Neuropharmacology
- Be able to explain how neurotransmitters can produce electrical changes by activating / inhibiting receptors in the post-synaptic cell
- Be able to outline the role of G-proteins in coupling a hormone/NT receptor complex to a) adenylate cyclase; b) hydrolysis of inositol phospholipids
- By means of simple diagrams and suitable examples, be able to describe the properties of the receptor-regulated ion channels and the neurotransmitters which activate them
- Describe the major neurotransmitter systems in the central and peripheral nervous systems
- Describe the role of protein kinases in transmitting the intracellular effects of second messengers
- Explain how an action potential is initiated by the summation of synaptic inputs
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Autonomic Nervous System
- Compare and contrast the SNS and ANS
- Draw labelled diagrams to show the general arrangement of motor and somatic reflexes.
- Name the divisions of the ANS, and describe the segmental organisation of the sympathetic and parasympathetic nervous systems.
- Draw a series of labelled diagrams to show the arrangement of nerve fibres in the divisions of the ANS at the anatomical and neurochemical and receptor levels,
- Describe how the adrenal medulla acts as a modified post-ganglionic cell.
- Briefly describe how the enteric nervous system can control gut function.
-
Homeostasis
- Medical knowledge: BIOCHEMISTRY (inc. Metabolism) (TD 8.3)
- Acid-Base Balance
- Amino Acids
- Medical knowledge: CELL BIOLOGY (TD 8.4)
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Biological Energy
- Define the principal energy stores in human cells
- Describe the principal biological roles of ATP in relation to biosynthesis reactions, transport and motility
- Describe the principal mechanisms of energy generation within the cell and distinguish between ATP generation through substrate level phosphorylation and via the proton motive force
- Explain the significance of B-group vitamins in terms of coenzyme structure and function
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Proteins
- Understand the role of the ribosome in mRNA translation; how and where, including co-translational translocation of membrane and secreted peptides at the ER
- Outline the common structural features of the amino-acids and the roles of their side chains in protein structure and function
- Describe the structure of proteins and the stabilising forces of the a-helix, b-pleated sheet and collagen triple helix
- Comprehend the problems of protein folding in vivo and the role of molecular chaperones in dealing with this
- Explain how post translational modifications can be important for stability and modulation of function
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Sugars and Polysaccharides
- Distinguish between the terms monosaccharide, disaccharide and polysaccharide and name a physiologically important example of each group
- Define the terms: glycosidic bond; sugar esterification (phosphates + sulphates); amino sugar, giving a physiologically relevant example of each one
- Define the mechanism and biological importance of protein glycosylation
- Outline the structures and biological roles of glycogen, heparin, proteoglycan and bacterial lipo-polysaccharide
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Cell and Tissue Structure
- Describe different types of cell to cell (intercellular) communication
- Identify the organelles and ultrastructural features of cells; describe organisation and functions of the following and, where applicable, relate to human disease
- Understand the functions of the principal components of the extracellular matrix and relate to cell function and disease
- Discuss the structure and function of inter-cellular connections in relation to tissue function eg adherens junctions, tight junctions, gap junctions, desmosomes, synapses and relate to disease
- Describe the steps and components in a simple intracellular pathway
- nucleus; mitochondrion; endoplasmic reticulum (rough and smooth); Golgi complex; lyosomes; peroxisomes; cytoskeleton; plasma membrane
- Relate the specialised structure of the cell surface (microvilli, cilia, pseudopodia) to the functions of the tissues and cells concerned
- Understand how signals may activate different responses in cells
- How intracellular signals can act as molecular switches via phosphorylation
- Explain the different types of intracellular and cell surface receptors
- Understand the importance of cell communication in physiological and pathophysiological conditions.
- Cell Differentiation and Cell Death
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Lipids and Membranes
- Distinguish between essential and non-essential fatty acids and understand their importance as energy stores and as precursors of membrane lipids and paracrines
- Explain the following terms in relation to enzyme catalysis: substrate specificity; active site; activation energy; cofactor and co-enzyme; proenzyme.
- Describe the physiological functions of cholesterol: as a component of biological membranes and as a precursor for steroid and bile salt synthesis
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Membrane Function
- Be able to describe the function of membrane proteins
- Understand the composition and architecture of biological membranes
- Distinguish between passive diffusion, facilitated diffusion, secondary active transport, and active transport giving examples of each in human tissues
- Relate specialisations of the plasma membrane to its function
- Describe how deficiencies in folding, trafficking and function of the CFTR protein cause cystic fibrosis
- To appecriate the key components that make up most of the ECM including collagen and proteoglycans,
- To appreciate the mechanism that allow cells to adhere and move through the extracellular matrix
- To describe how loss of cell ahesion can lead to diseases
-
Enzymes
- Define the following terms in relation to enzyme catalysis: substrate specificity; active site; activation energy; cofactor and co-enzyme; proenzyme.
- Explain the effects on enzyme catalysis of changes in temperature and pH. Distinguish between competitive and non-competitive inhibition, giving a physiological example of each.
- Define the term isoenzymes and their value in diagnostic enzymology.
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Biological Energy
- Medical knowledge: MOLECULAR BIOLOGY and GENETICS (TD 8.5, 8.6)
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Cell Division and its Control
- Describe the main features of the cell cycle
- Describe the main mechanisms and biological functions of mitosis and meiosis
- Discuss the role of genes in co-ordinating the cell cycle
- Give examples of human diseases associated with mutations in these genes
- Explain how some chemotherapeutic drugs may inhibit cell division in cancer cells
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Protein Synthesis
- Outline the key features of the genetic code
- What are the essential RNA species for translation
- Describe the events and regulation in the ribosome cycle of protein synthesis
- Describe the structural changes undergone by a newly synthesised polypeptide in order to constitute a biologically active protein in the appropriate site (post-translational modifications / targeting and sorting)
- How does viral and bacterial interference effect protein translation
- Know that antibiotics are used to target ribosomes
- Outline protein synthesis defects in inherited disease
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DNA Structure and Synthesis
- Describe, using simple diagrams, the structure of DNA and its organisation into nucleosomes, chromatin and chromosomes
- Outline the mechanism of DNA replication (synthesis) and describe how some antibiotics interfere in this process
- Explain the very low level of mistakes in the DNA replication process
- Outline methods of DNA repair with examples of inherited DNA repair defects
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RNA Structure and Synthesis
- Describe the Central Dogma and the basic structure of a gene
- Describe the process of transcription and explain the function of RNA polymerase
- Explain what a promoter is and its role in transcription
- How is RNA modified before leaving the nucleus?
- Describe the different types of RNA and their role in translation
- Describe how antibiotics can interfere in the process of transcription
- Epigenetics
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Genetic Variation
- Appreciate how much genetic variation we have: both rare and common variants
- Understand how prenatal diagnosis and PGD can be performed
- Discuss how DNA polymorphisms can be detected and how they may be used to identify individuals
- Appreciate how genetic variation may determine treatment options
- Think about the ethical issues with respect to personal genome sequencing
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Inheritance and Mutation
- Describe the different types of gene mutation and their consequences
- Review the types of genetic mutation and how they affect the organism
- Describe, with examples, the different patterns of inheritance of single gene disorders
- Review the types of chromosomal mutations
- Review the causes of genetic mutations
- Define the following terms in relation to human genetics and disease: homozygous; heterozygous; proband; sibling; recessive; dominant; co-dominant; penetrance; anticipation; imprinting phenotype; genotype; allele
- The Human Genome
- Genetics - General Outcomes
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Cell Division and its Control
- Medical knowledge: PATHOLOGY (TD 8.7)
- Medical knowledge: CANCER
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Neoplasia
- Define the terms: tumour, neoplasm, benign, malignant, histogenesis, differentiation, metastasis
- Identify and compare the major pathological features of benign and malignant neoplasms
- Give a brief classification of benign and malignant neoplasms according to their cell of origin
- Define the term paraneoplastic syndrome and give some examples
- To be able to describe the pathological features of carcinomas
- Identify and compare the behaviour between benign and malignant neoplasms
- Give a brief classification of benign and malignant neoplasms according to their cell of origin (histogenesis)
- List the aetiological agents that have been linked to the development of some malignant neoplasms
- Describe the effects of a neoplasm on the host
- Define the term paraneoplastic syndrome and give some examples
- Cancer and Genetic Disease
- Pathology of Cancer
- General
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Neoplasia
- Medical knowledge: IMMUNOLOGY and INFLAMMATION (TD 8.8)
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Immunology - General Outcomes
- 1. To understand that immunology is related to disease including infections, autoimmunity and allergy (hypersensitivity).
- Understand cytokines and their function
- Appreciate the key concept that cytokines are very beneficial molecules in small localised controlled doses, but are extremely harmful molecules in high prolonged and systemic doses
- Be aware of the main players in the immune system including lymphocytes (T-cells, B cells and NK cells), myeloid cells (macrophages and granulocytes), dendritic cells and antibodies
- Know that the immune system is an agent of harm in the modern age
- Appreciate that communication between cells is critical
- Realise the importance of long term immunological memory
- The Immune Response in Health
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Recognition and Response to Antigens
- Know how the immune system recognises antigens
- Know the meaning of the term antigen
- Understand the importance of distinguishing self from non-self
- Introduce the idea that TCRs and BCRs are made with random antigen recognition capacities
- Appreciate that innate immune cells recognise a limited array of microbial structures using pattern recognition receptors.
- Understand how T and B cells recognise antigens and how the diversity of antigen recognition receptors on these cells is generated.
- Be familiar with the basic structure of an antibody molecule.
- Understand the role of antigen presentation and the structure and function of major histocompatability complex (MHC) molecules.
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Communication between Immune Cells and Tissues
- Know that Th1 cells drive cell-mediated immunity
- Know that Th2 cells drive humoral immunity
- Know that Th17 cells drive responses to extracellular bacteria
- Know that T-reg cells retrain immune responses
- Know that memory T-cells remember our infection history
- Appreciate that CD4 or helper T-cells orchestrate adaptive immun responses
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Immunology - General Outcomes
- Medical knowledge: MICROBIOLOGY and INFECTION (TD 8.9)
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General Outcomes for Microbiology
- List the basic characteristics of viruses and the criteria by which they are classfied
- Be able to distinguish between the different groups of pathogens
- Describe the structure of viruses, defining the terms: capsid; capsomeres; genome; nucleocapsid, envelope
- Outline the structure of bacteria, emphasising differences from eukaryotic cells
- Describe how bacteria can be classified on the basis of staining properties and morphology
- Describe how viruses replicate
- List those parts of the body which should be sterile and those which have a normal flora
- Antivirals and Viral Infections
- Antimicrobials and Bacterial Infections
- Sources of Infection and Routes of Transmission
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Pathogenesis
- Describe portals of entry of pathogens and their adherence mechanisms
- For viruses, list their mechanisms of persistence, and explain their harmful effects (killing cells, alter functions of cells, giant cell formation, malignant change, hypersensitivity)
- For bacteria, list their mechanisms of persistence, describe how they make you ill, and how they survive the host response (involving stress, stealth, scavenging, striking back)
- Describe how pathogens are disseminated through host organs and how they exit from the host
- Terminology used in Microbiology
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General Outcomes for Microbiology
- Medical knowledge: PHARMACOLOGY (TD 8.10)
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Synaptic Transmission
- Review the various types of receptors
- Recall how synapses integrate excitatory and inhibitory signals
- Be able to explain how changes in axon diameter and myelination affect the conduction velocity of axons
- Describe how the action potential is converted into a chemical signal at the synapse
- Describe how sensory information is integrated and a motor response initiated if appropriate
- Explain why pre-synaptic calcium is important for chemical transmission
- Compare the effects of excitatory and inhibitory neurotransmitters on the post-synaptic membrane potential
- Drug Receptor Interactions
- Evidence Based Pharmacology
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Safe Prescribing and Drug Administration
- Describe the main routes of drug administration
- Identify the routes of administration that lead to 1st pass metabolism and how this contributes to the activity of a drug
- Recognise how phase I and phase II reactions contribute to the drugs elimination
- Describe how dosage regimes affect the activity of a drug
- Recognise the factors that affect drug interactions
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Synaptic Transmission
- Medical knowledge: SOCIOLOGY (TD 10 a-e)
- Health across the life course
- Medical knowledge: EPIDEMIOLOGY
- Medical Knowledge: SCIENTIFIC METHOD & RESEARCH
- General Topics
- General Topics
- Professional issues: ETHICS and LAW (TD 20 a-g)
- General Outcomes for Medical Professionalism
- Informed Consent
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Moral Philosophy
- Understand the nature and outline the various forms of an ethical problem; identify examples of ethical problems in medicine
- Outline the major moral theories and their criteria of identifying goodness
- Give examples of how each of these theories could be applied in medico-ethical decision making
- Describe the shortcomings of moral theories and suggest how they could be overcome
- Professional issues: MEDICAL FRAMEWORK IN THE UK (TD 23 c)
- Medical Leadership and Management - General
- Medical knowledge: ANATOMY (TD 8.1)
- General Outcomes for Community Care
- Medical knowledge: SOCIOLOGY (TD 10 a-e)