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PG Diploma in Clinical Cardiology: Conducted by IGNOU

By Dr. MV

Post-Graduate Diploma in Clinical Cardiology (PGDCC)

While India has only about 150 positions for training Cardiologists (DM and DNB in Cardiology), less than hundred doctors eventually becomes specialists every year. There is wide gap between availability of cardiology expertise and load of cardiac morbidity in rural as well as urban area. Whatever cardiologists are trained, they are employed / practicing in metropolitan cities or large towns.
 
This deprives the large population of our country from the cardiology expertise. In India , where 25 percent of the population are living below poverty line (2002) and more than 70 percent of them are living in rural area, most of the trained cardiologist are concentrated in the costly sophisticated tertiary care hospitals which are situated in the urban area. Since high tech hospitals are not only unaffordable but also non-accessible for most of the people of the country.
 
This Programme will have a great social relevance. Indians are genetically three times more vulnerable for heart attack than Europeans. While the average age of heart attack victims in Europe is more than 60 years, the average age of Indians is between 40 to 50 making it a disease of breadwinner of the family causing major socio-economic upheavals.
 
So, for obvious reasons we produce the largest number of children with heart disease in the world. A country with over a billion population requires at least few thousands cardiologists to be produced every year to address the growing needs of the heart patients. If a doctor is trained as a Cardiologist after doing his MD in Medicine he obviously prefers to live in major city rather than migrating to smaller towns whereas if an MBBS doctor is given a course in Clinical Cardiology his chances of going to smaller towns ans semi-urban areas are bright.
 
COURSE OVERVIEW:
 
Minimum Duration: 2 Years
Maximum Duration: 4 Years
Course Fee: Rs. 79,200
Minimum Age: No bar
Maximum Age: No bar

Eligibility: MBBS (MCI recognised)

Note:  Course Fees : Rs. 79,200 (Rs. 39,600/- per year. Student need to submit Rs. 39,600/- fee for the 1st Year fee during the admission. They need to submit the same amount as 2nd Year Fee before starting their 2nd Year Training.)

OBJECTIVES
To establish a core programme dedicated to train larger numbers of medical graduates in Clinical cardiology to deal effectively with the early recognition, management and prevention of common cardiovascular diseases (Non Invasive Cardiology) and associated diseases particularly Diabetes Mellitus.


CourseCode     Course Name Credits 
 MCC-001  Fundamentals of Cardiovascular System-I  4
 MCC-002  Fundamentals of Cardiovascular System-II  4
 MCC-003  Common Cardiovascular Diseases-I  6
 MCC-004  Common Cardiovascular Diseases-II  4
 MCC-005  Common Cardiovascular Diseases-III  4
 MCC-006  Cardiovascular Epidemiology  4
 MCC-007  Cardiovascular Related Disorders  4
 MCCL-001  Cardiovascular Evaluation-I  8
 MCCL-002  Cardiovascular Evaluation-II  6
 MCCL-003  Management of Common Cardiovascular Diseases  10
 MCCL-004  Management of Congenital Heart Diseases  4
 MCCL-005  Preventive Cardiology  8
 MCCL-006  Intensive Coronary Care  6

Admission Procedure

Admission cycle of this programme is July session every year. Admission in the PGDCC Programme will be offered through Entrance Examination. Advertisement for the entrance examination of this programme will be available in the month of October/November/December. Entrance Examination will be conducted in the month of February for the July admission cycle. Merit list will be prepared at the national level. There will be centralized counseling for the admission in this programme. The applicant called for counseling will not be entitled to any TA/DA reimbursement.

Implementation
 
The students are required to undergo a two year full time training at the identified / allotted programme study centres. The training schedule of this programme is as follows:
 
Practical Courses
Duration of Training
Minimum number of of Hands on Practical skill Training sessions
First Year
Wards + OPD (MCCL 003)
3 Months (90 days)
      30
ECG/Stress Testing (MCCL 001)
3 months (90 days)
      60
Echocardiography (MCCL 002)
3 months (90 days)
      45
ICU/CCU (MCCL 006)
3 months (90 days)
      30
Second Year
Special Observation (MCCL 006)*
1 month (30 days)
 
ICU/CCU (MCCL 006)
2 months (60 days)
     15
Ward + OPD (MCCL 003)
3 months (90 days)
     30
Paediatric Cardiology (MCCL 004)
3 months (90 days)
     45
Community Posting (MCCL 005)
3 months (90 days)
     45
*Special Observation posting on Cardiac cath Lab, Cardiac Surgery and other invasive cardiac procedures/investigations
  
Provision for the Guest Lecture

MCh cardiothoracic and Vascular Surgery, Diabetologists, Pulmonologists, Anesthesiologists, Nephrologists need to be invited as guest lectures for the programme. The Advisory committee of the PGDCC Programme suggested that there will be a total of 25 guest lectures for every batch. These lectures are in addition to the earlier prescribed 50 lectures (25 in each year) for each batch. The guest lecturers were further divided as follow:
 
SN
Name of the area
Number of the Lectures
1
Diabetes mellitus (MCC 007)
     6
2
Pulmonology (MCC 007)
     5
3
Radiology (MCC 001)
     4
4
Cardiac Surgery (MCC 005)
     4
5
Anesthesiology (for ICU) (MCCL 006)
     4
6
Nephrology (MCC 007)
     2

All the PICs (cardiologists) suggested that all the seminars, journal club and case discussion need to be included into formal teaching learning activity. The total number of these activities was agreed at 25 in a year besides the 25 theory counselling sessions practiced at present for a particular batch in a year. The number will be again divided as follows:
 
·Seminar : 8 
·Journal club: 8 
·Case discussions : 9
  
Theory counselling to be completed in the following topics
(each topic may have several classes):

1. Basic cardiac anatomy
2. Embryology of Heart
3. Basic cardiac physiology
4. Radiology of the heart
5. Electrocardiography
6. Cardiac arrhythmias
7. Stress testing
8. Cardiac catheterization and angiography
9. Radionuclides in cardiology
10. Clinical examination
11. Systemic hypertension
12. Heart failure
13. Valvular Heart Diseases
14. Atherosclerosis
15. Coronary artery disease
16. Cardiac Emergencies
17. Fluid Physiology and Electrolyte imbalance
18. Basic Principal of ICCU Management
19. Rheumatic heart disease
20. Infective endocarditis
21. Congenital heart disease and other paediatric cardiac disorders
22. Pericardial diseases
23. Peripheral vascular disorders
24. Pulmonary thromboembolism and pulmonary hypertension
25. Systemic diseases involving heart
26. Heart Muscle diseases / Cardiomyopathy
27. Traumatic heart diseases
28. Tumors of heart
29. Immunology related to cardiology
30. Cardiac Rehabilitation
31. Diabetes Mellitus
32. Cardiovascular Surgery
33. Pregnancy and heart diseases
34. Epidemiology and preventive cardiology
35. Cardiovascular pharmacology
36. ACLS training
  
List of the Video Programmes available as supplementary Study Material
 
All these video programmes for PGDCC students are distributed to respective study centres. The entire video programmes are available in the IGNOU website
S.No
Title of the Video Programme
Duration
( Min)
1.                
46.09
2.                
28.03
3.                
29.29
4.                
27.46
5.                
1.00.55
6.                
34.36
7.                
40.16
8.                
42.21
9.                
9.46
10.            
31.37
11.            
42.52
12.            
39.05
13.            
40.41
14.            
Mitral Stenosis and Mitral Regurgitation 1 [http://www.youtube.com/watch?v=lzzWhYO7ek4]
43.08
15.            
41.11
16.            
14.24
17.            
38.49
18.            
34.34
19.            
44.08
20.            
Echocardiographic Assessment of Valvular Heart Disease [http://www.youtube.com/watch?v=shxy03ln_UM]
41.35
21.            
Valvular Heart Disease Aortic Stenosis [http://www.youtube.com/watch?v=4CDnaRdpzyk]
47.45
22.            
 Echocardiography on Valuvular Heart Disease- 2 [http://www.youtube.com/watch?v=Lnt81FKvv4Q]
44.57
23.            
30.13
24.            
41.46
25.            
32.03
26.            
46.28
27.            
41.09
28.            
32.33
29.            
42.36
30.            
43.41
31.            
Congenital Cyanotic Heart Disease [http://www.youtube.com/watch?v=seUAKi2jHUo]
48.16
32.            
Congenital Heart Disease 1 [http://www.youtube.com/watch?v=YlbcexxSwKU]
46.32
33.            
Congenital Heart Disease 2 [http://www.youtube.com/watch?v=QrCqXynW3mo]
45.33
 
Examination & Evaluation
 
 
Assignment/Continuous/Internal Evaluation
 
 
 
PGDCC students will be evaluated periodically through assignment/continuous/internal evaluation for all theory and practical courses. The evaluation will be conducted at the respective Programme Study Centre with prior notice. Students are needed to pass in all courses separately. If any student failed in the internal examination which is conducted by the respective PSCs then he/she will be not eligible for writing theory (in that particular course) as well as practical Term End Examination. In this case the PICs send the report to the Registrar, Student Evaluation Division (SED) and Programme Coordinator of the result of internal evaluation and the attendance of previous 6 months or 1 year before 15th May for June exam and before 15th November for December Term End Examination. Candidates may fill up theory exam form but the Hall ticket will be not issued for the particular course (in which he/she failed in internal examination) or entire course (in case of shortage of attendance). In such scenario they will be delayed for 6 months for the particular student. Another internal examination needs to be conducted for the particular student/s for particular course (in which he/she failed) after 6 months before next term end examination. It was requested that all the PIC continue to maintain the quality of the training in their respective institutions. All facts need to be communicated to the students at the beginning.
The students would be expected to pass each of the theory and the practical separately both in continuous/internal evaluation as well as Term End Examination. The minimum pass percentage for both theory and practical would be fifty per cent. There will be of fifty per cent weightage for continuous evaluation and fifty per cent weightage for Term End Examination for both theory and practical courses. The internal assessment of the theory as well as practical component will be conducted by the counsellors located at the PSC. The counsellors and Programme in charge will make an objective and subjective assessment of your understanding and performance of knowledge and skill for both theory and practical courses.

The term end theory examination of the first year theory courses will be after the end of first year. The student passed in the first year theory courses (MCC-001, MCC-002, MCC-003 and MCC-004) after that he/she will appear only in second year theory courses (MCC-005, MCC-006 and MCC-007) at the end of the second year. If he/she does not pass at the end of the first year then he/she may again give the examination after the six-month of the initial term-end examinations. Student can appear the second year Term end examination without passing all the courses of first year term end examination. The students would be required to maintain log-books which will be signed before they will be allowed to appear for their Term End Practical Examination. The term end practical examination will be held after completion of two years training (24 months of training). Passing in internal assessment of all the practical courses separately is a prerequisite for appearing in the Term-end Practical examination. For term-end practical examination, there will be one internal and one external examiner.

Term-end Theory Examination

The examination of the first year theory courses will be after the end of the training of first year. If the student passed in the first year theory courses (MCC-001, MCC-002, MCC-003 and MCC-004) then he will appear only in second year theory courses (MCC-005, MCC-006 and MCC-007) at the end of the second year. If he does not pass at the end of the first year then he may again give the examination after the six-month of the initial term-end examinations.
Result will not be declared if examination division receive any kind of complain like, shortage of attendance against any student.
Students are requested to fill up the Theory Term End Examination with Rs. 60/- fee for each course before 31st March for June Term End Examination and before 30th September for December Term End Examination. The Examination form need to be send to the Registrar, Student Evaluation Division (SED), IGNOU, Maidan Garhi, Mew Delhi – 110068 OR Submit the examination form to the IGNOU Regional Centre. Students are encourage to fill up the on line form for the theory examination.

Term-end Practical Examination/ Evaluation

The Form for Term End Practical Examination needs to fill after completion of 24 months of the training in the PGDCC programme. Students are requested to submit the Practical Examination form to their respective Programme -Incharge (PIC). PIC will examine and further send the practical examination form to the Regional Director along with the attendance certificate, Completion of training in all the courses and result of continuous evaluation of all the courses. There is no fee for the Practical Term End Examination.
Following are the three prerequisite requirements to appear in the Term End practical examination.
1. Passed in all the theory and practical internal evaluation separately.
2. Completion of training in all the respective 6 practical courses with prescribed duration.
3. Attendance certificate showing more than 85 percent attendance in theory as well as practical training.
Students are requested to attach these certificates along with the form of Term end Practical examination. Students have to deposit the form with the respective programme in-charge.

For term-end practical examination, the number of examiner will be depending upon the number of the students. The internal examiners will be from the same programme study centre and the external examiners will be the counsellors from other IGNOU programme study centres (for PGDCC Programme) of other Programme Study Centre. Their names will be decided by Student Evaluation Division (SED) in consultation with the School of Health Sciences (SOHS). An observer from IGNOU may also be present. The practical term-end examination will be held only after completion of two years training of respective batch of the students. Following ratio of the examiners and students should maintained.

Number of the Students
Total Number of the Examiners
Number of the Internal Examiners
Number of the External examiners
Up to  6
2
1
1
7 - 12
4
2
2
13-18
6
3
3

The examination pattern will be uniform in the whole country. There will be three cases, slides/spots and viva. A student will have to score at least 50 percent of marks i.e. 30 marks out of 60 marks in each course separately in the six practical courses to pass successfully. Otherwise, he/she will have to repeat the respective course.
Marking scheme of the practical examination is given below:
No of Case
History taking


   

Marks  
Clinical Exam




Marks
Diagnosis & Differential Diagnosis (including investigation

 Marks
Management





Marks
 Total





Marks
Case: 1 -  MCCL 003
15
15
15
15
60
Case: 2 -  MCCL 004
15
15
15
15
60
Case : 3- (ICCU case) MCCL 006
15
15
15
15
60
MCCL 001
SPOTTERS
ECGs                       5 x 5 marks
25
60
Holter ECG            1 x 5 marks
5
TMT ECG              1x 5 marks
5
X Ray Chest             5 x 5 marks
25
MCCL 002
Echo Doppler (recorded spotter):3 x 10 marks
30
60
Echo Doppler  (Hands on skill during clinical): 1 x 30 marks
30
VIVA VOCE       
(MCCL 005)     
Preventive Cardiology  & Diabetes:
30 marks
60
 Cardiovascular diseases:
30 marks
 
 IGNOU Website: http://www.ignou.ac.in/ignou/aboutignou/school/sohs/programmes/detail/221/1


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