التاريخ الوظيفي:

• أستاذ مساعد بقسم الباطنة كلية الطب جامعة الملك سعود 1430هـ
• استشاري في الأمراض الباطنة والجهاز الهضمي والمناظير والكبد (من 1427هـ وحتى الوقت الحاضر).
• طبيب زميل في برنامج زمالة جامعة تورينتو  لامراض التهابات القولون التقرحي والتحببي من 1 يوليو 2007 إلى 30 ديسبر 2008 في جامعة تورينتو ، كندا
• طبيب زميل في برنامج الزمالة الكندية في الجهاز الهضمي والكبد 1 يوليو 2005 إلى الموافق 30 يونيو 2007 في جامعة تورينتو ، كندا
• طبيب مقيم في برنامج الزمالة الكندية في الطب الباطني 1 يوليو 2002  إلى 30 يونيو 2005، في جامعة كوينز بكندا.
• طبيب مقيم في الطب الباطني مستشفى الملك فهد للحرس الوطني في الرياض 
• • Internal Medicine Resident              

  King Abdul Aziz medical City, Riyadh Saudi Arabia

   

  • Internal Medicine Resident               

  Queen’s University, Kingston, Ontario Canada

   

  • GI Resident                                    

  University of Toronto, Toronto, Ontario Canada

   

  •     Clinical IBD Fellow                        

  University of Toronto, Toronto, Ontario Canada

  • Inpatients and Outpatients management of complicated IBD cases
  • Several presentations in IBD rounds and combined Gastroenterology, Radiology and Surgical rounds.
  • Participating and leading TPN team at Mount Sinai Hospital, Toronto.

   

  2007-2009 Internal medicine and Gastroenterology, Ontario, Canada

  Working as an independent internal medicine and gastroenterology staff

  • William Osler Health C

   

  2009-present: Assistance Professor of Medicine, Consultant Gastroenterology, College of Medicine, King Saud University, Riyadh, Saudi Arabia

   

  2010-present: Program  director of Internal Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia

التاريخ الوظيفي:

• أستاذ مساعد بقسم الباطنة كلية الطب جامعة الملك سعود 1430هـ
• استشاري في الأمراض الباطنة والجهاز الهضمي والمناظير والكبد (من 1427هـ وحتى الوقت الحاضر).
• طبيب زميل في برنامج زمالة جامعة تورينتو  لامراض التهابات القولون التقرحي والتحببي من 1 يوليو 2007 إلى 30 ديسبر 2008 في جامعة تورينتو ، كندا
• طبيب زميل في برنامج الزمالة الكندية في الجهاز الهضمي والكبد 1 يوليو 2005 إلى الموافق 30 يونيو 2007 في جامعة تورينتو ، كندا
• طبيب مقيم في برنامج الزمالة الكندية في الطب الباطني 1 يوليو 2002  إلى 30 يونيو 2005، في جامعة كوينز بكندا.
• طبيب مقيم في الطب الباطني مستشفى الملك فهد للحرس الوطني في الرياض 

• باكاليريوس من كلية الطب جامعة الملك سعود عام 1999
• الزمالة الأمريكية في الطب الباطني من البورد الأمريكي للطب الباطني عام 2006،  وتمت الدراسة في جامعة كوينز بكندا.
• الزمالة الكندية في الطب الباطني من الكلية الملكية للطب الباطني 2006، وتمت الدراسة في جامعة كوينز بكندا.
• الزمالة الكندية في الجهاز الهضمي والكبد من الكلية الملكية للطب الباطني في 2007 ، وتمت الدراسة في جامعة تورينتو، كندا
• الزمالة الأمريكية في الجهاز الهضمي والكبد في 2008 ، وتمت الدراسة في  جامعة تورينتو ، كندا
• الزمالة الأمريكية في الجهاز الهضمي والكبد في 2008 ، وتمت الدراسة في  جامعة تورينتو
• زمالة جامعة تورينتو لامراض التهابات القولون التقرحي والتحببي 2009 
• • 1999      Saudi license exam SLE
  • 2001      United States Medical Licensing Examination Part II
  • 2001  The Medical Council of Canada Evaluating Examination
  • 2001       Arab Board of Internal Medicine      Part I
  • 2001       Saudi Board of Internal Medicine     Part I
  • 2006  The Medical Council of Canada Qualifying Examination Part I and II
  • 2006       Royal College of Physicians of Canada certification in Internal Medicine
  • 2006       American Board of Internal medicine certification
  • 2007        Royal College of Physicians of Canada certification in Gastroenterology
  • 2008  American Board of Gastroenterology certification

Assistant Professor of Medicine

Consultant Gastroenterology

Program director of Internal medicine

Department of Medicine

College of Medicine , King Kha

King Khalid university hospital 

COURSE 341 -GUIDELINES
School year 1428 – 1429

 2007-2008    GENERAL COURSE ORGANIZER

DEPARTMENT  OF  MEDICINE
MED COURSE 341

Curriculum Proposal Form 

 

 

Course Name	Internal Medicine	الباطنة العام	اسم المقرر
Course Code & No	341	طبب 341	رقم المقرر ورمزه
Credits	10 ( 7 +3  )	10 (7+3) *	الساعات المعتمده
Duration	one year	سنة كاملة	مدة المقرر
Study year	Third year	الثالثة	سنة الدراسة

 

 

MED COURSE 341

10 Credit hours

Med Course 341 is the first clinical course for the medical students. It is a 10 credit hours course of theoretical part (lectures) and clinical part (bedside teaching). The main objective of the course is mastering history taking: learning the technique of how do physical exam and know the physical sings of patients. The course was taught over 28 week’s period.

TEACHING PART OF THE COURSE

THEORETICAL PART:   There shall be three lectures per week covering all the general medicine aspect such as cardiology, rheumatology, pulmonology, endocrinology, nephrology, gastroenterology, hematology/oncology, infectious diseases and neurology given over 84 lectures during 28 weeks.

CLINICAL BEDSIDE TEACHING:   There shall two clinical sessions per week. The teaching consists mainly of basic history taking, basic technique of different system examinations and definition and identification of physical sings.

 

ATTENDANCE

Attendance is continuously monitored and kept to see whether students will meet the required percentage of attendance set by the University.

As early as possible, any student noticed to have poor attendance would be given warning letters to call their attention and given them a chance to improve. As a rule, students should have attended at least 75% of the total 92 lectures and 56 sessions of the bedside clinical teaching of the course to be allowed to sit in the final exam. Names of students who will have less than 75% attendance will be submitted to the Vice Dean – Academic Affairs Office and will not be included in the exam until the University gives their approval.

CONTRIBUTING TEACHING STAFF / HOSPITALS

 

Students were distributed in two different hospitals, King Khalid University Hospital and Riyadh Medical Complex for their bedside clinical teaching. Consultants from KKUH rotates between the two hospitals to do the teaching.

 

RECOMMENDED REFERENCES

 

• Textbook of Medicine
  Any one of the following excellent books:

1.     Clinical Medicine – A textbook for Medical students and doctors.
P.J Kumar and M.L. Clark “Latest Edition”

2.     Textbook of Medicine – by Souhami and Moxham – Latest Edition

3.     Davidson’s Principles and Practices of Medicine – C.R. Edward and Ian, A.D
Bonchir – Latest Edition.

 

• Physical Examination
  Any one of the following books:

1.     A guide to physical examination and history taking, by Barbara Bates – Latest  
Edition.

2.    
Macleod’s Clinical Examination by John Munro and C. Edwards.

3.     Clinical Examination – 2nd Edition by Nicholas Talley and Simon O’Connor.

 

EXAMINATIONS

 

CONTINUOUS ASSESSMENT EXAM  is 40% from the total 100% marks.

• This is the first exam done after the students finished the first half of the course and it
  Consists of Written Exam (20%) and Clinical – Long Case Exam (20%)

FINAL EXAMINATION  is 60% from the total 100% marks.

• This will be the second exam after the students finished the 28 weeks of teaching and Just like the first exam it consists of written exam (30%) and clinical – long case exam (30%)

 

WRITTEN EXAM

• IS COMPOSED OF 45 QUESTIONS OF TRUE OR FALSE ANS 15 QUESTIONS OF SINGLE BEST , each question is required to have five stems, setting the questions in a standard form, 5 statements a to e. There shall be 1 mark to be awarded for each correct statement answered in True or False questions (i.e. 1 x 5 = 5) and 5 full marks on every correct answer in the Single Best questions. There is no negative marking in the written exam. Students are advice to answer all the questions and make sure to submit the answer sheets with out any empty space.

 

CLINICAL EXAM

• Students will be marked on his/her ability to take history and perform a physical examination of all the systems taking into consideration that this is their first clinical exam. On both occasions, examiners do not expect the students to know the diagnosis or differential diagnosis of patients. Students are not expected yet to know the management approach. 

 

MED COURSE 341 LECTURS

 

THE FOLLOWING ARE LECTURES GIVEN ON THE FIRST SEMESTER:

 

A. CARDIOLOGY
 

1. Hypertension/hypertensive Heart Disease
2. Hyperlipidemia – Diagnosis and Management
3. Investigation of Heart Disease
4. Angina Pectoris
5. Acute Myocardial Infarction
6. Chronic Valvular Heart Disease – 1
7. Chronic Valvular Heart Disease  - 11
8. Infective Endocarditis
9. Cardiac Arrhythmias
10.  Heart Failure
11.  Cardiomyopathies
12.  Pericardial Disorders

 

B. PULMONOLOGY

1. Pleural Effusion
2. Pulmonary Embolism
3. Interstitial Lung Disease (Allergic Alveolitis)
4. Respiratory Emergencies
5. Pneumonia
6. Investigation of Lung Disease
7. C.O.P.D.
8. Bronchial Asthma
9. Respiratory Failure

C. INFECTIOUS DISEASES

1. Malaria
2. Some Viral Infections
3. Diarrheal Diseases
4. Prevention and Prophylaxis of Infectious Diseases
5. Infection in the immuno-compromised host
6. Typhoid Fever and Brucellosis
7. Tuberculosis
8. Bacteremia and Septic Shock
9. AIDS
10.  Leishmania / Schistosomiasis
11.  Fever of Unknown Origin
12.  Use of Antibiotics

 

D. GASTROENTEROLOGY

1. Pancreatic Diseases
2. Malabsorption and Diarrhea
3. Peptic Ulcer Diseases
4. Irritable Bowel Syndrome
5. Acute Hepatitis and Complications
6. Chronic Liver Diseases (Chronic Hepatitis, Cirrhosis)
7. Oesophageal Diseases
8. Liver Cirrhosis and Complication
9. Liver Tumours
10.  Inflammatory Bowel Disease (Specific and Non-specific)
  
  

 

MED COURSE 341 LECTURS

 

THE FOLLOWING ARE LECTURES GIVEN ON THE SECOND SEMESTER:

E. ENDOCRINOLOGY

1. Clinical Aspects of Diabetes
2. Management and Complications of Diabetes
3. Metabolic Bone Disease
4. Disorders of the Parathyroid Glands
5. Obesity
6. Pituitary Disorders - I
7. Pituitary Disorders - II
8. Adrenal Disorders - I
9. Adrenal Disorders - II
10.  Hypothyroidism and Other Thyroid Disorders
11.  Hypothyroidism
12.  Sexual Disorders

 

F. ONCOLOGY / HAEMATOLOGY

1. Anemia - I
2. Anemia - II
3. Cancer Treatment
4. Acute Leukemia
5. Chronic Leukemia
6. Myeloproliferative Disorder
7. Lymphoma - I
8. Lymphoma - II
9. Haemostasis - I
10.  Haemostasis - II

 

G. NEPHROLOGY

1. Acute Glomerulonephritis
2. Nephrotic Syndrome
3. Tubulointerstitial Disease
4. Fluid and Electrolyte Acid Base Balance
5. Chronic Renal Failure
6. Dialysis and Immunology of Renal Transplantation
7. U.T.I. (including renal tuberculosis)
8. Acute Renal Failure

H. NEUROLOGY

1. Myelopathy & AbHC diseases
2. Epilepsy
3. Myopathies and Myasthenia Gravis
4. CNS Infections
5. Peripheral Neuropathies
6. Extra pyramidal Disorders
7. Dementia
8. CNS Demyelination
9. Headache and Migraine
10.  Localization in Clinical Neurology
11.  Cerebrovascular Diseases

I. RHEUMATOLOGY

1. SLE and Progressive Systemic Sclerosis
2. Infective Arthritis and Crystal Induced arthritis
3. Vasculitis / Myositis
4. Chronic Arthritis - I
5. Chronic Arthritis - II

 

THE MEDICAL INTERVIEW

 

The main purpose of the medical interview is to obtain information about the patient’s illness in order to reach a diagnosis. Diagnosis means identifying and characterizing the disease that the patient has. It is a mental exercise that depends on three basic components.

1.     History of illness

2.     Physical examination

3.     Diagnostic procedures (Laboratory of radiological, etc.)

Patient history is the most important component as 80% of diagnosis can be made from history alone. Physical examination increases the diagnostic yield by 10% and laboratory investigations by another 10%. Therefore taking a good medical history is essential in providing good patient care.

Clinical manifestation of disease are classified as:

1.     Symptoms:Abnormal sensations/changes that the patient feel or observe  (e.g. pain, weakness, shortness of breath).

2.     Sings:Abnormal findings detected by physician on examination (e.g. high temperature, enlarged liver, heart murmur).

HISTORY TAKING:

The objective of taking a medical history is to obtain information about patient illness to make a diagnosis, assess the severity of illness and evaluate its effects on patient’s bodily functions and life. It also serves to establish a relationship between the physician and the patient. The medical history consists of eight components:

1.     Personal data.

2.     Chief complaint (presenting illness)

3.     History of presenting illness

4.     Past history (medical and surgical)

5.     Family history

6.     Social history

7.     Drugs and allergies

8.     Review of systems

 

GENERAL GUDELINES:

Obtaining a good history and physical examination depends largely on patient’s cooperation and confidence in his physician. Students should learn ways to facilitate communication with patients and increase their cooperation during history taking and physical examination. The following are helpful guidelines:

1.     At the beginning, greet the patient and introduce yourself to him: call the patient by his/her first name (if young, use brother/sister: if old, use uncle/aunt). Ask the patient “how is he feeling now?”

2.     Put the patient at ease, make sure that he is comfortable, e.g. in posture, light and
Temperature. Draw the curtains around him to ensure privacy. For females, a female attendant or nurse has to be present.

3.     Show the patient that you are interested in him: by paying attention to his words,
Making sure he is comfortable, answering his needs (e.g. blanket, glass of water , bathroom, etc.). Your posture, words and facial expression should show continuous
Attention to the patient.

4.     Facilitate communication to promote free flow of information. This id done by
Asking general open-ended questions. Encourage the patient to speak freely about
His problem. Show interest in his statements by nodding your head, saying ÿes”, ähah”, änd then repeating the last phrase of his account.

5.     Avoid actions or words that reduce communication, e.g. using technical terms
(patients did not study pathology) or interrupting patient’s speech. Avoid actions that suggest to the patient that you are not interested in him, e.g. taking to another person while the patient talks, reading the hospital chart or book or not actively listening to him.

TECHNIQUE OF HISTORY TAKING

For proper history taking, you are advised to use a systematic approach covering the major components of the medical history mentioned above. I advise you to use the following method:
Step 1: Introduction

• Greet the patient (as above)
• Introduce yourself “I am (mention your name), I am part of the medical team responsible for your care, and I wish to speak to you about your illness”.
• Make sure he is comfortable … (as above), put him at ease.
• Ask “how are you feeling now?” “where are from, uncle?”
• To improve communication, you may chat with him about the weather, his city or
  Region, etc.

Step 2: Personal data

Get the patient’s name (preferably from records), age, sex, nationality, and area of
Residence, occupation.

Step 3: Chief complaint (presenting illness)

• Ask the patient about the symptom, complaint or problem that brought him to the
  Hospital, e.g. “What was the problem that brought you to the hospital? “When did
  It starts?” “Were you well before that?” “What was the first thing that you felt?”
  Here, encourages the patient to speak freely, and give a full account of his problem.
  Do not interrupt except by nodding your head or saying “Yes “, “ah “. “What else “? When the patient finishes his initial description, ask him “are there any other problems “. Repeat until the patient has nothing to add. Avoid suggestions and do not ask leading questions, e.g. “Do you have loin pain?”.
  Your objective here is to identify the main symptom or symptoms that the patient has and their duration. This is the chief complaint(s).

Step 4: History of present illness (HPI)

Here, your objective is to analyze or dissect the main symptom(s) in details, and in
A chronological order. Symptoms (e.g. pain) are usually characterized by the Following features:

1.     Body site (exact are a of body affected)

2.     Duration – since the beginning of the symptom

3.     Radiation – to other areas of the body

4.     Character – describe the symptom (what is it like) and clarify what the patient means by symptom.

5.     Onset – did it start gradually or suddenly

6.     Severity – mid, moderate, sever

o    Does it interfere with daily activity or sleep?

o    Frequency of the symptom (if intermittent)

o    Size (swelling), volume (fluid, sputum, etc.)

7.     Aggravating factors – factors that make it worse.

o    Precipitating factors – factors that lead to it.

o    Reliving factors – factors that make it better.

8.     Course of the symptom since the beginning: did it improve or get worse? If Multiple attacks, frequency and duration of attacks

9.     Associated symptoms: these include:

o    Positive symptoms within the same system or other systems.

o    Negative symptoms of the same system (state that they are absent)

o    General symptoms of disease (fatigue, weight loss, anorexia, fever) whether present or absent.

Step 5: Past History

• Ask about any significant medical problems in the past – since childhood. Hospital 
  Admissions, trauma, fractures, surgical operations, blood transfusions. Mention diseases/ surgeries and the dates (year).
• N.B.: Remember that past medical history includes illnesses that happened in the past and are cured. Chronic diseases that started in the past and are still present (like diabetes mellitus, hypertension, rheumatoid arthritis) are not past medical problems, they are current problems and should be included in history of present illness.

 

Step 6: Family History
 
Ask about:

• Family members and their state of health (parents, brothers and sisters, wife and  Children)
• Illnesses and deaths in the family
• 
  Any similar illness family members

Step 7: Social History

Ask about:

• Nature of occupation – recent and old
• Home surroundings
• Any problems with work or family members or financial problems
• Habits: Drinking/smoking
• History of travel

Step 8: Drugs and Allergies

• Is the patient using any drugs? Mention names, dosages.
• Is the allergic to any drugs or substances?

Step 9: Review of system

General :   Anorexia, weight loss, fatigue, fever, sleep disturbance
  
CVS  :   Chest pain, dyspnea, cough, hemoptysis, palpitations, syncope,
        Ankle swelling, leg pains.

  Respiratory :   Chest pain, dyspnea, cough, sputum, hemoptysis, wheezing.

G.I.T.  :   Nausea, vomiting, dysphagia, heartburn, abdominal pain,   
      Distension, dyspepsia, diarrhea, constipation, jaundice.

Urinary : History of loin pain, dysuria, hematuria, frequency, polyuria,
       Hesitancy, difficulty in micturition, urethral discharge 

Locomotor :   Joint pain, swelling, muscle pain, weakness, backpain, bone pain.

C.N.S. :   Headache, dizziness, loss of consciousness, seizures, visual or
Auditory symptoms. Weakness and numbness in any part of the   Body.

Skin  :   Skin lesion, itching

Blood  :   History of blood loss, bleeding tendency

 

CONTENTS

 

 

Course Title (Symbol and No.):	441 MED	Internal Medicine Practice
Credit Hours:	11 (0 +11)
Contact Clock  Hours:	Theoretical
	Clinical	7:30 AM - 4:30 PM
	Tutorials & Practicals

 

Summary of Course Contents

• This Course is a part of a clinical rotation.  It is a full time clinical clerkship for 12 weeks (preparing for internship in Medicine).  Students shall attend bedside clinical sessions, clinical tutorials, work as sub-interns in the Department of Medicine, attend at the emergency room and assist in various diagnostic and other procedures in the wards.

 

Course Objectives

1.   To ensure adequacy of width and depth of training, the Department would use, as required, the following modalities:

o    Rotation through two (2) hospitals during this period.  Each rotation is for six (6) weeks.

o    A weekly tutorial on the management of the various medical emergencies.

o    Attendance at the emergency room and participation in management of medical emergencies both at ER and they are admitted to the wards.  A  student rota or attendance will be drawn and the attendance of the student is signed by the Senior Registrar on call.

o    Tutorial/Discussions to cover medical emergencies and other topics infrequently met in routine ward clinical practice;

o    Bedside teaching - two (2) afternoons per week.

2.   During the sub-intership, the student should contribute to emergency duty, with the rest of the team at least once per week, and attend O.P. Clinic per week, and attendance of the admission rounds regularly.

3.   To train students how to perform a clinical examination by practical demonstration of how to obtain  a medical history and perform a complete physical examination.

4.   To teach students how to synthesize the information obtained from history and physical examination to make logical conclusions with respect of making a diagnosis or a differential diagnosis.

5.   To teach students how to confirm diagnosis by selecting the most appropriate, safe and cost-effective investigations and make a treatment plan.

6.   To train students how to adapt their medical knowledge to the problems of the community and how to utilize the available resources for that purpose.

7.   On successful completion of this course, the student is expected to be ready to function as a competent intern.

8.   The above objectives are fulfilled observing the spirit of Islam and the ethical conduct of a Muslim doctor.

 

Course Outline Methodology

1.   Didactic bedside teaching

2.   Clinical tutorials

3.   Practical demonstration of diagnostic procedures

 

Tutorial topics given on this course to cover common medical emergencies are as follows:

1.   Renal failure

2.   Cardiovascular disease
Cardiac arrest/arrythmias
Hypertensive crisis

3.   General (lab results interpretation)

4.   General Radiology

5.   Inflammatory polyarthritis

6.   Ischaemic heart disease

7.   Hematology/Oncology emergencies

8.   Neurological emergencies

9.   Myasthenia crisis

10.                Status epilepticus

11.                Endocrine emergencies

12.                Diabetic keto acidosis

13.                Thyroid emergencies

14.                Adrenal crisis

15.                Comatose patient (clinical approach)

16.                Gastrointestinal emergencies

17.                Acute G.I. Bleeding

18.                Acute hepatocellular failure

19.                Respiratory emergencies

20.                Respiratory failure

21.                Acute obstructive (airway disease)

 

Evaluation

One (1) Continuous Assessment Examination (Clinical and Written) 40%.  A final clinical, written and oral examination which carries 60% of the marks.

Recommended References

A. Textbooks of Medicine

Any one of the following excellent books:

1.   Clinical Medicine - A textbook for Medical students and doctors.  P. J. Kumar and M. L. Clark “latest edition”.

2.   Textbook of Medicine - By Souhami andMoxham, latest edition

3.   Davidson’s Principles and Principles of Medicines - C. R. Edward and Ian, A.D. Bonchir, latest edition

B. Physical Examination

Any one of the following books:

1.   A guide to physical examination and history taking by Barbara Bates,  latest edition.

2.   Macleod’s Clinical Examination by John Munro and C. Edwards

3.   Clinical Examination - 2nd Edition by Nicolas Talley and Simon O’Connor