Medicine and Dentistry

Preamble

The Core Curriculum and Minimum Academic Standards (CCMAS) are to be used for the undergraduate training in Medicine and Dentistry programmes in Nigeria. It is pertinent to note that this CCMAS document is expected to guide institutions in the design of curricula for their Medicine and Dentistry programmes by stipulating the minimum requirements.  Being such, institutions are encouraged to take due cognizance of the CCMAS while bringing necessary innovation to the content and delivery of their programmes towards achieving the overall goal of Medicine and Dentistry education and training in the country.

Programmes and Degrees

The programmes are Medicine and Dentistry which covers the following degree areas.

Table 1:1 List of Programmes and Degrees

The profile of NUC-approved programmes in Medicine and Dentistry in the Nigerian university system reflects the current status of the exponential growth in the medical and dental curricular since the time when Medicine programme was first estblished in 1948  at University College, Ibadan (now University of Ibadan). The Nigerian population is underserviced by medical personnel whose distribution is grossly skewed against rural areas, hence the continued expansion of the medical programmes in order to meet the ever rising demands of medical services. The CCMAS should be deligently implemented by the universities running the MBBS/MBChB and BDS/BChD programmes in order to guarantee quality medical and dental services to the populace.

Overview

Two programmes are taught under this discipline. One programme leads to the Bachelor of Medicine and Bachelor of Surgery (MBBS/MBChB) degree while the other leads to the Bachelor of Dental Surgery (BDS/BChD) degree. The two programmes are similar, and students take virtually the same courses up until the 400 level. The early parts of the curriculum that deal with issues of philosophy, mission, aims and objectives and others, are common to the two programmes.

The curriculum is unique in several respects and is designed to enable the graduate to meet the needs of a rapidly changing practice environment

Philosophy, Aims and Objectives of Medicine and Dentistry  

Philosophy

The education of health professionals must be attuned to the health needs of the society. This commitment should be reflected in a competency-directed and community-oriented approach in the training of the health professional with emphasis on social responsiveness and relevance, as well as life-long learning.

Objectives

The Bachelor of Medicine, Bachelor of Surgery and the Bachelor of Dental Surgery curricula are each designed for a six-year period, inclusive of the 100-level programme.

The broad objectives are to:

1. promote the production and development of medical doctors and dentists with sound knowledge in physiological, anatomical and biochemical processes in the human body that would lead to the understanding of various diseases;
2. produce medical doctors and dentists who are proficient in clinical clerkship and the use of modern technology for the diagnosis and management of patients;
3. produce medical doctors and dentists capable of understanding diseases and their manifestations using laboratory and pathological skills and knowledge, including the determination of the effect of diseases on the lives of individuals and persons in the community;
4. train medical doctors and dentists with sound knowledge and understanding of causes of diseases at the individual and community levels, and other public health challenges using evidence-based methods;
5. train medical doctors and dentists with an in-depth knowledge of therapeutics and with ability to determine drug actions in their patients;
6. produce medical doctors and dentists with knowledge of ethical principles of the medical profession to attend to diverse ethical situations in the multicultural setting of the Nigerian Nation and other cultures;
7. produce medical doctors and dentists as professionals who are polite, considerate, trustworthy, honest, act with integrity, maintain confidentially, respect patients’ dignity and privacy;
8. inculcate into the medical doctors and dentists the spirit of teamwork and multi-disciplinary approach to medical practice;
9. produce medical doctors and dentists with sound theoretical knowledge and skills capable of undertaking research in various fields of the medical and dental professions;
10. produce medical doctors and dentists as professionals who recognise the principles of patient-centered care, including self-care, and deal with patients’ healthcare needs in consultation with them and, where appropriate, their relatives or carers; and
11. produce medical doctors and dentists with skills for life-long and self-directed learning.

Learning Outcomes 

Domain of Knowledge

At the end of the training, graduates of the medical and dental degrees should be able to:

1. identify and understand diseases using knowledge and skills acquired in the basic medical, basic clinical and clinical sciences;
2. utilise investigative and diagnostic results to determine the various causes of diseases, their modes of transmission, manifestations and appropriate channels of management;
3. understand the structure and functions of healthcare delivery systems, including their maintenance and the utilisation of public health principles in the prevention of diseases; and
4. apply basic research tools at both the patient and community levels to answer research questions.

Skills and Competencies

At the end of the training, graduates should be able to:

1. apply scientific knowledge and available medical literature in the interpretation of diagnostic results;
2. demonstrate the use of common diagnostic and therapeutic instruments and appliances;
3. competently undertake various clinical procedures;
4. competently communicate with patients, colleagues and the general public;
5. demonstrate high level reasoning ability in solving clinical problems;
6. diagnose common illnesses among patients based on their history, physical examination and laboratory data/information;
7. develop a management plan based on competent medical evaluation of patients and relevant laboratory investigation results;
8. respond promptly as appropriate to medical/dental emergencies and work effectively with other health related professionals;
9. be digitally literate and proficient in the use of modern digital instruments including the computer and other ICT facilities in patient care and data management; and
10. seek for sources of information and materials in support of life-long learning on issues of health and disease.

Behavioural Attributes

Graduates of this discipline should be able to:

1. show sensitivity, honesty, comportment and integrity in their personal life and in the care of all patients, displaying utmost privacy, respect and dignity;
2. professionally communicate information to patients and relevant authority;
3. demonstrate leadership skills and promote the health and well-being of the host community;
4. work in a team alongside other health care professionals; and
5. dress and appear decently and appropriately, especially when attending to patients.

Admission and Graduation Requirements

Admission Requirements

Six-Year Programme

1. In addition to acceptable scores in the Unified Tertiary Matriculation Examination (UTME), candidates to be admitted into the degree programmes shall possess a credit pass in each of the following: Physics, Chemistry, Biology, Mathematics and English language at the Senior Secondary Certificate (SSC) or their equivalents at one sitting.
2. In addition, they will sit for and obtain an acceptable score for the university they wish to be admitted into at the Joint Admission and Matriculation Examination as well as the post UTME.

Five-Year Programme

1. Candidates who possess relevant ‘A’ level passes in Physics, Chemistry and Biology/Zoology.
2. Holders of first degrees in relevant science areas may also be admitted through the direct entry mode.
3. Candidates seeking direct entry into the programmes should in addition have credit passes in Physics, Chemistry, Biology, Mathematics and English language at the SSC or their equivalents at one sitting.
4. In addition, they will register for and be admitted through the Joint Admission and Matriculation Board as well as the post UTME and screening of the respective University.

Duration of the Programmes

Each of the programmes in Medicine and Dentistry shall be for a minimum of six (6) years consisting of one year of basic sciences, two years of basic medical sciences, one year of basic clinical sciences and two years of clinical sciences. Other than the one year of basic sciences, the periods for the basic medical, basic clinical and clinical sciences courses are not in strict compartments as they overlap slightly during the course of the programmes.

Graduation Requirements

1. To graduate from the MBBS/MBChB or BDS/BChD degree programmes, a student shall have undergone six (6) or five (5) academic sessions depending on the admission entry mode, Six Year Programme or Five Year Programme.
2. The student must have passed all prescribed professional examinations (from 200 level) with a score of not less than 50% in each course. For the clinical courses, a pass (minimum of 50% score) in the clinical component of each examination is also required. To graduate, a student must be found worthy in character throughout the period of his/her course of study. The student must also submit the report of a supervised research project.
3. The MBBS/MBChB and the BDS/BChD degrees shall remain unclassified according to the CGPA but excellence may be recognised through the award of distinctions.

Course System

This should be understood to mean a quantitative system of organisation of the curriculum in which subject areas are broken down into course units which can be examined and for which students earn credit(s). However, this should not be taken to mean that there is complete compartmentalisation between the subject matter in the various courses. Some of the advantages of this system are that all components of courses are taught and examined with organised structuring of the courses.

The MBBS/MBChB or the BDS/BChD programme is taught and examined as sessional programme courses with professional examinations taken at the completion of each phase of the training.

But for standardisation and quantification, courses taught are packaged into credit units assigned to semesters. This has the advantage of allowing an in-depth assessment for the purpose of producing academic transcripts for postgraduate admissions, interfaculty transfers and assessing conformity to regulatory requirements like those of the World Federation for Medical Education (WFME).

The courses are arranged in levels of academic progress such as Level 2 or Year 2 courses are 201, 202 and Level 5 or Year 5 courses are 501, 502. Furthermore, courses are assigned weights called Credit units.

Credit Units

Credit units consist of specified number of student-teacher contact hours per week per semester.  Credit units are used in two complementary ways, one, as a measure of course weighting, and the other, as an indicator of student workload. The total credit unit carried by medical and dental students is without prejudice to what is approved by Senates of universities for other degree programmes.

As a measure of course weighting for each unit course (such as ANA 201, PHY 203, MED 604), the credit unit to be earned for satisfactorily completing the course is specified, such as a 2-credit unit course may mean 1-hour lecture plus 3 hours of practical per week per semester.

As a measure of workload, ‘One Credit Unit’ applies to the following activities:

1. 15 lectures of one hour each per week;
2. Tutorial sessions of 45 hours;
3. Seminars of 45 hours; and
4. Laboratory or field work, clinical practice/practicum, studio practice or stadium sporting activity of 45 hours.

Grading of Courses

1. A grading system using both letter (A-F) and number (5-0) should be adopted.
2. The scoring and grading are as shown in table 1.2 below.
3. A minimum pass mark of 50% (letter Grade C) at all examinations should be adopted for the MBBS/MBChB and BDS/BChD programmes. In addition to continuous assessment tests, examinations should be administered at the end of each course. For the clinical courses, a pass in the clinical component of each examination is also required.

Table 1.2 Scoring and Grading System 

Grade Point Average and Cumulative Grade Point Average

Grade Point Average (GPA)

Performance in any semester is reported in Grade Point Average. This is the average of weighted grade points earned in the courses taken during the semester. The Grade Point Average is obtained by multiplying the Grade Point average in each course by the number of Units assigned to that course, and then summing these up and dividing by the total number of Units taken for the semester. 

Cumulative Grade Point Average (CGPA)

This is the up-to-date mean of the Grade Points earned by the student in a programme of study. It is an indication of the student’s overall performance at any point in the training programme. To compute the Cumulative Grade Point Average, the total of Grade Points multiplied by the respective units for all the semesters are added and then divided by the total number of units for all courses registered by the student.

Degree Classification

The MBBS/MBChB and the BDS/BChD degrees shall remain unclassified according to the CGPA. Excellence may be recognised through the awards of distinctions and prizes. Furthermore, the CGPA may be used for the issue of academic transcripts and determination of candidates for university wide prizes and awards.

Evaluation

Students should be assessed using both ‘formative’ and ‘summative’ examinations.

1. Formative (mock) examinations

These tests are conducted at least once every posting prior to the summative examinations to give the students feedback on their performance to improve their learning. The formative examinations should simulate the summative assessments in order to also prepare the students for the latter.

2. Summative examinations

These consequential examinations include all tests that determine the students’ progress during the course i.e. continuous assessments and professional final examinations.

Techniques of Students’ Assessment

The techniques of students’ assessment shall be by continuous assessment and end of course professional examinations. Continuous assessment of students shall be by means of term papers, frequent tests (formal and in-formal), assessment in workshop/laboratory/field/clinics/assignments, as may be applicable, which should constitute a minimum of 30% of the year’s assessment. The weightings for each of the professional examinations shall be a maximum of 70%.

External Examiners’ Systems

External examiners shall be used during the professional examinations in medicine and dentistry to certify the overall performance of the students and the quality of facilities and teaching. This serves as an external quality assurance system designed to review the standard of examination questions, marking schemes and answer scripts and departmental activities. External examiners should participate actively in clinical as well as oral examinations.

Student’s Evaluation of Courses

It is desirable to assess the quality of teaching both by peers and students. This could be by way of questionnaire.

Maintenance of Curricular Relevance

Medical schools should embrace the development, review and utilisation of tools for monitoring curricular implementation and evaluation. They should establish a permanent mechanism with the creation of a curriculum committee to specifically undertake annual evaluation of programmes and teachers while the review and reforms of the curriculum shall take place at least once every five (5) years.

Performance Evaluation Criteria

The general performance indices to be used for accreditation by internal and external assessors shall include adequacy of staff of all categories, physical facilities and space, equipment and instrument, library facilities and funding. The students’ pass rate and employers’ acceptance of graduates of the programmes shall be part of the indices. It is also desirable to assess the quality of teaching both by peers and students.

CCMAS: Medicine and Dentistry (New) - 2023

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