Prelims

Exam Preparatory Manual for Undergraduates FORENSIC MEDICINE AND TOXICOLOGY (Theory, Practical and MCQs)

As per the Competency-based Medical Education Curriculum

Third Edition

Dekal V Professor and Head Department of Forensic Medicine and Toxicology Meenakshi Medical College Hospital and Research Institute Enathur, Kanchipuram, Tamil Nadu, India Foreword TKK Naidu

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Exam Preparatory Manual for Undergraduates: Forensic Medicine and Toxicology (Theory, Practical and MCQs)

First Edition: 2015

Second Edition: 2018

Third Edition: 2024

9789356967311

Printed at India

About CBME Curriculum

Competency-Based Medical Education (CBME) was introduced by the National medical Commission (NMC) to create a medical graduate who is a clinician, leader, and member of the healthcare team, a communicator, a lifelong learner and with attributes of professionalism and ethics.

As per the CBME curriculum, the syllabus has not changed; the change is only in the teaching learning methods and assessment of the student's competency. Competency is the capability to apply or use a set of related knowledge, skills, and abilities required to successfully perform the task.

CBME is an outcomes-based approach to the design, implementation, and evaluation of medical education programs and the assessment of learners, using competencies or observ-able abilities. The goal of CBME is to ensure that all learners achieve the desired out-comes during their training.

The CBME curriculum is designed to identify the desired outcomes, define the level of performance for each competency, and develop a framework for assessing competencies. The CBME curriculum emphasizes on the complex outcomes of a learning process (i.e., knowledge, skills, and attitudes to be applied by learners) rather than mainly focusing on what learners are expected to learn about in terms of traditionally defined subject content.

This third edition of the book maintains the originality of serving as Exam Preparatory Manual along with that appropriate competency to be gained by every learner, which are incorporated at the beginning of every chapter.

The seven basic competencies to be gained by every medical graduate are:

Ability to inspire and motivate others
Convey high-integrity and honesty
The ability to analyze issues and problem solve
Drives for results
Strong communication skills
Teamwork and collaboration
Technical and professional expertise

Objectives of the Indian Graduate Medical Training Program

The undergraduate medical education program is designed with a goal to create an “Indian Medical Graduate” (IMG) possessing requisite knowledge, skills, attitudes, values, and responsiveness so that she or he may function appropriately and effectively as a physician of first contact of the community while being globally relevant.

Foreword

The third edition of the textbook Exam Preparatory Manual for Under-graduates: Forensic Medicine and Toxicology (Theory, Practicals and MCQs) by Dr Dekal V is a lucid elucidation of the essence of medico-legal aspects of medical practice, which is essential knowledge, any, compulsory knowledge, for all medical students and practicing doctors irrespective of their specialty.

Law and medicine are the world's oldest noble professions that are claimed to have been wedded long ago, transforming into a science of facts assisting to resolve the social evils. Professor Dr Dekal V is head of the department of Forensic Medicine and Toxicology at Meenakshi Medical College and Research Institute Kanchipuram, Tamil Nadu, India. He has profound experience and knowledge to compile and revise this book. His research publications available in the world forensic literature have earned many honors conferred on to him by the various authorities in India.

I have gone through this revamped third edition of the textbook Exam Preparatory Manual for Undergraduates: Forensic Medicine and Toxicology (Theory, Practicals and MCQs) by Dr Dekal V. The book has very useful information for the medical and law students and for the practicing physicians and legal professionals. The publisher's efforts to come out with the third edition clearly spell out the popularity of the book. Innumerable references cited in each chapter construe the scientific base for the book. The book also includes worthy appendices at the end, comprising of completely revised theory topics as per the CBME curriculum, covered all the practical exercises and viva-voce questions and MCQs.

The format and the printing of the book have been of very high order. The language is simple and easy to understand. The book should be kept in the clinic of every practicing doctor. This would be a blessing as a ready reference in the courtroom as well. I see a bright future for this book. I feel it may help the exam-going student as well. I wish the book all the success.

I am sure that the third edition of the book too will get very good reception. My best wishes to Professor Dr Dekal V.

TKK Naidu

MD (Forensic Medicine) LLB DFM PGDMLS

Professor and Head

Department of Forensic Medicine

Vice Principal

Prathima Institute of Medical Sciences

Karimnagar, Telangana, India

Preface to the Third Edition

I am very happy to come out with the third edition of this textbook Exam Preparatory Manual for Undergraduates: Forensic Medicine and Toxicology (Theory, Practical and MCQs) after a reasonable long period of time of 5 years since the second edition. I would first like to thank all my colleagues who recommended my book and to the students who with hope studied my book and scored excellent marks. I mainly wish to thank “M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India” who made it possible to make the book enter every part of India and the rest of the world.

There have been many new amendments to law in the recent years; a lot of recent advances have taken place in the subject of Forensic Medicine. The Medical Council has been replaced by the National Medical Commission (NMC), and the system of teaching has totally changed from the traditional teaching methods to Competency-Based Medical Education (CBME) which was introduced by the NMC in 2019. Because of all this, the need for the new edition of the book has become mandatory to enable the student to learn the subject in accordance with the CBME curriculum.

The readers and faculty who were reading this book know well that this is the only book on the subject of Forensic Medicine which satisfies all the needs of the subject, mainly Theory, Practical, Viva-Voce, and MCQs. The book is also very useful for various competitive examinations like NEET-PG/NEXT. The syllabus has not changed, but the teaching learning methods have totally changed. This book enables the reader to gain the necessary competencies as prescribed by the NMC.

The major change is in the examination pattern. The total marks have been set up as 200, out of which 100 marks are given for MCQs and Theory and 100 marks for practical and viva-voce examinations. This has been made universally the same in all the universities of India. Efforts are made to include the maximum number of MCQs in each chapter. Hence, there is a need for a reasonably exhaustive book which covers all the topics as per the CBME curriculum.

Thus, now the book will serve all the aspects of learning such as to know, know how, reproduce, demonstrate how to do under supervision and does the task independently. All the chapters are written in accordance with the syllabus prescribed by the NMC along with all the competencies as specified by the NMC which will help one to apply the skills in real-time life scenarios.

The competencies that the students are expected to gain during the course of learning every topic have been tabulated at the beginning of each chapter and the competency number is quoted against each question. I wish the readers the best experience of studying the book, gain reasonable knowledge, score excellent marks in exams, and also apply the skills throughout their lifetime.

With best wishes

Dekal V

Preface to the First Edition

Writing a book on Forensic Medicine is my lifetime ambition. The basic aim of me taking up this subject is to bring a reasonable standard of uniform Medico-Legal Services throughout the country, a good ethical practice of medicine, and also to bring life to the outdated term “Medical Etiquette”.

Working on this project of writing a book was a slow and studious process, and I started doing it very soon after I completed my postgraduate. I also wanted to be sure that my book should not be just an addition to the series of books in Forensic Medicine. I wanted to come out with a book which is student friendly, short, and precise; covers all the aspects of the subject, theory and practicals; and help the students to face the exams with confidence as well as learn the basic skills, thus helping them to apply these throughout their lifetime. All my dreams came true when M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India joined hands with me and gave me the opportunity to write this excellent student-friendly textbook.

Only doctors who possess the basic degree of MBBS are called medical experts in the court of law, so allopathic physicians apart from the basic duty of curing patients of their ailments have yet another important responsibility, which is to fight for social justice by enlightening the court by the truth based on strong scientific proof. To be frank only by the knowledge of this subject of Forensic Medicine and of course pathology, emergency medicine and surgery, we the allopathic physicians stand distinct in the huge crowd of doctors, but only a very few of us recognize this fact.

Even though plenty of forensic medicine experts are available in the country, yet nearly 90% of the Medico-Legal workload of the country is still being carried out by the doctors who do not possess a postgraduate degree in Forensic Medicine. Ultimately, they have to depend upon the knowledge gained by them in the second year of their MBBS course.

This book is entitled as Exam Preparatory Manual for Undergraduates: Forensic Medicine and Toxicology and is prepared in accordance with the syllabus prescribed by the Medical Council of India (MCI). All the chapters in this book are carefully written for easy understanding and are presented in a question-and-answer format, to help the students understand how the questions would be asked in exams and what they are expected to write as answer for each question.

Even though the book is in a question-and-answer format, it carries all the points which a standard textbook is expected to contain—questions in the form of topics/headings and answers in the form of explanations; thus, students can study only this book which would be more than enough for the undergraduate medical examination and they would be rewarded back with excellent marks.

For the welfare of the students, an important set of practical exercises is also discussed; thus, the students can also prepare well for their practical exams. This book will serve all the needs of the students for theory, practical, and viva-voce examinations.

Apart from the medical students, this book will also be useful for the investigation team, judiciary, and other branches of students who need to have knowledge of forensic medicine, such as students of criminology, criminal justice, and forensic science.

Dekal V

Acknowledgments

My heartful special thanks to:

Dr RC Siddesh, MD, PGDMLE, Associate Professor of FMT, SS Institute of Medical Sciences, Davanagere, Karnataka, for his endless contributions to the 3rd edition of this book.

Next, I wish to acknowledge my senior professors, colleagues, students, and well wishers.

Dr V Rajasekar, Dean and Professor of Radiology, Meenakshi Medical College and Research Institute, Kanchipuram, Chennai.
Dr TKK Naidu MD, LLB, DFM, PGDMLS, Professor and Head of FMT and Vice Principal, Prathima Institute of Medical Sciences, Karimnagar (TS).
Dr Ananda K, Formerly Professor and Head of FMT, Kempegowda Institute of Medical Sciences, Bangalore.
Dr K Thangaraj, Formerly Professor and Head of FMT, SRM Medical College, Chennai.
Dr P Sampath Kumar, Professor and Head of FMT, Saveetha Medical College, Chennai.
Dr B Santha Kumar, Formerly Director of Forensic Medicine, Tamil Nadu.
Dr Manohar, Professor and Head of FMT, SRM Medical College, Chennai.
Dr P Parasakthi, Director of Forensic Medicine, Government Madras Medical College, Chennai.
Dr R Selvakumar, Professor and Head of FMT, Sree Balaji Medical College, Chennai.
DR Jai Singh, Professor and Head of FMT, Government Coimbatore Medical College.
Dr BC Shivakumar, Professor and Head of FMT, Sapthagiri Medical College Bangalore.
Dr Vijaynath, Professor and Head of FMT, ESI Medical College, Bangalore.
Dr Jagannatha SR, Professor and Head of FMT, Kempegowda Institute of Medical Sciences, Bangalore.
Dr Balaji Singh, Professor and Head of FMT, ACS Medical College, Chennai.
Dr Priyadarshee Pradhan, Professor and Head of FMT, Sri Ramachandra Medical College, Chennai.
Dr Anand Kumar, Professor of FMT, ACS Medical College, Chennai.
Dr P Vedanayagam, Professor and Head of FMT, Bhaarath Medical College, Chennai.
Dr P Shruthi, Professor in FMT, Saveetha Medical College, Chennai.
Dr Geethanjali, Professor and Head of FMT, Government Villupuram Medical College.
Dr Sudarshan, Professor and Head of FMT, Lalithambigai Medical College, Chennai.
Dr Sanjeev, Professor of FMT, SRM Medical College, Chennai.
Dr Rajamani Bheema Rao, Vel Tech Medical College, Chennai.
Dr Priyadharshini, Associate Professor, Government Stanley Medical College, Chennai.
Dr Vinoth Kumar, Associate Professor of FMT, Sree Balaji Medical College, Chennai.
Dr Manigandaraj, Associate Professor and i/c Head of FMT, Government Chengalpattu Medical College.
Dr Naveen, Senior Assistant Professor and i/c Head of FMT, Government Thiruvarur Medical College.
Dr Karthikeyan, Senior Assistant Professor of FMT, Government Chengalpattu Medical College.
Dr Nanda Kumar, Senior Assistant Professor of FMT, Government Erode Medical College.
Dr Karpagam Dekal, Zonal Medical officer, Corporation of Chennai.
Dr R Dhuvaraga, Post-Graduate of FMT, SRM Medical College, Chennai
Dr D Priyadarshini, Post-Graduate in FMT, ACS Medical College, Chennai.
Mr Loganathan, Scientific Officer in FMT, Government Madras Medical College, Chennai.
Mr V Baskaran and Family, BS Enterprises and DR Properties, Chennai.

Special Acknowledgments to Our Publishers

I am very grateful to the whole team of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, who helped and guided me, Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Managing Director), Mr MS Mani (Group President), Dr Madhu Choudhary (Director–Educational Publishing), Ms Pooja Bhandari [Director–Production (Books and Journals)], Ms Sunita Katla (Executive Assistant to Group Chairman and Publishing Manager), Mr Ajay Kumar Sharma [Deputy General Manager (Books and Journals)], Ms Samina Khan (Executive Assistant to Director–Educational Publishing), Dr Upma Tomar (Development Editor), Mr Rajesh Sharma (Production Coordinator), Mr Sumit Kumar (Cover Visualizer) and their team members, for all their support to work in this project and make it a success. Without their cooperation, I could not have completed this project.

Competency Table

Competency No.	Competency: The student should be able to	Domain K/S/A/C	Level K/KH/SH/P	Core Y/N	Suggested teaching learning method	Suggested assessment method	Vertical integration	Chapter No.
FM1.1	Demonstrate knowledge of basics of forensic medicine like definitions of forensic medicine, clinical forensic medicine, forensic pathology, state medicine, legal medicine and medical jurisprudence	K	KH	N	Lecture/small group discussion	Written/viva voce		1
FM1.2	Describe history of forensic medicine	K	KH	N	Lecture/small group discussion	Written/viva voce		1
FM1.3	Describe legal procedures including criminal procedure code, Indian Penal Code, Indian Evidence Act, civil and criminal cases, inquest (police inquest and magistrate's inquest), cognizable and noncognizable offences	K	KH	N	Lecture/small group discussion	Written/viva voce		2
FM1.4	Describe courts in India and their powers: Supreme Court, High Court, sessions court, Magistrate's court, labour court, family court, executive magistrate court and juvenile justice board	K	KH	N	Lecture/small group discussion	Written/viva voce		2
FM1.5	Describe Court procedures including issue of summons, conduct money, types of witnesses, recording of evidence oath, affirmation, examination in chief, cross examination, re-examination and court questions, recording of evidence and conduct of doctor in witness box	K	KH	N	Lecture/small group discussion moot court	Written/viva voce		2
FM1.6	Describe offenses in court including perjury; court strictures vis-avis medical officer	K	KH	N	Lecture/small group discussion	Written/viva voce		2
FM1.7	Describe dying declaration and dying deposition	K	KH	N	Lecture/Small Group Discussion	Written/viva voce		2
FM1.8	Describe the latest decisions/notifications/resolutions/circulars/standing orders related to medico-legal practice issued by Courts/Government authorities, etc.	K	KH	N	Lecture/small group discussion	Written/viva voce	Radio-diagnosis, general surgery, general medicine, pediatrics	2
FM2.1	Define, describe and discuss death and its types including somatic/clinical/cellular, molecular and brain-death, cortical death and brainstem death	K	KH	Y	Lecture/Small Group Discussion	Written/viva voce	Pathology	8
FM2.2	Describe and discuss natural and unnatural deaths	K	KH	Y	Lecture/small group discussion	Written/viva voce	Pathology	8
FM2.3	Describe and discuss issues related to sudden natural deaths	K	KH	Y	Lecture/small group discussion	Written/viva voce	Pathology	8
FM2.4	Describe salient features of the organ transplantation and the human organ transplant (amendment act 2011) and discuss ethical issues regarding organ donation	K	KH	Y	Lecture/small group discussion	Written/viva voce AETCOM		8
FM2.5	Discuss moment of death, modes of death—coma, asphyxia and syncope	K	KH	N	Lecture/small group discussion	Written/viva voce	Pathology	8, 17
FM2.6	Discuss presumption of death and survivorship	K	KH	N	Lecture/small group discussion	Written/viva voce		8
FM2.7	Describe and discuss suspended animation	K	KH	N	Lecture/small group discussion	Written/viva voce		8
FM2.8	Describe and discuss postmortem changes including signs of death, cooling of body, postmortem lividity, rigor mortis cadaveric spasm, cold stiffening and heat stiffening	K	KH	Y	Lecture/small group discussion autopsy, doap session	Written/viva voce OSPE		9
FM2.9	Describe putrefaction, mummification, adipocere and maceration	K	KH	Y	Lecture/small group discussion autopsy, DOAP session	Written/viva voce OSPE		9
FM2.10	Discuss estimation of time since death	K	KH	Y	Lecture/small group discussion autopsy, DOAP session	Written/viva voce OSPE		9
FM2.11	Define and discuss autopsy procedures including postmortem examination, different types of autopsies, aims and objectives of postmortem examination	K	KH	Y	Lecture/small group discussion autopsy, DOAP session	Written/viva voce OSPE	Pathology	7
FM2.12	Describe the legal requirements to conduct post-mortem examination and procedures to conduct medico-legal postmortem examination	K	KH	Y	Lecture/small group discussion autopsy, DOAP session	Written/viva voce OSPE	Pathology	7
FM2.13	Describe and discuss obscure autopsy	K	KH	Y	Lecture/small group discussion	Written/viva voce	Pathology	7
FM2.14	Describe and discuss examination of clothing, preservation of viscera on postmortem examination for chemical analysis and other medico-legal purposes, post-mortem artefacts	K	KH	Y	Lecture/small group discussion autopsy DOAP session	Written/viva voce OSPE		7
FM2.15	Describe special protocols for conduction of medico-legal autopsies in cases of death in custody or following violation of human rights as per National Human Rights Commission Guidelines	K	KH	N	Lecture/small group discussion autopsy, DOAP session	Written/viva voce OSPE		7
FM2.16	Describe and discuss examination of mutilated bodies or fragments, charred bones and bundle of bone	K	KH	N	Lecture/small group discussion DOAP session	Written/viva voce OSPE		7
FM2.17	Describe and discuss exhumation	K	KH	N	Lecture/small group discussion autopsy, DOAP session	Written/viva voce OSPE		7
FM2.18	Crime scene investigation:- describe and discuss the objectives of crime scene visit, the duties and responsibilities of doctors on crime scene and the reconstruction of sequence of events after crime scene investigation	K	KH	Y	Lecture/small group discussion	Written/viva voce		6
FM2.20	Define, classify and describe asphyxia and medico-legal interpretation of postmortem findings in asphyxial deaths	K	KH	N	Lecture/small group discussion autopsy, DOAP session	Written/viva voce OSPE		10
FM2.21	Describe and discuss different types of hanging and strangulation including clinical findings, causes of death, post-mortem findings and medico-legal aspects of death due to hanging and strangulation including examination, preservation and dispatch of ligature material	K	KH	N	Lecture/small group discussion autopsy, DOAP session	Written/viva voce OSPE		10
FM2.22	Describe and discuss patho-physiology, clinical features, postmortem findings and medico-legal aspects of traumatic asphyxia, obstruction of nose and mouth, suffocation and sexual asphyxia	K	KH	Y	Lecture/small group discussion autopsy, DOAP session	Written/viva voce OSPE		10
FM2.23	Describe and discuss types, pathophysiology, clinical features, postmortem findings and medico-legal aspects of drowning, diatom test and gettler's test	K	KH	Y	Lecture/small group discussion autopsy, DOAP session	Written/viva voce OSPE		10
FM2.24	Thermal deaths: Describe the clinical features, postmortem finding and medico-legal aspects of injuries due to physical	K	KH	N	Lecture/ small group discussion/autopsy, DOAP session	Written/viva voce		15
	agents like heat (heat-hyper-pyrexia, heat stroke, sun stroke, heat exhaustion/prostration, heat cramps [miner's cramp] or cold (systemic and localized hypothermia, frostbite, trench foot, immersion foot)
FM2.25	Describe types of injuries, clinical features, patho-physiology, postmortem findings and medico-legal aspects in cases of burns, scalds, lightening, electrocution and radiations	K	KH	N	Lecture / small group discussion autopsy, DOAP session	Written/viva voce	General Surgery	15
FM2.26	Describe and discuss clinical features, post-mortem findings and medico-legal aspects of death due to starvation and neglect	K	KH	N	Lecture/small group discussion	Written/viva voce		11
FM2.27	Define and discuss infanticide, foeticide and stillbirth	K	KH	Y	Lecture/small group discussion	Written/viva voce	Pediatrics	22
FM2.28	Describe and discuss signs of intrauterine death, signs of live birth, viability of fetus, age determination of fetus, DOAP session of ossification centres, hydrostatic test, sudden infants death syndrome and munchausen's syndrome by proxy	K	KH	Y	Lecture/small group discussion autopsy, DOAP session	Written/viva voce OSCE	Pediatrics, human anatomy	22
FM3.1	Define and describe corpus delicti, establishment of identity of living persons including race, sex, religion, complexion, stature, age determination using morphology, teeth-eruption, decay, bite marks, bones-ossification centres, medico-legal aspects of age	K	KH	N	Lecture/small group discussion/bedside clinic/DOAP session	Written/viva voce skill assessment	Human anatomy	5
FM3.2	Describe and discuss identification of criminals, unknown persons, dead bodies from the remains-hairs, fibers, teeth, anthropometry, dactylography, foot prints, scars, tattoos, poroscopy and superimposition	K	KH	N	Lecture/small group discussion	Written/viva voce		5, 6, 14
FM3.3	Mechanical injuries and wounds: Define, describe and classify different types of mechanical injuries, abrasion, bruise, laceration, stab wound, incised wound, chop wound, defense wound, self-inflicted / fabricated wounds and their medico-legal aspects	K	KH	Y	Lecture/small goup discussion bedside clinic, DOAP session	Written/viva voce OSPE	General surgery	12
FM3.4	Define injury, assault and hurt. Describe IPC pertaining to injuries	K	KH	N	Lecture/small group discussion	Written/viva voce		14
FM3.5	Describe accidental, suicidal and homicidal injuries. Describe simple, grievous and dangerous injuries. Describe antemortem and postmortem injuries	K	KH	N	Lecture/small group discussion	Written/viva voce		14
FM3.9	Describe different types of firearms including structure and components, along with description of ammunition propellant charge and mechanism of fire-arms, different types of cartridges and bullets and various terminology in— caliber, range, choking	K	KH	N	Lecture/small group discussion	Written/viva voce	General surgery ortho-paedics	16
FM3.10	Describe and discuss wound ballistics-different types of firearm injuries, blast injuries and their interpretation, preservation and dispatch of trace evidences in cases of fire-arm and blast injuries, various tests related to confirmation of use of fire-arms	K	KH	N	Lecture/small group discussion bed side clinic, DOAP session	Written/viva voce OSCE	General Surgery Ortho-paedics	16
FM3.11	Describe and discuss regional injuries to head (Scalp wounds, fracture skull, intracranial hemorrhages, coup and contrecoup injuries), neck, chest, abdomen, limbs, genital organs, spinal cord and skeleton	K	KH	N	Lecture/small group discussion/bedside clinic/autopsy DOAP session	Written/viva voce/ OSCE/OSPE	General surgery ortho-pedics	13
FM 3.12	Describe and discuss injuries related to fall from height and vehicular injuries —primary and secondary impact, secondary injuries, crush syndrome, railway spine	K	KH	N	Lecture/small group discussion/ bedside clinic/autopsy DOAP session	Written/viva voce OSCE/OSPE	General surgery ortho-paedics	13
FM3.13	Describe different types of sexual offences. Describe various sections of IPC regarding rape including definition of rape (Section 375 IPC), punishment for rape (Section 376 IPC) and recent amendments notified till date	K	KH	Y	Lecture/small group discussion	Written/viva voce/OSCE/OSPE	Obstetrics and gynecology	23
FM3.14	Describe and discuss the examination of the victim of an alleged case of rape, and the preparation of report, framing the opinion and preservation and dispatch of trace evidences in such cases	K	KH	Y	Lecture/small group discussion bedside clinic, DOAP session	Written/viva voce/ OSCE	Obstetrics and gynecology	23
FM3.15	Describe and discuss examination of accused and victim of sodomy, preparation of report, framing of opinion, preservation and despatch of trace evidences in such cases	K	KH	Y	Lecture/small group discussion bedside clinic, DOAP session	Written/viva voce/OSCE	Obstetrics and gynecology psychiatry	6, 23
FM3.16	Describe and discuss adultery and unnatural sexual offences sodomy, incest, lesbianism, buccal coitus, bestiality, indecent assault and preparation of report, framing the pinion and preservation and despatch of trace evidences in such cases	K	KH	Y	Lecture/small group discussion	Written/viva voce	Obstetrics and gynecology psychiatry	23
FM3.17	Describe and discuss the sexual perversions fetishism, transvestism, voyeurism, sadism, necrophagia, masochism, exhibitionism, frotteurism, necrophilia	K	KH	N	Lecture/small group discussion	Written/viva voce	Obstetrics and gynecology psychiatry	23
FM3.18	Describe anatomy of male and female genitalia, hymen and its types. Discuss the medico-legal importance of hymen. Define virginity, defloration, legitimacy and its medico-legal importance	K	KH	Y	Lecture/small group discussion	Written/viva voce	Gynecology	18
FM3.19	Discuss the medico-legal aspects of pregnancy and delivery, signs of pregnancy, precipitate labour, superfoetation, superfecundation and signs of recent and remote delivery in living and dead	K	KH	Y	Lecture/small group discussion	Written/viva voce	Obstetrics and gynecology	20
FM3.20	Discuss disputed paternity and maternity	K	KH	Y	Lecture/small group discussion	Written/viva voce	Obstetrics and gynecology	20
FM3.22	Define and discuss impotence, sterility, frigidity, sexual dysfunction, premature ejaculation. Discuss the causes of impotence and sterility in male and female	K	KH	Y	Lecture/small group discussion	Written/viva voce	Obstetrics and gynecology, general medicine	19
FM3.23	Discuss sterilization of male and female, artificial insemination, test tube baby, surrogate mother, hormonal replacement therapy with respect to appropriate national and state laws	K	KH	Y	Lecture / small group discussion	Written/viva voce	Obstetrics and Gynaecology	19
FM3.27	Define, classify and discuss abortion, methods of procuring MTP and criminal abortion and complication of abortion. MTP Act 1971	K	KH	N	Lecture/small group discussion	Written/viva voce	Obstetrics and gynecology AETCOM	21
FM3.28	Describe evidences of abortion - living and dead, duties of doctor in cases of abortion, investigations of death due to criminal abortion	K	KH	N	Lecture/small group discussion	Written/viva voce	Obstetrics and gynecology, pathology	21
FM3.29	Describe and discuss child abuse and battered baby syndrome	K	KH	Y	Lecture/small group discussion	Written/viva voce	Pediatrics	22
FM4.1	Describe medical ethics and explain its historical emergence	K	KH	Y	Lecture/small group discussion	Written/viva voce	AETCOM	3
FM4.2	Describe the Code of Medical Ethics 2002 conduct, etiquette and ethics in medical practice and unethical practices and the dichotomy	K	KH	Y	Lecture/small group discussion	Written/viva voce	AETCOM	3
FM4.3	Describe the functions and role of National Medical Commission and State Medical Councils	K	KH	Y	Lecture/small group discussion Moot Court	Written/viva voce	AETCOM	3
FM4.4	Describe the National Medical Commission Register	K	KH	Y	Lecture/small group discussion	Written/viva voce	AETCOM	3
FM4.5	Rights/privileges of a medical practitioner, penal erasure, infamous conduct, disciplinary Committee, disciplinary procedures, warning notice and penal erasure	K	KH	Y	Lecture/small group discussion	Written/viva voce	AETCOM	3
FM4.6	Describe the Laws in Relation to medical practice and the duties of a medical practitioner towards patients and society	K	KH	Y	Lecture/small group discussion	Written/viva voce	AETCOM	3
FM4.7	Describe and discuss the ethics related to HIV patients	K	KH	Y	Lecture/small group discussion	Written/viva voce	AETCOM	3
FM4.8	Describe the Consumer Protection Act-1986 (Medical Indemnity Insurance, Civil Litigations and Compensations), Workman's Compensation Act and ESI Act	K	KH	Y	Lecture/small group discussion	Written/viva voce	AETCOM	3, 4
FM4.9	Describe the medicolegal issues in relation to family violence, violation of human rights, NHRC and doctors	K	KH	N	Lecture/small group discussion	Written/viva voce	AETCOM	3
FM4.10	Describe communication between doctors, public and media	K	KH	Y	Lecture/small group discussion	Written/viva voce	AETCOM	3
FM4.11	Describe and discuss euthanasia	K	KH	Y	Lecture/small group discussion	Written/viva voce	AETCOM	3
FM4.12	Describe legal and ethical issues in relation to stem cell research				Lecture/small group discussion	Written/viva voce	Pharmacology AETCOM	3
FM4.13	Describe social aspects of medico-legal cases with respect to victims of assault, rape, attempted suicide, homicide, domestic violence, dowry- related cases	K	KH	Y	Lecture/small group discussion	Written/viva voce	AETCOM	3
FM4.14	Describe and discuss the challenges in managing medico-legal cases including development of skills in relationship management—human behaviour, communication skills, conflict resolution techniques	K	KH	Y	Lecture/small group discussion	Written/viva voce	AETCOM	3
FM4.15	Describe the principles of handling pressure —definition, types, causes, sources and skills for managing the pressure while dealing with medico-legal cases by the doctor	K	KH	Y	Lecture/small group discussion	Written/viva voce	AETCOM	3
FM4.16	Describe and discuss bioethics	K	KH	Y	Lecture/small group discussion	Written/viva voce		3
FM4.17	Describe and discuss ethical principles: Respect for autonomy, nonmalfeasance beneficence and justice	K	KH	Y	Lecture/small group discussion	Written/viva voce	Pharma-cology AETCOM	3
FM4.18	Describe and discuss medical negligence including civil and criminal negligence, contributory negligence, corporate negligence, vicarious liability, res ipsa loquitor, prevention of medical negligence and defenses in medical negligence litigations	K	KH	N	Lecture/small group discussion	Written/viva voce		4
FM4.19	Define Consent. Describe different types of consent and ingredients of informed consent. Describe the rules of consent and importance of consent in relation to age, emergency situation, mental illness and alcohol intoxication	K	KH	N	Lecture/small group discussion	Written/viva voce		4
FM4.20	Describe therapeutic Privilege, malingering, therapeutic misadventure, professional secrecy, human experimentation	K	KH	N	Lecture/small group discussion Moot Court	Written/viva voce		4
FM4.21	Describe products liability and medical indemnity insurance	K	KH	N	Lecture/small group discussion	Written/viva voce		4
FM4.23	Describe the modified declaration of Geneva and its relevance	K	KH	Y	Lecture/small group discussion	Written/viva voce	Pharma-cology AETCOM	3
FM4.24	Enumerate rights, privileges and duties of a registered medical practitioner. Discuss doctor-patient relationship: professional secrecy and privileged communication	K	KH	Y	Lecture/small group discussion	Written/viva voce		3
FM4.25	Clinical research and ethics. Discuss human experimentation including clinical trials	K	KH	N	Lecture/small group discussion	Written/viva voce	Pharma- cology AETCOM	3
FM4.26	Discuss the constitution and functions of ethical committees	K	KH	Y	Lecture/small group discussion	Written/viva voce	Pharma cology AETCOM	3
FM4.27	Describe and discuss ethical guidelines for biomedical research on human subjects and animals	K	KH	N	Lecture/small group discussion	Written/viva voce	Pharma cology AETCOM	3
FM4.28	Demonstrate respect to laws relating to medical practice and ethical code of conduct prescribed by medical council of India and rules and regulations prescribed by it from time to time	A and C	SH	Y	Lecture/small group discussion	Written/viva voce	–	3
FM4.29	Demonstrate ability to communicate appropriately with media, public and doctors	A and C	KH SH	Y	Lecture/small group discussion	Written/viva voce	–	3
FM4.30	Demonstrate ability to conduct research in pursuance to guidelines or research ethics	A and C	KH SH	Y	Lecture/small group discussion	Written/viva voce	–	3
FM5.1	Classify common mental illnesses including post-traumatic stress disorder (PTSD)	K	KH	N	Lecture/small group discussion	Written/viva voce	Psychiatry	24
FM5.2	Define, classify and describe delusions, hallucinations, illusion, lucid interval and obsessions with exemplification	K	KH	N	Lecture/small group discussion	Written/viva voce	Psychiatry	24
FM5.3	Describe civil and criminal responsibilities of a mentally ill person	K	KH	N	Lecture/small group discussion	Written/viva voce	Psychiatry	24
FM5.4	Differentiate between true insanity from feigned insanity	K	KH	N	Lecture/small group discussion	Written/viva voce	Psychiatry	24
FM5.5	Describe and discuss delirium tremens	K	KH	N	Lecture/small group discussion	Written/viva voce	Psychiatry General Medicine	24
FM5.6	Describe the Indian Mental Health Act, 1987 with special reference to admission, care and discharge of a mentally ill person	K	KH	N	Lecture/small group discussion	Written/viva voce	Psychiatry	24
FM8.1	Describe the history of toxicology	K	KH	Y	Lecture/small group discussion	Written/viva voce	Pharmacology	25
FM8.2	Define the terms toxicology, forensic toxicology, clinical toxicology and poison	K	KH	Y	Lecture/small group discussion	Written/viva voce	Pharmacology	25
FM8.3	Describe the various types of poisons, toxicokinetics, and toxicodynamics and diagnosis of poisoning in living and dead	K	KH	Y	Lecture/small group discussion	Written/viva voce	Pharma-cology	25
FM8.4	Describe the laws in relations to poisons including NDPS Act, medico-legal aspects of poisons	K	KH	Y	Lecture/small group discussion	Written/viva voce	Pharma-cology	25
FM8.5	Describe medico-legal autopsy in cases of poisoning including preservation and dispatch of viscera for chemical analysis	K	KH	Y	Lecture/small group discussion, autopsy, DOAP session	Written/viva voce	Pharma-cology	25
FM8.6	Describe the general symptoms, principles of diagnosis and management of common poisons encountered in India	K	KH	Y	Lecture/small group discussion bedside clinic, DOAP session	Written/viva voce	Pharma-cology	25, 33
FM8.7	Describe simple bedside clinic tests to detect poison/ drug in a patient's body fluids	K	KH	Y	Lecture, small group discussion, bedside clinic, DOAP session	Written/viva voce/ OSCE	Pharma-cology, general medicine	25
FM8.8	Describe basic methodologies in treatment of poisoning: Decontamination, supportive therapy, antidote therapy, procedures of enhanced elimination	K	KH	Y	Lecture, small group discussion, bedside clinic, DOAP session	Written/viva voce OSCE	Pharma-cology, general medicine	25
FM8.9	Describe the various types of poisons, toxicokinetics, and toxicodynamics and diagnosis of poisoning in living and dead	K	KH	Y	Lecture/small group discussion	Written/viva voce	Pharmacology	25
FM8.10	Describe the general principles of analytical toxicology and give a brief description of analytical methods available for toxicological analysis:	K	KH	Y	Lecture, small group discussion	Written/viva voce	25	25
	Chromatography – thin layer chromato-graphy, gas chromato-graphy, liquid chromatography and atomic absorption spectroscopy
FM9.1	Describe general principles and basic methodologies in treatment of poisoning: Decontamination, supportive therapy, antidote therapy, procedures of enhanced elimination with regard to: caustics: Inorganic-sulfuric, nitric, and hydrochloric acids; organic-carbolic acid (phenol), oxalic and acetylsalicylic acids	K	KH	Y	Lecture, small group discussion, bed side clinic, autopsy, DOAP session	Written/viva voce OSCE	Pharma-cology, general medicine	27
FM9.2	Describe general principles and basic methodologies in treatment of poisoning: Decontamination, supportive therapy, antidote therapy, procedures of enhanced elimination with regard to phosphorus, Iodine, barium	K	KH	Y	Lecture, small group discussion, bedside clinic, autopsy, DOAP session	Written/viva voce OSCE	Pharma-cology, general medicine	28
FM9.3	Describe general principles and basic methodologies in treatment of poisoning: Decontamination, supportive therapy, antidote therapy, procedures of enhanced elimination with regard to arsenic, lead, mercury, copper, iron, cadmium and thallium	K	KH	Y	Lecture, small group discussion, bedside clinic, autopsy, DOAP session	Written/viva voce OSCE	Pharma-cology, general medicine	28
FM9.4	Describe general principles and basic methodologies in treatment of poisoning: Decontamination, supportive therapy, antidote therapy, procedures of enhanced elimination with regard to ethanol, methanol, ethylene glycol	K	KH	Y	Lecture, Small group discussion, bedside clinic, autopsy, DOAP session	Written/viva voce/ OSCE	Pharma-cology, general medicine	30
FM9.5	Describe general principles and basic methodologies in treatment of poisoning: Decontamination, supportive therapy, antidote therapy, procedures of enhanced elimination with regard to organophosphates, Carbamates, organochlorines, pyrethroids, paraquat, aluminum and zinc phosphide	K	KH	Y	Lecture, small group discussion, bedside clinic, autopsy, DOAP session	Written/viva voce OSCE	Pharma-cology, general medicine	26
FM9.6	Describe general principles and basic methodologies in treatment of poisoning: Decontamination, supportive therapy, antidote therapy, procedures of enhanced elimination with regard to ammonia, carbon monoxide, hydrogen cyanide and methyl-isocyanate, tear (riot control) gases	K	KH	Y	Lecture, small group discussion, bedside clinic, autopsy, DOAP session	Written/viva voce OSCE	Pharma-cology, general medicine	32
FM10.1	Describe general principles and basic methodologies in treatment of poisoning: decontamination, supportive therapy, antidote therapy, procedures of enhanced elimination with regard to: Neuro-psychotoxicology barbiturates, benzodiazepins phenytoin, lithium, aloperidol, neuroleptics, tricyclics. Narcotic Analgesics,	K	KH	Y	Lecture, small group discussion, bed side clinic, autopsy, DOAP session	Written/viva voce/ OSCE	Pharma-cology, general medicine	30, 31
FM11.1	Describe features and management of Snake bite, scorpion sting, bee and wasp sting and spider bite	K	KH	Y	Lecture, small group discussion, autopsy	Written/viva voce	General medicine	29
FM12.1	Describe features and management of abuse/poisoning with following camicals: Tobacco, cannabis, amphetamines, cocaine, hallucinogens, designer drugs and solvent	K	KH	Y	Lecture, small group discussion, autopsy	Written/viva voce/ OSCE	Pharma-cology, general medicine	30
FM14.7	To identify and draw medico-legal inference from common poisons e.g. datura, castor, cannabis, opium, aconite copper sulphate, pesticides compounds, marking nut, oleander, Nux vomica, abrus seeds, snakes, capsicum, calotropis, lead compounds and tobacco.	K	KH	Y	Small group discussion, DOAP session	Log book/ viva voce	General medicine	29
Practical Excercise
FM14.1	Examine and prepare medico-legal report of an injured person with different etiologies in a simulated/supervised environment	K	KH	Y	Bedside clinic (ward/ casualty), small group discussion	Log book/ skill station/viva voce/OSCE	General surgery ortho-pedics	Exercise-4
FM14.4	Conduct and prepare report of estimation of age of a person for medico-legal and other purposes and prepare medico-legal report in a simulated/ supervised environment	K	KH	Y	Small roup discussion, demons-tration,	Log book/ skill station /viva voce/OSCE	Radiology	Exercise-1
FM14.5	Conduct and prepare postmortem examination report of varied etiologies (at least 15) in a simulated/supervised environment	K	KH	Y	Small group discussion, autopsy, DOAP session	Log book/ skill station/viva voce/OSCE		Exercise-11
FM14.9	Demonstrate examination of and present an opinion after examination of skeletal remains in a simulated/ supervised environment	K	KH	Y	Small group discussion, DOAP session	Log book/ skill station/viva voce		Exercise-3
FM14.10	Demonstrate ability to identify and prepare medico-legal inference from specimens obtained from various types of injuries e.g. contusion, abrasion, laceration, fire-arm wounds, burns, head injury and fracture of bone	K	KH	Y	Small group discussion, DOAP session	Log book/ skill station/viva voce/OSCE		Exercise-12
FM14.11	To identify and describe weapons of medicolegal importance which are commonly used e.g. lathi, knife, kirpan, axe, gandasa, gupti, farsa, dagger, bhalla, razor and stick. Able to prepare report of the weapons brought by police and to give opinion regarding injuries present on the person as described in injury report/	K	KH	Y	Small group discussion, DOAP session	Log book/ skill station/ vViva voce/OSCE		Exercise-12
	PM report so as to connect weapon with the injuries. (prepare injury report/PM report must be provided to connect the weapon with the injuries)
FM14.12	Describe the contents and structure of bullet and cartridges used and to provide medico-legal interpretation from these	K	KH	Y	Small group discussion, DOAP session	Log book/ skill station/ viva voce/OSCE		Exercise-12
FM14.13	To estimate the age of fetus by postmortem examination	K	KH	Y	Small group discussion, DOAP session	Theory/clinical assessment/viva voce		Exercise-8
FM14.14	To examine and prepare report of an alleged accused in rape/unnatural sexual offence in a simulated/ supervised environment	K	KH	Y	Small group discussion, DOAP session	Log book/ Skill station/viva voce/ OSCE	OBG	Exercise-6,7
FM14.16	To examine and prepare medico-legal report of drunk person in a Simulated/supervised environment	K	KH	Y	Small group discussion, bed side clinic, DOAP session	Log book/ skill station/ viva voce/OSCE		Exercise-5
FM14.17	To identify and draw medico-legal inference from common poisons e.g. datura, castor, cannabis, opium, aconite copper sulphate, pesticides compounds, marking nut, oleander, nux vomica, abrus seeds, snakes, capsicum, calotropis, lead compound and tobacco	K	KH	Y	Small group discussion, DOAP session	Log book/ viva voce		Exercise-12

Chapter Notes