CURRICULUM ON RESIDENCY PROGRAM FOR FCPS MOLECULAR PATHOLOGY (Advanced Level Course on Curriculum Development in Health Professions Education, Department for Educational Development, The Aga Khan University)

1. CURRICULUM ON RESIDENCY PROGRAM
FOR FCPS MOLECULAR PATHOLOGY
Group B
(Dr Ayesha Iqbal, Dr Jibran Mohsin, Dr Muhammad Attaullah Khan, Dr Uzma Chishti)
Advanced Level Course on Curriculum Development in Health Professions Education
Department for Educational Development
The Aga Khan University

2. Outline
• Introduction
• Problem Statement / Literature review / Rationale
• Needs assessment (general and targeted)
• Competency model
• Goal
• Learning objectives / educational Strategies / assessment tools
• Assessment plan
• Implementation
• Evaluation
• Dissemination
• Concept Map
• Annexures

3. Introduction
• Molecular Pathology deals with the diagnosis and treatment of diseases at
the molecular level.
• Earlier and more accurate diagnosis
• Improved survival by using targeted therapy.
• Outside Pakistan, recognized as a separate specialty
• Need for curriculum development in this emerging field for better
diagnosis and treatment of diseases that involve molecular pathology.

4. Problem Statement
• Lack of availability of optimal molecular pathology testing and interpretation
• Coronary heart disease (CAD) - leading cause of death in the Indo-Pak Subcontinent. [1]
• Candidate genes – the molecular basis for diagnosis, prevention, and intervention.
• Prophylactic (breast cancer – most common cancer in Pakistan - BRCA 1 and 2 ) [2]
• Prognostic (MSI for colorectal cancer). [3]
• Detection of microorganisms in cases of nonconclusive conventional tests. [4]
1. Jafar TH, Qadri Z, Chaturvedi. Coronary artery disease epidemic in Pakistan: more electrocardiographic evidence of ischaemia in women than in men. Heart 2008;94:408–413.
2. Ahmad Zubair, Idrees R, Fatima S, et al. Commonest Cancers in Pakistan - Findings and Histopathological Perspective from a Premier Surgical Pathology Center in Pakistan. Asian Pac J
Cancer Prev, 17 (3), 1061-1075.
3. Zeinalian M, Chaleshtori MH, Salehi R, et al. Clinical Aspects of Microsatellite Instability Testing in Colorectal Cancer. Ad Biomed Res. 2018; 7: 28.
4. Pandolfo AM, Horne R, Jani Y, Reader TW, et al. Intensivitists’ belief about t rapid multiplex molecular diagnostic testing and its potential role in improving prescribing decisions
and antimicrobial stewardship: a qualitative study. Resist Infect Control (2021) 10:95

6. Rationale
Keeping in mind the above-mentioned importance of molecular
pathology in an era of personalized care and no postgraduate residency
program available in Pakistan, we have proposed the curriculum for
FCPS molecular pathology.

7. Need Assessment
Current Approach Ideal Approach
Patient • Lack of optimal molecular pathology testing
and interpretation
• Improper diagnosis
• Over/under treatment
• Nonavailability of prognosis data
• Increased latency time for the start of
appropriate treatment
• Optimal molecular pathology testing
and interpretation
• Accurate and timely diagnosis
• Optimal treatment
• Prognostic data availability
• Minimal latency period
Health Care Professionals • Challenges in decision making during the
management of disease dependent on
molecular pathology testing
• Molecular pathology will help in
decision making for best possible
patient care
Medical Educators • Minimal emphasis on teaching and practicing
molecular pathology
• Formal curriculum and specialized
training program required
Society • Morbidity and mortality associated with
diseases that involves molecular testing
• Proper diagnosis and therapy will help
in reducing morbidity and mortality,
financial health cost on community

8. Need Assessment
• Problem Identification (Ideal vs Current Approach)
• Lack of availability of quality molecular pathology testing.
• Difficulties in decision-making in patient care.
• Minimal emphasis on formal training (no residency program)
• Increased disease burden on society

9. Targeted Needs Assessment
• Targeted learners
• Post IMM Pathology residents.
• Targeted learning environment
• Settings: Approved and accredited laboratories, well equipped with relevant facilities
• Duration: Two years supervised
• Modules: 4 in number (6 months each)

11. Goal
The goal of the residency program in molecular pathology is to develop
professionals with specific knowledge, analytical skills, and excellence
in molecular techniques for the diagnosis and management of complex
clinical diseases in order to achieve optimal patient care.

12. CPSP COMPETENCY Knowledge & Critical thinking
LEARNING OBJECTIVES At the end of the residency training in molecular pathology, a resident shall be
able to:
• Select appropriate molecular pathology testing as indicated.
• Demonstrate critical thinking and problem solving
• Identify and interpret appropriate investigations
• Discriminate different problems within a time frame.
Educational
Strategies
Educational methods • Weekly presentations, Case-based learning, small group discussion, Readings
Resources required • Classroom, AV aids, Faculty, Reading materials, Time slot
Assessment
Formative Assessment • End of modules written (MCQs, SEQs) assessment
Summative Assessment • Theory (MCQs, SEQs)
Resources required • Classroom, Printing materials, a Question bank, Faculty, Time slot, Administration
staff

13. CPSP COMPETENCY Technical Skills
LEARNING OBJECTIVES At the end of the residency training in molecular pathology, a resident shall be
able to:
• Perform all required technical skills and procedures in the specialty (Annexure A)
Educational
Strategies
Educational method • Demonstration, hands-on training, supervised clinical practice
Resources required • Required equipment's and facilities(labs), Faculty
Assessment
Formative Assessment • Minimum 3 OSATs (Annexure B) per module, maintain a logbook
Summative Assessment • OSATs (Annexure C) (sign off for all necessary skills), logbook (sign off)
Resources required • Tools printing material, Trained faculty time, resident time

14. CPSP COMPETENCY Research
LEARNING OBJECTIVES At the end of the residency training in molecular pathology, a resident shall be
able to:
• Critically appraise the research articles for evidence-based practice.
• Perform at least two research studies individually or in a group that will be published
in peer-reviewed indexed journal
Educational
Strategies
Educational method to achieve • Journal club, workshops, small group discussion
Resources required • Time slot, Trained researcher/faculty, classroom, AV aids, reading material, IRB
Assessment
Formative Assessment • Demonstration of critical appraisal
Summative Assessment • Evidence of two publications in Indexed journals.
Resources required • Supervisor time, resident time, Journals

15. CPSP COMPETENCY Team work
LEARNING OBJECTIVES At the end of the residency training in molecular pathology, a resident shall be
able to:
• Work as an effective member/ leader of the team
• Facilitate collaborative group interaction as a team member to build strong teams
• Demonstrate respect, tolerance, and interdependence amongst team members.
• Demonstrate support for other team members to grow
Educational
Strategies
Educational method to achieve • Peer learning, Role modelling
Resources required • Workplace
Assessment
Formative Assessment • Mini CEX (Annexure D)
Summative Assessment • 360 degree feedback
Resources required • Tools’ printing material, clinical environment

16. CPSP COMPETENCY Communication skills
LEARNING OBJECTIVES At the end of the residency training in molecular pathology, a resident shall be
able to:
• Demonstrate effective counselling of the patient with cultural sensitivity
• Demonstrate effective interpersonal communication skills
• Demonstrate focused, and logical presentation of cases.
Educational
Strategies
Educational method to achieve • Peer learning, Role modelling
Resources required • Workplace environment
Assessment
Formative Assessment • Mini CEX
Summative Assessment • 360 degree feedback
Resources required • Tool material, faculty time

17. CPSP COMPETENCY Professionalism
LEARNING OBJECTIVES At the end of the residency training in Molecular Pathology, a resident shall be
able to:
• Maintain confidentiality of patients
• Practice ethical standards in dealing with patients
Educational
Strategies
Educational method to achieve • Peer learning, role modelling
Resources required • Workplace environment
Assessment
Formative Assessment • Mini CEX
Summative Assessment • 360 degree feedback
Resources required • Tool material, faculty time

18. CPSP COMPETENCY Leadership
LEARNING OBJECTIVES At the end of the residency training in Molecular Pathology, a resident shall be
able to:
• Demonstrate responsibility for their decisions and actions, and that of their team
• Demonstrate a willingness to assume a leadership role(s) when needed in given
situations or events.
Educational
Strategies
Educational method to achieve • Role modelling
Resources required • Workplace
Assessment
Assessment • 360 – Degree feedback
Resources required • Tool printing material, time of faculty

19. ASSESSMENT PLAN
Formative Assessment 1. End of module written (30 MCQs, 5 SEQs) assessment
2. Minimum 3 OSATs and 3 mini CEX per module
3. Maintain logbook and review at the end of each module
4. Demonstration of critical appraisal
Summative Assessment
(at the end of 2 years of
residency)
1. Theory (30 MCQs, 5 SEQs) 40 % weightage
2. OSATs (sign off for all necessary skills) 10 % weightage
3. Logbook (sign off) 10% weightage
4. Evidence of two publications in Indexed journals 20 % weightage
5. 360 – Degree feedback 20 % weightage

20. IMPLEMENTATION
Resources Personnel Faculty training Residents, Administration staff, Technicians, Curriculum Committee, IT staff,
Secretarial and other support staff
Time Curriculum Director, Faculty, Support staff, Residents
Facilities Accredited Laboratories (infrastructure), Equipment, testing kits, Analysers, IT facilities,
Classroom, Printing reading material
Financial Direct financial costs, hidden costs
Support Internal Approval from university Dean Office, laboratory director, department chair, program
director, faculty, learners, Administration staff (Faculty development and funding)
External CPSP, Govt of Sindh, Healthcare commission
Administration Structure Curriculum Director, curriculum coordinator, Faculty, learner, support staff,
Communication Periodic meetings, institutional website, memos
Operations Curriculum Director, Support staff
Scholarships Two publication in indexed journal
Anticipated barrier Financial, Human Resources, Job Security, Power and authority, Accreditation process
Introduction of Curriculum Targeted needs assessment, educational strategies

21. EVALUATION
Whose Opinion Matters? Laboratory director, accrediting body, faculty and residents,
Curriculum Review Committee
What would really be meaningful for them? • Determining effectiveness,
• Identifying areas for improvement,
• Optimizing resource allocation,
Evaluation Approach Competency-based approach
Outcomes aligned with educational goal As per CPSP competency model
Representative sample Subject experts, learners
Down to up approach (outcome- Method- Instrument- Modality)
Already tested, valid and reliable tool will be used
Internal: 2 yearly
External: 5 yearly

22. DISSEMINATION
Dissemination of need assessment, goal, and objectives is important as it is a new curriculum and all
stakeholders must be well aware of it before its implementation
Mode of dissemination • Presentation (Departmental level, institutional
level, university level, accrediting body,
Policymakers, funding agencies)
• Online modules
• Press release

23. Concept Map

24. Annexure A (Technical Skills)
At the end of the residency training in molecular pathology, a resident shall be able to demonstrate all required
technical skills and procedures in the specialty including
1. PCR techniques and analysis
2. Sequencing techniques and analysis
a. Sanger
b. Target
c. RNA
d. Illumina
e. Nano-core
3. Karyotyping techniques and analysis
4. Gel Electrophoresis and analysis
5. Fluorescence In-Situ Hybridization and analysis

25. Annexure B (Formative OSAT)

26. Annexure C (Summative OSAT)

27. Annexure D (mini CEX)

28. THANK YOU