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THIS IS AN EVOLVING DOCUMENT

The College of Physicians and Surgeons Pakistan
would appreciate any criticism, suggestions, advice from the
readers and users of this document. Comments may be sent in
writing or by e-mail to the CPSP at:

DIRECTORATE OF NATIONAL RESIDENCY PROGRAM (DNRP)

College of Physicians and Surgeons Pakistan (CPSP)
7th Central Street, Defence Housing Authority, Karachi-75500.
nrp@[Link]

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CONTENTS

ABOUT THE COLLEGE 01

FCPS PART-I GROUPS OF DISCIPLINES 03

GENERAL REGULATIONS 04

CURRICULUM 05

CPSP COMPETENCY MODEL 06

SYLLABUS 12

• PAPER-I 12

• PAPER-II 15

EXAMINATION 21

CURRICULUM FCPS PART-I

Anaesthesiology
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ABOUT THE
COLLEGE
The College was established in 1962 through an ordinance
of the Federal Government. The objectives/functions of the
College include promoting specialist practice of Medicine,
Obstetrics & Gynaecology, Surgery and other specialties by
securing improvement of teaching and training, arranging
postgraduate medical, surgical and other specialists training,
providing opportunities for research, holding and conducting
examinations for awarding College diplomas and admission to
the Fellowship of the College.

Since its inception, the College has taken great strides in

improving postgraduate medical & dental education in Pakistan.
Competency-based structured Residency Programs have now
been developed, along with criteria for accreditation of training
institutions, and for the appointment of supervisors & examiners.
The format of examinations has evolved over the years to achieve
greater objectivity and reliability in methods of assessment. The
recognition of the standards of College qualifications nationally
& internationally, particularly of its Fellowships, has enormously
increased the number of trainees and consequently the number
of training institutions and the supervisors. The rapid increase in
knowledge base of medical sciences & consequent emergence
of new subspecialties have gradually increased the number of
CPSP fellowship disciplines to eighty one including specialties in
dentistry.

The first step in the organization of postgraduate medical and

dental education is to select those students who demonstrate
that they have adequate fund of knowledge & aptitude to pursue
postgraduate medical and dental education. CPSP at present has
formulated 11 groups of similar specialties and has designed a
curriculum for each of these groups. The format for the FCPS Part-I
CURRICULUM FCPS PART-I

examination consists of two single best MCQ papers with a clinical

scenario so as to test the application of knowledge of basic and
clinical sciences learnt during undergraduate studies and Hence,
it is treated as a screening test. But this test does not take into

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account the aptitude of the candidates and Hence, CPSP allows

the accredited institutes to ascerting it through penal of subject
specialists for induction into each specialty.

This booklet covers the curriculum for surgical & allied specialties
and provides guidance for the students as well as the examiners
regarding the objectives, syllabus and examination format. The
students aspiring to appear in FCPS Part-I examination or advised
to go through this document while prepairing for the exam.

The postgraduate medical and dental education is a combination

of learning experiences followed by some sort of test, formative
or summative. The purpose of formative tests is to provide
constructive feedback to coverup the deficiencies and hence are
a powerful tool of learning after completing first two years of
training during IMM, the trainees are allowed to proceed to the
advance phase of FCPS training in the specific specialty of
choice for 2-3 years. However, it is mandatory to qualify IMM
examination before taking the FCPS-II exit examination.

The average number of candidates taking CPSP examinations

each year is to a minimum of 32,000. The College conducts
examinations for FCPS-I (11 groups of disciplines), IMM, FCPS-II
(81 disciplines), MCPS (22 disciplines), including MCPS in Health
Professions Education and Health Care System Management. A
large number of Fellows and senior medical teachers from within
the country and overseas are involved at various levels of
examinations of the College.

The candidates who wants to pursue postgraduate medical or

dental education are advised to select the specialty of their choice
after collecting information about that specific specialty from
their seniors or from those who have successfully completed the
fellowship programme.

Prof. Khalid Masood Gondal

President
CURRICULUM FCPS PART-I

College of Physicians and Surgeon Pakistan

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FCPS PART-I GROUPS OF DISCIPLINES

The College conducts FCPS Part-I examinations in the following

groups of disciplines:

1. Anaesthesiology

2. Community Medicine

3. Dentistry

4. Diagnostic Radiology

5. Medicine and Allied

6. Obstetrics & Gynaecology

7. Ophthalmology

8. Otorhinolaryngology (E.N.T)

9. Pathology

10. Psychiatry

11. Surgery and Allied

CURRICULUM FCPS PART-I

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CPSP
COMPETENCY
MODEL
College of Physicians and Surgeons Pakistan has moved to
competency-based medical education and has developed
its own competency model shown below. Those who wish to
pursue any fellowship programme of the college, should at the
outset become aware of its training model. A generic explanation
of the model is given below and it is expected that all its residency
training programmes follow the components of this model in
accordance to the requirements of each specialty.

Patient or population care occupies the pivotal center. Patient

care includes all clinical skills such as history taking, physical
examination, ordering investigations, making diagnoses and
managing the care. The inner leaves of the model represent
the five major competencies directly related to patient
care, while the three competencies in the outer circle are
mega-competencies related to patient care and also
incorporate education, professionalism, leadership, advocacy
and population health.
By the end of the Residency Programme, residents are expected
to acquire these competencies and their constituent learning
outcomes, and provide promotive, preventive, curative and
rehabilitative patient-centered (or population-centered) care.

Inner Leaves:
1. Knowledge and Critical Thinking
CURRICULUM FCPS PART-I

2. Technical Skills
3. Communication Skills
4. Teamwork
5. Research

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Outer Leaves:
6. Professionalism
7. Pedagogy
8. Advocacy

1. Knowledge and Critical Thinking

• Demonstrate application of wide and current readings to
critical thinking and problem solving
• Relate the alteration of body function to the presenting
condition
• Interpret and integrate history and examination findings to
arrive at an appropriate provisional and credible
differential diagnoses
• Sequentially order, justify and interpret appropriate
investigations
• Apply knowledge and reasoning skills to
• Analyze data for problem identification and to rule in
and rule out contending conditions
• Synthesize and evaluate solutions for decision-making
in solving familiar and less familiar problems based on
best current evidence
• Prioritize different problems within a time frame.
• Select, outline and provide, with evidence-based
justifications, appropriate pharmacological and
non-pharmacological management strategies
• Assess new medical knowledge and apply it to resolve
patient problems (Evidence-based practice)
• Apply quality assurance procedures in daily work.
(Professionalism)
• Demonstrate shared-decision-making with the patient
or family
• Provide cost-effective care while ordering investigations
and in management
• Use resources appropriately
• Demonstrate awareness of bio-psycho-social factors in
assessment and management of a patient.
CURRICULUM FCPS PART-I

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2. Technical Skills
• Demonstrate International Patient Safety Goals (IPSG)
• Demonstrate competent performance of all required
technical skills and procedures in the specialty, including:
• Obtaining informed consent
• Preoperative planning
• Pre-interventional care and preparation
• Intra-Intervention technique including exposure and
closure, global and task specific items, and
communication and team skills
• Post-interventional care
• Follow-up Care.

3. Communication Skills
• Written Communication Skills
• Maintain clear, concise, accurate and updated medical
records
• Write clear, focused, evidence-based and logical
management plans and discharge summaries
• Write respectful, clear and focused letters and referrals
to other colleagues.
• Verbal Communication Skills: Demonstrate
• Effective interpersonal communication skills: clear,
considerate and sensitive towards patients, their
relatives, other health professionals and the public, and
towards students
• Non-verbal communication skills:
• Empathy and respect towards patients and their
relatives
• Effective counseling of the patient and the family with
cultural sensitivity: explain options, educate them and
promote joint decision-making.
• Appropriate verbal and body language on the campus
and all work situations including seminars, bedside
sessions, outpatient sessions and others
• Respect and tolerance for all health care professionals,
including peers, juniors and seniors
CURRICULUM FCPS PART-I

• Clear, focused and logical presentation of cases.

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4. Teamwork
• Demonstrate constructive team-communication skills.
• Facilitate collaborative group interaction as a team
member to build strong teams demonstrating respect, toler-
ance and interdependence.
• Support other team members to grow
• Demonstrate willingness to assume responsibility and
leadership as needed.

5. Research
• Interpret and use results of various research studies
(critical appraisal)
• Conduct a research study individually or in a group by using
appropriate
• Selection of research question(s) and objectives
• Research design and statistical methods to answer the re-
search question
• Ethical and R&RC approval of the synopsis
• Demonstrate competence in academic writing by writing an
appropriate dissertation and/or publishing research
article(s) as a step towards resolving issues or concerns in
their specialty
• Guide others in conducting research by advising about
research methodology including study designs and
statistical methods
• Demonstrate clear, focused and logical presentations of their
research.

6. Professionalism
• Demonstrate the highest level of personal integrity:
honesty, punctuality, regularity, timely task completion
• Deal with all patients in a non-discriminatory,
prejudice- free manner, demonstrating the same level of care
for every human being irrespective of gender, age, ethnic
background, culture, socioeconomic status and
religion
• Establish a trusting relationship with patients, their
CURRICULUM FCPS PART-I

relatives and care-givers

• Deal with all patients with honesty, empathy and
compassion, putting patients’ needs first (altruism)
• Facilitate transfer of information important for promotion of

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health, prevention and management of disease

• Encourage questioning by the patient and be receptive to
feedback
• Pursue self-directed and life-long learning. Keep abreast of
medical literature and assess new knowledge and apply it to
resolve patient problems
• Know one’s limitations and ask for help as needed from col-
leagues, consultations or referrals
• Apply quality assurance procedures for improvement in daily
work
• Be a role model for others.

Ethics
• Maintain patient autonomy by demonstrating shared-
decision-making with the patient and/or family
• Obtain informed consent, maintain patient confidentiality
and do no harm
• Provide cost-effective care while ordering investigations and
in management and use resources appropriately.

Leadership
• Demonstrate accountability for their decisions and actions,
and that of their team
• Demonstrate willingness to assume leadership role(s) when
needed in given situations or events (rush call/code).
• Change and bring about change as necessary, as a leader or
supportive leader.

7. Pedagogy
Should be able to demonstrate competence in teaching skills:
• Effective clinical/community-based teaching
• Some evidence of acquisition of theory regarding learning
and education
• Practice some of the best teaching methods.
CURRICULUM FCPS PART-I

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8. Advocacy
Advocacy is needed at multiple levels
• Advocacy for the Patient
• Doctors and nurses are the advocates of the patients,
otherwise patients are likely to be lost in the system.
All care should be timely, putting patients first.

• Advocacy for the Practice

• Working in a service or practice, doctors must highlight
limitations and issues
• They must identify solutions for the problems, and
recommend and implement improvements for the
practice(s) and institutional system(s).

• Advocacy for the Health System and Society

• Know one’s role in the Health System(s) and build
strong referral systems
• Keep patient and community interests paramount,
above one’s own personal or professional interest
• Demonstrate advocacy for elimination of the social
determinants of health
• Demonstrate advocacy for prevention of serious
illnesses of their specialty/sub-specialty.

• For the Profession

• Strive for building trust in the public for your profession
• Demonstrate improvement and enhancement of
profession, specialty and sub-specialty
• Be conscientious gate-keepers of their profession,
specialty and subspecialty.

• For the Profession

• Strive for building trust in the public for your profession
• Demonstrate improvement and enhancement of
profession, specialty and sub-specialty
• Be conscientious gate-keepers of their profession,
specialty and subspecialty.
CURRICULUM FCPS PART-I

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GENERAL
REGULATIONS
Following regulations apply to all candidates taking FCPS Part-I
examinations. Candidate will be admitted to the examination in
the name (surname and other names) as given in the MBBS degree.
CPSP will not entertain any application for change of name on
the basis of marriage / divorce / deed.

ELIGIBILITY
• MBBS or equivalent qualifications registered with the PMC.
• One year house job in an institution recognized by the CPSP
/ PMC, which should have been completed at least two
months before the date of examination.
• Deficiency of house job can be compensated by an equal
period of residency in an institution recognized by the CPSP.

EXEMPTION
An application for exemption from FCPS Part-I must be submitted
to the College with all the relevant documents and a bank draft of
prescribed fee (non-refundable processing fee).
After due verification and payment of the prescribed fee, College
shall grant exemption from FCPS Part-I to those applicants who
have acquired the following qualifications in Anaesthesiology:
• Diplomate American Board of Specialities.
• FCPS Part-I, Bangladesh.

In all other cases after proper scrutiny and processing, the College
will decide acceptance or rejection of the request for exemption
from FCPS Part-I on case-to-case basis.
All applicants who are allowed exemption will be issued an
exemption certificate on payment of prescribed fee (exemption
certificate fee). A copy of this certificate will have to be attached
with the application to the Registration and Research Cell (R&RC)
of the CPSP, for registration as FCPS-II trainee and later with the
CURRICULUM FCPS PART-I

application for appearing in FCPS-II examinations.

The exemption from FCPS Part-I shall be valid for a period of three
years plus the period of training in the concerned discipline.

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AIM AND OBJECTIVES

AIM
The overall aim of FCPS Part-I examination is to select candidates
who have acquired a solid foundation of basic science knowledge
and the ability to apply it for resolving common clinical problems.
The objectives of the two papers are instrumental for achieving
this aim.

OBJECTIVES
Paper-I: To test application of core concepts of Basic Sciences to
clinical problems common across all groups of specialties of CPSP.

Paper-II: To test application of basic science knowledge to clinical

problems related to each specific specialty.

SYLLABUS

Candidates for the Fellowship of the College are expected to

have a sound working knowledge of the structure and functions
of the human body and the various mechanisms whereby these
structures & functions are altered leading to diseased states. The
emphasis in the FCPS Part-I examinations is on comprehension of
the various mechanisms by which the body works and adjusts to
external and internal changes. Concepts of the integration and
interrelationship of various parts of the body are to be given more
importance than finer details of structure and function.

The outline of various topics given in this syllabus is a guide

to what at the moment are considered to be important topics
which the candidate is expected to know. This is to help both the
candidate and the examiner in defining the minimum boundaries
of FCPS Part-I examination.
CURRICULUM FCPS PART-I

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SYLLABUS

The syllabus given below is common for all specialties, but the
emphasis should be on clinical problems that are important to
know by all candidates seeking entry to any specialty.

ANATOMY
General Embryology:
• Early development
• Congenital Gametogenesis
• Fertilization
• Implantation and Factors Affecting it
• Process from Fertilized Ovum to Germ Layer Formation
• Derivatives of the Germ Layers
• Formation of the Neural Tube, Neural Crest Cells and their
Derivatives
• Twinning
• Basic concepts of Congenital Abnormalities and their
Prenatal Diagnosis
• Chromosomal Abnormalities and their Consequences
(Structural and Numerical)
• Normal and Defective Development of:
• Musculoskeletal System
• Urogenital System
• Gastrointestinal Tract (GIT)
• Cardiovascular System
• Respiratory System
• Central Nervous System (CNS)
• Head and Neck
• Special senses

General Histology
• Cells and Tissues Related in the Organization of the Body
• Microscopic Features of:
• Epithelia and Cell Junctions
• Connective Tissue including Bone and Cartilages
• Muscular Tissue
CURRICULUM FCPS PART-I

• Nervous Tissue

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Special Histology
• Microscopic Features of the Organs Present in:
• Gastrointestinal Tract (GIT)
• Genitourinary System
• Immune System
• Endocrine System
• Respiratory System
• Integumentary System
• Special senses

Gross Anatomy
• Normal Features and Anatomical Basis of Common Clinical
Conditions in:
• Upper Limb
• Lower Limb
• Thorax
• Respiratory System
• Cardio Vascular System (CVS)
• Abdomen
• Gastrointestinal Tract (GIT)
• Biliary System
• Abdominal Wall
• Peritoneum
• Pelvis (Male and Female Genitourinary Organs)
• Head and Neck

Neuroanatomy
• Structures and Functions of the Parts of Nervous System and
Neurological Problems Arising from their Derangement:
• Spinal Cord
• Forebrain
• Midbrain
• Hindbrain
• Ventricular System
• Blood Supply of Brain
CURRICULUM FCPS PART-I

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PHYSIOLOGY
Cell, Nerve and Muscle
• Cell Functions and Signaling
• Transport across Cell Membrane and Homeostasis
• Nerve Transmission, Skeletal and Smooth Muscle Contraction
• Neuromuscular Transmission

Blood and Immunity

• Blood Cell and Plasma Functions
• Immunity and Allergy
• Hemostasis
• Blood Groups

Cardiovascular System
• Cardiac Excitation
• Cardiac Cycle
• ECG (Applied)
• Blood Pressure Regulation
• Microcirculation
• Circulatory Shock
• Cardiac Failure

Respiratory System
• Pulmonary Ventilation and Perfusion
• Gaseous Exchange
• Transport of Gases
• Regulation of Respiration

Gastrointestinal Tract (GIT) and Liver

• GIT Motility
• Secretions
• Hormones
• Regulation
• Gastrointestinal Disorders
• Hepato-biliary Functions

Renal and Body Fluids

CURRICULUM FCPS PART-I

• Regulation of Body Fluids and Electrolytes

• Functions of Kidneys
• Regulation of Urine Osmolarity
• Blood Pressure
• Acid Base Balance

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CNS
• Organization of CNS
• Sensory System
• Motor System
• Higher Mental Functions
• Autonomic Nervous System (ANS)
• Neurotransmitters

Special Senses
• Vision
• Hearing and Body Balance
• Olfaction
• Gustation

Endocrinology
• Hormones of:
• Hypothalamus
• Pituitary
• Thyroid
• Parathyroid
• Pancreas
• Adrenal Glands

Reproduction
• Male Reproductive System
• Female Reproductive System (Reproductive Cycle, Fertiliza-
tion, Pregnancy, Parturition, Lactation)
• Neonatal Physiology

Exercise and Unusual Environment

• Sports Physiology
• High Altitude Physiology
• Deep Sea Physiology
• Disaster Physiology

BIOCHEMISTRY
Structure, Functions and Metabolism of Biomolecules
CURRICULUM FCPS PART-I

• Carbohydrates
• Proteins
• Lipids
• Nucleic Acids

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Control, Regulation and Disorders of Metabolism

• Enzymatic Control of Metabolism
• Hormonal Regulation of Metabolism
• Clinical Uses of Enzymes, Co-Enzymes, Minerals & Hormones
• Digestive and Metabolic Disorders
• Congenital and Acquired Metabolic Disorders
• Disorders of Enzymes, Co-Enzymes, Minerals and Hormones

Biomedical Diagnostic Techniques and their Application

• Photometry
• Enzyme-linked Immuno-sorbent Assay (ELISA)/
Radio-immuno Assay (RIA)
• Electrophoresis
• Chromatography
• Techniques in Molecular Genetics
• Recombinant DNA and Genomic Technology
• Estimation of Proteins, Lipids, Carbohydrates, Nucleic acids
• Polymerase Chain Reaction (PCR)
• Cloning
• Blotting Techniques
• DNA and RNA Sequencing
• Microarray Techniques

PHARMACOLOGY
Pharmacology syllabus comprises of basic concepts in
pharmacokinetics, pharmacodynamics and their clinical
application. Systemic pharmacology includes classification
of drugs, mechanism of action at molecular level, indications,
contraindications and side-effects.

General Pharmacology
• Movement of Drug Molecules across Cell Membrane
• Ion Trapping
• Metabolism
• Phase I and II Reactions, Role of Cytochrome p450
Enzymes.
• Genomics – Fast & Slow Metabolizers, Enzyme Inducers
CURRICULUM FCPS PART-I

and Inhibitors.
• Adverse Drug Reactions, Drug-Drug Interactions
• Plasma Protein Binding and Bioavailability
• Clearance

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• Half-Life, Steady State Concentration, Loading and

Maintenance Dose
• Receptor Types
• Receptor-Receptor Interaction
• Efficacy, Potency

Autonomic Nervous System (ANS) and Central Nervous System

(CNS)
• Autonomic Nervous System (ANS)
• Sympathetic and Parasympathetic (Mimetic and Lytic)
Drugs
• Organophosphate Poisoning
• General /Local Anaesthesia
• Anti-depressants, Mood Stabilizers, Anxiolytics, Anti-psy-
chotics, Anti-convulsants, Drugs used in Parkinson’s Disorder,
Alzheimer’s and Dementia
• Analgesics
• Opioids and Drug Abuse
• Non-steroidal Anti-inflammatory Drugs (NSAIDs)
• Disease-modifying Anti-rheumatic Drugs (DMARDs)’s and
Anti-Gout Drugs
• Spasmolytics

Cardiovascular System (CVS) and Blood

• Cardiovascular System (CVS)
• Anti-hypertensives
• Anti-arrhythmics
• Anti-anginal Drugs
• Drugs used in Dyslipidemia and Cardiac Failure
• Blood
• Anti-platelet Drugs
• Anti-coagulant Drugs

Gastro-Intestinal Tract (GIT) and Hepato-Biliary System

• Drugs used in Acid Peptic Disease, Inflammatory Bowel
Diseases, Irritable Bowel Syndrome and Intestinal Motility
Disorders
CURRICULUM FCPS PART-I

• Anti-protozoal and Anti-helminthic Drugs

Respiratory System
• Drugs used in Treatment of Asthma and Chronic Obstructive
Pulmonary Disease (COPD)

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Endocrine System
• Anti-diabetic Drugs
• Anti-thyroid Drugs
• Adreno-corticoids and Adreno-cortical Antagonists
• Drugs that affect Bone Mineral Homeostasis

Chemotherapeutic Agents
• Anti-microbials
• Anti-tubercular Drugs
• Immunosuppressive Drugs
• Anti-viral Drugs
• Anti-fungal Drugs
• Anti-neoplastic Drugs
• Targeted and Non-targeted Therapy

GENERAL PATHOLOGY
• Effects of Injury on Cell by Physical, Chemical and Biological
Agents
• Inflammation
• Acute
• Chronic including Granulomatous
• Regeneration and Repair
• Metabolic Response to Trauma
• Disturbance of Homeostatic Mechanism
• Haemorrhage and Shock - Mechanism and Types
• Oedema
• Disturbance of Fluids and Electrolytes
• Thrombosis and Embolism, Infarction and Gangrene
• Disorders of Growth - Atrophy, Hypertrophy, Hyperplasia
• Carcinogens and Pre-Malignant Lesions
• Neoplasia: Types and Spread of Tumor
• General Characteristics of Bacteria, Viruses, Parasites and
Fungi
• Immune System: General Principles
• Medical Genetics - Basic Concepts
• Interpretation of Routine Biochemical Tests such as Liver
Function Tests, Glucose, Urea, Creatinine
CURRICULUM FCPS PART-I

• Nutritional Diseases, Disorders due to Deficiency of Vitamins

and Minerals
• Cancer Epidemiology

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RESEARCH AND BIOSTATISTICS BASIC CONCEPTS

• An Introduction to Epidemiology and its Role in Understanding
Distribution and Determinants of Epidemiology of Disease
• Measures of Disease Occurrence
• Study Designs, their Advantages and Disadvantages
• Measures of Association
• Chances, Bias and Confounding
• Screening

Biostatistics
• Introduction to Biostatistics
• Data and its Kinds
• Summarization of Data
• Measures of Central Tendency and Dispersion
• Normal Distribution
• Point and Interval Estimation and Probability
• Hypothesis Testing, Significance Level and Power
• Sampling and its Techniques

BEHAVIOURAL SCIENCE & MEDICAL ETHICS-GENERAL PRINCIPLES

• Medical Ethics
• Communication Skills including Doctor-Patient Relationship
and Counseling
• Psycho-social Aspects of General Health Care

CURRICULUM FCPS PART-I

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PAPER-II

1. ANESTHESOLOGY (FCPS Part-I)

Anatomy
Respiratory System:
• Mouth, nose, pharynx, larynx, trachea, main bronchi,
segmental bronchi, structure of bronchial tree
• Lobes of right and left lung

Cardiovascular System:
• Gross anatomy of heart, coronary circulation, Conduction
system
Nervous System:
Sensory & Motor
• Cervical plexus, Brachial plexus, Intercostal nerves
• Lumber plexus
• Sacral and coccygeal plexuses

Autonomic:
• Sympathetic and Parasympathetic innervations.

Cerebral Cortex:
• Gross organization, Blood Supply and Functions of various
regions.

Hypothalamus and Thalamus:

• Afferent and efferent connections and their functional
correlations nuclear groups.

Basal Ganglia:
• Subdivisions, connections and functions and effects of
lesions.

Limbic System:
• Core structure function of the limbic system.
• Other nuclei and pathways associated with limbic system.
CURRICULUM FCPS PART-I

Vertebral Column:
• Cervical, thoracic and lumbar vertebrae Sacrum, Sacral
hiatus. Features of vertebrae of different regions &
Ligaments of vertebral column

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Musculo-Skeletal:
• Identification of bony landmarks on plain x-ray.
Thoracic cage, parts of ribs and morphology of a typical rib.
• Respiratory movements of thorax.
Muscles of the thorax, arrangement of intercostal
muscles and their nerve supply.
• The thoracic inlet and 1st rib
• Para-vertebral space
• Anterior and posterior Abdominal wall
• Antecubital fossa, Popliteal fossa

• Diaphragm: development, functions, structures and

attachments, openings and structures transmitted, nerve
and blood supply, lymphatic drainage.
• Structural organization of Shoulder girdle, Axilla & Ankle
• Base of skull, Nerves & Blood Supply of Scalp

Gastro -Intestinal System:

• Anatomy of oesophagus, stomach, small and large
intestine and rectum, liver spleen and pancreas

Genito Urinary System:

• Structural organization of Kidneys, uterus Prostate &
Urinary Bladder
• Ovaries & Uterus

Miscellaneous:
• Large veins of neck
• Large veins of leg

2. PHYSIOLOGY
Body fluids and their functions and constitutions:
• Capillary dynamics and interstitial fluid.
• Osmolarity, osmolality, partition of fluids across
membranes
• Lymphatic system
• Special fluids especially cerebrospinal fluid and ocular
CURRICULUM FCPS PART-I

fluids. Pleural, pericardial and peritoneal fluids

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Muscles:
• Action potential generation and its transmission
• Neuromuscular junction and transmission
• Muscle types

Gastrointestinal:
• Gastric function; secretions, nausea and vomiting Gut
motility, sphincters and reflex control Digestive functions

Hepatobiliary:
• Liver & gall bladder function

Genito-Urinary:
• Kidney function and other genitourinary functions

Vascular System:
• Laws of haemodynamics governing flow, pressure and
resistance in blood vessels.
• Arterial blood pressure measurement and regulation.
• Vasomotor system and control of blood vessels.
• Characters of arterial and venous pulse.
• Significance of central venous pressure.
• Structure and functions of the arteries, arterioles,
capillaries and veins.
• Shock and its type
• Coronary, cutaneous, splanchnic and peripheral circulation.

Respiratory System:
• Pulmonary ventilation: volumes, flows, dead space.
• Effect of IPPV on Lungs Mechanism of respiration:
• Ventilation/perfusion abnormalities.

Nervous System:
• Central nervous system: Brain and spinal cord
• Peripheral nervous system Afferent (Sensory) Efferent
(Motor)
• Autonomic nervous:
CURRICULUM FCPS PART-I

• Sympathetic
• Parasympathetic

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Pain Pathways & Physiology:

• Nociception
• Afferent nociceptive pathways, dorsal horn, peripheral and
central mechanisms,
• Neuro-modulatory system, supraspinal mechanisms
• Visceral pain, neuropathic pain

Senses of the Body:

• Receptors – sight – hearing – smell – taste – touch
– vestibular system – proprioception

Physiology with Pregnancy:

• Physiological changes associated with normal pregnancy
• Functions of the placenta: dynamic of placental transfer
• Fetus: changes at birth

Physiological differences between neonates and adults.

3. PHARMACOLOGY
• Opioids and other analgesics
• Hypnotics, sedatives
• Volatile Anesthetic
• Medical gases
• IV anesthetics agents
• Non-steroidal anti-inflammatory drugs
• Neuromuscular blocking agents & Cholinesterase inhibitor
• Drugs acting on the autonomic nervous system:
cholinergic and adrenergic agonists and antagonist
• Drugs acting on the heart (antiarrhythmic,
chronotropes and inotropes) cardiac glycosides
• Vasodilators
• Antihypertensive
• Anticonvulsants
• Neuroleptics & Anti parkinsonism Drugs
• Antibiotic in general
• Corticosteroids and other hormone preparations
• Antacids. Drugs influencing gastric secretion & motility
CURRICULUM FCPS PART-I

• Antiemetic agents
• Local anesthetics
• IV fluids and Plasma volume expanders
• Diuretics

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• Antidepressant
• Anticoagulants & Procoagulants
• Drugs acting on the respiratory system
• Drugs interaction
• Oral hypoglycemic agents and insulins
• Thyroid, anti-thyroid drugs
• Disinfectants and antiseptic

4. PHYSICS & CLINICAL MEASUREMENTS

• Basic principles of physics
• Fundamental and derived units of Mass, force, work and
power
• Heat: conduction, convection, radiation, Laws of
thermodynamics.
• Physics of gases : Absolute and relative pressures, The
gas laws, triple point, critical temperature, density and
viscosity of gases, laminar and turbulent flow,
• The Bernoulli principle, freezing point, melting
point, latent heat of vaporization, Vapor pressure.
• Colligative properties
• Measurement of Blood pressure: Direct & indirect
methods, Measurement of pulmonary artery pressure.
• Measurement of volume and flow of gases and liquids.
Peak flow measurement, spirometry cardiac output
absolute and relative pressure.
• Measurement of temperature and humidity
• Measurement of gas concentrations, especially oxygen,
carbon dioxide, volatile anaesthetic agents,
capnography, pulse oximetry
• Basic Concepts of Electricity, resistance, capacitance,
Sources and methods of reducing electrical interference
and light sources
• Defibrillator, Diathermy, Electrical hazards: causes and
prevention
CURRICULUM FCPS PART-I

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ASSESSMENT
EXAMINATION SCHEDULE
The FCPS Part-I examinations will be held thrice a year as per
schedule notified on yearly basis.
• Theory examinations are held in different cities of the country.
At present, the centres are Karachi, Quetta, Hyderabad,
Larkana, Bahawalpur, Multan, Lahore, Faisalabad, Islamabad,
Peshawar, Abbottabad and Muzaffarabad (AJK). Overseas
Centres are Riyadh in Saudia Arabia and Kathmandu in Nepal.
• Medium of examinations will be English.
• Any change in the dates and format of the examinations will
be notified by the College before the examinations.
• Every successful candidate in FCPS Part-I examinations will
be issued a letter to enable him/her to seek placement for
training in a recognized training institute after which he/she
will have to register with R&RC.
• A competent authority appointed by the College has the
power to debar any candidate from any examination if it is
satisfied that such a candidate is not a fit person to take the
College examinations because of using unfair means/
misconduct or other disciplinary reasons.

EXAMINATION FEES
• Applications along with the prescribed examination fee and
required documents should be submitted latest by the last
date notified for this purpose before each examination.
• The details of examination fee and fees for change of
centre, subject, etc. shall be notified before each
examination.
• Fees deposited for a particular examination, shall not be
carried over to the next examination in case of withdrawal /
absence/ exclusion.
CURRICULUM FCPS PART-I

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ALL FEES ARE PAYABLE BY CASH AT CPSP DESIGNATED BANKS OR

BANK DRAFT / PAY ORDER MADE OUT IN FAVOUR OF “COLLEGE
OF PHYSICIANS AND SURGEONS PAKISTAN”. PERSONAL CHEQUES
AND POSTAL ORDERS ARE NOT ACCEPTED. HOWEVER FEES/DUES
CAN BE PAID AT THE IDENTIFIED BRANCHES OF UNITED BANK IN
9 CITIES OF THE COUNTRY. CANDIDATES FROM BAHAWALPUR,
ABBOTTABAD AND MUZZAFARABAD ARE REQUIRED TO SEND A
DEMAND DRAFT OF THE FEES AMOUNT DIRECTLY TO THE CPSP
HEAD OFFICE KARACHI. (ANY FURTHER INFORMATION CAN BE
OBTAINED FROM THE REGIONAL OFFICE).

REFUND OF FEES
On a written request for not appearing in the examination,
submitted up to the last date of withdrawal of application, the
refund is admissible to the extent of 75% of fees only. No request
for refund will be accepted after the last date of withdrawal of the
application.
• In case the application of a candidate is rejected by the CPSP,
75% of the examination fee will be refunded, after deduct-
ing 25% as processing charges. No refund will be made, for
fees paid for any other reason, e.g. late fee, change of centre/
subject fee, etc.

FORMAT OF EXAMINATION
The examinations shall consist of two theory papers (Paper-I and
Paper-II), consisting of 100 MCQs (One Best Type) each:

PAPER-I (three hours) will contain questions from the core

knowledge of the following subjects:
• Anatomy
• Physiology and Biochemistry
• Pathology and Microbiology
• Pharmacology
• Research and Biostatics
• Behavioural Sciences and Medical Ethics

PAPER-II will contain questions from specialty related Basic

CURRICULUM FCPS PART-I

Medical Sciences.

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Validity of FCPS-I
• A candidate who successfully qualifies FCPS Part-I
examination is required to register as FCPS resident within
three years of passing FCPS Part-I.
• The validity of FCPS Part-I Exam shall vary with the presence
or absence of Intermediate Module (IMM) in the specialty:
Specialty programs with Intermediate Module (IMM):
Following registration with the RTMC (R&RC), the resident
must pass Intermediate Module (IMM) examination (both
Theory & TOACS) within six (06) consecutive attempts,
availed or un-availed, from the date of completion of two
years in training.
Specialty programs without Intermediate Module (IMM):
Following registration with the RTMC (R&RC), the resident
must appear at least once in the final FCPS-II examination
within a period of 7 or 8 years depending upon the length of
their residency training (4 or 5 years) plus 3 years.

Note:
Failure to comply with the above mentioned policies will result
in the pass status of FCPS Part-I to become null and void. The
candidate will therefore be required to re-appear and pass FCPS
Part-l examination to keep the residency status alive and to make
further attempts in IMM or FCPS-II examination.
CURRICULUM FCPS PART-I

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Note:
Failure to comply with the above mentioned policies will result
in the pass status of FCPS Part-I to become null and void. The
candidate will therefore be required to re-appear and pass FCPS
Part-I examination to keep the residency status alive and to make
further attempts in IMM or FCPS-II examination.

THE COLLEGE RESERVES THE RIGHT TO ALTER/AMEND ANY RULES/

REGULATIONS
Any decision taken by the College on the interpretation of these
regulations will be binding on the applicant.
CURRICULUM FCPS PART-I

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Last Updated: 2 October 2023

Published: 31st December 2020
COLLEGE OF PHYSICIANS AND SURGEONS PAKISTAN
7th Central Street, Defence Housing Authority, Karachi-75500.
Phone No. 9926400-10, UAN: 111-606-606, Fax No. 99266432

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