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MBBS/ Forensic Medicine & Toxicology/FM10.4

FM10.4

Describe the Code of Medical Ethics 2002 conduct, Etiquette and Ethics in medical practice and unethical practices & the dichotomy

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Forensic Medicine & Toxicology157 competencies

FM1.1 Define Forensic medicine, Clinical Forensic Medicine, Forensic Pathology, State Medicine, Legal Medicine and Medical Jurisprudence
FM1.2 Describe history of Forensic Medicine
FM1.3 Describe legal competencies including Bharatiya Nagarika Suraksha Sanhita (BNSS), Bharatiya Nyay Sanhita (BNS), Bharatiya Sakshya Adhiniyam (BSA), Protection of Children from Sexual Offences Act (POCSO), Civil and Criminal Cases, Inquest (Police Inquest and Magistrate's Inquest), Cognizable and Non-cognizable offences
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
FM1.5 Describe Court competencies 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 & conduct of doctor in witness box
FM1.6 Describe Offenses in Court including Perjury; Court strictures vis-a-vis Medical Officer
FM1.7 Describe Dying Declaration & Dying Deposition
FM1.8 Describe the latest decisions/notifications/resolutions/circulars/standing orders related to medico-legal practice issued by Courts/Government authorities etc.
FM1.9 Describe the importance of documentation in medical practice in regard to medico legal examinations, Medical Certificates and medico legal reports especially - maintenance of patient case records, discharge summary, prescribed registers to be maintained in Health Centres - maintenance of medico-legal register like accident register - documents of issuance of wound certificate - documents of issuance of drunkenness certificate - documents of issuance of sickness and fitness certificate - documents for issuance of death certificate - documents of Medical Certification of Cause of Death - Form Number 4 and 4A - documents for estimation of age by physical, dental and radiological examination and issuance of certificate
FM2.1 Select appropriate cause of death in a particular scenario by referring ICD 11 code
FM2.2 Write a correct Medical Certificate of Cause of Death (MCCD) certificate as per ICD 11 document
FM2.3 Define, describe and discuss death and its types including somatic/clinical/cellular, molecular and brain-death, Cortical Death and Brainstem Death
FM2.4 Describe salient features of the Organ Transplantation and The Human Organ Transplant (Amendment) Act 2011 and discuss ethical issues regarding organ donation
FM2.5 Describe and discuss issues related to sudden natural deaths
FM2.6 Describe and discuss natural and unnatural deaths
FM2.7 Discuss moment of death, modes of death - coma, asphyxia and syncope
FM2.8 Describe and discuss suspended animation
FM2.9 Describe and discuss post-mortem changes including signs of death, cooling of body, post-mortem lividity, rigor mortis, cadaveric spasm, cold stiffening and heat stiffening
FM2.10 Describe putrefaction, mummification, adipocere and maceration
FM2.11 Discuss estimation of time since death
FM2.13 Describe and discuss autopsy competencies including post-mortem examination, different types of autopsies, aims and objectives of post-mortem examination
FM2.14 Describe the legal requirements to conduct post-mortem examination and competencies to conduct medico-legal post-mortem examination
FM2.15 Describe and discuss obscure autopsy and Virtopsy
FM2.16 Describe and discuss examination of clothing, preservation of viscera on post-mortem examination for chemical analysis and other medico-legal purposes, post-mortem artefacts
FM2.17 Describe the clinical features, post-mortem finding and medico legal aspects of injuries due to physical agents like heat (heat-hyperpyrexia, heat stroke, sun stroke, heat exhaustion/prostration, heat cramps [miner's cramp]) or cold (systemic and localized hypothermia, frostbite, trench foot, immersion foot)
FM2.18 Describe types of injuries, clinical features, patho-physiology, post-mortem findings and medico-legal aspects in cases of burns, scalds, lightening, electrocution and radiations
FM2.19 Describe and discuss clinical features, post-mortem findings and medico-legal aspects of death due to starvation and neglect
FM2.20 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
FM2.21 Describe and discuss examination of mutilated bodies or fragments, charred bones and bundle of bones
FM2.22 Describe and discuss exhumation
FM2.23 Crime Scene Investigation: Describe and discuss the objectives of crime scene visit, the duties & responsibilities of doctors on crime scene and the reconstruction of sequence of events after crime scene investigation
FM2.24 Investigation of anaesthetic, operative deaths: Describe and discuss special protocols for conduction of autopsy and for collection, preservation and dispatch of related material evidences
FM2.25 Demonstrate professionalism while conducting autopsy in medico legal situations, interpretation of findings and making inference/opinion, collection, preservation and dispatch of biological or trace evidences
FM2.26 Demonstrate ability to work in a team for conduction of medico-legal autopsies in cases of death following alleged negligence, medical dowry death, death in custody or following violation of human rights as per National Human Rights Commission Guidelines on exhumation
FM2.27 Demonstrate ability to exchange information by verbal or nonverbal communication to the peers, family members, law enforcing agency and judiciary
FM2.28 Demonstrate ability to use local resources whenever required like in mass disaster situations
FM3.1 Define, classify and describe asphyxia and medico-legal interpretation of post-mortem findings in asphyxial deaths
FM3.2 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
FM3.3 Describe and discuss patho-physiology, clinical features, post-mortem findings and medico-legal aspects of traumatic asphyxia, obstruction of nose & mouth, suffocation and sexual asphyxia
FM3.4 Describe and discuss types, patho-physiology, clinical features, post-mortem findings and medico-legal aspects of drowning
FM4.1 Define and describe Corpus Delicti, establishment of identity of living persons including race, sex, religion, complexion, stature.
FM4.2 Discuss teeth-eruption, decay, bite marks, and medico-legal aspects of teeth.
FM4.3 Discuss age determination using morphology, bones- ossification centers and medico-legal aspects of age.
FM4.4 Describe and discuss identification of criminals, unknown persons, dead bodies from the remains-hairs, fibers, teeth, anthropometry
FM4.5 Dactylography, footprints, scars, tattoos, poroscopy and superimposition
FM5.1 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
FM5.2 Define injury, assault & hurt. Describe Bharatiya Nyay Sanhita (BNS) pertaining to injuries
FM5.3 Describe accidental, suicidal and homicidal injuries. Describe simple, grievous and dangerous injuries. Describe ante-mortem and post-mortem injuries
FM5.4 Describe healing of injury and fracture of bones with its medico-legal importance
FM5.5 Describe factors influencing infliction of injuries and healing, examination and certification of wounds and wound as a cause of death: Primary and Secondary
FM5.6 Describe and discuss different types of weapons including dangerous weapons and their examination
FM6.1 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 relation of firearm - caliber, range, choking
FM6.2 Describe and discuss wound ballistics-different types of firearm injuries, blast injuries and their interpretation, preservation and dispatch of trace evidences in cases of firearm and blast injuries, various tests related to confirmation of use of firearms
FM7.1 Describe and discuss regional injuries to head (Scalp wounds, fracture skull, intracranial hemorrhages, coup and countercoup injuries), neck, chest, abdomen, limbs, genital organs, spinal cord and Skeleton
FM7.2 Describe and discuss injuries related to fall from height and vehicular injuries - Primary and Secondary impact, Secondary injuries, crush syndrome, railway spine
FM8.1 Describe various sections of BNS and BNSS related to definition of rape, medical examination of rape victim/ survivor and accused of rape, police information by the doctors and medical care with recent amendments notified till date (i.e. Sections 63 BNS, 200 BNS, 397 BNSS & 184 BNSS, 52 BNSS), and sections 3 to 12, 27 and 41 of Protection of Children from Sexual Offences (POCSO) Act.
FM8.2 Describe and discuss the examination of the survivor of an alleged case of rape, and the preparation of report, framing the opinion and preservation and dispatch of trace evidences in such cases
FM8.3 Describe and discuss informed consent in sexual intercourse. Describe and discuss histories of gender and sexuality-based (sexual orientation) identities and rights in India. Describe history of decriminalization of 'adultery' and consensual adult homosexual sexual behaviour. Describe sexual offences with its medicolegal significance - Forced/ non-consensual penetrative anal sex; Forced/ non-consensual oral sex; Sexual acts with animals/ bestiality/ zoophilia; Forced/ non-consensual insertion of fingers or objects; Forced/ non-consensual touching or groping or disrobing ('indecent assault').
FM8.4 Define and discuss infanticide, foeticide and stillbirth
FM8.5 Define and discuss signs of intrauterine death, signs of live birth, viability of foetus, age determination of foetus, DOAP of ossification centres, Hydrostatic test, Sudden infant death syndrome and Munchausen's syndrome by proxy.
FM8.6 Describe the difference between paraphilia and paraphilic disorder. Describe paraphilic disorder as per the latest guidelines of DSM and ICD and describe medico-legal implications of paraphilic disorder by referring scientific literature and legal justification (if any). Describe and discuss various paraphilias in the context of informed consent during any sexual interaction.
FM8.7 Describe legitimacy and its medico legal importance. Describe and discuss how 'signs' of virginity (so called 'virginity test', including finger tests on female genitalia) are unscientific, inhuman and discriminatory. Describe and discuss how to appraise the courts about unscientific basis of these tests if court orders it.
FM8.8 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
FM8.9 Discuss disputed paternity and maternity
FM8.10 Discuss Pre-conception and Pre Natal Diagnostic Techniques (PC&PNDT) - Prohibition of Sex Selection Act 2003 and Domestic Violence Act 2005 with Amendments
FM8.11 Define and discuss impotence, sterility, frigidity, sexual dysfunction, premature ejaculation. Discuss the causes of impotence and sterility in male and female
FM8.12 Discuss Sterilization of male and female, artificial insemination, Test Tube Baby, surrogate mother, hormonal replacement therapy with respect to appropriate national and state laws
FM8.13 Discuss the relative importance of surgical methods of contraception (vasectomy and tubectomy) as methods of contraception in the National Family Planning Programme
FM8.14 Discuss Assisted Reproductive Technology Regulation Act 2021 and Surrogacy Act 2021 for accreditation, supervision and regulation of ART and Surrogacy Clinics in India.
FM8.15 Define, classify and discuss abortion, methods of MTP and criminal abortion and complication of abortion. MTP Act 2021 and recent amendments.
FM8.16 Describe evidences of abortion - living and dead, duties of doctor in cases of abortion, investigations of death due to criminal abortion
FM9.1 Describe and discuss child abuse and battered baby syndrome
FM9.2 Describe and discuss issues relating to torture, identification of injuries caused by torture and its sequalae, management of torture Survivors
FM9.3 Describe and discuss guidelines and Protocols of National Human Rights Commission regarding torture
FM9.4 Should be able to demonstrate the professionalism while dealing with survivor of torture and human right violations, sexual assaults- psychological consultation, rehabilitation
FM10.1 Describe Medical Ethics and explain its historical emergence
FM10.2 Describe the Indian Medical Register
FM10.3 Describe the functions and role of National Medical Commission and State Medical Councils
FM10.4 Describe the Code of Medical Ethics 2002 conduct, Etiquette and Ethics in medical practice and unethical practices & the dichotomy
FM10.5 Rights/privileges of a medical practitioner, penal erasure, infamous conduct, disciplinary Committee, disciplinary competencies, warning notice and penal erasure
FM10.6 Describe the Laws in Relation to medical practice and the duties of a medical practitioner towards patients and society
FM10.7 Describe and discuss ethics related to HIV patients and legal aspects as per The Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome (Prevention and Control) Act, 2017.
FM10.8 Describe the Consumer Protection Act-2019 (Medical Indemnity Insurance, Civil Litigations and Compensations)
FM10.9 Describe the medico-legal issues in relation to family violence, violation of human rights, NHRC and doctors
FM10.10 Describe communication between doctors, public and media
FM10.11 Describe and discuss euthanasia and Do not Resuscitate (DNR)
FM10.12 Discuss legal and ethical issues in relation to stem cell research
FM10.13 Describe social aspects of Medico-legal cases with respect to survivors of assault, rape, attempted suicide, homicide, domestic violence, dowry-related cases
FM10.14 Describe & discuss the challenges in managing medico-legal cases including development of skills in relationship management - Human behavior, communication skills, conflict resolution Techniques
FM10.15 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
FM10.16 Describe and discuss Bioethics
FM10.17 Describe and discuss ethical Principles: Respect for autonomy, non-malfeasance, beneficence & justice
FM10.18 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
FM10.19 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
FM10.20 Describe therapeutic privilege, Malingering, therapeutic Misadventure, Professional Secrecy, Human Experimentation
FM10.21 Describe Products liability and Medical Indemnity Insurance
FM10.22 Explain Oath - Hippocrates, Charaka and Sushruta and procedure for administration of Oath.
FM10.23 Describe the modified Declaration of Geneva and its relevance
FM10.24 Enumerate rights, privileges and duties of a Registered Medical Practitioner. Discuss doctor-patient relationship: professional secrecy and privileged communication
FM10.25 Clinical research & Ethics: Discuss human experimentation including clinical trials
FM10.26 Discuss the constitution and functions of ethical committees
FM10.27 Describe and discuss Ethical Guidelines for Biomedical Research on Human Subjects & Animals
FM10.28 Demonstrate respect to laws relating to medical practice and Ethical code of conduct prescribed by National Medical Commission and rules and regulations prescribed by it from time to time
FM10.29 Demonstrate ability to conduct research in pursuance to guidelines or research ethics
FM11.1 Classify common mental illnesses including post-traumatic stress disorder (PTSD)
FM11.2 Define, classify and describe delusions, hallucinations, illusion, lucid interval and obsessions with exemplification
FM11.3 Describe Civil and criminal responsibilities of a mentally ill person
FM11.4 Differentiate between true mental illness from feigned mental illness
FM11.5 Describe & discuss Delirium tremens
FM11.6 Describe the Indian Mental Health Act, 2017 and recent amendments with special reference to admission, care and discharge of a mentally ill person
FM12.1 Describe different types of specimen and tissues to be collected both in the living and dead: Body fluids (blood, urine, semen, faeces, saliva), Skin, Nails, tooth pulp, vaginal smear, viscera, skull, specimen for histo-pathological examination, blood grouping, HLA Typing and DNA Fingerprinting. Describe Locard's Exchange Principle
FM12.2 Describe the methods of sample collection, preservation, labelling, dispatch, and interpretation of reports
FM12.3 Cyber Forensic in relation to Privacy of Medical Documents
FM12.4 Demonstrate professionalism while sending the biological or trace evidences to Forensic Science laboratory, specifying the required tests to be carried out, objectives of preservation of evidences sent for examination, personal discussions on interpretation of findings
FM12.5 Demonstrate the professionalism while preparing reports in medico legal situations, interpretation of findings and making inference/opinion, collection, preservation and dispatch of biological or trace evidences
FM12.6 Enumerate the indications and describe the principles and appropriate use for: DNA profiling, Facial reconstruction, Polygraph (Lie Detector), Narcoanalysis, Brain Mapping, Digital autopsy, Virtual Autopsy, Imaging technologies
FM13.1 Describe the history of Toxicology
FM13.2 Define the terms Toxicology, Forensic Toxicology, Clinical Toxicology and poison.
FM13.3 Describe the various types of poisons, Toxicokinetics, and Toxicodynamics and diagnosis of poisoning in living and dead
FM13.4 Describe the Laws in relations to poisons including NDPS Act, Medico-legal aspects of poisons
FM13.5 Describe Medico-legal autopsy in cases of poisoning including preservation and dispatch of viscera for chemical analysis
FM13.6 Describe the general symptoms, principles of diagnosis and management of common poisons encountered in India
FM13.7 Describe simple Bedside clinic tests to detect poison/drug in a patient's body fluids
FM13.8 Describe basic methodologies in treatment of poisoning: decontamination, supportive therapy, antidote therapy, competencies of enhanced elimination
FM13.9 Describe the procedure of intimation of suspicious cases or actual cases of foul play to the police, maintenance of records, preservation and dispatch of relevant samples for laboratory analysis.
FM13.10 Describe the general principles of Analytical Toxicology and give a brief description of analytical methods available for toxicological analysis: Chromatography - Thin Layer Chromatography, Gas Chromatography, Liquid Chromatography and Atomic Absorption Spectroscopy
FM13.11 Describe General Principles and basic methodologies in treatment of poisoning: decontamination, supportive therapy, antidote therapy, competencies of enhanced elimination with regard to: Caustics Inorganic - sulphuric, nitric, and hydrochloric acids; Organic - Carbolic Acid (phenol), Oxalic and acetylsalicylic acids
FM13.12 Describe General Principles and basic methodologies in treatment of poisoning: decontamination, supportive therapy, antidote therapy, competencies of enhanced elimination with regard to Phosphorus, Iodine, Barium
FM13.13 Describe General Principles and basic methodologies in treatment of poisoning: decontamination, supportive therapy, antidote therapy, competencies of enhanced elimination with regard to Arsenic, lead, mercury, copper, iron.
FM13.14 Describe General Principles and basic methodologies in treatment of poisoning: decontamination, supportive therapy, antidote therapy, competencies of enhanced elimination with regard to Ethanol, methanol, ethylene glycol, Local Made Liquor and Hooch Tragedy
FM13.15 Describe General Principles and basic methodologies in treatment of poisoning: decontamination, supportive therapy, antidote therapy, competencies of enhanced elimination with regard to Organophosphates, Carbamates, Organochlorines, Pyrethroids, Paraquat, Aluminium and Zinc phosphide
FM13.16 Describe General Principles and basic methodologies in treatment of poisoning: decontamination, supportive therapy, antidote therapy, competencies of enhanced elimination with regard to Ammonia, carbon monoxide, hydrogen cyanide & derivatives, methyl isocyanate, tear (riot control) gases
FM13.17 Describe General Principles and basic methodologies in treatment of poisoning: decontamination, supportive therapy, antidote therapy, competencies of enhanced elimination with regard to: i. Antipyretics - Paracetamol, Salicylates ii. Anti-Infectives (Common antibiotics - an overview) iii. Neuropsychotoxicology - Barbiturates, benzodiazepines, phenytoin, lithium, haloperidol, neuroleptics, tricyclics
FM13.18 Describe General Principles and basic methodologies in treatment of poisoning: decontamination, supportive therapy, antidote therapy, competencies of enhanced elimination with regard to: iv. Narcotic Analgesics, Anaesthetics, and Muscle Relaxants v. Cardiovascular Toxicology - Cardiotoxic plants - oleander, Cerbera odollam, aconite, digitalis vi. Gastro-Intestinal and Endocrinal Drugs - Insulin
FM13.19 Describe features and management of Snake bite, scorpion sting, bee and wasp sting and spider bite
FM13.20 Describe features and management of abuse/poisoning of Tobacco, cannabis, amphetamines, cocaine, hallucinogens, designer drugs & solvent, Mushroom Poisoning, Food Poisoning
FM13.21 Describe toxic pollution of environment, its medico-legal aspects & toxic hazards of occupation and industry
FM14.1 Examine and prepare Medico-legal report of an injured person with different etiologies in a simulated/ supervised environment
FM14.2 Demonstrate the correct technique of clinical examination in a suspected case of poisoning & prepare medico-legal report in a simulated/ supervised environment
FM14.3 Assist and demonstrate the proper technique in collecting, preserving and dispatch of the exhibits in a suspected case of poisoning, along with clinical examination
FM14.4 Conduct and prepare report of estimation of age of a person for medico-legal and other purposes & prepare medico-legal report in a simulated/ supervised environments
FM14.5 Examine and prepare Medical Certificate Of Cause Of Death (MCCD) in a simulated/ supervised environment
FM14.6 Conduct & prepare post-mortem examination report of varied etiologies (at least 15) in a simulated/ supervised environment
FM14.7 Demonstrate the correct technique to perform and identify ABO & RH blood group of a person
FM14.8 Demonstrate examination of & present an opinion after examination of skeletal remains in a simulated/ supervised environment
FM14.9 Demonstrate ability to identify & prepare medico legal inference from specimens obtained from various types of injuries e.g. contusion, abrasion, laceration, firearm wounds, burns, head injury and fracture of bone
FM14.10 To identify & describe weapons of medico legal importance which are commonly used e.g. lathi, knife, kripan, axe, gandasa, gupti, farsha, dagger, bhalla, razor & 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/ PM report so as to connect weapon with the injuries.
FM14.11 Describe the contents and structure of bullet and cartridges used & to provide medico-legal interpretation from these
FM14.12 To estimate the age of foetus by post-mortem examination
FM14.13 To examine & prepare report of an alleged accused person in cases of various sexual offences in a simulated/ supervised environment
FM14.14 To examine & prepare medico-legal report on an alleged victim/ survivor of various sexual offences in a simulated/ supervised environment. (Guidelines and protocols of Medico Legal Care for Survivors/ Victims of sexual violence; Ministry of Health and Family Welfare, GOI - with latest modifications if any). Demonstrate an understanding of framing the opinion, preservation and dispatch of trace evidences in such cases. Describe and discuss sympathetic/ empathetic examination and interview of victims/ survivors of sexual assault, including presence of trusted adult figure (person) in cases of minor victims/ survivors.
FM14.15 To examine & prepare medico-legal report of drunk person in a simulated/ supervised environment
FM14.16 To identify & draw medico-legal inference from common poisons e.g. dhatura, castor, cannabis, opium, aconite, copper sulphate, pesticides compounds, marking nut, oleander, Nux vomica, abrus seeds, Snakes, capsicum, calotropis, lead compounds & tobacco.
FM14.17 To examine & prepare medico-legal report of a person in police, judicial custody or referred by Court of Law and violation of human rights as requirement of NHRC, who has been brought for medical examination
FM14.18 To record and certify dying declaration in a simulated/ supervised environment
FM14.19 To collect, preserve, seal and dispatch exhibits for DNA-Fingerprinting using various formats of different laboratories.
FM14.20 To give expert medical/ medico-legal evidence in Court of law

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