Department of Psychiatry
Psychiatry Syllabus
Third and Fourth Year
1.0 Programme : MBBS
2.0 Course Name : Psychiatry
3.0 Course Number :
4.0 Year
: Third & Fourth year
5.0 Presented to : College of Medicine
6.0 Presented by : Department of
Psychiatry
7.0 Method of assessment : End of Block
Examinations 100%
8. Aims of the Study
To provide the students with basic knowledge and skills in psychiatry so that they are able to treat
or deal effectively with all the common clinical problems of psychiatry at primary level. The
students should also have a broad knowledge of psychology, medicine and pediatrics relevant to
psychiatry.
9. Introduction
In the third year, students will have a two week block in which they will be introduced to basic
development psychology and child psychopathology and introduced to the general set up of
mental health services in Malawi with visits to some institutions dealing with mental health.
They will also be introduced to general adult psychopathology and the classification of mental
disorders.
The fourth year block is for five weeks and comprises of two sections. The first section is for three
weeks and deals with theoretical background on the major psychiatric disorders including their
management while the last two weeks are a clinical attachment at Zomba Mental Hospital. During
the clinical rotation, the students review patients in the ward and present them at both academic
and business ward round.
10. Course Objectives
At the end of the two blocks i.e. the one in third year and the forth year one, students should:

Have knowledge of basic developmental psychology relevant to
Psychopathology.

Have theoretical knowledge of Basic Child and Adolescent Psychiatry.

Have theoretical knowledge of Basic General Adult Psychiatry.

Gain skills in assessing and managing psychiatric patients at primary level.
11. Topics of Study
Third Year Block
11.1 Psychology
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Important theories of personality development.
Interaction of heredity and environment in development.
Social and cultural influences on personality development.
Cognitive development
Intelligence and subnormality
Concepts of maturation and learning
Developmental tasks of each life phase
The relevance of immature or distorted development to psychiatry.

Principles of psychotherapy.
2. Child Psychiatry

Know the classification of the different psychiatric disorders in childhood.
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Know the clinical features of the common child and adolescent
Psychiatric disorders including mental retardation, autism, behavioural disorders, anxiety
disorders etc.
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Know the principles involved in the management of child and adolescent psychiatric
disorders.
Know the principles of psychopharmacology in children.
3. Psychopathology

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Know the definition of abnormal behaviour.
Know the typical signs and symptoms in psychiatry.
Know the cultural influences on the signs and symptoms.

Know the broad classification of psychiatric disorders.
4. Introduction to Mental Health Services in Malawi

Visit some Non-Governmental Organizations dealing with Mental Health patients.

Visit Zomba Mental Hospital for orientation.
12.0 Topics Of Study
Fourth Year Block
1. General Adult Psychiatry
- Know the current status of Mental Health Services in Malawi including the problems and strong
points.
- Know the classification of Adult psychiatric disorders using ICD 10 (International Classification
and Diseases, British and W.H.O. version) and have a broad idea of the DSM IV Classification
(Diagnostic and Statistical Manual, American Version).
- Know the clinical features of the common adult psychiatric disorders including;
1.
2.
3.
4.
5.
6.
7.
8.
Schizophrenia and other psychotic disorders
Mood disorders
Anxiety disorders
Personality disorders
Somatoform disorders
Sleep disorders
Sexual dysfunction disorder
Eating disorders
- Know the different modes of treatment including
1. Psychopharmacology: the different types of medications, indications and side effects
including antipsychotic, antidepressants, mood stabilizing agents, anxiety
relieving agents, stimulants, anti-epileptics, drugs used in alcoholism, anti-parkinsonian
agents.
2. Psychotherapy: the different types and indications.
3. ECT, Indications, preparation of patients for ECT and side effects.
o
o
Know the different types of psychiatric emergencies and how to manage them.
Know the clinical features and management of pregnancy related psychiatric
disorders including postpartum psychosis. Also know the principles of managing general
psychiatric disorders in pregnancy i.e. effects of psychotropic medications on the fetus and breast
feeding.
12.2 Substance Abuse
o
Know the different drugs of abuse including: Cannabis, alcohol,
Heroin, cocaine, prescription medication, and features in intoxication, withdrawal.
- Know the principles of management of patients with dependence to the different drugs of abuse
including in emergencies (overdose), withdrawal etc.
12.3 Forensic Psychiatry
- Know the major issues/areas affecting Medial Officers in the Mental Health Act of Malawi.
- Know the principles of assessment and management of psychiatric patients who have
committed a crime and relevant legal issues.
- Know ethical issues relevant to psychiatry including informed consent, confidentiality, report
writing etc.
4. Neuropsychiatry
- Know the common types of dementias and their clinical features.
- Know the neuropsychiatry effects of:
1.
2.
3.
4.
5.
H.I.V.
Neurosyphilis
Cerebral Malaria
Epilepsy
Head Injury
- Know the causes and management of delirium.
- Know the principles in the diagnosis and management of patients with psychiatric symptoms,
secondary to a general medical condition.
5. Culture And Psychiatry
- Know the role of social and cultural context in defining psychopathology.
- Know the cultural differences and effects on;
1. Illness presentation
2. Interpretation
3. Different modes of psychiatric treatments.
-
Know examples of culture bound syndromes in Malawi
6. Community Psychiatry
- Know the importance of community based clinics in the Malawian context.
- Know the principles of setting up and running community based clinics.
- Visit some community based clinics during clinical rotation.
7. Clinical Skills
The student should be able to:
- Take an effective psychiatry history from a patient or relative , i.e. elicit the main complaints;
obtain a clear description of the present illness; follow positive leads in the history; obtain
adequate information of mental and physical function, and about development, past illnesses and
family history.
- Perform a systematic mental state examination.
- Perform a complete physical examination, including a competent neurological examination.
- Solve clinical problems, i.e. recognize relevant and significant data and assess priorities; use
appropriate investigations; present a comprehensive diagnostic formulation, and rationally plan a
programme of management.
- Demonstrate effective therapeutic skills.
- Have skills in managing psychiatric emergencies.
- Skills in initiating psychiatric treatment at Primary level and follow-up of chronic psychiatric
patients.
8. Assessments
- Students will not have an assessment in third year but materials covered will be included in
assessment in fourth year.
- At the end of the first three weeks of the fourth year block, students will have a written
assessment on theory on materials covered in the third year and fourth year.
- On the last day of the 5th week, students will be given a clinical case to assess and do a 30
minute presentation with oral questions.
- Those students who fail, will be expected to do remedial work or resit examinations.
13.0 Teaching Methodology
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Lectures
Case discussions tutorials
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Video i.e. DVDs
14. Work Load For Students
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Approximately 80 hours in third year and 200 hours in fourth year.
15. Teaching Materials Provided To Students
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Handouts
Can borrow DVDs
Books from college library
16. General Statement On Current Set Up Of Study
The current set-up of the programme creates problems of clinical teaching. Students are given a
lot of theoretical knowledge but very minimal clinical exposure and as a result, they finish the
block still lacking skills and confidence in managing psychiatric patients.
All the students do the block at once and it is very difficult to organize supervision for
them. Future plans should include splitting the students into small groups which will make the
teaching more efficient and effective and also reduce the number of staff levels needed.
17. Staff needed for topics of study.
1. Academic level
17.1(a) Third year block

Lecturers: 3 i.e. one child psychologist, one child
Psychiatrist and one general adult psychiatrist.
17.1(b) Fourth year block

Lecturers: 6 i.e. this will give a ratio of ten students to
One lecture for clinical supervision.
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Assistant Lecturers: 2 i.e. will help with the supervision of
Students.
18. Staff Workload

Approximately 3 hour teaching session of theory per day during the third year 2-week
block.
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Approximately 2 hour teaching session of theory per day during the fourth year block in
the first three weeks.
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Approximately 6 hours of clinical supervision per day during the last two weeks of the
fourth year block.
19. Infrastructure Needed
An academic center to be situated at Zomba Mental Hospital with offices for staff, a lecture
theatre and small hostel for students.
This would make the organization of the course much easier because the students would then be
split into small groups. Each group would do a block of five weeks during which theory and
clinical teaching would be done simultaneously. This would reduce the number of lecturers
needed to teach psychiatry to even as much as two.
20. Equipment Needed
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Computer for academic center
Projector
Projecting screen
Teaching DVDs
21.0 Recommended Textbooks
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Core Oxford Textbook of psychiatry
Synopsis of Psychiatry (Kaplan and Saddock)
Oxford Textbook of Psychiatry