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MCMSE Guidance
MCMSE Guidance
Medical Council
Malta Statutory
Examination
Guidance document based on the competencies outlined by the Faculty of
Medicine and Surgery, University of Malta
MMC/UoM
1/1/2015
Introduction
The Health Care Professions Act 2003, Chap 464, Articles 11(1)(c) and 12(1)(c), stipulates
that the Medical Council of Malta may require a Medical Professional whose primary
degree is not from Malta or from an EU-Member State 'to sit for and pass a professional and
linguistic proficiency test' (Medical Council Malta Statutory Examination) in order to be
granted registration in Malta.
This document is aimed at prospective candidates sitting for the Malta Medical Council
Statutory Exam (MMCSE) and explains the exam set up, as well as provides guidance on
the required competencies expected of a medical professional seeking registration with the
Medical Council of Malta.
The list of competencies outlined in Appendix A has been kindly provided by the Faculty of
Medicine and Surgery, University of Malta.
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Competencies to be assessed
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Timing
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The exam will be held twice a year, in April and September, unless otherwise
stated.
Publication of results
The result of the exam will be published on the Malta Medical Council Notice Board
and website. The results will also be communicated to the candidates within 2
weeks of the exam date by email.
A breakdown of the result of all the topics will be forwarded to each candidate.
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Appendix A: Competencies
This is a list of competencies outlining the knowledge and skills that would be expected of a
candidate sitting for the MMSCE.
A candidate should have the capability to:General Skills
Carry out a consultation with a patient: taking a history, carrying out a physical
examination while protecting the patients dignity elicit the appropriate signs, interpret
clinical findings and assessing a patients mental state.
2. Make evidence-based clinical judgements and decisions.
3. Communicate effectively with empathy, by providing explanation and advice,
reassurance and support.
4. Assess clinical presentations, order and interpret investigations (haematological and
biochemical investigations, arterial blood gasses, medical imaging, ECG etc) and make
differential diagnoses.
5. Make and negotiate a management plan.
6. Prescribe drugs accurately while being cognizant of the benefits and risks.
7. Carry out basic practical procedures including administration of oxygen, intravenous
therapy and blood transfusion.
8. Assess the psychological and social aspects of a patient's illness
9. Provide immediate care of medical emergencies, including First Aid and
Resuscitation; showing knowledge of Adult and Paediatric Basic and Advanced life
support protocols).
10. Explain the important aspects of breaking bad news.
11. Demonstrate how to obtain informed consent.
12. Communicate with colleagues in a medical context.
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MEDICINE
Cardiovascular
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Name the gross and microscopic features, detailed blood supply and innervation of the
heart, its chambers, valves and great vessels and their clinical correlates
Outline the surface projections and methods of clinical examination of the heart, its
valves and great vessels
Identify on radiographs and other imaging systems the features of the cardiovascular
system
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Outline the development of the cardiovascular system and how this relates to
common developmental anomalies
Explain the anatomical basis for the localisation of pain arising from heart disease
Describe the conducting system of the heart and the reflex control of heart rate
Construct simple pressure-volume diagrams from the events during the cardiac cycle
and annotate these graphs with valve openings and closures and correlate these with
electrocardiographic events.
Construct an integrated picture of the various systems that control blood pressure and
apply this to specific clinical examples involving blood loss or fluid overload
Explain the physiological changes that occur in the cardiovascular system in response
to pregnancy
Outline the renin-angiotension system and its role in the aetiology of hypertension
Obtain an accurate measurement of systolic and diastolic blood pressures using a
sphygmomanometer and stethoscope
Describe a systematic approach to ECG interpretation
Interpret simple clinical cases involving the cardiovascular system (including
hypertension, angina, myocardial infarction, valve disease and thromboembolism) in
terms of disordered anatomy and physiology and the basic investigations and drugs
used to treat these conditions
Outline the genetic and lifestyle factors influencing and the public health implications
of cardiovascular disease
Respiratory
1. Name the gross and microscopic features, blood supply and innervation of the
respiratory tract and their clinical correlates
2. Outline the surface projections and methods of clinical examination of the components
of the respiratory system
3. Identify on radiographs and other imaging systems the bones, ligaments and muscles
of the chest, the components of the lungs and their major relations
4. Outline the development of the respiratory tract and how this relates to common
developmental anomalies
5. Outline the mechanics of the process of respiration, using anatomical and physiological
principles of muscle action, flow, pressure etc.
6. Outline the important biochemical changes relating to blood gas solution, diffusion and
interaction with the body's buffering system.
7. Outline the patterns of nervous and chemical control of the respiratory pathways and
how these relate to common disorders of the respiratory system and the appropriate
therapeutic agents.
8. Discuss the common pathologies of the respiratory tract in terms of disordered
anatomy and physiology and the basic drugs used to treat these conditions.
9. Identify different chest sounds.
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SURGERY
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Describe the risks and benefits associated with regional versus general anaesthesia.
Analyze the risk factors that lead to increased peri-operative risk e.g Ischaemic heart
disease, COAD, etc.
Identify various approaches to peri-operative pain management.
Demonstrate the ability to take a focused pre-operative history and physical
examination.
Present the pre-operative assessment in a clear, concise and complete format.
Explain the current legal and ethical aspects of consent for surgery, anaesthesia and
blood transfusion.
Make an early identification of deteriorating patients.
Demonstrate knowledge of surgical pathophysiology, clinical presentation,
investigation and management of common surgical conditions such as endocrine
disease including thyroid, parathyroid, adrenal and breast disease; gastrointestinal
disease including upper and lower gastrointestinal tract, hepatobiliary and pancreatic
disease as well as abdominal wall herniae.
Demonstrtate knowledge of surgical pathophysiology, clinical presentation,
investigation and management of common vascular as well as cardiothoracic disease
including ischaemic heart disease, valvular heart disease and chest trauma; and
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FAMILY MEDICINE
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Use and practice appropriate consultation skills for different clinical scenarios e.g.
clinic, home, telephone.
Use sensitivity to gain insight to compliance.
Present verbal reports of clinical encounters to summarize the key findings in a
succinct, well-organized manner that highlights the clinical reasoning process and
provides a clear rationale for investigation and management.
Translate the patients narrative and symptoms into a working diagnosis.
Ability to use different methods of gaining the patients ideas, concerns and
expectations (ICE).
Use the patient-centered clinical method with a particular focus on:
a. Undifferentiated symptoms such as abdominal pain, musculoskeletal pain, chest
pain, dizziness, fatigue, fever, headache, cough / dyspnoea; and
b. Chronic disease management including Diabetes mellitus, Hypertension, Coronary
artery disease, Mental health (e.g. anxiety, depression, addiction), and Lung
disease (e.g. COPD, asthma)
Discuss the stress in a family dealing with a terminally ill member or significant health
related events.
Evaluate the relationship between socioeconomic disadvantage and health status.
Knowledge of preventive medicine and identification of risk factors skills for
motivational change.
Describe the legal and ethical requirements for obtaining informed consent and
demonstrate skills in discussing consent with patients based on these requirements.
Demonstrate cultural competence when working with patients and families.
Negotiate the management plan.
Demonstrate an evidence based approach in psychosexual health issues at primary
care level.
Demonstrate a respectful attitude towards other colleagues, teachers and members of
an interprofessional team and work collaboratively for patient-centred care.
Demonstrate application of an ethical framework in the clinical decision-making
process.
Explain that continuity of care and the importance of record keeping.
Discuss the current and past definitions of disability and work related impairment.
Describe the range of organizations in different communities that promote the wellbeing of patients (e.g., community agencies, self-help groups).
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PATHOLOGY
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Discuss topics relating to the maternal and foetal systems in normal and abnormal
pregnancies.
Outline the requirement related to antepartum care including its aims and method of
implementation.
Describe the normal and abnormal intrapartum process.
Identify the problems of the postpartum period and puerperium and their
management.
Explain the anatomical and physiological changes that occur during pregnancy, and the
role these play in disease states.
Describe the clinical, biophysical and biochemical assessment for foetal wellbeing in
relation to congenital abnormalities and placental insufficiency.
Demonstrate a practical knowledge of the reproductive hormonal function in the
female detailing the abnormalities that can occur.
Outline the causes, investigations and management of infertility.
Discuss issues related to contraception. Demonstrate ability to explain to a patient in a
professional and sensitive manner the correct use of the methods available for family
control. Safely prescribe the oestrogen-progesterone combine contraceptive showing
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