Skip to main content
  • King Edward Medical University, Lahore
  • Mayo Hospital
  • css image gallery
1 King Edward Medical University, Lahore2 Mayo Hospital3 4 5
css slider by v8.8

The sound of Silence

A short story by Hamdan Ali Khan, 1st Year MBBS

The old man sat on the beach, barefooted and alone. Silence reigned everywhere except the occasional thrashing of waves which disturbed the acoustic equilibrium. Night it was, the sky filled with a million lanterns, the birds dozing off quietly and the sea like an old pirate sang a silent shanty. Oh! He missed his youth, when he could swim to the Black Rock without drowning, when he could shout at the vast ocean, his resonant voice fading upon the edges of horizon. But all good things come to an end, the voice that once resonated; now a husky whisper. The man who was the fastest swimmer; now an ancient remainder of time and its echoes. The doctors said he had terminal cancer that he would die in a week. He didn’t fear death, he had no family, nothing to lose except maybe the sight when someone would break his 50 years old record. The silence of the calm sea nurtured in him a desire to swim to the Black Rock once again, one last time. He …

Online Medical Education in Pakistan: Experience in Blended learning.

By Danish Bhatti MBBS, MD. 

Teachers Need Real Feedback.
Most teachers love to teach but how do we tell them where are they doing a good job and
where they can improve.
And how do you know when the learning has occurred?

For proper learning student it is important to understand what is learning and how is he learning. The burden of learning is traditionally been on the student and the teachers considered it students fault if they are lagging behind.

If we teach today’s students as if we taught yesterday, we rob them of tomorrow – John Dewey (Philosopher, Educator)

Clearly the traditional seminar-style teaching has worked in the past and continues to work. Current suggestions are not intended to challenge traditional teaching but only to build up on them. What we are trying to understand what makes a great teacher, a great teacher and what makes a good student, a really good student. What we are trying to say is that every teacher can be a great teacher and every student can be a really good student. Why should learning be a challenge. And that's where the online teaching tools come into play. However adopting new methods of teaching is not easy and requires a paradigm shift. It is not easy even in the developed countries where education has been evolving constantly over the last two three decades. At a survey in University of Nebraska Medical Center 74% of the faculty are not comfortable In using technology at campus. And this number has not changed in last 15 years.

Learning is not DONE to students.
Learning is a PROCESS.
The Person who does the WORK does the learning.

If we look at standard checklist for new teaching methods such as flip learning there is little if any stress on the technology to use for such methods rather its on a culture change. Such as flexibility where teacher continually observe and monitor student to make adjustments as appropriate and provide students different ways to learn content rather than one single approach. Similarly there is focus on giving Stern opportunities for activities or engagement and providing self-paced learning, curating and creating relevant content for the student to use on their own, interacting with students regularly understand their grasp of knowledge that is formative assessment. (

Current education research highlights the following 7 evidence-based principles of student center learning:
1. Students’ prior knowledge can help or hinder learning.
2. How students organize, knowledge influences how they apply knowledge.
3. Students Motivation determines what they do to learn.
4. To develop mastery, students must acquire component skills, practice integrating the and know when they can apply what they have learned. Mastery= skills + Practice + Application
5. Goal-directed practice coupled with targeted feedback enhances quality of student learning. Learning Goal, students need to know the specific learning goal (objective).
6. Students current level of development interacts with climate of the course to impact learning.
7. To become self-directed learners’ students must learn to monitor and adjust their approaches to learning.


To explore the benefit of using complement of online education for residents training we developed a short five week course on movement disorder in form of Blended learning. Residents were scheduled to receive once a week educational movement disorders for 5 weeks in traditional didactics Is a single 12 hour lecture once a week. We developed an online course to compliment that we clear that you're using our learning management system platform of
CANVAS. A learning management system (LMS) is an online platform that offers various tools to provide education using above mentioned principles. A LMS provides the flexibility of self paced learning and benefits of formative assessments to guide the learning in an interactive way. It provides the flexibility of various learning approaches to the same group. It offers detailed insight into student performance and reports their involvement and activity.

Neurology residents participated in a 5-week blended learning course including traditional face-to-face weekly lecture and online materials using Canvas learning management system. Coursework included weekly modules with required and optional reading material, task assignments (such as mind map, memory matrix), formative quizzes, discussion forums, twitter feeds and podcast. Course performance was evaluated with blinded pre-test and post-test questionnaire. Of 16 residents 15 completed pre-test and 11 completed post-test for evaluation.

There were 5777 online page views over 5 weeks (mean 385/resident, range 32-1319). Residents made 167 submissions with timely submission rate of 55% (CI 37-73, range 0-100%), completed 5 weekly quizzes with average score of 65.9% overall as a group (range 58.9-71.3%). There were 86 responses posted within 12 discussion topics.

Eleven residents completed post-test with 100% showing an improvement on the score (average 23.8% CI 20.4-27.2, range 10-46%). Pre-test score average was 41% (n=15, range 2-72%) and post-test score average was 72.7% (n=11, range 48-86%). Combined Score for all assessments (total 410) for all 15 residents was 35.8% on average (mean 147, CI 113-180, range 1.2-80.8%) showing large spread of results due to variable participation. Improvement on post-test scores (n=11) show a correlation with timely assignment submission (coefficient 0.52, CI 0.6 to -0.11), weekly quiz scores (coefficient 0.5, CI 0.6 to -0.14) and number of page views (coefficient 0.48, CI 0.6 to -0.16).

Blended learning is a feasible and effective for training neurology residents. Online tracking allows formative assessment and detailed performance analysis. Factors influencing resident participation and adoption require further study.


To explore the feasibility of online teaching tool especially for distance learning we designed and completed 6 months online course on movement disorders for neurologist.

There are no Fellowship trained movement disorders neurologist in Pakistan and a gap exist for better trained General neurologist in movement disorders such as Parkinson's disease, tremor and dystonia etc. The course was conducted in partnership with Pakistan Society of Neurology and movement disorders Society of Pakistan. We selected 20 participants out of 39 applicants for this pilot project. 7/20 participants were in their residency training while 13 were practicing neurologists with average duration since graduation of 1.35 years. The participants were selected from 8 cities end 14 institutions.

The online course was built in a learning management system namely Moodle and hosted  on a free Cloud Server. The six-month course was divided into 12 modules with each module lasting for 2 weeks and each model discussing specific topic. Each module with a specific structure that included an introduction, recorded video lectures with PowerPoint slides, required reading materials and optional reading materials, quiz and task assignment. we also included a podcast in each module.

Patient cases were discussed routinely and every module participants submitted assessments and plan for a real case for grading. Whatsapp was used as the primary platform for discussion. Participants also submitted summary of the reading material for grading. Each module they were given an assignment to complete that varied in each module such as Concept map, memory matrix etc.

18/20 participants completed the online course (90% retention rate). A total of 9098 page views were recorded online excluding quizzes (each question requiring a page view by each participant) and 5714 page views were required for all the quizzes (including pre and post test) or an average of 285 questions for each participant throughout the course. And average page view of 455 per participant over 24 weeks.

WhatsApp remained the dominant medium of discussion and communication in the group. Total number of messages sent are text 1186, photos 23, Videos 64, voice messages 28 and 31 documents. A total of 41 assignments and quizzes were conducted throughout the course including both required and optional assignment (excluding pre and post test). Participants completed on average 32/33 required assignments (97%, range 29-33) and 4.6/9 optional assignments (51%, range 1-9).

Overall average improvement of 31% total (range 2%-54%) is noted for the group or 162% over original score on average (range 8%-360%). Pre-test score average is 43% (range 26%-58%) and post test score is74% (range 50%-88%). 14/18 people have more than 25% total improvement.

A strong 71% correlation was found in the total score in the course and the number of optional assignments completed. Similarly, a significant positive correlation was found (30%) between number of optional assignments completed and improvement in the post-test score which is even more significant as there was no correlation between the actual post test score and optional assignments. A negative correlation was found between pre-test score and the optional assignments completed of -31%. A weaker but positive correlation of 14% was also found between total course score and the post test improvement.

 “If you do not change directions, you may end up where you are heading”. _Lao Tzu

Some more discussion on the education and teaching transformation can be seen here.

About the author:

I am a Movement Disorder neurologist interested in innovative medical education and use of technology in education and clinical care of my patients. My primary interest is in Parkinson Disease and am currently involved in online courses in Movement Disorders and Research with Parkinson Study Group in Neuro-protection. My hobby is biosensors and smartphone applications for diagnosis.


Here's more you should read...

USMLE Step 1 Experience by Ayaz Mehmood (Score : 99/266)

USMLE Step 1 Experience by Ayaz Mehmood (Score : 99/266)
Salam everyone, let me start in the name of Allah who’s the greatest benefactor of all mankind. I am going to write a detailed composition regarding preparation for USMLE Step 1. I am a final year student at King Edward Medical University and I took my exam on June 10th. Final year is the year before internship/ house job in Pakistan. I just got my scores: 99/266

Let me introduce some myths surrounding USMLE Step 1 which are especially prevalent within Pakistan; I am not too sure about India because I heard their students typically appear in their final years.

 Myth number 1:Do not appear for USMLE Step 1 within your graduation

 Verdict: Baseless, illogical reasoning

Explanation: This is so prevalent in Pakistan it’s almost pathetic. One of the biggest concerns surrounding our students is that Step 1 is a huge risk to be taken before graduation. Let me put it in another way: Step1 would always remain a risk whenever it is taken, …

Australian Medical Council AMC Part 1 Guide - Experience and Tips

AMC Part 1 by Dr. Asad Khizar Malik (Rank : 77/620) Australian Medical Council  Guide - Experience and Tips
Salam people, let me start in the name of Allah who’s the greatest benefactor of all mankind. Hope everyone is doing great. I'll try to write as much as I can for the people who are due to various reasons more interested in joining Australian Hospitals for post-grad training as compared to the USMLE pathway.

I am a graduate of King Edward Medical University, class of 2004-2010. I did my 6 months house job after graduation in Mayo Hospital, and after that, i gave my AMC Part 1 in November, 2010 from Brisbane. With the grace of Allah, I passed that in first attempt.


First thing in mind that comes with post grad training in Pakistani doctors minds is: Which way to go after graduation? That is a very tough decision that is …

FSc Premedical Guide - How to fly high..

FSc Premedical Guide - How to fly high.. Unsa Athar Your 40% needs to be excellent to get into KEMU or  some other good place.
(Dedicated to my teachers who not only taught me the fsc books but also many priceless lessons of life)
(Unsa Athar)
The tree that never had to fight For sun and sky and air and light, But stood out in the open rain And always got its share and rain, Never became a forest king, But lived and died a scrubby thing… Good timber does not grow with ease, The stronger wind, the stronger trees.
Getting yourself educated in the desi manner i.e. through the Board of Intermediate and Secondary Education is one of the top most challenges of today’s society. Matriculation seems difficult at that time, but when you enter FSc, you realize that matric was the easiest job in the world.  Those obese books of intermediate part I and part II are the worst enemies one can ever have.  People say Medical is tougher, but I find one basic difference in both. When you enter a medical college, y…


Anatomy/Histology Gallery
Read the instructions here 1st Year

Histology Slides for Professional Exams
Folder 1- Labelled Folder 2 - Labelled Folder 3 - Labelled
Histology Revision Slides Updated (2011)
by Laiba Khalid
Lower Limb Anatomy Spotting Labelled

Embryology Models Some models are labelled and others mentioned in comments

Anatomy Museum Models (unlabelled) This album covers Upper limb, Lower limb and Thorax regions of anatomy

2nd Year
HISTOLOGY Diagrams Hand-drawn CARDS 2ND YEAR MBBSThese are hand-drawn histology diagrams by Demonstrator Dr. Shaista (Dept of Anatomy, KEMU) and submitted by Anosha.NEUROLOGY/ Neuroantomy SPOTTING  (LABELLED SPECIMEN) 2ND YEAR  Each structure is labelled and a great job done by Anosha. Neuroanatomy / Brain 2nd Year Important topics by LaibaNeuroanatomy Models Labelled  Gross models labelled by Maryam Shahid Abdomen & Pelvis Anatomy Spots Labelled Excellent job by Maryam Shahid
Anatomy Learni…

USMLE Step 2 CK experience by Rizwan Khan (254)


     I recently got done with Step 2 CK exam & I want to elaborate my experience and the mistakes that I made during my prep so that any of my colleagues who are preparing for this exam might benefit from them. I wont go much in detail about how to prepare and where to prepare from since it is already highly debated on the forum and in the previous posts but would focus more on my personal experience and the bad choices which I made during the preparation phase.
SELF-ASSESSMENTS AND QBANKS Uworld 74% Kaplan Qbank 69%
Kaplan diagnostics  = 80% (70 days before exam) Kaplan Simulation Exam 1 = 71% (50 days before exam) Kaplan Simulation Exam 2 = 76%  (40 days before exam) Fred simulation for CK = 84% (39 days before exam) NBME 2 (offline) 21 mistakes (30 days before exam)
NBME 4  =    263 (13 days before exam) UWSA =  259 (2 days before exam)
Real exam = 254