Department of Forensic Medicine

At the end of the course of instruction, the learner should be able to:

• Knowledge

1. • Have the knowledge of common medico-legal cases in Myanmar, and the principles of management of such cases
   • Correlate between the clinical manifestations and the autopsy findings.

• Skill

1. • Serve as a competent medical witness in the law courts.

• Attitude

1. • Have the knowledge and attitude to abide by the moral and legal codes of the ethical medical practice.
   • Have the awareness that it is one of the duties of a medical officer to assist law enforcement agencies and thereby help in the management of medico-legal problems of the community.
   • Be aware of the importance of consultation / referral to Specialist whenever necessary.

INTRODUCTION TO FORENSIC MEDICINE

At the end of the course of instruction, the student should be able to:

1. Define Forensic Medicine.
2. State the various branches of Forensic Medicine.
3. State the laws and regulations, which are relevant to Forensic Medicine.
4. Describe the role of Forensic Medicine in criminal investigation and in the law courts

LAW COURTS AND CRIMINAL PROCEDURE

At the end of the course of instruction, the student should be able to:

1. List the principles of administration of justice in the Legal System of Myanmar.
2. Outline the constitution of the law courts in Myanmar and their judicial power, especially the township and district law courts.
3. Describe how a criminal case is brought before a law court.
4. Describe the types of witness, examination of a witness, conduct of a medical witness, professional secrecy and privileged communication.
5. Have the knowledge that it is one of the duties of a medical officer to attend a court of law as an expert witness when a summons has been served.
6. Define evidence (legal proof) and describe the different types of evidence including dying declaration and deposition.
7. Describe the essential features of a medico-legal report and be able to write a report on common medico-legal cases in Crime 38 / Police 75 form and comprehend the impact of the medico-legal report and medico-legal opinion on the administration of justice.
8. Appreciate the importance of the Police case register.
9. State the aims and types of punishment.
10. Describe the procedure for issuing a death / burial certificate

PERSONAL IDENTIFICATION

At the end of the course of instruction, the student should be able to:

1. Define personal identification
2. Explain the purpose of personal identification.
3. State the identifying features (Basic and absolute characteristics) in the living and the dead                             
4. Distinguish the sex of the pelvic bone and the skull bone.
5. State the medico-legal importance of age.
6. Determine the age of a person:

(a) in the intra-uterine period

(b) in the pubertal age period

(c) from skeletal remains.

(d) from dental eruption of the milk and permanent teeth. 

7. Describe the absolute characteristics: – fingerprints, dental data, tattoo marks, clothing, scars, personal belongings, deformities, and moles.
8. Determine the stature of a person from human skeletal remains
9. Describe the procedure for investigation of fragmentary remains.
10. Describe the procedure for exhumation, discuss the possible practical problems that could be encountered, and the medico-legal management of such an investigation.

MEDICO-LEGAL ASPECTS OF DEATH

At the end of the course of instruction, the student should be able to: 

1. Define death
2. Diagnose death in a person who has just died
3. Describe the changes in the body after death in order to determine time since death, and discuss their significance.
4. Describe the process of decomposition, the modified forms of decomposition and discuss its medico-legal importance.
5. Discuss the factors, which are helpful in estimation of time since death.

THE MEDICOLEGAL AUTOPSY

At the end of the course of instruction, the student should be able to: 

1. State the types of autopsy.
2. State the objectives of autopsy.
3. Describe the preliminaries to an autopsy.
4. Outline the techniques of autopsy. (External and internal examination) {in particularly, head and neck dissection}
5. Write a medico-legal autopsy report systematically.
6. List the types of death in which forensic autopsy should be done.

ASPHYXIA

At the end of the course of instructions the student should be able to: 

1. Define anoxia and asphyxia.
2. Describe the 4 main types of anoxia.
3. List the general non-specific pathological changes in death from anoxia and describe in detail about petechial haemorrhages
4. Drowning /Submersion

• • Describe seawater and fresh water drowning.
  • Describe the post-mortem features of fresh water drowning.
  • Outline the laboratory diagnosis of drowning.
  • Explain the mode of death in drowning.
  • Discuss the possible practical problems that could be encountered in investigating a dead body retrieved from water, and describe the medico-legal management (death investigation) of such a case.

5. Hanging

• • Describe the typical ligature mark in hanging.
  • Explain the mode of death in hanging.
  • Describe the common post-mortem features of a typical case of suicidal hanging.
  • Outline the procedure for investigation at the scene of hanging.
  • Describe the possible problems that could be encountered in investigating a case of hanging and outline the death investigation of such a case.
  • Describe about sexual asphyxias.

6. Strangulation

• • Define ligature strangulation.
  • Describe the ligature mark in ligature strangulation.
  • Differentiate between hanging and strangulation by examination of the ligature mark and the whole body.
  • Define manual strangulation (throttling)
  • Describe the specific external and internal postmortem features.
  • Explain the mode of death in strangulation.

7. Suffocation

• • Define and describe the various types of suffocation.
  • Describe the post-mortem features of various types of suffocation.

MEDICO-LEGAL ASPECT OF WOUNDS

At the end of the course of instruction, the student should be able to:-

1. State and explain the following sections of the Myanmar Penal Code, which are relevant to wounds:

      Section.    319    – Hurt

      Section.    320    – Grievous hurt

      Section.    323    – Causing hurt

      Section.    324    – Causing hurt by dangerous weapon

      Section.    325    – Causing Grievous hurt

      Section.    326    – Causing Grievous hurt by dangerous weapon

      Section.    299    – Culpable homicide

      Section.    300    – Murder

      Section.    304(A)- Causing Death by Rash and Negligence

      Section.    309    – Attempt to commit suicide

2. Explain the meaning of men rea and actus reus in criminal offences.
3. Explain the meaning of ‘ intention to kill’ in relation to homicide
4. Outline the medico-legal purpose of examination of wounds.
5. Describe a wound systematically for medico-legal purposes.
6. Define the various types of wounds; describe how they are caused and their medico-legal significances.
7. State and explain the medico-legal opinions regarding:

• • Simple or grievous hurt.
  • Cause of death.
  • The four categories of severity of bodily injury resulting in death and give (2) examples of each category.
  • The weapon used.
  • Position of the victim and assailant.
  • Amount of force used.
  • Volitional power.
  • Ante-mortem or post-mortem wound.
  • Age of the wound.
  • Whether the wound was accidental, suicidal or homicidal.

8. Describe defence wounds and feigned wounds.
9. Describe the mode of death, cause of death and manner of death.
10. Describe briefly the relationship between trauma and disease.

ACCIDENT /SUICIDE /HOMICIDE

At the end of the course of instruction, the student should be able to:

1. Describe the factors, which are useful in differentiating between accident, suicide and homicide.

FIRE-ARM WOUNDS

At the end of the course of instruction, the student should be able to:

1. State the purpose of examination of firearm wounds.
2. Outline the basic principle of ballistics.
3. Draw and label the vertical sections of rifled gun and shotgun cartridges.
4. Distinguish an entrance wound from an exit wound.
5. Describe the appearance of entrance wound at various ranges by a rifled firearm and shotgun.
6. Determine the direction of gunfire.
7. Describe the characteristic features of suicide by firearm.
8. Outline the method of identification of the firearm used by examination of the bullet.
9. Outline the tests used for gunpowder detection.
10. Outline the method of collection and preservation of firearm evidences.
11. Describe the causes, classification, postmortem features and medico-legal importance of explosive injuries

BURNS

At the end of the course of instruction, the student should be able to:

1. State the purpose of investigation of death from burns.
2. List the types of burns from different physical agents.
3. Distinguish ante-mortem and postmortem burns.
4. Describe the different degrees of burns.
5. Assess the total body surface area of burns.
6. State the possible causes of death in a burning building.
7. Describe spurious wounds in burns.

HYPER AND HYPOTHERMIA

At the end of the course of instruction, the student should be able to:

1. Describe the medico-legal importance of hyperthermia and hypothermia.
2. Describe the classification of them.
3. Describe the postmortem features of hyperthermia and hypothermia.

ELECTROCUTION

At the end of the course of instruction, the student should be able to:

1. State the medico-legal aspect of death from electrocution.
2. Describe briefly the factors influencing the outcome of an electrical shock.
3. Describe the post-mortem features of death from electrocution especially the electrical lesions on the skin.
4. Describe the causes of death from electrocution.

LIGHTNING

At the end of the course of instruction, the student should be able to:

1. State the medico-legal aspect of death from lightning.
2. State the cause of death and effect of lightning.
3. Describe the post-mortem features of death from lightning.

VEHICULAR INJURIES (RTA)

At the end the course of instruction, the student should be able to:

1. State the purpose of medico-legal investigation of injuries and death caused by motorvehicle accident.

2. Describe the injuries sustained in various forms of motor vehicle accident.
3. State and explain the law on “Causing death by Rash and Negligence”.
4. Describe the injuries and other evidences which would be helpful in identification of the hit-and-run car.
5. State and explain the opinions regarding ; –

• • whether death was due to car accident.
  • The cause of death
  • amount of speed/ force involved.
  • reconstruction of the accident.
  • Presence of disability in the victim.

REGIONAL INJURIES

At the end of the course of instruction, the student should be able to:

Head

1. Describe the different types of injuries to head resulting from assault with blunt weapon, sharp weapon
2. Describe the different types of intra-cranial haemorrhage resulting from trauma to the head
3. Coup and contre-coup head injury
4. Describe the types of skull fractures and their medico-legal significance.
5. Mention briefly about cerebral injuries.

Face

1. Describe the injuries to the face, which will amount to grievous hurt.
2. Describe the possible dangers to life as a result of injuries to the face.

Neck

1. Describe the possible dangers to life after receiving injuries on the neck
2. Mention briefly about injury to the spine.

Thorax

1. Describe the possible dangers to life resulting after injury to the thorax.
2. State and explain the medico-legal opinions regarding the survival period and volitional power resulting from stab wound of heart and large vessels and the lungs.

Abdomen

1. Describe the possible dangers to life resulting from injury to the abdomen.

Extremities

1. Describe the possible dangers to life resulting from injury to the extremities.

External genitalia

1. Describe the possible dangers to life resulting from injuries to the penis and scrotum.
2. Describe the injury to the penis or testes, which could lead to impotence.

Fall from height

1. Describe the medicolegal importance and postmortem feature of a death because of fall from height.

Non-accidental injury in children

1. Describe briefly the causes and pattern of non-accidental injury in children.

INVESTIGATION OF THE SCENE OF CRIME

At the end of the course of instruction, the student should be able to:

1. State the purpose of investigation of the scene of crime.
2. State the attitude that the investigating doctor should have at the scene.
3. List the equipments necessary for the investigation.
4. Outline the general procedure for investigation at the scene of crime and the special procedures especially in cases of hanging, murder by wounding and suspicious deaths.
5. Describe Locard’s principle on theory of material interchange.

SUDDEN AND UNEXPECTED NATURAL DEATH

At the end of the course of instruction, the student should be able to: 

1. State the purpose of investigation of sudden and unexpected deaths.
2. Define sudden and unexpected death.
3. List the classification of sudden and unexpected deaths.
4. Describe the clinical features of common causes of sudden death due to natural diseases and the gross pathological findings in such cases.
5. List the conditions that could cause sudden cardiac inhibition.

INSANITY AND ITS MEDICO-LEGAL ASPECTS

At the end of the course of instruction, the student should be able to:

1. Explain what insanity means.
2. Define and explain MPC Section 84.
3. Describe the criminal and civil responsibilities of the insane person.
4. Describe and describe the various manifestations of insanity and their medico-legal significance.
5. Distinguish between true insanity, feigned insanity and an insane murderer.
6. Classify the types of insanity related to criminal cases.
7. Outline the procedures by which an insane person is admitted into a psychiatric hospital.

SEXUAL OFFENCES

RAPE

At the end of course of instruction, the student should be able to:

1. Define and explain the laws on rape (MPC Section 375 and 376)
2. Describe the medicolegal examination of the victim and the accused in a case of alleged rape
3. State and explain the medicolegal opinions in cases of sexual offences.

UNNATURAL SEXUAL OFFENCES AND BEHAVIOURS

At the end of course of instruction, the student should be able to:

1. State the law on unnatural sexual offences (MPC section 377).
2. State and describe the various types of unnatural sexual offences.

SODOMY

1. Define sodomy.
2. Describe the medicolegal examination and medicolegal opinion.

BESTIALITY

1. Define bestiality.
2. Discuss briefly about bestiality including incriminating evidences.

UNNATURAL SEXUAL BEHAVIOURS

1. Describe the various types of unnatural sexual behaviors and their medicolegal significance

INFANTICIDE

At the end of course of instruction, the student should be able to:

1. Define infanticide, viable child, live birth, stillbirth, and dead born child.
2. Describe the features of a viable child, live-birth, stillbirth, macerated fetus and full-term fetus.
3. Describe the common methods of infanticide.
4. Determine the intra-uterine age of a fetus especially viable age.
5. Outline the medicolegal investigation of a case of alleged infanticide

CRIMINAL ABORTION

At the end of course of instruction, the student should be able to: –

1. State and explain the laws on criminal abortion
2. State the three main types of abortion
3. Describe the methods and dangers of criminal abortion
4. Describe the features of a woman who had recently delivered or aborted.
5. Discuss the medicolegal duties and ethical aspects of a doctor who had to treat a case of criminal abortion.

STERILIZATION LAWS

At the end of course of instruction, the student be able to:

1. Define and explain the laws on sterilization.
2. Describe the procedure to be followed for a legal sterilization.

MEDICO-LEGAL ASPECTS OF SEXUAL FUNCTION

IMPOTENCY, STERILITY AND MARRIAGE

At the end of the course of instruction, the student should be able to:

1. Define impotency, sterility and marriage.
2. State the causes of impotency and sterility.
3. Discuss the medico-legal aspects of impotency, sterility and marriage.                                                                          

PREGNANCY

At the end of the course of instruction, the students should be able to:

1. State the medicolegal aspects of pregnancy.
2. Describe the features of pregnancy in a living person and in a dead woman
3. Discuss the legal aspects of the period of gestation
4. Discuss the features of recent delivery in the living and the dead.

 

MEDICAL ETHICS

At the end of course of instruction, the student should be able to:

1. State and explain the aims of the medical profession.
2. State the Hippocratic Oath.
3. Describe the Declaration of Geneva (both in English and Myanmar).
4. State the International Code of Medical Ethics.
5. State the constitution of the Myanmar Medical Council and summarize its functions.
6. State the requirements needed to be a registered / licensed medical practitioner.
7. Define “Serious professional misconduct” (Infamous conduct) and describe the main types commonly committed by medical practitioners in Myanmar.
8. State the conditions where a medical practitioner can be de-registered or de-licensed.
9. The Law Relating to Private Health Care Services
10. Summarize the guidelines of “Good medical practice”. (UK and Myanmar)
11. Discuss “Professionalism”.
12. State the Rights of patient.

 

MEDICAL NEGLIGENCE

At the end of course of instruction, the student should be able to:

1. Define and explain medical negligence.
2. Describe the terms:

• • res ipsaloquitor
  • respondeat superior
  • contributory negligence

3. Describe the common causes for medical negligence actions.
4. Distinguish between civil and criminal negligence.
5. Describe how a doctor should defend himself against a charge of medical negligence.

PRINCIPLES AND GUIDELINES IN THE MANAGEMENT OF ML CASES IN MYANMAR

At the end of course of instruction, the student should be able to:

1. State the common medicolegal problems encountered by Township medical officers in Myanmar.
2. Describe the guidelines and management that should be followed in such cases.

FAMILY MEDICINE

At the end of course of instruction, the student should be able to:

1. Describe the Rights of patient.
2. Discuss about Professional secrecy and describe the conditions where Professional secrecy may be waived.
3. Discuss about ethical dilemmas and describe the four basic ethical principles
4. Case scenarios

TOXICOLOGY

At the end of course of instruction, the student should be able to:

1. State the various definitions of poison.
2. Name the laws relating to poisons.
3. Summarize the important sections related to the medical profession, contained in the 1993 Narcotics and Psychotropic Substances Law.
4. List ten poisons commonly encountered in Myanmar
5. Describe the action of common poisons in Myanmar, diagnosis of such poisons, detection of poisons, collection, labelling, dispatch and preservation of materials for chemical analysis.
6. List the characters of a good homicidal poison.
7. List the circumstances, which influence the action of poisons.
8. State the features of poisoning simulating the diseases.
9. Describe the duty of a medical practitioner in a case of suspected poisoning
10. Describe the sources, characters, properties, sign and symptoms, nature of fatal result and outline the remedial measure of the following poison:

(a) Corrosive poisons        : Sulphuric acid, Hydrochloric acid, Nitric acid, Oxalic acid and strong alkalies

(b) Irrespirable gases        : Carbon monoxide

(c) Insecticides                  : Organo-phosphates, rodenticide, strychnine, Paraquet

(d) Neurotic poisons         : Narcotics and psychotropic substances;especially Narcotics, Amphetamines, Cocaine, Cannabis, Tranquilizers, Paracetamol

(e) Animal poisons            : Poisonous snakes

(f) Miscellaneous              : Alcohol, Methanol

                                            Cyanide

                                            Food poisoning

11. Describe briefly the general management of poisoning.