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MD · General Medicine

General Medicine thesis topics, with the design and feasibility for each

Almost every general medicine thesis is built from the medical OPD, the ward admission register and the medical ICU, so the data walks through the door on its own and the real constraint is the proforma rather than the caseload. The usual difficulty is the opposite of scarcity: a unit that admits everything will enrol a mixed population unless the inclusion criteria are tight, and the commonest correction at synopsis stage is narrowing the question to one disease at one stage. Examiners in general medicine press hardest on how the diagnosis was defined, whether the comparison group was assembled the same way as the cases, and whether the primary outcome was fixed before the first patient was enrolled.

Topic register · 45 entries · 7 designs[6]

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  • NMC PGMER-2023
  • NBEMS 180 days / 26 months
  • UGC 2018 · under 10%
  • ICMR 2017 · ethics

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The General Medicine register

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Filter by design or by feasibility, or search the titles and outcomes. Filtering only hides entries: every topic stays on the page, so nothing is lost if you clear the filters or arrive by a deep link.

Feasibility in a teaching unit

Showing 45 of 45 topics

The sample figure on each plate is a planning range read off the design, not a calculated answer. Your own number comes from a calculation against your own assumptions — the difference you would call clinically meaningful, the variability in your setting, the power you want — and it belongs in the synopsis with those assumptions written beside it.

  • Topic 01 / 45

    Link to this entry

    Glycaemic control and lipid fractions in newly detected type 2 diabetes mellitus

    DesignCross-sectionalFeasibilityStraightforward
    Primary outcome
    Correlation coefficient between HbA1c and each lipid fraction, with fractions also compared across HbA1c strata
    Collection time
    9 to 12 months of OPD enrolment
    Sample, as a planning figure
    roughly 150–250 patients for a correlation, subject to a proper calculation once you fix the coefficient you want to detect

    What your unit must already have

    • diabetes OPD with a steady flow of newly detected cases
    • in-house HbA1c run by a single method
    • fasting lipid profile on the hospital analyser

    What derails it

    Newly detected is the hard part: most patients reaching a teaching hospital OPD have already been started on something at a nursing home, and once you exclude prior oral hypoglycaemic or statin use the eligible flow drops sharply, so count genuinely drug-naive cases for a fortnight before you commit to a number.

  • Topic 02 / 45

    Link to this entry

    Screening for distal symmetrical polyneuropathy in type 2 diabetes using the Michigan Neuropathy Screening Instrument

    DesignCross-sectionalFeasibilityStraightforward
    Primary outcome
    Proportion with a positive MNSI examination score, and its relation to diabetes duration and HbA1c
    Collection time
    8 to 10 months
    Sample, as a planning figure
    about 200–300 for a prevalence estimate, to be fixed once you choose the precision you will accept

    What your unit must already have

    • diabetes follow-up clinic
    • 128 Hz tuning fork, 10 g monofilament and a tendon hammer
    • one examiner trained on the MNSI so scoring stays consistent

    What derails it

    If two residents share the monofilament examination the agreement drifts within weeks, so either one person examines every patient or you report a formal inter-observer agreement from a pilot of twenty.

  • Topic 03 / 45

    Link to this entry

    Urinary albumin-to-creatinine ratio and its relation to disease duration and blood pressure in type 2 diabetes

    DesignCross-sectionalFeasibilityStraightforward
    Primary outcome
    Proportion in each KDIGO albuminuria category, and the relation of category to diabetes duration
    Collection time
    9 months
    Sample, as a planning figure
    around 200–300 patients, subject to a prevalence sample size calculation

    What your unit must already have

    • biochemistry able to run urine albumin and creatinine on spot samples
    • a searchable diabetes OPD register
    • a repeat sample protocol for confirming albuminuria

    What derails it

    A single spot sample misclassifies patients because fever, exertion and urinary infection all raise albumin transiently, so build the confirmatory second sample into the protocol or your albuminuria group will not survive the viva.

  • Topic 04 / 45

    Link to this entry

    Precipitating factors and in-hospital course of diabetic ketoacidosis in adults

    DesignRetrospectiveFeasibilityStraightforward
    Primary outcome
    Distribution of documented precipitating factors, with in-hospital mortality and duration of insulin infusion
    Collection time
    3 to 4 months of record retrieval across a three-year window
    Sample, as a planning figure
    80–150 admissions, depending on what three years of records actually hold

    What your unit must already have

    • medical records with retrievable discharge summaries and ICU charts
    • ethics committee waiver of consent for record review
    • an admission register searchable by diagnosis

    What derails it

    Precipitating factor is only as good as what was written on admission day, and infection is often recorded as an impression rather than a culture, so define in advance what documentation you will accept for each precipitant or unclassified will become your largest category.

  • Topic 05 / 45

    Link to this entry

    Hypoglycaemic episodes in elderly patients on sulfonylureas

    DesignProspective observationalFeasibilityModerate
    Primary outcome
    Incidence of symptomatic hypoglycaemia confirmed by capillary glucose below the study threshold over three months of follow-up
    Collection time
    12 months, with three months of follow-up per patient
    Sample, as a planning figure
    roughly 120–180 patients, pending a calculation against the event rate you assume

    What your unit must already have

    • geriatric or diabetes OPD seeing patients above sixty on sulfonylureas
    • glucometers and strips the patient will actually use at home
    • telephone follow-up with a symptom diary

    What derails it

    Elderly patients frequently cannot do a capillary glucose at the moment of symptoms, so unless you supply strips and teach a household attendant you will end up counting reported giddiness rather than documented hypoglycaemia.

  • Topic 06 / 45

    Link to this entry

    Thyroid function abnormalities in patients with type 2 diabetes mellitus attending a medical OPD

    DesignCross-sectionalFeasibilityStraightforward
    Primary outcome
    Proportion with subclinical hypothyroidism, overt hypothyroidism and thyrotoxicosis on TSH with reflex free T4
    Collection time
    8 to 10 months
    Sample, as a planning figure
    around 250–350 for a prevalence estimate, to be fixed by a formal calculation

    What your unit must already have

    • TSH and free T4 in house or through a fixed outsourcing arrangement
    • diabetes OPD attendance register
    • a protocol for repeating an abnormal TSH before labelling it

    What derails it

    A TSH drawn during acute illness or soon after a steroid course misclassifies patients, so exclude anyone admitted in the preceding six weeks and insist on the confirmatory repeat, or the subclinical group will be contaminated.

  • Topic 07 / 45

    Link to this entry

    Lipid profile in subclinical hypothyroidism compared with euthyroid controls

    DesignCase-controlFeasibilityModerate
    Primary outcome
    Difference in mean LDL cholesterol and triglycerides between subclinical hypothyroid cases and euthyroid controls matched for age, sex and body mass index
    Collection time
    12 months
    Sample, as a planning figure
    roughly 60–90 per group, subject to a proper calculation using a standard deviation taken from a comparable setting

    What your unit must already have

    • TSH, free T4 and fasting lipid profile in house
    • a control recruitment route that is not the lipid clinic
    • anthropometry on one weighing scale and stadiometer

    What derails it

    Control selection is where this gets attacked: pulling controls from relatives accompanying dyslipidaemia patients imports the very exposure you are measuring, so recruit from an unrelated clinic and match on body mass index, not only age and sex.

  • Topic 08 / 45

    Link to this entry

    Electrocardiographic criteria for left ventricular hypertrophy in hypertension, against echocardiography as the reference standard

    DesignDiagnostic accuracyFeasibilityModerate
    Primary outcome
    Sensitivity, specificity and predictive values of Sokolow-Lyon and Cornell voltage criteria against echocardiographic left ventricular mass index
    Collection time
    10 to 12 months
    Sample, as a planning figure
    about 150–220 patients, driven by the expected sensitivity and the proportion hypertrophic on echo

    What your unit must already have

    • hypertension clinic with patients not previously echoed
    • echocardiography with a cardiologist or trained reporter
    • one ECG machine with calibration checked and recorded

    What derails it

    The echo reader must not see the ECG and the ECG reader must not see the echo, and in a small unit the same person usually does both, so arrange the blinding and the order of examinations before enrolment rather than explaining it away later.

  • Topic 09 / 45

    Link to this entry

    Agreement between clinic and home blood pressure measurement in patients attending a hypertension clinic

    DesignCross-sectionalFeasibilityModerate
    Primary outcome
    Proportion reclassified as white-coat or masked hypertension when a seven-day home reading schedule is set against the clinic reading
    Collection time
    10 to 12 months
    Sample, as a planning figure
    roughly 120–180 patients, subject to a calculation against the reclassification proportion you assume

    What your unit must already have

    • a pool of validated upper-arm oscillometric devices you can lend out
    • a printed home reading diary and a teaching session for each patient
    • clinic staff willing to take readings by a fixed protocol

    What derails it

    Home diaries come back with suspiciously round numbers and missing mornings, so read values from the device memory rather than the diary, or much of your data will be what the patient thought you wanted.

  • Topic 10 / 45

    Link to this entry

    Clinical profile of patients with apparent treatment-resistant hypertension in a medical OPD

    DesignCross-sectionalFeasibilityStraightforward
    Primary outcome
    Proportion of hypertensive attendees meeting the definition of apparent resistance, with their drug combinations and documented secondary causes
    Collection time
    10 months
    Sample, as a planning figure
    screen around 600–900 attendees to characterise the resistant group, refined once you fix the precision

    What your unit must already have

    • hypertension clinic with prescriptions retrievable per patient
    • adherence assessed by a structured questionnaire
    • basic secondary-cause workup including electrolytes and renal imaging

    What derails it

    Non-adherence masquerades as resistance and a single pill count will not separate them, so decide at protocol stage that you are reporting apparent resistance and say so in the title, rather than claiming true resistance you cannot demonstrate.

  • Topic 11 / 45

    Link to this entry

    Ambulatory blood pressure patterns in patients with chronic kidney disease not on dialysis

    DesignProspective observationalFeasibilityDemanding
    Primary outcome
    Proportion with a non-dipping nocturnal pattern on 24-hour ambulatory monitoring, by CKD stage
    Collection time
    14 to 18 months
    Sample, as a planning figure
    about 90–140 patients, subject to a calculation against the proportion you expect to be non-dippers

    What your unit must already have

    • at least two working ambulatory blood pressure monitors with cuffs in several sizes
    • a nephrology clinic with staged CKD patients
    • a technician who can fit and download the monitor reliably

    What derails it

    One monitor means one patient per twenty-four hours at best, and failed studies from cuff slippage or broken sleep routinely discard a fifth of recordings, so compute enrolment from machine-days rather than from clinic attendance.

  • Topic 12 / 45

    Link to this entry

    SOFA and APACHE II scores at admission as predictors of in-hospital mortality in a medical intensive care unit

    DesignProspective observationalFeasibilityModerate
    Primary outcome
    Discrimination for in-hospital mortality as area under the ROC curve for each score, with calibration
    Collection time
    12 months
    Sample, as a planning figure
    roughly 200–300 consecutive admissions so that enough deaths accrue, subject to a formal calculation

    What your unit must already have

    • medical ICU recording a complete set of first-24-hour variables
    • arterial blood gas and biochemistry available round the clock
    • a scoring sheet filled at a fixed time, not reconstructed later

    What derails it

    APACHE II needs the worst value in the first twenty-four hours for every variable, and night-shift gaps in arterial gases quietly force you to impute normal values, which flattens the score, so audit a week of charts for completeness before you fix which score you will use.

  • Topic 13 / 45

    Link to this entry

    Serum lactate clearance at six hours and outcome in septic shock

    DesignProspective observationalFeasibilityModerate
    Primary outcome
    In-hospital mortality compared between patients achieving and not achieving the pre-specified six-hour lactate clearance threshold
    Collection time
    12 to 15 months
    Sample, as a planning figure
    around 100–160 patients with septic shock, pending a calculation against the mortality difference you assume

    What your unit must already have

    • point-of-care or laboratory lactate at any hour with a quick turnaround
    • medical ICU admitting septic shock directly
    • a fixed resuscitation protocol so the six-hour mark means the same thing for everyone

    What derails it

    The six-hour sample is missed constantly because it falls during handover or a trip to radiology, and a missing second lactate makes the patient unanalysable, so nominate who draws it and enter the time in the nursing chart as a standing order.

  • Topic 14 / 45

    Link to this entry

    Blood culture yield and organism profile in adults admitted with acute undifferentiated fever

    DesignCross-sectionalFeasibilityStraightforward
    Primary outcome
    Proportion of admissions with a positive blood culture, with organisms isolated and their susceptibility pattern
    Collection time
    12 months to cover a full seasonal cycle
    Sample, as a planning figure
    roughly 300–450 consecutive admissions, since a low yield needs volume; refine with a proportion calculation

    What your unit must already have

    • microbiology with automated or manual blood culture and a documented turnaround
    • a fever admission register
    • a fixed volume and timing protocol for drawing cultures

    What derails it

    Most admitted fever patients have already taken an antibiotic from a local practitioner, which collapses the yield, so record prior antibiotic exposure as an explicit variable and report yield separately in those who took none.

  • Topic 15 / 45

    Link to this entry

    Clinical profile and complications of scrub typhus in adults admitted during the post-monsoon months

    DesignProspective observationalFeasibilityModerate
    Primary outcome
    Proportion developing a pre-defined complication, with time to defervescence after starting doxycycline
    Collection time
    12 months, with enrolment concentrated in the transmission season
    Sample, as a planning figure
    about 80–120 confirmed cases, which usually means planning around the seasonal peak; fix the figure with a proper calculation

    What your unit must already have

    • scrub typhus IgM ELISA in house or by a fixed referral
    • medical wards receiving fever admissions directly
    • a case definition agreed with microbiology before enrolment

    What derails it

    The season is short, so a study that starts enrolling in February sits idle for months before a single case arrives; work backwards from the local transmission months when you set the enrolment window.

  • Topic 16 / 45

    Link to this entry

    Warning signs at admission and subsequent need for fluid resuscitation in adults with dengue

    DesignProspective observationalFeasibilityModerate
    Primary outcome
    Proportion progressing to severe dengue as defined by WHO, in relation to the warning signs recorded at admission
    Collection time
    12 to 15 months, to capture two outbreak periods if needed
    Sample, as a planning figure
    roughly 150–250 confirmed admissions, subject to a calculation against the progression proportion you assume

    What your unit must already have

    • NS1 antigen and dengue IgM in house
    • daily haematocrit and platelet counts at fixed times
    • ward capacity to record fluid balance accurately

    What derails it

    Haematocrit decides the analysis and it is the variable most often drawn at varying hours or after a litre of fluid has run in, so fix the sampling times and record fluid given before each sample, otherwise the leakage assessment falls apart.

  • Topic 17 / 45

    Link to this entry

    Diagnostic performance of the Widal test against blood culture in adults with suspected enteric fever

    DesignDiagnostic accuracyFeasibilityModerate
    Primary outcome
    Sensitivity and specificity of a single Widal titre at the locally used cut-off, against blood culture as reference
    Collection time
    12 months
    Sample, as a planning figure
    about 200–300 suspected cases, driven by the expected sensitivity and the culture-positive proportion in your setting

    What your unit must already have

    • microbiology running both Widal and blood culture by documented methods
    • a standing case definition for suspected enteric fever
    • enough culture bottles for a full year of enrolment

    What derails it

    Blood culture is an imperfect reference in a population that takes antibiotics before admission, so either restrict enrolment to patients with no prior antibiotic or pre-specify a composite reference standard, and write the limitation into the protocol rather than discovering it at the viva.

  • Topic 18 / 45

    Link to this entry

    Anaemia and iron status in patients with chronic kidney disease not yet on dialysis

    DesignCross-sectionalFeasibilityModerate
    Primary outcome
    Proportion anaemic by WHO criteria, with the distribution of transferrin saturation and serum ferritin by CKD stage
    Collection time
    10 to 12 months
    Sample, as a planning figure
    around 150–220 patients, subject to a prevalence calculation stratified by stage

    What your unit must already have

    • nephrology or medicine OPD with staged CKD patients
    • serum iron, TIBC and ferritin in house
    • estimated GFR calculated by one agreed equation

    What derails it

    Ferritin rises with any inflammation and these patients often have an intercurrent infection or a recent access procedure, so measure CRP alongside and pre-specify how you will interpret an iron profile drawn in an inflamed patient.

  • Topic 19 / 45

    Link to this entry

    Early complications of vascular access in patients initiating maintenance haemodialysis

    DesignProspective observationalFeasibilityModerate
    Primary outcome
    Proportion with a catheter-related or fistula-related complication within ninety days of initiation, by access type
    Collection time
    15 to 18 months
    Sample, as a planning figure
    roughly 90–140 patients initiating dialysis, pending a calculation against the complication rate you assume

    What your unit must already have

    • a dialysis unit starting a predictable number of new patients each month
    • access to the team that creates the fistulae
    • a ninety-day follow-up route for patients who later dialyse elsewhere

    What derails it

    A good share of patients start dialysis with you and then shift to a cheaper centre near home, taking the ninety-day outcome with them, so secure telephone follow-up consent at enrolment or attrition will decide your result.

  • Topic 20 / 45

    Link to this entry

    Electrocardiographic changes in relation to measured serum potassium in patients with hyperkalaemia

    DesignCross-sectionalFeasibilityStraightforward
    Primary outcome
    Proportion with each pre-defined electrocardiographic abnormality across potassium strata, and the sensitivity of any ECG change for potassium above the severe threshold
    Collection time
    10 to 12 months
    Sample, as a planning figure
    about 120–180 hyperkalaemic episodes, subject to a calculation against the expected proportion showing changes

    What your unit must already have

    • biochemistry that flags a high potassium to the ward promptly
    • an ECG machine available in emergency and ward areas at all hours
    • a reporter blinded to the potassium value

    What derails it

    A haemolysed sample gives a falsely high potassium and haemolysis is common when blood is drawn through a small cannula, so require a confirmatory repeat from a fresh venepuncture before an episode enters the study.

  • Topic 21 / 45

    Link to this entry

    Acute kidney injury by KDIGO stage and its outcome in medical intensive care admissions

    DesignProspective observationalFeasibilityModerate
    Primary outcome
    Proportion progressing to a higher KDIGO stage or needing dialysis, with in-hospital mortality by peak stage
    Collection time
    12 months
    Sample, as a planning figure
    roughly 180–280 consecutive ICU admissions to accumulate enough staged cases, refined by calculation

    What your unit must already have

    • daily creatinine on every ICU patient as routine
    • hourly urine output charting that is genuinely done
    • an agreed baseline creatinine rule for patients with no prior value

    What derails it

    KDIGO needs a baseline creatinine and most emergency admissions have none, so write the baseline rule into the protocol, because choosing it after the fact shifts the staging of a large share of patients.

  • Topic 22 / 45

    Link to this entry

    Child-Turcotte-Pugh and MELD scores as predictors of three-month mortality in decompensated cirrhosis

    DesignProspective observationalFeasibilityModerate
    Primary outcome
    Discrimination for three-month mortality as area under the ROC curve for each score
    Collection time
    15 months including follow-up
    Sample, as a planning figure
    around 120–180 patients so that enough events accrue, subject to a formal calculation

    What your unit must already have

    • a ward admitting decompensated cirrhosis regularly
    • INR, bilirubin, albumin, creatinine and sodium available reliably
    • three-month telephone follow-up with consent taken at admission

    What derails it

    Three-month mortality here is ascertained by telephone and families often stop answering after a death, so take two numbers and a neighbour's contact at enrolment, otherwise the patients lost to follow-up will be precisely the ones who died.

  • Topic 23 / 45

    Link to this entry

    Lactulose with rifaximin compared with lactulose alone in overt hepatic encephalopathy

    DesignRandomised controlledFeasibilityDemanding
    Primary outcome
    Proportion with reversal of overt encephalopathy to West Haven grade 0 or 1 within the pre-specified period
    Collection time
    15 to 18 months
    Sample, as a planning figure
    roughly 45–70 per arm, subject to a proper calculation against the reversal proportion you assume

    What your unit must already have

    • a ward admitting overt encephalopathy at a predictable rate
    • ethics approval and Clinical Trials Registry of India registration before the first enrolment
    • a documented allocation procedure and a reliable study drug supply

    What derails it

    Consent must come from a relative because the patient is encephalopathic, and that relative is often simultaneously arranging money for the admission, so a quarter of otherwise eligible patients are lost at the consent step; budget enrolment for that.

  • Topic 24 / 45

    Link to this entry

    Glasgow-Blatchford score at admission and the need for intervention in upper gastrointestinal bleeding

    DesignProspective observationalFeasibilityModerate
    Primary outcome
    Proportion requiring transfusion, endoscopic haemostasis or surgery, in relation to the admission score
    Collection time
    12 to 15 months
    Sample, as a planning figure
    about 150–220 admissions, subject to a calculation against the intervention proportion you expect

    What your unit must already have

    • upper gastrointestinal endoscopy available within the usual window
    • blood bank records retrievable by patient
    • an admission proforma completed before endoscopy

    What derails it

    The score must be calculated from values taken before any transfusion, and in practice the first unit is often running before the resident sees the patient, so capture the first haemoglobin and urea in the emergency department and record the transfusion start time.

  • Topic 25 / 45

    Link to this entry

    Ultrasonographic fatty liver grade and metabolic syndrome components in adults attending a medical OPD

    DesignCross-sectionalFeasibilityStraightforward
    Primary outcome
    Distribution of ultrasound fatty liver grades and the number of metabolic syndrome components present by one stated definition
    Collection time
    9 to 12 months
    Sample, as a planning figure
    around 250–350 participants, to be fixed by a prevalence calculation

    What your unit must already have

    • ultrasound with a consistent reporter and a stated grading scheme
    • waist circumference, blood pressure, fasting glucose and lipids on every participant
    • an alcohol history taken with a structured question set

    What derails it

    Ultrasound grading of fatty liver is operator dependent and two radiologists will not grade the same liver alike, so use one reporter throughout or document inter-observer agreement on a pilot subset, and exclude alcohol intake by a stated threshold rather than by impression.

  • Topic 26 / 45

    Link to this entry

    Morphological classification of anaemia by peripheral smear compared with red cell indices in adult outpatients

    DesignCross-sectionalFeasibilityStraightforward
    Primary outcome
    Agreement between smear-based morphological category and index-based category, reported as a kappa statistic
    Collection time
    8 months
    Sample, as a planning figure
    roughly 200–300 anaemic patients, subject to a calculation for the agreement you wish to estimate

    What your unit must already have

    • a haematology analyser giving full red cell indices
    • a pathologist to report smears blinded to the indices
    • a fixed staining protocol so smear quality stays consistent

    What derails it

    Smears reported weeks later from a box of dried slides look different from fresh ones and the dimorphic category swells, so set a maximum interval from collection to reporting and keep the reporter unaware of the analyser output.

  • Topic 27 / 45

    Link to this entry

    Aetiological spectrum of pancytopenia in adults evaluated with bone marrow examination

    DesignCross-sectionalFeasibilityModerate
    Primary outcome
    Distribution of final aetiological diagnoses after marrow aspiration with or without trephine biopsy
    Collection time
    12 to 15 months
    Sample, as a planning figure
    about 90–140 patients with confirmed pancytopenia, refined by a proportion calculation

    What your unit must already have

    • a pathology department reporting marrow aspirates and biopsies routinely
    • the ability to aspirate marrow in the ward or day care
    • agreed diagnostic criteria for each aetiological category

    What derails it

    A dry tap or an inadequate aspirate happens most often in exactly the conditions you most want to identify, so plan trephine biopsy in the same sitting for every case or a stubborn fraction will sit in your results as inconclusive.

  • Topic 28 / 45

    Link to this entry

    Neurological manifestations in adults with megaloblastic anaemia and low serum vitamin B12

    DesignCross-sectionalFeasibilityModerate
    Primary outcome
    Proportion with each pre-defined neurological sign on a structured examination, in relation to the serum B12 value
    Collection time
    12 months
    Sample, as a planning figure
    roughly 80–120 patients, subject to a proportion calculation

    What your unit must already have

    • serum vitamin B12 assay in house or by a fixed referral
    • a structured neurological examination proforma with one examiner
    • nerve conduction study access if you intend to confirm neuropathy objectively

    What derails it

    Many of these patients are poorly nourished with coexisting folate deficiency and alcohol use, so record both explicitly, because an examiner will ask how you attributed the neuropathy to B12 rather than to everything else the patient has.

  • Topic 29 / 45

    Link to this entry

    Admission NIHSS score and functional outcome at ninety days in acute ischaemic stroke

    DesignCohortFeasibilityModerate
    Primary outcome
    Modified Rankin Scale at ninety days, dichotomised at the pre-specified cut-off, in relation to admission NIHSS
    Collection time
    15 to 18 months including follow-up
    Sample, as a planning figure
    around 120–180 patients after allowing for attrition, subject to a formal calculation

    What your unit must already have

    • CT or MRI to confirm infarct before enrolment
    • a resident certified in NIHSS scoring so the baseline is reliable
    • a ninety-day follow-up route by clinic visit or structured telephone interview

    What derails it

    Ninety-day follow-up in stroke loses the most disabled patients first because they cannot travel, so set up a structured telephone modified Rankin interview and check it against in-person scoring in your first twenty, or the outcome distribution will drift towards the ambulant.

  • Topic 30 / 45

    Link to this entry

    Aetiological evaluation of a first unprovoked seizure in adults

    DesignProspective observationalFeasibilityModerate
    Primary outcome
    Distribution of aetiologies identified after a pre-defined protocol of imaging, electroencephalography and metabolic screening
    Collection time
    12 to 15 months
    Sample, as a planning figure
    about 100–150 patients, refined by a proportion calculation

    What your unit must already have

    • CT or MRI for every enrolled patient
    • electroencephalography with a reporter
    • admission biochemistry including sodium, calcium and glucose

    What derails it

    Separating a first seizure from a first witnessed seizure rests entirely on the history, and patients routinely omit earlier nocturnal events, so use a structured symptom questionnaire with a household informant rather than accepting the admission note.

  • Topic 31 / 45

    Link to this entry

    Clinical profile and in-hospital outcome of tuberculous meningitis in adults

    DesignProspective observationalFeasibilityModerate
    Primary outcome
    In-hospital mortality and modified Rankin Scale at discharge, by British Medical Research Council stage at admission
    Collection time
    15 to 18 months
    Sample, as a planning figure
    roughly 60–100 patients, which in most units means planning for the full eighteen months; fix the figure with a proper calculation

    What your unit must already have

    • cerebrospinal fluid analysis including a nucleic acid amplification test for tuberculosis
    • neuroimaging for every patient
    • a case definition for definite, probable and possible disease agreed in advance

    What derails it

    Microbiological confirmation is achieved in only a fraction of cases, so the study stands or falls on how tightly you wrote the probable and possible categories, and those definitions belong in the synopsis rather than in the analysis.

  • Topic 32 / 45

    Link to this entry

    Disease activity by DAS28 and serum 25-hydroxyvitamin D in rheumatoid arthritis

    DesignCross-sectionalFeasibilityModerate
    Primary outcome
    Correlation between DAS28-ESR and serum 25-hydroxyvitamin D concentration
    Collection time
    10 to 12 months
    Sample, as a planning figure
    around 100–150 patients, subject to a calculation for the correlation you wish to detect

    What your unit must already have

    • a clinic following diagnosed rheumatoid arthritis
    • 25-hydroxyvitamin D assay through one fixed laboratory
    • one examiner doing every twenty-eight joint count

    What derails it

    Patients already taking vitamin D will blunt everything and many are on it from an old prescription they no longer mention, so ask about supplements by brand and dose and pre-specify whether supplemented patients are excluded or analysed separately.

  • Topic 33 / 45

    Link to this entry

    Clinical and laboratory profile of systemic lupus erythematosus with and without renal involvement

    DesignCross-sectionalFeasibilityDemanding
    Primary outcome
    Proportion with renal involvement by a stated definition, with SLEDAI-2K score compared between groups
    Collection time
    15 to 18 months
    Sample, as a planning figure
    about 60–100 patients, which usually needs a unit acting as a referral centre for connective tissue disease, and in any case subject to a proper calculation

    What your unit must already have

    • a lupus caseload large enough to accumulate numbers in eighteen months
    • antinuclear antibody, anti-dsDNA and complement assays
    • nephrology collaboration for biopsy-confirmed renal involvement

    What derails it

    Outside a referral centre the annual lupus caseload is far smaller than residents expect, so count the patients seen in your unit over the last two years before choosing this, and widen to connective tissue disease if the register is thin.

  • Topic 34 / 45

    Link to this entry

    Potentially inappropriate medication use among elderly medical inpatients assessed by the Beers criteria

    DesignCross-sectionalFeasibilityStraightforward
    Primary outcome
    Proportion of patients with at least one potentially inappropriate medication on the discharge prescription by the current Beers criteria
    Collection time
    8 to 10 months
    Sample, as a planning figure
    roughly 250–350 elderly admissions, to be fixed by a prevalence calculation

    What your unit must already have

    • discharge prescriptions retrievable for every elderly admission
    • the current Beers criteria list with a consistent application rule
    • a pharmacology colleague or clinical pharmacist to cross-check classification

    What derails it

    Two assessors classify the same prescription differently, especially for drugs inappropriate only in a named condition, so write a decision rule for every ambiguous class in advance and report agreement between two independent assessors.

  • Topic 35 / 45

    Link to this entry

    Clinical Frailty Scale at admission and length of hospital stay in elderly medical inpatients

    DesignCohortFeasibilityStraightforward
    Primary outcome
    Length of hospital stay in days compared across frailty categories, with in-hospital mortality as a secondary outcome
    Collection time
    12 months
    Sample, as a planning figure
    around 200–300 admissions, subject to a calculation against the difference in stay you regard as meaningful

    What your unit must already have

    • a ward admitting elderly patients in reasonable numbers
    • one or two trained assessors applying the scale within twenty-four hours of admission
    • accurately recorded admission and discharge dates

    What derails it

    Length of stay in a government hospital is driven as much by when an attendant can arrange transport home as by illness, so record the reason for every discharge delay and pre-specify how administrative delays are handled in the analysis.

  • Topic 36 / 45

    Link to this entry

    CD4 count at presentation and spectrum of opportunistic infections in adults newly registered for antiretroviral therapy

    DesignRetrospectiveFeasibilityModerate
    Primary outcome
    Distribution of baseline CD4 strata and the proportion with each opportunistic infection documented at registration
    Collection time
    4 to 6 months of record review covering several years
    Sample, as a planning figure
    roughly 250–400 records, depending on the size of the centre register

    What your unit must already have

    • an antiretroviral therapy centre with a retrievable patient register
    • CD4 counts recorded through the study period
    • ethics approval with explicit confidentiality safeguards for HIV records

    What derails it

    HIV records carry confidentiality obligations beyond ordinary chart review, so agree the de-identification procedure in writing with the centre in-charge and the ethics committee first; a protocol that treats these like any other case sheets comes back unapproved.

  • Topic 37 / 45

    Link to this entry

    Medication adherence in hypertension and diabetes assessed by the eight-item Morisky Medication Adherence Scale

    DesignCross-sectionalFeasibilityStraightforward
    Primary outcome
    Proportion in the low, medium and high adherence categories, with reasons for non-adherence recorded in a structured list
    Collection time
    8 months
    Sample, as a planning figure
    about 300–400 patients for a prevalence estimate with reasonable precision, subject to calculation

    What your unit must already have

    • a chronic disease follow-up clinic with repeat attenders
    • the instrument licensed from its copyright holder and in the local language, with documented translation and back-translation
    • interviewers trained to administer it uniformly

    What derails it

    Adherence answers given to the doctor who wrote the prescription are systematically optimistic, so have the questionnaire administered by someone not involved in that patient's care and state plainly that this remains self-report.

  • Topic 38 / 45

    Link to this entry

    Acute kidney injury following haemotoxic snake bite and its short-term course

    DesignProspective observationalFeasibilityModerate
    Primary outcome
    Proportion developing acute kidney injury by KDIGO criteria and the proportion needing dialysis during admission
    Collection time
    15 to 18 months, weighted to the monsoon months
    Sample, as a planning figure
    roughly 80–130 bites with systemic envenomation, dictated largely by the local season

    What your unit must already have

    • a unit receiving snake bite directly rather than after referral
    • antivenom supply with a written administration protocol
    • dialysis available for those who need it

    What derails it

    Most of these patients arrive having already had antivenom and sometimes a traditional treatment elsewhere, which changes both the clotting test and the renal course, so record referral interval and prior treatment as core variables rather than a footnote.

  • Topic 39 / 45

    Link to this entry

    Waist circumference and waist-hip ratio compared with body mass index for identifying metabolic syndrome components in adults

    DesignCross-sectionalFeasibilityStraightforward
    Primary outcome
    Proportion with three or more metabolic syndrome components identified by each anthropometric measure, with agreement between measures
    Collection time
    8 to 10 months
    Sample, as a planning figure
    around 300–400 adults, subject to a prevalence calculation

    What your unit must already have

    • one non-stretchable tape, weighing scale and stadiometer used by a single observer
    • fasting glucose, triglycerides and HDL on every participant
    • a definition of metabolic syndrome fixed before enrolment

    What derails it

    Waist circumference measured over clothing or at the wrong landmark moves a patient in and out of the abnormal category, so fix the landmark, the phase of respiration and the observer, and repeat measurements on a pilot twenty to document your own error.

  • Topic 40 / 45

    Link to this entry

    Serum magnesium in patients with type 2 diabetes stratified by glycaemic control

    DesignCross-sectionalFeasibilityStraightforward
    Primary outcome
    Mean serum magnesium compared across HbA1c strata
    Collection time
    8 to 10 months
    Sample, as a planning figure
    roughly 120–180 patients, subject to a calculation using the standard deviation of magnesium from a comparable laboratory

    What your unit must already have

    • serum magnesium on the hospital analyser with documented quality control
    • diabetes OPD with HbA1c by one method
    • a drug history capturing diuretics and proton pump inhibitors

    What derails it

    Diuretics, proton pump inhibitors and chronic diarrhoea all move magnesium independently of glycaemia and are common in the same patients, so set explicit exclusions or your strata will differ by drug use rather than by control.

  • Topic 41 / 45

    Link to this entry

    Nutritional risk by the modified NUTRIC score and outcome in medical intensive care patients

    DesignProspective observationalFeasibilityModerate
    Primary outcome
    In-hospital mortality and duration of mechanical ventilation compared between high and low nutritional risk groups
    Collection time
    12 to 15 months
    Sample, as a planning figure
    about 150–220 ICU admissions, subject to a formal calculation against the mortality difference assumed

    What your unit must already have

    • medical ICU recording the first-24-hour variables the score needs
    • use of the modified score stated explicitly, since interleukin-6 is not usually available
    • ventilator days recorded reliably in the nursing chart

    What derails it

    The score needs comorbidity and the admission-to-ICU interval, both poorly documented for patients transferred internally from the ward, so decide how you will timestamp ICU admission for ward transfers before enrolment begins.

  • Topic 42 / 45

    Link to this entry

    Thirty-day readmission after discharge for acute decompensated heart failure

    DesignRetrospectiveFeasibilityStraightforward
    Primary outcome
    Proportion readmitted for any cause within thirty days of discharge, with documented precipitating factors for readmission
    Collection time
    4 to 6 months of record review over a two to three year window
    Sample, as a planning figure
    roughly 200–300 index discharges, depending on the unit's heart failure volume

    What your unit must already have

    • a records system that can link a readmission to an earlier discharge
    • discharge summaries recording ejection fraction and discharge medication
    • ethics committee waiver of consent for record review

    What derails it

    Readmissions to a different hospital are invisible in your records, so a count from your own files understates the figure; say so explicitly and consider a telephone check on a random subsample to estimate how much is missing.

  • Topic 43 / 45

    Link to this entry

    Echocardiographic profile and six-month rehospitalisation in newly diagnosed heart failure

    DesignCohortFeasibilityModerate
    Primary outcome
    Proportion rehospitalised for heart failure within six months, by ejection fraction category at diagnosis
    Collection time
    18 months including follow-up
    Sample, as a planning figure
    around 100–150 patients after allowing for loss to follow-up, subject to calculation

    What your unit must already have

    • echocardiography with ejection fraction measured by a stated method
    • a heart failure clinic or a follow-up register
    • telephone follow-up with consent and two contact numbers taken at enrolment

    What derails it

    An ejection fraction reported by visual estimate varies between operators by enough to move a patient between categories, so insist on a measured method recorded in the report and either use one reporter or document an agreement exercise.

  • Topic 44 / 45

    Link to this entry

    Factors associated with multidrug-resistant urinary tract infection in patients with diabetes: a case-control study

    DesignCase-controlFeasibilityModerate
    Primary outcome
    Odds of prior exposures, including a recent antibiotic course, catheterisation and previous hospitalisation, in patients with multidrug-resistant isolates compared with susceptible isolates
    Collection time
    12 to 15 months
    Sample, as a planning figure
    roughly 80–120 cases with a comparable number of controls, subject to a calculation against the exposure proportion assumed

    What your unit must already have

    • microbiology reporting susceptibility with a stated definition of multidrug resistance
    • diabetes and medicine OPD and ward with culture-positive urinary infections
    • a structured exposure history taken before the culture result is known

    What derails it

    Taking the exposure history after the susceptibility report is available invites recall that follows the result, so interview every culture-positive patient at sampling and classify them as case or control only afterwards.

  • Topic 45 / 45

    Link to this entry

    Risk factor profile of first-ever ischaemic stroke in adults under forty-five: a case-control study

    DesignCase-controlFeasibilityModerate
    Primary outcome
    Odds of conventional and non-conventional risk factors in young stroke cases compared with age and sex matched hospital controls
    Collection time
    15 to 18 months
    Sample, as a planning figure
    about 70–110 cases with one or two controls each, subject to a formal calculation

    What your unit must already have

    • imaging-confirmed ischaemic stroke in patients under forty-five, which needs a reasonable stroke volume
    • a control recruitment route from non-neurological and non-vascular clinics
    • basic workup including echocardiography, lipids and a vasculitis screen where indicated

    What derails it

    Young stroke is uncommon even in a busy unit, so count the imaging-confirmed cases under forty-five in the last two years of records before committing; if the figure is under forty a year, widen the age band in the protocol rather than discovering the shortfall at month twelve.

The designs

What each design commits you to

The designs in this General Medicine register

The design is not a label on the title; it decides your ethics route, your timetable and the test that answers your primary question. Only the designs that appear above are explained here.

  • Cross-sectional

    19 topics

    One contact per participant. Usually the quickest to complete, and the design most often chosen when time is short.

  • Prospective observational

    14 topics

    Participants are followed after enrolment without allocating an intervention. Ethics approval must precede the first enrolment.

  • Retrospective

    3 topics

    Existing records only. Faster, but limited by what was recorded, and a waiver of consent is normally sought from the ethics committee.

  • Randomised controlled

    1 topic

    Allocation is randomised. Prospective interventional studies are registered with the Clinical Trials Registry of India before the first participant is enrolled.

  • Diagnostic accuracy

    2 topics

    An index test measured against a reference standard. The sample size depends on the expected sensitivity or specificity and the prevalence in your setting.

  • Case-control

    3 topics

    Cases and controls compared for prior exposure. Control selection is where these are most often criticised.

  • Cohort

    3 topics

    A defined group followed over time. Attrition is the usual threat, so plan for it in the sample size.

What the feasibility mark means

A judgement about a typical teaching unit, not about yours. Confirm the volume, the equipment and the co-operation a topic needs before your synopsis goes in, because after that the timetable stops being negotiable[2].

  • Straightforward

    16 topics

    Achievable in most teaching units with routine caseload and no equipment beyond what is already in use.

  • Moderate

    26 topics

    Achievable, but needs either a specific piece of equipment, a collaborating department, or a caseload you should confirm before committing.

  • Demanding

    3 topics

    Only take this on if your unit already has the volume, the equipment and the co-operation it needs. Confirm all three before your synopsis goes in.

Next steps

Before you commit to one

What to do with a topic you like

Three steps, in this order. None of them is us: the first is arithmetic, the second is your guide, the third is a search only you can run.

  1. Do the arithmetic

    The figure on each plate is a planning range, not an answer. Put your own assumptions — the difference you would call clinically meaningful, the variability you expect, the power you want — into the free sample size calculator, then divide the result by the eligible patients your unit sees in a month and see whether the months you have left permit it.

  2. Take it to your guide

    Nothing on this page is approved by anybody. Your guide and your department decide what is feasible in your unit, and your ethics committee decides whether it may start — before the first participant, not before the analysis[5]. Where your university ordinance is stricter than anything here, the ordinance wins[1].

  3. Run the search yourself

    We make no claim that any question here is novel, under-studied or a gap, because that depends on a literature search run today in your own field. Read what the search returns before you write the introduction, and be ready to say why the question is worth asking in your setting.

What a thesis in this field has to satisfy — the obligations, the statistics and the questions residents ask first — is set out on the General Medicine page. Other specialties are in the topic bank index, and the method is worked through in the guides.

Undertakings

Mechanisms, not promises

What protects your draft, and who owns the work

Each line below is a mechanism this platform implements or a published instrument it is built around. None of them is a guarantee, and we are affiliated with no regulator or university.

Protection of your work

  • Row-level security

    Every table enforces row-level access. You read your own record, and nothing else.

  • View-only streaming

    Drafts are streamed to you through an authenticated route, not handed over as a file.

  • Watermarked to you

    Every page you read carries your own name and email across it.

  • Download gated

    The final file unlocks when the fee is settled in full, and not before.

  • Mumbai region · DPDP 2023

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  • Anonymised data only

    We accept no patient identifiers. An NDA is available on request.

How this works

Instruments we work to

  • NMC PGMER-2023

    The thesis obligations set out in the postgraduate medical education regulations.

  • NBEMS

    DNB and DrNB protocol and thesis timelines, and the page limit, as published.

  • UGC 2018 · <10%

    The academic integrity convention we work to on every draft.

  • ICMJE · Vancouver

    Authorship criteria and reference style, applied as published.

  • No affiliation

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How this works

Authorship and the uniqueness check

  • Sole author

    Mentoring, editing, statistics and compliance. You remain the sole author of your thesis.

  • Not ghostwriting

    We will not write your thesis for you, and we will not be named in it.

  • MDSoftune

    Word-level uniqueness checking, built with REDENN Informatics Inc., Canada.

  • Every version

    Each draft is checked word by word before your university sees it.

How this works

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Document: Topic bank — General Medicine · Revision 1 · Last reviewed

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