Download KUHS (Kerala University of Health Sciences) MBBS (Bachelor of Medicine, Bachelor of Surgery) 3rd Year Community Medicine Syllabus
1. Clinical Pharmacology chart ? 1 = 2 marks
2. Interpretation of experimental chart -1 = 3 marks
3. Interpretation of data (providing lab: reports) -1 = 1 mark
4. Criticize and rewrite informed consent form ? 1 = 3 marks
5. ADR (clinical problem) -1 = 1 mark
OR
6. Give an irrational prescription with wrong dosage, wrong route, wrong frequency
and inadequate supportive drugs. Exercise to correct the mistakes and form a rational
prescription-1=3marks
OR
7. Demonstrate route of administration (loading syringe,cleaning,different
routes IM.IV.SC etc) or demonstrate use of Inhaler or use of eye drops, OC etc)
-1= 3 marks
Total = 10marks
VIVA VOCE
Total 4 stations each student to be examined by all the four
examiners Total 15 marks
COMMUNITY MEDICINE
A. VISION
To develop a group of medical graduate who will be proactive in identifying and
responding to public health challenges the society is facing.
B. MISSION
To bring out a group of Medical Graduates who can practice the science of medicine with
Social responsibility and social accountability and provide cost effective, value based
comprehensive health care.
C. GOAL
To equip the students to function efficiently and effectively as first level physicians in the
community in accordance with the committed vision and mission of community
medicine.
D. DEPARTMENTAL OBJECTIVES
D.1. GENERAL OBJECTIVE
To train Medical Students with knowledge, attitude and skills required to become
doctors with empathy, and, who can effectively function as healthcare providers,
decision makers, communicators, community leaders and managers in rural and urban
settings.
D.2. SPECIFIC OBJECTIVES
D.2.1. KNOWLEDGE
1. To identify the multi-factorial determinants & dimensions of health and
disease, dynamics of community behaviours and human society
2. To understand the structure and process of the health care delivery system
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3. To identify the health needs of the community in general and vulnerable groups
in particular
4. To understand the science of applied epidemiology and biostatistics and describe
their application to health and disease in the community or hospital situation
5. To understand the environmental and occupational factors in health and disease
6. To identify the role of nutritional factors in health and science
7. To understand the concept of heredity and inheritance in relation to individual
and community health
8. To understand the objectives, strategy, implementation monitoring and
evaluation of all National Health Programmes (NHP)
9. To understand the population dynamics and their impact on health and disease
10. To enumerate the principles and components of primary health care and
national health and related policies to achieve millennium development goals
(MDG)
11. To understand the principles and techniques in health management and health
economics
12. To understand the social dynamics and social factors in relation to health and disease
13. To understand the Gender issues in health and diseases
14. To understand the Developmental Health Interface & health of populations.
D.2.2. ATTITUDE
1. To see "the human being in disease, "not the disease in Human being" and
provide health care in an environment of care and compassion
2. To safe guard human dignity, equity and solidarity adhering to professional ethics.
3. To acknowledge and respect the differences in the needs, values and cultures of
different communities.
4. To assume social responsibilities at all times and take initiative in times of
natural disasters, calamities and accidents.
5. Readiness to work in rural, tribal, urban slum areas and other constrained
situations where services are most needed.
D.2.3. SKILLS
1. To diagnose and manage common health problems and emergencies using drugs
rationally.
2. To identify community Health problems, prioritize them and chalk out solutions
with local resources and community participation.
3. To deliver evidence based, need oriented, primary health care in a competent
manner in diverse settings.
4. To work effectively as a health care team member with the community hand in
hand with various sectors to bring about health promotion.
5. Use epidemiology and biostatistics as scientific tools to study the phenomenon of
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health and disease and make rational decisions relevant to community and
hospital situation.
6. To collect, compile, analyze and interpret health related data for disease
surveillance and health promotion initiatives.
7. To communicate effectively and appropriately with people at large and patients
and their families in particular
8. To impart health education using appropriate tools and educational methods
with special reference to national health issues.
9. To implement, monitor and evaluate National Health Programmes.
10. Be capable of syntheses between cause and illness in the environment of
community and individual health, and respond with leadership qualities to
institute remedial measures for these.
11. To manage human resources, money, material, time and information required
for delivering health care
D.3. INTEGRATION
Horizontal as well as vertical integrated teaching are conducted with in-house sister
departments and extramural organizations (Government and non-Government) which
are involved in the delivery of primary health care, implementation of National Health
Programmes and/or running social welfare institutions.
Course Details
Duration of the course - First Semester, Third to Seventh semesters (330 hours)
Lectures - 130 hours ?( Phase I ? 30 hours, Phase II ? 100 hours)
Practicals - First phase- 30 hours
Second phase-170 hours
COURSE CONTENTS
I.
CONCEPT OF HEALTH & DISEASE
1 Definition, concepts & evolution (history) of Public Health
2 Definition of health, holistic concepts of health including the concept of
spiritual health, appreciation of health as a relative concept, dimensions &
determinants of health.
- Disease as an experience - Patient as a person with physical, emotional,
psycho-social and spiritual concerns
- How to recognize the role of patient-family unit as important in healthcare inputs
- Quality of Life - What does quality of life mean? Examples of it being subjective
- Subjectivity of symptoms - example pain
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Characteristics of agent, host and environmental factors in health and disease
3
and
the multi factorial etiology of disease.
4
Understanding the concept of prevention & control of disease.
5
Understanding the natural history of disease and application of interventions
at various levels of preventions
6
Introduction to various health indicators
7
Health profile of India-already in Chapter XIV
II
SOCIAL AND BEHAVIORAL SCIENCES
1
Concept of Sociology& Behavioral Science, Clinico-socio-cultural and
demographic evaluation of the individual, family and community.
2
A ssessment of barriers to good health and health seeking behavior
3
Role of family in Health and Disease
4
Socio-cultural factors related to health and disease in the context of urban
and rural societies
Assessment of socio-economic status, effect of health and illness on socio
5
economic
status
6
Doctor-patient relationship
7
Social Psychology, Community Behavior and community relationship, hospital
sociology and psychology
8
Social security-Health Insurance: Organized sector, unorganized sector, special
groups (Eg: elderly)
9
Impact of urbanization on health and disease-will be covered in chapter XIII
10 Poverty link to health and disease and poverty alleviation programmes
Household Poverty in India caused by Healthcare expenditure. Current status of
Health Insurance in India
11 Intelligence ? IQ and EQ
12 Personality ? Types, Interpersonal relationships
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13 Attitude, Behaviour, habits
14 Emotions, Frustrations, role of emotions in health & coping with emotions
15 Conflicts-internal, interpersonal & conflict resolutions, defence mechanisms
16 Stress & coping skills ? integrated (Psychiatry)
17 Ethics
Confidentiality, Autonomy, Privacy, Human rights aspects of patient care
18 Learning ? Types and skills
19 Development & Health interface-Poverty & Health, Health of the marginalized,
Sustainable & inclusive development
20 Gender & Health including gender based violence, Epidemiology of violence
and its prevention and control Life skill education
III
ENVIRONMENT AND HEALTH
1
Water: Concepts of safe and wholesome water, sanitary sources of waterborne
diseases, water purification process. Water quality standards.
2
Physical, Chemical &bacteriological standards of drinking water quality and
tests of assessing bacteriological quality of water.
3
Health hazards of air, water, noise, radiation pollution.
4
Concepts of water conservation, rainwater harvesting & Global warming.
5
Concepts of solid waste, human excreta and sewage disposal.
6
Awareness of standards of housing and his effect of housing on health.
7
Role of vectors in the causation of diseases.
8
Identifying the features of vectors and their control measures.
9
Life cycles of vectors and advantages and limitations of various vector control
measures.
10 Mode of action, application cycle of commonly used insecticides and rodenticides.
11 Urban waste management.
12 Recent and emerging issues in environmental health
a Stockholm
b. Basel convention
c. Kyoto Protocol. etc
13 Radiation Prevention and Control
14 Newer methods of solid & liquid waste disposal
Composting
Solar (Renewable source of energy)
e-waste
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C NGE. (INFORMATION, EDUCATION, COMMUNICATION)
IV. HEALTH PROMOTION AND EDUCATION/COMMUNICATION OR BEHAVIOURAL
CHANGE. (INFORMATION, EDUCATION, COMMUNICATION) ----
a. Understand the concepts of health Promotion and education, IEC, Behavioural
change communication, Counselling
b.
Principles & methods of health promotion and education.
c.
Barriers of effective communication and methods to overcome them.
d.
Various methods of Health education with their advantages and limitations.
e. Organizing health promotion and education activities at individual, family and
community settings.
f.
Evaluation of health promotion and education programme.
V. NUTRITION
1 Common sources of various nutrients and special nutritional requirements according
to age, sex, activity, physiological conditions
Real life knowledge on which Indian dietary component, fruits, vegetables, grains,
grams have high sodium, high potassium, high fiber, high protein
Introduction to current evidence on health impact of red meat, refined oil, white
sugar, caffeine containing soft drinks, artificial tastes, flavours, dairy products, GM
foods,
2 Nutritional assessment of individual families and the community by using
appropriate method such as; anthropometrics, clinical examination 24 hour dietary
recall and other methods of diet survey etc.
3 Plan and recommend a suitable diet for the individual and families as per local
availability of food and economics status etc.
4 Common nutrition related health disorders (like protein energy, malnutrition,
obesity, childhood obesity, Vitamin A deficiency, anaemia, iodine deficiency,
fluorosis, food toxin diseases) and their control and management.
5 Food fortification, additives and adulteration food
hygiene.
6 Social and cultural factors in nutrition and Health.
7 Important National nutritional programmes.
8 National Nutrition policy.
9 Nutritional surveillance, education and rehabilitation.
10 New WHO Growth Charts.
11 Principles of Therapeutic Diet
12. Food plate
VI. OCCUPATIONAL HEALTH
1 Relate the history of symptoms with specific occupations including agricultural related
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occupation.
2 Employees State Insurance Act.
3. Specific occupational health hazards, their risk factors and its preventive measures.
Primary Secondary and tertiary prevention including personal protective devices
4. Concepts of ergonomics.
5. Diagnostic criteria of various occupational related diseases.
6 Other legislations related to occupational health.
7 Digital Health Computer associated Illness.
8 Occupational health in unorganized sector
9 Integrated learning on non-pharmacological management of pain Visit to
PMR department
VII. BIO-STATISTICS
a. Collection, Classification, analysis, interpretation and presentation of statistical
data.
b. Application of Statistical methods in various study designs.
c. Common sampling techniques, simple statistical methods, frequency distribution,
measures of central tendency and dispersion.
d. Apply common tests of significance in various study designs
VIII. BASIC EPIDEMIOLOGY
1 Epidemiology: definition, concepts, uses and its role in health and diseases.
2 Use of basic epidemiological tools to make a community diagnosis of the health
situation, in order to formulate appropriate intervention measures.
3. Definition of the terms used in describing diseases transmission and control.
4 Modes of transmission and measures for prevention and control of
communicable and non-communicable diseases.
5 General Principles of prevention and control of communicable, non
communicable diseases and other health conditions of public health
importance.
6 Principle Sources of Epidemiological data.
7
Definition, Calculation and interpretation of morbidity and mortality indicators
standardization (Direct & Indirect)
8 Screening of health related attributes & issues need, uses and evaluation of
screening tests.
9 Investigation of an epidemic of communicable disease and to understand the
principals of control measures.
10 Epidemiological study design & Research Methodologies
11 Concepts of association, Causation and biases
12 Application of computers in epidemiology
13 Use of principles of epidemiology in practice of medicine
14 Introduction to Evedence based medicine
15 Use of diagnostic tests
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IX.EPIDEMIOLOGY OF SPECIFIC DISEASES: COMMUNICABLE & NON COMMUNICABLE
Communicable and non-communicable diseases of public health importance, relevant to
the region, for which National Disease control/Eradication Programmes have been
formulated.
Communicable Diseases: Intestinal infectons: Poliomyelitis, Viral hepatitis, Diarrhoea,
Cholera, Helminthisis, typhoid, Amoebiasis & Giardiasis, Food Poisoning.
Respiratory Infections: Acute Respiratory infections, Measles, Diphtheria, Whooping
cough, Tuberculosis, SARS, Influenza, Meningococal meningities, Mumps.
Vector borne infections: Malaria, Filaria, KalaAzar, Dengue, Yellow Fever,
Chickungunya fever. Surface infections:
Sexually transmitted diseases, Syndromic approach, HIV & AIDS, Tetanus Leprosy, scabies,
Pediculosis. Zoonosis: Rabies, Japanese encephalitis Plague Kyasanur Forest Disease,
Leptospirosis, Anthrax.
Hospital Acquired Infections
New Emerging Diseases
Zika Virus, Ebola Virus
Investigation of food poisoning outbreak
Non Communicable Lifestyle Diseases: Coronary heart diseases, Hyper tension,
Stroke,Rheumatic heart disease, Cancers, Obesity, Diabetes, Blindness, Injury and
Accidents.
1 Extent of problem, epidemiology and natural history of diseases
2 Public health important of particular diseases in local area.
3 Influence of social ,cultural and ecological factors on the epidemiology of particular
diseases
4 Diagnosing diseases by clinical methods, using essential laboratory techniques at
primary care level.
5 Treatment of a case, as per National programme guidelines, and also follow up of
case 6 National health programme for health diseases.
7 Understand the principles of measures to control a diseases epidemic
8 Principles of planning, implementing and evaluating control measures for diseases at
community level bearing in mind the public health importance of the diseases.
9 Training of health workers in diseases surveillance, control and treatment, health
education.
10 Management information system in a particular diseases
11 Prevention and control of new emerging diseases and life style related health
problems. 12 International classification of diseases.
X. DEMOGRAPHY AND VITAL STATISTICS
1 Concepts of demography, demographic cycle, Vital Statistics.
2 Definition, Calculation and interpretation of demographic indices like birth rate, death
rae, fertility rates.
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3 Population dynamics of India.
4. Population control measures. Family planning methods including NSVand emergency
contraception
5. National population Policy.
6. Sources of Vital Statistics like census, SRS NFHS, NSSO etc.
XI. REPRODUCTIVE AND CHILD HEALTH
1. Current statistics of reproductive and child health.
2. Screening of high risk groups and common health problems.
3. Local customs and practices during pregnancy, child birth, lactation and child
feeding practices.
4. IYCF (Infant and young child feeding practices)
5.
6. Organization , implementation and evaluation of reproductive child health (RCH)
7. components, including child survival and safe motherhood(CSSM),Universal
immunization Programme(UIP), Integrated child development services scheme
(ICDS), integrated management of Neonatal and childhood illness (IMNCI), Janani
Suresh Yojna (JSY)& Accredited Social Health Activist (Asha) under national rural
health mission(NRHM) and other existing Programmes.
6. Various Family Planning methods, their advantages and Shortcomings.
7. Medical Termination of Pregnancy and Act(MTP Act) & Pre Natal Diagnostic
Test Act (PNDT Act)
8. Adolescent Health
9. Handicapped Child. Community based Rehabilitation
10. Organizations, technical and operational aspects of the National family welfare
Programme.
11.MCTS(Mother and Child Tracking System)
XII. SCHOOL HEALTH
1. Objectives and components of school Health programme
a. Periodic Medical Examination of the children and the
teachers b. Immunization of the children in the school.
c. Health promotion and education
d. Mid-day meals.
e. WIFS(Weekly Iron and Folic Acid)
XIII. URBAN HEALTH
1. Common health problems (Medical, Social, environmental, Economical,
Psychological) due to Urbanization of Urban Slum dwellers
2. Organization of health services in urban slums
3. National policy on urban health.
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XIV. HEALTH CARE SYSTEM IN INDIA
1. Concepts of Primary Health care and Comprehensive Health care.
2. Health profile of India
3. Health Care Delivery System in India and Infrastructure at peripheral, Primary,
Secondary and tertiary care level
4. Job responsibilities of different category of workers in health System
5. Voluntary Health agencies working in India.
XV. HEALTH PLANNING, MANAGEMENT AND ADMINISTRATION
1. Concepts of Planning, Management, Public Health administration. Seminar on
India's National Policy ? NPCDCS, elderly health, mental health and on Palliative
Care
2. Components of health planning activity.
3. Classification and Understanding of various qualitative and quantitative Health
management techniques.
4. Overview of administration at village, block, district, state and central level in India.
5. Integrated Disease Surveillance Project (IDSP)
6. Health Related Millennium Development Goals and sustainable development goals
7. National health Policy & National Rural Health Mission (NRHM)
8. Concepts of Health Economics I Health Planning and management.
9. Concepts, Scope and methods of Health Audit.
10. Role of Planning Commissions and Five year plan in development of health sector
in India
11. Various health committees of government of India and their important recommendations
12. Decentralization and PRI Institutions.
13. Inventory Control
XVI. DISASTER MANAGEMENT
1. Principles of disaster preparedness and application of these in disaster management.
2. Bio-terrorism
3. Pandemic Preparedness
XVII. LEGISLATION AND PUBLIC HEALTH
(Recent Amendments to be included)
1. Census act 1948
2. Registration of Birth and Death Act 1969
3. The Epidemic Diseases Act, 1897.
4. The Transplantation of Human Organs Act, 1994
5. The prevention of food Adulteration Act 1954(FSSAI)
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6. The International Health Regulations
7. The Cigarettes and Other Tobacco product Act2003
8. The Narcotic and Psychotropic substance Act 1958
9. The Medical Termination of Pregnancy Act 1971(MTP Act)
10. The Dowry Prohibition Act
11. The Immoral Traffic (Prevention) Act 1956
12. The Prenatal Diagnostic Techniques (Regulation and Prevention of Misuse) Act 1994
13. The Juvenile Justice Act 2000
14. Child Labour (Prohibition and Regulation) Act1986
15. The Persons with Disabilities (Equal opportunity, Protection of rights
and full participation) Act 1995
16. The Factories Act 1948
17. The Employees State Insurance Act 1948
18. The Environment (Protection) Act 1986
19. The Bio-Medical Waste (Management and Handling) Rules 2000
20. The Consumer Protection Act 1986
XIX. INTERNATIONAL HEALTH
1. Role of various multilateral, bilateral international health organizations like WHO,
UNICEF etc.
. WHO Resolutions ? on Non-communicable diseases, palliative care
Sustainable Development Goals as relevant to India
2. Organizational structure of these organizations
3. New International health Regulation (IHR)
XX. HEALTH CARE WASTE MANAGEMENT
1. Classification/Category, sources, health hazards and treatment of Bio-Medical Waste.
2. Application of these principles in different setting of health care delivery system.
3. Safe Injection Practices
4. Universal Precautions
XVIII. HEALTH CARE OF ELDERLY
National Policy
1. Health problems of Aged
2. Preventive Geriatrics ? Prevention of falls
3. Care of Aged
XIX. MENTAL HEALTH AND BEHAVIORAL PROBLEMS
1. Importance of mental health care in primary care settings.
2. Comprehensive Mental Health Care at primary care settings.
3. Common Mental Health disorders.
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4. Substance use disorders Tobacco, Alcoholism and Drug Addiction- and prevention
5. Gender Issues and Women Empowerment
6. Gender Based Violence, Domestic Violence, Epidemiology Prevention and Control
7. Suicides
XX. DEVELOPMENT AND HEALTH INTERFACE
1) Poverty and Health (Evidence based learning ? to show real data )
2) Poverty and Health
3)
Poverty Alleviation Programme
4) Health of the marginalized ?eg. Transgender, Tribals
5) Sustainable and inclusive
Development
6) . Universal health Concept in India, Sustainable Development Goals
XXI. GENETICS
1. Epidemiology of Genetic Diseases
3. Screening of Genetic Diseases
4. Prevention and Control of genetic Diseases
XXII. DISABILITY
1. Types of Disability
Paraplegia/ Quadriplegia ? as a seminar ? prevention, and care of those who
have irreversible paraplegia
Physical, emotional concerns and management
Assisting in Economic self sufficiency ? as a social health concern of the doctor
Role of Medical Social Workers
? working as Multi disciplinary Team for total care
2. Rehabilitation-- Clinical and community level.
3. Palliative Care
Concept, need in the country, relevance Applicability in chronic disease
Concept of Non-abandonment if disease is not curable
2 levels ? Palliative care Approach, generalist Paliative Care, Specialist
Palliative Care
-Where, How Paliative Care is to be delivered
Concept of Home based care
SKILLS
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The student should be able to do:
1. Elicit Clinico-social history. Describe agent , host and environmental factors in
determining health and disease.
2. Identify, prioritize and manage common health problems of community.
3. Apply elementary principles of epidemiology in carrying out simple
epidemiological studies.
4. Work as a team member in rendering health care.
5. Carry out health promotion and education effectively in the community.
Skills in relation to specific topics
1. Communication:
Should be well versed with the art of interviewing techniques to elicit the desired
information
& with art of counseling to counsel. The student should be able to communicate
effectively with family members at home, patients at clinics or at home; and
community. The student should also be able to communicate with individuals, family
or a group for health promotion and education, and also with peers.
- Basic Communication Skills
- Importance of good communication skills
- Barriers ? for the Patient and for the doctor
- Active listening
- Basic Clinical communication skills
- Examples of good and poor communication as Role Play - affecting diagnosis
and management
In 3rd Professional Year
- The stepwise breaking of Bad News
Handling Collusion
2. Team Activity
Work as an effective member of the team; in planning and carrying out field work like
school health, conduct health camps ,investigation of epidemic etc.
3. Environmental Sanitation:
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Able to assess environmental risk factors plan and suggest
action Able to collect water and stool samples for micro
biological analysis
Able to identify insects of public health importance, able to use effective insecticides.
Purification of water-small scale.
Vector Survey and control measures.
Newer methods of solid & liquid waste disposal
Composting
Solar (Renewable source of energy)
e-waste
4. Communicable and Non-Communicable disease.
? Eliciting Clinico-social history and examining the patients for diagnosis and treatment.
? Assessing the severity and /or classifying dehydration in diarrhea, upper respiratory
tract infection, dog bite, leprosy, classify tuberculosis (Categorization) and STD.
? Fixing, Staining and examining peripheral smear for malaria, sputum for AFB,
hemoglobin estimation, urine and stool examination.
? Adequate and appropriate treatment and follow up of public health diseases and of
locally endemic diseases. (The Integrated Care Model of WHO for chronic conditions ? 5
As ? Assess, Advice, Agree, Assist, Arrange)
? Advice regarding prevention and prophylaxis against common and locally endemic
diseases.
? Use of proper screening methods in early diagnosis of certain diseases, applicable at
primary care level.
? Able to detect outbreak in early stage, spot mapping, investigation of outbreak,
notification of notifiable diseases.
? Surveillance skills development, calculating various health indicators and their
interpretations.
5. Reproductive and Child Health:
? Antenatal-examination of women, application of at risk approach in antenatal care.
? Intranatal care ?conducting a normal delivery, referral indications.
? Postnatal ?assessment of new-born and mother, promotion of breast feeding, advice
on weaning and family planning.
Preventive oncology in women and barriers
? Immunization-able to immunize the eligible using desired routes, for providing vaccines.
Adverse Event Reporting
? Contraception-able to advice appropriate method.
? Able to insert any Intra Uterine Device (IUD) Condom demonstration.
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6. Statistics:
? Able to draw sample using simple sampling techniques.
? Apply appropriate test of significance.
? Calculation of various health indicators and presentation of data
7. Nutrition:
Conduct complete nutritional assessment of individual using clinical, anthropometric
and diet survey tools.
Ability to use and interpret road to health card.
Advice appropriate balance diet and suggest any dietary modification.
Nutritional promotion and education to specific groups and related to specific
nutritional diseases.
Prescribe a therapeutic diet.
8. Occupational health:
Screening of workers for any occupation related health problem.
9. Managerial Skills:
Able to make community diagnosis and take remedial measure for improving
health of community.
Organize antenatal, under five clinics, health education camps.
Ability to manage Health Management Information System, including maintenance of
health records at primary care level.
Able to show effective leadership, supervision skill not only at primary care level but
also in inter-sect oral coordination.
Ability to manage money, material and manpower at primary care level.
Ability to do cost effective analysis as per primary care needs. Ability to
implement cost containment measures in public health
Community Participation and cooperation skills. Community engagement,
community ownership for effective health care ? models in India ? in preventive
health, in self ?help healthcare initiatives
10. Basic Laboratory investigation at primary care level
Hemoglobin estimation
Urine examination for normal and abnormal constituents.
Thick and thin blood smear for malaria parasite examination
Peripheral smear for type of anemia
Acid fast staining
Estimation of chlorine demand and residual chlorine.
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Identification of life cycle stages of various insects of public health importance
11. Minor surgical procedures at primary care level
All type of injection techniques
Universal precautions and safe injection practices (use of AD syringes)
Common wound dressings
Incision and Drainage of abscess under local anesthesia.
Suturing of wounds
12. First Aid, Initiation of emergency care, Triage and referral
13. Transportation of injured and seriously ill patients from site of first contact.
14. Participatory Rural appraisal
Social Mapping
Focus group Discussion
Key informant Interview. . Local self governance bodies, Village Health, Sanitation,
Nutrition committes, recognizing local resources ? dais, elders, ASHA workers, teachers,
postman [who knows to read things out]
15. Health Education
Health Education to various groups (individual and group Assignments).
16. Animal bite Management.
E. DETAILS OF INTERACTIVE LECTURES
TOPICS
1. Introduction
Objectives of Medical education need for value based medical education history of medicine
with reference to community medicine
Concept of Health
Concept of Diseases
Concept of control & prevention
Learning ?Type & skills-How to learn effectively
Intelligence-IQ, EQ
Personality-Type interpersonal relationships
Attitude, Behaviour, Habits
Emotions, Frustrations, role of emotions in health & coping with emotions - 1hr
Conflicts-internal, Interpersonal & conflict resolutions, defence mechanisms - 1hr
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Stress & coping skills-Integrated (psychiatry). Burn out and self care
Ethics
Gender Health Including Gender Based Violence
Life Skill Education
2. Epidemiology
Epidemiology-Introduction, tools & Measures of
Mortality Standardization Direct & Indirect Measures
of Morbidity
Descriptive studies
Case control studies Cohort
studies Experimental studies
Association& Causation
Application of epidemiology
Screening for diseases
Infectious Diseases Epidemiology_ concepts
Dynamics of Diseases Transmission & Concepts of prevention & control
Investigation of an epidemic (integrated with Microbiology,Health services )
Introduction to Evidence based medicine/evidence pyramid in day today practice
Use of diagnostic tests
3. Communicable Diseases
Smallpox & Chicken pox
Measles, Mumps, Rubella
Diphtheria, pertussis, Meningococcal meningitis
ARI &ARI control Programme
TB-Epidemiology& Control
Poliomyelitis
Viral hepatitis
Typhoid fever, Cholera & ADD
Food poisoning & Food toxicants
Dengue fever, Chikungunya, Malaria
Filaria
Rabies
JE & KFD
Leptospirosis
Plague and Yellow fever
Leprosy
Trachoma & tetanus
STD-Syndromic approach
AIDS
Emerging & Re-emerging infections
Hospital acquired infections &Health Care Waste Management
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Non Communicable Diseases
Coronary Heart Diseases & Rheumatic Heart Diseases
Hypertension & stroke
Cancers
Prevalence of Advanced cancer in the community and their needs
Diabetes mellitus & obesity
Blindness & control Programme
Accidents (Integrated)
Non-abandonment when disease is progressive
4. Demography & Family Planning
Demographic cycle, Trends & National population Policy
Family Planning Methods Including Non scalpel
Vasectomy, Emergency Contraception and MTP Act
5. Maternal and Child Health
Maternal health-ante, intra, postnatal care &
problem (Integration with O &G)
Growth & Development/Growth Charts, WHO Growth
Chart (Integration with Paediatrics)
Behavioural problems & Juvenile Delinquency
Indicators of MCH Care
Geriatric problems (Size, need for special care, National policy of elderly)
Special presentation of ailments, common issues and integrated care ? rather that
multi-speciality approach to care
Challenges of Poly pharmacy
Adolescent problems
6. Nutrition
PEM& Child hood obesity
Nutritional requirements-RDA-integrated (Biochemistry)
Nutritional Disorders-integrated (Biochemistry)
National Nutritional Programmes.
Nutritional status assessment & Surveillance
Ecology of malnutrition,
Food adulteration - PFA , FSSAI
7. Social science
Concepts in sociology ,
Family and cultural factors in Health & Diseases
Social problems-overview of Social security measures
8. Development and Health
Development and Health Interface
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Poverty and health, poverty alleviation programmes
Health of Marginalized
Sustainable and Inclusive Development
9. Genetics
Epidemiology of Genetic Diseases
Screening of genetic diseases
Prevention and control of genetic disease
10. Mental and Behavioral Problems
Importance of mental health care in primary care settings
Comprehensive Mental Health Care at primary care settings.
Common Mental Health disorders.
Substance use disorder-Tobacco, Alcoholism and Drug addition
11. Gender and Health
Gender Issues and Women Empowerment
Gender Based violence, Domestic Violence -causes, Prevention and
Control (Integrated Surgery, O&G, Legal and Police Department)
12. Environmental Health
(1) Pollution- Air, Water and soil
(2) Waste Disposal in urban &rural areas
(3) Recent issues & advances in environmental health
policies Eg. Basel Convention
Stockholm Convention
(4)Emerging environmental health issues-eg: e- wastes
13. Occupational health
1. Occupational health problems
2. Prevention of occupational diseases and ergonomics
14. Communication process
Communication process, Types, barriers & Health Communication
- Reactions to loss and grief
- Respect; Being non-judgmental
- Basic Communication Skills
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- Importance of good communication skills
- Barriers ? for the Patient and for the doctor
- Active listening
- Basic Clinical communication skills
Examples of good and poor communication as Role Play - affecting diagnosis and
management
Health education-Definition & Principles
15. Health Planning, Health System& Health economics
Health Planning & Planning Cycle
Health System& Health Care Delivery system
(Rural, urban, tribal) Health
Information system Health
committees
Concepts of health care-primary health care
Health care for all
National Health Policy, Millennium development goals
Seminar on India's National Health Policy ? NPCDCS, elderly health, mental health and
on Palliative Care
Universal health status in India
Sustainable Development Goals
Role of Voluntary agencies in Health, New International Health
regulations Panchayati Raj
Management & Managerial Techniques
Health economics & cost containment issues health
care Disaster management, Pandemic preparedness
Bioterrorism
16. National Health Programmes
Revised National TB Control Programme
National Anti-Malaria Programme
National Filaria Control Programme
(Mass Drug Administration & Morbidity Management)
National Vector borne disease control programme
National AIDS Control Programme
National Mental Health Programme &District Mental Health Programme
Evolution of Family Planning Programme &Reproductive & Child Health
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Programme National Rural Health Mission and Indian Public Health Standards
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NPCDCS ? National Program for Cancer, Diabetes, Cardiac diseases, Stroke
NPPC ?National Program on Palliative Care
17. Legislation and Public Health
1. Census act 1948
2. Registration of Birth and Death Act 1969
3. The Epidemic Diseases Act, 1897.
4. The Transplantation of Human Organs Act, 1994
5. The prevention of food Adulteration Act 1954(FSSAI)
6. The International Health Regulations
7. The Cigarettes and Other Tobacco product Act2003
8. The Narcotic and Psychotropic substance Act 1958
Recent Amendment ? 2014 ? Purpose for the amendment, Current procedure for
accessing essential narcotic drugs [ENDs
9. The Medical Termination of Pregnancy Act 1971(MTP
Act) 10. The Dowry Prohibition Act
11. The Immoral Traffic (Prevention) Act 1956
12. The Prenatal Diagnostic Techniques (Regulation and Prevention of Mis use) Act 1994
13. The Juvenile Justice Act 2000
14. Child Labour (Prohibition and Regulation) Act1986
15. The Persons with Disabilities (Equal opportunity, Protection of rights and full
participation) Act 1995
16. The Factories Act 1948
17. The Employees State Insurance Act 1948
18. The Environment (Protection) Act 1986
19. The Bio-Medical Waste (Management and Handling) Rules 2000
20. The Consumer Protection Act 1986
PRACTICALS/FIELD VISITS
Practical should offer first-hand experience in the community through visits, mock
sessions and hands-on exercises. Visits may be planned based on public health
importance, relevance and feasibility. For each visit objectives may be specified and
orientation given prior to the visit. Five minutes may be allotted for presenting report of
previous day's activities, learning experiences and suggestions. Integrated and interactive
team teaching may be employed wherever possible.
Phase I
30hrs
Visit to community and families
Following up one family with a patient with chronic disease for 1 year with at least 3 home
visits and recorded interaction with family members? and submit a structured case
reflection at the end of 6th semester - under physical, emotional, socio-economic and
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spiritual concerns of that patient/family unit. All this is done with assigned mentorship.
Reflection and practice points
Visit to support and auxiliary health facilities
Identify a community Health Problem
Introduction to the Hospital system
Hands-on exercise on first aid
Phase II
170 hrs
Family studies ? Community diagnosis
Basic clinical skills training-history taking skills Innovative
community based problem solving exercises
Biostatistics-hands-on exercises- central
tendency/dispersion/sampling/hypothesis/significance tests
Community interaction, identification and solving community health problems with
community participation
Entomology including field assignments ?vector survey/control measures
Epidemiological exercises ? Mortality, Morbidity, Risk/ Screening, including study
designs and standardization
Visit to public health institutions
Visit to social welfare organizations
Accompanied by Medical Social Worker team member
Implementation of National Health Programmes through CHC/ PHC and sub centre visits
Visits to institutions of public Health importance
Pain & palliative care centre
Supervised home based care visits with the palliative care
team Vocational Rehabilitation Centre
Water works
Anganwadi
Analyst lab
De addiction centre
Food inspector's Office etc.
BCC (IEC) Strategies-individual & group
assignments Review of current health issues &
policies
Review of museum specimens, poster presentations
Participation in health related activities in the
community
Research methodology ? Participation in workshop & Project work, computer skills, Nutrition
skills ? Diet survey, balanced diet, Nutritional requirements, RDA, Nutritional disorders,
Community Nutrition programmes
Balanced diet and therapeutic diet
Food Hygiene
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PFA act
Universal Precautions & Safe Injection Practices
Health Care Waste Management
Participatory techniques in health
Health Planning & Management exercises
Disinfection
Immunization agents & Immunity---Vaccines, Cold Chain
Hazards of immunization including adverse event reporting
Fertility related statistics and Family Planning methods, Growth c harts
Art of Interviewing
Doctor-Patient relationship and Hospital sociology
Concept of therapeutic relationship
Rights and duties
Oath Sanitary well, well Chlorination Procedure
Purification of water ? large and small scale
Water Quality Standards and surveillance
Sanitary Survey
METHODS OF ASSESSMENT
Modified essay question
Short answer questions
Problem solving exercises
OSCE, OSPE Epidemiological and statistical exercises
One Case reflection of a home bound patient's concerns and way forward evaluation
Analysis of ethical dilemmas of hospital based disease management ? from clinical cases
and approach to solving it
Actor patients ? interviewing style, communication
skills, Breaking bad news, Handling collusion
Records review
Research, Project Reports
Viva Voce
TEACHING LEARNING METHODS
Structured interactive sessions
Role play ? for teaching good/ poor communication skills
Small Group discussion
Focus Group Discussion (FGD)
Participatory learning appraisal (PLA)
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Institutional visits
Practicals including demonstrations
Problem based exercises
Video Clips
Written case scenario Self-learning tools. Choose movies with healthcare message
Interactive learning
E-modules
TIME OF EVALUATION
University examination of Community Medicine should be at the end of 7th Semester.
Formative and summative assessment during internship so that we have a basic doctor,
competent to provide comprehensive care.
LEARNING RESOURCE MATERIALS
Text books Reference books
Practical note books
Internet resources, Video films etc
SUGGESTED TOPICS FOR LEARNING THROUGH e-MODULES:
History of Medicine and Public Health
Environmental Health
Nutrition (Except public Health Nutritional Programme)
Epidemiological methods
Screening
Planning Cycle
Health management techniques
Entomology
Biostatistics
Demography
Disaster management
Biomedical waste management
International health
National Health Organizations
TOPICS FOR INTEGRATED TEACHING WITH DEPARTMENT OF COMMUNITY
MEDICINE AS PARTICIPANT
Nutrition
Iron deficiency anemia
Communicable diseases with National Health Programmes like
o -HIV/AIDS
o -Tuberculosis
o -Malaria
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o -Polio
o -Diarrheal diseases
o -Leprosy
o -Zoonotic diseases
Lifestyle related diseases with preventive and palliative aspects like
o Diabetes
o Hypertension
o Stroke
o Obesity
o Cancers
o Jaundice
Alcoholism Death and Dying Geriatric Medicine
Adolescent Health
Rational Drug Use Contraception
Industrial health Ethical issues
Applied Epidemology and statistics in clinical
medicine
TOPICWISE MARKS DISTRIBUTION IN COMMUNITY MEDICINE
Paper I
Marks
1 Concept of Community Medicine
5
2 Sociology & Developmental Health Interface
5
3 Environment including entomology
10
4 RCH and Health of Elderly
10
5 Nutrition& Genetics
10
6 Basic Epidemiology & Screening
15
7 Demography , Biostatistics & Health Information System
5
Total
60
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Paper II
1 Communicable diseases including Emerging & re-emerging diseases
15
2 Non-Communicable diseases, Disability, Rehabilitation , Caring for the
10
chronically Ill ? establishing continuity of care
3 Biomedical Waste management, Occupational Health
5
4 Health care delivery system & Urban health
10
Disaster Management Health Planning, management& Financing
5 Mental & behavioral health problems
5
Health Education
6 National Health Programs & NRHM
10
7 Health legislation & International Health
5
Essential Medicines & Counterfeit Medicines , , Purpose of NDPS
Amendment, implications
Total
60
Each Paper should have:
a. Structured essay one question: 10 marks
b. Remaining structured short essay question: 50 divided marks
c. Around 50 %problems based competency testing (Cognitive domain) in theory question
paper
d. Each paper shall be of 3 Hours duration
Distribution of Marks
1. Theory
Theory
Max.Marks
Theory Paper I
60
Paper II
60
Internal assessment
20
Oral
10
Total
150
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2. Practical
Practical and oral should be conducted in one day
Exercise
Max.Marks
Epidemiological exercise
3
Statistics
4
Clinic social case study
8
2
OSCE
Spotting & OSPE
6
Diet prescription
3
Project
4
Internal assessment
20
Total
50
Grand Total (Theory & Practical) ? 200
E. TEXT BOOKS RECOMMENDED:
Prescribed Books
a. Park's Text book of preventive and Social Medicine, K. Park (23rdedn.) Banaridas Bhanot
b. Textbook of Parasitology, Protozoology and Helminthology ? Chatterji K D c.
Introduction to Health Statistics ? Swaroop S E & S. Livingstone Ltd.
d. A treatise on Hygiene and Public Health ? Ghosh B N Scientific Publising Company,
Calcutta
e. Text Book of Social & preventive medicine -Mahajan
f. Epidemiology for undergraduates ? Marina Rajan Joseph ? Jaypee Publishers (2007) 1st
edn.
g. Syamalan's Statistics in Medicine (2006); National Health Programme by Jugal Kishore
h. National Health Programme by D K Taneja
i. Textbook of preventive & Social Medicine by Sunder lal, Adarsh,
Pankaj j. Textbook of preventive & Social Medicine by T Bhaskar Rao k.
Biostatistics by A Indrayan
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l. Methods in Biostatistics by B K Mahajan
m. Textbook of Preventive & Social Medicine by Gupta & Ghai
n. Text book of Preventive & Social Medicine by Gupta& Mahajan
o. Essentials of Community Medicine by Suresh Chandra
p. Introduction to Biostatistics by Sathya Swaroop
q. Community Medicine with Recent Advances by AH Suryakantha
r. Principles and Practice of Community Medicine by Dr. Asma Rahim
s.Indian Primer to Palliative Care
t. Community Medicine Simplified by Sreejith P S, Paras Medical Books
Reference Books:
a. Preventive Medicine and Public Health Appleton Century Crofts ? Maxcy, Kennith F
Rosenau
b. Preventive Medicine for the doctor in his community ? Level H R & Clark E G; Mc Graw
HillBook Company
WHO Online resources
c. Theory & Practice of Public Health ? Hobson W Oxford University
Press d. American P H Association Communicable Disease Control in man
e. Manson's tropical diseases ? Wilcock's & Manson
f. Oxford test book of Public Health 4th edn.
g. Public Health & Preventive Medicine J M Last
WHO online resorsess
National health websites- mohfw, ncdc
OPHTHALMOLOGY
I. Goal
The broad goal of the teaching of students in Ophthalmology is to provide such knowledge and
skills to the student that shall enable him/her to practice as a clinical and as a primary eye care
physician: and also to function effectively as a community health leader to assist in the
implementation of National Programme for the prevention of blindness and rehabilitation of
the visually impaired.
II. Objectives
At the end of the course, the student shall be able to:
1. Identify common diseases of the eye
2. Diagnose and treat common diseases of the external eye-conjunctivitis, stye, extraocular
foreign body, corneal abrasion, Vitamin A deficiency
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This post was last modified on 06 August 2021