An Ultimate Guide to Community Medicine Prithwiraj Maiti, Bismoy Mondal
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1An Ultimate Guide to COMMUNITY MEDICINE2
3An Ultimate Guide to COMMUNITY MEDICINE
Prithwiraj Maiti MBBS RG Kar Medical College Kolkata, West Bengal, India Bismoy Mondal MBBS RG Kar Medical College Kolkata, West Bengal, India
Jaypee Brothers Medical Publishers (P) Ltd
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© 2016, Jaypee Brothers Medical Publishers
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Medical knowledge and practice change constantly. This book is designed to provide accurate, authoritative information about the subject matter in question. However, readers are advised to check the most current information available on procedures included and check information from the manufacturer of each product to be administered, to verify the recommended dose, formula, method and duration of administration, adverse effects and contraindications. It is the responsibility of the practitioner to take all appropriate safety precautions. Neither the publisher nor the author(s)/editor(s) assume any liability for any injury and/or damage to persons or property arising from or related to use of material in this book.
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An Ultimate Guide to Community Medicine
First Edition: 2016
Printed at
This book is our first work together with its delicacy, to produce a concise intricate narrative of this vast subject of Community Medicine.
Textbook writing is not a cup of tea for us and since there are innumerable access to tougher textbooks and journals for our colleagues and juniors pursuing this vast career, we never quite got around to writing it. Rather, we have sown the idea of improvising a Standard Students' Guide for this subject, which would glean many new insights, both in theoretical as well as scorers' aspect. So we have given our every strength to it with a dream to revolutionize a subject, which we are sure that many students fail to grow interest in.
This book has been incubating in our heads for the last 2 years since we came across the voluminous syllabi of this subject ourselves and could not have access to a concise form of ‘Must know’. There is something distinctly fascinating even about this subject and our idea was to emerge that which precedes these thorough endeavor.
This whole idea includes itself from the roots of PHC up to WHO in its deliberate and illustrative format, with efficiency of being a handy dealing during examinations. The references and schematic illustrations have been skillfully checked and improvized to avoid echoes of perpetuation and recent values have been updated till date.
We are grateful to many renowned personalities of this subject who were with us being actively involved in the project from its inception. Any kind of mistake is unintended and may kindly be excused; we will surely entertain all the suggestions and rectify them in the subsequent editions.
We are very much hopeful for this title because we have already put our best efforts to ensure the student-friendliness of this book. We hope this book will reduce the pressure of the students during tough times and as well will hold the position of one of the most updated books of the regarding subject in current times. Last but not least, we would be highly elated if this book emphasizes own potential and accessibility at its best for whom it is written and presented throughout these years.
Prithwiraj Maiti
Bismoy Mondal6789101112
West Bengal University of Health Sciences (WBUHS)
  1. Introduction to Community Medicine: Concepts and evolution of Public Health, Preventive Medicine, Social Medicine and Community Medicine, Concepts of individual, family and community health, Significance of community medicine in promotive, curative, preventive and rehabilitative health interventions.
  2. General concepts of Health and Disease: Definition of health, Definition of disease, Interrelation between health and overall human development, Indicators of health and human development, Disease causation, Natural history of disease and its significance in prevention and control of disease, Disease prevention, Levels of prevention and modes of interventions, Community diagnosis, Community physician, Functions of a physician, International classification of diseases.
  3. Epidemiology—General considerations: Definition, Aims and uses of epidemiology; Sources of epidemiological data, Measurements of disease frequency, Health related states and events, Measurements of mortality, Certification of death, Epidemiological indicators and its application, Epidemiological triad. Descriptive, analytical and experimental epidemiology; Epidemiological studies: types, purposes, methods, advantages and disadvantages; Etiological hypothesis, Association and causation, Research methodologies. Application of epidemiological methods in assessment of health and disease and evaluation of health programmes, Natural history of diseases, Multifactorial causation, Dynamics of disease transmission, Modes of disease transmission, Concepts and strategies for disease prevention, control, elimination and eradication; Disease surveillance. Host immunity, Immunizing agents, Cold chain, Adverse events following immunization, Immunization schedules, Universal immunization programme, Conduction of immunization session and calculation of vaccine requirement. Disinfection, Sterilization, Universal precaution. Investigation of epidemic and outbreak control. Epidemiological exercises.
  4. Disease screening: Concepts and application in community health, Definition and significances of sensitivity, specificity and predictive value.
  5. Epidemiology of communicable diseases (including relevant National programmes): Smallpox, Chickenpox, Measles, Rubella, Mumps, Influenza, Diphtheria, Whooping cough, Meningococcal meningitis, Tuberculosis, Acute respiratory infections, Poliomyelitis, Viral hepatitis, Acute diarrhoeal diseases, Cholera, Typhoid, Food poisoning, Amoebiasis, Ascariasis, Hookworm infection, Dracunculiasis, Malaria, Filaria, Dengue, Rabies, Yellow fever, Japanese encephalitis, Rickettsial diseases, Plague, Leishmaniasis, Trachoma, Tetanus including Neonatal Tetanus, Leprosy, Scabies, Sexually transmitted diseases, HIV and AIDS.
  6. 14Epidemiology of non-communicable diseases (including relevant National programmes): Coronary heart disease, Hypertension, Diabetes, Obesity, Rheumatic heart diseases, Cancer, Blindness, Accidents, Geriatric health problems and interventions.
  7. Demography and population dynamics: Demographic trends in world and India, Impact on socio-economic and health situation, Demographic parameters, Fertility, Factors determining fertility, Fertility indicators, Fertility situation in India and population stabilization, Family planning and family welfare, National Population Policy 2000, National socio-demographic goals, Methods of contraception, Medical Termination of Pregnancy Act.
  8. Maternal and child health: Significance of maternal and child health in relation to overall health situation in India, Reproductive and child health problems in India, Maternal health interventions during pregnancy, childbirth and lactation, Child health care with special reference to essential newborn care, nutrition during infancy and childhood, growth and development, growth surveillance, Low birth weight and prematurity. Indicators of maternal and child health, Prevention and control of maternal and child morbidity and mortality. School health programme. Adolescent health. National programmes related to MCH care with special reference to RCH program. (National programmes related childhood diseases like ARI, diarrhoea, VPDs to be dealt with Epidemiology of communicable diseases).
  9. Nutrition and health: Macronutrients and Micronutrients—physiological functions, dietary sources, requirements, deficiency conditions, Classification of food and nutritional values, Balanced diet. Nutritional diseases of public health importance in India – PEM, nutritional anemia, vitamin A malnutrition, iodine deficiency disorders, fluorosis. Nutritional factors in coronary heart disease, diabetes, cancer and obesity. Assessment of nutritional status at community level, Diet survey, Nutritional surveillance. Food hygiene – milk, meat, fish; Food-borne diseases, Food toxicants. Food fortification, Food additives, Food adulteration, Prevention of Food Adulteration Act. National programmes on nutrition, Integrated Child Development Service Scheme.
  10. Social and behavioural science: Concepts of sociology and behavioural sciences as relevant to practice of Community Medicine, Health behaviour and factors affecting it. Society, community, social stratification, social problems, social security, interrelation between socio-cultural factors and health, Socio-economic class. Family—types, functions, role in health and diseases. Psychosocial problems affecting health, Drug addiction, alcoholism and juvenile delinquency.
  11. Environment and health: Relationship between environment and health, Health hazards arising out of environmental conditions. Concepts of safe water, Water pollution and contamination, Hazards of unsafe water, Water-borne diseases, Hazards of water contamination with special reference to arsenic and fluoride, Water purification at family and community level, Water quality standards, Bacteriological surveillance of water quality, Disinfection of drinking water sources. Air pollution – sources, health hazards, air quality monitoring. Housing and health, Housing standards, Overcrowding. Assessment of housing and environmental condition at community level. Noise pollution, Radiation hazards, Thermal environment and health. Sanitation barrier, Excreta disposal, Solid waste 15management, Liquid waste management. Bio-medical waste management, Hazards of unplanned industrialization and urbanization. Arthropods of medical importance [may be integrated with teaching of communicable diseases]: Mosquito/housefly/louse/rat flea/sand fly/hard tick/soft tick/itch mite/Cyclops—life cycle, diseases transmitted, control measures, Integrated vector control.
  12. Occupational health: Health hazards due to occupational environment, Occupational diseases including Pneumoconiosis, Lead poisoning, Occupational cancers and occupational dermatitis. Prevention and control of occupational diseases, Health protection of workers, Ergonomics, Sickness absenteeism, Social security for workers. Indian Factories Act, Employees State Insurance Act.
  13. Genetic disorders: Human genetics and community health, Prevention and control of genetic diseases of public health importance, Genetic counseling.
  14. Health information system: Sources of health information and its uses, Census in India.
  15. Bio-statistics: Types of data, Methods of data compilation, Analysis and presentation. Rate, ratio, proportion, statistical averages, measures of dispersion, Normal distribution and normal curve, Basic concepts of probability theory and binomial distribution, Basic understanding of tests of significance. Sampling – methods, uses, calculation of sample size. Statistical exercises.
  16. Health education and communication: Principles of health education, Communication for behaviour change, Information, education and communication, Communication process, channels of communication, types of communication, advantages and disadvantages of different channels and methods of communication. Counseling, Application of counseling in health programmes. Planning and implementation of IEC programmes.
  17. Health planning, management: Definition of planning, Steps of planning, Planning cycle. Resource management with special reference to rural health care setting, Supervision, monitoring and evaluation of health programmes. Health planning in India, National Health Policy, Health for all.
  18. Health care delivery system in India: Levels of health care with special reference to primary health care. Definition, principles and components of primary health care. Health care system in India, Health care administration and organization at Center, State, District and Block levels; Community Development Blocks, Role of Panchayati Raj Institutions– community participation and decentralized planning. Health care system in rural India – organization and functions of health institutions at block level and below, Primary health center, Subcenter, Community level health functionaries, Functions of different categories of health personnel. Non-Government Organizations. International health agencies (WHO, UNICEF). National health program implementation at the block level and evaluation of health programmes. [To be integrated with teaching of relevant health problems].
  19. Disaster management: Types of disasters, Health hazards of disasters, Disaster preparedness, Disaster management.
TOTAL = 200 marks
A. Written paper: 60 marks in each paper × 2 papers = 120 marks
1. General concepts of health and disease
1. Demography
2. Epidemiology
2. Maternal and child health
3. Disease screening
3. Nutrition and health
4. Epidemiology of communicable (including childhood diseases, like ARI, diarrhoea, VPDs) and non-communicable diseases
4. Social and behavioural sciences as relevant to community health
5. Health information
5. Occupational health
6. Biostatistics
6. Health education and communication including counseling
7. Environmental health
7. Health planning and management
8. Disaster management.
8. Health care delivery.
B. Viva: 10 marks
C. Practical: 30 marks
D. Internal Assessment: 40 marks
Group—A [Answer any one question]
  1. Define epidemiology and epidemic. Enumerate with examples the different types of time trends in disease occurrence. Mention briefly the important differences between case-control and cohort studies. [2+2+4+4 = 12]
  2. What is ‘disease surveillance’? Discuss the activities under AFP surveillance currently being undertaken in India. [2+10 = 12]
Group—B [Answer any two questions]
  1. Malaria cases are occurring frequently in your block. Discuss the steps you would take as BMOH for management. [12]
  2. A few cases of enteric fever have been reported in a hostel of a medical college. How will you investigate the outbreak? What measures will you take to control the outbreak? [6+6 = 12]
  3. An under-five child with history of cough and difficult breathing has been brought to subcenter. How the subcenter health worker (female) will assess, classify and manage the case? [4+3+5 = 12]
  1. Write short notes on any three: 4 × 3=12
    1. Health hazards of radiation
    2. Iceberg phenomenon of a disease
    3. Risk factors of coronary heart disease
    4. Biological transmission
  1. Answer in brief, any three of the following: 4 × 3=12
    1. Urban slum dwellers are subjected to multiple environmental hazards – explain.
    2. Modalities for prevention of Hepatitis B.
    3. Coliform bacteria are chosen as the indicator of faecal contamination of water – Why?
    4. There are multiple sources of health information – explain.
Group—A [Answer any one question]
  1. Enumerate the National Nutritional Programmes. What are the objectives of ICDS programme? Who are the beneficiaries and what are the services provided under ICDS scheme? [2+3+2+5 = 12]
  2. What is ‘pneumoconiosis’? Enumerate the different types with the causative factor for the respective types of pneumoconiosis. Briefly outline the measures for prevention of pneumoconiosis. [2+4+6 = 12]
Group—B [Answer any two questions]
  1. CPR is reported to be very low in your block. As BMOH, how will you plan and organize awareness campaign in your block to improve the situation? [12]
  2. Maternal mortality was found to be high in your block. What measures will you take to reduce the problem? [12]
  3. A large number of women are suffering from nutritional anemia in a block. As a BMOH how will you assess the problem? What measures will you take up to control the problem? [6 + 6 = 12]
  1. Write short notes on any three: 4 × 3 = 12
    1. Demographic cycle
    2. Functions of WHO
    3. MTP Act
    4. Family
  1. Answer in brief, any three of the following: 4 × 3 = 12
    1. Subcenters are the nodal points for delivery of health care in rural areas – justify the statement.
    2. Outline various methods of contraception after an unprotected intercourse.
    3. Explain why IMR is considered as a very sensitive indicator of health status.
    4. Medical care and health care is not synonymous – Explain.
19All India Institute of Medical Sciences (AIIMS)
Concepts in community health
Bio-statistics in Health
Behavioural sciences and their relevance to community health
Natural history of disease and levels of prevention
Measuring the burden of disease in community
Culture, habits, customs and community health
Health problem associated in urbanization and industrialization
Health estimation in India
Family and its role in health and disease
Measuring vital events in community
Health seeking behavior—barriers to health
Health planning in India
Collection of vital statistics in the community
Epidemiology as a tool for community health
Health Planning in India
Collection of vital statistics in the community
Epidemiology as a tool for community health
collection of data—sampling methods, sample size
Community organization in rural and urban areas—community participation
Environment and community health
Survey methods and interview techniques in community health
Attitudes: development and measurement
Water and community health
Probabilities and conditional probabilities
Socio-economic measurement status and its role in community health
Analysis of qualitative data
Normal distribution, Bi-nominal distribution and poison distribution
Medico-social problem, beliefs and practices related to acute and chronic diseases
Waste disposal
Tests of significance of statistical hypothesis
Indoor environment and health
Human sexuality; sex and marriage counseling
Introduction to nutrition and nutritional problems of India, introduction to family health advisory service and approaching the families in community—1
IEC and health education strategies
Measurement of nutritional status of community, introduction to family health advisory service and approaching the families in community—2
Health education tools and audio-visual aids
Nutritional requirements and sources
Planning and evaluation of health education programmes
Food hygiene, food adulteration and food poisoning
Introduction to maternal and child health
Protein energy malnutrition, growth monitoring and promotion
Infant and child mortality
Breastfeeding and weaning and baby-friendly hospital breast feeding promotion
High risk strategy and risk factors in pregnancy and child birth
Nutrition programmes in India
Food habits, customs related to pregnancy, child birth and lactation
Causation and association
Reproductive and child health programme
Case-control studies
Cohort studies
Health care of special groups: Adolescents and school children
Cross-sectional studies
Health care of aged
Interventions trial in community
Screening methods in community
Population dynamics: Demographic cycle, demographic transition
Working environment and community health
Demographic trends in India
Family planning methods: spacing methods
Health hazards faced by agricultural workers
Family planning methods: permanent methods
Industrial toxic exposures
Fertility and fertility related statistics
Prevention of occupational diseases and ESI
National Family Welfare Programme—1
Life tables and life table technique for evaluation of family planning methods
National family welfare programme—2
National population policy
Dynamics of disease transmission and control
Immunity, herd immunity, immunization schedule routine and specific, immunization: active and passive
Disinfection, disinfectants, disposal of infective material, concurrent and terminal disinfection surveillance: Active, passive, sentinel and international health regulations
Introduction to management: Planning, management and evaluation
Epidemiology of tuberculosis and control programme
Health services organisation
Epidemiology of malaria and control programme
National health policy: concepts of health care, primary health care
Epidemiology of leprosy and control programme
Functions of primary health centre: Health care team training and supervision
Epidemiology of filariasis and control programme
Voluntary agencies and international health agences
Epidemiology of diphtheria and pertussis and control programme
Health resources management: Personnel and material
Epidemiology of tetanus/tetanus neonatorum and control programme
Introduction to health economics
Epidemiology of poliomyelitis and control programme
Epidemiology of kala-azar and control programme
Epidemiology of viral hepatitis and control
Epidemiology of typhoid and control
Epidemiology of diarrhoeal diseases and control programme
Epidemiology of measles, mumps, rubella and control
Epidemiology of re-emerging diseases: Plague, yellow fever, influenza, meningococcal meningitis
Epidemiology of re-emerging diseases: Dengue, JE, encephalitis, KFD
Epidemiology of rabies and control
Epidemiology of Chickenpox and control, Smallpox eradication
Epidemiology of helminthic and protozoal infections and control (Hookworm, Roundworm, amoebiasis, Guinea worm)
Epidemiology of sexually transmitted diseases including AIDS and control
Demographic and epidemiological transition in India
Epidemiology and control of blindness
Epidemiology and control of cancers with special reference to cancer of cervix and breast cancer, tobacco related cancers, lung cancer, head and neck cancer
Epidemiology and control of accidents
Epidemiology and control of cardiovascular diseases
Epidemiology and control of diabetes mellitus
Total Marks = 600 (Theory = 300, Practicals = 300)
  • Internal assessment
: 150
Distributed equally in theory and ...........
  • Pre-professional Exam
: 150 practicals
  • Professional Exam
: 300
22Tamil Nadu M.G.R. Medical University
I. Concepts in Health
Must know
  1. Definition of health.
  2. Determinants of health.
  3. Characteristics of agent, host and environmental factors in health and disease and the multifactorial aetiology of disease.
  4. Various levels of prevention and modes of intervention with appropriate examples.
  5. Indices used in measurement of health.
  6. Health situation in India: demography, mortality and morbidity profile and the existing facilities in health services.
Nice to Know
  1. Appreciation of health as a relative concept.
  2. Disease classification: International classification of diseases.
II. Epidemiology
Must Know
  1. Use of basic epidemiological tools to make a community diagnosis.
  2. Epidemiology: Definition, concept and role in health and disease.
  3. Definition of the terms used in describing disease, transmission and control.
  4. Natural history of a disease and its application in planning intervention.
  5. Modes of transmission and measures for prevention and control of communicable and non-communicable diseases.
  6. Definition, calculation and interpretation of the measures of frequency of diseases and mortality.
  7. Common sampling techniques, simple statistical methods for the analysis, interpretation and presentation of data, frequency distribution, measures of control tendency, measures of variability.
  8. Need and uses of screening tests.
  9. Accuracy and clinical value of diagnostic and screening tests (sensitivity, specificity, predictive values).
  10. Planning and investigation of an epidemic of a communicable disease in a community setting.
Desirable to Know
  1. Principle source of epidemiological data
  2. Various types of epidemiological study designs.
Nice to know
  1. Institution of control measures and evaluationa of the effectiveness of these measures.
  2. Application of computers and epidemiology.
III. Biostatistics
Must Know
  1. Sampling.
  2. Collection, classification and presentation of statistical data.
  3. Analysis and interpretation of data.
  4. Obtaining information, computing indices (rates and ratio) and making comparisons.
Nice to Know
  1. The scope and use of biostatistics.
  2. Use of statistical tables.
IV. Entomology
Must Know
  1. Role of vectors in the causation of diseases.
  2. Clinical features of and mode of transmission of common vector borne diseases (Malaria, Filaria dengue, Jap. B. Encephalitis, Kala-azar).
  3. Methods of vector control.
Desirable to Know
Advantages and limitations of each method of vector control.
Nice to Know
Mode of action, dose and application cycle of commonly used insecticides.
V. Environmental Sanitation
Must Know
  1. Concept of safe and wholesome water.
  2. Requirement of sanitary sources of water (sanitary well).
  3. Sources, health hazards and control of environmental pollution.
  4. Standards of housing and the effect of poor housing on health.
Desirable to Know
  1. Methods to purification of water with stress on chlorination of water large scale and small scale purification.
  2. 24Disposal of solid waste and liquid waste both in the context of urban and rural conditions in the country.
  3. Problems in the disposal of refuse, sullage and sewage.
  4. Concepts of safe disposal of human and animal excreta.
  5. Influence of physical factors—like heat, humidity, cold, radiation smoke and noise—on the health of the individual and community.
Nice to Know
  1. Various biological standards.
  2. Physical, chemical standards, tests for assessing quality of water.
  3. Hospital waste management.
  4. Animal excreta.
VI. Epidemiology of Specific Diseases
The specific objectives of selected communicable diseases of public health importance for which National Disease Control/Eradication Programmes have been formulated are described here. For other diseases, the individual teacher would formulate the objectives while drawing the lesson plans. The idea of formulating objectives for a few diseases is to highlight their importance and to emphasis certain learning outcomes.
Poliomyelitis, Infective hepatitis, ARI, Tuberculosis, Leprosy, Malaria, Filariasis, Kala Azar, STDs HIV and AIDS. Diarrhoeal diseases, Hypertension, Coronary heart disease, Blindness, Mental Health, Diabetes, special emphasis on emerging and reemerging infectious diseases.
Must Know
  1. Extent of the problem, epidemiology and natural history of the disease.
  2. Relative public health importance of a particular disease in a given area.
  3. Influence of social, cultural and ecological factors on the epidemiology of the disease.
  4. Control of communicable and non-communicable diseases:
    1. Case definition, diagnosing and management (laboratory and treatment)
    2. Principles of planning, implementing and evaluating control measures for the diseases at the community level bearing in mind the relative importance of the disease.
  5. Discuss prevention issues with regards to 5 levels of prevention.
  6. National Programmes.
VII. Occupational Health
Must Know
  1. Employees States Insurance Scheme.
  2. Identification of the physical, chemical and biological hazards to which workers are exposed while working in a specific occupational environment.
  3. Preventive measures against these diseases including accident prevention.
Desirable to Know
Various legislations in relation to occupational health.
Nice to Know
Diagnostic criteria of various occupational diseases.
VIII. Nutrition
Must Know
  1. Common source of various nutrients.
  2. Nutritional assessment of individual.
  3. Common nutritional disorders: Protein energy malnutrition, vitamin-A deficiency, anaemia, iodine deficiency disease, fluorosis, food toxins diseases and their control and management.
  4. National programmes in nutrition.
Desirable to Know
  1. Special nutritional requirement according to age, sex, activity, physiological condition.
  2. Assessing the nutritional status of the family and the community by selecting and using appropriate methods such as: anthropometry, clinical, dietary, laboratory techniques.
  3. Diet for individual and families and special groups.
  4. Food hygiene and food fortification.
Nice to Know
Laboratory techniques.
IX. Genetics and Community Health
Must Know
Role of genetics in health and preventive measures in inherited disorder.
Desirable to know
Population genetics.
Nice to Know
  1. Genetic predisposition in common disorders.
  2. Preventive and social measures—Eugenics, genetic counselling.
X. Sociology and Community Health
Must Know
Social factors influencing health and disease.
Desirable to Know
Assessment of socio-economic status.
Nice to Know
  1. Concepts in sociology.
  2. Poverty and social security.
XI. Health Education
Must Know
  1. Effective communicable with individuals, family and community using tools and techniques of information, education and communication.
    1. Barriers to effective communicable
    2. Principles, methods and evaluation of health education
    3. Methods of health education—their advantages and disadvantages
    4. Selection and use of appropriate media (simple audio-visual aids) for effective health education.
XII. Demography and Family Planning
Must Know
  1. Definition of demography.
  2. Population pyramid.
  3. Stages of the demographic cycle and their impact on the population.
  4. Definition, calculation and interpretation of demographic indices like birth rate, death rate, growth rate, fertility rates, etc.
  5. Definition of family planning. Different family planning methods and their advantages and shortcomings. Recent advances in contraception.
  6. Medical Termination of Pregnancy Act.
  7. National Family Welfare Programme.
Desirable to Know
  1. Reasons for rapid population growth in India.
  2. Need for population control measures and the National Population Policy.
XIII. Maternal and Child Health (MCH)
Must Know
  1. Magnitude and causes of maternal morbidity.
  2. Concepts of ‘high risk’ and ‘MCH Package’. Child survival and safe motherhood. Integrated Child Development Scheme and other existing regional programmes—RCH I and RCH II, IMNCI.
  3. Under-5: Morbidity, mortality, high risk and care (perinatal, infant and child).
  4. Monitoring of growth and development and use of road to health chart and under 5 clinic.
  5. Organisation, implementation and evaluation of programmes for mothers and children as per National Programme Guidelines; supervising health personnel; maintaining records; performing a nutritional assessment; promoting breastfeeding.
  6. Immunization programmes, immunization schedules and cold chain.
Desirable to Know
Need for specialized services for these groups.
Nice to Know
Local customs and practices during pregnancy, child birth and lactation.
XIV. School Health
Must Know
  1. Objectives and activities of the School Health Programmes.
  2. Participation of the teachers in the school health programmes including maintenance of records; defining healthful practices; early detection of abnormalities.
XV. Community Geriatrics
Must Know
  1. Health of the elderly and preventive measures (e.g. osteoporosis).
  2. Care of elderly in organized and unorganized sectors and role of various health care provider including family.
Desirable to Know
Economic and psychosocial needs of the aged.
XVI. Urban Health
Must Know
  1. Reasons for Urban Health becoming an issue.
  2. Special health problems in urban area, e.g. homelessness.
  3. Organization of health services in urban areas including slums.
XVII. Mental Health
Must Know
  1. Community Mental Health services.
  2. Alcoholism, drug dependence—Epidemiological factors and prevention.
Desirable to Know
Importance of Mental Health.
XVIII. Health Planning and Management
Must Know
  1. Salient features of the National Health Policy.
  2. Process of health care delivery in India
    • the health systems and health infrastructure at Centre, State and District levels.
    • the inter-relationship between community development block and primary health centre.
    • the organization, function and staffing pattern of First Referral Unit/Community Health Centers. Primary Health Centres and sub-centre.
    • the job description of health supervisor (male and female) health workers, village health guide, anganwadi workers, traditional birth attendants.
    • the activities of the health team at the primary health centre.
  3. Management techniques: Define and explain principles of management; explain the trhee broad functions of management (planning, implementation and evaluation) and how they relate to each other (planning cycle).
  4. Appreciate the need for International Health Regulations and Disease Surveillance.
  5. Disease Management.
  6. Concepts in Health Economics—including cost effectiveness, cost benefit.
  7. Health for all, PHC concepts, principles and element.
  8. Health committees: Bhore, Srivastava, Mudaliar.
Desirable to Know
  2. Health Committee: National Rural Health Commission (NRHM).
  3. Five year plans.
Nice to Know
  1. Constitutional provisions for health in India: Enumerate the three major divisions of responsibilities and functions (concerning health) of the Union and the State Governments.
  2. Appreciate the role of National and International Voluntary Agencies in health care delivery.
XIX. Other Special Groups
Must Know
Desirable to Know
  1. Tribal health
  2. Children with special needs.
Nice to Know
  1. Child guidance clinics.
  2. Juvenile delinquency.
Internal Assessment
80 marks
40 marks
40 marks
80 marks
Pattern of Examinations
Two papers of three hours duration —100 marks each
Paper I shall cover those topics of the syllabus serially numbered from I to VII under course contents.
Paper II shall cover those topics of the syllabus which are serially numbered from VIII to XIX under course contents.
Community Medicine (2 papers) Each 100 marks
No. of Questions
2 × 15 =
Short notes
10 × 5 =
Short answers
10 × 2 =
Practical I
Clinical Social Case Discussion
Practical II
Epidemiological Exercises
4× 10 =
Spotters and specimens
5 × 2 =
Internal assessment
Grand Total
Theory 100 × 2
Practical Examination
60 marks
Practical I
30 marks
Clinical Social case discussion
Practical II
Epidemiological exercises (2 × 10) :
20 marks
Spotters and specimen (5 × 2) :
10 marks
30 marks
60 marks
20 marks
Guidelines for Practical Examination
  1. In all the subjects of III MBBS Part I, the no. of candidates examined per day shall not normally exceed 30.
  2. There shall be four examiners (2 External and 2 Internal) to conduct the Clinical and Vival Examination.
  3. For Viva: Two sets of examiners shall examine separately on different portions on the syllabus.
Marks Qualifying for a Pass
50% in theory
50% in practical including viva
35% in internal assessment
Total 50% aggregate