Course Details - M.med in Family Medicine
Course Details - M.med in Family Medicine
Course Details - M.med in Family Medicine
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I. PREAMBLE
There are close to 2, 50,000 General Practitioners (GPs) in India who have no access to
postgraduate education. Since the government has not mandated continuous education for
physicians, most of the GPs do not make much effort to remain up-to-date with the developments
in medical education. The lack of continuous updating of the knowledge and skills by these GPs
has led to a situation where there are excessive referrals because they are not confident in handling
cases even with the slightest complication. Many patients, therefore, end up visiting multispecialty hospitals where the health care costs are very high. No wonder, in a World Bank study
done in the year 2004, it was found that the private healthcare sector was responsible for drowning
many below the poverty line!
A Family Physician is a multi-competent specialist who not only provides the point of first
contact, but also provides the continuum of care in a patient-centric way. The number of Family
Physicians doctors satisfying the above definition in the Indian sub-continent is grossly
inadequate to cater to the huge population.
II. THE OVERALL OBJECTIVE
The overall objective of the M.MED (FAM. MED.) program is to build the capacity of GPs and
enable them to manage more cases so that referrals become less necessary hence the motto:
REFER LESS, RESOLVE MORE
HANDBOOK
1
Basics of Family
Medicine
2
Medicine I
Neurological
Problems , Mental
Health
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TOPICS YEAR
MODULE
1
2
3
Medical Documentation
Head Ache
Seizures
Stroke
10
11
12
Movement Disorders
Sleep Disorders
Mental Health Problems
13
Substance Abuse
3
Womens Health
Part I
4
Child Health
Part I
5
Surgical topics for
a Family
Physician Part I
6
MedicineII
Cardiovascular
Problems
7
Medicine III
Respiratory/
Gastro-intestinal
Problems
HANDBOOK
8
Becoming a Family
Physician Roles,
responsibilities,
Attitudes
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14
Antenatal Care
15
Antepartum Problems
16
17
Intra-partum Problems
18
Postnatal Care
19
Contraception
20
Violence in Women
21
Neonatal Screening
22
Neonatal Resuscitation
23
Neonatal Problems
24
25
Immunisation
26
Developmental Delay
27
Neck Swellings
28
Leg Ulcers
29
Acute Abdomen
30
Gastrointestinal Bleeding
31
32
33
34
Chest Pain
35
Dyspnea Part 1
36
Palpitations
37
Syncope
38
Oedema Part 1
39
Hypertension
40
Shock
41
Dyspnea Part 2
42
Approach to Cough
43
44
Dyspepsia
45
Loose Stools
46
Constipation
47
Approach to Jaundice
MODULE
TOPICS YEAR 2
48
49
50
51
Health Advocacy
52
Bio-medical Ethics
53
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Medicine IV
Infections &
Genito-Urinary
Problems
10
Womens Health
Part II
11
Child Health
Part II
12
Surgical topics
for a Family
Physician Part II
13
Medicine V
Musculo-skeletal
Problems & Life
Style Medicine
14
Skin/Blood
Problems &
Emergencies
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54
55
Medico-legal Aspects
56
Health Informatics
57
Fever Part 1
58
Fever Part 2
59
60
HIV
61
Haematuria
62
63
Edema Part 2
64
65
66
Vaginal Discharge
67
Breast Problems
68
Infertility
69
Menopause
70
71
72
73
74
Child Abuse
75
Groin Swellings
76
Head Injury
77
Oral Health
78
Red Eye
79
Diminished Vision
80
81
82
Joint pains
83
Backache
84
85
Weight Loss
86
Obesity
87
Diabetes
88
Lifestyle Modifications
89
90
91
Anemia
92
Bleeding Disorders
93
94
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Occupational
Health & Age specific
Health Problems
95
Occupational Health
96
97
Mens Health
98
Geriatric Problems
99
100
101
VI.2. VIDEO-LECTURES
There are some pre-recorded video-lectures which are part of the course curriculum. Some of them,
you will be watching during the contact programs.
Some will be end-of-day assignments during contact programs where you will have to watch them
in the evenings as preparation for the next class.
Some will be assigned to be watched at home. These will be intimated to you from time to time.
VI.3. CONTACT PROGRAMS
The contact programs form a very important part of the course components. You will be required
to attend 3 compulsory Contact Programs of 11 days each, during the course period of 2 years.
These are intensive sessions of 33 X 8= 264 hours duration.
Objectives of the contact program
1. To impart in this short time
a vision to practice ethical, rational and evidence-based medicine
a strong overview of the principles of Family Medicine
motivation to practice caring and compassionate health care
2. To augment your theory knowledge base
3. To help you hone some of your skills
4. To discuss broad clinical approach to various health problems with a Family Medicine
focus
5. To assess you through face-to face interactions with them as well as through the log
books, which goes into your formative assessment
Contact Centers:
You will be assigned to any one of the below listed centers for your contact programs.
Christian Medical College Vellore, Tamil Nadu
St. Stephens Hospital, New Delhi,
Christian Fellowship Hospital, Oddanchatram, Tamil Nadu
Christian Institute of Health Sciences & Research, Dimapur, Nagaland
Allotment of contact centers is strictly under the purview of CMC.
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Table 2: List of Core Clinical skills taught during the contact programs:
M.MED IN FAMILY MEDICINE CORE COMPETENCIES
GENERAL CORE SKILLS
FAMILY
MEDICINE
SKILLS
SKILLS IN
MEDICINE
& ALLIED
SPECIALTI
ES
GENERAL
MEDICINE
Cardiovascular exam
Respiratory exam
C-V risk assessment
Wells score- DVT decision tool
CHADS2- AF decision tool
CRB 65- respiratory severity score
Abdominal exam
Quick Neuro exam
Foot exam
MENTAL
HEALTH
EMERGENC
Y
MEDICINE
GERIATRIC
S
DERMATOL
OGY
PALLIATIV
E CARE
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Skin examination
BLS/ ACLS
Stabilising and transfer of a
trauma patient
Interpretative
skills
ECG
interpretation
Chest X-ray
interpretation
GENERAL
SURGERY
ORTHOPEDI
CS
SKILLS IN
SURGERY
& ALLIED
SPECIALT ENT
IES
ANAESTHES
IA
MATERNA
L&
CHILD
HEALTH
OBS &
GYNAE
Fundoscopy
Examination of the eye
Eye pads and dressings
Otoscopy
Syringing of ear
Placing an ear-wick
PAEDIATRI
CS
PoP application
Splints and slings
SKILLS IN
Interpretative
skills
OPHTHALM
OLOGY
Breast exam
Neck exam for lumps
Rectal exam
Examination of Genitalia
Back exam
Joint exam e.g. knee
Antenatal exam
Postnatal exam
Vaginal exam
Newborn exam Paediatric
Examination
IMNCI Assessments&
management
APGAR scoring
Developmental Assessment
Limb X-rays
interpretation
Basic
CT/MRI
interpretation
Interpretative
skills
Metrogram
Partogram
Hearing test
Paed Otoscopy
Neonatal Resuscitation
Understanding
normality
Family Oriented
Care
Specific features
Understanding illness behaviour
Understanding help-seeking behaviour
Understanding culture
Understanding quality of life
Understanding risks of medicalisation
Understanding behaviour and relationship
theory
Importance + Influence of Family
Importance Assessment
Family Conference
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Broad
Concepts
Problem -solving
approach
Community
Specific features
Problem-based Vs. disease based
Clinical reasoning
Screening, assessment &decision tools
Use of resources
Integrating doctor and patient agenda
Local epidemiology
Community profile
approach
Family Therapy
Family-at-risk + Thinking Family
Prioritisation
Managing
multiple problems
Information
management
Effective medical
care
Quality assurance
Screening and
prevention
Treatment and
care
Working in teams
Knowing professional boundaries
Using patient record for management
Maintaining patient record
Registers; call and recall systems
Access on line tools
Confidentiality
Evidence based medicine
Guidelines
Formularies
Critical thinking
Research
Audit
Significant event analysis
What's worth screening for and what's
not
Doctor as 'drug'; placebo effects;
Iatrogenic illness
Alternative therapies
Carers
Auxiliary health care professionals
Empowering
patients, carers
and staff
Co-ordination of
care
The Consultation
Health Service
Structure
Comprehensive
care
Cradle to grave
Learning disability
Coping with uncertainty
Rational investigations
Managing risk
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Home nursing
Rehabilitation
Teaching 'skill mix'
Referral procedures
Lead role in complex care
Consultation models
Therapeutic environment
Doctor / patient relationship
Specific communication skills
Telephone consultations
Government programs
Legal framework
Health beliefs
Patient centred care
Doctor and society
Ethics
Understanding
yourself
Encouraging self-care
Behaviour change
Self care
Values, attitudes, feelings, beliefs
Reflective practice
Lifelong learning
'Professional' behaviour, skills& attitudes
Leadership
Doctor as
professional
Teamwork
Conflict resolution
Managing a busy clinic
Quality improvement
Advocacy: patient; self; staff, community
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Fees Per
Installment
Rs. 50,000
Rs. 26,500
As per the University norms, candidates who have completed MBBS abroad will have to pay an
additional fee of Rs.12, 000 toward University Registration.
X. ADMISSION PROCESS
You can download the admission bulletin by clicking on the link:
http://admissions.cmcvellore.ac.in/program.php?programid=11
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I believe that one drop at a time, will eventually make an ocean of responsible and committed
doctors, in service to this nation.
Dr. Maria S Denzil, Bangalore
This course enriches our clinical knowledge and enables us to treat the patients more confidently.
Dr. Rinku Ghosh, Bangalore
The practical sessions of otoscopy & fundoscopy helped in improving my clinical skills.
Dr. Preetha S.R, Trivandrum
The problem approach which the modules contained stimulated my reading
Dr. Devavaram Prathipaty, Guntur, Andhra Pradesh
The two year program has been an enlightening one and has brought about in us a positive attitude
and confidence to carry on our profession to the best of our capabilities.
Wishing CMC and the Distance Education Dept success in all their future endeavors.
God bless.
Dr. Julie Jose, Oman
The entire prospectus and the study material has been designed in a very interesting manner
I am a much more confident Doctor now.
Dr. Mitaly Pathak Agarwal, Bangalore
The algorithms provided in the course booklets served as useful guides.
Dr.M.Thulasimani, Pondichery
The course has added tremendous value to the way I manage co-morbidities in my patients.
The central office at Vellore has been exemplary in its support and flexibility to me and I
understand to many others, to help complete the course.
Dr. Nandini Vallath, Bangalore
It is very useful for medical practitioners who are practising in rural areas and cannot attend regular
courses leaving their practice. The modules are very attractive and make the students to read it and
complete the assignments also. It empowers the medical practitioners with knowledge. I strongly
feel FAMILY MEDICINE is the specialty which is needed for the community at present.
Dr. R.Parimala, Coimbatore
When I joined the course, I had the desire to know something about everything. During these past
2 years, my views and thoughts about the medical profession have changed.
Dr. Suryakanthi C, Ernakulam, Kerala
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It gave me the necessary confidence and a new paradigm Refer less and resolve more
Dr. Renu Saraogi, Bangalore
Now I serve as the patients advocate, explaining the causes and implications of illness to the
patients and their families, and I serve as an advisor and confidant to the family.
Thank you.
Dr Pragati Kumar, Ghazipur, UP
This course, not only changed my approach towards health concerns but also helped in extending
continuing care of varied medical conditions which are not limited to a diagnosis or organ system.
Dr. Kaushik Chatterjee, Mohanpur, Nadia, WB
I am working as medical officer at the ESI Dispensary. By this course I have gained confidence,
patience and good communication skills.
Dr. Sushama Mary, Kollam, Kerala
The course has given me confidence in dealing with patients with the limited resources
Dr. Jennifer Shullai, Shillong, Meghalaya
It has taught me to listen to my valuable patients patiently and to listen to their spoken and
unspoken problems and to address them in a broader way, and thus establish a good doctor- patient
relationship I used to avoid pediatric patients before, but now I dont.
Dr. Debasish Sinha, Kolkata
I have come to realization that most cases presenting to our out patients are primary care problems.
The algorithmic style of approach to diagnosis leads to institution of early proper treatment and
better outcome.
Dr. Tshiani.K. Nigeria
The whole concept of Refer less and resolve more, is a wonderful concept, which will actually
resolve 3/4th of our countrys health problems, and THIS is what the whole PGDFM course has
conveyed, in words and in action in the last two years.
For a Radiologist like me, who purely took up this course due to my own unquenchable love for
Clinical Medicine, in spite of branching off into Radiology for the last 20 years, it was pure bliss
to recapitulate and even unlearn and relearn so many things.
The contact programs were delightful with the instructors so very dedicated and passionate about
Family Medicine.
I enjoyed the journey more than the Destination, and the Journey will go on life long,..
Dr. Akhilandeswari Prasad, New Delhi.
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Well crafted, concise, updated, evidence based, tailored to Indian standards, easy to study even for
busy doctors, is what I can say in a line about the course.
Now I feel that a Family Medicine is itself a speciality which requires the same or even higher
level of clinical skill than my consultant colleagues for which no substitute exist or is in no way
inferior. Now I know the healing power of a properly done personalized consultation.
Dr. K.J.Anoop, Kerala.
This is one course I would advocate for all who are struggling in their specialties and super
specialties and have forgotten the art of dealing with the general O.P.D.
Dr. Beatrice Madhavan, Aligarh.
Each and every subject in the modules are written so nicely and are helpful for our practice.
Dr. Dilip Kumar Phukan, Dangari, Tinsukia, Assam.
I imbibed the concepts of Family Medicine and changed my practice from patient care to FAMILY
ORIENTED PATIENT CARE. Now, health education and training paramedical staff has become
part of my practice. I feel happy to be part of this great concept of changing Indian health scenario
and encouraging & incorporating the practice of Family Medicine in our healthcare system.
Dr. Chilaka Rajesh, Visakhapatnam.
made me feel like a real learner.
Dr. Lal Mohan Ho, Bhubaneswar, Odisha.
Being posted in remote and inaccessible areas since I graduated in 2008, this course has become a
blessing to many a patient, who do not have to go too far off towns for treating their ailments any
more, and made me a likeable person.
Dr. P. Hegin Tungdim, Churachandpur, Manipur.
It enabled me to look at the whole person Most importantly this course has prompted me to dig
deeper into the world of Medicine and seek more knowledge.
Dr. Moanarola Ao, New Delhi.
it will be a feather in my cap and a great value addition to my career.
Dr. Narendra Kumar Gupta, Patna.
My approach to the patients has completely changed for the better; I learnt the importance of a
Family Physician in the community.
Apart from the medical aspect I got to meet many doctors from different places and got into a
professional network of friends.
Dr. M.Porselvi, Bangalore.
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I have learnt the art of breaking bad news to my patients and their relatives based on my encounter
in this program- Above all the course has taught me, Christian Values, imbibed at CMC.
DR. Sokowo Allagwoni Jacob, Nigeria.
an excellent, informative and enlightening journey.
I was wondering whether I would be able to remember everything. But the flow of the chapters
made learning easy and enjoyable.
Doing this course is helping me in my practice and also in advising and treating my own family.
Dr.Prathiba Janardhanan, Dhrishti Eye Care, Chennai.
I thank God for the training, my life is so blessed. I learnt about the correct attitude to have towards
the profession seeing it as a vocation and not a carrier. In short my patients are enjoying better
services. .
Dr. Vincent Baba Abaya, Nigeria.
These books are going to be of great value, as a ready reckoner during daily practice.
One remarkable fact I would like to point out, is the openness and acceptance of each other that
prevailed. There was a perfect camaraderie and I am thankful for this experience which
transformed us from busy hard core professionals, to students willing to learn from each other.
Dr. Rukhsana Dutt, Muscat, Oman.
From the first module itself I understood there were a huge amount of things which a General
Practitioner should learn. This course really gave me immense amount of confidence in dealing
from paediatric to geriatric. I dont consider myself as a great physician, but know that Im a better
physician than I was before.
Dr. Sunil Vijayakumar, Sharjah, UAE.
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And Jesus, when He came out, saw a great multitude and was moved with compassion for them,
because they were like sheep not having a shepherd. So He began to teach them many things.
When the day was now far spent, His disciples came to Him and said, This is a deserted place,
and already the hour is late. Send them away, that they may go into the surrounding country and
villages and buy themselves bread; for they have
nothing to eat.
But He answered and said to them, You give them something to eat.
And they said to Him, Shall we go and buy two hundred denarii worth of bread and give them
something to eat?
But He said to them, How many loaves do you have? Go and see.
And when they found out they said, Five, and two fish.
Then He commanded them to make them all sit down in groups on the green grass. So they sat
down in ranks, in hundreds and in fifties. And when He had taken the five loaves and the two
fish, He looked up to heaven, blessed and broke the loaves, and gave them to His disciples to set
before them; and the two fish He divided among them all. So they all ate and were filled. And
they took up twelve baskets full of fragments and of the fish. Now those who had eaten the
loaves were about five thousand men.
Mark 6:30-44 (Bible)
Anything given in the Lords hands multiplies!
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