Fourth Year Community Medicine Guidelines 2023

Download as pdf or txt
Download as pdf or txt
You are on page 1of 9

COMMUNITY MEDICINE GUIDELINES

BY ALEEZA UROOJ
Introduction:
Almost all of you will hear from your seniors that C-med is very dry and hard to grasp but trust
me it is different and interesting. It is more of a practical subject than a theoretical one. There
is going to be a lot of practical work during the session and all of that will be counted in your
internal assessment.

UHS Exam Pattern:


1. Written Exam
• 65 MCQs (1 mark each)
• 14 SEQs (5 marks each)
• Internal Assessment (15 marks)
2. Practical Exam
• OSPE (40 marks)
• Internal viva (35 marks)
• External Viva (35 marks)
• Practical work of whole year (40 marks)

Study Material:
• Class lectures are most important
• Excel Community Medicine and Public Health
• Park’s Textbook of Preventive and Social Medicine

How to Study:
From my personal experience, I would advise you to must attend and understand the lectures
especially by HOD, Dr. Mehwish and Dr. Sana. As C-med is a vast subject and cannot be
covered from a single or two books so, teachers provide the right amount of knowledge and
almost everything regarding proff. After lectures, you’ll go through book and you’ll find it quite
easy. C-med is very volatile subject. You study it for test and that’s enough. You have to pay
special attention to the practical work in order to get good internal assessment as everything
in proff viva depends on it.

C. Med Department and Proff:


Department is so good, supportive and helping MA. They guide you throughout the year every
way possible. In proff, HOD is so lenient and most of the times your viva marks depend upon
your internal assessment. Unfortunately, we got the worst external examiner ever in the
history, he didn’t pass a single student and awarded us with zero marks but our department
saved us from supplies. In short, if you are good throughout the year, you’ll end up getting
good marks IA.

PRACTICAL WORK
1. Research
Research is a major part of practical and it carries 15 marks. Group of 10 to 12 people will
work on it. One will be the leader. There will be 6-7 lectures in class and then you’ll follow all
the steps of research practically. I must tell you in the beginning that a Performa will be filled
in the end to evaluate that who did the maximum work and who just joined the group and did
nothing so internal assessment marks will be given according to that. The steps include
selection of topic, synopsis, ERB approval, data collection, analysis, results, abstract and final
report. Data will be analyzed in spss software (you can get this software from seniors). Also,
there is a conference named SCICON, in which you present your research orally or by poster.
Aimcacademia.blogspot.com
Email: aimcacademia@gmail.com
Facebook: m.facebook.com/aimcacademia
1
It also will ensure you additional marks in internal. You don’t have to worry about the process
as teachers will spoon feed you everything regarding this.

2. Household Survey and Report


You will fill out 10 household survey forms in summer vacations, analyze the data and present
the result in the form of a report. Spss software will be used for this also and guidelines will be
provided by the department for presentation.

3. Field Trips
Field trips are also very important. There are 10 field trips each carrying 1 mark. Field trips are
actually fun. If you have missed any, you should attend it with another batch. At the end of
field trips, there will be an ospe. There are specific topics for ospe which I’ll tell you later. Try
to fill out the forms which are provided to you on field trips as they will help you in your journal.

4. Assignments
There will be tests for some topics and assignments for others. Obviously, they also carry
marks in internal assessment. So, try to submit assignments on time. They are very important
for epidemiology.

5. Journal
There are two sections.
• News Cuttings
You have to paste news cuttings of almost 10 news related to topics provided by the
department like mental health, occupational health, communicable disease etc. Also,
you have to mention the date, source, news and your interpretation.
• Field trips
You have to fill in the data of field trips as I already mentioned. Also, you have to post
pictures of your relevant field visits and growth chart in the MCH field visit.

THEORY
1. BASIC DEFINITIONS
Read the whole chapter for concept building.
Important topics
• Program and its types
• Community diagnosis, the concept of disease control
• Epidemiological triad
• Agent factors for disease
• Levels of preventions and modes of intervention (mcq can come with a scenario and
you have to apply any level or seq can come with a disease and you are asked to apply
the levels and modes)

2. CONCEPT OF HEALTH AND DISEASE


The whole chapter is important. Definitions are a must.
Important topics
• Spectrum of disease and Iceberg of disease
• Determinants and Dimensions of health (mainly headings)
• Indicators of health (very imp from mcq pov)
• PQLI & HDI
• Millennium goals (just names of goals but in order)
• SDGS (just names)
• Diff. b/w community medicine and clinical medicine (fav q of hod)
Aimcacademia.blogspot.com
Email: aimcacademia@gmail.com
Facebook: m.facebook.com/aimcacademia
2
3. PRIMARY HEALTHCARE
3 mcqs & 1 seq
Mam Mehwish will teach you this topic so good that you will memorize then and there the
important seqs.
Important topics
• Definition, elements & principles of PHC
• Health for all (imp from viva pov)
• Health planning cycle (imp seq)
• 5-star doctor
• Levels of health care (services, staff, buildings)
• Diff. b/w BHU & RHC (table at the end)
• Duties of staff like LHV, LHW, Doctor at BHU
• Selective vs Comprehensive health care (GOBIFFF imp)

4. BIOSTATISTICS
1 seq 4 mcq 1 or 2 ospe station
This chapter will be favorite of those who love math and lectures of Dr. Sana are must.
This will also help in household report and research. I would advise to have a look from park.
First three pages up to scattered diagram are important for ospe & mcqs.
Important topics
• Measures of central tendency and dispersion (ospe station and seqs of calculation,
standard deviation is most imp.)
• Chi square test
• Student t test
• Test of significance
• Life table
• Normal distribution curve
• Probability
• Standard error
• Hypothesis and its types

5. EPIDEMIOLOGY
1 seq & 5 mcqs
Very important chapter regarding written, viva, research, ospe (HODs fav topic)
First few pages and their formulae are very important. Case control and cohort studies are
super important. Blinding and investigating a case of epidemic are also very important. In
short, whole chapter is important. It is conceptual chapter and HOD himself teaches this. All
the formulae are important and usually numerical comes and you have to solve this. So, if you
have good understanding only then you can solve the questions in paper and ospe.
Important seqs
• Def, components, uses of epidemiology
• Formulae in measures of mortality (numerical type questions. CFR imp)
• In measures of morbidity, incidence, prevalence, & secondary attack rate are v imp
• Case control and cohort studies (numericals, advantages, disadvantages)
• Experimental for mcqs
• Blinding and types
• Association types (mcqs)
• Criteria for judging causality
• Web of causation and types of epidemics
Aimcacademia.blogspot.com
Email: aimcacademia@gmail.com
Facebook: m.facebook.com/aimcacademia
3
• Basic steps of epidemic investigation
• Bias and its type

6. IMMUNOLOGY
1 seq, 5 mcqs & 1 ospe station
Important chapter as sometimes seq from the disease chapter is covered from this topic. EPI
schedule is most important.
Important questions
• Immunizing agents
• Cold chain & cold chain equipment
• Vvm
• EPI (typhoid is also included at 9 months)
• Adverse effects of vaccines
• Tetanus toxoid & tetanus vaccine in females (especially reproductive age)
• Polio vaccine and causes of failure of polio eradication in Pakistan
• Post exposure prophylaxis of tetanus and hepatitis
• Immunization recommended for people travelling for hajj
• Covid vaccines
• Post polio vaccines
• Freeze dried vaccines

7. SCREENING AND SAMPLING


1 seq, ospe station and mcqs
Whole chapter is important.
Imp seqs
• Screening, definition, aims, uses, types
• Criteria for screening, types of variations
• Validity (sensitivity, specificity, predictive values, False positives and negatives.
definitions, formula calculation)
• Types of probability sampling (scenario comes and they ask for type of sampling used
and definition)
• Advantages and disadvantages of probability sampling
• 5-Non probability sampling (Def, Types, Advantages and disadvantages)
• 6-Sampling error

8. COMMUNICATION IN HEALTH EDUCATION


1 seq & 1 mcq
This chapter is not that much important and it is easy. You have to remember mainly the
headings of whole chapter.
Important questions
• Define communication, Components, channels of communication (detail is also
important)
• Shannon weaver communication model, Types of communication
• Methods in health communication
• Barriers of communication (vvv.imp)
• Define health education, Functions of health communication
• Stages of health education
• Contents of health education
• Models of health education
• Principles of health education
Aimcacademia.blogspot.com
Email: aimcacademia@gmail.com
Facebook: m.facebook.com/aimcacademia
4
• Difference between Health education and propaganda

9. SCHOOL HEALTH SERVICES


Occasionally 1 seq and important for mcqs and ospe as one of the field visits is school. Just
read it like a newspaper.
Important topics
• Define school health services, Aims
• Aspect of school health services (periodic exam)
• Duties of school medical officer
• Types of desks (vvvvv.imp)
• School health problems and immunization done at school

10. FAMILY PLANNING


This chapter is considered with reproductive health, mostly seq is from that chapter. This is
important for ospe. You have to read the whole chapter.
Important topics
• Cafeteria choice and classification
• IUCD, Mechanism, Advantages, Contraindication, Side Effects
• Depot formulations and post-coital methods
• Calendar method
• Terminal methods
• Evaluation of contraceptive method choice
• Classification of contraceptive methods
• Oral contraceptive pills, Classification, Mechanism, Schedule, Use of iron pills,
Disadvantages (ye bot imp and disadvantages (from google), Uses
• Pearl index

11. DEMOGRAPHY
1 seq & 3 mcqs, 1 ospe station
Almost all chapter is important with respect to calculations and formulae. This topic is well
explained in Ilyas.
Important topics
• Calculate Doubling time
• Growth rate (do pay attention on the formulae told by Dr. Sana)
• Determinants of fertility, causes of high fertility and how infant mortality affects fertility
• Basic fertility measures calculations
• Population pyramid, Define, Types, uses
• Calculate dependency ratio and sex ratio
• Virtual index
• Demographic Transition, Stages of demographic cycle
• Population momentum

12. REPRODUCTIVE HEALTH


1 seq & 5 mcqs, also imp for ospe
Whole chapter is important.
Important Seqs
• Define maternal health
• Maternal morbidity and mortality definitions and formula
• Causes of maternal mortality and measures to reduce MMR
• High risk approach in pregnancy
Aimcacademia.blogspot.com
Email: aimcacademia@gmail.com
Facebook: m.facebook.com/aimcacademia
5
• Antenatal care, Objectives, Components, Routine visits, minimum visits
• Intranatal care
• Difference between domiciliary and institutional care
• Care of the new born
• LBW, define, prevention and treatment
• Growth chart, define, uses, Pitfalls
• Care of under-five child
• Breast feeding, advantages, Contraindications, what do you know about weaning
• Indicators of MCH care
• Infant mortality, measures to reduce IMR
• Safe motherhood (WHO strategies)

13. NUTRITION
This is an important topic regarding viva and ospe. Tables given at the end of chapter in excel
are important seqs. This topic is better written in park especially values.
Important topics
• Caloric values of nutrients (from park)
• Definition of balanced diet
• Daily Caloric requirements (requirements in pregnancy and lactating women are v.
imp)
• Food fortification
• Food adulteration with examples
• Food borne diseases
• Methods of preservation of food
• Milk
• Assessment of nutritional status is most important
• Protein energy malnutrition, definition, types, classification (Gomez and water low),
prevention
• Kwashiorkor vs Marasmus
• Nutritional Anemia (cut off, management)
• Vitamins, diseases by their deficiency and excess
• Minerals (imp are calcium, iron, iodine)
• Prudent diet (dietary goals)
• Interventions for anemia
• Difference between malnutrition and under-nutrition
• Iodine deficiency disease and correction
• All tables of differentiation

14. OCCUPATIONAL HEALTH


1 seq, 4 MCQs, 1 ospe station
This whole chapter is important.
• Occupational health definition and functions
• Ergonomics and sickness absenteeism
• Occupational diseases
• Pneumoconiosis is very imp
• Scenario comes and they ask for diagnosis, agent, management plans
• Management includes all steps (medical measures, engineering measures and
legislative measures)
• Measures for general health promotion and protection of workers
Aimcacademia.blogspot.com
Email: aimcacademia@gmail.com
Facebook: m.facebook.com/aimcacademia
6
• Occupational Hazards
• Lead poisoning (Clinical picture, Investigations, Prevention)

15. DISASTER MANAGEMENT


1 seq, 1 mcq
Important and very easy. You have to do the whole chapter.
Important seqs
• Define disaster, Types of disaster
• Steps in Disaster management (Predisaster, during disaster and post disaster
management)
• Question can be specific for earth quack or flood etc.
• Steps of Predisaster management
• Disaster preparedness
• Disaster mitigation
• Disaster response
• Triage
• Post disaster management (They may ask this question as disaster relief phase /
Responsibility of health authority in recovery phase / Measures to prevent health
problems in disaster-affected people)
• Reasons for increased transmission of communicable diseases after disaster
• Measures in flood disaster

16. HOSPITAL WASTE MANAGEMENT


This chapter is not that important. Important for mcqs only.
Possible seqs
• types of waste, hazards of health care waste
• Enumerate steps in waste management

17. NON-COMMUNICABLE DISEASES


There are usually two questions from diseases and mostly both are from communicable
diseases. The pattern of seq is they give the scenario and ask for diagnosis, treatment,
preventions, levels of prevention, modes of intervention. It is also important for ospe.
Most of the topics are common and you already know about them. The most repeatedly asked
asked question is from snake bite, so prepare it well.

18. MENTAL HEALTH


This chapter is considered with social and behavioral sciences and there is 1 seq and 1 mcq.
Prepare complete chapter. Important seqs are
• Definition and classification of mental illness, Etiology of mental illness
• Crucial points in life cycle, Characteristics of mentally healthy person, Warning signs
of poor mental health
• Common mental health problems in Pakistan, Prevention
• Define Delusion, illusion, Drug addiction, Drug habit, Drug abuse, Drug dependence
• Enlist dependence producing drugs, Factors associated with high drug abuse,
symptoms of drug addiction, Prevention and treatment
• Alcohol (Causes, Related psychosocial and health issues, Prevention and
management)
• Tobacco smoking, Chemical constituents, Related health problems, dependence
syndrome, WHO recommendations to combat tobacco smoking.

Aimcacademia.blogspot.com
Email: aimcacademia@gmail.com
Facebook: m.facebook.com/aimcacademia
7
19. SOCIAL AND BEHAVIOURAL SCIENCES
This chapter is unimportant. Normally seq and mcq come from mental health.
Possible seq
• Family and its types.

20. IMNCI
This chapter is important.
Important seqs
• IMNCI, Its components and advantages
• Diarrhea (Management, D/w ORS and ORT, Component of ORS)
• Acute respiratory Infections (Criteria of fast breathing, classification, Management,
Tables of diagnostic signs and Treatment of ARI)

21. ENVIRONMENT
1 seq, 5 mcqs, 1 ospe station
This chapter is comparatively dry but is simple and easy. You can prepare it selectively or if
you are aiming for distinction, prepare whole chapter.
A-WATER
Topics you can leave (Cone of filtration, Horrocks apparatus, Double pot, Surveillance of
drinking water)
IMP SEQs
• Classification of water, Criteria for quality of water, WHO standards for safe water
supply
• Purification of water on large scale
• Chlorination
• Purification of water on small scale
• Steps in well disinfection
• Health hazards associated with swimming pool, Sanitary measures
• Water related diseases
• B-AIR
• Read whole topic
• Imp seqs
• Causes of air pollution, Effects of air pollution/health hazards
• Global warming
• Purification of air
C- OTHER
• In Housing, criteria for healthful housing, housing standards & effects of poor housing,
Hazards of overcrowding.
• Acceptable noise level (imp for mcqs), Effects of noise exposure and control, Effects
of heat stress and cold stress, Methods of refuse disposal, Methods of excreta disposal
(mainly headings)
• Definitions and the tables at the end are important.

22. RADIATION
This chapter is not as much important and considered with environment. Prepare complete
chapter from excel.
Important SEQ
• Radiation, types, biological effects, uses, prevention.

23. MEDICAL PARASITOLOGY


Aimcacademia.blogspot.com
Email: aimcacademia@gmail.com
Facebook: m.facebook.com/aimcacademia
8
This is mainly the parasitology of 3rd year. You’ll diagnose the case from your micro knowledge
and then preventions are the main things.

24. COMMUNICABLE DISEASES


This chapter is very vast and extensive but is equally important for proff. I would suggest to
prepare it side by side along with other slybus. Keep revising and you’ll grasp it IA. There are
some common things in all the diseases like primary, secondary and tertiary preventions,
health education, improve quality of life and diet, seminars, early diagnosis, vaccine,
rehabilitation etc. you have to relate it with immunology like you should know the doses and
time of administration of vaccine. Good thing is same questions are repeated over the years.
Important topics:
• Corona virus
• Chicken pox
• Cholera
• Malaria
• Dengue
• Diphtheria
• Measles
• Mumps
• Polio
• Rabies
• Scabies
• Tetanus
• TB
• Hepatitis
• typhoid

Aimcacademia.blogspot.com
Email: aimcacademia@gmail.com
Facebook: m.facebook.com/aimcacademia
9

You might also like