PSM syllabus for MBBS in India (Competency-based Education/CBME 2019)

Topics & competencies in PSM for MBBS as per the CBME

Topic	Competencies	Practicals	Procedures for certification	Integrations
1. Concept of Health and Disease	10	2	NIL	V-2 / H-0
2. Relationship of social and behavioural to health and disease	5	3	NIL	NIL
3. Environmental Health Problems	8	3	NIL	V-5 / H-0
4. Principles of health promotion and education	3	1	NIL	NIL
5. Nutrition	8	2	NIL	V-7 / H-1
6. Basic statistics and its applications	4	4	NIL	V-4 / H-0
7. Epidemiology	9	4	NIL	V-8 / H-1
8. Epidemiology of communicable and non- communicable diseases	7	1	NIL	V-5 / H-1
9. Demography and vital statistics	7	1	NIL	V-2 / H-0
10. Reproductive maternal and child health	9	NIL	NIL	V-5 / H-0
11. Occupational Health	5	NIL	NIL	NIL
12. Geriatric services	4	NIL	NIL	V-4 / H-0
13. Disaster Management	4	NIL	NIL	V-4 / H-0
14. Hospital waste management	3	NIL	NIL	V-0 / H-3
15. Mental Health	3	NIL	NIL	V-3 / H-0
16. Health planning and management	4	NIL	NIL	NIL
17. Health care of the communtiy	5	NIL	NIL	NIL
18. International Health	2	NIL	NIL	NIL
19. Essential Medicine	3	NIL	NIL	V-0 / H-3
20. Recent advances in Community Medicine	4	NIL	NIL	NIL
Total: 20	107	21	NIL	V-49 / H-9

Sample of the detailed description of the competencies:

No	Competency	DLC	Teaching	Assessment	V/H
CM5.1	Describe the common sources of various nutrients and special nutritional requirements according to age, sex, activity, physiological conditions	K-KH-Y	Lecture, Small group discussion	Written / Viva voce	V: General Medicine, Pediatrics
CM5.2	Describe and demonstrate the correct method of performing a nutritional assessment of individuals, families and the community by using the appropriate method	S-SH-Y	DOAP sessions	Skill Assessment	V: General Medicine, Pediatrics
CM5.3	Define and describe common nutrition related health disorders (including macro-PEM, Micro-iron, Zn, iodine, Vit. A), their control and management	K-KH-Y	Lecture, Small group discussion	Written / Viva voce	V: General Medicine, Pediatrics

Abbreviations & details:
- No & Competencies: No – serial number of the competency with subject/topic coding, & Competencies – description of competencies
- Domain/level-Core (DLC):
  1. Domain (Identifies the domain): K- Knowledge, S – Skill, A – Attitude/professionalism, C- Communication.
  2. Level (Identifies the level of competency): K – Knows, KH – Knows How, SH – Shows how, P- performs independently.
  3. Core: Y – must achieve/compulsory, N – non-core/desirable/optional
- Skills required to certify: P – many procedures must be done independently for certification/ graduation.
- Integration: V – Vertical Integration, H – horizontal integration.

General Objectives of PSM for MBBS

The broad goal of teaching in Community Medicine is to prepare the student to function effectively as a community physician.
Objectives: Knowledge – At the end of the course, the student should be able to:

1. Describe the concepts of community health and measures of levels of health.
2. Describe the epidemiological methods.
3. Apply appropriate epidemiological methods to communicable and non-communicable diseases in the hospital and community situations.
4. Use epidemiological tools to make rational decisions relevant to individual and community levels.
5. Describe and use basic bio-statistical methods.
6. Select, use and interpret bio-statistical methods to make inferences from hospital/community data.
7. Describe the demographic pattern of the country and its relation to health.
8. Define vital statistics and describe the various methods that are used to collect vital statistics in India.
9. Describe environmental hazards – inside the home, at the workplace, and in the community.
10. Describe and analyze the importance of water and sanitation in human health.
11. Suggest feasible methods of environmental control at household and community levels.
12. Describe common occupational hazards in industries, agriculture, and services available to industrial workers.
13. Describe feasible methods of control of occupational hazards.
14. Plan, collect, analyze, interpret and present data from a hospital/community survey.
15. Describe and analyze the roles of the individuals, family, community and socio-cultural milieu in health and disease.
16. Diagnose and manage maternal and child health problems and advise couples and the community on he family planning methods available.
17. Describe the methods of nutritional assessment in the community.
18. Describe the important/common health problems in India.
19. Describe the School Health Programme
20. Describe the health information system in India with reference to the Management Information System.
21. Describe and evaluate the National Health Programmes.
22. Describe the health care delivery system in India.
23. Describe the organization and functions of the health care team at Primary Health Centre, Community Health Centre and District levels.
24. Interact with other members of the health care team and participate in the organization of health care services and implementation of National Health Programmes.
25. Plan and implement measures for disaster management.
26. Describe the principles and components of primary Health Care, National Health Policy and its implementation in the country.
27. Diagnose and manage common health problems and emergencies at the individual, family and community levels keeping in mind the existing health care resources, prevailing socio-cultural beliefs and family resources.
28. Plan and implement an intervention programme with community participation.
29. Plan and implement, using simple audiovisual aids, a health educational programme and carry out its evaluation.

Teaching and learning methodology in PSM for MBBS

Details of the competencies, lectures, practicals & skills to be acquired are mentioned in the table given above.
Teaching Learning Method:
1. Learner centric didactic lectures with Vertical/horizontal integrations (CBME).
2. Tutorial & Seminars
3. Problem-based Learning (PBL) & Small group discussions (especially focus on practical & clinical implications of the knowledge through cases)
4. Conventional Practical classes & DOAP session (Demonstrate, Observe, Assess, Perform),
5. Self-directed learning +/- multimedia aids (Audiovisual presentations).
6. Seminars, symposia & quizzes.

Distribution of approximate teaching hours in PSM for MBBS

Total number of teaching hours: approximately 150 hrs (teaching hours & distribution might differ slightly per university).
Theory & Practicals:

	Topic	Hours
1	Man and medicine: changing concepts in public health	1 hr.
2	Concept of health and disease	5 hrs.
3	Environment and health	28 hr.
4	Medicine and social science	7hrs
4	Family visit & socio clinical case study	52 hrs.
5	Screening for disease	3 hrs
6	Hospital waste management	3hrs
7	Epidemiology	25 hrs
8	Epidemiology of communicable diseases	48 hrs.
9	Epidemiology of non-communicable disease	12 hrs
10	Demography and family planning	8 hrs
11	Preventive medicine in pediatrics, obstetrics and geriatrics	20 hrs.
12	Nutrition and health:	18hrs.
13	Disaster management	1 hr
14	Occupational health	3 hrs
15	Genetics and health	3 hrs
16	Mental health	2 hrs
17	Health information and basic medical statistics	20 hrs
18	Communication for health education	3hrs
18	Case studies & visit	2hrs.
19	Health planning and management	31hrs.
20	Health care of the community	3hrs.
21	International health	2hrs
22	Health programs in India	15hrs.

Field postings in community medicine:

1. Urban Health Posting during the IV and V Semesters: (Duration: 8 Weeks)
2. Family Health Advisory Service (FHAS) during IVth & Vth Semester MBBS (Once a Week )
3. Rural Posting during the VII Semester: Duration: 6 Weeks

Examination pattern & marks distribution in PSM for MBBS

Exam pattern:
1. The formative or internal assessment will not be added to the university examination marks.
  - Should score 50 % & in theory and practical combined to be eligible to sit for university exams.
2. University exam: Each subject will have two papers.
  - 200 marks will be reserved for the theory of two papers.
  - Another 100 will be reserved for either practical, oral, or clinical exam.
  - Should secure 50 % in theory and practical to pass in university examinations

Formative Assessment:
1. Theoretical assessment: clickers, one-minute papers, and muddiest point
2. Practical/clinical assessment: one-minute preceptor (OMP) and/or viva voce.
3. Scheduling: during teaching-learning activities & planned by the teachers on a day to day basis and modified depending on the tasks at hand.
Internal assessment
1. Theory: Written tests, should have essay questions, short notes, and creative writing.
2. Practical / Clinical: practical/clinical tests, Objective Structured Clinica/Objective Structured Practical Examination (OSPE) and/or viva voce.
3. Scheduling:
  - Minimum Number of tests during the year: 2
  - Clinical subjects should also be tested at end of each posting (EOP)-Theory and Practical
  - There should be at least one short question from AETCOM in each subject
  - One of the tests in Ophthalmology, Otorhinolaryngology/Forensic Medicine & Toxicology/ Community Medicine should be prelim or pre-university examination

Formative & internal assessments

1. Daily assessment: field exercise, visits made & presentation of domiciliary visits

2. End posting assessment

3. Clinical assessment: history taking, total management (hospital & domiciliary) of the patient demonstration of the procedures taught (if feasible), Community Medicine Presentation of field exercise, Viva Voce on the activities that you have observed and participated in during the posting & OSVE.

Summative assessment (For Universities)
- Theory Papers: 2 papers for 200 marks
  1. Suggested combination of various types of question:
    1. Structured essays (Long Answer Questions – LAQ)
    2. Short Answers Questions (SAQ)
    3. Objective type questions (Various type of MCQs: < 20% weightage)
  2. Distribution of the competencies: The examiner must sample the contents appropriately from competencies.
- Practicals for 100 marks:
  1. Application-oriented exercises (Should not be simple tests of knowledge).
  2. Objective Structured Practical Examination (OSPE), One- Minute Preceptor (OMP), Directly Observed Procedural Skills (DOPS) etc. can be suitably modified for this purpose and/or viva voce.
- Scheduling: