MCI guidelines

Guidelines for Competency Based PG Training Programme for MD – Community
edicinePreamble:

The purpose of this programme   is to standardize community Medicine teaching at post graduate through out country so that it will benefit in achieving uniformity in undergraduate teaching of the subject as of the post graduate student are expected to be involved in teaching as faculty member and also in the various  areas and fields of public health. 
Programme Objectives:

A candidate upon successfully  qualifying in the M.D (community Medicine) examination should be competent in the following areas.
(I)     Public Health Management
(II)    Epidemiology
(III)   Health Team Leadership
(IV)  Teaching and Training
(V)    Research

Specific Learning Objective
 
In the area of (I) Public Health Management, he/she should be able to 

(I)     Identify health problems of the community in the context of the socio-cultural milieu
(II)    Priorities health problems.
(III)   Identify threats to the environment.
(IV)   Identify groups which require special attention (elderly, adolescents, gender, the poor and other marginalized groups) including those facing occupational hazards.
(V)    Set  objectives, prepare action plan, implement programmers and monitor, supervise and evaluate them.
(VI)   Manage Health Information System and respond appropriately to the information gathered.
(VII)  Assess costs and carry out program budgeting.
(VIII) Implement public health laws.
(IX)   Initiate, implement and supervise National Health Programmes.
(X)    Establish Surveillance System and respond to public health threats efficiently and effectively
(XI)   Anticipate, prepare for and resour development
(XII)  Manage logistics and materials effectively.
(XIII) Monitor and assure quality in programme implementation.

In the area of (II) Epidemiology, he/she should be able to :

(I)     Conduct epidemiological investigation of communicable, non – communicable and other diseases of public health importance and suggest appropriate solution.
(II)    Use effectivel y the tools of epidemiology for understanding disease causation and determinants of diseases.
 

In the area of (III) Health Team Leadership, he/she should be able to:

(I)   Interact, communicate educate effectively persons from diverse backgrounds, ages and preferences to promote healthy behavior through community participation.
(II)   Explain scientific information to public, decision makers and opinio leaders.
(III)   Nurture team spirit and harmonize activities of various members. 
(IV)   Facilitate inter-sectoral coordination.
(V)    Promote and establish partnerships.

In the area of (IV) Teaching and Training, he/she should be able to:

(I)     Asses the jearning needs of any given group (students, staff or community).
(II)    Formulate learning objectives.
(III)   Plan curriculum and prepare curriculum materials.
(IV)   Select and implement appropriate learning methods.
(V)    Evaluate learning experiences.

 In the area of (V) Research, he/she should be able to:

(I)     Critically evaluate data, identify gaps in knowledge and formulate research questions.
(II)    Design and implement Epidemiological and Health Systems Research studies.
(III)   Analyze data and present findings and Public Health Information.
(IV)   Effectively communicate findings and public Health Information.
(V)    Apply ethical principles to the collection, maintenance, use and dissemination of data and information.
Post Graduate Training
To achieve the stated objectives, various modalities and methods are recommended:-

The proportion of these modalities and methods will vary from Institution to institution due to facilities for exposure and number of postgraduate students and recognized teachers. However, modalitywise minimum exposure is suggested below:-
1. Orientation- is suggested along with PGs of other disciplines for a period of one week within three months of admission. During orientation course, they should be exposed to the concepts of human behaviour, research methodology including ethics, statics, Health Management including economics, health policies etc. 
2. PG activities should be held at least thrice a week.
3. Class room and field learning
1.     Self directed: At least twice a week in which the student will present srticles, abstracts from journals, seminars, group work, epidemiological and statistical exercises, case studies, family presentation by rotation.

2.     Lectures: The recognized teachers should take lecture. The frequency of lectures should be once a month. The frequency can be increased up to one a week depending on number of teachers.

3.     Participation in scientific activities, Participation in panel, Symposia, details, workshops, conferences.

 4.   Field posting and work

  1. Posting at subentries/PHC/CHC/urban Health   centres : Total period of one year.

  2. Posting in the hospital for exposure to clinical departments namely Pediatrics, Gynec & Obstetrics etc. for one month

  3. Wherever possible work attachment as District Health Office and Directorate of Health Services – one month.

  4. Short duration posting in various camps, public health emergencies, Investigation of epidemics,  implementation of National Health Programmes e.g. Pulse Polio, Leprosy etc.

Visits to various institution of public Health Importances.

5. Teaching exposure: They should conduct group teaching of undergraduate students. Each  student must take 30 classes. They should participate in the training programme conducted by department and should conduct few sessions. They should use the techniques of pedagogy. 

6. Research:

 1.   Thesis: The protocol must be submitted within 6 months and completed thesis should be submitted one year before the University examination.
2.    They should be involved in departmental research projects.
3.    They should publish at least one paper in scientific journal.
4.    They should be exposed to computer application, internet, website, media statistical software’s etc. 

Post Graduate Examination

The post Graduate examination shall be in there parts

(1)  Thesis to be submitted by each candidate at least 6 months before the date of commencement of the theory examination.

(2)  Theory: There shall be theory papers.

Paper I    :  History of public Health, Concepts in Community Medicine and Epidemiology.
Paper II  :  Health Services Management
Paper III :  Nutrition, Environmental Health and Demography
Paper IV   :  Mental Health and Health Technology

(3)    Practical examination should be spared over two days.

I)        Generic Units of Evaluation
II)       Determine the Health needs of a family
III)      Family Health Exercise
IV)      2  Short cases
V)       Statistical cum epidemiological exercise
VI)      Spots
VII)     Microbiological/public Health Laboratory practical
VIII)   Viva-Voca

Course Content

  Paper-I

     1. History of public Health and Evolution of community Medicine.

2. Concepts in Community Medicine: Concept of Health & Disease, positive Health, Health Spectrum, Theories related to Disease Causation, Determinants of Health, Health indicators, Methods of Assessment of Health Individual and community, Difficulties in measurements, Health Status of various groups and areas, Natural History of Disease, Levels of prevention, Primary Health Care, Comprehensive Health Care, Immunity & Immunization, Evidence based Medicine etc.

3.Epidemiology

·   Definition, aim and uses
·   Measurement of disease frequency
·   Distribution of disease, time, place and person
·   Determinants of Diseases
·   Screening
·   Measures of association and potential impact
·   Casual association
·   Epidemiological study  designs
·   Epidemiological biases and their control
·   Surveillance of diseases /disorders/health conditions
·   Investigation of outbreaks/epidemics
·   Prevention & Control of communicable and non-communicable diseases and other conditions
Paper – II 
1.Health Management
·   National Health related policies and committees
·   Programme planning, implementation, monitoring and evaluation
·   Strategic projects management
·   Organizational behavior
·   Logistic management
·   Medical audit
·   Introduction to human resource management
·   Social Marketing
·   Quality management, continuous quality improvement
·   Operations Research
·   Introduction to  public health laws
·   Introduction to Health  Medical Information System
·   Health Systems( organisations, agencies, infrastructure etc.): International & within the country
·   Communication in organizations, networking and advocacy
·   Public Health emergencies
·   Health Economics

  • Introduction to Macro and Micro-economicsPharmaco-economics
  • Demand and supply
  • Health financing
  • National and District health Accounts
  • Insurance (commercial, social security)
  • User fees
  • Resource mobilization and utilization
  • Costing and budgeting
  • Financial sustainability
  • International Health   

2. Heath Services for Special Group

A. Reproductive and Child Health, Family Planning and Population Medicine :

Problems and strategies related to various services, initiatives, policies, Legislations and programmes for ANC, INC, PNC, under 5 children population control, Women Empowerment, Gender related issues and Recent Advances.
B. School Health
C.  Adolescent Health
D.  Older persons : Health problems, Services and programmes
E.  Disadvantaged group : Health problems, Services and Programmes

Paper III

1. Nutrition :  Definitions,  concepts,  principles,  Food Hygiene,  Nutritive values,  Nutritional Assessment  of  individual  and  Community,  Nutritional  Problems,  Strategies, Initiatives, Nutritional policy and programmer at various levels, Diet for various groups, Food  Adulteration and Legislation to control, Recent Advances in Nutrition.

2. Environment Health

·   Principles of environmental health and human ecology
·   Environmental health risk assessment
·   Environmental health impact assessment
·   Environmental pollution
·   Toxicology related to public health
·   Food sanitation and safety
·   Medical entomology including vector and rodent control
·   Waste disposal
·   Housing sanitation
·   Environmental health policy, programmes , & legislations
·   Current and emerging issues in Environmental health (e.g. slum, health city,Global warming, etc.)

3. Occupation health and safety : Evolution,Definition, Scopes, Work  related Diseases,

Initiatives, policies, strategies, programmes and legislation related to safety, welfare and Work, Ergonomics, Organization and Administration of medical care in a work environment including industries in unorganized and organized sectors, Injuries types, impact on health, Prevention and control and recent advances.

4. Population science & Genetics

· Factors affecting the size of the population
· Measures of fertility and mortality
· Population projection
· Demographic transition
· Implication of rapid population growth
· Life table
· Urbanization
·Genetics : Definitions, concepts, problems, genetic counseling management

5.     Biostatistics

· Probability theory
· Level of management
· Central tendency and dispersion
· Sampling errors and confidence intervals
· Test of significance
· Sample size calculation
· Adjustments of confounding
· Introduction to multivariate analysis
· Correlation
· Interaction

Paper IV

1. Mental Health : Definitions, concepts, problems, prevention and control of mental Disorders including programmes and legislation

2. Medical Sociology and Behavioral Sciences : Definitions, concepts, social and Behavior problems, Cultural, socio-economic and psychological Determinants and impacts on  health problems, methods of Assessment, Strategies, policies for prevention and control, community participation, Utilization of health services, knowledge, Attitude, Behavior and practices related to various public health problems , Clinico-social evaluation of individuals, public Relation, Doctor-patient relationship and hospital sociology, Urbanization and health impacts, Medicals anthropology, Acceleration changes in life style.

3. Information, Education and Communication :- Definitions, concepts, Principles, methods, planning, organization and evaluation, Internet application in community medicine.

      4.Research methods

·         Literature search
·         Choosing research topics
·         Formulating research questions
·         Study designs – Quantitative & Qualitative
·         Measuring reliability and validity
·         sampling  
·         Instrument development
·         Data collection and management
·         Data analysis and report
·         Communication research findings
·         Scientific writing
·         Development of research proposal
·         Ethical issues

5. Pedagogy: Learning objectives, learning methods, Learning methods, techniques, processes,      evaluations.
6. Health Technology- Computer application, Software for research and statistical analysis, Awareness regarding remote Sensing, GIS and other new technologies.                                                               

·         Instrument development
·         Data collection and management
·         Data analysis and report
·         Communication research findings
·         Scientific writing
·         Development of research proposal
·         Ethical issues              

MCI Requirements for 150 Admissions

(         *A.  Lecture theatres

                There shall be a minimum of five lecture theatres preferably air conditioned, of gallery type in the Institution out of which four will be of seating capacity for 180 students and one will be of capacity for 350 students each. Lecture theatre shall be provided with necessary independent audio-visual aids including overhead projector, slide projector, LCD projector and a microphone. These lecture theatres shall be shared by all the departments in a programmed manner. There shall be provision for E-class. Lecture halls must have facilities for conversion into E­class/Virtual class for teaching.

(B)         Demonstration room-There shall be two demonstration rooms (60 sq.mt.) fitted with strip chairs, Over Head Projector, Slide projector, Television Video and other audio­visual aids, to accommodate at least 75-100 students.
(C)            There shall be a laboratory (200 Sq.m.area) with facilities for purposes of demonstration of various laboratory practicals.
(D)           Museum-There shall be a museum (125 Sq.m.area) for the display of models, charts, specimens and other material concerning communicable diseases, Community Health, Family Welfare planning, Biostatics, Sociology, National Health Programmes, Environmental Sanitation etc.
(E)            Departmental Library-There shall be a Departmental library-cum-seminar room (30 Sq.m.area) with at least 80-100 books. However, not more than two copies of anyone book shall be counted towards computation of the total number of books.

(F)             Research - There shall be one research laboratory (50 Sq.m.area) for research purposes.
(G)      Accommodation shall be provided for the staff as under, namely:-
1. Professor & Head of the Department- (18Sq.m.area);
2.      Associate Professor/Reader-Two rooms (15 Sq.m.area each);
3.      Asstt. Professor/Lecturers -One room (15 Sq.m.area );
4.      Statistician cum Lecturer-One room (12 Sq.m.area)
5.      Epidemiologist cum Lecturer-One room (12 Sq.m.area)
6.      Tutor/Demonstrators-Two rooms (15 Sq.m.area each)
7.      Department office cum Clerical room - one (12 Sq.m.area); and 8. Working accommodation for non-teaching staff (15 sq.m. area)

(H)           Primary Health Centre/Rural Health Training Centre

Every medical college shall have three primary health centres/rural health training centres for training of students in community oriented primary health care and rural based health education for the rural community attached to it. Out of these one primary health centre shall be within a distance of 30 km. or within one hour of commuting distance from the medical college. Separate residential arrangements for boys and girls, interns and undergraduates with mess facilities shall also be provided in at least one of the primary health centres/rural health training centres which shall be under the full administrative jurisdiction of the medical college. Adequate transport shall be provided for carrying out field work, teaching and training activities by the department of Community Medicine and other departments (both for staff and students).

(I)              Urban Health Training Centre- it shall be under the administrative control of Deptt. of community Medicine. Adequate transport shall be provided for commuting the staff and students.