STUDY GUIDE

Community Medicine
th
4 Year MBBS, AFM&DC

1
 TABLE OF CONTENTS

Sr No Chapter Page No
1 Table of contents 2

2 Introduction to Community Medicine 3

3 Department organogram 4

4 Time Table 5

5 Gantt’s chart 6

6 Table of specifications 7

7 Leaning objectives 11

8 Evaluation methods 30

9 Recommended text books 31

2
 INTRODUCTION
Community Medicine is that branch of medicine, which deals with the study of provision of preventive, promotive,
curative, rehabilitative, and evaluative services to the community at large, through an organized comprehensive
healthcare delivery system.

The Department of Community Medicine, Aziz Fatima Medical and Dental College is involved in teaching and training of
4th year MBBS students through lectures, tutorials, presentations and field visits in the subject. Field visits of places of
public health importance, household survey and research work are being arranged regularly. The department has a
lecture hall which can accommodate more than 100 students, 3 offices and a beautiful museum for practical training of
students. The Department also has computer facility to maintain department records and to prepare lectures, slides and
demonstrations. The Department Museum is well equipped with required models, specimens and equipment for
practical demonstrations and tutorials.

Close and excellent student-teacher relationship is maintained. The teaching is done using the most modern methods i.e.
with the help of latest audiovisual aids like multimedia & projectors, achieving excellent results. Since teaching is ongoing
process, the faculty members participate in various workshops and seminars which are supervised by experts of national
repute to refresh and update their knowledge. Research has already been made compulsory for the students of 4th Year
MBBS by UHS, so the students are trained for actively writing research papers by giving them regular assignments
having reference from most modern journals under supervision of our staff members.

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DEPARTMENT ORGANOGRAM

4
 Day Weekly Break up of Lectures and Tutorials
1 2 3 4 5
8:00 am – 8:45 am 8:45 am - 9:30 am 9:30 am - 0:15 am 10:30 am - 1:300 pm 1:30 pm – 3:00 pm

Monday Lecture Practical/ Tutorial

Tuesday Practical/ Tutorial Lecture
Wednesday Lecture Practical/ Tutorial
Thursday Practical/ Tutorial Lecture
Friday Lecture Practical/ Tutorial

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 Gantt’s Chart for syllabus completion

Topics Dec Jan 2019 Feb Mar Apr May Jun Jul Aug Sep
2018
Welcome &
Introduction S
Nutrition U
Research M
M
Communicable
E
diseases
R
Concept of health
and disease
V
Primary health A
care C
Epidemiology A
Non- T
communicable I
diseases O
Demography N
Screening S
Mental Health
Disaster &
Accidents
Geriatric Med
Biostatistics
Maternal and child
health
Immunology

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 Community Medicine (SEQs and MCQs)
TABLE OF SPECIFICATIONS
Table of specifications for the MCQ examination:
Total marks: 65. Total number of questions: 65

Sr. Topics C1 C2 Weighting % of items and marks per

# content
1 Concept of heath and disease, natural history of the disease, levels of   3MCQs 5%
prevention, control, elimination, eradication and surveillance, (3 MCQs = 3 Marks)
Sterilization and Disinfection

2 Introduction to public health and health systems in Pakistan, primary   3 MCQs 5%

health care, leadership and motivation, national and international health (3 MCQs = 3 Marks)
agencies

3 Epidemiology
3.a General Epidemiology and research methodology,   5 MCQs 8%
dynamics of infectious disease (5MCQs = 5 Marks)
Transmission

3.b: Epidemiology, control and prevention of   4 MCQs 6%

communicable diseases,
(4 MCQs = 4Marks)
3.c: Epidemiology, control and prevention of non   2 MCQs 3%
communicable diseases (2 MCQs = 2 Marks)
3.d: Immunology   5 MCQs 8%
(5 MCQs = 5 Marks)
4 Biostatistics + HMIS + Sampling   4 MCQs 6%
(4 MCQs =4 Marks)
5 Demography and Population dynamics   3 MCQs 5%
(3 MCQs = 3 Marks)
6 Food and nutrition   5 MCQs 8%
(5 MCQs = 5 Marks)

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Sr. Topics C1 C2 Weighting % of items and marks per
# content
MCH + reproductive health + family planning   6 MCQs 9%
7 (6 MCQs = 6 Marks)
8 School health   3 MCQs 5%
(3 MCQs = 3Marks)
9 Environmental Health   6 MCQs 9%
9.a: Air, b: Water, c: Radiation, d: Climate, e: Noise, f; Housing, g: Waste (6 MCQs = 6 Marks)
disposal
10 Occupational health   4 MCQs 6%
(4 MCQs = 4 Marks)
11 Entomology and arthropod bone diseases   2 MCQs 3%
(2 MCQs = 2 Marks)
12 Parasitology and parasitic diseases   2 MCQs 3%
(2 MCQs = 2 Marks)
13 Snake bite   1 MCQ 2%
(1 MCQ = 1 Mark)
14 Mental health / Medical Ethics   1 MCQ 2%
(1 MCQ = 1 Mark)
15 Behavioural sciences and life style   4 MCQs 6%
15.a: Drug abuse (4 MCQs = 4 Marks
15.b: Addiction
15.c: Smoking
15.d: Personal hygiene
15.e: Child abuse / Child labor
16 Information, Education and Communication (IEC)   1 MCQ 2%
(1 MCQ = 1 Mark)
17 Accidents / Disasters   1 MCQ 1%
(1 MCQ = 2 Mark)

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Table of specifications for the SEQ examination:

Total marks allocated: 70. Total questions: 14

Sr. Topics C1 C2 Weighting % of items and marks per

# Content
1 Concept of heath and disease, natural history of the disease, levels of   2 SEQs 14%
prevention, control, elimination, eradication and surveillance. (2 SEQs = 10 Marks)
1.a: General Epidemiology and research methodology, dynamics
of infectious disease transmission.
1.b: Epidemiology, control and prevention of Communicable and non-
communicable diseases

2 Introduction to public health and health systems in   1 SEQ 7%

Pakistan, primary health care, leadership and motivation, national and (1 SEQ = 5 Marks)
international health agencies

3 Immunology   1 SEQ 7%
(1 SEQ= 5 Marks)
4 Biostatistics / HMIS   1 SEQ 7%
(1 SEQ = 5 Marks)
5 Demography and Population Control   1 SEQ 7%
(1 SEQ = 5 Marks)
6 Food + Nutrition   1 SEQ 7%
(1 SEQ = 5 Marks)
7 MCH / Reproductive Health   1 SEQ 7%
(1 SEQ = 5 Marks)

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Sr. Topics C1 C2 Weighting % of items and marks per
# Content
8 Environment   1 SEQ 7%
8.a: Air pollution (1 SEQ = 5 Marks)
8.b: Water
8.c: Radiation
8.d: Housing
8.e: Waste disposal
8.f: Climate
8.g: Noise

9 Occupational Health   1 SEQ 7%

(1 SEQ = 5 Marks)
10 Parasitology + Entomology + Snake Bite   1 SEQ 7%
(1 SEQ = 5 Marks)
11 Mental health + Behavioral Sciences   1 SEQ 7%
(1 SEQ = 5 Marks)
12 Dental Health / School Health / Health Education   1 SEQ 7%
(1 SEQ = 5 Marks)
13 Accidents / Disasters   1 SEQ 7%
(1 SEQ = 5 Marks)

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11
Course Topic Sub-topic Learning objective Domain Level Mode of Venue of Time Assessment
instruction instruction allocation

Community Medical Ethics Introduction to Define ethics C1 1 Lectures Lecture 45 minutes SEQS, MCQs,
Medicine Ethics Hall Class tests,
Send up,
Questioning
Differentiate between C2 3
different branches of
ethics
Describe 4 principles of C1 2
medical ethics
Development of Describe Nuremberg C1 2
medical ethics code
Describe Helsinki C1 3
declaration
Describe code of C1 2
medical ethics
Guidelines by Describe Guidelines by C1 2
Pakistan Medical Pakistan Medical and
and Dental Dental Council
Council

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Course Topic Sub-topic Learning objective Domain Level Mode of Venue of Time Assessment
instruction instruction allocation

Community Community Mental health, Define mental health C1 1 Lectures Lecture 45 minutes Viva, OSPE,
Medicine Mental Health Hall SEQs, MCQs,
questioning,
Describe etiology of mental
health
Discuss magnitude of mental C2 3
health problems (local and
international)
Types of mental Describe common mental C2 1
health health problems in Pakistan
Evolution of Discuss historical evolution of C2 3
mental health mental health
Prevention Discuss waysto improve C2 1
against mental mental health issue and
illness principles of preventing mental
illnesses
Behaviour Substance abuse Be able to define basics C1 1 Lectures Lecture 45 minutes Viva, OSPE,
Sciences concepts insubstance abuse, Hall SEQs, MCQs,
questioning,
differenciate between drug C2 2
addiction, drug abuse and drug
misuse.
briefly describe the magnitude C3 3
of the problem
Describe the typesof drugs C2 3
abused in Pakistan.
discuss the etiology of drug C2 2
addiction.
Discuss Prevention (at all C2 1
levels) against drug addiction

Tobacco control Describe Commonly used C1 2

forms and routes of tobacco
intake,

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Course Topic Sub-topic Learning objective Domain Level Mode of Venue of Time Assessment
instruction instruction allocation

Community Non- Burden of Understand the burden of C2 2 Lectures Lecture 45 minutes Class test, Send
Medicine Communicable NCDs, NCDs worldwide and Hall up, MCQs,
Diseases (NCDs) Pakistan SEQs, OSPE

Risk factors of Describe the role of C2 2

NCDs different risk factors of
NCDs
Common List common NCDs in C1 1
NCDs in Pakistan, their causes,
Pakistan impact and prevention

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Topic Sub-topic Learning Objective Domain Level Mode of instruction
Venue of instruction
Time allocation
Assessment
Nutrition Definitions Definitions of C1 1 Lecture Lecture Hall 45 Viva, OSPE, SEQs,
nutrition minutes MCQs, questioning
Macronutrient Definitions sources C1, C2 2 Lecture lecture Hall 45 Viva, OSPE, SEQs,
s and uses of minutes MCQs, questioning
macronutrients.
Requirements and
effects of
deficiencies
Micronutrients Definitions sources C1, C2 2 Lecture Lecture Hall 45 Viva, OSPE, SEQs,
and uses of minutes MCQs, questioning
micronutrients.
Requirements and
effects of
deficiencies
Nutritional Methods of C3 2 Lecture Lecture Hall 45 Viva, OSPE, SEQs,
assessment assessment of minutes MCQs, questioning
nutritional status
Food Pasteurization and C1, C2 2 Lecture lecture Hall 45 Viva, OSPE, SEQs,
processing and other methods of minutes MCQs, questioning
Preservation food and milk
preservation
Health LBW, PEM, obesity, C2, C3 1 Lecture Lecture Hall 45 Viva, OSPE, SEQs,
problems food poisoning minutes MCQs, questioning
related to
nutrition

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Course Topic Sub-topic Learning objective Domain Level Mode of Venue of Time Assessment
instruction instruction allocation

Community Occupation Background, aims Describe the background C2 1 Tutorial and Tutorial 2 hours 30 Viva, OSPE,
Medicine al Health and objective of aims and objective of visit to an room, minutes. SEQs, MCQs,
occupational occupational health industry industry questioning, log
health book

Functions of Describe the functions of C2 1 Viva, OSPE,

occupational occuaptional health SEQs, MCQs,
health services services and practices questioning, log
and practices book
Ergonomics Define ergonomics C1 2 Viva, OSPE,
SEQs, MCQs,
questioning, log
book
Describe the application C2/C3
of ergonomics

Occupational Enlist various C1 2 MCQs,,SEQ,Vi

diseases occupational diseases va
Explain the etiology of C2 2 MCQs,,SEQ,Vi
occupational diseases va
Explain the etiology of C2 2 MCQs,,SEQ,Vi
occupational diseases va
Enlsit differential C1 2 MCQs,,SEQ,Vi
diagnosis of va
occupational diseases
Describe preventive C2 2 Field trip Industry 2 hours OSPE,Log book
strategies for
occupational diseases

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Primary Introduction Define Primary health care C1 1 Lectures, Lecture 45 minutes MCQs,,SEQ,Viva
health care Hall

Describe fundamentals principles C2 1 MCQs,,SEQ,Viva

of PHC
Describe essentail components of C2 1 MCQs,,SEQ,Viva
PHC
Explain key concepts of PHC C2 1 Field trip BHU and 2 hours 30 OSPE,Log book
RHC, minutes
Community Define community health C1 2 Lectures, BHU and 2 hours 30 Viva, OSPE, SEQs,
Problems problems field visits RHC, minutes + 45 MCQs, questioning,
to HF Lecture minutes log book
(BHU and Hall
RHC)
Enlist community health problems C1

prioritise community health C3 2

problems
Describe the solution to the given C3 2
Community health problem.

PHC in Define PHC in Pakistan C1 2 Lectures, BHU and 2 hours 30 Viva, OSPE, SEQs,
Pakistan field visits RHC, minutes + 45 MCQs, questioning,
to HF Lecture minutes log book
(BHU and Hall
RHC)
Integrated Describe the concept of C2 3 Lectures, BHU and 2 hours 30 Viva, OSPE, SEQs,
Rural health integrated of rural health field visits RHC, minutes + 45 MCQs, questioning,
complex complex, to HF Lecture minutes log book
(BHU and Hall
RHC)
comprehensive Discuss comprehensive and C2 2
helath care selective health care

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Course Topic Sub-topic Learning Objective Domain Level Mode of instruction
Venue of instruction
Time allocation
Assessment
Community Reproductive Safe motherhood Define woman health, Define safe C1 1 Lecture Lecture 45 minutes Viva, OSPE,
Medicine and child motherhood and its components. Hall SEQs, MCQs,
health questioning

Reprodutive health Define reproductive health its C2 1

and its components comopnents

Maternal mortality Define maternal mortality. C1, C3 1 45 minutes

Calculate Maternal mortality
ration. Describe causes of maternal
mortality. Define risk factors and
prevention against maternal
mortality. Tell the maternal
mortality of Pakistan
perinatal, neonatal, Define perinatal mortality, neonatal C1, C3 1 45 minutes
Infant, post- mortality,infant mortality, post-
neonatal, peri neonatal mortality, formulas to
neonatal calculate their rates, causes, risk
mortalities factors and prevention

Essentail of Define EOC. Differentiate C1, C3 2 45 minutes

Obstetric care between basic and comphrehensive
EOC, three delays

TBA training Define TBA training program, its C1, C2 2 45 minutes

programm importance and advantges

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Course Topic Sub-topic Learning Domain Level Mode of Venue of Time Assessment
objective instruction instruction allocation

Community School health Introduction Define school C1 1 tutorial Lecture 2 hours 30 SEQS,
Medicine service to school health Hall minutes MCQs,
health OSPE, viva,
services class tests,
send up
List the C1 1
components of
school health
List the members C1 1
of school health
team

Describe role of C2 1
school health
team members
Describe the C1 1
functions of
school health
program
Discuss common C1 1
health problem
of school
children
Equipment of List common C1 2
school health medicines and
service equipment
School health C2 2
service in
Paksitan
types of desks C1 1
Special Requirements of C2 3
children handicapped
children

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Course Topic Sub-topic Learning objective Domain Level Mode of Venue of Time Assessment
instruction instruction allocati
on
Community Artropods Arthropod Describe arthropod C1 2 Lecture Lecture 45 Viva, MCQs,
Medicine Hall minute questioning,
s OSPE
Name common arthropod borne C1 1
diseases
Control of Describe control measure of C1 2
arthropods arthropods
Insecticcides Insecticcides and their public C1 2
health importance
Parasitolog Parasitic Name parasitic diseases of public C1 1
y diseases health importance
Describe the routes of transmission C2 1
of all parastic diseases in human
beings
Discuss the preventive measures C3 1
against parasitic diseases
Snake bite Types of Describe the types of poisonous C1 1
snakes snakes in Pakistan
Types of Name the type of venom in each of C2 1
venom the snake
Protection Describe protection and prevention C3 1
against snake bite

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Topic Sub-topic Learning Objective Domain Level Mode of instruction
Venue of instruction
Time allocation
Assessment
Biostatistics and Biostatistics Define Biostatistics, C1 1 Lecture and Lecture 45 minute + By asking
HMIS Visit to the Hall; 2 hour 30 related
BHU and Health minutes questions at the
RHC to Facilities end of the
understand (BHU and lecture, Class
DHIS RHC) Test OSPE,
MCQs and
SEQs
Describe Concepts and uses of C2 2
Biostatistics
Data Define data C1 1
Describe types of data C1 1
Measurements Define rates, ratios and proportions C1 1
Differentiate between crude, specific and C2 2
standardized rates
Data presentaion Discuss different methods of data C2 1
presentation
Measures of central Define measures of central tendency C1 1
tendency
Measure and interpret central tendency of C3 1
given data
measures of dispersion Define measures of dispersion C1 1

Measure and interpret measures of C2 1

dispersion
Standard error define and calcualte standard error C1, C3 2
Normal distribution Define normal curve C1 1
curve
Use information about normal curve to C3 2
solve problems
Hypothesis testing Define hypothesis testing C1 1
Formulate null and alternate hypotheis C2 1
find out whether to accept or reject null C3 1
hypothesis in a given scenario

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Course Topic Sub-topic Learning objective Domain Level Mode of Venue of Time Assessment
instruction instruction allocation

Community Concept of Introduction to define health, disease, illness C1

Medicine health and health and disease and wellbeing
disease
Iceberg Describe iceberg C1, C3
phenomenon phenomenon of diseasea and
discuss it with ref to
important diseases
Definitions Define basic terminologies C1
used in community Medicine

Prevention List all levels prevention C1

Find out the level of given C3
prevention against any
disease
Mckeown's concept Describe Mskeown's concept C1

seven star doctor List the attributes of 7 star C1

doctor
Sustainable list the SDGs and point out C1, C2
developmental goals those relevent to public
(SDGs) health

22
Course Topic Sub-topic Learning objective Domain Level Mode of Venue of Time Assessment
instruction instruction allocation

Community Disaster Disaster Define disaster C1 1 Lecture and Lecture hall 45 minutes
Medicine video clip

Classify disasters C2 1
Differentiate between C2 2
disaster and accident
Disaster Describe steps in pre and C2 1
management post disaster phases of
disaster cycle
Describe triage and tagging C1 2 45 minutes

Public health intervention C2 1

after disaster

Effects of Describe the magnitude and C2 2

different disasters effects of dfferrent types of
disasters and their public
health consequences

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Course Topic Sub-topic Learning objective Domain Level Mode of Venue of Time Assessment
instruction instruction allocation

Community Environmental Environment Definition

Medicine helath sciences

Air Describe composition of

air
Enlist causes of air
pollution
Mehtods of purification
or air
diseases caused by name the diseases
air poullution caused by air pollution

Explain the methods of

prevention of diseases
caused by air pollution

Water Enumerate sources of

water
tell daily water
requirement for human
beings
metods of purification of
water
Water pollution Discuss causes of water
pollution
Discuss methods of
prevention against water
pollution
Water quality Discuss water quality
standards standards

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Background Derfinition of C1 1 Lectures Lecture 45 Viva, OSPE,
measurements mortality, Hall minutes SEQs, MCQs,
morbidity and questioning,
disability

uses and C1, C2, C3 1 Lectures Lecture 45 Viva, OSPE,

applications Hall minutes SEQs, MCQs,
of motality, questioning,
morbidity,disa
bility, fatality

Epidemiologi Definitions C1, C2, C3 1 Lectures Lecture 45 Viva, OSPE,

cal mthods and Hall minutes SEQs, MCQs,
application of questioning,
different
epidemiologic
al methods
(descritpive,
analytical,
experimental)

epidemiologic define and C1, C2, C3 2 Lectures Lecture 45 Viva, OSPE,

al transition describe Hall minutes SEQs, MCQs,
association questioning,
and causation

25
Course Topic Sub-topic Learning Domain Level Mode of Venue of Time Assessment
objective instruction instruction allocation

classification classify C2 1 Lectures Lecture Hall 45 minutes Viva, OSPE,

of Communicable SEQs, MCQs,
Communicabl diseases questioning,
e diseases,
important
CDs
define C1 1 Lectures Lecture Hall 45 minutes Viva, OSPE,
terminalogy used SEQs, MCQs,
in CD, questioning,

differentiate C3 3 Lectures Lecture Hall 45 minutes Viva, OSPE,

between infective SEQs, MCQs,
disease and questioning,
Communicable
disease

Control of Epidemiology, C2, C3 1 Lectures Lecture Hall 6 hours Viva, OSPE,

infection control and (about 8 SEQs, MCQs,
spread of lectures) questioning,
important
Communicable
diseases, and
prevention against
each of them at
primary,
secondary and
tertiary levels

26
Course Topic Sub-topic Learning objective Domain Level Mode of Venue of Time Assessment
instruction instruction allocation

Communit Information, Concept of Define health education

y education and health education
Medicine communicatio
n (IEC)
Explain contents, principles
and stages of health
education
Describe aims and
objectives of health
education
Discuss Approaches used
in public health
Communication Discuss mehods of
communication
Describe barriers of
communication
skills of communication
heald education Plan a health education
program program
organize and evaluate
health social
Social marketing define education program
marketing and
its uses healt education

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Course Topic Sub-topic Learning objective Domain Level Mode of Venue of Time Assessment
instruction instruction allocation

Community Dynamics of Reseervoir and Define reservoir and source C1 1

Medicine infectious source of infection of infection
disease
transmission
Discuss the procedure of C1 1
escape of organism from
reservoir
discuss mode of entry of C2 1
pathogen into the host
Define host and susceptible C1 2
host
Immunity Define immunity C1 1
describe types of immunity C2 1
Immunization Define immunization C1 1
Describe EPI schedule with C2 1
details of each vaccine
Control of Prevention against Describe the methods of C2 1
infection infection controlling reservoir of
infection
What is notification C1 2
Discuss Primary,secondary C2 1
and tertiary prevention
against infection
describe interruption of C2 2
transmission

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 EVALUATION METHOD
(4th Year MBBS Professional Examination)

29
 REFERENCE BOOKS
(as listed in the UHS curriculum)

1. Textbook of Community Medicine by Park J E. Latest edition

2. Textbook of Community Medicine by Ilyas Ansari. Latest edition
3. Textbook of Community Medicine by Maxcy-Rozenau-Last. Latest edition
4. Medical statistics by R. Kirkwood. Latest edition
5. Online Journals and reading materials through HEC digital library facility and WHO website

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