Community Medicine Curriculum FOR MBBS at Kathmandu University
Compiled By:
Dr. Surya B. Parajuli
Kathmandu University-Birat Medical College & Teaching Hospital
Budhiganga Rural Municipality-2, Tankisinuwari, Morang, Nepal
www.suryaparajuli.com.np
SEMESTER I
- Human and Medicine
- Medicine in antiquity (Primitive Medicine, Indian Medicine, Chinese Medicine, Egyptian Medicine, Greek Medicine, Roman Medicine)
- Dawn of scientific medicine
- Modern medicine
- Medical revolution
- Socio-cultural aspects of health in Nepal
- Eugenics
- Alternative medicine
- Medical ethics
- Concept of Health and Disease
- Definition of health and well-being
- Dimension and determinants of health
- Epidemiological triad
- Theories of disease causation
- Natural history of disease
- Risk factor concept
- Concept of control of disease
- Levels of prevention
- Modes of intervention
- Primary health care
- Goals/targets set to achieve "Health for All"
- Critical review of HFA 2000
- Revitalizing primary health care
- MDGs in the context of Nepal
- Nutrition-I
- Protein-energy malnutrition
- Iron deficiency
- Vitamin A deficiency
- Determinants of nutritional status of individual/ community
- Nutritional sources and requirements
- Balanced diet
- Nutritional deficiency disorders e.g. PEM, Iron deficiency, Vitamin A deficiency
- Nutritional problems in Nepal
- Nutritional status assessment in a community
- Nutrition-II
- Iodine deficiency disorders (IDD)
- Magnitude of the problem in Nepal
- Community assessment of IDD
- Zinc deficiency
- Salt fortification
- Environment Health-I
- Environment: physical environment inside and outside the home
- Water: safe water, potable water, purification of water at the household and community levels
- Waste disposal- necessity of waste disposal
- General principles of waste disposal
- Excreta disposal – necessity of excreta disposal
- General principles of excreta disposal
- Family environment and principles of good housing
- Biostatistics-I
- Need of biostatistics in medicine
- Statistical method
- Frequency distribution
- Measure of central tendency
- Proportions
- Presentation of statistical data
- Tables: simple and frequency distribution tables
- Charts and diagram: bar, histogram, frequency polygon, line diagram, pie-chart, pictogram
SEMESTER II
- Epidemiology-I
- Definition of epidemiology
- Uses of epidemiology in hospital, community and health planning
- Basic measure in epidemiology e.g. rate, ratio and proportion
- Mortality: concepts of crude, specific and standard prevalence of disease
- Significance of time place and person distribution in epidemiology
- Sources of epidemiological data
- Information Education Communication (IEC)
- Health educational methods including A-V aids for individual, group & mass
- Significance, advantages and disadvantage of the methods
- Planning a health education program
- Information, education and communication strategies
- Evaluation of health education activities
- Environmental Health-II
- Air pollution source, effects, control , greenhouse effect, ozone layer
- Energy conservation: alternate source of energy
- Noise pollution: sources, effect and control
- Ventilation
- Lighting
- Radiation hazards
- Hospital waste management
- Urban health
- Global warming
- Meteorology of medical relevance
Entomology
- Mosquito, Housefly, Lice, Ticks, Fleas, Sand-fly, Reduviid bugs
- Rodents and their control
- Demography
- Importance of demography
- Demography cycle
- World population trend: regional difference, birth and death rate
- Growth Rate
- Transmigration
- Demographic trends of the country: age and sex composition, age pyramids
- Sex ratio, density of population, family size, urbanization, literacy, life expectancy
- Fertility- determinants of fertility: biological and behavioral determinants
- Fertility related statistics
- Effect on population of changes in birth, death and growth rates
- Vital statistics and method of collection: census, registration of vital events
- Hospital records, population surveys
SEMESTER III
- Sociology
- Types of family
- Function of family
- Role of family in health and disease
- Culture factors influencing health and disease
- Social organization and community participation
- Measurement of the socio-economic status of a family and its importance in health and disease
- Community Diagnosis Orientation (Collect demographic date and study)
- The Community environment
- Family environment
- Family support system
- Water collection/storage
- Refuse/waste disposal
- Customs/beliefs during pregnancy, lactation, postpartum
- Customs/practices towards elderly/ disabled
- Illness behavior
- Food practices/customs/ beliefs
- Beliefs about family size/ son (male) preference
- Child rearing practices
- Acute morbidity in the family
- Follow up a pregnant woman, neonate, under five year child to record growth and development
- Diet pattern of a pregnant, lactating and post-partum woman
- Follow up an adolescent
- Follow up elderly/disabled persons
- Follow up eligible couples and provide family planning advice
- Family Medicine
- Identify and diagnose illness in the family
- Follow up and study response(s) of the individual /family/community to the specific illness
- Identify and diagnose and manage illness in the family as a family physician to acquire familiarity with the common illness such as:
- Acute respiratory infections
- Rubella
- Mumps
- Diptheria
- Pertusis
- Chickenpox
- Pneumonia
- Tuberculosis
- Measles
- Diarrhea
- Fever
- HIV and AIDS
- Bronchial asthma
- COPD
SEMESTER IV
- Epidemiology-II
- Epidemiology studies; descriptive, analytical and experimental
- Basic concepts about transmission of infectious agents
- Principles of control about communicable disease
- Principles of control of non-communicable disease
- Investigation and control of an epidemic
- Epidemiological principles underlying screening
- Distinction between screening and diagnostic test
- Calculate: sensitivity, specificity, positive predictive value etc. for screening test
- Collect and interpret clinical, psycho-social information from patient/ family to understand natural history of a disease
- Behavioral science
- Factors affecting behavior attitude
- Attitudes, nature, development
- Cognitive development
- Puberty and adolescence
- Behavior problem
- Sexual behavior
- Normal and abnormal behaviors
- Implications of behavior in illness
- Methods to change attitude behavior
- Measurement of attitudes
- Questionnaire/pre-testing and validation of a questionnaire/ interview schedule
- The need for counseling in various situations (e.g. HIV/AIDS affected person)
- Proper approach and attitude of counselor
- Communication skills required of a counselor
- Community based integrated management of childhood illness (CBIMNCI)
- Introduction to CB IMNCI and orientation to the global problem
- Importance of CB IMNCI in family medicine
SEMESTER VI
- Communicable Diseases
- Respiratory diseases (TB, Influenza, SARS)
- Vector borne diseases (Malaria, Filaria, Dengue, Leismaniasis )
- Intestinal infection (Acute Diarrheal Diseases, Viral Hepatitis , Typhoid fever, Cholera)
- Zoonosis (Rabies, Japanese Encephalitis, Chikungunya, Yellow Fever, Plague, Leptospirosis)
- Surface infections (STDs, HIV/AIDS, Leprosy)
- Emerging and re-emerging diseases
- Hospital acquired infections
- National Plans for Communicable Diseases
- Malaria
- STD / AIDS
- Pulmonary tuberculosis
- Leprosy
- Kala-azar
- Vaccine preventable diseases (VPDs) included in the Expanded Program of Immunization: cold chain and surveillance of VPDs
- Diarrhoeal diseases
- Occupational Health
- Working environment: health hazards of industrial and agricultural workers
- Common occupational diseases
- Industrial toxic substances, health hazards & international safety limits
- Principles of control of occupational diseases
- Legal aspects
- Mental Health
- Problem of mental health
- Assessment of mental health
- Causes of mental ill health
- Types of mental illness
- Mental development in children
- Mental retardation
- Conversion reaction
- Schizophrenia
- Depression
- Alcoholism & drug abuse/addiction
- Suicide a deliberate self-harm
- Problem of sexuality & gender disorders
- Prevention of mental ill health
- Mental health services in Nepal
- Epilepsy
- Non-communicable Diseases
- Epidemiology of non-communicable diseases
- Nutritional disorders
- Rheumatic heart diseases
- Coronary heart diseases
- Hypertension
- Cancers
- Blindness
- Diabetes
- Obesity
- Accidents
- National Plans for Non-communicable Diseases
- National plan on non-communicable diseases
- Program for control of Iodine Deficiency Disorders, Blindness control programs
- Program for control of other Nutritional Disorders e.g. nutritional anemia, Night Blindness etc.
- Impairment / Disability / Handicap: Definitions and concepts
- Assessment of Impairment / Disability / Handicap: e.g. Post-Polio residual paralysis
- Programs for rehabilitation at the individual and community levels
- Community based rehabilitation
SEMESTER - VII
- Reproductive Health
- Maternal and child health
- Safe motherhood
- Magnitude of the problem
- Maternal morbidity and mortality
- Under 5 year child morbidity and mortality
- Breast feeding and weaning
- Family planning methods
- National Health programs for specific age group
- School health program
- Problems for the elderly
- Social organizations to assist the elderly
- EPI – Info
- How to design a computer compatible questionnaire in “EPED”
- How to “ENTER” data in the questionnaire
- Simple forms of “CHECK” programs while entering data e.g. range checks, legal values etc
- “ANALYSIS” of data set
- Cleaning of data set
- Frequencies and other tables
- Graphical output
- Cross-tabulations
- Health Planning and Management
- Primary health care
- Management of health resources
- Planning and organization of health services in Nepal
- Health team at district hospital, health post etc.
- Voluntary agencies in health care
- Evaluation of a health program: epidemiology and management principles
- Need of health economics.
- Concepts of cost benefit and cost effectiveness
- Health delivery system in Nepal
- Evolution of health services
- Organization of health delivery system in Nepal from center (MoH) to Sub Health Post functions of different category health personnel
- Inferential Statistics
- Probability
- Normal distribution, Poison distribution, Binomial distribution
- Estimation of standard error
- Confidence interval
- Tests of significance
- Concepts of alpha and beta error
- Bias and random error
- Sample size calculation
- Sampling
- Correlation and regression
- Disaster Management
- Definitions of Calamity, Disaster- natural and man-made
- Concepts of Hazard and Vulnerability
- Disaster Cycle
- Planning for Disaster management
- Disaster management committee: constituents, line of command etc.
- Relief measures: when and what to ask for?
- Concept of Triage
- Practical play in a disaster situation
- Simulated exercise on patient triage
- International Health
- Need of International Health Organization
- Structure and functions of WHO
- Other UN agencies and their role in Health care
- Bilateral Health Agencies
- Non-government International Health Agencies
- Research Methodology
- Introduction
- Types of research: Descriptive/Experimental/Non-experimental
- Systematic Review and Meta-analysis
- Writing a research Proposal/Conduct Research Project/ Writing a research report