Undergraduate Course (Final Part I M.B.,B.S, )

                        Subject contents are outlined under four major headings. The scope of content covers all aspects of teaching - learning experiences relating to lectures, demonstrations, tutorials, field teaching etc.

 

A. CONCEPT OF HEALTH AND SOCIAL MEDICINE

1. History and evolution of Preventive & Social Medicine.
2. Concept of Health.
3. Community Medicine: concept and practice.
4. Measurement of Health.
5. Factors influencing Health.
6. Mental Health
7. Definition and scope of Social medicine.
8. Definition and characteristics of "Policy"
9. National Health Policies.

 

B. DISEASE CONTROL

1. General epidemiology (including methodology)
2. Principles of prevention and control.
3. Natural history of disease.
4. Levels of prevention.
5. Immunizations.
6. Diseases under national surveillance.
7. International health regulations.
8. Communicable diseases

8.1     Plague
8.2    Cholera
8.3    Dengue hemorrhagic fever
8.4    Japanese encephalitis
8.5    Small pox
8.6    Diphtheria
8.7    Poliomyelitis
8.8    Whooping cough
8.9    Tetanus
8.10  Measles
8.11  Malaria
8.12  Trachoma
8.13  Tuberculosis
8.14  Sexually transmitted diseases
8.15  Filariasis
8.16  Leprosy
8.17  Enteric fevers
8.18  Food poisoning
8.19  Leptospirosis
8.20  Diarrhoea and dysentery
8.21  Anthrax
8.22  Influenza
8.23  Viral hepatitis
8.24  Rabies
8.25  Arborviruses
8.26Yellow fever
8.27Rickettsial diseases
8.28Intestinal helminthiasis

9.   Non-communicable Disease

      9.1    Nutritional diseases: PEM, Iron deficiency anaemia, Iodine Deficiency Disorders.
      9.2   Cardiovascular diseases
      9.3   Malignancies
      9.4  Accidents
      9.5  Hormonal diseases: Diabetes, Thyrotoicosis
      9.6  Mental disorders

C.  HEALTH MANAGEMENT AND ADMINISTRATION

1. Principles of management.
2. Health administration in Myanmar.
3. National Health Plan.
4. Health education.
5. Health and vital statistics.
6. International health.
7. Public health laws.
8. Maternal and child health.
9. School health
10. Occupational health in industry and agriculture.
11. Care of aged persons.
12. Care of handicapped persons.
13. Junvenile delinquency.
14. Drug addiction.
15. Nutrition promotion and rehabilitation services.
16. Problem children : Deprived children, Behavioural disorders of children.
17. Primary Health Care.
18. Health For All beyond 2000.

 

D. ENVIRONMENTAL HEALTH

1. Water sanitation.
2. Housing and health
3. Excreta disposal
4. Refuse disposal
5. Food sanitation
6. Management of fairs and festivals
7. Disinfection and disinfectants / Insecticides / Rodenticides
8. Pest control

E. FIELD TEACHING PROGRAMME

1. Clinico-social case taking and presentation
2. Family health care visits to suburban communities
3. Visits to places of public health interest in urban areas.
4. Residential field training to townships and rural areas.

FAMILY HEALTH CARE VISIT

Place of visit               :           Selected village

Time and duration       :           The specified WEDNESDAY during the PSM posting

8:30 am to 12:00 noon (traveling time inclusive)

Objectives of FHC:

1. To let aware of the community way of life
2. To develop insight into the environmental factors influencing health and disease in a society
3. To develop student's ability in analyzing multifactorial causation of disease
4. To promote ability in the practice of comprehensive health care of the family
5. To facilitate the development of
(a) Communication skill
(b) Sense of responsibility
(c) Self-confidence and
(d) Empathy

Introduction: Family health care visits are conducted under guidance of the Department of Preventive and Social Medicine by the Final Part I students during their posting period. It is a form of organized health care visits to allotted families in rural communities where the students participate in identification of health and social problems of families’ concerned. Student also learn the components of Comprehensive Health Care by practically involving in preventive, promotive, curative and rehabilitative health care services to the assigned families. During the process, they also observed and analyze the social and environmental factors associated with (influencing) the health status of a family.

Content : Definition, components, requirements of family, factors influencing family.

Specific tasks: Students are required to fulfil the 90% attendance requirement during FHC visits. Those who fail to meet the above requirement will not be allowed to appear for the Posting Completion Test.

DURING THE FIRST VISIT students are required to:

• Present him/her to the allotted families with due preliminary courtesies. Each student will have to take care of two families in the selected village. It is essential to make a brief conversation with the family members on the purpose of the visit to ensure their acceptance.
• Observe the environmental condition of the community, compound (sanitation, housing condition, water supply, disposal of excreta and refuse, and other significant conditions of the household which may influence the health of family members.
• Note the general health status of all household members encountered.
• Conduct thorough physical examination to those with specific clinical complaints
• Note down the particulars of the visited family and its family members.
• Discuss with the family member to reveal their values and opinions regarding health and disease
• Try to discover their individual felt needs and felt needs of the family
• Give special care to extreme age group; geriatric care of the aged, paediatrics care of under-five covering GROWTH MONITORING and ASSESSMENT OF IMMTINIZATION STATUS, (Note that serial weighing and MAC measurements of all under-fives in the assigned family during the FHC visits are to be included in the FHC REPORT).
• Provide special care to the pregnant and lactating mothers as necessary.
• Observe the family's nutritional status: preparation pattern and contents of family meal (daily consumption of food, the proportion of income utilized for food and food taboos of the family should also be asked).
• Provide treatment for minor ailments and make referral whenever required.

AFTER THE FIRST VISIT, the students are required to:

• Record the findings of each family
• Fill in the provided Family Record Chart
• Identify the health needs of the family based upon the theoretical knowledge of the requirements of a healthy family
• Compare the professionally identified needs with the felt needs of the family and the family members
• Identify the gaps between health needs of the family and the family members
• Consider ways and means of closing that gap
• Write down clearly in narrative form of - the age and sex of the family members
• Significant findings in the family and its environment - their felt needs and health as identified
• the need gap and possible ways of closing the gap, and student's personal opinion an achievements of the visit together with the services rendered the first visit.
• Submit the narrative report and Family Record Chart to the assigned supervisor not later than 15:00 hours on the following Friday.

NOTE THAT:

• The teacher concerned will act as liaison for the first visit to assist the students in introducing to the family members.
• The teacher concerned will provide assistance and guidance as required (especially for curative and referral services)
• The students will be given appropriate advice for the SECOND VISIT by the teacher after reading the submitted FHC report.
• The FHC reports will be sent back to the students on the morning of the NEXT VISIT
• Those students who fail to submit the FHC reports will not be allowed to appear for the VIVA VOCE examination

DURING THE SECOND VISIT, students are required to;

• Visit the allotted families.
• Repeat the same procedure for those family members who missed the first visit
• Observe any changes in environmental conditions of the household
• Enquire the health status of family members and provide appropriate health care measures
• Discuss with the family members based upon the identified health needs
• Find some areas where the health needs and family's expressed needs can overlap(or)are somewhat similar
• Try to convince the family members why physical, mental and social well-being of individual family member as well as the family as a whole is essential
• Talk to convince the family members about the preventive and rehabilitative health care services available for that community.
• Note any specific demand made by the family members
• Help the family members in acquisition of their health needs/demands by promoting the family' s self-reliance and self-dependence
• Explain about the physical, mental and intellectual development of children (if any preschool and school going age children are present)
• Talk with the adolescent child (if present) regarding the physical changes during puberty, psychological adaptation to puberty and social pressures during adolescent period
• Make suggestion for improvement of physical, mental and social conditions. (Note that the suggestion should be feasible, and affordable within the family's sociocultural and economic limitations)
• Explore any psychological and social problems seem to exist in the family
• Take weight and height measurements of under fives

AFTER THE SECOND VISIT, students are required to:

• Record the changes observed
• Note any new findings regarding the health and social condition of the family
• Comment on the outcomes (both positive and negative) of the first visit
• Describe the family demands (if any)
• Present any problems encountered during the visit
• List those health needs accepted by the family
• Describe the services rendered and explain why those services were given
• Plan what should be done on the THIRD VISIT
• Submit the REPORT including the above recordings to the assigned supervisor not later than 15:00 hours on the following FRIDAY.

NOTE THAT: serial weight and height and MAC measurements are to be included in the report. The teacher concerned will provide comments on any changes in measurements. Further suggestions for the THIRD VISIT will be given based upon your report

DURING THE THIRD VISIT, students are required to:

• Visit the allotted families
• Explain that this will be the last visit
• Repeat the above procedures of assessing the health and nutritional status of family members
• Observe any improvements
• Ask for the family's opinion on your visit
• Give health education on special issues relevant for the allotted family; eg. ORT and immunization of families with under-fives; smoking, drugs and AIDS prevention for families with adolescents and young adults; prevention of Cardiovascular diseases for families with elderly members; prevention against locally endemic diseases and occupational hazards for working age groups, etc.
• Conclude yow findings during the visits and give your personal opinion on the family's achievements (Try to give as much positive findings as possible)
• Discuss with the family members on how to improve and maintain their health, and on how to seek health related advices from local health persons
• Make farewell

AFTER THE THIRD VISIT, the students are required to:

• Write down all the significant findings and achievements as usual
• Submit the narrative report not later than 15:00 hours on the following FRIDAY
• Work in groups to compile and analyse the recorded data from Family Record Chart
• Prepare a FINAL REPORT to be presented to the whole class on FHC presentation session

THE FINAL REPORT should contain

1. Date and time of the visits
2. Visited community and community profile
3. Number of visited houses and environmental sanitation of that area
4. Number of family members encountered, age and sex, education and occupation, average family size, per capita consumption power, etc.
5. Number of births, deaths, and marriages during that period
6. Morbidity among the family members: priority disease
7. Analysis of the health conditions of the visited community
8. Recommendations &
9. The extent of the achievement of the FHC objectives in the conclusion

Give feedback to the community concerned through the Head of the Township Health

Department: ONE COPY OF FHC FINAL REPORT will be sent back to the Township Health Department and the identified health needs of the community will be fed back to the community leaders. Apply the experiences gained from FHC visits in their day-to-day life situations.

CLINICO-SOCIAL CASE STUDY AND PRESENTATION

Place of visit:     (a) Clinical wards of Magway Region General Hospital
                            (b) Home visit in the community or the work place

Time and duration:   9:00 am to 12:00 noon (travelling time included)

Introduction

CSC- case taking, presentation and discussion- are conducted under the guidance of the Department of Preventive and Social Medicine supported by Clinico-social officers, by the Final Part I students during their urban posting period. A group of (15-18) students are assigned to one clinical case. In addition to usual clinical history the students have to take detail history of social factors involved in the assigned case. The students then write case report individually after which cases are presented in group session, where feasible measures, to solve the existing problems and to prevent further complications are proposed and discussed.

Objective of CSC

1. To make students aware of the influence of the social factors in disease causation, also in effective management of diseases
2. To develop the attitude of viewing the patients and families as a whole
3. To develop the student's abilities in identifying the multiple factors involved in disease causation, and describing how these factors - biological, environmental, socio-economic, socio-cultural, socio-psychological, and other factors contribute to the management of the disease
4. To let the students to apply epidemiological methods in clinical management of patients
5. To create student's awareness of the importance of comprehensive health care in effective management of the disease
6. To facilitate the development of
   1. Team spirit
   2. Communication skill
   3. Innovative ideas

Specific tasks:

A. CLINICO-SOCIAL CASE TAKING

Students have to

• Present him or herself at the assigned clinical ward accompanied by group supervisor.
• Take clinical examination and investigations comprising the following aspects:
  • Clinical aspect
  • Relevant history of social and community aspect
  • Physical examination
  • Laboratory test & special investigators
  • clinical treatment
• Place more emphasis in eliciting the social history in addition to routine clinical case taking. The social history should be closely related to the me{ical situation with which students are relating. It should aim to assist the understanding of the patient,s illness and the planning of his treatment and aftercare.
• Study the patient as an individual patient and also as a member of a family or a community, and the interaction, interdependence within the family and social relationships.

 

B. HOME VISITING:

The students are required to

• Make home visit and observe the living quarter, environment, and interview his spouse, relatives, neighbours and place of work.
• Have considerate and respectful behaviour and politeness in dealing with the family members or the community when paying home visits
• Conduct interview in the presence of responsible supervisor gr the medico-social officers.
• Note the social factors and the conditions related to his illness to be discussed as social pathology, and generate social therapy after clinical considerations.

C. FOLLOW UP OF THE CASE:

• Where the relevant follow up of the case should be arranged.

D. REVIEW OF LITERATURE ON CLINICAL ASPECTS, EPIDEMIOLOGY AND

MANAGEMENT

• Review literature
• Discuss and describe only the relevant factors in the report

E. ANALYSIS OF SOCIAL FACTORS INVOLVED, AND SYNTHESIS OF SOCIAL

AETIOLOGY

• Note the social aspect of the disease and identify the environmental, socio-psychological, biological and other factors, as well as available resources, influence the management of the Patient, in

• immediate management (at individual and family level)
• long term management (at all levels - individual, family, community & national level)

• discuss how treatment and after care may be planned in the light of the social background of the Patient.

F. SUMMARY OF THE CASE

• Summarize the report which have relevant and concise personal characteristics, social history leading to synthesis of social etiology, social pathology and social therapy.

G. REPORT WRITING AND SUBMISSION

• Report must be written individually. on the clinic-social case taken by his/her group mentioning clearly his/her name and class roll number.
• Submit individual case report on the day of case presentation at not later than 16:00 hour.

H. CSC PRESENTATION AND DISCUSSION

• CSC cases will be presented as a group activity at the end of the posting period. A chosen student will present for the group.
  • Only 15 minutes for presentation (short and sweet presentation)
  • 30 minutes discussion for each cases
  • All the students of the posting group should participate in "discussion".

NOTE that the supervisor concerned will provide assistance and guidance as required

• The medico-social workers will also provide assistance, and will act as liaison-officer for the home visit
• Those students who fail to submit the CSC report will not be allowed to appear for the VIVA VOCE in Final Examination.

 

DEPARTMENT OF PREVENTIVE & SOCIAL MEDICINE
UNIVERSITY OF MEDICINE MAGWAY
CURRICULUM FOR THE RESIDENTIAL RURAL FIELD TRAINNING PROGRAMME

Learning objectives

            At the end of the 3 weeks residential field training the students should be:

1. Aware of  the community lifestyle & appreciate community values, norms, tradition, and customs;
2. Familiarize with the setup & functioning of the health departments, centers, programs and projects at the peripheral level;
3. Observant of the roles of government & non-governmental organizations in implementation of health care activities;
4. Attentive of notable issues & conditions in the community which may facilitate or impede the effective functioning of health care programs, and the solutions;
5. Realize the importance of communication skills in health care;
6. Acquire the required knowledge & skills concerning health research;
7. Eager to get involved in health & community activities for the total development of the country;

B. Program out line

            Residential Field Training Program, a three-week-course, is a required curricular activities for the final part 1, M,B.,B,S to acquire the community exposure during under graduate medical training in accordance with the guidelines recommended by the medical education seminars. The program is mainly an observation tour participatory and research elements to some extent. During the first one week, the students are posted at the township level, and the later two weeks they are trained in the rural areas. Group of twelve to seventeen students are sent to the townships assigned for the University. Currently, 16 townships have been selected by the joint effects of the Department of Health Professional Resource Development and Management, Department of Public Health, Department of Medical Services and Regional Public Health Department.

            The respective TMOs of the selected townships plan, monitor and supervise the Field Training program with the use of curricular outline provided by the PSM department. The teaching staffs of PSM department are involved in the training program starting from the planning phase, to the evaluation at the end of the training. The faculties of university of Medicine take part in supervision of students on their journey to the townships & to the training sites when situation permits.

            Evaluation of the students is done by the respective TMOs on the student’s participation and performance during the training period, as well as by the faculty who supervise through out the journey to the township. Assessment is made by the teaching staff on the individual student’s report of daily activities & the quality of group work, i.e., assigned project and research work.

C. Time Span:

            30 hrs in urban areas {assigned townships}   : six hrs per day for 5 days.
            60 hrs in rural areas {as selected by TMOs}   : six hrs per day for 10 days.

Though the weekends have been excused from the training period, students are liable to participate in the community developmental activities as planned and organized by the TMOs & local health staffs of the townships.

D. Learning Strategies

1. Observation of township health & medical care activities carried out at the township health department, township hospital, health center, rural health center, station health unit, sub centers (urban & rural) & within community.
2. Discussion with the township health authorities, health staff and persons involved in health care delivery of the township, and the voluntary health workers, governmental & NGOs involved in health care, community leaders & others voluntaries etc.
3. Participation in health care activities like hospital work, clinic work, domiciliary health visit, health education activities, environmental sanitation, immunization, special disease control activities, school health, MCH etc; and other community development programs and health promotion activities.
4. Implementation of special survey or research work: Planning, Data Collection, Analysis and Report Writing on the assigned topic will be done by the students with proper guidance and assistance of the Department. The survey topic will be related situation of the selected townships.

 

E. Learning Materials

1. Basic health services of the area

2. Voluntary health services available in the area

3. Governmental and NGOs

4. Rural and Urban communities

5. Special health care situations

6. Specific local situations

 

F. Assessment

1. Assessment by TMOs concerned

Student’s performance during the field-training period will be assessed by the respective TMOs using checklist provided by the Department of PSM.

2. Assessment by the faculty who supervises the journey
3. Day Book submitted

Each student is required to record his/ her daily activities at the end of each working day. This daily record book is to be submitted to the Dept. of PSM within 7 days of completion of Field Training.

4. Group Work

The general profile of the assigned township: Each group of students is required to collect information regarding the township profile to be submitted as a portion of their group work.

5. The survey or Research report: Each group is required to compile and analyze the collected data and information from the field survey during the post-trip period. Group-wise reports are to be submitted within four weeks on their return. The final report of the survey is to be presented to the faculty members and authorities concerned after SIX WEEKS of field training.

 

DEPARTMENT OF PREVENTIVE AND SOCIAL MEDICINE

UNIVERSITY OF MEDICINE, MAGWAY

Residential Field Training Program                                         Final Part ( I ) M,B.,B,S Course

Station -TOWNSHIP CENTER    

Curriculum Contents                                                                                        Proposed duration

1. Organization & function of Township Health Unit                                                      ½ day

• Organization set up
• Administration
• Functions
• Duties & responsibilities of staff

 

2. Township Hospital Activities                                                                                       ½ day

• Organization and staffing
• Functions
• Outlines responsibilities of hospital staff

Students are required to observe and participate in all emergency care activities during their stay in township.

 

3. Maternal and child health & School Health                                                                 1  day

• Organization & staffing
• Function & responsibilities of staff
• Field visit with staff
• NGO: their roles and involvement

 

4. Township developmental (municipal) activities                                                            1  day

• Organization
• Functions
• Environmental Sanitation, water supply, excreta & refuse disposal
• Market eating establishments’ sanitation
• Slaughter house sanitation

 

5. Disease control activities                                                                                              1  day

• Campaign disease; malaria, Leprosy, TB, Trachoma, STD
• Disease under national surveillance

 

6. Research Work (Assigned Research Project)                                                               1  day

 

7. Participation in Occupation Health (if any)                                                                 

8. Co-operative & coordinate activities with other Departments in the Township

9. Participation in community development program activities

10.Role of TMO in medico legal issues                                                                            ½ day

• management of police cases based upon TMOs recent experiences
• Preparation for presentation of medico legal evidences & expert opinion

 

** Curriculum content No. 8 & 9 could carried out during the weekends.

*** Students are required to observe, participate & discuss with the health & health related staff to ensure accurate understanding of the situation at the township.

 

DEPARTMENT OF PREVENTIVE AND SOCIAL MEDICINE

UNIVERSITY OF MEDICINE, MAGWAY

 

Residential Field Training Program                                    Final Part ( I ) M,B.,B,S Course

RURAL CENTRES

1. Organization & function of Station Health Unit                                                    1  day

• Organization set up

• Administration
• Functions
• Outline & responsibilities of SMO
• Daily work at SHU
• Field study of SHU activities by participation in health & medical   care services of SHU.

 

2. Rural Health Center Activities                                                                               2 days

• Organization
• Administration
• Functions
• Duties & responsibilities of HA, LHV, MW, PHS 1 & 2
• Daily work at RHC
• Participation in the health care activities at respective RHC
• Field visit with RHC staff

 

3. Disease Control Activities                                                                                      2  days

• Malaria, Leprosy, TB, VBDC, Trachoma

It should include case detection at RHC level, management of cases and specific control program conducted in that particular area.

 

4. Role of BHS and Voluntary Health workers in NHP                                            1 day

• NHP activities in rural area
• Special program under NHP
• AMWs, CHWs, TTBs, THHWs
• Field visit with the VHW of the area

It should cover the selection, training, duties and responsibilities of VHWs with their difficulties. Students are required to discuss with the health workers as well as the community to ensure proper understanding of the importance of community acceptance & involvement for the success of healthcare programs.

 

5. Role of RHC & sub-centers in environmental sanitation                                       1   day

Simple chlorination of a shallow well, Construction & maintenance of a sanitary pit   latrine, Refuse disposal in rural area / rodent control, Environmental sanitation project of the area.

 

6. Research Work (assigned research project)                                                            1-2 day

7. Participation in community development program                                                 1   day

8. Management of fairs & festival (if any)

 

The duration of the study proposal for each component is subjected to change at the discretion of the TMO concerned.

 

TEACHING – LEARNING APPROACH

1. Teaching Strategies

The strategy is based on the educational principles of:

• Learning is individual
• Active involvement of the learners
• Perceived purposes
• Motivation and reinforcement of the learner, etc.

As such, the following strategies are used:

• individual as well as group learning
• on-campus as well as off-campus teaching
• training cum-service
• learning through participation in health and health related projects
• learning through research

 

2. Teaching Methods

1. Large Group Teaching

• didactic lecture
• lecture-discussion
• seminars
• presentation and discussion of projects and research reports.

2. Small Group Teaching

• group discussion
• tutorials
• clinico-social case presentation and discussion
• on-the-spot discussions and discussion after Field Visits.

3. Individual Learning

• individual assignments
• family health care visits
• electives

 

3. Teaching components and utilization of time

	Teaching components	Time utilization
		Individual students	For the Dept
A.	On-campus
	- lecture	72 hrs	72 hrs
	- tutorials	12 hrs    X 4 gps	48 hrs
	- seminars	1.5 hrs   X 4gps	6 hrs
	- posting completion test	1.5 hrs   X 4 gps	6 hrs
	- term tests : 2hrs X 3 times	6 hrs	6 hrs
B.	Off-campus
	- family health care visits 2 hrs X 3 times	6 hrs     X 4 gps	24 hrs
	- clinico- social case taking	4 hrs     X 10 gps	40 hrs
	- urban field visits 2 hrs X 12 visits	24 hrs   X 4 gps	96 hrs
	- rural field training	90 hrs	90 hrs
C.	Electives	4 hrs     X 4 gps	16 hrs
	Total time utilization	231 hrs	404 hrs

 

Out of 231 hrs, each student spends approximately 93 hrs on on-campus teaching programmes; 124 hrs on off-campus teaching programmes; and has 4 hrs for electives.

TEACHING / LEARNING MEDIA

 

1. Physical

- Blackboard & Chalk

- Display Charts

- Flannel graphs

- Flip charts

- Flash cards

- Overhead projector

- Slide projector

- LCD projectors

- P.A. system

- Computers: Desktops and Laptops

- Computer software: EpiInfo, Word processor, Spreadsheet

- Microscopes, etc.

- Non-living teaching environment

- Transportation facilities

 

2  Non-physical

• Personal contacts
• Observation and monitoring
• Demonstration
• Discussion
• Fact-finding and analysis
• Participation
• Learning by doing
• Group dynamics and team work
• Self learning
• Living environment which governs the teaching/ learning process.

 

ASSESSMENT

 

Department Policy for Assessment of Students' Performance for promotion.

 

1. Objectives

            To formulate on educationally sound, feasible and consistent system of student assessment for promotion.

 

2. Policy Guidelines

            The policy is formulated within the framework of National Health Policy, Aims of Medical Education, Institutional Objectives and Departmental Objectives.

 

3. Background Information

            Preventive and Social Medicine is taught to medical Undergraduates in the final Part I Class. A course of instructions span a period of one academic year, starting in June with a final promotion examination in February and March of the subsequent year. An average of approximately 200 to 300 students attended in each academic year. Teaching is mainly undertaken through dynamic orientation of students by practical field training, seminars, case presentations, visits and small group discussions. This aspect of the curriculum covers 160hrs while didactic lectures are given for 72 hr per year approximately.

            Attempt is made to standardize the system of assessment in all four (five) Universities of Medicine. The aim is to render the system more objective and consistent in the assessment of student performance.

 

4. Strategy of Assessment

            The overall requirement for a student to appear for the final promotion examination is that he will have to be credited with at least 75% of the total attendance; failing which he will be debarred from appearing for the examination.

Student assessment involve three main components:

1. Class work
2. Written Examination
3. Viva Voce Examination.

 

            1.Class work

            Class work would carry 30% weightage in final evaluation.

            The subcomponents of class work are classified as follows:

       1.  Term Tests                                                                   * 50%

       2.  Bloc Posting                                                                * 25%

            - Clinico-social cases                                                      7.5%

            - Family health care                                                        7.5%

            - Posting completion test                                               10%

       3.  Rural field visits                                                          * 25%

            - Assessment by TMO/supervisors                                   5%

            - Assessment of the records/reports                               20%

                                                            Total                               100%

 

1.1. Term Tests

There would be a total of three term tests for each academic year. All tests carry equal weightage and their mean world contribute 50% to total class work.

1. First term test

    would be held just before students depart for the rural field training. Topics covered are General Epidemiology, Environmental Health and Organization of Health Services.

2. Second term test

    would be conducted after returning from the field training and would cover mainly field training experiences in public health administration and management.

3. Third term test

     would be conducted one month before the final examination. It would cover the whole course of study.

4. Feedback to students in the form of test reviews, would be undertaken within a month after a test.

 

1.2.      Block Posting

            It would contribute 25 % to the total class work score.

           

1. Clinico-social case taking

contributes 7.5 % to the final class work score. Half of the score is given according to the quality of the written paper based upon:

                                    - accuracy of factual data

                                    - format of presentation

                                    - logical conclusion

Assessment however is group wise and the same score would be given to all members of the group.

The remaining ½  is given to the quality of the presentation based upon:

                                    - thoroughness in preparation

                                    - comprehensiveness

                                    - logical answers to questions.

Assessment/general is groupwise and the same score would be given to all members of the group. However, in the event that individual student deviates widely from other members of the group, his score is considered individually.

 

2. Family health care

 contributes 7.5% to the final class work score. Scoring is made entirely on the basis of the quality of the reports submitted after each family health care visit.

 

         3. Posting completion test

contributes 10% of the total class work score.. The scoring is based on 2 hours MSQ test.

 

 

1.3.      Rural Field Visits /Training

Contributes 25% to the final class work score. 20% is given to the quality of the day-book and report submitted within one month following the return from filed training.

Assessment is based on:

            - accuracy of factual data

            - expression of individual ideas & comments

            - presentation format.

The remaining 5% is based on the assessment made by township medical officer and supervisors assessment based on performance and general behaviour. Assessment of each student is based upon: leadership qualities,  interpersonal relationship,  interest in the subject, participation in learning activities. Though this assessment is liable to be subjective, every attempt is made to make it fair and objective.

 

1.5.      Final Weighted Class work score

Original maximum scores for each component of class work is set at 100%. Class works would contribute 30 % of the final scores.

 

2. Written Examination

       1.  Scope of the questions

Questions would be based upon the syllabus covered during the course. Decisions on the choice of question content would be a collaborative effort of the three departments of Preventive & Social Medicine.

            Every endeavor would be made to ensure that the questions conform to the Specific Instructional and Departmental Objectives.

 

        2. Types of Questions

            The present system of one essay type question and five short essay type questions would be used, bearing in mind their advantages and limitations. It is hoped that an optimal mix of different types of questions could be utilized in the near future when staff of all three Institutes become familiar with more objective types of questions such as: Multiple choice question, Modified essay type of question, Patient management problem type of questions, etc.

 

       3.  Scoring

Scoring would be based upon a grid of possible correct answers and are to be drawn up by group consensus at the time of question setting.

 

A. Long essay type question (marks allocation- 25)

     Broad grid

- accuracy of factual details                                              60%

- organization of thought & sequencing                           15%

- free expression of ideas & opinion                                 10%

- innovation                                                                         5%

- wide reading                                                                    5%

- tidiness                                                                              5%

 

            B. Short essay type question (marks allocation - 15 each)

                 Broad grid

                        - accuracy of factual details                                        90%

                        - preparation format                                                      5%

                        - tidiness                                                                        5%

 

         4 Script correction

         The chief examiner may delegate the responsibility of correcting answer scripts to co-examiners in his department, to increase the thoroughness of assessment to ensure that there be uniform marking, each examiner would be responsible for correcting specific questions.

           

 

Viva Voce examination

Realizing that the present viva voce examination is deficient in validity, uniformity and consistency, the department intend to conduct it as follows:

P & SM course will be divided broadly into four sections as outlined under '2'i.e, Subject Content.

The chief examiners from the three Institutes would for each day of the viva voce examination formulate six questions from each of the four given sections and agree upon to their broad answers as grids. These 24 questions for the day would then be classified into six sets each containing one question from the four sections referable.

Students then choose by lot the set of questions that he must answer. He would be asked at least two questions from each of the set. Approximately ten minutes would be spent for each candidate. Scores would be allotted to each candidate basing upon the grid. Arrangements would be made so that the candidate after appearing for the viva voce examination in the same day will have no chance of meeting other waiting candidates. This system will be repeated for each day of the viva voce examination.

 

Final Evaluation

            1. Minimum Passing Level

                Overall average of 50%

                Obtain 50% of the allotted scores in at least 2 components

            2. Moderation

                It will be considered for students scoring less then 50% but not less than 46% in overall average.

            3. Decision for promotion

                 Those students obtaining more than or equal to the Minimum passing level (after moderation board) would be classified as "PASS"

            4. Distinction

                 A candidate scoring at least 75% both in class work and written examination will have to sit for Grand Viva represented by examiners from all three Institutes. A mark of distinction would only be granted upon satisfying the chief examiner as well as the majority of co-examiners.

 

CURRICULUM FOR

MASTER OF MEDICAL SCIENCE {PREVENTIVE & TROPICAL MEDICINE}

{ M.Med.Sc. (P &TM) }

I. NAME OF THE COURSE

Master of Medical Science in Preventive & Tropical Medicine [M.Med.Sc (P & T M)]

II. PREAMBLE

As the Ministry of Health and Sport is now trying its best to promote hearth and to extend longevity of human life, the quality of health care is becoming a major issue in Myanmar Hearth Care Delivery System. For effective prevention and control of Communicable Diseases prevalent in Myanmar, the quality of preventive and curative care at the peripheral level should be urgently promoted. Since our country's health system is highly recognized for its well organized infrastructure, quality care could be obtained even at the grass-root leve1 through proper training of township level health workers.

The Master of Medical Science in Preventive & Tropical Medicine course is an initial step to improve the quality of township level medical and health officers who are taking sore responsibility of prevention and control of diseases in their assigned areas. The medical doctors holding this Master degree could be confidently utilized as the Public Health Managers for promotion of community health as well as for provision of quality comprehensive health care to the community.

The estimated requirement of Public Health Doctors for township and district level health care position is about 400, i.e.; 334 townships and 54 districts, currently there is an urgent need to meet these requirements (i.e., human resources for public health). Yearly production of existing MPH holders that is currently undertaken by University of Public Health, Yangon is approximately between 30 and 40. Therefore the proposed M.Med.Sc (P & TM) program will help meet this requirement. Each University of Medicine would be responsible for training of l0- 15 M.Med.Sc (P & TM) candidates per year which is compatible with the current institutional capacity. Further institutional strengthening could be carried out gradually while running the courses.

The curriculum developed for the M.Med.Sc (P & TM) course covers all the basic essential areas of Public Health including Tropical Medicine, Basic Biostatistics and Research Methodology. Individual research project will be assigned to corresponding field training areas. The whole course will be completed within TWO CALENDAR YEAR.

 

III. AIM AND OBJECTIVES

III. A. AIM

To produce skilled public Health & Tropical Medicine Specialists who will be able to effectively promote health, prevent and control diseases using existing facilities both at the township level and central level.

III.B. OBJECTIVES

Upon graduation, the candidate should be able to

1. demonstrate his/her knowledge of

(a) factors influencing health

(b) social and behavioural aspects of health and disease

(c) components and operation of health care delivery systems

(d) basic and advanced statistical principles and methods

(e) essential Epidemiological and Social Science techniques

2. promote healthy lifestyles among community members by using appropriate communication and technique thereby improving the Quality of Life of people and the his/rer care
3. undertake preventive md control measures competently against Epidemic & Endemic diseases prevalent in the community with emphasis on Tropical Diseases
4. lead and manage a health team effectively and efficiently
5. obtain the trust of people in the community and initiate action on their behave
6. acquire the habit of Self-directed Learning and practice it so as to remain contemporary with new developments in medicine

 

IV. SELECTION OF CANDIDATES

For regular courses, the candidate:

1. must be a holder of either M,B.,B,S Degree or an equivalent medical degree registrable at Myanmar Medical Council,
2. must have passed the SELECTION EXAMINATION held by the Central Selection Board.
3. must be equal or less than 50 years (of age).

* Selection criteria may be modified at the discretion of Central Selection Board.

**Yearly intake of 30 to 40 candidates (OR) 10 to 12 candidates per each medical university would be able to meet the country's current public Health man power requirement

*** The number of candidates to attend the course is to be decided by the Central Selection Board for Postgraduate Studies.

 

V. TRAINING PROGRAM

A) OVERVIEW OF SUBJBCTS & CRTDTTS

First Year

1. Public Health Administration                                 300 hours        (10 credits)

2. Epidemiology                                                          270 hours        (  9 credits)

3. Bio-statistics and Demography                               180 hours        (  6 credits)

4. Occupational and Environmental Health                120 hours        (  4 credits)

5. Microbiology and Public Health Laboratory          150 hours        (  5 credits)

6. Tropical Medicine                                                   360 hours        ( 12 credits)                             Total                                                               1380 hours      ( 46 credits)

 

            Second Year

1. Field Work /Group Work                                                                (  4 credits)

2. Individual Thesis                                                                            ( 12 credits)

Total                                                                                       ( 16 credits)

Grand TOTAL                                                                     ( 62 credits)

 

B) DESCRIPTION OF SUBJECTS & MODULES

Subjects	Modules	Contents	Credits
Public Health Administration	PHA 201 Principles of Health Administration and Health Management	Principles of PHA (Principles and Practices of Management, Motivation, Supervision, Monitoring & Control) Strategic Management Leadership Health System Management Hospital Management Global & International Health Logistic & Supply – Chain Managements	90 hrs (3 Credits)
	PHA 202 Practices of PHC Management	PFC, HFA, MDGS NHP and Programs MCH, RH, WCHD, SH, Adolescent Health, Urban Health, EPI Policy Development Mental Health	60 hrs (2 Credits)
	PHA 203 Health Social Science and Health Communication	Social & Behavioural Science Social Welfare in Myanmar Health Education Communication	60 hrs (2 Credits)
	PHA 204 Public Health Nutrition	Nutrition Food Safety & FDA	60 hrs (2 Credits)
	PHA 205 Health Economics and UHC	Principles of Health Economics Universal Health Coverage	30 hrs (1 Credits)
Epidemiology	Epi 201 Fundamentals of Epidemiology	Descriptive Epidemiology Analytic Epidemiology	30 hrs (1 Credit)
	Epi 202 Research Methods and Research Ethics	Quantitative Methods Qualitative Methods Bias, Confounding & interactions Causal Inference Critical Appraisal on Published   Ethics in Research Evidenced Based Public Health Meta-Analysis	90 hrs (3 Credits)
	Epi 203 Applied Epidemiology	Outbreak investigation Disease Surveillance Screening of a Disease Disaster  Management	30 hrs (l  Credit)
	Epi 204 Infectious Disease Epidemiology and Chronic Disease Epidemiology	HIV/AIDS, TB, Leprosy, Diarrhoeal Diseases, VBDC, Vaccine Preventable (EPI) Diseases, DD & STDs. ARI	90 hrs (3 Credit)
		Policy, Practices & Global Strategies for P&C of NCDs Accidents & Injuries -Substance Abuse HTN, CHD, DM, P of Blindness
	Epi 205 Seminar & Workshop in Epidemiology	Workshop on HSR & OR Seminar on Critical Appraisal	30 hrs (l Credit)
Bio-Statistics and Demography	Bio 201 Fundamentals of Bio-Statistics	Descriptive Statistics Probability Distribution Sampling Distribution Inferential Statistics Sampling & Sample Size Determination	60 hrs (2 Credit)
	Bio 202 NPT in Research	Common Non-Parametric Statistics used in Research	30 hrs (l Credit)
	Bio 203 Advanced Bio-Statistics	ANOVA, ANCOVA, MANOVA Multivariate Analysis (Multiple Linear & Logistic Regression) Survival Analysis ROC Analysis	30 hrs (l Credit)
	Bio 204 Application of Computer in Data	Utilization of Statistical Software in Data Analysis	30 hrs (l Credit)
	Bro 205 Demography	Vital Statistics Life fable Census Population Projection	30 hrs (l Credit)
Occupational and Environmental Health	OEH 201 Fundamentals  of EH	Environmental Epidemiology including concepts, methods & practices such as Water Sanitation & Sampling, Excreta Disposal, Refuse Disposal, Vector Control, Sanitation of Public Places, Air pollution Environmental Policies and practices EIA, SIA Climate Change Field Visit	60 hrs (2 Credits)
	OEH 202 Essentials of OH	Industrial & Hospital waste Management Housing & Town planning OH including occupational diseases & hazards Agriculture Field Visit	60 hrs (2 Credits)
Microbiology and Public Health Laboratory	Micro 201 Fundamentals of Microbiology (4 C) PHL 201 Fundamentals of PHL (l C)	Bacteriology Virology Parasitology Mycology Helminthology PHL	150 hrs (5 Credits)
Tropical Medicine	TropMed 201 Fundamentals of Tropical Medicine	Neglected Tropical Diseases Tropical Diseases commonly encountered in Clinical Practice	360 hrs (12 Credits)

 

C) METHODS OF TEACHIN & LEAINING

1. Didactic lectures
2. Topic discussions

4. Assignment/discussions
5. Journal reading/ Seminar/ Tutorial
6. Field visit
7. Clinical posting/ Bed-side teaching & discussions
8. Practical work (Teaching Laboratories)

 

VI. DURATION OF THE COUITSE

The minimum is 2 years & maximum is 3 years.

 

VI. ASSESSMENT & THESIS

1. FORMATIVE ASSESSMENT (for First year)

• Monthly assessment of the log-book by the assigned supervisor from the Department of Preventive & Social Medicine
• Assessment of field visits by the field supervisors and evaluation of day-books
• Term test

B) SUMMATIVE ASSESSMENT (FINAL EXAMINATION) for First year

First year of the course is composed of "two semesters"; first semester is from January to June and second semester is from July to December, Therefore final exanimation will be done at the end of each semester. The final examination at the end of first semester (i.e., end of June) will cover modules PHA 201 & PHA 202 of Public Health Administration, modules Epi 201 & Epi 202 of Epidemiology, all modules of Bio-Statistics & Demography and all modules of Microbiology.

The final examination at the end of second semester (i,e,, end of December) will cover remaining modules (i.e,, PHA 203, PHA 204, PHA 205, Epi 203, Epi 204, Epi 205, Occupational & Environmental Health and Tropical Medicine).

One week will be allowed for private study at each final examination.

If a candidate fails, he or she will be given a chance to try again for additional two attempts at subsequent examinations (i.e., supplementary examination) that will be held every six weeks. Compartmental privilege will be given according to the existing post graduate rules and regulations. If a candidate fails more than half (50%) of subjects in any examination, he or she needs to sit for all subjects in supplementary examination. otherwise (i.e. if a candidate fails <50% of subjects) the supplementary examination will cover the subjects he or she failed in previous examination.

If a candidate fails in third attempt he or she will be terminated from the course.

B.1. SUMMATIVE ASSESSMENT FOR PUBLIC HEALTH ADMINSTRATION, EPIDEMIOLOGY, BIOSTASTICS & DEMOGRAPHY AND OCCUPATIONAL & ENVIRONMENTAL HEALTH

Each examination for PHA, Epidemiology, Biostatistics & Demography and Occupational & Environmental Health will comprise:

(a) written theory examination (MSQ) of 3 hours duration, which will carry 50% of the total marks

(b) Viva voce that will carry 50% of the total marks. Pass marks for each subject is 60% from each compartment separately, viz: written examination and viva voce. Credit marks and distinction marks will be 75%, and 80% for each compartment separately.

 

B.2. SUMMATIVE ASSESSMENT FOR MICROBIOLOGY

Final exam: will be composed of written exam:, practice exam: and viva voce. Written exam: will be 10 out of 12 MSQs; practical exam: will be spot test containing 10 slides. Written exam: practical exam: and viva voce will contribute 50%, 15% and 35% of the total marks. Pass marks is 60% from each compartment separately, viz: written examination and viva voce & practical. Viva voce and practical will be considered as one compartment. Credit marks and distinction marks will be 750% and 80% for each compartment separately.

 

B.3. SUMMATIVE ASSESSMENT FOR TROPICAL MEDICINE

Assessment will include theory and viva examinations. Pass mark is 60% from each compartment; theory and viva, Theory exam will comprise of 6 MSQs and 60 best of five response quiz to be completed in three hours. Sixty marks will be given for MSQs and forty marks for best of five questions. For viva session, 5 picture quiz will be given within 10 minutes, and 2 data and 1 problem have to be discussed within 20 minutes (10 minutes for data and 10 minutes for problem). Fifty marks will be given for 5 picture quiz and 25 for2 data and 25 marks for one problem.

 

B. 4. SUMMATIVE ASSESSMENT FOR PUBLIC HEALTH LABORATORY

There will be no formal examination for public health laboratory. Attendance must be at least 90%.

 

C) THESIS

Protocol submission to the board of research and ethical committee must be satisfactory within first three months of second year (i.e., must be satisfactorily submitted at the end of March). Thesis submission and defence will be done two month and one month before the end of two year course, respectively. This means that the thesis must be submitted at the end of October, distributed to examiners at the end of first week of November and thesis defence will be held during first week of December. If the candidate fails to submit thesis in-time, he/she will be regarded as failure ( 1 F). The candidate will be allowed to extend the course for maximum one year period (six month extension in one time for maximum two times) to make the necessary correction or preparation for final thesis. Satisfactory defence is expected not more than three years from the start of the course.

 

D) TERMINATION OF THE COURSE FOR STUDENTS

If a candidate fails the first year examination even if he/she tries for three attempts (or) if a candidate cannot achieve satisfactory defence for his/her thesis within three years from the start of the course, the respective candidate will be terminated from the course.

 

E) SUMMARY TABLE SHOWING HOW THE EXAMS ARE CONDUCTED

No.	Subject	Written	Viva	Practical
1. 2. 3. 4. 5. 6.	PHA Epidemiology Biostatics & Demography Occupational & EH Microbiology Tropical Medicine	Yes Yes Yes Yes Yes Yes	Yes Yes Yes Yes Yes Yes	No No No No Yes No

 

VII. RESOURCES

A) PERSONNEL

Additional teaching staff and supporting staff will be required for on-campus and off -campus program.

B) BUDGET

Additional budget allocation will be needed in order to run the course smoothly.

 

C) MATERIALS

C.l . Teaching aids

(a) OHP and Projectors

(b) Scientific calculators

(c) Computers

(d) Copiers

(e) Stationery

C.2. Transportation facilities for field visits to the health and related departments.

 

IX. DEGREE

Master of Medical Science in Preventive and Tropical Medicine {M.Med.Sc (P & TM)} will be conferred by University of Medicine after successful completion of the course requirements.