CHRISTIAN MEDICAL COLLEGE
VELLORE – 632 004, TAMIL NADU, INDIA
DEPARTMENT OF DISTANCE EDUCATION
LEARNER COURSE HANDBOOK
2014
Master in Medicine in Family Medicine
(M. Med in Fam. Med.)
Previously known as ‘Post Graduate Diploma in Family Medicine’
(PGDFM)
(A 2-Year Distance Education Course for MBBS & Post Graduate
Doctors)
This course is provisionally accredited by the Tamil Nadu Dr. MGR
Medical University, Chennai, Tamil Nadu, India.
CONTENTS
I.
II.
III.
IV.
V.
VI.
VII.
VIII.
IX.
X.
XI.
XII.
XIII.
XIV.
XV.
XVI.
XVII.
XVIII.
Welcome Note
History of CMC, Vellore
Vision & Mission
Purpose of this Handbook
Importance of Family Medicine
Family Medicine in India
Distance Education Department – an Overview
Reach of the Distance Course in Family Medicine
Course Objectives
Course Expectations
X.1.What to expect from this course
X.2.What not to expect from this course
X.3.What we expect from you in this course
Course Components
XI.1. Self-Learning Modules
XI.2. Video-lectures
XI.3. Contact Programs
XI.3.a. Objectives of the contact program
XI.3.b. Dates & Attendance
XI.3.c. Contact Program Centres
XI.3.d. Preparing for the contact program
XI.3.e. Getting there…
XI.3.f. Sample program schedule
XI.3.g. Contact Program Format
XI.3.h. Log books
XI.3.i. Facilitators
XI.3.j. Maximising the learning experience
XI.4. Assignments
XI.5. Project Work
XI.6. Elective skills training
XI.7. E- Talks
Assessments
XIII.1. Formative
XIII.2. Summative (University Examinations)
Team Concept
E-learning
Student Support
Conduct & Decorum
Fees
Contact information
I. WELCOME NOTE
Dear Learner,
It is indeed a great privilege and joy for us to welcome you to this course. And we welcome you
to be part of the CMC family!
Some of you would have joined this course because you are eager to update your knowledge and
skills, some of you might have felt rusty after years of practice and may have wanted to get back
to some form of studies, some of you ladies may have taken a career break or may have kept
your career low-key to take care of the family, some of you may have just wanted to do the
course because of the ‗CMC tag‘ on it, whatever the reason, by joining this course, you have
committed yourself to a new learning culture, a process of change in practice and to life-long
learning!
There was a king who wanted to build the biggest palace on earth. He put a whole lot of workers
on the task. One day there were some royal visitors from the neighbouring countries, curious to
see the palace being built. They found some masons working there, placing the stones on the
cementing mortar. They asked them what they were doing. The first mason said, ―Oh! I am just
placing the stones on the cement‖, the second mason said, ―Oh, I am just building this wall‖ and
the third mason stood up proudly and said, ―I am part of this team building this great palace for
my King, which is going to be the biggest palace in the world.‖
If you go through the course as someone who is ―just getting some more knowledge‖ (‗just
placing the stones on the cement‘) or ―just building your practice‖ (‗just building a wall‘), the
purpose of this course is lost. The course is designed to help you see the larger role you are
responsible to play in this great nation of ours in terms of delivering good healthcare and in
― being part of the team building this great specialty of Family Medicine‖ (‗part of this team
building this great palace‘). Also, we who are fortunate to be in mainstream of the society have
social responsibility towards the society – poor, underprivileged, neglected!
I wish you an exciting learning experience as you go through this course and you would not only
become confident to ‗Refer less and Resolve more‘, but also would gain momentum transform
the future of medical practice in this country.
Dr. Jachin Velavan
Coordinator
Department of Distance Education
CMC, Vellore
II. HISTORY OF CMC, VELLORE
The Christian Medical College (CMC) was founded in the beginning of the 20th century by
Dr.Ida Sophia Scudder with the intention of providing health care services to women and
children.
Although in her youth Dr. Ida had no intentions of following the family tradition of working as a
missionary and dedicating her life for the welfare of others, a particular incident transformed her
thoughts and motivated her to study medicine and come back to India to serve the needy.
On a fateful night in 1890, young Ida witnessed the deaths of three young Indian women during
childbirth, though her father, a doctor, was present; but the constricting social norms that did not
allow him to cater to the needs of these female patients. These deaths, which could have easily
been prevented, affected young Ida deeply.
Dr. Ida did her medical education at Philadelphia and Cornell. She returned to India in 1900 – an
India where the average life expectancy was 24 years and started a hospital with one bed as the
only doctor in that area.
Thus, the Christian Medical College, Vellore (CMC) began as one of the several mission
hospitals all over the country in the beginning of 20th century offering primary healthcare.
Today with 2,500 beds, 1,210 doctors and many achievements, CMC is the beacon of medical
education, research and patient care in India.
http://www.youtube.com/watch?v=9MF2WNd8nT8
http://www.youtube.com/watch?v=hdDKJK4pNWY
III. VISION & MISSION
VISION STATEMENT – CMC
The Christian Medical College (CMC), Vellore, seeks to be a witness to the healing ministry of
Christ, through excellence in education, service and research.
MISSION STATEMENT - CMC
The primary concern of the Christian Medical College, Vellore is to develop through education
and training, compassionate, professionally excellent, ethically sound individuals who will go
out as servant-leaders of health teams and healing communities. Their service may be in
promotive, preventive, curative, rehabilitative aspects of health care, in education or in research.
MISSION STATEMENT – DEPARTMENT OF DISTANCE EDUCATION
The Distance Education Unit focuses on training and capacity-building HRH (Human
Resources for Health) at all levels of healthcare with a goal to strengthen healthcare delivery
systems and Primarycare research in India and other developing countries and to bring
sustained health transformation with a special objective to facilitate healthcare access to the
poor and marginalised, in the spirit of Christ.
MOTTO OF CMC:
IV. PURPOSE OF THIS HANDBOOK
The purpose of this handbook is to capture in these pages, the spirit of CMC, the vision and
passion of the Distance Education Department and help you become part of it.
It is also designed to :

Walk you through the course in the smoothest possible way.

Give you overall picture of the course

Understand the various course components

Outline the curriculum involved in the course

Brief you on the various milestones that you may have to achieve in this course

Draw your attention to the important dates/events during the academic year 2013-15

Assist you to plan well in advance and maximize your learning
So, it is essential that you read this handbook thoroughly many times and understand all
that is described in this.
V. IMPORTANCE OF FAMILY MEDICINE
India‘s 1 billion-strong population presents huge health needs which are mostly catered to by
2,50,000 General Practitioners and 30,000 Government doctors who work in primary and
secondary level hospitals. With only 1/3rd of Medical graduates getting into post-graduation
annually, this large group of doctors in both private and public sectors are left with very few
options to update their knowledge and skills which has resulted in 3-fold problems:
1. Inadequately trained with unethical practices
2. Excessive and unwanted referrals to specialists
3. Escalating health costs
The general practitioners in the private sector are pressurised by the pharmas, labs and imaging
centres and resort to irrational prescribing, accepting kick-backs from imaging centres,
laboratories etc.) and lack updating and competencies leading to excessive referrals to specialists
and unnecessary investigations.
The problems are similar in the public sector too. Also, we fall way too short of funds and human
resources to staff FRUs (First Referral Units) with a pentagram of 5 consultants— Physician,
Surgeon, ObGyn, Paediatrician and Anaesthetist. Even if we did achieve this, who would
manage cases that will fall between the cracks: Psychiatry, Orthopedics, Dermatology, ENT,
Ophthalmology etc.?
What then is the solution?
A multi-competent Family Physician providing a single-window, ethical, holistic healthcare
could be a cost-effective and feasible solution.
So, training, equipping and empowering doctors to become such physicians will reduce
unnecessary referrals and thus the health costs considerably.
Distance medical education using all the andragogic methods can be used to train large number
of doctors without displacing them from their work-places.
Why Family Medicine?
1. A family physician is a multi-competent specialist who can handle efficiently and confidently
more than 90% of the common ailments. He does this in a compassionate, patient-centered
way and takes care of the whole person and the entire family.
2. A Family Physician concept is a tried and successful model in health systems of developed
countries like Australia, UK and US and developing countries like South Africa.
3. In the absence of this concept, patients either approach physicians practicing nearby who are
not confident of handling them or leading to excessive and unnecessary referrals or patients
themselves choose to go to specialists.
VI. FAMILY MEDICINE IN INDIA
This is a very exciting phase for Family Medicine in this country…lot of things happening and
lot more in the offing…!
Lot of pro-Family Medicine changes are happening in the country at all levels - from policy level
– the Health Secretary directing all states and Universities to start courses on Family Medicine
and stating that Family Medicine should be the preferred specialty for appointment in PHCs &
CHCs - to the academic level where the MCI has directed all Universities to start MD in Family
Medicine and PGDFM, the CMC-run PGDFM course has become M.MED in FAMILY
MEDICINE which is now a Tamil Nadu DR.MGR Medical University-accredited diploma!
The onus is on us to help set the right trends in this upcoming specialty of Family Medicine in
terms of compassionate, rational and ethical care of the patient.
References:
1. RECOMMENDATIONS – NATIONAL CONSULTATION ON FAMILY MEDICINE
http://nhsrcindia.org/pdf_files/resources_thematic/Public_Health_Administration/NHSRC_Cont
ribution/Family%20Medicine/NHSRC%20_Family%20Medicine%20Programme_NRHM.pdf
2. NRHM INTEREST
http://www.nhsrcindia.org/pdf_files/resources_thematic/Public_Health_Administration/NHSRC
_Contribution/Family%20Medicine/HS_Family%20Medicine.jpg
3. http://www.nhsrcindia.org/pdf_files/resources_thematic/Public_Health_Administration/NHSRC
_Contribution/Family%20Medicine/NCFM%202013.pdf
4. DISTANCE DUCATION IN FAMILY MEDICINE http://www.jfmpc.com/article.asp?issn=22494863;year=2012;volume=1;issue=1;spage=3;epage=6;aulast=Velavan
5. WHO RECOMMENDATIONS ON FAMILY MEDICINE
http://apps.searo.who.int/pds_docs/B3426.pdf
6. WHO RECOMMENDATIONS ON FAMILY MEDICINE
http://www.searo.who.int/entity/primary_health_care/documents/sea_hsd_351.pdf
VII. DISTANCE EDUCATION DEPARTMENT –
AN OVERVIEW
What are we about?
The Distance education unit focuses on capacity-building HRH (Human Resources for Health) at
all levels of healthcare with a goal to strengthen healthcare delivery systems in India and other
developing countries with a special objective to facilitate healthcare access to the poor and
marginalised, in the spirit of Christ.
What do we do?
This goal is accomplished by conducting various courses, training programs and workshops for
doctors, nurses, community workers, medical students, aspirants for health-professions training
etc.
Distance medical education uses all the andragogical methods aided by advancing technology
and delivers through problem-based self-learning modules, video-lectures, video-conferencing,
face-to-face contact programs and innovative teaching-learning methods. These have helped in
training large numbers without displacing them too much from their work-places. Both private
and public sectors are benefitted by these trainings, along with a large number of international
students from Africa and other South-East Asian countries.
Distance programs we offer:
At present, the department runs the following programs:
1. Post Graduate Diploma in Family Medicine (PGDFM) - a 2 year distance course with the
motto ‗refer less, resolve more‘, for equipping General practitioners the country and for
building capacity of Government doctors from 8 northern EAG states sponsored by the
NRHM. This has now been affiliated to the Tamil Nadu Dr. MGR Medical University and is
called M.MED in Family Medicine. The PG Diploma in Family Medicine for fresh
graduates from CMC and other Mission hospitals is run by the MEU in collaboration with
the Distance Education Unit. So far, 1830 doctors have been enrolled in this course.
2. Distance Fellowship in Diabetes Management (DFID) – With Diabetes reaching epidemic
proportions in India and the gross mismanagement of Diabetes across the country prompted
us to launch this 1 year Distance course for Physicians and Family Physicians, run in
partnership with The Department of Endocrinology, Diabetes & Metabolism. So far, 374
doctors have been enrolled in this course.
3. Supplementary Education for Medical students (SEMS) – a one year distance certificate
course targeting medical students in their clinical years across the country to introduce them
to problem-based integrated learning, supplemented by one-weekend-a month hands-on at
the nearest Mission Hospital. The idea is also to expose medical students to low-cost highquality ethical medical care during these week-end visits to Mission Hospitals. This is a
tripartite venture partnering CMAI & EMFI. 22 students have been enrolled so far in this
pilot project.
4. Community Lay-leaders Health Training Certificate (CLHTC) Program – a 1-year
distance course aimed at equipping being the 10,000 NGO workers based in very remote
areas of the country to equip them to give basic primary healthcare in partnership with
RUHSA. So far, 540 students have been enrolled in this course.
Who are our Collaborators?
The Distance Education unit runs its programs in collaboration with various partners:
1. Mission Hospitals, which by functioning as contact centres for hands-on training have become
platforms for change.
2. Mission organisations
3. Other partners like 1. CIHSR (Christian Institute of Health Sciences and Research),
Dimapur, Nagaland 2. 4B Healthcare, Bangalore and 3. University of Edinburgh,
Scotland to start Masters in Family Medicine for African countries.
How many have been trained?
What are our other initiatives?
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The department also focuses on Faculty Development, developing a network of national and
international faculty and also empowering and developing bright and promising alumni of the
distance courses we run, to become future faculty by conducting a series of Faculty
Development Workshops.
A multi-media development unit and a Primary care research desk have already been put
in place.
The e-learning platform is being launched this year.
3 centres in Africa will be set up for training African doctors in collaboration with the
Edinburgh University, Scotland.
Setting up of skills lab is planned in all regional centres.
Starting other need-based distance courses like courses in Hypertension, Primary care
Research, Community dentistry, Family Physician Assistant, Dental Assistant, Geriatrics,
Bioethics etc.
VIII. REACH OF THE DISTANCE COURSE IN FAMILY
MEDICINE
This is not ‘yet another academic program’, this is focused on transformation. Knowledge can
be ‘googled’ in a minute by the click of a mouse … this course is not about knowledge, this is
all about bringing about sustainable change in medical practice and healthcare delivery in
India and other developing countries.
The course was first offered in 2006, accommodating 250 students each year and since then 5
batches have graduated after completing their course. The course impacted the GPs in a big way
in the sense that it helped them read and update themselves, use simple algorithms to reach
proper diagnoses, write rational prescriptions, introduced ethical principles into their practice ,
confidently handle patients whom they were referring before and shift gear from the
‗commercial‘ focus to the ‗care‘ focus.
Interest from the Government Sector
Observing the impact of the course, the Government of Tamil Nadu (TNHSP) started sponsoring
doctors posted in Primary Health Centres - 45 doctors per year. Two batches of doctors from the
tribal PHCs have passed out. Following this, the NRHM (National Rural Health Mission), the
apex Central Government body in health wanted Primary Health Centre doctors in 8 backward
North Indian states to be trained in Family Medicine and they sponsor 150 doctors per year. The
MGIMS (Mahatma Gandhi Institute for Medical Sciences, Sewagram) has signed on MOU with
us to run this program on 3 Northern states.
International Interest
As applications kept pouring in from abroad, we also opened up the course for enrolling students
from African countries, Bangladesh and the Middle East. As the students have to come to India
thrice during the contact programs, collaboration is being worked out with African Countries to
start a contact centre there for the students to be trained.
The University of Edinburgh , Scotland, UK , has collaborated with us to train African students
in a Masters in Family Medicine. We have secured a British Council grant to build our capacity
to offer the Family Medicine distance course in an e-learning format.
We also have a resourceful and enthusiastic team of international faculty from the US, UK,
Australia, South Africa etc. who periodically come and coordinate our contact programs at the
various centres in the country.
The WHO is very keen to take this model to other developing counties where this method of
training doctors and health professionals in their workplaces without displacing them much will
be helpful in their low resource and low manpower settings.
IX. COURSE OBJECTIVES
Overall Course Objective:
The overall objective of the M.MED (FAM. MED.) programme is to build the capacity of GP‘s
and enable them to manage more cases so that referral becomes less necessary – hence the
motto:
‘Refer less, Resolve more’.
Specific Course Objectives:
A graduate of the course should be able to perform the following functions, with a high
level of integrity, commitment and competency:
1. Develop a strong base in the core Family Medicine principles like patient centeredness,
comprehensiveness, whole person care etc.
2. Diagnose and treat effectively the common diseases occurring in all age groups, across a
wide spectrum of disciplines including medicine, surgery, pediatrics, obstetrics and
gynecology, and orthopedics, dermatology, ENT and ophthalmology.
3. Detect at an early stage, life, limb and vision-threatening potential emergencies, so that
urgent treatment and prompt referral to tertiary care hospital is made.
4. Promptly treat common emergencies that present to a general outpatient set up and refer
patient after initial stabilization.
5. Develop a broad-based comprehensive approach to health problems affecting all age groups.
6. Discuss the relevant and up-to-date basic science, etio-pathogenesis of diseases in the context
of diseases presenting in undifferentiated forms or in the background of chronic diseases.
7. Use a syndromic and algorithmic approach to management of health problems without the
use of sophisticated investigations.
8. Incorporate the role of cost-effective holistic management.
9. Develop an ethical and compassionate approach to patients under their care.
10. Practice focused clinical history-taking and physical examination in specific clinical settings
11. Network with the specialists such that they can continue the care of patients undergoing
sophisticated tertiary level care, between appointments.
12. Implement recognized protocols for health promotion in all age groups.
13. Organize and promote rehabilitation of the disabled.
14. Participate in community health programs especially those which are components of national
health policies.
15. Be motivated to improvise and problem-solve in resource-poor settings.
16. Generate enthusiasm in the health team, so that they can provide high quality, appropriate,
ethical and comprehensive care.
17. Ensure a therapeutic environment for patients and relatives, to enhance confidence in the
health system and the health care professionals.
18. Competent in medical record-keeping and data management.
19. Develop as teachers who can communicate and train team members, community members
and other medical fraternity
X. COURSE EXPECTATIONS
X.1.WHAT TO EXPECT FROM THIS COURSE

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To obtain a strong base in Family Medicine principles
To get a wide knowledge base with a Family Medicine focus based on must know, need to
know and good to know
To become oriented to and confident in Algorithmic approach to problems
To hone an update your skills – the core basic clinical skills every Family Physician should
have
To get a strong base in bioethics and values
To become a socially responsible Family Physician who knows the health scenario of the
country as well as the global trends.
To network and make great relationships with peers and faculty
To receive good administrative and academic support
To become part of CMC‘s life-long learning initiatives.
X.2.WHAT NOT TO EXPECT FROM THIS COURSE

Please do not expect a cake-walk: This is not a course in which just by paying the course fee
one becomes eligible for a piece of paper called ‗certificate‘. This involves dedication,
commitment and hard work. But we will walk the whole way with you!

Please do not expect spoon-feeding: If you come expecting that a string of specialist-type
lectures will be handed down to you in the contact programs, you are sure to be disappointed.
What will be taught will be down-to-earth practice-related stuff which you learn by active
engagement in the learning process.

Please do not expect ‘traditional’ teaching methods: If you expect contact programs to be a
conference-type, sit-back, listen-listen-listen kind of sessions, you cannot be more wrong. All
programs are planned on the basis of evidence-based ‗Adult Learning Principles‘ and involve
Group activities, Group discussions, Role-plays, Student seminars etc. Active participation in
these goes towards your formative assessment.
 Please do not expect ‘glamorous content’: The course materials and contact programs will be
geared towards giving you confidence in latest evidence-based protocols that you will need
and can apply to your practice. If you expect the latest fancy things to be taught, you will be
disappointed.

Please do not expect excessive real patient encounters: We are geared to traditional medical
school teaching where we feel good only if we poke around a few patients in order to learn.
You are no longer in medical college! You are a responsible adult learner and an experienced
physician who has seen truck-loads of patients in your many years of practice. It makes no
sense to see another 20 patents in the contact programs. What will be taught is approach to
patients and skills, most of which are taught in innovative interesting ways instead of
imposing ourselves on patients. Patients are used only when necessary.
X.3.WHAT WE EXPECT FROM YOU IN THIS COURSE

We expect Commitment and enthusiasm form you. We do not want you to come with an
attitude of ‗just getting a diploma‘ but to be truly with zeal to learn.

We expect you to read regularly. We have sent you a Study calendars. The books are
written with great care to make it interesting and to give you the needed knowledge in fun
ways, but it will not help if you do not read. You have paid a large sum of money for this
course , why don‘t you make the best use of it?

We expect that you will be willing to change. Life is dynamic, things keep changing and we
need to change with things or we will become redundant. You may have done things
differently all these years, but a good learner is always willing to change and adopt best
practice.

We expect you to ‗Apply what you learn’. Unless we apply what we learn to our life and
practice, we feel the whole exercise of doing this course is a waste.

We expect you to maintain good conduct and decorum all through your engagement with
the course. More on this is in section XVI.

We expect that you will become great pillars for Family Medicine and its development
promotion in this country.

We expect that you will be continuously involved with the initiatives of this department.
XI. COURSE COMPONENTS
The Masters in Medicine in Family Medicine is a 2 year Distance Program. However, the
candidates have an extension period of 2 years after the prescribed 2 years to complete the
course.
For e.g. The 2 years course duration for a candidate admitted in the 2013 batch is from 20132015 but the candidate has an extension period till August 2017 to complete the course
requirements.
The Course components include the following:
1. 100 Self-Learning Modules – for updating knowledge base
2. 60 Video-lectures – for updating knowledge base
3. 30 days of Contact Programs – for developing Core Clinical Skills
4. 100 Assignments to be worked-through and submitted
5. Project Work
6. Elective skills training
7. E-Talks
XI.1. SELF-LEARNING MODULES
This course is designed in the form of 15 booklets which comprises of 100 self-learning
modules. Each booklet contains 6 to 8 modules. An average of 1.5 hours per day (10 hours a
week) will be needed to complete the booklets in the above time period. The modules are
problem-based and are designed to challenge you to give answers to problems posed, think of
options, and to apply the material just learned.
The problems are chosen and designed such that as a practicing physician, you are familiar with
them, and are therefore motivated to respond out of your individual prior experience. The
teaching module is followed by answers to the questions asked during the module. This instant
feedback will help you to go back over the material if you have doubts.
The modules are written in a self-learning format and we have tried to make them interesting and
easy to read. We know you are busy, but unless you set apart time to read regularly, you will lose
out much on this course. The algorithms and protocols given in these modules need to be
internalised if you want to practice good, responsible, ethical and evidence-based Family
Medicine confidently and that can happen only through regular reading!
The table below indicates how the topics are organized in the various booklets.
MODULES - YEAR 1
BOOKLET
MOD
ULE
1.1
1.2
TOPIC
Principles of Family Medicine
Health promotion & Disease
Prevention in Family Practice
Communication & Consultation
in Family Medicine
1
1.3
Basics of
Family
Medicine
1.4
Medical Documentation
1.5
Referrals in Family Practice
1.6
Family Practice Management
2
Medicine – I
Neurological
Problems &
Mental
Health
3
Womens
Health
Part I
4
Child Health
Part I
BOOKLET
MOD
ULE
TOPIC
5.1
Neck Swellings
5.2
Leg Ulcers
5
5.3
Acute Abdomen
Surgical topics
for a Family
Physician Part I
5.4
Hematemesis & Melena
5.5
Common ENT problems
5.6
BLS,ACLS, Shifting of a critically
ill patient
5.7
Orthopedic problems Part 1
2.1
Head Ache
6.1
Chest Pain
2.2
Seizures
6.2
Dyspnea part 1
2.3
Stroke
6.3
Palpitations
2.4
Movement Disorders
6.4
Syncope
2.5
Sleep Disorders
6.5
Oedema part 1
2.6
Mental Health Problems
6.6
Hypertension
2.7
Substance Abuse
6.7
Shock
6.8
Fever – Part 1
6.9
Fever – Part 2
7.1
Dyspnea Part 2
7.2
Approach to Cough
7.3
Nausea and vomiting
7.4
Dyspepsia
7.5
Loose Stools
7.6
Constipation
7.7
Approach to jaundice
3.1
Antenatal Care
3.2
Ante-partum Problems
3.3
Intra-partum Problems
3.4
Postnatal Care
3.5
Contraception
3.6
Violence in Women
4.1
Screening for high-risk neonates
4.2
Newborn Resuscitation
4.3
Common Neonatal Problems
4.4
Immunisation
4.5
Developmental delay
4.6
Infant Nutrition & Weaning
6
Medicine –II
Cardiovascular
Problems &
Infectious
Diseases
7
Medicine – III
Respiratory/Ga
stro-intestinal
Problems
MODULES - YEAR 2
BOOKLET
MOD
ULE
8.2
Roles & Responsibilities of a
Family physician
Chronic Disease Follow-up
8.3
National Health Programs
8.4
Health Advocacy
8.1
8
Being a
Family
Physician
9
Medicine –
IV
Renal /
Metabolic/
Blood
Problems
10
Womens
Health
Part II
12
Surgical topics
for a Family
Physician
Part II
MOD
ULE
TOPIC
12.1
Groin swellings
12.2
Head Injury
12.3
Lower GI bleed
12.4
Oral Health
12.5
Red Eye
12.6
Diminished Vision
Bio-medical Ethics
8.6
Team Concept & Leadership
8.7
Family Physician and the
Community
12.7
Orthopaedic problems Part 2
8.8
Medico-legal Aspects
12.8
Anaesthesia for a Family Physician
9.1
Haematuria
13.1
Joint pains
9.2
LUTS
13.2
Aches and Pains (Bodyache)
13.3
Backache
13.4
Foot Problems
9.3
Oedema Part 1
9.4
Obesity
9.5
Weight Loss
9.6
Diabetes
9.7
Anaemia
9.8
Bleeding disorders
10.1
Menstrual Irregularities – Part 1
10.2
Menstrual Irregularities – Part 2
10.3
Breast feeding
10.4
Breast Problems
10.5
Vaginal Discharge
10.6
Infertility
Growth Monitoring &
Malnutrition
Common Paediatric Problems
Part 1
Common Paediatric Problems
Part 2
Common Paediatric Problems
Part 3
11.2
Child Health
Part II
BOOKLET
8.5
11.1
11
TOPIC
11.3
11.4
11.5
Child abuse
13
Medicine – V
Musculoskeletal
Problems &
Emergencies
14
Occupational
Health &
Age- specific
Health
Problems
15
Skin , Sexual
Health &
Lifestyle
Medicine
13.5
13.6
Emergencies for a Family
Physician – Part 1
Emergencies for a Family
Physician – Part 1
14.1
Occupational Health
14.2
Adolescent Health Problems
14.3
Mens Health
14.4
Geriatric Problems
14.5
Palliative care – Part 1
14.6
Palliative care - Part 2
15.1
Common Infectious skin condition
15.2
Common Non-infectious skin
conditions
15.3
Sexually transmitted Diseases
15.4
HIV
15.5
Life Style Modifications
15.6
Supplementary module for
miscellaneous topics
XI.2. VIDEO-LECTURES
There are some pre-recorded video-lectures which are part of the course curriculum. Some of
them, you will be watching during the contact programs.
Some will be end-of-day assignments during contact programs where you will have to watch
them in the evenings as preparation for the next class.
Some will be assigned to be watched at home. These will be intimated to you from time to time.
XI.3. CONTACT PROGRAMS
The contact programs form a very important part of the course components. You will be required
to attend 3 compulsory Contact Programs of 11 days each, during the course period of 2 years.
These are intensive sessions of 33 X 8= 264 hours duration.
XI.3.a. Objectives of the contact program
1. To impart in this short time
 a vision to practice ethical, rational & evidence-based medicine
 a strong overview of the principles of Family Medicine
 motivation to practice caring and compassionate healthcare delivery
2. To augment your theory knowledge base
3. To help you hone some of your skills
4. To discuss broad clinical approach to various health problems with a Family Medicine
focus
5. To assess you through face-to face interactions with them as well as through the log
books, which goes into your formative assessment.
XI.3.b. Dates & Attendance
The dates for the contact programs :
Contact Programs 1
17th to 28th Feb 2014
11 Days
Contact Programs 2
7th to 18th October 2014
11 Days
Contact Programs 3
June/ July 2015
11 Days
Note: All dates are subject to revision
You need to possess :

A minimum of 11days attendance in the first contact program - to appear for the 1st year
University Examination.

A total of 22 days attendance (including the 1st year attendance) - to appear for the 2nd
year University Examination.

A total of 30 days (minimum 90%) attendance for successful course completion.
In case a candidate skips/misses a contact programs, he/she should attend the respective contact
programs along with the next batch of M. Med Students.
For eg: If a candidate from the 2013 batch fails to obtain 11 days of attendance in the 1st
Contact programs in Feb 2014, he/she will not be eligible to appear for the 1st Year exams in
August 2014. But he/she can make up a total attendance of 11 days by attending the 2nd contact
program in October 2014, in order to be eligible to sit for the Feb 2015 supplementary exam.
However, he/she has to cover the attendance lost in the 1st contact programs by attending the 1st
Contact programs in Feb 2015 scheduled for the 2014 batch. In the same manner, for 2nd and
3rd contact program when a candidate skips/misses, he/she has to attend the subsequent year 2nd
and 3rd contact program respectively.
XI.3.c. Contact Program Centres
List of Regional Study Centres for the M.MED FAM MED program
1
2
Vellore
Tamil Nadu
3
Oddanchatram
Chennai
4
Kerala
Kolencherry
5
Karnataka
Bangalore
6
Andhra Pradesh
Hyderabad
7
Delhi
Delhi
8
Uttarakhand
Herbertpur
9
Assam
Tezpur
10
Madhya Pradesh
Padhar
11
West Bengal
Kolkata
C M C, Vellore – 632 004
Christian Fellowship Hospital,
Oddanchatram-632 619
Dindigul District
Railway Hospital,
Perambur, Chennai
MOSC Medical College
Kolencherry
Ernakulam 682311, Kerala
Bangalore Baptist Hospital,
Bellary Road, Hebbal,
Bangalore – 560 024.
Vijay Marie Hospital
10-1-673/1, Saifabad,
AC Guard, Kahiratabad
Hyderabad -500 004,
St.Stephens Hospital, Tis Hazari,
New Delhi – 110 054
Hebertpur Christian Hospital,
Post: Herbertpur,
Uttarakhand – 248 142
Baptist Christian Hospital
Tezpur, Assam 784 001
Mission of Mercy Hospital,
125/1 Park Street
Kolkata -700 017
PO - Padhar, District - Betul, Madhya Pradesh
460 005
There are presently 11 Regional contact centers for the private batch and 3 centres for the
Government batch which are connected to CMC by Tele-link to facilitate videoconferencing in
some of the programs. Each contact centre usually caters to 20 – 25 candidates.
These Regional Centres are busy hospitals who were invited by CMC to partner in this program
aimed at transformation in health and who have accepted the invitation out of their interest and
good-will. These hospitals give good quality healthcare at affordable cost and are very ethical in
their practice. There is a Local Coordinator and an Administrative Assistant in each of these
centres who help with local logistics. All these centres also have a Tele-medicine trained
technician who helps with the link up to Vellore during the afternoon sessions.
XI.3.d. Preparing for the contact program
1. Complete all the pre-contact program assignments & E-talks submissions
2. Get the relevant equipment kit ready
3. Correspond with the administrative person of your centre regarding accommodation. If your
centre does not offer accommodation facilities, you need to make your own arrangements.
4. Get your travel and accommodation bookings well in advance.
XI.3.e. Getting there…
If you are from another city/town, please check into your accommodation on the previous
evening of the contact program.
Be punctual and be at the contact program 5 to 10 minutes before the scheduled time. In cities
where traffic is more make sure to leave early enough to make it to the contact program venue.
Punctuality is also counted for your formative assessment.
XI.3.f. Sample program schedule
The generic tentative program schedule for the contact program will be circulated to you 3
weeks before the contact program. But each centre will tailor-make the program for that
particular centre and you will get the final program schedule of your centre on the first day of the
contact program. A sample contact program schedule is given in the next page:
TENTATIVE 1 st CONTACT PROGRAM - Family Medicine Distance course 2014
Theme
8.00 - 9.30
AM
Interactive
9.30 - 11.30 AM
Patient Discussions
11:30 AM - 1 PM
Group Activity
2 - 3 PM
Clinical Skills
Day 1
17.2.2014
Mon
Starting
the
journey
Introductions Identity Walk
Map Walk
Creating our own
culture of learning
What is Family
Medicine? Who is a
Family Physician Group Discussion
Day2
18.2.2014
Tue
Family
Medicine
Consultation
models in
Family
Medicine
Consultation & 3-stage
assessment in Family
Medicine
Day 3
19.2.2014
Wed
Importance +
Neurology Influence of
Family
Date and
Day
Day 4
20.2.2014
Thurs
Common
Dermatological
Consultation Skill
problems - Group
Discussions
Patient
discussions/Scenarios
about Patients with
neurological problems
Patient
Neonatolo
Family
discussions/Scenarios on
gy
Assessment
neonatal problems
SEIZURES
Role Play
Quick neuro
examination &
Tuning Fork Test
Examination of
Newborn
NLS - Neonatal
resuscitation
Neck Swelling Examination
Day 5
21.2.2014
Fri
Surgery
Family
Conference
Patient discussions/
Scenarios about Lower
GI Bleeding
Acute Abdomen Student Seminar
Day 6
22.2.2014
Sat
Diagnosti
cs
Family
Therapy
ECG
Copper -T Insertion
lecture demo & skill
practice
Day 7
24.2.2014
Mon
ENT
Family-at-risk
+
Thinking
Family
Patient discussions/
Scenarios about ENT
Patients
Epley & Halpike
manouvre
Day 8
25.2.2014
Tue
Mental
Health
Health
Promotion &
Prevention
Patient discussions/
Scenarios about
Psychiatry (relevant to
General practice)
Day 9
26.2.2014
Wed
Obstetric
s
Management
in Family
Medicine
Patient discussions/
Scenarios about
antenatal Patients
Day 10
27.2.2014
Thurs
Orthopedi
cs
Family
Medicine
Records
Patient discussions/
Scenarios about
orthopaedic Patients
Joint examination upper limb
Day 11
28.2.2014
Fri
Family
Medicine
Fam Med
Research +
Critical
Reading
Patient
discussions/Scenarios
about Patients
Referrals in Family
Practice Role Play
3 - 3:45PM
Video-lectures
DVD - Course
Orientation
DVD - Principles
of Family Medicine
DVD - Common
Neuro Problem 2
4 - 4.45 PM - Videoconferencing
4.45 - 5.15
Generating a Critical Mass of
Family Physicians
Dr. Jachin Velavan
Log Book &
Reflections
End-ofday
Assignme
PDF Clagary
Cambridge
Discussion Moderators
DVD Dr. Peter Le Feuvre, UK
Log Book & Common
Dr. Sarah Montgomery, UK
Reflections
Neuro
Dr. Frederik Kellerman, S.Africa
Problem 1
Discussion Moderators
Dr. Cijoy Kuriakose, ODC
Dr. Jeremy Hill, UK
DVD Immunisation
Discussion Moderators
Dr. Anuradha Bose , CMC
Dr. Immanuel, CMC
DVD - Neck
Swellings
Discussion Moderators
Dr. Amit Tirkey , CMC
Dr. Owen Lewis , Australia
pdf
Log Book & Neonatal
Reflections resuscitati
on
DVD Log Book &
Lower GI
Reflections
bleed
Log Book &
Reflections
pdf basics of
ECG
Tea - 10.15 am to 10.30 am
Tea - 3.45pm to 4 pm
ENT examination
DVD Common ENT
problems for a
Family Physician
Discussion Moderators
Dr. Valsa Tharien, ODC
Dr. Pramod Arora, UK
Log Book & Prep Reflections student
seminar
Discussion Moderators
Substance Abuse - Using HAD Scale for
Log Book & pdf Dr.Susheel Tharien, ODC
DVD - Psychiatry for
Student Seminar
Depression
Reflections practice
a Family Physician Dr. Frederik Kellerman,S. Africa
managem
ent
Discussion Moderators
Log Book &
Using Metrogram & Consultation of an
DVD - Antenatal
Dr.Reeta Vijayaselvi
Partogram
antenatal patient
Reflections CSRA
Care
Dr. Jachin Velavan
prep
Limb X-ray
Interpretation
DVD Common Ortho
Problems for a FP
Part 1
Clinical Skills Review & Assessment
(CSRA)
XI.3.g. Contact Program Format
Each day‘s schedule is divided into 2 parts
Morning session
Afternoon session
Discussion Moderators
Dr. Vidya Sagar
Dr. Owen Lewis
Steps Forward….
Discussion Moderator
Dr. Jachin Velavan
Log Book &
Reflections CSRA
prep
Log Book &
Reflections
The morning session:
The morning sessions can be flexible as per the availability of patients and consultants in the
respective centres. The Morning sessions are again sub-divided into 3 parts.
Morning session
8.00 am - 9.00 am
Interactive lecture
9.00 am-11.30 am
Patient / scenario
discussions/OPD
11.30 am-1.00 pm
Group Activity
A. The Interactive lecture is taken by the Facilitator. This is focused on principles of Family
Medicine and how to apply them to practice.
B. The Patient or Scenario discussions – You will be divided into groups and each group will
be allotted a patient or given a patient scenario pertaining to that day‘s theme to work
through and bring in the summary for discussions.
Please note: As mentioned before, there will be very few sessions in the contact program with
real patient interactions, only where deemed necessary.
C. The last part of the morning (pre-lunch session) which is a Group Activity - this includes
Group discussion/Role plays/investigations/some clinical skills and is usually taken by the
facilitator.
Afternoon session
The afternoon video-lecture & telelink session are fixed and cannot be changed unless intimated
to do so by CMC.
Afternoon session
2.00 pm – 3.00 pm
Clinical Skills
3.00 pm - 3.45pm
Pre-recorded Video-lecture
4.00 pm- 4.45 pm
Virtual Classroom by Video-conferencing
Clinical skills session will usually be facilitated by the CMC facilitator except some instances
where a local specialist may help. This is followed by a pre-recorded video-lecture from CMC.
After this there is an online discussion forum through videoconferencing between all 11 centres
and CMC.
Active participation and attendance in all sessions is expected and will be counted towards your
formative assessment marks.
Table: List of Core Clinical skills that the student will learn/practice in the contact
programs:
M.MED IN FAMILY MEDICINE –CORE COMPETENCIES
GENERAL CORE SKILLS
1.Consultation & Communication skills
2.Core Family Medicine Skills (see – Table 5)
3.Team Management & Leadership skills
FAMILY 4. Management skills for all common Health problems and emergencies (with
problem-based, algorithmic, protocol -based approach and rational prescription and
MEDICIN
investigations (See List of modules above)
E SKILLS
5. Chronic Disease management and follow-up skills
6. Skills for Prevention, Promotion and Counseling activities
7. Community-based approach and management skills
SPECIFIC CORE SKILLS
Examinatio Assessment Instrument
Procedural
Interpretati
n Skills
Skills
al skills
skills
ve skills
Cardiovascular
exam
Respiratory
exam
GENERAL
MEDICINE
Abdominal
exam
Quick Neuro
exam
C-V risk
assessment
Wells scoreDVT decision
tool
CHADS2- AF
decision tool
CRB 65respiratory
severity score
MENTAL
HEALTH
Triaging
EMERGEN
CY
MEDICINE
GERIATRI
CS
DERMATO
LOGY
PALLIATI
VE CARE
Elderly exam
Alcohol abuse
screening tool
dementia
screening tool
Depression and
anxiety
screening tool
Assessing &
managing shock
Assessing &
managing all
emergencies
given in
Frailty
assessment
Skin
examination
Breaking Bad
News
IV Access
ECG
interpretation
Spirometry
Ascitic tap
Chest X-ray
interpretation
BP
measurement
Bladder
catheterization
Use of
Glucometer
Nebulization
therapy
Foot exam
SKILLS IN
MEDICINE &
ALLIED
SPECIALTIES
Peak flow
meter
BLS (Basic Life
support)/ ACLS
Stabilising and
transfer of a
trauma patient
Skin Scraping &
smears
Pain Scoring
Examinatio
n Skills
Assessment
Skills
Breast exam
GENERAL
SURGERY
ORTHOPE
DICS
SKILLS IN
SURGERY
& ALLIED
SPECIALTI
OPHTHAL
ES
MOLOGY
ENT
Instrument
al skills
Procedural
skills
Proctoscopy
Dressings
Neck exam for
lumps
Rectal exam
Examination of
Genitalia
Stitchcraft
Incision &
Drainage
PoP
application
Splints and
slings
Back exam
Joint exam e.g.
knee
Eye examanterior
chamber &
ocular
movements
Epley &
Halpike
Manouvre
Interpretative
skills
Visual Acuity
and fields
Fundoscopy
Digital
Tonometry
Examination
of the eye
using a torch
Use of tuning
fork
Otoscopy
Limb X-rays
interpretation
Basic CT/MRI
interpretation
Eye pads and
dressings
Syringing of
ear
Placing an earwick
ANAESTH
ESIA
Examination
Skills
Examination
Skills
Assessment
Skills
Pre-op
assessment of
patient
Assessment
Skills
Antenatal exam
SKILLS IN
MATERNA
L & CHILD
HEALTH
OBS &
GYNAE
Instrumental
skills
Procedural
skills
Use of Bag
and mask
Local
Anaesthesia
Instrumental
skills
Speculum
exam
Procedural
skills
IUCD
insertion
Pap smear
Postnatal exam
Vaginal exam
Newborn exam
PAEDIATR
ICS
Paediatric
Examination
APGAR
scoring
IMNCI
Assessments &
management
Developmental
Assessment
Otoscopy
Hearing test
Neonatal
Resuscitation
Interpretative
skills
Interpretative
skills
Metrogram
Partogram
Table: List of Core Family Medicine skills that the student will become competent in:
Broad
Specific features
Broad
Specific features
Concepts
Concepts
Understanding
normality
Family –
Oriented Care
Managing
multiple
problems
Information
management
Effective
medical care
Quality
assurance
Screening and
prevention
Treatment and
care
Understanding illness behaviour
Understanding help-seeking behaviour
Understanding culture
Understanding quality of life
Understanding risks of medicalisation
Understanding behaviour and relationship
theory
Importance + Influence of Family
Community
approach
Use of resources
Integrating doctor and patient agenda
Local epidemiology
Community profile
Importance Assessment
Influence of poverty, ethnicity, resources
Family Conference
Family Therapy
Family-at-risk + Thinking Family
Prioritisation
Knowledge and skills sharing
Encouraging self-care
Behaviour change
Home nursing
Working in teams
Knowing professional boundaries
Using patient record for management
Maintaining patient record
Registers; call and recall systems
Access on line tools
Confidentiality
Evidence based medicine
Guidelines
Formularies
Critical thinking
Research
Audit
Significant event analysis
What's worth screening for and what's
not
Doctor as 'drug'; placebo effects;
Iatrogenic illness
Alternative therapies
Carers
Auxiliary health care professionals
Consent and capacity to consent
Continuity of Personal , episodic, 24 hour
care
Comprehensive Cradle to grave
Learning disability
care
Coping with uncertainty
Rational investigations
Managing risk
Problem solving
approach
Problem-based Vs. disease based
Clinical reasoning
Screening, assessment &decision tools
Knowing referral thresholds
Knowing own competence
Proper use of time
Empowering
patients, carers
and staff
Co-ordination
of care
The
Consultation
Health Service
Structure
Values and
beliefs
Rehabilitation
Teaching 'skill mix'
Referral procedures
Lead role in complex care
Consultation models
Therapeutic environment
Doctor / patient relationship
Specific communication skills
Telephone consultations
Government programmes
Legal framework
Health beliefs
Patient centred care
Doctor and society
Ethics
Understanding
yourself
Doctor as
professional
Self care
Values, attitudes, feelings, beliefs
Reflective practice
Lifelong learning
'Professional' behaviour, skills& attitudes
Leadership
Teamwork
Conflict resolution
Managing a busy clinic
Quality improvement
Advocacy: patient; self; staff, community
XI.3.h. Log books
Log Books are part of the Formative assessments and they need to be completed during each
contact program.
You need to record reflections on the day‘s learning and how this will impact on future clinical
practice in the ‘Reflection Section’ of the log book.
The assessment of clinical skills will be done by facilitators and the ‗Clinical skills section’
logbook needs to be signed off at each Contact programs. Examples of clinical skills include:
fundoscopy, otoscopy etc.
You will also be asked to maintain a ‗Work-based logbook’ which will be explained to you
during the contact program.
XI.3.i. Facilitators
There will be one or more Facilitators (usually a Family Physician) posted by CMC to facilitate
and teach in the contact program in each of these regional centres. They will be from our pool of
Family Medicine faculty who may be CMC faculty, Family Physicians deputed by CMC from
elsewhere in the country, International facilitators and Alumni facilitators. Local consultants
from the regional centre may also take some classes.
Be courteous and friendly with the facilitators and
XI.3.j. Maximising the learning experience
The course mandates a total of just 33 days of face-to-face contact programs. You need to make
the best use of this protected time for learning and learn as much as possible. Contact session
brings together collective experiences of all participants an facilitators and hence it is an exciting
learning experience.
Family Physician Tool kit
You need to bring some basic instruments for the contact program. You will get a list of
instruments and also some links from where you can purchase some of them.
XI.4. ASSIGNMENTS TO BE WORKED-THROUGH AND SUBMITTED
There are 100 modules in 15 volumes of the books. Each module will have a set of 10
assignments questions based on MCQ/EMQs. These assignments are to be submitted
periodically as per the due dates as partial fulfillment of the course. Separate Assignment
Booklets will be sent to you 2 Booklets a time along with the corresponding Study Materials.
The Due dates for each assignment is below.
Year 1
Assignments
Booklet 1 & 2
Due date for
submission
st
1 March 2014
Booklet 3 & 4
1st April 2014
Booklet 5 & 6
1st May 2014
Booklet 7
1st June 2014
Submission of Assignment 1-7 before 1st June 2014 is compulsory to be eligible to appear for
the 1st year Exams in August 2014. The dates for year 2 assignment submissions will be sent to
you later.
A CMC Year Planner has been sent to you. Kindly use the year planner to plan your Study for
the Year and to complete and submit your assignments on time.
XI.5. PROJECT WORK
The candidates are also required to complete a project work. Different topics will be allotted for
students belonging to different batches.
Project Work is a course requirement and can be carried during the 2nd year. Project work
requires some fact finding, applied learning and basic research methodology and paper writing
skills. Details about the project will be intimated to you later.
XI.6. ELECTIVE SKILLS TRAINING
Interested candidates can opt for an elective in skills training areas of their choice for a period of
2 weeks to 6 months from the following specialties:
a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
k.
l.
m.
Family Medicine
General Medicine
Surgery
Paediatrics
OG
Anaesthesia
Orthopaedics
Dermatology
Psychiatry
Palliative care
Geriatrics
PMR – Physical Medicine & Rehabilitation
Community Medicine
This skills training will be based in Mission Hospitals allotted by CMC. The list of hospitals and
further details will be intimated to you later.
XI.7. E- TALKS
You will be required to participate in a few online email-based discussions on certain topics. You
will be allotted group-mates and facilitators to help you with it. You will receive more
information on this later. Participation in the E- Talks is mandatory and will go towards your
formative assessment marks.
XII. ASSESSMENTS
The course assessment is done in two parts: formative assessment and summative assessment
where the formative assessments have equal weightage as the summative assessments.
SUMMATIVE ASSESSMENT:
The M. Med in Family Medicine Exams will be conducted as per the University Pattern. There
will be:
1. Two outgoing theory exams at end of year 1 and year 2.
2. Two OSCE format practical exams at end of year 1 and year 2.
The details of the examination are in the table below.
Exam
Papers/ Contents
1st year Theory
Paper 1 – Medical & Allied Sciences
Paper 2 – Surgery & Allied Sciences
Paper 3 – Maternal & Child Health
Paper 4 – Principles of Family Medicine
& Primary Care
1st Year
Practical
OSCE, Skill Stations & Viva
2nd Year
Theory
Paper 1 – Medical & Allied Sciences
Paper 2 – Surgery & Allied Sciences
Paper 3 – Maternal & Child Health
Paper 4 – Principles of Family Medicine
& Primary Care
2nd Year
Practical
OSCE, Skill Stations & Viva
Regular exam
Month/ Year
Supplementary
Exam Month/Year
August 2014
February 2015
August 2015
February 2016
The Question Content for the 1 st year theory and practical examinations will be from the Study
Material Booklets 1-7 and the content taught in contact program 1 and the Question Content for
the 2nd year theory and practical examinations will be from the Study Material Booklets 8-16 and
the content taught in contact programs 2&3.
Model Question Paper for the theory and Practical exams and a comprehensive description of the
practical exam components will be sent to you by email for reference purposes.
Exam Prerequisites
To be eligible to appear for the University Examinations you need to
1. Fulfill attendance criteria :
You need to possess :
 A minimum of 11days attendance in the first contact program - to appear for the 1st year
University Examination.
 A total of 22 days attendance (including the 1st year attendance) - to appear for the 2nd
year University Examination.
2. Submit the assignments pertaining to the respective exam before the deadlines. (Please refer
to Section VII of this circular on Assignments for details.)
 Submission of Assignment 1-7 before 5th July 2014 is compulsory to be eligible to
appear for the 1st year Exams in August 2-14. The dates for year 2 assignment
submissions will be sent to you later.
Exam Venues
The University Exam venues will be intimated later.
Exam Fees
The Exam Fees for the M. Med Exam is as per the University requirements. As mentioned to you
in the Selection letter, the fee paid by you thus far is not inclusive of the University Exam Fee.
You may refer the following link for details of the University Exam Fees. Please refer the ―PG
Diploma‖ under Medical Section in the following link.
http://web.tnmgrmu.ac.in/index.php/fees-menu/examination-fees
The Fee for one theory paper is Rs.2000 and for the Practical Exam is Rs.4000. The total amount
you have to pay for the exams of each year (1st or 2nd) is Rs. 12,000. Therefore, you need to pay
Rs.12,000 for the 1st Year Examination and Rs.12,000 for the 2nd Year Examinations along with
application and hall ticket fees as prescribed by the University.
Please Note: In case you are appearing for the supplementary exams, then you need to pay for
that again. The amount for the supplementary exam will depend on the number of theory paper/s
taken and/or practical exam taken.
All fees are subject to revision by the University from time to time.
FORMATIVE ASSESSMENT:
This involves assessment of:
 Log Books

Assignments

Project-Work

Active participation in Contact program activities

Active participation in E-Talks
CRITERIA FOR THE AWARD OF DEGREE:
A candidate should satisfy the following criteria for the successful completion of the course:
i)
50% mark in the theory examinations
ii) 50% mark in the practical examinations
iii) 50% mark in the assignments.
iv) 50% mark in Log Books.
v) 50% mark in Project Work.
vi) 90% attendance (30 days) in contact programs.
The course should be completed within a maximum period of 4 years.
XIII. THE TEAM CONCEPT
* Training of Family Physician Assistant
A Family Physician can be a very effective healthcare provider, if he works in a team setup.
His/her impact is greatly helped and multiplied by a good team of other Family Physicians,
nurses, health workers, counselors etc. Though this may be the ideal, the simplest and the
possible first step would be for a Family Physician to employ and work closely with a trained
Family Practice nurse or at least a clinical assistant trained in Family Medicine concepts and
principles.
To facilitate the formation of this basic team, a short-term comprehensive training with selflearning modules and a one-week intensive training at CMC is being offered to the nurse or
clinic assistant (minimum qualification 12th standard), who works with you in your clinic.
This can be availed in the 2nd year of your course by paying a sum of Rs.7,500/=.
The training will be conducted at Vellore only, in three languages - Tamil, Hindi and
English.
XIV. E-LEARNING
We will be soon launching the e-learning website. You will be given passwords to access it.
We hope that it will help us be connected life-long and also to help you with life-long
learning.
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XV. STUDENT SUPPORT
We offer academic and administrative support for your course. You will be divide into egroups for academic support purposes. We will send more details later.
Contact details: Email ID dedu@cmcvellore.ac.in
Phone No.0416-2283451, 0416-2283433 09003461291
Change of Address/ Phone Number
If you change your address or phone number during the period of the course, please inform us
about the same by EMAIL. We will update the information in our database and give you a
confirmation by email.
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XVI. CONDUCT AND DECORUM
1. Punctuality: Please be punctual to classes and also in completing all the course
requirements. You will be sent a ‗Time-line‘ document. Please put it up on the wall and try to
meet the deadlines.
2. Classroom conduct: Please be courteous to your batch-mates and your faculty. It is very
important in collaborative learning to respect each other‘s views. Please do not disrupt the class
with mobile phones and by chit-chatting during the class.
3. Exam Hall conduct: Copying and malpractice are viewed very seriously by CMC and
action will be taken against any student indulging in these kind of activities.
4. Respect: Please be respectful when you talk over phone, in person, in your emails and with
all cadres of staff, faculty, peers and patients.
5. Bedside manners
Greeting – Recognizing the presence of the patient is important! Do not immediately start
asking the patient – ―What‘s the problem‖.
Introduce yourself either by name or by saying-― I am the ….specialist or the doctor who will
look after you‖.
Greeting can be – How are you? Or Namaste or if you know the name greet him by name
Get the name of the patient right.
Learn the name and the occupation of the patient and if there are friends and relatives get the
relationship right.
Eavesdroppers – it may be necessary to see that there are no curious hangers on. Even friends
and relatives who are not close to the patient may not need to be there especially when the
problem is quite private.
Speaking the local language – It is best if you can communicate in the local dialect. However,
it may be permissible to communicate in the state language if the patient is proficient in it.
However, if the patient does not understand the state language then it is best to employ the
interpreter, assuming the doctor does not know the language. The patient communicates at
greater depth and more detail when he/she does it in the local dialect. In the long run every
doctor who is long term should learn the local language.
Touching the patient –
Touching or holding the patient is very therapeutic. It can be done at various stages.
1. When the patient is giving the history specially when it has got painful components.
(It was so painful that I did not sleep the whole night or the kerosene lamp fell on my
baby and she got burnt)
2. During a painful examination – When you are palpating the abdomen with the right
hand you may want to hold the arm of the forearm or the shoulder with the left hand.
This reassures the patient that you are not going to cause unnecessary pain.
3. Before departure when you are reassuring the patient you can again hold the hand or
the forearm or the arm and give it a light squeeze.
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Touching radically alters the patient/doctor relationship from being a merely a business
contractual one. It reassures, allays fear and communicates compassion.
Note: Even dealing with extremely orthodox Muslim women touching poses no problem as long
as it is done sensitively.
Patient diagnosis –
The patient always has his/her diagnosis.
The patient may feel that the present abdominal pain was all because he/she ate gooseberries.
The patient may suggest to you that the bone tumor was the result of the fall she had sustained
a few days before the tumor was visible.
The patient may over diagnose or under diagnose as follows:
A patient with a mild headache may feel she/he has cancer. (Over diagnosis). The patient may
suggest that the cause of the peritonitis was because she ate overripe bananas (Under
diagnosis)
It is important to listen to the patient‘s diagnosis because it helps make the patient feel that you
have now understand the whole story
Acknowledge to the patient as follows:
―So you think that all this is because of your overripe bananas. O.K.‖
Getting permission from the patient before examination:
The patient is made in the image of God and this needs to be remembered. The body of the
patient belongs to him and he comes to you in the form of a little Christ. Hence respect of the
body is very key.
Explain and get permission –
―I have to examine your lungs with a stethoscope and so can you please lift up your shirt?‖
―Can you please keep your mouth open and keep taking deep breaths? It will help me to listen
better.‖
― I want to do a special examination of your inside (Rectal exam). You will have to turn on
your side and take deep breaths. I guarantee you that there will be no pain excepting for mild
discomfort like when you are passing hard stools.‖
Don’t
Tug at the cloths, pull at the clothes or un-button the cloths yourself.
Don‘t push the patient into any position by force. Let the patient do it by himself or herself.
Don‘t suddenly dig into the abdomen or suddenly put in the finger without warning for a rectal
exam.
Willingness to soil your hands –
It is possible that the patient may be dirty, sweaty or some part of the anatomy smeared with
urine etc. A good physician will be willing to soil his/her hands to touch the patient to be able
to examine the patient better. It also gives the message to the patient that the physician is so
concerned that he does not mind soiling hands. It increases the trust.
Don‘t examine the patient with the tips of your fingers to keep yourself from becoming or
feeling dirty.
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Privacy and confidentiality –
It is important that you put a screen around the patient whenever any private examination is
done. Unnecessary bystanders should not be allowed.
Confidential information about the patient‘s illness should not be shared with their relatives or
with inappropriate people.
Always have a nurse when examining a female patient.
The patient always is more relaxed when this is done
Never examine a patient in the middle of the night, or in the dark (Power cut) with out a nurse.
Explanation –
An explanation of your findings and a possible diagnosis is important.
― I can feel a mass in the abdomen. It will be necessary to do an ultrasound to determine if an
operation is necessary.‖
Sometimes a simple diagram will help the patient to understand better.
At this stage the relatives will need an explanation. Select the leader amongst the relatives,
someone who is close to the patient and tell him to deal with all the relatives who will need to
be informed.
Explanation should be –
 Clear without ambiguity
 Use a diagram to be explicit
 Use no scientific jargon
 Not over optimistic
 Diet explanation will be important, as relatives are usually obsessed with food
 A clear treatment plan should be outlined: for example- We will have to do tests which
may take about 3 days and then we will know if an operation is necessary. If the tests
prove negative we will be able to discharge you on the fourth day. We expect the
expenses to be about Rs 3000 if no surgery is required and Rs 6000 if surgery is.
Questions
It will be important to answer all the questions from the patient or the relatives. The more the
anxiety the more the questions. The more serious the illness the more questions will surface
Answering questions clearly will give the impression to the patient that you are in control and
you know what you are doing. It will allay anxiety and will lay the framework for a lasting
relationship.
Patient judge doctors on how well they answer questions.
Departure
Before departure ask if there are some issues that are a problem in the hospitalization. Often
there are issues relating to the looking after of children at home etc. If possible help; if not
show sympathy.
Use the patient‘s first name to say bye. It will help the patient to feel special.
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XVII. FEES
COURSE FEES
The total Course Fee for the entire 2-year Programme is Rs.76,200/=. Fee for the foreign
candidates will differ according to the country they belong to. The fee can be paid in 2
instalments.
1. You have already paid the 1st installment.
2. 2nd Installment of Rs.26,200 should be paid by 31st January 2014
The fees once paid cannot be refunded to the candidates for any reason.
Scholarship for candidates working /willing to work in the Mission Hospitals which are
affiliated to CMC, Vellore:
Those candidates who are working or willing to work in the hospitals which are affiliated to
the CMC council are eligible for scholarship. Details can be obtained by sending an email to
dedu@cmcvellore.ac.in or by calling 0416-2283451.
EXAM FEES
The Exam Fees for the M. Med Exam is as per the University requirements. As mentioned to
you in the Selection letter, the fee paid by you thus far is not inclusive of the University Exam
Fee. You may refer the following link for details of the University Exam Fees. Please refer the
―PG Diploma‖ under Medical Section in the following link.
http://web.tnmgrmu.ac.in/index.php/fees-menu/examination-fees
The Fee for one theory paper is Rs.2000 and for the Practical Exam is Rs.4000. The total
amount you have to pay for the exams of each year (1st or 2nd) is Rs. 12,000. Therefore, you
need to pay Rs.12,000 for the 1st Year Examination and Rs.12,000 for the 2nd Year
Examinations along with application and hall ticket fees as prescribed by the University.
Please Note: In case you are appearing for the supplementary exams, then you need to pay for
that again. The amount for the supplementary exam will depend on the number of theory
paper/s taken and/or practical exam taken.
All fees are subject to revision by the University from time to time.
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XVII. CONTACT INFORMATION
Email ID dedu@cmcvellore.ac.in
Phone Nos.
09003461291, 09367985536
0416-2283451
0416-2283433
ADDRESS
The Coordinator
Department of Distance Education,
2nd Floor, Main Block, CMC Hospital,
Ida Scudder Road,
Vellore – 632 004.
Tamil Nadu, India
In all your correspondences, mention your University Register Number and the content of
the envelope in short on the top of the envelop.