I’ve dealt my experiences and knowledge with WHO’s this year theme Health for all

Let`s define Health for all-“Attainment of a level of health that will enable every individual to lead a socially and economically productive life”

When wealth is lost nothing is lost

When health is lost something is lost

When a character is lost everything is lost

Last year WHO stressed on the character aspect that too in individual level through the topic, ”Depression-Let’s talk”. This year we are dealing with the health aspect in community level and the wealth which is needed to establish the health system

“WHO was founded in 1948 to make health a human right and not as a privilege. We’ve crossed 70 years and still the conviction is as strong as ever”, these are the words of WHO director Dr.Tedros

As a third-year medical student, PSM is the subject which gave me the most joy as it dealt with health in community level. Health is something which is to be learned at a community level for the overall health promotion. Health is the only thing which is needed by the richest and also the poorest in the country without any compromise. It would be ruthless and barbaric to put an option like health or food/education/basic needs among the poor. That’s why this year WHO insisted on Health for all everyone everywhere

Now I’ll tell you my real life impact on community health during my 3rd-year ward posting. 8 year old female named Dhivya came to the pediatric OPD with chief complaints of respiratory distress. She is a known case of spastic cerebral palsy who had lost her mother during labor and father to an accident. She is now under the care of her grandmother. On head to foot examination, we found severe pediculosis affecting her scalp and eyebrows. We asked her caretaker to maintain proper hygiene by providing her regular bath and prescribed her ketoconazole shampoo to be bought outside (as it was not available in the hospital pharmacy). But she didn’t take the prescription and wept about her poor socioeconomic status to buy the shampoo which costs Rs.180. This patients history raised me questions in my mind. Why should the innocent girl suffer this? Is this any incurable medical condition like malignancy or AIDS? NO INDEED. Then there is no point in her suffering. The entire humanity should feel ashamed for her suffering as we are spending millions in finding and drug and testing it by clinical trials. Yet this Rs.180 made pushed the therapy to an unreachable altitude.

Sometimes I get inspired by watching medical series like HOUSE MD and got inspired by the American health care system. But after doing research regarding that I came to know that the health insurance companies only cover those people who are in good jobs. What about the homeless old man wandering in their streets? Does their insurance companies think that is a life not worthy of a medical care? We need a policy from our leaders which establishes equity among people. This year is the time to ask our leaders our basic right, OUR HEALTH.

For a good health care facility, we need people, services, products, finances and information and everything is needed especially in times of an outbreak. A good example of our health care system can be explained by the Nipah virus outbreak in Kerala. This is a deadly virus an too difficult to establish a diagnosis in index and primary cases. But our health care facility was able to tackle the situation and saved millions in spite of losing a few.

Here we are providing health care free of cost and health insurance also free of cost. As a medico from a government institution, I came across a lot of people from low socioeconomic class (as per modified Kuppusamy scale) seeking medical attention and they were given excellent care under free of cost. Few cost expensive services like MRI are covered under their insurance scheme. But still, we are not providing some advanced services like bone marrow transplantation, gene therapy, etc. which are provided by corporate hospitals. This is one milestone we need to achieve.

When we went to field trips to PHC, ICDS, Health sub-centre during field visits, I can see that at least essential health care is accessible to all individuals and families in an acceptable and affordable way with their full participation. We have launched a sustaining primary health care by formulating national policies, strategies, and plans of action as per Alma-Ata-conference. In spite of inequality among education, social status, economic status, etc, Healthcare is the only this we`ve tried to establish some equality and equity among people.

Regarding the inspiring 2018 theme of WHO I came to know that half of the world`s population don’t have access to a proper healthcare facility. Millions are pushed to poverty due to money spent on food. WHO insisted the need that No one should have to choose between health and food/education/shelter. Then what is the solution? The answer is to establish affordable health services for EVERYWHERE, EVERYONE. This universal health coverage can be achieved if and only if the political will is strong. WHO is calling leaders this year to make universal health coverage a reality for everyone, everywhere.

The very special 2 things in 2018 universal health coverage concept:

  • First, this stresses the importance of nurses and midwives in the health care system. Generally, they are underrated. They are the pillars of our health care system. I’ve seen a Nurses strike in my college. The whole hospital was stranded. They have the number and knowledge for our health infrastructure.
  • Second, universal health coverage stresses the importance of healthcare for older people. It considers their health issues in a novel approach. WHO does not want them to seek a doctor for their diabetes another doctor for arthritis and another doctor for hypertension. It wants them to have a health coverage in such a way that they can whatever the services they need in a single institution with their health-related data and treatment history being synchronized among different specialties.

Countries with universal health care include

Austria, Belarus, Croatia, Czech Republic, Denmark, Finland, France, Germany, Greece, Iceland, Italy, Luxembourg, Malta, Moldova, the Netherlands, Norway, Portugal, Romania, Russia, Serbia, Spain, Sweden, Switzerland, Ukraine and the United Kingdom.

There is a very peculiar thing about this list of countries. Have you noticed any South East Asian county on the list? The answer is a big NO. In South East Asia over 800 million people don’t have full coverage of essential health services. 65 million people are pushed to poverty because of the health costs. We cannot accept or afford a world like this. Especially as a South Asian Country, India cannot accept this atrocious state of us and our neighborhood. That’s why we should make health services universal so that these people do not suffer from financial hardship. By tracking who is not getting health care and who is being improvised by health care, we can make policy to establish this system. This would pave a way for a fairer and healthier world.

Health is a human right. No one should get sick and die just because they are poor or because they cannot access the health services they need. 97 million deaths can be prevented worldwide when the global community makes the right investments in the right health care system. This is quite a big number. The SDG or Sustainable Development Goals insists on making the right investment in the next 15 years to prevent this death. The SDG price tag in 67 countries which has 75% of the world`s population is 3.9 trillion dollars for the 15 years. These countries don’t have the economic source to pay the price tag (India is not one of those countries we have enough resources). But most other countries have the fund to make an investment in these countries. By giving economic assistance is theoretically proven that SDG can be established worldwide. This could add 535 million extra years of healthy living to the world’s population.

People-centered care:

Recently a lot of money invested in health has been wasted due to unnecessary investigations etc. To avoid this year WHO insists on people-centered care. People-centered care means health services are ensured to people’s needs and provided in partnership with them rather than simply given to them. It means the care where people, community, and families were respected informed engaged and treated with dignity and compassion. This improves the trust, experience, and outcome from people and gives confidence and job satisfaction among professionals. This would also improve the quality and efficiency of the healthcare system

Let’s take a look at these facts by WHO:

  • 5 million people don’t receive treatment for TB
  • 17 million people do not receive treatment for HIV
  • 20 million infants are not vaccinated against DPT
  • 204 million women do not receive adequate family planning
  • 1.1 billion people are living with uncontrolled hypertension
  • 2.3 billion people lack basic sanitation

What do we infer from these points? All the above-mentioned care is available now that’s what we are thinking, isn’t it? What is the whole point in developing a care that is not reaching millions and billions of people? We have the good knowledge I accept but we need to make this knowledge useful to the community. Otherwise, all these knowledge are vain.

Social media and mass media: Boon or ban for HEALTH FOR ALL:

Everyone will think that social media and mass media will be useful in spreading knowledge and improving the concept of health for all. But my point is they are better in collapsing the health care system rather than promoting it.

A good example is the MMR vaccination program last year. It was a great program to prevent 3 deadly childhood diseases Mumps, Measles, and Rubella. But it was a failed program. Because of fake what’s app message telling about researches in which they’ve proven that this MMR has lots of ADR?

My cousin refused to vaccinate her child with MMR.

I’ve shown her the researches about the vaccine in PubMed and yet she insisted on that wapp message and ignored me. In the history, there were a lot of failure programs due to mass media also.

. Universal health coverage is more than just health insurance, more than just health care. It means people can get quality health services where and when they need them without suffering financial hardship. Half of the population have no access to healthcare and millions are pushed to poverty due to health expenses. Universal health coverage is the solution to all this problem. Evidence and experience show that all countries at all income levels can make progress with the resources they have also show us that there is no single path to Universal health coverage. All countries must find their own way in their own political social and economic circumstances. Let`s take Ghana and Rwanda as examples,

In Ghana, a remote household receives support from community healthcare workers. They help people to receive relevant health care. I’ve read an interesting story about a 16-year-old boy, Shaibu, who was found to have a deadly skin disease and was spotted during such visits. He was referred to hospital to get specialized quality care. Ghana`s National Health Insurance provides free health services for children under 18. Since 2003, this health insurance covered over 6000 patients.

In Rwanda, Dr.Olushayo Olu WHO representative in Rwanda really wanted to create a community where everybody has a good access to health care, basic services like water and sanitation. He developed a system in which financial barriers are removed. The main problem is lots of their people were working in the informal sector. Generally, health insurance schemes focus on people who are working. So the government decided to create different categories called “UBUDEHE”. This classified people according to socioeconomic status and to know who needs assistance and what level of assistance they need. And the Community based health insurance scheme was rolled out. Now they have a coverage of over 80% which by African standards and by any standards represent a great number and they are now progressing towards 100%.

In India, states like our Tamil Nadu have the glory of having a state government implemented a government insurance scheme. Now the central government also made an initiative, Ayshman Bharat which could be the world’s largest health insurance program.


Universal health coverage not only improves health. It reduces poverty, creates jobs, spares inclusive economic growth and increases gender equality. Strong healthcare systems based on the foundation of primary care are also the best defense against outbreaks and other health emergencies. Universal health coverage and health security are truly two sides of the same coin. Now it is the time for all countries to invest in universal health coverage.

It`s time to talk about the best ways to get health services to all.

Time to remind the world leaders “Health is a human right”

It’s time to have the Right care in Right time in the Right place.



For starters, I want to share my experience with students who want to go on this route and with people who are just curious about what it’s all about – Becoming a doctor.
 I still remember the first day of landing to medical college; the cheerfulness, happy moment, excitement and dream that everybody carries to become a doctor.
Well, my journey was both sweet and sour. The first phase is one of the important years I believe, That is when students have to acclimatize to the new environment. Nevertheless, it’s the year when everyone is ready to get kick started to become a doctor. Everyone is usually more focused during the first phase and eventually, some people start drifting away from their goals. I can’t say that’s the worse thing in the world since that’s how most of us learn the major life lessons. However, I would say getting a good grip on the first phase subjects anatomy, pathology and physiology go a long way. They make the foundation for a smooth journey ahead. I must add, I am not saying that biochemistry isn’t important. Each and every subject carries its own importance. What I see, in the medical field seniors are the motivators, guides and helpers.there are so many books and every writer had their own opinion regarding the books. and they help us in choosing the finest book to read and pass an exam. I love to read ROBBINS PATHOLOGY and GUYTON’S physiology.these book changed the way what I saw in the entire medical field, Guyton telling the all the normal physiology that happens in our body where Robbins explained the detail possible cause where physiology goes wrong to cause disease. studying these books throughout the first phase of my basic science tells me the start from normal physiological cell to the concept of a necrosed cell.
The first year is very fast but at the same time its sort of slow. It might be because its hard to forget the memories made especially during this year. The big transition from school to college is difficult to forget for the most of us. Then comes the second year, which is 1 years long on TU. Well, my biggest mistake was to think “Oh no biggie, I have a lot of time to hit the books.” I was wrong. this year we have to study all system remaining after the first year. Pathology and Anatomy is a major subject of the second year and its best to get a head start rather than waiting until the end. In my opinion, the best case scenario will be a student who not only focuses on the second year subjects but also adds medicine to pathology. Worse case scenario would be waiting until the end to open books!! Well, this is also the year when students start planning trips and enjoying college life. Have fun but don’t overindulge to a point that you can’t come back.
The third year is the easiest year I think. But also because I studied decently throughout the year and it’s very feasible. The holy grail of M.b.b.s is the fourth and final year. Its the hardest I believe. Mostly because practicals weigh just as much as theory, and I was always terrified of vivas. So focus on both theory and practicals. Attend the clinical postings from the third year onwards and be well equipped with the history taking skills.
The internship is one year long. That’s when most of the students learn the basic procedures and get a good taste of the hospital life specifically being on call or night duties.
Moreover, I believe that my medical journey was both sweet and sour.W e are not alone in the journey there is a lot in the world who are with us on the journey. I want to share  a great word by ARISTOTLE



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A. Written paper: 60 marks (paper I 60 + papers II 60 = 120 marks)
General concepts of health & disease,
Disease screening
Epidemiology of communicable (including childhood diseases like ARI, diarrhoea, VPDs) &
non-Communicable diseases
Health information
Environmental health
Disaster management
Maternal & child health
Nutrition & health
Social & behavioural sciences as relevant to community health
Occupational health
Health education & communication including counseling
Health planning & management
Health care delivery.
B. Viva: 10 marks
C. Practical: 30 marks
i. Epidemiological exercise = 5 marks
ii. Statistical exercise = 5 marks
iii. Problem solving exercise = 10 marks
iv. Project work = 5 marks
v. Family study exercise = 5 marks
D. Internal assessment: 40 marks (theory 30+ practical 30)


Group A
1. What are the characteristics of ideal indicator? Enumerate the morbidity indicators. Describe briefly the Infant
mortality rate and case fatality rate.
2. Enumerate diseases under National Vector Borne Disease Control Programme (NVBDCP). Write down a brief
note on integrated vector control. Describe in brief the national drug policy 2014 on Malaria.
1. Enlist the types of epidemiological studies. Discuss the importance of incubation period in epidemiological
studies. Describe different time trends in disease occurrence.
2. Name two important chemicals of health significance present in ground water of West Bengal. Describe in brief
the health effects and control measures of any one.
1. Epidemiology. How can you estimate the disease risk in a case control study? What are the biases in case control
study including the process of elimination as applicable.
2. Enumerate the levels prevention and different modes of intervention in each level. Discuss the levels of
prevention in context to diabetes.
1. What do you mean by indicators of health? Write down the different disability rates with example. What is the
concept of disability limitation?
2. Discuss in brief the strategies under the National Vector Borne Disease Control Programme (NVBDCP) for
prevention and control of vector borne diseases. Write down general guidelines for treatment of uncomplicated
malaria as per National Drug Policy on malaria 2013
1. Describe the salient features of different types of time trends in disease occurrence with suitable examples. What
are the different possible changes that you should keep in mind while interpreting time trends.
2. Describe the natural history of disease. Discuss briefly the different levels of prevention and modes of
intervention as applied to pulmonary tuberculosis.
1. What do you mean by multifactorial causation of disease? Describe with suitable examples.
2. What is sampling? What are the different types of sampling? Describe them briefly with their advantages and
1. What are the different types of epidemic? How will you investigate an epidemic of fever in a block?
2. What are the risk factors of coronary heart disease (CHD)? Discuss preventive strategies of CHD.

1. Enumerate the determinants of health. How do socioeconomic conditions act as one of the determinants of health?
2. Enlist major causes of blindness in India. Outline the strategies adopted for control of blindness under National
1. Define epidemiology. Enlist the different epidemiological studies. Explain briefly the merits and demerits of case
control and cohort studies.
2. Illustrate how the levels of prevention and the modes of intervention can be applied in poliomyelitis.
1. Define epidemiology. Classify epidemiological studies. Mention briefly the important differences between case
control and cohort studies.
2. Enumerate the cancers most commonly found in India. What are the early warnings signs of cancer? Describe
some preventive measures of cancer cervix.
1. Define screening. How does it differ from diagnostic test? Describe the criteria of screening.
2. Enumerate different modes of intervention under levels of prevention. Discuss. in brief, the levels of prevention
in relation to leprosy.
1. Enumerate the functions of primary health centre. What are the services provided by subcentre?
2. Mention the causes and detrimental effects of nutritional anaemia. Describe the measures undertaken to combat
anaemia among adolescents according to national programme.
1. Enumerate the objectives of school health pregremme. Briefly mention the different components under the
2. Enlist the disorders caused by iodine deficiency. What are the strategies to control iodine deficiency in India?
1. Define malnutrition. How will you assess the quality of protein? Name the nutritional programme currently
available in India. Discuss any one of them.
2. What are the eligibility criteria for enrolment in ESl Scheme? Write in brief the benefits available under ESI
scheme during and after working tenure. What are the services available under medical scheme?
1. What do you mean by essential obstetric care? What are the services delivered under essential obstetric care
according to RCH-II programme? What is the importance of maternal death review?
2. Define ‘Factory’ under Indian Factories act 1948. Write in brief the provisions recommended in Indian Factories
Act 1948 to protect health of workers.

1. Define maternal mortality ratio and maternal mortality rate. Describe the important cultural and social factors
affecting infant mortality.
2. What are the health problems of adolescent? Mention the national programs concerning improvement of
adolescent health. Outline the important health educational messages for benefit of an adolescent girl.
1. Enumerate different components of ICDS programme.
2.Name the types of occupational hazards. Describe the different medical measures to prevent occupational
1. Enumerate the 4 major nutritional problems in India. Discuss in brief, methods of nutritional assessment of Under-
5 children in a community.
2. Discuss the 3-tier system of Health Care Delivery in your state. What are the reforms made to give better service
to people? Discuss the role of PPP in efficient delivery of health services.
1. Enumerate the principles of primary health care. How is it delivered in rural India?
2. What is malnutrition? Discuss its prevention strategies in terms of different levels of prevention.
1. Enumerate types of family. Describe the stages of family cycle. Discuss the role of family in health and disease.
2. Define ergonomics. Discuss the importance of preplacement examination with suitable examples
1. Define social security. Discuss briefly any one social security measure in India.
2. Enumerate fertility indicators. What do you mean by NRR = 1? Write in brief advantages and disadvantages of
contraceptive methods which an eligible couple should adopt in different phases of their reproductive life to achieve
‘small family norm’
1. What is pneumoconiosis? Enumerate the different types of causative factor for the respective type of
pneumoconiosis. Enumerate the benefits provided under ESI Act. Describe one benefit under ESI Act which is
relevant to pneumoconiosis.
2. How RCH programme differs from CSSM programme? Describe briefly the package of services under RCH Programme.


1. A 35 years sedentary obese man with smoking habit is found to have blood pressure of 126/100 mm. of Hg. How
will you classify this blood pressure? Describe the management with special emphasis on diet of the person.
2. In a block several cases of Dengue are reported for last one month. How Dengue can be diagnosed? What
measures do you like to suggest for its control and prevention?
3. Many school students in your block are found suffering from reduced ability to see the board-work by the teachers
in class room. As BMOH, how will you manage the situation?
1. A sputum positive pulmonary TB patient was found sputum smear positive after 5 months of treatment with
category 1. What is your inference about the case? What is the next line of management as per RNTCP?
2. A six month old child was brought by the mother at OPD, presented with loose stools for more than three times
and vomiting from last night. On examination. the child was found restless and drinking eagerly. Classify diarrhoea.
Outline the management. What information you want to make the mother aware of the situation?
3. Significant no. of cases of jaundice was reported from an urban locality. As a public health expert how will you
investigate it and what remedial measures will you suggest for the problem?
1. Mention the modes of transmission of HIV/AIDS. Explain the role of high risk group in HIV transmission.
Outline the strategies undertaken in National program to reduce transmission from high risk group.
2. A recent public demonstration has occurred in a Block primary health Centre about the disposal of biomedical
waste contaminating water body by the side of the hospital. As a BMOH of that hospital, what measures would you
like to adopt for proper waste management of your hospital.
3. In Kolkata and its suburbs, a few cases of dengue are being reported for last one month. How dengue can be
diagnosed? What measures do you like to suggest for its control.
1. What do you mean by essential hypertension? What is its prevalence in lndia? What are the risk lactors for it?
What preventive measures should you take to reduce prevalence and complication due to hypertension?
2. What do you mean by disaster? What are the common causes of disaster? As a BMOH of a cyclone prone
block how will you proceed for preparedness to tackle the impending disaster in your block?
3. After having dinner with fried rice, egg curry and salad in a hostel, 20 students complained of vomiting and
diarrhoea at midnight and another 15 students reported the same complaints in the morning. How will you
investigate the outbreak and take control measures?
1. Rising trends in the occurrence of diabetes has been observed throughout lndia. Describe the epidemiological
determinants of diabetes. Describe the methods of primary prevention of type 2 diabetes.
2. A person was bitten by a dog in the street. The bite was single and on the face. What is the category of bite?
Outline the management of the case. What is pre-exposure prephylaxis?
3. What are the functions of a BPHC? Mention the national programs under a BPHC. What is ‘Record linkage and
what is ‘Tracking of Beneficiaries’ under MCH care?


1. Describe shortly the epidemiology and clinical presentation of dengue fever. Write the measures to be taken to
control dengue outbreak in a town.
2. What are the early signs of cancer? Describe in brief the epirlmnlnlngy of oral cancer and its primary levels of
3. Define ‘Safe and Wholesome water’?. Discuss the different tests for the bacteriological surveillance of drinking
1. A man comes to your health centre with lacerated injury of both legs caused by the bite of a dog about an hour
ago. Discuss steps of management. Suggest measures for minimising the risk of human rabies in the area.
2. Name the different types of waste generated in your hospital. Suggest measures for their safe disposal as per
national and state level rules. What is the importance of waste tracking?
3. Immunisation rate in your district has fallen to 50%. How would you investigate to find out the reason? How
would you concurrently try to increase the immunisation rate?
1. A 2 year old child presented with history of frequent passage of loose stool for 2 days, irritability, excess thirst
and skin turgor going back slowly. Classify the condition with proper justification in accordance with national
programme guidelines. Outline the management of the child.
2. A 30 year old man, attended OPD with more than 5 hypopigmented patches on different parts of the body. Write
down the diagnosis. Outline the management of the case as per National guideline.
3. Enumerate different health hazards likely to occur during and following flood. As a BMOH, describe your
preparedness plan to mitigate such hazards in future.
1. A 25 year old man reported in medical OPD with high fever, chills and retroorbitai pain. Outline the diagnosis,
case management and community intervention as per national guideline.
2. A 10 years old child reported with dog bite on call region in casualty OPD within 2 hours of bite. As CMO
suggest measures to prevent rabies in this child.
3. A 7 days old baby is brought to your CPU with excessive cry, refusal of feeds and convulsions. Discuss the
diagnosis, case management and preventive strategies as per national immunisation program.
1. Your BPHC is situated by the side of a busy highway. Cases of road traffic accidents are common. Describe the
measures you would take as BMOH to reduce the problem.
2. Give a brief account of epidemiology of kalaazar. Briefly outline the strategies of control of kalaazar. Enumerate
the causes of resurgence of kala-azar.
3. A child bitten by a street dog on hands and fingers was brought to the casualty ward of medical college with’n an
hour of bite. As a MOI/C what measures will you suggest to prevent rabies in this case?
1. The BMOH reported large number of cases clinically suspected to be Dengue. He also referred two cases to
district hospital and suspected an outbreak has occurred. As a BMOH how will you investigate and control the
2. What are the danger signals of cancer? Outline the epidemiology of oral cancer and methods of its prevention in to community.

3. A 2 years old child with history of passing watery stool every 2-3 hours, who is restless with dry mouth a sunken
eyes has been brought to the subcantre. How the health worker assess, classify and manage the case? What advice
should give to the mother for prevention of occurrence of such condition in future?
Paper II
1. A 28 years old mother with children aged 4 year and 1 year, has come to you for family planning advice. Describe
different methods of contraception that can be offered to her with merits and demerits.
2. Describe different types of Pneumoconiosis. As a medical officer of a coal mine, what measure you like to adopt
to prevent Pneumoconiosis?
3. A recently delivered (2 weeks back) mother has come for check up. Mention the components of post natal check
up. What might be the post natal complications? What measures can be taken to improve post natal care at
community level?
1. What is balanced diet? Enumerate different nutritional problems prevalent in lndia. How primary prevention
plays an important role in prevention of protein energy malnutrition.
2. In a block of West Bengal recent statistics showed lower rate of institutional delivery, As a health administrator
of the block what measures you like to adopt for improving institutional delivery of your block.
3. Enumerate different methods of diet survey. Briefly describe the methods you have applied to assess the
nutritional status in your ‘Family programme’.
1. What do you mean by neonatal mortality? Why it is so important? Write in brief the components of Essential
New-born Care with special reference to breastfeeding.
2. What are the average populations catered in relation to health -in a village. subcentre, PHC, BPHC or CHC? Who
serves at the level of subcentre? What are the activities carried out at BPHC/CHC?
3. Immunisation drop outs and left outs are found to be quite high for consecutive years in a block. Mention the
possible reasons and outline the measures that can be adopted by the health administrator in that block to improve
the situation.
1. Define sex ratio. What are the factors behind decline sex ratio in India? What are the measures adopted to correct
the situation?
2. Write the national sociodemographic goals for 2015? Outline the steps for evaluation of family Planning
3. Define ‘Low Birth Weight’. What is its prevalence in India and the target to achieve? What measures would you
like to adopt as BMOH to reduce the Low Birth Weight in your block.
1. Cases of AEFl are being reported from subcentres of a block. Due to apprehensions among people, dropouts for
immunisation are also increased. How the AEFl are classified mention with examples. Describe important health
managerial functions / measures need to be undertaken to address and overcome the problem in that block.
2. Many cases of silicosis were reported from a pottery and ceramic industry. As an industry health officer, what
measures will you recommend for prevention and control of the problem?


3. In a block of Nadia district the couple protection rate is much less in comparison to neighbouring blocks. What
are the social causes of poor couple protection rate and what measures you will take up as a BMOH to improve the
1. Mention the packages of services under RCH programme. Outline as to how the services are provided through
different levels health care facilities available in a block.
2. In a block 40% of eligible couples are protected by modern contraceptive methods. As BMOH outlines the
interventions to improve the situation.
3. Maternal mortality ratio in a block is found to be persistently high. As a BMOH outline the :
i. Investigation procedure to find out the causes of maternal mortality and
ii. Interventions to be adopted to reduce the MMR.
1. There is sudden rise of infant mortality in a block. What are the measures you would like to adopt to reduce lMR
in the block?
2. Enumerate the different vector borne diseases. Describe the principle of vector control programme according to
existing national control programme.
3. What is a disaster? What are the different aspects of disaster management. Outline the management aspects of
disaster impact in a flood prone area.
1. Percentage of fully immunised children is very low while drop out and left out rates are unexpectedly high in
your block. What measures you will adopt as a BMOH to improve the situation.
2. Proportion of institutional delivery is very low in your district. There is also poor utilisation of JSY, referral
transport and Ayushmati Scheme. What steps you would like to take as a CMOH to improve the situation?
3. Define health education. How it differs from BCC? Briefly outline the different health educational measures to
prevent cervical cancer in a block as a BMOH.
1. IMR is high in your block. As a BMOH suggest measures to improve the situation.
2. Prepare an action plan to conduct an IEC campaign in your block to reduce anaemia among pregnant women.
3. Enumerate different types of food toxicants. Suggest measures to control epidemic dropsy in your area.
1. Proportion of LBW babies in your block is very high. As a BMOH, what action will you take to tackle the
2. Outline your plan of action as BMOH to reduce the health hazards due to flood in your flood prone block.
1. A 25 year old mother with 2 children aged 5 year and 1 year, has come to the OPD for family planning advice.
Discuss different methods of contraception that can be offered to her with merits and demerits.
2. Few cases of NNT is reported from a block of a district. As BMOH what measures will you take to prevent its
further occurrence?
3. Large no. Of PEM cases among Under 5s have been identified in your block. What social factors are responsible
for it? Name the nutritional programmes currently available in India. Describe briefly any one of them.

Vaccination in disaster.
Indoor air pollution.
Sanitation barrier.
Multiphasic screening
Modifiable risk factors of hypertension
Types of ventilation
Bacterial indicators of drinking water quality
Cancer registry
Laboratory network under RNTCP
Triple blinding in epidemiological studies
Measures of dispersion
Types of sampling
Health hazards of ionising radiation
Bacteriological surveillance of water quality
Principles of biomedical waste management
Preventable blindness
Preventive services offered by your medical college and hospitals
Disaster preparedness
Principles of chlorination of water
lntradermal rabies vaccination
Biological treatment of sewage
Normal curve
Statistical averages
Chemotherapy of multibacillary leprosy
Integrated vector management
Interpretation of false negatives of a screening test

Human development index
Hazards of noise pollution
Sanitary land-fill
Sources of health information
Standard normal curve
Hepatitis B vaccine
Water-borne diseases
Biological transmission of disease
BCG vaccine (Bacille Calmette and Guerin)
Indicators of air pollution
Quality of life
Risk factors of diabetes
Biological transmission
Disaster preparedness
Family physician.
Standard Normal curve.
Sources of health information.
Indian Redcross
Endemic fluorosis
Social stress
Pasteurisation of milk
Principles of primary health care with examples
Facility based newborn care
Food safety

Role playing
Geriatrics health problems
Juvenile delinquency
Social mobilisation
Modifiable risk factors of hypertension
Non-government organisation
Sickness absenteeism
Village health and nutrition day (VHND)
Juvenile delinquency
Central government health scheme
Health problems of geriatrics
Measures of dispersion
Health insurance scheme
Child labour
Pre-placement examination
Spectrum of iodine deficiency disorders
Unmet need for family planning
Voluntary health agencies
Principles of primary health care
Common home made oral rehydration solutions
Healthy life styles
Channels of communication
Health problems of geriatrics
Elements of primary health care
Indian Redcross
Interpretation of ICDS growth chart
Intersectoral coordination

Injection safety is important for the recipient, provider and community – Justify.
Zinc is given with ORS in treatment of ‘Diarrhea’- justify.
Data carry little meaning when considered alone.
Screening and diagnostic test differ.
Sterilisation and disinfection are not synonymous.
Majority of blindness can be prevented Explain.
Biomedical waste should be segregated at source.
Carriers though less infectious are epidemiologically dangerous.
Quarantine and isolation are not synonymous Explain.
Triage approach can provide maximum benefit in disaster situation-justify.
Integrated vector control management is the most effective method of vector control justify.
The census is an important tool of health information explain.
Cohort studies are not always prospective Explain.
Screening test and diagnostic test are not synonymous Justify.
Sputum smear examination is the method of choice for case finding in TB Explain.
BMI is the best of all indices of obesity.
ICTC should be supported by ART/Link ART centre Explain.
Prioritisation is an important step in health planning Explain why?
Sensitivity and specificity of a screening test is inversely related -justify.
For small sample median is a better measure of central tendency than mean, why?
Screening and case finding are not synonymous Explain.
Carriers are more dangerous than cases -justify.
Overcrowding can influence health -justify.
Hepatitis B infection should be considered more dangerous than HIV infection Justify.
All influenza pandemics were caused by influenza virus A and not by B or C Explain.
Lung cancer can be controlled by primary preventive measures justify.
RNTCP gives priority on detection of new smear positive cases Explain.
WHO definition of ‘Health‘ has defects Explain.

HIV is a behavioural disease explain.
Vitamin A supplementation is necessary after measles infection-give reasons.
AEFI include events beyond side effects of vaccines explain.
Sanitation barrier aims at breaking the transmission cycle of faecal-borne disease explain.
Role of pretest counselling for HIV/AIDS is useful explain.
Sentinel surveillance of disease is better than periodic mass screening explain.
Carrier stage of a disease is not amenable to control explain.
Role of IPV in polio eradication.
Submerged part of the disease ice-berg has immense importance to an epidemiologist explain.
Syndromic management of STD is the most appropriate approach in India justify.
Carriers are more dangerous than cases justify
lndia is yellow fever receptive area Explain.
The tem source and reservoir are not always synonymous explain with suitable example.
Live vaccines are more potent immunising agent than killed vaccine Explain.
Discuss health hazards of immunisation.
Discuss active surveillance in malaria.
Cost effectiveness analysis is best suitable than cost benefit analysis in health sector.
ORS is an example of appropriate technology.
Family performs many functions: Explain.
Parboiled rice is nutritionally superior to milled rice.
Supplementary and therapeutic nutrition are different
FRU can reduce MMR -Explain
Importance of genetic counselling in preventing genetic disorders.
Use of auto-disable syringe in national immunisation programme has several advantages.
Prioritisation is an important step in health planning Justify.
Community participation is essential for success of a health programme.
India is in third stage of demographic cycle-explain.
Significance of a false positive screening test.

Feedback is very important in health planning.
Apart from growth monitoring growth chart has many other uses -explain.
Primordial prevention is a subset of primary prevention justify.
NRR is regarded as a superior method to GRR for measuring population growth -justify.
Social security measures have a great role in preventing health problem explain with examples.
Accessibility cannot be equated with acceptability of health services justify.
Explain why family is considered as an epidemiological unit.
Population pyramid is important for public health.
Food additives and food adulteration are not synonymous Explain.
Interpersonal communication is better than mass media for advocacy purpose Explain.
’Equittable distribution of health services” an important principle of primary health care justify.
Cost effective analysis and cost benefit analysis are not synonymous -explain.
Cangaroo care.
Short term high dose of Vit. A is useful for prevention of xerophthalmia.
lDD is a social and preventable problem.
Fluorine is often called two-edged sword Explain.
Revised lCDS growth chart currently in operation differ from the earlier one -explain.
Parboiled rice is nutritionally superior to milled rice explain.
Prioritisation is an important step in health planning Explain why?
Periodical examination is effective in prevention of occupational diseases justify.
ASHA links health care delivery with community -Explain.
Networking with voluntary health agencies play an important role in health care delivery
Institutional deliveries can reduce maternal mortality to a great extent explain.
Growth chart can play multiple roles explain.
FRU will reduce MMR Explain.
Subcentre is considered as pivot of health care delivery system in rural areas Explain.
Use of growth chart is a quick methodology for identification at under nutrition justify.
Management consists of four basic activities explain.
Problems at industrialisation.
Different aspects of school health service
Medical care and health care are not synonymous.
Primary health care is basically the responsibility of the state.




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Marks Distribution
Total Marks 100 Pass Marks 50
Theory: 40 Marks
Pre & Para clinical subject
Group A Long question (No alternative): 10 Marks
Operative and Clinical question
Group B Short notes (Two out of three): 10 (5×2) Marks
Group C Long questions (One out of two): 10 Marks
Group D Short notes (Two out of three): 10 (5×2) Marks
Oral: 10 Marks
[Oral questions, Instruments, X-ray & other imaging]
Practical: 30 Marks
[Long case, Short case]
Internal Assessment: 20 Marks


Sorted Questions

1. Describe the anatomy of lacrimal apparatus with a labelled diagram. Enumerate the causes of
watering of eye. [2018]
2. Describe a schematic diagram of pupillary light reflex. Mention the drugs acting on pupil.
3. Describe anatomy and physiology of lens. What is mechanism of accommodation? [2016]
4. Discuss the theories of Aqueous Humour formation, circulation and drainage. [2015]
5. Describe the anatomy of the upper eyelid with a labelled diagram. [2014]
6. Describe the anatomy of physiological lens. What is the mechanism of accommodation?
7. Describe the pathway of light reflex with diagram. [2012]
8. Describe the anatomy of conjunctiva. [2011]
9. Discuss pupillary reactions with special reference to their basis and clinical significance.
10. Describe the origin, insertion, nerve supply and action of extra ocular muscles. [2009]


1. Describe symptoms, signs and management of acute attack of angle closure glaucoma. [2018]
2. A 65 years old patient presented with gradual painless dimness of vision in both eyes during
last 2 years. Discuss the differential diagnosis and management. [2018] {Hint: D/D- Senile
cataract, POAG, Age related macular degeneration, Diabetic retinopathy, Presbyopia, Degenerative
myopia, Retinitis pigmentosa}
3. What is Keratoplasty? What are types? How will you collect the donor cornea and how will
you preserve it? [2017] {Hint: Keratoplasty = Corneal transplantation}
4. Enumerate the postoperative complications of cataract surgery. Briefly outline the treatment
of any one of them. [2017] {Hint: Most common late complication of ECCE is posterior capsular
5. What is chronic dacryocystitis? Describe the steps of dacryocystorhinostomy. [2016] {HintDacryocystitis = inflammation of lacrimal sac}

6. How do you prepare a patient before cataract operation? How to predict the outcome of
cataract surgery? [2016]
7. Describe in brief the management of a case of a bacterial corneal ulcer. How would you treat
a non-healing ulcer? Enumerate the complications of corneal ulcer. [2015]
8. What are causes of seeing rainbow halo around light? Describe the management of one such
case having severe pain in the eye. [2015] {Hint: Causes of rainbow halo include Angle closure
glaucoma, Immature cataract & Mucopurulent conjunctivitis; out of these acute attack of angle closure
glaucoma is extremely painful}
9. Enumerate the possible causes of sudden painful dimness of vision in a 35 years old female
patient. Briefly discuss the signs, symptoms and management of any one of the cause. [2014]
{Causes include Acute attack of angle closure glaucoma, Acute keratitis, Acute Iridocyclitis, Orbital apex
syndrome, Chemical or thermal burn etc.}
10. A 7 years old boy was hit by a cricket ball in one eye. Enumerate possible damage in each of
the ocular structures expected in such a case. Describe the options for treatment to each
injury. [2014] {Hint: Blunt trauma}
11. A patient comes with Rainbow haloes. How do you diagnose the case? [2013] {Hint:
Differentiated by Fincham’s stenopaeic slit test, irrigating discharge etc.}
12. Enumerate the causes of night blindness. Write down the clinical features and management of
Vitamin A deficiency. [2013] {Hint: Causes include Vitamin-A deficiency/ xerophthalmia, Retinitis
pigmentosa, High myopia, Open angle glaucoma, Nuclear cataract etc.}
13. What are the causes of red eye? Write in brief about their differential diagnosis with
management. [2012] {Hint: Causes of red eye include Conjunctivitis, Keratitis, Acute iridocyclitis, Acute
angle closure glaucoma, Episcleritis, Scleritis, Subconjunctival haemorrhage etc.}
14. Describe the effect of blunt trauma on the eye. [2012]
15. Same as 8. [2011]
16. Describe the signs, symptoms and management of acute iridocyclitis. [2011] {Hint: Iridocyclitis
= anterior uveitis}
17. How would you diagnose a case of open angle glaucoma and follow up such a patient? [2010]
18. Write down the causes of gradual painless loss of vision and their management. [2009]
19. What is intraocular pressure? Mention conditions where intraocular pressure is low. [2009]
{Hint: Causes of hypotony include Chronic uveitis, Recent penetrating injury, Wound leak, Post-surgical
(e.g. trabeculectomy), Choroidal detachment, Retinal detachment etc.}



1. Myopia [2015, 2009], Pathological Myopia [2014, 2011], Treatment of myopia [2018]
2. Hypermetropia [2012]
3. Presbyopia [2017]
4. Vernal Conjuctivitis [2011], Clinical features of vernal keratoconjunctivitis [2013]
5. Phlyctenular conjunctivitis [2017]
6. Red eye [2010]
7. Pterygium [2015], Management of recurrent pterygium [2017]
8. Bacterial Corneal Ulcer [2012]
9. Hypopyon corneal ulcer [2016]
10. Removal of corneal foreign body [2013]
11. Paracentesis [2016]
12. Indications of keratoplasty [2009], Eye banking and keratoplasty [2015]
13. Staphyloma [2016, 2012]
14. Keratic precipitates [2018, 2009]
15. Endophthalmitis [2018]

16. Panophthalmitis [2014]
17. Evisceration [2014, 2012]
18. Hypermature cataract [2009], Morgagnian Cataract [2011]
19. Capsulotomy in cataract extraction [2011]
20. SICS [2013]
21. Biometry [2018, 2012]
22. Early postoperative complications following cataract surgery [2009]
23. Posterior capsular opacification (PCO) [2017]
24. Buphthalmos [2017]
25. Field changes in Primary Open Angle Glaucoma [2015]
26. Phacolytic glaucoma [2016]
27. Trabeculectomy [2014]
28. Vitreous haemorrhage [2010]
29. Diabetic Retinopathy [2011]
30. Retinoblastoma [2016]
31. Enucleation [2018, 2011]
32. Binocular Vision [2013]
33. Management of estropia in a 2 year old [2010]
34. Entropion [2013]
35. Symblepharon [2014]
36. Epiphora [2015]
37. Syringing of the Lacrimal passage [2012]
38. Acute Dacryocystitis [2013]
39. Symptoms, signs and management of a case of chronic dacryocystitis [2010]
40. Dacryocystorhinostomy [2009]
41. Alkali burn of eye [2018]
42. Anti-glaucoma drugs [2016]
43. Side effects of topical corticosteroids [2010]


44. Use of laser in eye [2014]
45. Nutritional blindness [2017]
46. Vision 2020 [2015]
47. Various methods of determination of visual acuity [2010]

N.B. Chapter division is based on “Comprehensive Ophthalmology by A K Khurana”

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