PMDC National Licensing Examination Community Medicine and Behavioral Sciences Syllabus

Community Medicine and Behavioral Sciences syllabus — full chapter and topic list

Expand any chapter to see its topics and sub-topics. This is the whole examinable outline for Community Medicine and Behavioral Sciences in PMDC National Licensing Examination, not a summary of it.

1. 1

   Epidemiology and Biostatistics

   4 topics

   • Study Designs
   • Measures of Disease Frequency and Association
   • Screening and Diagnostic Tests
   • Basic Biostatistics
2. 2

   Communicable and Non-Communicable Diseases

   3 topics

   • Epidemiology of Infectious Diseases
   • Expanded Programme on Immunization (EPI)
   • Burden of Non-Communicable Diseases
3. 3

   Health Systems and Public Health in Pakistan

   4 topics

   • Primary Health Care
   • National Health Programs
   • Maternal and Child Health
   • Environmental and Occupational Health
4. 4

   Nutrition and Health Promotion

   2 topics

   • Nutritional Assessment and Deficiencies
   • Health Education and Promotion
5. 5

   Behavioral Sciences and Medical Ethics

   3 topics

   • Doctor-Patient Communication
   • Medical Ethics and Professionalism
   • Stress, Coping and Mental Health

Community Medicine and Behavioral Sciences flashcards for PMDC National Licensing Examination

23 of 51 cards from the Community Medicine and Behavioral Sciences deck — real questions with worked answers.

1. In epidemiologic study designs, which design is best suited for studying rare diseases, and why?

   The case-control study. It starts with cases (people with the disease) and compares past exposures to controls, so even rare diseases can be studied efficiently without needing to follow a huge cohort.

2. What is the key difference between a cohort study and a case-control study in terms of direction of inquiry?

   A cohort study goes from exposure to outcome (prospective, exposure known first). A case-control study goes from outcome to exposure (retrospective, disease known first).

3. Which measure of association is calculated in a cohort study, and which in a case-control study?

   Cohort study: Relative Risk (Risk Ratio). Case-control study: Odds Ratio (RR cannot be directly calculated because incidence is not measured).

4. What type of study measures disease and exposure simultaneously at a single point in time, and what measure does it yield?

   A cross-sectional (prevalence) study. It measures prevalence and yields prevalence-based associations; it cannot establish temporality/causation.

5. What is the strongest study design for establishing causation, and what is its defining feature?

   The Randomized Controlled Trial (RCT). Its defining feature is random allocation of participants to intervention and control groups, minimizing confounding.

6. Define incidence rate and give its formula.

   Incidence is the number of NEW cases occurring in a population at risk over a specified period. Incidence rate = (Number of new cases during period / Total person-time at risk) × 1000.

7. Define prevalence and give its formula.

   Prevalence is the total number of EXISTING cases (old + new) in a population at a given time. Point prevalence = (Number of existing cases / Total population) × 1000.

8. State the relationship between prevalence, incidence, and disease duration.

   Prevalence ≈ Incidence × Duration (P = I × D). When incidence and duration are stable, prevalence depends on both.

9. How is Relative Risk (Risk Ratio) calculated and interpreted?

   RR = Incidence in exposed / Incidence in unexposed. RR = 1: no association; RR > 1: exposure increases risk; RR < 1: protective effect.

10. How is the Odds Ratio calculated from a 2×2 table (a=exposed cases, b=exposed controls, c=unexposed cases, d=unexposed controls)?

    OR = (a × d) / (b × c), the cross-product ratio. It approximates RR when the disease is rare.

11. Define Attributable Risk (AR) and its formula.

    Attributable Risk = Incidence in exposed − Incidence in unexposed. It is the excess risk in the exposed group attributable to the exposure.

12. What is the formula for Attributable Risk Percent (Attributable Fraction in the exposed)?

    AR% = [(Incidence in exposed − Incidence in unexposed) / Incidence in exposed] × 100, or equivalently [(RR − 1)/RR] × 100.

13. Define sensitivity of a screening/diagnostic test and give its formula.

    Sensitivity = ability to correctly identify those WITH the disease (true positive rate). Sensitivity = TP / (TP + FN) × 100.

14. Define specificity of a screening/diagnostic test and give its formula.

    Specificity = ability to correctly identify those WITHOUT the disease (true negative rate). Specificity = TN / (TN + FP) × 100.

15. What is Positive Predictive Value (PPV) and how is it calculated?

    PPV = probability that a person with a positive test truly has the disease. PPV = TP / (TP + FP). PPV increases with higher disease prevalence.

16. What is Negative Predictive Value (NPV) and how is it calculated?

    NPV = probability that a person with a negative test is truly disease-free. NPV = TN / (TN + FN). NPV decreases with higher prevalence.

17. How does disease prevalence affect predictive values versus sensitivity/specificity?

    Sensitivity and specificity are intrinsic properties of the test (independent of prevalence). PPV rises and NPV falls as prevalence increases; the reverse occurs as prevalence falls.

18. What is the difference between a screening test and a diagnostic test?

    A screening test identifies apparently healthy people who may have disease (should be highly sensitive, cheap, simple). A diagnostic test confirms presence/absence of disease (should be highly specific, definitive).

19. State Wilson and Jungner's key criteria for a worthwhile screening programme.

    The condition must be an important health problem with a recognizable latent/early stage; a suitable, acceptable, valid test must exist; effective treatment must be available; the natural history must be understood; and screening must be cost-effective and continuous.

20. Differentiate lead-time bias and length-time bias in screening.

    Lead-time bias: screening appears to prolong survival merely by earlier diagnosis without changing outcome. Length-time bias: screening preferentially detects slow-growing, less aggressive cases, overstating benefit.

21. List the measures of central tendency and state which is best for skewed data.

    Mean, median, and mode. For skewed (non-normal) distributions, the median is the most appropriate measure of central tendency as it is not affected by extreme values.

22. What does the standard deviation measure, and what proportion of data lies within ±1, ±2, and ±3 SD in a normal distribution?

    SD measures dispersion/spread around the mean. In a normal distribution: ~68% lies within ±1 SD, ~95% within ±2 SD, and ~99.7% within ±3 SD.

23. Which statistical test compares means of two independent groups, and which compares proportions/categorical data?

    Student's t-test compares means of two groups (ANOVA for >2 groups). The Chi-square test compares proportions/categorical data.

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