DNB Family Medicine

a. Janani Shishu Suraksha Karyakaram (JSSK)

b. RashtriyaKishorSwasthyaKaryakram(RKSK)

c. Rashtriya Bal SwasthyaKaryakram (RBSK)

d. Universal ImmunisationProgramme

e. Mission Indradhanush / Intensified Misson Indradhanush f. Janani Suraksha Yojana (JSY)

g. Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA)

h. Navjaat Shishu Suraksha Karyakram (NSSK)

a. National Iodine Deficiency Disorders Control Programme

b. MAA (Mothers’ Absolute Affection) Programme for Infant and Young Child Feeding

c. National Programme for Prevention and Control of Fluorosis (NPPCF)

d. National Iron Plus Initiative for Anaemia Control

e. National Vitamin a Prophylaxis Program

f. Integrated Child Development Services (ICDS)

g. Mid-Day Meal Programme

Communicable Diseases

a. Integrated Disease Surveillance Programme (IDSP)

b. Revised National Tuberculosis Control Programme (RNTCP)

c. National Leprosy Eradication Programme (NLEP)

d. National Vector Borne Disease Control Programme

e. National AIDS Control Programme (NACP)

f. Pulse Polio Programme

g. National Viral Hepatitis Control Program

h. National Rabies Control Programme

i. National Programme on Containment of Anti- Microbial Resistance (AMR)

Non-Communicable Diseasesa.

a. National Tobacco Control Programme (NTCP)

b. National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases & Stroke (NPCDCS)

c. National Programme for Control Treatment of Occupational Diseases

d. National Programme for Prevention and Control of Deafness (NPPCD)

e. National Mental Health Programme

f. National Programme for Control of Blindness& Visual Impairment

g. Pradhan Mantri National Dialysis Programme

h. National Programme for the Health Care for the Elderly (NPHCE)

b. Historical evolution of primary health care

c. Health care teams in primary care

d. Universal Health Coverage

e. Health Insurance and Healthcare financing

f. Alma Ata Declaration 1978

g. 2018 Asthana Declaration on Primary Health Care

h. WHO and Global Health?

i. SDG – Sustainable Development Goals 2030

j. Global Health and International Healthcare Delivery Models – UK, USA, Brazil, South Africa, Sri Lanka, Cuba, Thailand, Nepal

k. Indian Healthcare Delivery Models -Best practices fromstates

l. Comprehensive Vs. Selective Primary Care

m. Principles of Community Oriented Primary Care (COPC)

b. The provision of comprehensive primary care to the rural population.

c. Provision of secondary care to the rural population

d. Response to medical emergencies in rural and remote locations.

e. Population-based approach

f. Care provision to culturally diverse communities

g. The practice of medicine within an ethical, intellectual, and professional framework

i. EmOC & LSAS (Community Setting – longitudinal integration)

b. Personal Life Goals

c. Personal Management

d. Personal growth and development

e. Continuous professional development

f. Personal wholeness and health and well-being

g. Management of tress

h. Preventing and dealing with burn-out

i. The family physician’s family health and wholeness

j. The family physician’s lifestyle to be healthy

k. Personal finance management and financial success

b. Leadership principles and practices (styles)

c. Principles of teamwork

d. Team formation and functioning and facilitating

e. Conflict management

f. Working as a team (with/at the PHC and with/at the CHC and with the ward-based outreach teams and with the home-care teams)

g. Multidisciplinary, multi-professional approach to healthcare, including with government and non-governmental agencies

h. Working with other agencies

i. Teaching and training the team for optimal, effective and efficient service

j. Management principles and methods, including the management cycle (of doing a situational analysis, setting objectives, assessing, planning, implementing, evaluating, recording) – applied to the team and the services rendered, Etc.

k. Stewardship and mutual accountability and productivity

l. Continuous training and support of and working with community health workers (like the ANM/VHN/ASHA workers, and others)

n. How to conduct morbidity and mortality (M+M) meetings

o. How to deal with a medical mistake or unethical behavior of a colleague or healthcare worker or with an impaired health practitioner

p. Relevant healthcare legislation

b. Establishing a new practice or clinical facility

c. Managing a busy clinic – strategies

d. Record-keeping

e. Cost-effective care and management

f. Medicolegal aspects of family medicine

g. Quality, standards, and accreditation

h. Quality Improvement Cycle

i. Quality assurance (QA)/ Quality improvement (QI)

j. Audit (clinical and practice and financial)

k. Legal framework compliances of practice

l. How to maintain and aesthetically beautify the physical facilities (inside and outside) and the physical and ambient surroundings (e.g., flower- garden, vegetable garden, birdbaths, trees, Etc.)

m. Budgeting and financial management

n. How to do a stock inventory at CHC level

o. How to manage human resources (people), material (equipment and information), minutes (time), money, meetings, medicines, myself, my family, Etc.

p. Data interpretation of what is being reported by the Data Entry Officer (DEO)

q. How to stimulate and facilitate organizational development (both on health service and health facility levels)

b. Telemedicine and digital health

c. Use of electronic devices for practice support and enhancement

d. Professional use of social media

e. Electronic communication

f. Information technology and health promotion

g. Big data and population health

h. Healthcare automation

i. Artificial Intelligence

b. Concept of Prevention

c. Health screening

d. Preventive health checkup

e. Immunization

f. Chemoprophylaxis

g. Age-specific prevention guidelines

h. Injury prevention

i. Principles of nutrition

j. Calorie calculation

k. Diet advises during sickness

l. Diet for chronic diseases

m. Human physiology and principles of exercise

n. Types of exercise

o. Exercise prescription

p. Prevention and treatment of Malnutrition

q. Obesity and weight management

r. Smoking cessation

s. Alcohol dependence management

b. Neonatal Resuscitation

c. Newborn Care

d. Common neonatal problems

e. Dealing with congenital anomalies

f. Breastfeeding and weaning

g. Well baby clinic

h. Immunization

i. Normal development, Developmental Delay

b. Optimal use of the Road-To-Health-Card (RTHC)

c. Vitamin deficiency diseases

d. Common pediatric illnesses like infectious diseases, asthma, Etc.

e. Behavioral disorders, mental retardation, learning disabilities, child abuse issues,

f. Sudden infant death syndrome (SIDS),

g. Genetic disorders,

h. School health program

i. National Immunization Program.

j. Integrated Management of Childhood and Neonatal Illnesses (IMNCI) Guidelines

k. Common Pediatric emergencies

b. Puberty and adolescence: male & female

c. Adolescent and the law

d. Behavior problems /stress/psychosocial problems/nutrition and exercise

e. Diagnosis and management of substance abuse

f. Eating disorder

g. Reproductive and sexual health

h. Immunization in adolescents

i. Gadget addiction

j. Adolescent contraception

k. Menstrual hygiene

l. Early marriage

m. Gender identity issues

b. Menstrual problems: Premenstrual syndrome, Dysmenorrhea, Abnormal uterine bleeding, post-coital bleeding, and intermenstrual bleeding; primary and secondary Amenorrhea

c. Common disorders of uterus and ovary including fibroid uterus, genital prolapse, ovarian tumors, polycystic ovarian disease

d. Vaginal discharge, Pelvic infection, Sexually Transmitted Diseases Infections

e. Pelvic mass, screening and early detection of genital tract malignancy,

f. Preconception counseling, Contraception, Infertility

g. Approach to: Breast pain, breast lumps, Galactorrhea and nipple discharge, Hirsutism, Dyspareunia, Pelvic pain

h. Menopause, Complications of menopause, Hormone Replacement therapy, post- menopausal bleeding, Incontinence, Vaginal prolapse

i. Medically Unexplained Symptoms

k. Gender identity issues

b. Physiological changes in pregnancy, Antenatal Care, normal labor & postnatal care

c. Medications during pregnancy

d. Abortion

e. Common problems during pregnancy including hyperemesis gravidarum, urinary tract infections, low backache

f. Basic Antenatal care including health education, nutritional guidance, immunization

g. SBA – Skill Birth Attendant competencies

h. High-risk pregnancy & medical diseases in pregnancy: identification, management, and appropriate referrals

i. EmOC: Emergency Obstetrical Skills

(a) Basic EmOC

(b) Comprehensive EmOC (longitudinal integration)

j. LSAS: Life Saving Anesthesia Skills for EmOC (longitudinal integration)

k. Counseling the mother and the family

l. Postnatal care and puerperal problems

m. Breastfeeding

n. Medicolegal issues related to women’s health

b. Undifferentiated presentations,

c. Recognition, assessment, management, follow- up of common medical conditions in an adult man/woman in the community,

d. Prevention and health promotion, knowledge of Diagnostic methods, interpretation of results and Referral criteria

a. Including viral, bacterial, rickettsia, mycobacterial, protozoal, Etc.

b. Example malaria, filariasis, rabies, leptospirosis, dengue fever, enteric fever, hepatitis, poliomyelitis, meningitis, encephalitis, HIV/AIDS, sexually transmitted infections, common fungal infections, skin infections,

varicella, herpes zoster, rickettsia, measles, mumps, tetanus, Chikungunya fever, newer emerging infections (avian influenza and Zika virus) c. Sepsis, tuberculosis, HIV / AIDS, malaria, enteric fever, UTI, leptospirosis, rickettsia fevers, tetanus, STDs, leprosy, kala-azar, fever of unknown origin, infective endocarditis

b. Approach to a patient presenting with syncope

c. Approach to a patient presenting with palpitations (dysrhythmias)

d. Approach to a patient with breathlessness (cardiac failure, acute pulmonary edema)

e. Approach to a patient with edema

f. Approach to a patient with hypertension and dyslipidemia g. Common congenital heart diseases

h. Others: acute rheumatic fever, rheumatic heart disease, infective endocarditis, cardiomyopathy, peripheral vascular disease

b. Approach to a patient with a running nose – allergic disorders

c. Approach to a patient presenting with difficulty in breathing (asthma, pneumonia, COPD, management of acute exacerbation of bronchial asthma and COPD, interstitial lung disease, sarcoidosis

d. Approach to a patient presenting with tuberculosis and other infections (empyema, bronchiectasis, lung abscess, pleural effusion)

e. Approach to a patient presenting with occupational lung diseases

f. Approach to a patient presenting with sleep apnoea

g. Diagnostic methods in pulmonary medicine, principles of the pulmonary function tests

h. Bronchodilators and steroids in respiratory medicine i. Malignancies in lung j. Smoking cessation

b. Approach to a patient presenting with acute and chronic abdominal pain: cholecystitis, pancreatitis, peptic ulcer disease, non-ulcer dyspepsia, gastritis

c. Approach to a patient presenting with jaundice

d. Hepatitis, liver failure, cirrhosis of the liver, hepatic encephalopathy

e. Approach to a patient presenting with diarrhea: Infective causes, inflammatory bowel disease, irritable bowel syndrome, malabsorption, food poisoning, parasitology including amebiasis/ giardiasis/worm infestations, and investigations in gastrointestinal diseases)

f. Approach to a patient presenting with constipation

g. Approach to a patient presenting with ascites – tuberculous abdomen and various other etiologies

h. Patient presenting with hematemesis – Variceal and non-variceal bleeding i. When to refer for investigations – GI scopies, USG

b. Approach to a patient presenting with headache (primary and secondary causes – meningitis, encephalitis, ICSOLs)

c. Approach to a patient presenting with seizures

d. Approach to a patient presenting with movement disorders – Parkinsonism other disorders presenting with tremors

e. Approach to a patient presenting with peripheral neuropathy, cranial neuropathy

g. Approach to a patient with memory loss h. Patient presenting with dizziness

b. Approach to a patient with polycythemia

c. Approach to a patient with thrombocytopenia

d. Approach to a patient with bleeding disorders Hemophilia and others

e. Approach to a patient with hematological malignancies

f. Interpretation of lab investigations

g. Principles of anticoagulation

b. Cervical

c. Breast

d. Prostate

e. Lung

f. Hematological

g. Gastro-intestinal

h. Head and neck

b. Approach to joint pain in the elderly: osteoarthritis

c. Approach to a patient with back pain – ankylosing spondylitis

b. Approach to a patient presenting with hematuria (glomerulonephritis, calculi, and others)

c. Approach to a patient presenting with edema (acute renal failure, chronic renal failure, nephrotic syndrome, nephrotic syndrome)

d. Interpretation and management of electrolyte imbalances

e. Renal replacement therapy

f. Diabetic nephropathy

b. Thyroid diseases

c. Growth and developmen

t d. Metabolic Syndrome

e. Dyslipidemia

f. Obesity

g. Osteoporosis

h. Vitamin D deficiency

i. Common endocrine diseases related to pancreas, pituitary and adrenal glands

b. Bacterial: Impetigo, TB, Leprosy, Cellulitis, Infestation: scabies, lice, insect bites

c. Fungal and yeast infections: Candida, pityriasis versicolor, tinea skin diseases associated with HIV infections

d. Diagnosis of Non-Infectious skin conditions and management: Acute contact dermatitis, Psoriasis, Chronic leg ulcers, Generalized pruritus, Angioedema / Anaphylaxis, Acne, Alopecia, Vitiligo, Eczema

e. Diagnosis of Nutritional disorders causing skin lesions and management

f. Skin tumors: Premalignant lesions in the skin: like solar keratosis, Bowen’s disease

g. Malignant lesions like basal cell cancer, squamous cell cancer, Malignant melanoma

b. Pre-employment health checkup

c. Sickness certification

d. High-risk occupations and medical fitness certification

e. Sports fitness certification

f. Basic ergonomics and office health

g. Stress Management

h. Factory Health

i. Legislations related to occupational health

b. Recognition, Basic Management and appropriate referral of patients with psychosis

c. Follow-up care of patients with psychosis

d. Care of patients with unexplained symptoms without an organic basis

e. Care of patients undergoing bereavement, social and family stress

f. Assessment of suicide risk

g. Diagnosis, detoxification and team-based management of patients with substance abuse

h. Recognition and management of patients in delirium

i. Recognition, referral and follow up of patients with dementia

j. Recognition, referral and follow up of patients with developmental disorders

k. Recognition, basic management and appropriate referral of patients with personality disorders, eating disorders and behavioral disorders in children and adolescents,

l. Basic principles of psychotherapy, rational use of psychotherapeutic medication)

b. Acutely dyspneic patient

c. Shock

e. Loss of consciousness

f. Seizures

g. Epistaxis

h. Acute gastrointestinal emergencies

i. Trauma and poly-trauma, including road traffic accidents, sexual assault, victims of violence, mass casualty, drowning, and near-drowning.

j. Hemoptysis

k. Acute burns

l. Acute musculoskeletal disorders including fractures, sprains, dislocations and compartment syndromes

m. Life-Saving Anesthesia Care (LSAS) for EmOC (Emergency setting- (longitudinal integration)

n. Common poisonings, animal bites, and stings,

o. Environmental disasters (floods, earthquakes, Etc.)

p. Acute urinary system disorders including retention and anuria,

q. Psychiatric emergencies

r. Disaster management

b. Experience and expertise should be gained in recognizing and appropriate evaluation and initial management of the following common conditions. · Head Injury · Burns and wounds, ulcers, bedsores · Lumps in neck, breast, groin, abscess and small bumps elsewhere in the body · Upper GI bleed, rectal bleed, hematemesis, and Malena, · Abdominal pain · Dysphagia, nausea, vomiting · Peptic ulcer, GOERD, gastritis · Disorders of gall bladder and pancreas · Intestinal obstruction, specific and nonspecific infections · Abdominal mass · Leg Ulcers, varicose veins, · Diabetic foot

c. Red flags – identification stabilization and treatment and referral of shock, electrolyte and fluid requirements, blood transfusion,

d. Suture methods and materials, universal precautions.

e. Life-Saving Anesthesia Care (LSAS) for EmOC (OT setting- longitudinal integration)

b. Recognition, assessment, management, appropriate referral and follow-up of common ENT conditions: Acute bacterial pharyngitis, Acute & Chronic Rhinitis, Acute & Chronic Sinusitis,

c. Acute & Chronic Tonsillitis, Quinsy

d. Adenoiditis/adenoid hypertrophy with eustachian tube dysfunction/OMe, Acute Otitis Media, Chronic (safe and unsafe) otitis media, Otitis externa, Fungal infections of the ear,

e. Mastoiditis, Otitis externa, Fungal /bacterial infections of the ear, – perichondritis/ seroma/hematoma of the pinna. Mastoiditis, Nasal Polyps

f. Tuning fork tests

g. Management of Bell’s palsy

h. Nasal polyps

i. Deviated nasal septum

j. Emergency tracheostomy kit

b. Recognition, assessment, management, appropriate referral, and follow-up of common Eye conditions:

c. Redeye (Conjunctivitis, Corneal abrasions/ulcers, Uveitis, Glaucoma)

d. Decreased vision (Refractiveory error, Cataract, Diabetic retinopathy, Retinal Detachment, optic neuritis,

e. Lid disorders, Chalazion, Stye, Lagophthalmos

f. Bitot’s spots, Xerophthalmia,

g. Pterygium, Phlycten, Episcleritis, Scleritis

h. Diabetic retinopathy

i. Foreign body in the eye

j. Panophthalmitis/ Orbital Cellulitis

k. Color blindness, Squint

l. Congenital eye problem

m. First-line management and referral protocols of eye emergencies

n. Identification and referral of malignancies o. A national program for control of blindness and visual impairment (NPCBVI)

b. Acute and Chronic joint pains – small joints, large joints, Arthroscopy

c. Acute and Chronic backache

d. Acute/Chronic neck pain

e. Shoulder pain

f. Myofascial pain syndrome

g. Fractures and dislocations – early management and referral

h. Arthritis: Osteoarthritis, RA, Gout, Periarthritis of the shoulder, Etc.

i. Infections: septic Arthritis, osteomyelitis, Tuberculosis

j. Synovitis, fasciitis, tendinopathies

k. Sports injuries

l. Bony tumors m. Management of ganglion

n. Congenital deformities

o. Assessment and management of patients with disabilities

p. Principles of Community based rehabilitation

q. Pressure ulcers prevention and management

r. Disability terminology- Impairment, activity limitation and participation restriction

s. Legislation and rights of people with disabilities

b. Equipment’s

c. Pre-anesthetic assessment of patient- (risk assessment asa grade 1-5 classify according to grades 1-3 can be done by a family physician)

d. Types of Anesthesia and details on each modality- local anesthesia,

e. Regional anesthesia including field, digital, ankle, wrist and penile block, endotracheal intubation Intravenous sedation,

f. Monitoring patient while under anesthesia care and follow up, red flags for referral, adverse events in anesthesia, Awake analgesics

g. Life-Saving Anesthesia Care (LSAS) for EmOC (longitudinal integration)

b. Comprehensive assessment of elderly

c. General principles of elder care

d. Geriatric syndromes – falls & fractures incontinence, constipation, delirium, dementia, aches, and pains in elderly

e. Prescribing in elderly

f. Palliation & management of terminally ill patients g. Rehabilitation in elderly

h. Communication skills in bereavement, problems of the family after the death

i. Caregiver support,

j. Care of elderly, social and psychological problems in the elderly

b. Physical care

c. Essential palliative care medications & Psychosocial and spiritual care

d. Terminal illness and end-of-life care

e. Nursing care communication

f. Ethical aspects of care

g. Integrated care and network with other healthcare providers

h. Teamwork

i. Selfcare

j. Recognition, assessment, management, follow- up of common medical conditions in a terminally ill patient

k. Home-based care

l. Stroke rehabilitation

m. Cardiovascular rehabilitation

n. Post-trauma rehabilitation

o. Musculoskeletal diseases

p. Pain management