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      Training medical undergraduates in the core disciplines of community medicine through community postings – an experience from India

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          Abstract

          Objective: Family medicine, epidemiology, health management and health promotion are the core disciplines of community medicine. In this paper, we discuss the development of a community posting program within the framework of community medicine core disciplines at a primary health centre attached to a teaching hospital in Puducherry, India.

          Methods: This is a process documentation of our experience.

          Results: There were some shortcomings which revolved around the central theme that postings were conducted with department in the teaching hospital as the focal point, not the primary health centre (PHC). To address the shortcomings, we made some changes in the existing community posting program in 2013. Student feedback aimed at Kirkpatrick level 1 (satisfaction) evaluation revealed that they appreciated the benefits of having the posting with PHC as the focal point. Feedback recommended some further changes in the community posting which could be addressed through complete administrative control of the primary health centre as urban health and training center of the teaching hospital; and also through practice of core disciplines of community medicine by faculty of community medicine.

          Conclusion: It is important to introduce the medical undergraduates to the core disciplines of community medicine early through community postings. Community postings should be conducted with primary health centre or urban health and training centre as the focal point.

          Most cited references13

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          A taxonomy of community-based medical education.

          The authors propose a classification of community-based education (CBE) as it is implemented all over the world. To create this taxonomy, they used reports in the literature of 31 active programs in many locations. A CBE program is an instructional program carried out in a community context, outside the academic hospital. The authors distinguish between programs that are developed primarily to provide services to an underserved community; programs that have a research focus; and programs that have as their primary goal the (clinical) training of students. These three major types can be subdivided in six minor types, among them community development programs, health intervention programs, and simple community-exposure programs. The ultimate goal of creating the taxonomy is to contribute to the development of a theory of CBE and provide a more systematic way to study CBE. In addition, the proposed taxonomy clearly demonstrates the various ways in which medical schools, their staffs, and their students can become involved with the communities served. CBE is not a unitary concept but a set of attempts to contribute to the quality of life in a particular community and, at the same time, create conditions for students to acquire hands-on understanding of the nature of the problems to be faced in future professional practice, and to develop relevant skills. The taxonomy also enables those involved in the development of CBE programs in their medical schools to see alternative approaches, which will help them choose the approaches that fit their particular educational goals. Last, it demonstrates the intricacies involved in the implementation of CBE, in particular the complexity of building a learning environment that is productive for students and, at the same time, responsive to community needs.
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            Sidney Kark's contributions to epidemiology and community medicine.

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              Linking undergraduate medical education to primary health care.

              Under graduate medical education aims at producing doctors who are competent in preventive, promotive and curative knowledge and skills. The community medicine curriculum in All India Institute of Medical Sciences, New Delhi has been designed with this objective in view. Students are given community oriented training in urban and rural settings whereby students are taught to carry out various activities under the guidance of faculty members. This curriculum has evolved over many years and provides ample exposure to the students to understand the health problems, and health system of the country especially at the primary and secondary level. There is a sequential teaching of community medicine, which starts from fourth semester through internship. Successful training in community medicine lies outside the walls of the department and the involvement of other partners like the community, health systems etc contribute largely.
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                Author and article information

                Journal
                FMCH
                Family Medicine and Community Health
                FMCH
                Compuscript (Ireland )
                2009-8774
                2305-6983
                July 2016
                August 2016
                : 4
                : 3
                : 45-50
                Affiliations
                [1] 1Department of Community Medicine, Indira Gandhi Medical College and Research Institute, Puducherry, India
                [2] 2Department of Community Medicine, Velammal Medical College Hospital & Research Institute, Madurai, India
                [a] aInternational Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, C-6, Qutub Institutional Area, New Delhi, India
                [b] bDepartment of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
                Author notes
                CORRESPONDING AUTHOR: Hemant Deepak Shewade, MBBS, MD, International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, C-6, Qutub Institutional Area, New Delhi 110016, India, E-mail: hemantjipmer@ 123456gmail.com
                Article
                FMCH.2015.0153
                10.15212/FMCH.2015.0153
                76dcf294-697b-4f54-b711-6b67aedca7ea
                Copyright © 2016 Family Medicine and Community Health

                This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 Unported License (CC BY-NC 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See https://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 9 September 2015
                : 2 November 2015
                Categories
                Case Study

                General medicine,Medicine,Geriatric medicine,Occupational & Environmental medicine,Internal medicine,Health & Social care
                clinical posting,Family medicine,community posting,community-based medical education,undergraduate medical education,epidemiology,health management,health promotion

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