Mastering Practical

& Viva Exams:

A Senior's Guide
Community Medicine
CM-III (Marking Scheme)

S.N Particulars Marks

1 College Presentation + CHD 100

2 Report 50
3 Viva 50
200
Total [Converted to 100 (divided
by 2)]
Approach To VIVA
• Descent & formal appearance, Wear ID Card, Symbol No
• Introduce yourself properly
• Take your Exam Admit Card with you
• Address the examiners respectfully
• Stay calm and composed; Listen carefully
• Be confident but not arrogant
• Maintain good eye contact
• For CM, Take a copy of report with you while entering hall &
Prepare from your questionnaire and report.
Topics you must excel on:
• Epidemiology: Epidemiologic Studies; Error/Bias, Immunization
Schedule
• Biostatistics: Sampling
• Demography: Demographic Measures
• Health Promotion and Education: Communication, Methods and
Media, Planning and Implementation
• Env. Health: Water, Waste
• Family Health: Contraceptives, ANC, PNC
• Nutrition: Breast Feeding, Supplementary Feeding, Malnutrition :
Z-score, Shakir’s Tape
FAQs
FAQs
• What kind of epidemiological study is CHD? How? (Difference
between Descriptive and Analytical Study)

• Your learnings? Role of CHD in personality & Skill development?

• What are the subjects you read in community medicine and How
are they applicable in CHD?

• Your Portion in Report Writing and Questions related to that

portion..
FAQs
• Summary of Report

• Summary of What you did in the whole month? (Describe the

Action Plan)

• Particular Findings: Nutritional Status, MCH Status, Hygiene and

Sanitation Status, etc. & their indicators

• Rate, Ratio, Proportion. Contingency Table & its uses.

FAQs
• MHP. How did you select the Topic for MHP? Your Role?

• Sampling. What Sampling Technique did you choose and why? Your
Sampling frame and sample size

• Difference between geographical and social mapping?

• Differentiate Sex and Gender and how is that knowledge applicable

in medicinal practice?
ANATOMY
Anatomy (Marking Scheme)
S.
Particulars Marks
N
1. Spotter (passing section) 80
3. Viva - Internal examiner 8
4. Viva – External examiner 8
5. Histology file 4
100
Total
Converted to 25 (divided by 4)
Spotters

20 spotters
 Histology slides-4 (epithelial, muscular, nervous, connective
tissue)
 Genetics-1
 X-ray-1
 Bones-2 ( and landmarks)
 Embryology (mostly teratogenesis and its causes)
 Muscles (nerve innervations, functions)
 Nerves (Root value important)
 Joints (Joints of hand and legs important)
Spotters
• Osteology: identify the bones, sides (right or left) important
landmarks with basic clinical aspects. (Don’t spend too much time
memorizing the attachments)

• A sure question from any joint is its related ligaments and bursa:
Knee joint, shoulder joint, or hip joint.

• Muscles of the Face, Thigh (especially muscles forming the femoral

triangle) and Arm (especially rotator cuff muscles) are very
important. Hand & Legs
Spotters
• Karyotyping or pedigree chart (genetics) unique: Mitochondrial
Inheritance along with clinical diseases

• Figure and props of branchial arch, placental villi, Twins,

Anencephaly and its cause, facial development shown to you in a
demonstration for your embryology

• X-ray, Types(Plain, Contrast Radiograph), Discovery (Wilhelm Conrad

Roentgen)
Spotters
• Brain: Cross-section of the brain, Gyrus/ Sulcus, Surfaces, Dura
mater coverings, Clinical condition like Caput Succedaneum.

• Simple questions from the eye, ear, and mammary gland are also
asked.

• Major nerves of the Brachial plexus, Femoral, Sciatic, Tibial and

Peroneal nerve and their innervation, and clinical applied aspect.

• Identification of any cranial nerve is sure especially CN V, VII, IX, and

VIVA
• Don’t spend too much time on this, since it carries very less marks.

• Answer confidently, do not repeat wrong answers

PHYSIOLOGY
Physiology (Marking Scheme)
S.N Particulars Marks

1. Spotter 20
2. Clinical examination 35
3. Viva - Internal examiner 20
4. Viva – External examiner 20
5. Logbook and attendance 5
100
Total [Converted to 25 (divided by
4 )]
Spotters
• 10 spotters ( Mostly Clinically Oriented)

• Pictures of Guyton are MOST IMPORTANT

• Don’t forget to know about the use of basic instruments used in the
physiology lab.
Clinical examination
• You have to write the ”PRINCIPLE” and “MATERIALS Required”
before performing the clinical examination.
• Don’t forget to introduce yourself and ask permission from your
friend while performing the examination (consent is a must).
• Make sure you have practiced the clinical examination before the
exams properly otherwise you might mess while performing it
directly in the exam.
• Proper concept about the theory aspect related to that particular
clinical examination.
• For example: If you are testing the visual acuity of a person, you should have a
clear idea about distant and near vision, use of Snellen’s and Jaeger’s chart, etc.
VIVA
• Internal examiner
 Have a good revision of all basic topics from all the systems
taught in 1st year.

• External examiner
 It completely depends on your viva teacher.
 Answer questions unanswered by your friend if you can (if
asked only).
PATHOLOGY
Pathology (Marking Scheme)

S.N Particulars Marks

1. Spotter 7x2= 14

3. Viva - Internal examiner 5

4. Viva – External examiner 5

5. Pathology file 1

Total 25
Spotters
• Both gross and microscopic features are asked.
• Focus more on the slides which were taught during revision.
• Don’t worry even if you fail to recognize slides, you can use the
clues from the clinical case. (Age, organ involved, etc)
 For eg: Ewing sarcoma is mostly seen in males below 10 years old
where whereas Giant cell tumor is seen in adults of 20-40
years.Differential diagnosis in some cases like Retinoblastoma: Coats
disease and Endopthalmitis
• Try to have good contact with residents for help before exam
VIVA
• The teacher will ask you either from General / MSK+Neuro.
Shuffle each day
• Memorize the definition of all basic topics (line to line from
Robbins)
• General pathology :
 Cellular adaptation, Apoptosis, Inflammation, Hypersensitivity,
Autoimmunity, sometimes SLE and HIV.
 Neoplasia is a very important topic for viva, Tumor suppressor gene,
hallmarks, metastasis, paraneoplastic syndromes, etc.
VIVA
• Neuro:
 Classification & Morphology of CNS tumors, Grading (I-IV) , Drop Metastasis
 Types of meningitis with CSF picture
 Stroke/Cerebrovascular Disease, Alzeimer’s vs Parkinsons, Aneursyms
 Guillian Barre Syndrome
 Less asked from Ear, Eye

• MSK:
 Muscular Dystrophy, Paget’s Disease, Rickets
 Osteo sarcoma and classifications of bone tumors
 Ewing vs Giant Cell Tumors, Examples of Small Blue Round Cell Tumors
 Skin tumors, Soft tissue tumors: Classification, Morphology
PHARMACOLOGY
Pharmacology (Marking Scheme)

S.N Particulars Marks

1. Spotter 15

2. Viva - Internal examiner 5

3. Viva – External examiner 5

Total 25
Spotters
• Drugs related – 3 (General, MSK, Neuro): Identify, MOA,
Therapeutic Uses, ADR, Rationale of Combination)

• Graphs – 1 (Efficacy and Potency, types of antagonism, Steady State

Concn)

• Therapeutic Drug Monitoring /Toxicology – 1 (OP poisoning,

Paracetamol poisoning, opioid poisoning, barbiturates poisoning,
etc)
Spotter Drugs
• Atropine
• Aspirin
• Alprazolam
• Lignocaine/ Lidocaine (+ Adrenaline)
• Paracetamol (Suppository)
• Methotrexate
• Ketoconazole
• Chloroquine
Spotter Examples
Spotter Examples
1. Identify the drug? [1]

2. Write 2 indication of the drug? [1]

3. Write specific adverse effect of the drug? [1]

4. Mechanism of action? [2]

Toxicology
and TDM

Drug Normal Range

(μg/mL)
Phenytoin 10-20

Phenobarbitone 15-40

Paracetamol 10-20

Carbamazepine 4-12
VIVA Questions
• General:
 Topics generally not asked in theory exams are of special
importance:
o Anti-Malarial, Anti-Viral, Anti-neoplastic, Anti-filariral
o Chelating Agents
 Basics of pharmacokinetics & dynamics, ADR, Routes, TDM,
Bioavailability, etc.
•MSK: DMARDs, 2nd gen vs 1st gen Anti-histaminics, NSAIDs
•Neuro:
 Cholinergic, Adrenergic, And their antagonists
 Anti- Psychotics , Anti-epileptic, Anti-parkinsonian, Extra-
BIOCHEMISTRY
Biochemistry (Marking Scheme)

S.N Particulars Marks

OSPE
1. 10
(Objective Structured Practical Examination)
3. Viva - Internal examiner 5

4. Viva – External examiner 5

5. Biochemistry file and practical 5

Total 25
OSPE
• Read all the clinical cases of the file given to you by the
Biochemistry department (15 questions)
• Practice MCQs from Vasudevan
• Most Questions are repeated, so consult with your friends.
• Structures of different compounds are asked: Prostaglandins,
• Most of the questions come from the handouts given to you by the
department.
OSPE Demo Questions
Q. The product of glycolysis in erythrocytes is
1. Lactate
2. NADPH
3. Pyruvate
4. CO2
OSPE Demo Questions
Q. Amino acid with hydroxyl group:
1. Valine
2. Leucine
3. Threonine
4. Histidine
OSPE Demo Questions
Q. Enzyme substrate complex breaks down to products and
enzyme is regenerated. Which of following equation is correct?
1. E + S = ES = Product
2. E + S = ES = E + Product
3. E + S = ES = S + Product
4. E + S = ES = S = Product
VIVA
• Both internal and external teachers will be evaluating you
simultaneously.

• They will ask you basic questions, especially from the questions in
OSPE.

• 2 students at a time in our case

• Don’t worry, just have a surface revision of all topics in 1st year.
Practical & Practical File
• Free marks (You don’t need to do practical yourself, residents are
there for you.)
• Just memorize the principles and clinical aspects of protein and
glucose estimation.
MICROBIOLOGY
Microbiology (Marking Scheme)

S.N Particulars Marks

1. Spotter 10
Viva - Internal examiner+Microbiology
3. 5
File
4. Viva – External examiner 5
5. Gram staining 5
Total 25
Spotters
• Culture media
• Biochemical tests (Oxidase, Catalase, TSI, SIM, Urea Hydrolysis,
Citrate utilization)
• Instruments (Autoclave, Inoculating loop and wire, Candle jar,
Incubator, Hot air oven, Water Bath, Centrifuge, Spirit Lamp vs
Bunsen Burner, Diamond pencil)
• RDT kit and its principle
• Bacteriophage
• Microscope (Gram staining, AFB)
• LPCB, KOH mount, India Ink
VIVA
• Internal:
 Importance of Gram Staining, Principle, Procedure, Modified
gram staining techniques like Jensen modification, Brown and
Brenn modification, etc.
 Mostly you’ll be asked about General Microbiology.
 Refer to Page, 14 and 15, Apurva Shastry, 3rd edition: for table
of Gram positive and Negative Organisms
• External: Anything, Mistakes in Spotter, Use of biochemical tests.
• Discuss questions you mistook after exiting the spotter exam hall.
Gram Staining
• Identify whether the bacteria is gram-positive or negative, bacilli
or cocci.
• The next question will be about a list of Gram-positive or negative
bacteria. (sure question)
• Take H&E pencil with you
• Label correctly: Don’t write –ve and +ve, underline
• Bacilli in chain or cluster, see the cocci not surrounding
• Wash your hands and properly dispose the slides, before you leave
the exam hall
Experience Sharing
Thank YOU!
Chill GUYS! Pass To ho hi Jaoge😉