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Key Facts: PGIM MD Community Medicine Exam

2

Structured essay questions

1 hour

Paper duration

45% / 50%

Per-question minimum / aggregate

Rs. 76.5k

Full fee (state sector)

The PGIM Selection Examination in MD (Community Medicine) is a single one-hour written paper of two structured essay questions, open only to doctors who have passed the MSc (Community Medicine). A candidate needs at least 45% for each question and a 50% aggregate.

Sample PGIM MD Community Medicine Practice Questions

Try these sample questions to review concepts for the PGIM MD Community Medicine exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A public health epidemiologist conducts a 5-year prospective cohort study among 1,000 estate workers in Nuwara Eliya to quantify the risk of occupational chronic obstructive pulmonary disease (COPD). At baseline, all subjects are free of COPD. During follow-up, 100 individuals develop COPD at an average of 2.5 years of observation, 200 workers migrate away and are lost to follow-up at an average of 2 years, and the remaining 700 subjects complete the entire 5 years disease-free. What is the incidence density (incidence rate) of COPD in this cohort?
A.20.0 cases per 1,000 person-years
B.24.1 cases per 1,000 person-years
C.25.0 cases per 1,000 person-years
D.100.0 cases per 1,000 person-years
Explanation: Incidence density is calculated as the number of new incident cases divided by the total person-time at risk contributed by all cohort members. The total person-time is: (100 cases × 2.5 years = 250 person-years) + (200 lost to follow-up × 2 years = 400 person-years) + (700 disease-free completers × 5 years = 3,500 person-years) = 4,150 person-years. Dividing 100 incident cases by 4,150 person-years gives 0.024096, which corresponds to 24.1 cases per 1,000 person-years.
2An epidemiologist is evaluating all-cause mortality in an industrial gem-mining division in Rathnapura with a small population of 12,000 residents. The age-specific death rates within individual age strata in this district have very small counts, resulting in unstable local rates. Which method of standardization is most appropriate to compare the mortality of this division with the national Sri Lankan population, and how is its primary summary metric interpreted?
A.Direct standardization; interpreted as the Comparative Mortality Figure
B.Indirect standardization; interpreted as the Standardized Mortality Ratio (SMR)
C.Direct standardization; interpreted as the Crude Death Rate ratio
D.Indirect standardization; interpreted as the Proportional Mortality Ratio
Explanation: Indirect standardization is the method of choice when the study population is small or age-specific rates within individual local strata are unavailable or statistically unstable due to small numbers of events. By applying stable national age-specific mortality rates to the local age-stratified population structure, one calculates the 'expected' deaths and determines the Standardized Mortality Ratio (SMR = Observed deaths / Expected deaths).
3During a seasonal surge of leptospirosis among paddy farmers in the Western Province, a Medical Officer of Health (MOH) notes 240 confirmed cases and 18 deaths over a 3-month period in a divisional population of 150,000. Which of the following statements correctly distinguishes the case fatality rate (CFR) from the disease-specific mortality rate in this scenario?
A.The CFR is 7.5% and reflects disease severity/virulence, while the mortality rate reflects the population-wide risk of dying from leptospirosis
B.The CFR is 12.0 per 100,000 population and reflects community incidence, while the mortality rate reflects individual prognosis
C.The CFR is 7.5 per 100,000 population and measures transmission velocity, while the mortality rate reflects hospital survival
D.The CFR and mortality rate are mathematically equivalent when calculated over an outbreak period shorter than one year
Explanation: The case fatality rate is the proportion of confirmed cases that die from the disease, calculated here as (18 / 240) × 100 = 7.5%, and directly reflects disease severity, clinical virulence, and patient prognosis. In contrast, the cause-specific mortality rate measures the rate of death in the total population at risk, calculated as (18 / 150,000) = 12 per 100,000 population, reflecting the population-level risk of dying from the condition.
4A hospital-based case-control study is designed at the Teaching Hospital Anuradhapura to explore the association between chronic organophosphate pesticide exposure and chronic kidney disease of uncertain etiology (CKDu). The investigators enroll CKDu patients from the nephrology ward as cases and patients admitted to the cardiology ward with essential hypertension as controls. If hypertension is independently associated with agricultural pesticide exposure, how will this control selection strategy most likely bias the odds ratio?
A.It creates Berkson's bias, spuriously biasing the odds ratio toward the null
B.It causes non-differential misclassification, inflating the odds ratio away from the null
C.It leads to lead-time bias, falsely prolonging apparent disease survival
D.It induces attrition bias, distorting the cumulative risk estimate over time
Explanation: Selecting hospital controls whose admission condition (hypertension) is positively associated with the exposure of interest (pesticides) inflates the exposure prevalence in the control group above that of the source population. This phenomenon is a classic manifestation of Berkson's bias (admission rate bias), which results in an underestimated odds ratio that is biased toward the null value of 1.0.
5In a study investigating the association between betel quid chewing and oral leukoplakia in a rural community, the crude odds ratio (OR) is 3.8. When stratified by concurrent tobacco smoking status, the stratum-specific odds ratio among non-smokers is 1.8 (95% CI: 1.2–2.6) and among active smokers is 6.5 (95% CI: 4.8–8.9). A Woolf's test for homogeneity of odds ratios yields p < 0.001. How should the investigator interpret and report these findings?
A.Smoking is an extraneous confounder; report the pooled Mantel-Haenszel odds ratio of 3.8
B.Smoking is an effect modifier (biological interactor); report stratum-specific odds ratios separately rather than pooling them
C.The variation between strata is attributable to random sampling error; report the crude odds ratio
D.Smoking exhibits negative confounding; adjust for smoking by matching and report a single standardized relative risk
Explanation: Effect modification (interaction) is present when the measure of association between the primary exposure and outcome differs significantly across levels of a third variable. A statistically significant test of homogeneity (p < 0.001) confirms that the effect of betel quid chewing is genuinely heterogeneous between non-smokers (OR = 1.8) and smokers (OR = 6.5); therefore, pooling the data into a single Mantel-Haenszel summary measure obscures meaningful biological synergy and is contraindicated.
6A cluster of acute gastroenteritis cases occurs among guests following a wedding reception in Negombo. An epidemic curve plotted using 2-hour intervals displays a steep upward slope reaching a single sharp peak 14 hours after the banquet, followed by a gradual downward slope with all cases occurring within a 30-hour window. What type of outbreak exposure pattern does this epidemic curve most strongly demonstrate?
A.Point-source (common vehicle) epidemic
B.Propagated person-to-person epidemic
C.Continuous common-source epidemic
D.Intermittent common-source epidemic
Explanation: A point-source epidemic curve is characterized by a rapid, steep rise to a single prominent peak, followed by a more gradual tail-off, with all cases occurring within the span of a single incubation period of the causative organism. This classic unimodal pattern confirms that all individuals were exposed simultaneously to a common vehicle over a brief, well-defined time interval.
7Following the introduction of a primary case of varicella into a semi-closed residential hostel housing 65 unimmunized female adolescents, an outbreak investigation is initiated. Two roommates of the index case had documented prior chickenpox infection in childhood. Over the subsequent incubation period of 10 to 21 days, 31 secondary cases are diagnosed among the remaining hostel residents. What is the secondary attack rate of varicella in this setting?
A.47.7%
B.48.4%
C.50.0%
D.51.7%
Explanation: The secondary attack rate measures the probability of transmission among susceptible contacts exposed to a primary index case. Denominator = Total exposed contacts - (Primary index case + Immune contacts) = 65 - 1 (index case) - 2 (immune residents) = 62 susceptible contacts. The secondary attack rate is therefore (31 secondary cases / 62 susceptible contacts) × 100% = 50.0%.
8A newly developed rapid diagnostic test for scrub typhus has a constant sensitivity of 90% and a specificity of 90%. An epidemiologist applies this test to two distinct populations: Population X (fever hospital inpatient clinic, where scrub typhus prevalence is 30%) and Population Y (community-wide screening in a low-endemic dry zone hamlet, where scrub typhus prevalence is 2%). How will the Positive Predictive Value (PPV) and Negative Predictive Value (NPV) differ between Population X and Population Y?
A.PPV will be substantially higher in Population X, whereas NPV will be higher in Population Y
B.PPV and NPV will remain completely identical across both populations because sensitivity and specificity are fixed
C.PPV will be lower in Population X, whereas NPV will be lower in Population Y
D.PPV will be higher in Population Y, whereas NPV will be higher in Population X
Explanation: Predictive values are heavily dependent on the prior probability (prevalence) of disease in the tested population. In Population X (prevalence 30%), the PPV is approximately 79.4% and NPV is 95.5%; in Population Y (prevalence 2%), the PPV plunges to approximately 15.5% while the NPV rises to 99.8%. Therefore, higher disease prevalence increases PPV, whereas lower disease prevalence increases NPV.
9A national screening programme introduces visual inspection with acetic acid (VIA) for cervical pre-cancer detection among women aged 35 in Sri Lanka. An initial evaluation shows that women diagnosed via VIA have a significantly longer 5-year survival rate from the time of diagnosis compared to women diagnosed clinically after presenting with postcoital bleeding. However, overall cervical cancer mortality rates in the target population remain unchanged. Which screening evaluation bias best accounts for this apparent paradox?
A.Length-time bias
B.Lead-time bias
C.Volunteer (healthy screenee) bias
D.Verification bias
Explanation: Lead-time bias occurs when screening identifies a disease earlier in its natural history without advancing or altering the ultimate date of death. Because the survival clock starts earlier at the point of screening detection rather than clinical symptom onset, survival time appears artificially prolonged even though patient lifespan is entirely unaffected and population mortality remains unchanged.
10In an opportunistic breast cancer screening programme using annual mammography, the screened cohort exhibits an exceptionally high proportion of low-grade, indolent ductal carcinoma in situ (DCIS) with near 100% 10-year survival, while interval cancers occurring between screening rounds are predominantly aggressive, high-grade triple-negative carcinomas with poor survival. What screening phenomenon is demonstrated by this selective over-representation of slow-growing disease?
A.Length-time bias
B.Lead-time bias
C.Berkson's bias
D.Hawthorne effect
Explanation: Length-time bias refers to the overrepresentation of slowly growing or indolent lesions in screening-detected cohorts because such slow-progressing conditions possess a prolonged asymptomatic preclinical phase (sojourn time), giving screening tests a much wider window of opportunity to detect them. In contrast, fast-growing aggressive tumors spend very little time in the preclinical phase and frequently present clinically as interval cancers.

About the PGIM MD Community Medicine Exam

The Selection Examination in MD (Community Medicine) is conducted by the Postgraduate Institute of Medicine, University of Colombo, for medical officers who have passed the MSc (Community Medicine) examination and seek entry to the MD (Community Medicine) training programme leading to board certification in Community Medicine in Sri Lanka. It is set and sat in English under the 2015 Community Medicine Prospectus.

Exam sponsor: Postgraduate Institute of Medicine, University of Colombo. The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Assessment

One written paper of two structured essay questions, one hour in duration, sat after the MSc (Community Medicine) examination. There is no MCQ, OSCE or viva component.

Time Limit

One hour.

Passing Score

A minimum of 45% for each of the two structured essay questions with an aggregate of 50%.

Exam / Certification Fees

Rs. 76,500 for state-sector candidates (Rs. 17,500 registration + Rs. 9,500 application + Rs. 49,500 examination fee). Non-state-sector candidates pay 50% more.

Exam sponsor website

Reported exam pass rate: All successful candidates are eligible to register for the MD training programme in Community Medicine; no numerical intake cap is stated in the circular.. The PGIM publishes merit lists and pass index numbers per sitting rather than percentage pass rates. Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Official sources

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

Structured essay paper

Epidemiology & Outbreak Investigation

Study designs, measures of association and impact, bias and confounding, causal inference, screening evaluation, surveillance systems and outbreak investigation.

Structured essay paper

Biostatistics & Research Methods

Descriptive statistics and distributions, hypothesis testing and error, sample size and sampling design, regression and survival analysis, and interpretation of confidence intervals.

Structured essay paper

Health Policy, Systems & Management

The Sri Lankan health system and devolution, primary health care reorganisation, health financing and economic evaluation, quality improvement, planning tools and health legislation.

Structured essay paper

Maternal, Child, Environmental & Occupational Health

Maternal and child health indicators and the MDSR system, the National Immunisation Programme and cold chain, nutrition, NCD screening, water and sanitation, vector control and occupational health.

Preparing for the PGIM MD Community Medicine Exam

What You Need to Know

  • Passing score: A minimum of 45% for each of the two structured essay questions with an aggregate of 50%.
  • Assessment: One written paper of two structured essay questions, one hour in duration, sat after the MSc (Community Medicine) examination. There is no MCQ, OSCE or viva component.
  • Time limit: One hour.
  • Exam / certification fees: Rs. 76,500 for state-sector candidates (Rs. 17,500 registration + Rs. 9,500 application + Rs. 49,500 examination fee). Non-state-sector candidates pay 50% more. Official sources

Using Our Practice Resources

  • Work through all 100 available questions
  • Review every answer and explanation
  • Track weak areas and revisit them
  • Use our AI tutor for tough concepts

PGIM MD Community Medicine: Suggested Study Strategy

1Master calculations for sensitivity, specificity, positive predictive value, relative risk, odds ratio, and number needed to treat.
2Review the administrative hierarchy of Sri Lanka's healthcare delivery system from the Ministry of Health down to the Medical Officer of Health (MOH) level.
3Thoroughly study the National Immunization Schedule of Sri Lanka and target coverage indicators.
4Understand steps in investigating a food-borne or water-borne disease outbreak in a local community setting.
5Review health policy evaluation frameworks, cost-effectiveness analysis, and maternal mortality surveillance protocols.

Frequently Asked Questions

What is the entry requirement for the PGIM MD Community Medicine selection exam?

Candidates must have successfully completed the MSc in Community Medicine examination conducted by the PGIM, University of Colombo.

What is the format of the PGIM MD Community Medicine selection examination?

A single written paper of two structured essay questions, one hour in duration. There is no MCQ, OSCE or viva component.

What is the passing criterion for the examination?

At least 45% for each of the two structured essay questions, with an aggregate of 50%.

What career pathway does passing this examination lead to?

All candidates who pass the selection examination are eligible to register for the MD (Community Medicine) training programme, which leads to the MD degree of the University of Colombo and, after post-MD training and the Pre-Board Certification Assessment, to board certification in Community Medicine.

How many attempts are allowed for the selection examination?

Under current PGIM general regulations, eligible candidates are allowed up to six attempts.

Are these official PGIM questions?

No. These are independent practice questions authored by OpenExamPrep to assist candidates preparing for the PGIM Community Medicine assessment.

Does this practice bank simulate the official PGIM examination format?

No. The official selection examination is a one-hour structured essay paper, not a multiple-choice test. This is an independent English-language MCQ study bank by OpenExamPrep covering the same public health knowledge base; it is a study aid for recall and applied reasoning, not a format simulation or a substitute for practising extended written answers.