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GPSC Medical Officer Interview - Complete Preparation Guide

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1. NFHS-6 (National Family Health Survey - Round 6)

Key Findings (NFHS-6):

Note for interview: NFHS-6 dropped anaemia and clean cooking fuel indicators - a controversy. Obesity, HTN, diabetes (NCDs) showed significant rise. NFHS-6 signals India's double burden of disease - undernutrition AND overnutrition.

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2. SRS 2024 (Sample Registration System) - Latest Released May 2026

DLHS (District Level Household Survey) - DLHS-5 is the latest round. It covers district-level data on reproductive and child health. Key use: planning at district level.

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3. Fertility Indicators - Complete List

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4. TB - NTEP (National TB Elimination Program)

Renamed:

• RNTCP (Revised National TB Control Program) → NTEP (National TB Elimination Program) since 2020

Treatment Regimens (Updated):

• 2HRZE / 4HR - Standard 6-month regimen
• New: Shorter 4-month regimen (2HPZM/2HPM) for eligible adults (adopted internationally)

• Older: 18-24 months injectable-based
• Updated: Shorter 9-11 month oral regimen (WHO adopted)
• 2022 update: BPaLM regimen - Bedaquiline + Pretomanid + Linezolid + Moxifloxacin (6 months) for MDR-TB
• BPaL without Moxifloxacin for XDR-TB

• High-risk contacts: 3HP (3 months weekly Isoniazid + Rifapentine) OR 6H (6 months daily Isoniazid)
• Contraindications: Active TB, acute/chronic hepatitis, heavy alcohol, peripheral neuropathy

NIKSHAY POSHAN YOJANA (NPY):

• Applicable: All cases notified after 1st April 2018
• Patient incentive: Rs. 500/month per patient till completion of treatment
• Provider/Supporter incentives:
  • New case: Rs. 1000 at completion
  • Previously treated: Rs. 1500 at completion
  • DR-TB intensive phase completion: Rs. 2000
  • DR-TB full treatment completion: Rs. 3000
• Mode: Direct Benefit Transfer (DBT) to patient's bank account via Nikshay portal

Other NTEP Schemes:

• Ni-kshay: Digital case notification portal
• PMTBMF (PM TB Mukt Bharat): Ni-kshay Mitra - adopt TB patients, provide nutritional support
• Ni-kshay Mitra initiative: Community/corporate/individuals adopt TB patients

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5. Malaria - Updated Strategy

Treatment Protocol (India 2024):

• Universal bed net (LLIN - Long Lasting Insecticidal Nets) distribution in high-burden areas
• IRS (Indoor Residual Spraying)
• ABER (Annual Blood Examination Rate) target: >10%
• API (Annual Parasite Incidence) - monitoring tool

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6. Leprosy - Updated Protocol

Treatment (MDT - Multi Drug Therapy):

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7. Disaster Management Steps

Phases of Disaster Management:

1. Mitigation - Reducing risk (structural, non-structural measures)
2. Preparedness - Training, stockpiling, mock drills, EOC setup
3. Response - Immediate action during disaster
4. Recovery/Rehabilitation - Restoration and rebuilding

Epidemic/Outbreak Response Steps (Medical Officer Role):

1. Detection - Identify unusual cluster of cases (surveillance)
2. Reporting - Report to CMO/District level within 24 hours; Integrated Disease Surveillance Programme (IDSP) - P (provisional), L (laboratory), S (syndromic) data forms
3. Verification - Confirm diagnosis
4. Risk assessment - Assess magnitude, at-risk population
5. Investigation - Epidemiological investigation (line list, case definition)
6. Containment - Isolation, quarantine, treatment
7. Prevention - Vaccination, vector control, safe water/food
8. Communication - Risk communication, IEC/BCC
9. Evaluation - Review and lessons learned

IDSP - Integrated Disease Surveillance Programme:

• Weekly reporting via S (Syndromic), P (Probable/Provisional), L (Laboratory confirmed) forms
• Sentinel surveillance for epidemic-prone diseases
• IHIP (Integrated Health Information Platform) - digital upgrade of IDSP

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8. Pulse Polio Programme

Key Features:

• NID (National Immunization Days): Usually January and February
• SNID (Sub-National Immunization Days): High-risk states
• Booth days + House-to-house rounds for missed children
• Target: Children 0-5 years
• Vaccine: OPV (Oral Polio Vaccine) - 2 drops
• IPV (Inactivated Polio Vaccine) added to routine immunization at 6 and 14 weeks (2015 onwards)
• bOPV (Bivalent OPV - type 1 and 3) replaced tOPV after type 2 eradication globally
• Supervisory zones: Booth zone, transit zone (railway stations, bus stands), mobile teams

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9. E-Mamta Card (Gujarat Specific)

Key Features:

• Unique ID for every pregnant woman and child
• Tracks ANC visits (minimum 4 ANCs as per MCP card)
• Immunization schedule tracking
• Beneficiary registration by ANM/ASHA
• Linked with RCH (Reproductive and Child Health) portal
• Generates alerts for missed services
• Mamta Divas: Fixed day health services (FDS) at sub-center/AWC
• E-Mamta card carries: Name, age, EDD, ANC status, immunization record, high-risk flags

For Gujarat GPSC: E-Mamta is the state's digital mother and child tracking platform integrated with national MCTS portal.

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10. BPL / APL Guidelines

Health Benefits for BPL:

• Free treatment in government hospitals
• PMJAY (Ayushman Bharat): Rs. 5 lakh/year insurance for BPL + PM-JAY beneficiaries
• Free drugs under AMRIT/Jan Aushadhi
• Free diagnostics
• Free ambulance (108 and 102 services)
• Subsidized JSY (Janani Suraksha Yojana) benefits (higher for BPL in low-performing states)

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11. Sub-Center, PHC, CHC - Staff & Functions

Sub-Center (SC):

• 1 ANM (Auxiliary Nurse Midwife) - Key functionary
• 1 Male Health Worker (MPW-M) / MHW
• 1 Lady Health Worker (LHW) in some areas
• Part-time Medical Officer (for some upgraded SCs)

• MCH services (ANC, PNC, immunization)
• Family planning counselling and services
• Nutrition and IYCF counselling
• Basic first aid
• Health education
• Disease surveillance reporting
• Distribution of ORS, iron, folic acid, OCP pills
• Referral of complicated cases

Primary Health Center (PHC):

• 1 Medical Officer (MBBS) - in-charge
• 1 Pharmacist
• 1 Staff Nurse
• 1 Lab Technician
• 1 ANM (Lady Health Visitor/LHV)
• 1 Health Assistant (Male and Female)
• 1 Peon/Ward boy
• Driver for ambulance

• OPD (4 days/week minimum)
• Antenatal, natal, postnatal care
• Immunization
• Emergency care (first contact)
• Referral services
• Lab services (basic)
• Health education and IEC
• Disease surveillance
• School health
• Nutrition programmes
• Family planning services (including IUD insertion)

Community Health Center (CHC):

• 4 Medical Specialists (Medicine, Surgery, OBG, Pediatrics)
• Anesthesiologist
• Dental Surgeon
• 9 Nurses/Staff Nurses
• Radiographer, Pharmacist, Lab Technician
• OT staff, support staff

• 30-bedded hospital
• Emergency obstetric care (EmOC - Comprehensive)
• Surgical services (C-section, appendectomy)
• Specialist OPD
• Blood storage unit
• Newborn Stabilization Unit (NBSU) - Level II SNCU
• Referral for complex cases to District Hospital

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12. Mission Sickle Cell Anaemia Elimination 2047

Objectives:

1. Universal screening of 0-40 years population in tribal and high-prevalence areas
2. Genetic counselling and premarital/preconception counselling
3. Comprehensive management of SCD patients
4. Capacity building of healthcare workers
5. Awareness generation at community level

Target:

• Screen 7 crore people in 3.5 years
• Priority: Tribal population (India has 8.6% tribal = 67.8 million people)

Screening Tools:

• HPLC (High Performance Liquid Chromatography) - gold standard
• Solubility test (Sickling test) - screening
• Electrophoresis - confirmatory

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13. Sickle Cell Disease (SCD) - Clinical Details

What is SCD?

• Autosomal recessive genetic disorder
• Mutation: Glutamic acid → Valine at position 6 of beta-globin chain (HbS)
• HbSS = Sickle Cell Disease (homozygous)
• HbAS = Sickle Cell Trait (heterozygous carrier)

Pathophysiology:

• HbS polymerizes under low oxygen → red cells become sickle-shaped → vaso-occlusion, hemolysis

Clinical Features:

• Vaso-occlusive crisis (pain crisis) - most common
• Acute Chest Syndrome
• Stroke
• Splenic sequestration (children)
• Avascular necrosis (hip, shoulder)
• Chronic hemolytic anemia
• Growth retardation
• Repeated infections (Salmonella osteomyelitis common)
• Organ damage: lungs, kidneys, heart, liver, eyes, brain

Sickle Cell Trait (SCT):

• HbAS - carrier state
• Usually asymptomatic
• Mild sickling under extreme hypoxia, dehydration, high altitude
• Hematuria can occur (papillary necrosis)

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14. Who Can Marry with Sickle Cell?

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15. NRC Guidelines for SAM (Severe Acute Malnutrition)

SAM Criteria (WHO/IAP):

• Weight-for-Height < -3 SD (Z score) OR
• MUAC (Mid-Upper Arm Circumference) < 11.5 cm (children 6-59 months) OR
• Bilateral pitting edema (kwashiorkor)

NRC Admission Criteria:

• SAM with medical complication OR
• SAM infant < 6 months (with mother) OR
• Failed RUTF (Ready-to-Use Therapeutic Food) appetite test

NRC Protocol:

• Treat/prevent hypoglycemia: 10% dextrose 5 ml/kg or sugar water
• Treat/prevent hypothermia: Kangaroo care, warm environment
• Treat/prevent dehydration: ReSoMal (Rehydration Solution for Malnourished) - not ORS
• Correct electrolytes: K+, Mg2+, Phosphate (no Na+ initially - sodium overload risk)
• Treat/prevent infections: Broad spectrum antibiotics (Amoxicillin + Gentamicin)
• Start cautious feeding: F-75 formula (75 kcal/100ml)
• Treat micronutrient deficiencies (NO iron in Phase 1)

• Transition to F-100 (100 kcal/100ml) or RUTF
• Sensory stimulation and play therapy
• Maternal education
• Iron supplementation starts in Phase 2
• Target: Weight gain > 8 g/kg/day

• MUAC ≥ 12.5 cm OR W/H ≥ -2 SD
• No edema for 2 weeks
• Eating well, immunized

• Peanut-based paste, 500 kcal/sachet
• Given at home for uncomplicated SAM (Community-based management)

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16. Handwashing - WHO 7 Steps

1. Wet hands and apply soap
2. Palm to palm - rub hands together
3. Right palm over left dorsum with interlaced fingers, then vice versa
4. Palm to palm with fingers interlaced
5. Backs of fingers to opposing palms with fingers interlocked (interlocked fingers)
6. Rotational rubbing of left thumb clasped in right palm and vice versa
7. Rotational rubbing backwards and forwards with clasped fingers of right hand in left palm and vice versa

1. Before touching patient
2. Before clean/aseptic procedure
3. After body fluid exposure risk
4. After touching patient
5. After touching patient surroundings

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17. STD Kit - Updated Color Coding

Syndromic Case Management (SCM) approach - treat based on syndrome without waiting for lab confirmation to prevent loss to follow-up.

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18. PCOS - New Name

PMOS - Polyendocrine Metabolic Ovarian Syndrome

• PCOS was a misnomer - not all women have polycystic ovaries
• Not primarily a gynecological disorder
• It is a multisystem condition involving:
  • Endocrine dysfunction
  • Metabolic syndrome (insulin resistance, diabetes risk)
  • Reproductive issues
  • Dermatological (hirsutism, acne)
  • Psychological health (depression, anxiety)
• Affects 170 million+ women worldwide
• New name reflects the true pathophysiology better
• International disease classification systems (ICD) to be updated accordingly

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19. Contraception - Types in Detail

A. Temporary Methods:

• Male condom - OTC, protects against STIs, 85-98% effective
• Female condom - Femidom, 79-95%
• Diaphragm - with spermicide, 88-94%
• Cervical cap
• Spermicide alone - 72-82%

• OCP (Combined Oral Contraceptive Pills) - Ethinylestradiol + Progestin; 91-99%; Contraindicated in DVT, hypertension, smoking >35 yrs, migraine with aura
• POP (Progestin-Only Pill/Mini Pill) - Safe in breastfeeding mothers
• DMPA (Depo-Provera) - 150mg IM every 3 months; causes amenorrhea
• Implants (Implanon) - Etonogestrel subdermal; 3 years; >99%
• Hormonal IUD (LNG-IUS/Mirena) - 5 years; reduces menstrual blood loss
• Emergency Contraceptive Pill (ECP): Levonorgestrel 1.5mg within 72 hours (better within 24 hrs); also called "i-pill"
• Combined ECP (Yuzpe method): Less used now

• Cu-T 380A - 10 years; free under govt program
• Cu-T 375 - 5 years; most commonly inserted in PHC/CHC
• Postpartum IUCD (PPIUCD) - inserted within 48 hours of delivery (govt incentive: ASHA gets Rs. 150 per insertion)

• LAM (Lactational Amenorrhoea Method) - 6 months PP, exclusive breastfeeding, amenorrhea = 98% effective
• Calendar/Rhythm method
• Billings ovulation method (cervical mucus)
• Safe days (Standard Days Method)
• Coitus interruptus (withdrawal) - least effective

B. Permanent Methods:

• Tubectomy (Female Sterilization):
  • Minilap (mini laparotomy) - most common in India
  • Laparoscopic sterilization
  • Timing: Interval, Postpartum (within 7 days), Post-abortion
  • Incentive (govt): Rs. 1400 (BPL) in accredited facilities
• Vasectomy (Male Sterilization):
  • NSV (No-Scalpel Vasectomy) - preferred
  • Simpler, safer, cheaper than tubectomy
  • Incentive: Rs. 1100 (BPL)

Mission Parivar Vikas:

• High fertility states (UP, Bihar, MP, Rajasthan, Jharkhand, Chhattisgarh, Assam)
• Free sterilization, PPIUCD, target FP

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20. Neonatal Resuscitation - IMNCI/NRP Protocol

India follows: FBNC (Facility Based Newborn Care) + ENBC (Essential Newborn Care)

Steps (IMNCI/NRP - 2025 Updated AHA/AAP 9th Edition):

• Prepare warm surface, dry towels, suction device, bag-mask (T-piece preferred), oxygen source

• Full-term? Tone? Breathing or crying?
  • YES to all three → Routine care (warm, dry, skin-to-skin)
  • NO → Start resuscitation

• Warm, dry, stimulate (rub back or flick soles)
• Clear airway if necessary (bulb suction - only if secretions visible)
• Delayed cord clamping: ≥60 seconds (2025 guideline - key update)

• Breathing/crying?
• Heart rate (use ECG or pulse oximetry - more accurate than auscultation)
• Color (less important now - SpO2 is preferred)
• If HR < 100 or apneic → PPV

• Rate: 40-60 breaths/min
• Start with room air (21%) for term infants (key change from older guidelines)
• Mask ventilation with T-piece or self-inflating bag
• MR SOPA (Mask adjustment, Reposition airway, Suction, Open mouth, Pressure increase, Alternative airway) if chest not rising

• If HR < 60 after 30 sec of effective PPV
• 2-thumb encircling method (preferred) OR 2-finger method
• Ratio: 3:1 compressions to ventilation (90 compressions + 30 breaths = 120 events/min)
• Switch to 100% oxygen when starting compressions

• Adrenaline (Epinephrine):
  • IV (preferred): 0.01-0.03 mg/kg (1:10,000 solution)
  • ETT (if no IV): 0.05-0.1 mg/kg (1:10,000)
  • Can repeat every 3-5 min if HR remains < 60
• Volume expansion: Normal saline 10 ml/kg IV if hypovolemia suspected

Thermoregulation (key for neonates):

• Delivery room temperature: 25-26°C
• Plastic wrap/bag for preterm < 32 weeks
• Warmer/radiant heat source

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Quick Revision Points for Interview

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Interview tip for tribal/Gujarat posting: Emphasize your knowledge of Mission Sickle Cell Elimination 2047, the role of E-Mamta in Gujarat, NVBDCP for malaria in tribal areas, and community-level nutrition rehabilitation through NRC. These are highly relevant to your posting context and show practical awareness.