Family Medicine

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World Book of Family Medicine – European Edition 2015 One of the most effective family practice exposures for medical students occurs in the Mini-Fellowship in Family Medicine (MF2) programme; an elective clerkship over one to two weeks (40 or 80 hours). Students see patients under supervision of SOBRAMFA’s faculty and residents in a broad range of family doctors’ private practices. The MF2 started in 2004 and to date, 162 students from 46 different medical schools have participated in the programme. Students learn how to develop communication skills understanding the whole person and the family context; they also learn about continuity of care, solving complicated problems with inpatients, dealing with other physicians and facilitating health professional teams in order to provide better care. Finally, they address selfknowledge as a surprising outcome of the programme. The students gain respect for the specialty and spread this “discovery” to their colleagues. The Family Medicine Miles Programme (5) was created to measure students´ participation in SOBRAMFA activities and in which students are rewarded with grades (miles). The Miles Programme allows an individual assessment of each student, offers balance between theory and practice, provides tutorial guides, and fosters leadership among the students. This “continuous medical education programme” fosters students´ interest in family medicine, and encourages those who will be able to apply for the residency programme currently under development by SOBRAMFA. The Family Medicine Miles Programme is managed by the SOBRAMFA web site, and students can track their own performance, as well as monitor specific guidance in order to improve their training. Training Young Doctors through the Pacemaker Agenda There is a growing diversity of opportunities for family doctors in private practice supported by Insurance Health Companies in São Paulo, Brazil. Patient’s satisfaction, problem-solving while keeping costs low are the real basket of services companies ask for. The practising scenarios in private practice include: Geriatric Care, Managing Complicated Patients with co-morbidities in Hospitals, Palliative Care, Family Medicine Clinics and Ambulatory, Home Visits, Nursing homes and Hospices. For a proper training of young doctors in such variety of practices, in a city with a population of 14 million people (São Paulo), SOBRAMFA has developed an innovative agenda in which several components are incorporated for pursuing excellence and expanding opportunities. This Agenda, required for all trainees and faculty members, has been ongoing for more than a decade and includes: 1. Scientific “pacemaker” - Weekly Scientific Meeting. A two-hour meeting. Case-based discussion, update with articles from the most relevant publications, case-decisions for specific patients supported by Evidence Based Medicine. 2. Construction “pacemaker”- Monthly Meeting, conducted as workshops and to include topics to promote reflective practice: professionalism, medical education, humanism, family medicine core values, personal development, teamwork, and leadership. 3. Cultural monthly Meetings - at dinner time and displayed as a familiar get-together and targeting an openmind scenario, with acknowledged leaders in several fields (Philosophers, Journalists, Educators, Lawyers, Artist and Musicians, Entrepreneurs). 4. Young Doctor Monthly Meeting- case-based discussions lead by medical students and young doctors acting as facilitators, fine-tuning their teaching skills. 5. Mentoring and Evaluation- trainees are evaluated and giving feedback by their respective preceptors. The Main Outcomes of the Pacemaker Agenda Are: 1. Effective Training- Clinical Competence - Trainees develop expertise in doctoring, skills in managing complicated patients and leading health teams. 2. Mastering Communication with patients, families and their peers. 3. Respect, Credibility and Happiness - They are recognized as good physicians by the patients they are caring for, by their peers in the clinical setting, and by the owners of the Insurance Companies. Take Home Messages 180
World Book of Family Medicine – European Edition 2015 Family doctors as role models in the academic undergraduate curriculum are needed to promote FM among medical students. Students exposed to the real practice of a family doctor realize they need family medicine core values to improve their future doctoring. The Mini Fellowship in FM (MF2) and the Family Medicine Miles Programme are two successful initiatives which involve medical students in family medicine through a non-curricular process, allowing for concurrent involvement for students from different medical schools.. The Pacemaker agenda is set for training young family doctors for the wide basket of services and the growing diversity of opportunities in private practice. Original Abstract http://www.woncaeurope.org/content/3434-family-medicine-miles-program-getting-students-involved-where-there-no-familymedicine References 1. Freeman J, Kelly P, Blasco PG, Levites MR. Attitudes about Family Medicine among Brazilian medical students. O Mundo da saúde. 2010;34(3): 336-340. 2. Blasco, PG; Rodnick, JE. Family Medicine in Brazil: Establishing the Specialty. Family Medicine. 2005, 37(9): 668-668 3. Blasco, PG; Levites, MR; Freeman, J; Haq, C. Educating Physicians for the Health of Brazil: The Role of Family Medicine. Wonca News.2004, 30( 3): 13-15. 4. Blasco, PG; Roncoletta AFT; Moreto, G; Benedetto, MAC; Levites, MR; Janaudis MA. SOBRAMFA has promoted family medicine education in Brazil since 1992. Medical Education. 2008, 42:115. 5. Blasco, PG; Levites, MR; Janaudis, MA; Moreto, G; Roncoletta, AFT; Benedetto, MA. ; Pinhero, TRP. Family Medicine Education in Brazil: Challenges, Opportunities, and innovations. Academic Medicine, 2008. 83(7): 684-689 6. Blasco, PG; Roncoletta AFT; Moreto G; Levites, MR; Janaudis MA. Accompanying Physicians in Their Family Practice: A Primary Care Model for Medical Students’ Learning in Brazil. Family Medicine.2006, 38(9): 619-621. 7. Janaudis MA, Levites MR, Roncoletta AFT, Garcia DSO, Moreto G, Benedetto MAC, Pinheiro TRP, Blasco PG. Academic Family Medicine in Brazil. GP-Miles: the Brazilian approach to make medical students enthusiastic for Family Medicine. Primary Care. 2009. v.9, p.280 – 281. 181
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Family Medicine

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