Family Medicine

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Conclusion World Book of Family Medicine – European Edition 2015 UME curriculum should be composed of topics predominantly related to primary and thus preventive health care services. However, it takes time for this fact to become a reality in its application within the UME. Over the last 40 years, there has been an extended gap in the discipline, and the recent developments and improvements are promising for the future. We believe that the WONCA working parties (http://www.globalfamilydoctor.com/groups.aspx) have contributed much to this success. Of special value are the activities of EURACT (www.euract.eu/) and EGPRN (www.egprn.org). Improvements are especially remarkable in the number of academic departments and staff. However, most of the contributions so far are via lecturing and interactive teaching inside the medical school facilities. Family medicine is a comparatively new medical speciality, but it is probably the oldest medical discipline. Hence, there is still a long way to go to involve clinical family practice in UME. Take Home Messages Although most medical graduates practice in primary care, most of the training is based in hospital settings. Even in the earliest documents of family medicine it was suggested that family medicine should be included in undergraduate medical education. Today almost 90% of European universities have a GP / FM curriculum, the duration of clinical rotations ranging from 1-12 weeks. Being a relatively new medical speciality, but probably the oldest medical discipline, family medicine should play a much greater part in undergraduate medical education. We suggest family medicine play a part in all preclinical phases plus the internship period of the undergraduate medical education. Original Abstract http://www.woncaeurope.org/content/63-role-family-practice-undergraduate-medical-education-experiences-trakya-university References Allen J, Gay B, Crebolder H, Heyrman J, Svab I, Ram P. The European Definition of General Practice/Family Medicine. Barcelona: 2011. Starfield B. Is primary care essential? The Lancet. 1994;344(8930):1129-33. Aktürk Z, Dağdeviren N, Şahin EM, Özer C, editors. The Role Of Family Practice in Undergraduate Medical Education - Experiences at Trakya University Medical Faculty. The 2001 Conference of the European Society of General Practice/Family Medicine; 2001; Tampere. Haviland JW. Implementing the Report of the Citizens Commission on Graduate Medical Education. Jama. 1969 Dec 8;210(10):1902-5. PubMed PMID: 4390945. Wright HJ. The contribution of general practice to undergraduate medical education. The Journal of the Royal College of General Practitioners. 1973 Aug;23(133):531-8. PubMed PMID: 4785745. Pubmed Central PMCID: 2157174. Brekke M, Carelli F, Zarbailov N, Javashvili G, Wilm S, Timonen M, et al. Undergraduate medical education in general practice/family medicine throughout Europe - a descriptive study. BMC medical education. 2013;13:157. PubMed PMID: 24289459. Pubmed Central PMCID: 4220558. Ünlüoğlu İ. Aile hekimliği disiplininde akademik yükselmeler ve doçentlik sınavları. Turkish Journal of Family Practice. 2013;17(3):137-41. Saultz J. Around the kitchen table. Family medicine. 2014 Jan;46(1):61-3. PubMed PMID: 24415512. 24
World Book of Family Medicine – European Edition 2015 Jessica Watson, MBChB, DRCOG, DCH, DFSRH Jessica.Watson@bristol.ac.uk 6 – Developing National Curricula for the Education and Training of Family Doctors Dr Jessica Watson, MBChB, DRCOG, DCH, DFSRH Academic Clinical Fellow School of Social and Community Medicine University of Bristol As a GP trainee, I sometimes feel like an endangered species. Many of my peers from medical school have chosen hospital specialties, and non-medical friends find it hard to understand that I have chosen to be ‘just a GP’. Across Europe the proportion of doctors who train as specialists is rising (1). In the press General Practitioners face regular denigration, even from some specialist colleagues in hospital who have warned that ‘GPs are part of the NHS’s problem, not the solution’ (2). Yet the evidence suggests the opposite, that countries with strong primary care infrastructures have healthier populations, reduced health inequalities and greater cost-effectiveness (Starfield et al 2005). As a result, in 2008 Iona Health called for ‘A GP for every person in the world’ (3, 4). Yet before this can be achieved we need high quality general practice training schemes for every country in the world. Currently, even in Europe, general practice training varies considerably, and not all countries require a qualification in family medicine to work as a family doctor (4). In order to achieve improved training in family medicine for all, we should be looking at what already works, in countries with well-established training, using an evidencebased approach. WONCA provides an ideal forum for sharing innovation, knowledge and experience and at the annual Vasco da Gama preconference for new and future GPs, the topic of training is regularly discussed. Enthusiasts debate the relative merits and disadvantages of their countries’ training systems, highlighting areas for improvement. How can this shared learning and communal knowledge be captured, drawn out and used to benefit training throughout and beyond Europe? Various initiatives to compare training schemes in Europe have grown already from WONCA conferences. One initiative from EURACT was to develop a dynamic interactive database with information enabling comparisons between training schemes throughout Europe (2). Another approach which grew from the grassroot enthusiasm of trainees themselves was to create a motivation and satisfaction questionnaire, with the aim of exploring differences in motivation, satisfaction and workload across these very different vocational training schemes of Europe (5). Results showed high levels of satisfaction amongst family medicine trainees, and demonstrated that ‘positive’ motivators such as ‘challenging medically broad discipline’ are the main reasons for a career choice in family medicine. ‘Negative’ motivators such as ‘it remained after I ruled out other options’, ‘non availability of another specialty training’ and ‘did not get specialty training because of my grades’ were chosen by a minority, challenging some negative preconceptions of family medicine. Other more formal work arising from WONCA Europe has been highly influential in the development of family medicine training, such as the European Definition of Family Medicine (5), which describes the core competencies of family doctors. This 25
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Family Medicine

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