International primary care snapshots: Nigeria and Poland.

Abstract

Doctors have been working as generalists in primary care in Africa and Nigeria, and in rural hospitals without any further training, since the start of the 19th century.1 In Nigeria, postgraduate training in family medicine (previously known as general medical practice) began in 1981,1 although the Medical and Dental Council of Nigeria recognised it as a specialty when it established postgraduate medical training in the 1970s.2 Its popularity among young medical graduates has steadily risen since then to its present status where it is now the preferred specialty of choice in postgraduate residency training in Nigeria. Its graduates, Fellows of the Specialty in Nigeria, now number 313, and hold the same status as other specialists in terms of remuneration, career path, and privileges.3 Many Nigerians also hold the West African version of the degree from the West African College of Physicians.4 These fellows are distributed in all generalist settings, serving as consultant family physicians in general hospitals, university teaching hospitals, federal medical centres (tertiary hospitals), voluntary agency (mission) hospitals, and general practices. Due to their broad training, they also fill in for surgeons, obstetricians, internal medicine specialists, and paediatricians when there are shortages in general hospitals and federal medical centres, as well as fulfilling their generalist roles.4 GPs, under the aegis of the Association of General and Private Medical Practitioners of Nigeria, are being encouraged to take the Diploma in Family Medicine course, run by the Faculty of Family Medicine (FFM) of the National Postgraduate Medical College (NPMC), so as to mainstream them into the family medicine movement.4 Although Nigeria has a strong culture of medical research in family …