Medical care: elitism or social commitment?

Abstract

As a director of a family medicine programme at the American University of Beirut Medical Center, Beirut, I have to make sure that residents receive proper training. The programme I work on is based in a tertiary care hospital. This has its pluses and minuses. Our paediatrics load is minimal, and the number of deliveries requested by the Accreditation Committee for Graduate Medical Education in the US is difficult if not impossible to attain in my setting. Having a satellite clinic in a marginalised community may overcome these barriers. With the help of a resident, I identified a non-governmental organisation (NGO) that runs a clinic in Sabra Camp in Beirut. After listening to a presentation by a doctor who worked in that clinic I visited the place. The road to the clinic is narrow and barely allows the passage of two cars. This puts the cars of residents and faculty at risk of accidents. If an accident happens, neither the NGO nor the institution we work in will cover that. One of our faculty members was against sending our residents to this clinic as it will give an impression that family medicine is a specialty for the poor! After reviewing the website of the NGO, I realised that occasionally there are armed clashes between two clans in the area, which puts the residents and me in danger. In this situation lives are at risk. Why then send the residents to this set-up? My visit included the clinic and the ‘houses’ of three families in the community. The clinic consisted of three rooms, a kitchen, one bathroom, and a terrace. The doctor's room occupied less than 9m2 area; but it serves the purpose. The other two rooms were bigger and are around 12m2 each. One room is used to …