Abstract

BackgroundThe practice of family medicine is not well established in many developing countries including Sri Lanka. The Sri Lankan Government funds and runs the health facilities which cater to the health needs of a majority of the population. Services of a first contact doctor delivered by full time, vocationally trained, Family Physicians is generally overshadowed by outpatient departments of the government hospitals and after hours private practice by the government sector doctors and specialists. This process has changed the concept of the provision of comprehensive primary and continuing care for entire families, which in an ideal situation, should addresses psychosocial problems as well and deliver coordinated health care services in a society. Therefore there is a compelling need to teach Family Medicine concepts to undergraduates in all medical faculties.DiscussionA similar situation prevails in many countries in the region. Faculty of Medicine Peradeniya embarked on teaching family medicine concepts even before a department of Family Medicine was established. The faculty has recognized CanMed Family Medicine concepts as the guiding principles where being an expert, communicator, collaborator, advocate, manager and professional is considered as core competencies of a doctor. These concepts created the basis to evaluate the existing family medicine curriculum , and the adequacy of teaching knowledge and skills, related to family medicine has been confirmed. However inadequacies of teaching related to communication, collaboration, management, advocacy and professionalism were recognized. Importance of inculcating patient centred attitudes and empathy in patient care was highlighted. Adopting evaluation tools like Patient Practitioner Orientation Scale and Jefferson’s Scale of Empathy was established. Consensus has been developed among all the departments to improve their teaching programmes in order to establish a system of teaching family medicine concepts among students which would lead them to be good Family Physicians in the future.SummaryTeaching Family Medicine concepts could be initiated even before establishing departments of family medicine in medical faculties and establishing the practice of family medicine in society. Family medicine competencies could be inculcated among graduates while promoting the establishment of the proper practice of Family Medicine in the society.

Highlights

  • The background situation of the country relevant to practice and teaching Family Medicine was evaluated based on available documents

  • Teaching Family Medicine demands teaching competencies expected by the society that extend beyond teaching facts and skills

  • Teaching family medicine concepts to all the graduates is an imperative need of society

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Summary

Discussion

Teaching Family Medicine demands teaching competencies expected by the society that extend beyond teaching facts and skills. Patient centred history-taking emphasis asking open-ended questions and effective listening to accommodate total stories and perspectives of patients This practice could be established by teaching training as well as by introducing a structured feedback from peer students and patients. Even without such positions doctors in our society become advocates of health care policies automatically Their role as advocates extends beyond individual patients and families. They get involved in schools, temples and the entire society enabling them to make a major contribution in health promotion and integrating health care with society These aspects of advocacy skills could be sharpened during the undergraduate curriculum so that they become effective and useful to the society. Skills as a scholar and a researcher in the society A doctor needs to be a scholar and demonstrate lifelong commitment to reflective learning They should contribute to dissemination and application of new knowledge. Establishing family practice in a country needs dedicated evaluation of the current practices and needs of the society [12,36]

Background
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Conclusion
Murtagh JE
10. World Health Organization: The World Health Report 2008
13. CanMEDS Family Medicine
20. Charon R
25. Cowie MR
35. Beaulieu MD
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