Primary care in Asia: a call for compulsory vocational training

Abstract

As there is wide recognition of the unique professional skills of primary care, vocational training for the discipline has evolved from a voluntary process into a mandatory universal standard in many Western countries. However, advanced Asian economies like Japan, Singapore, Taiwan, and Hong Kong have yet to follow suit. In this article, we compare the training requirements of primary care doctors in these four places with that in the Western world, discuss the drawback of the current policy in Asia, and contend that the next generation of primary care doctors should all receive compulsory vocational training for the purpose of certification. Primary health care is mainly delivered by family physicians in the US and GPs in the UK. Medical graduates in the US must complete 3 years of residency in family medicine to become a family physician (a specialist in family medicine). In the UK, medical graduates are required to undertake vocational training for a minimum of 3 years in order to practice as a GP. Elsewhere, the training of family physicians in Canada is similar to that in the US while the training of GPs in Australia resembles the UK system. There is also mandatory postgraduate vocational training for all GPs in most northern European countries.1 However, vocational training is still voluntary for primary care doctors in the following four advanced economies in Asia. In Japan, The Japan Primary Care Association (JPCA) provides 3 years of vocational training for family physicians following 2 years of internship.2 However, training is voluntary and family medicine was not even recognised as a speciality until a new category of general practice was officially created in the Japanese medical system in 2012.3 While the training …