Family Medicine Course Research Articles

'Hold the course(s)!' - a qualitative interview study of the impact of pandemic-triggered contact restrictions on online instruction in community-based family medicine teaching.

The COVID-19 pandemic has been identified as a catalyst for the digitalization of medical education. Less is known about the specific impact of the pandemic on decentralized, community-based education, such as in General Practitioner practices. The aim of this study is to understand the impact of the digital transformation process, triggered by the COVID-19 pandemic. As, family medicine courses involve both university-based and community-based teaching, this study focuses the mode and quality of instruction and instructors in family medicine teaching. A qualitative interview study was conducted. The participants (N = 12) of a multi-perspective Quality Circle in family medicine teaching were interviewed twice: first, in 2019, about digitalization in family medicine teaching in Tübingen, Germany, not yet aware of the global changes and local transformation that would take place shortly thereafter. Second, in a follow-up interview in 2020 about the transition process and digitalization following the impact of contact restrictions during the pandemic. Grounded Theory was used as a qualitative research approach to analyze the complex processes surrounding this transformation. By analyzing the interviews with various stakeholders of community and university-based teaching, a model for the digital transformation process of family medicine teaching at the University of Tübingen in response to an external stimulus (the pandemic) was developed. It involves six chronological steps: "The calm before the storm," "The storm hits," "All hands on deck," "Adrift," "Reset course," and "The silver lining." This model seeks to understand the process of digital transformation and its impact on the teaching institution (medical faculty of the University of Tübingen, Institute for General Practice and Interprofessional Health Care) and instructors from an integrated perspective and thereby critically revisits prior concepts and opinions on the digitalization of medical teaching. Insights gained are presented as key messages.

A Qualitative Study Exploring the Impact of Covid-19 Pandemic on Teaching and Learning of Family Medicine Course among Undergraduates in a Local University in Malaysia

Introduction: The COVID-19 pandemic significantly impacted the global teaching and learning process (TnL). Unfortunately, to date, not many qualitative studies have been published specifically on the impact of COVID-19 on the Family Medicine course, particularly in Malaysia. Hence, this study aimed to explore the impact of COVID-19 pandemic on the teaching and learning experience of undergraduate students undergoing their Family Medicine course at a local university. Methods: A qualitative study using focused group discussion (FGD), was conducted among undergraduate students during the lockdown period. A semi-structured interview guide was used to interview 20 students, in their fifth undergraduate year, undertaking their fourth to fifth week of a total six-week course. They were selected using purposive snowball sampling method. There were four focus group discussions (FGD) with five students in a group. All interviews were audio-taped, transcribed verbatim, and the contents were analysed using the standard content analysis framework. Subsequently, thematic content analysis was conducted, and three major themes were produced. Results: The three major themes were (1) facilitators to learning, (2) barriers to learning, and (3) rooms for improvement. Conclusion: Although COVID-19 pandemic had significant impact on TnL of Family Medicine course among undergraduates, the students remained optimistic and proposed some improvement from their point of view. However, a creative, realistic, effective, and impactful way of TnL, particularly in clinical aspects should be developed and experimented. Technological progress and advancement should permit this idea to be achievable and implemented in near future.

Remodelling family medicine teaching at the University of Lausanne using a modified Delphi method

In the context of implementing a new framework for pre-graduate medical education in Switzerland (PROFILES) and the ongoing reform of the medical curriculum at the Faculty of Biology and Medicine of the University of Lausanne, we set out to determine the priority teaching themes of family medicine and to collect expert opinions about the most appropriate teaching methods for family medicine. Such data would contribute to the production of a coherent family medicine teaching programme encompassing its specificities as well as future challenges facing medicine in general. We mapped the current family medicine courses at the Faculty of Biology and Medicine to obtain an overview of current learning objectives and teaching content priorities. We classified and analysed the lessons using the PROFILES grid and the principles of family medicine described by the World Organization of Family Doctors (WONCA). Then we used a modified Delphi method with a selected panel of experts and two consensus rounds to prioritise objectives for family medicine teaching at the University of Lausanne. After choosing the top objectives/activities for family medicine, subgroups of experts then discussed what would be the best teaching methods for family medicine at the University of Lausanne. The mapping of family medicine teaching at the University of Lausanne showed that current teaching addresses most of the primary topics of family medicine education. The modified Delphi method allowed us to identify priority themes for teaching family medicine at the University of Lausanne: (1) take a medical history and clinical examination; (2) doctor-patient relationship / patient-centred care; (3) clinical reasoning; (4) interprofessional collaboration; (5) care planning/ documentation; (6) shared decision-making; (7) communication; (8) cost-effective care; (9) health promotion; (10) assessment of urgency. The discussion with the experts identified the strengths and weaknesses of the various teaching modalities in family medicine education. Teaching should be structured, coherent and show continuity. Clinical immersion and small group teaching were the preferred teaching modalities. This approach made it possible to create the guidelines for restructuring the family medicine teaching curriculum at the University of Lausanne.

Preceptoria médica: percepções e perspectivas de novos médicos de família no Brasil

Abstract: Introduction: Learning in practical environments consists in an essential component of medical education. In recent decades, medical schools have sought to immerse their students in professional settings since the early years of studying. In these scenarios, the preceptors, more experienced physicians, are responsible for supporting their students in the development of professional knowledge, skills, and attitudes. Objective: This study aimed to analyze the perceptions and perspectives of participants of the Preceptorship Training Course (PTC) in Family Medicine - UNA-SUS about preceptorship and medical education. Methods: The quantitative descriptive study was conducted in two phases: ‘Population Outlining’ phase, including participants’ academic data, and ‘Survey Questionnaire’ phase, performed by applying a questionnaire through a digital platform. Results: The ‘Population Outlining’ identified 2,530 participants in the PTC, with the predominance of females and southeastern residents. The ‘Survey Questionnaire’ phase constituted of 232 respondents, of whom 73.4% reported acknowledging their preceptors’ contributions, and more than 90% expressed interest in teaching activities, valuing their curriculum enhancement and academic acknowledge. Conclusion: Our findings evidenced positive perceptions about preceptorship and a propensity to engage in teaching activities among the participants, reinforcing the importance of debates about qualification, recruiting and retention of preceptors.

Experiência da residência de medicina de família e comunidade no teleatendimento pelo monitora Covid-19

INTRODUÇÃO: a infecção pelo vírus SARS CoV 2 causa a COVID-19, caracterizado por sintomas gripais como tosse, febre, odinofagia, alterações gustativas e olfativas, podendo complicar com pneumonia, síndrome respiratória aguda grave, sepse e eventos trombóticos. Com a transmissão comunitária no Brasil, no final de março, vários serviços não essenciais foram fechados e procedimentos eletivos adiados. A legalização temporária da telemedicina mostrou-se conveniente para as cirscunstâncias das pandemia, permitindo telemonitoramento e teleconsultas, como ocorre no aplicativo Monitora COVID-19. OBJETIVO: relatar as potencialidades desses aplicativo no desenvolvimento de habilidades dos residentes de medicina de família e comunidade no acompanhamento dos casos de síndrome gripal. RELATO DE EXPERIÊNCIA: por meio do processo de trabalho nesse aplicativo, reforçaram-se princípios de integralidade, multidisciplinariedade e o método clínico centrado na pessoa, tão importante para saúde da família. O acompanhamento dos pacientes de maneira integral requereu o conhecimento das subjetividades, da experiência da doença e algumas vezes criação de vínculo. O aperfeiçoamento da habilidade comunicativa e competência cultural foram importantíssimos para boa relação e diálogo com o paciente no aplicativo. CONCLUSÃO: o aplicativo possibilitou a acompanhamento remoto de pacientes com síndrome gripal, orientando autocuidado e encaminhamento resolutivo nos casos graves. O papel da medicina de família e comunidade, seus princípios e práticas mostram-se importantes para aperfeiçoamento das práticas de cuidado nessa ferramenta.

Rocketship and the Rural Health Workforce Revolution in the Pacific: Growing Skilled Medical Generalists Across the "Blue Continent".

Dramatic shifts are occurring in the size, shape and skill of rural health workforces in Pacific island countries (PICs) due to an unprecedented convergence of political agreement, policy commitment, donor support and technical assistance. In particular, the impact of “medical internationalism” is being felt across the Pacific region, with new doctors returning home in far greater numbers than ever before, the majority having graduated from medical schools in Cuba, China and other countries outside the region, in addition to the more typical numbers graduating and returning home from the region's main medical schools in Fiji and Papua New Guinea. With an agreed regional vision of “Healthy Islands” across the Pacific, the main objective of expanding overseas training opportunities for Pacific island medical students has been to correct the widespread centralization and maldistribution of the medical workforce in PICs and improve health access and quality of care in rural areas by deploying the new graduates to outer-island facilities. However, the return of these new graduates in several PICs has demonstrated that additional training is required to equip them with the knowledge and skills necessary to practice safely and sustainably in unsupervised settings. Thus, the development of specific postgraduate programmes has been urgently needed to provide pathways to vocational training and specialization in rural medicine appropriate to the Pacific region. Rocketship Pacific Ltd. (Rocketship) is an international health charity, based in Australia, dedicated to improving health in Pacific island countries through stronger primary care. Rocketship's particular focus to date has been on education and capacity-building for doctors and nurses working in rural communities and outer-island facilities. Since 2015, Rocketship has been working in partnership with the Ministries of Health and other key partners in Solomon Islands, Timor-Leste, Tonga and Vanuatu to design and deliver postgraduate training programmes in the core generalist disciplines family, community and rural hospital medicine. To date, this has resulted in new postgraduate Family Medicine courses being established in Timor-Leste and Tonga; a rural medical workforce support programme being delivered in Vanuatu; and a new Postgraduate Diploma in Rural Generalist Medicine being designed in Solomon Islands. These new programmes, as well as other notable initiatives elsewhere in the Pacific such as the Master of Medicine (Rural) programme in Papua New Guinea, the Diploma and Master of Family Medicine programme in Fiji and the Cook Islands Fellowship in General Practice, are transforming the health workforce in PICs with the potential to benefit island people across the “Blue Continent.” This paper describes the establishment of new postgraduate training programmes in family, community and rural hospital medicine in Timor-Leste, Tonga, Solomon Islands and Vanuatu from the perspective of Rocketship, the non-profit organization engaged by each country's Ministry of Health (or equivalent) to provide expert technical assistance with their initiative.

Teaching family medicine online: the experience in Cyprus.

Cyprus has an underdeveloped primary care system.1 As in many other countries in the Middle East, family medicine has never grown from its roots so the first point of contact for patients remains secondary care doctors, with paediatricians and obstetrician-gynaecologists providing care for their respective groups. Yet those physicians working as family doctors are eager to pursue postgraduate training, gain due accreditation and ultimately raise the contribution of family medicine to the nation’s health care. To meet this demand in the region, the University of Nicosia Medical School launched a postgraduate family medicine course in 2014. It already had experience of teaching an international undergraduate course in English in collaboration with St George’s Hospital Medical School in London and an MD programme developed by the University. Setting up an international academic programme with on-the-job training raised unique challenges. The …

At what stage in the undergraduate curriculum is it best to train in family medicine? A study from two medical schools in Spain

Background: A course in family medicine (FM) could dispel the possibility of negative stereotyping about this speciality, and instil in students a greater interest. However, when is it preferable: at the beginning or at the end of undergraduate training?Objectives: To determine changes in knowledge and attitudes towards FM by medical students completing a course in primary care at the beginning or the end of the undergraduate training and whether those changes anticipate the choice of speciality.Methods: Students from Albacete and Seville medical schools (primary care course in second and sixth years, respectively) were asked to respond to the ‘valuation of attitudes towards and knowledge of family medicine questionnaire’ (CAMF). Students from Albacete answered before and after the course, and in Seville second-year students answered at the end of the first trimester. All students were invited to respond again at the end of their undergraduate training. Afterwards, we investigated the score on the speciality exam (order for the election from highest to lowest score) and their choice of speciality. The outcome measures were the MIR exam score, the number in the ranking, the chosen speciality and the result of the CAMF.Results: In Albacete 88 and 64 and in Seville 50 and 98 students responded in their second and sixth years, respectively. In Albacete, mean CAMF scores were 15.4, 22.7 before and after the course, and 21.8 at the end while in Seville, 13.9 in the second year, and 23.5 in the sixth year. Logistic regression analysis showed an association of the choice of FM only with the score on the speciality exam (OR: 0.667; 95%CI: 0.553–0.806).Conclusion: There were no significant differences between CAMF scores at the end of undergraduate training. Only the score on the speciality exam predicts FM choice: the higher the score, the lower the probability of choosing FM.

Deficits in history taking skills among final year medical students in a family medicine course: A study from KSA.

ObjectivesHistory taking is considered an important diagnostic tool in medicine. Medical students should be competent in focused history-taking skills to reach initial diagnosis. The aim of this study was to identify deficits in history-taking skills among final year medical students in family medicine courses in Qassim University, KSA.MethodsAll objective structured clinical examination (OSCE) sheets were collected and analysed to evaluate the history-taking component of the final examination from 2016 until January 2018.ResultsA total of 94 OSCE sheets were evaluated. Achievement in some history taking skills of the students was low (differential diagnosis 31.9%, alarming symptoms of disease 39.4%, clarification of major complaint-associated symptoms 47.9%, and stress, anxiety, and depression screening 59.6%). However, the students' performances were better with respect to communication skills in general and exploration of the patients' ideas, concerns, and expectations. Significantly more male than female students had a better performance in some skills such as facilitating technique, appropriately exploring major complaint-associated symptoms, enquiring about differential diagnoses, and to rule out alarm symptoms.ConclusionsIn this study, the students' performance was generally better with respect to communication skills and psychosocial history. However, the students showed poor knowledge in other aspects of history-taking skills as they failed to formulate more than one hypothesis and to ask about alarm symptoms. Teaching communication and clinical reasoning skills and connecting physical and psychosocial aspects of patient care promotes understanding of the patient as a whole and should be taught in all courses of the clinical phase, with emphasis on bedside training.

Comparing Medical Students' and Preceptors' Views of a Longitudinal Preclerkship Family Medicine Course.

Despite the increasing popularity of longitudinal primary care experiences in North America and beyond, there is a paucity of work assessing these medical undergraduate experiences using reliable and valid questionnaires. Our objective in this study was to evaluate a new preclerkship longitudinal family medicine experience (LFME) course at McGill University by assessing family physician preceptors' self-reported ratings of the perceived effects of this course, and to compare their responses with ratings provided by medical students who completed the course. This study is part of a larger evaluative research project assessing the first edition of the LFME. Students (N=187) and preceptors (N=173) of the 2013-2014 cohort were invited to complete separate online questionnaires in the spring through summer of 2014. The preceptor survey contained 53 items, 14 of which were nearly identical to items in the student survey (published elsewhere) and served as the basis for comparing preceptor and student ratings of the LFME. Ninety-nine preceptors (57% response rate; 55% female) and 120 students (64% response rate; 58% female) completed the surveys. Preceptors and students did not significantly differ in their overall ratings of the course, as both groups were satisfied with the quality of the LFME and felt it was an appropriate and valuable educational experience. However, preceptors had more positive ratings regarding their role and the benefits of the course than did medical students. This study corroborates prior work showing extensive perceived benefits of longitudinal preclerkship exposure to primary care; however, preceptors were found to report more positive reviews of the course than students. This study also provides new innovative tools to assess students' and preceptors' perceptions of longitudinal, preclerkship family medicine courses available for use over time and in different educational contexts.

“The Doctor” Teaches Humanities to Medical Students

Education in humanities is an important part of medical curriculum. With traditional didactic approaches, it is difficult to teach humanities. Using movies and other audio-visual materials can make the teaching of humanities for medical students easier. We used “The Doctor” movie during our family medicine course for educating the last year medical students about communication and patient-doctor relationships, which belongs to the core elements of medical humanities. The movie was evaluated by the students through a questionnaire with structured and open-ended questions and was discussed in the classroom. This study reports the findings of the students’ selfreports and discussions. The overall rating of the movie was 2.5 on a five point Likert scale. There was no significant difference in terms of rating among male and female students. Most of the students found this movie little or not at all emotional. Most of the students reported a positive emotional impact of the movie. Most of the students found the movie more useful than lectures (90.9 %) and journal articles (90.9 %) in teaching the patient-doctor relationships. This proportion was 54.5 % compared to bedside rounds and this finding revealed that students accept the bedside rounds as an important component of learning patient-doctor relationships. We concluded that movies should be an enhancement tool for the curriculum, but not the curriculum. The curriculum with some instructional goals such as understanding, reasoning, critical thinking, and reflection should guide the use of movies.

European General Practice Research Network (EGPRN)

Latvia is a country by the Baltic Sea populated by 1 969 000 inhabitants. It is called a ‘green’ country due to its forests and abundance of wildlife. About half of inhabitants above 15 years of age (45% women and 55% men) are sure that they are in very good or good health. Inhabitants are in general appreciating family medicine as 62% are fully and 28% are partly satisfied with their family physician. Representative studies on health behaviour of the Latvian population show that there is still a significant effort needed by both family physicians and patients to implement favourable lifestyle changes. For example, half of working-age people (54.6%) are overweight or obese and traditions of riding bicycles are still to be enhanced, as 77% report not riding bicycles at all. Latvians are still to be encouraged to accept preventive measures as coverage of cancer screening programmes is below 40% and human papilloma virus vaccination rates in 12-year old females do not exceed 45%. As both healthy life expectancy at birth (67.1 years) and the public spending on health as a share of GDP per capita (below 4%) is one of the lowest in the European region, effective primary healthcare (PHC) teams are essential in Latvia.In clinical family medicine, Latvia has implemented an impressive change since 1993. It has switched from the Soviet polyclinic-based healthcare system with different specialists dealing with individual health problems of a patient towards a Western system based on a comprehensive patient-oriented approach of a family physician. Since then the number of family physicians in the country has grown from 0 to 1450. The opinion of family physicians is now considered as an effort of two powerful associations: Association of Latvian Family Physicians and Association of Latvian Rural Family Physicians. A total of 1329 physicians have public agreements with National Health Service (6.7 PHC physicians per 10 000 inhabitants) and on average 1530 patients are registered per physician. Most family physicians have their private practices supported by one or two nurses or physician’s assistants. Primary healthcare paediatricians and internists form a minor part of PHC. E-medicine is being currently piloted. After trying different financing systems and models, Latvia has now stopped at mixed capitation model. Quality criteria are set but seem to be non-motivating. In this set-up, the main challenge is to fit competencies of the family physician so well incorporated in the Wonca tree into the legislative and financial framework of Latvia.As 54% of primary healthcare physicians are older than 55, education of young family physicians is crucial. The education system of a family physician in Latvia is like Lithuania and Estonia with six undergraduate years and three post-graduate years. Two universities (Riga Stradins University and University of Latvia) are training both undergraduate and postgraduate physicians. Family medicine is incorporated in the last year of the programme for undergraduates and there is a great intention to introduce basics of family medicine earlier. The prestige and number of medical students is growing every year in Riga Stradins University, e.g., during the academic year 2016/2017, a total of 315 students (including 116 international students) undertook a basic course in family medicine. Most students are satisfied with the course and a new perspective of problem-solving. On average 40 postgraduates are trained in family medicine each year since 2014 with most training in family medicine during the last year.Research in family medicine has been slower, compared to other Baltic countries. Establishment of the Department of Family Medicine in Riga Stradins University in 2010 was a serious sign of changing attitudes towards family medicine. Now the department comprises 10 lecturers with only one assistant professor in family medicine. The main challenge is involvement of clinically active, competent physicians into academic and research environment. Capacity building in writing project proposals and publications is still essential. Postgraduates (residents) are a serious potential for further research activities. Latvia is ready to continue its journey towards academic family medicine, and hosting the EGPRN Riga Conference is another big step towards reaching this target.

How do medical students engaging in elective courses on acupuncture and homeopathy differ from unselected students? A survey

BackgroundWe aimed to investigate whether students at German medical schools participating in elective courses on acupuncture and homeopathy differ from an unselected group of students regarding attitudes and personality traits.MethodsElective courses on acupuncture and homeopathy in the academic half-year 2013/14 all over Germany were identified and participants invited to fill in a questionnaire including nineteen questions on attitudes towards Complementary and Alternative Medicine (CAM), orientation towards science, care and status orientation, and a short validated instrument (Big-Five-Inventory-10) to measure personality traits (extraversion, neuroticism, openness, conscientiousness, and agreeableness). Participants of a mandatory family medicine course at one university served as unselected control group.ResultsTwo hundred twenty and 113 students from elective courses on acupuncture and homeopathy, respectively, and 315 control students participated (response rate 93%). Students participating in elective courses had much more positive attitudes towards CAM, somewhat lower science and status orientation, and somewhat higher care orientation than control group students (all p-values for three-group comparisons < 0.001). There were no differences between the three groups regarding personality traits with the exception of lower values for agreeableness in controls (p = 0.009).ConclusionsThe findings of this study show that attitudes of students participating in elective courses on acupuncture or homeopathy at German medical schools differ to a considerable degree from the attitudes of unselected students.

Family medicine practice in Saudi Arabia: The current situation and Proposed Strategic Directions Plan 2020.

OBJECTIVES:The objectives of this study were to assess the current situation of the teaching and training of undergraduate and postgraduate programs in family medicine in KSA, assess the current practice of family medicine, and draw a roadmap to achieve Saudi vision 2020.MATERIALS AND METHODS:This study was conducted with the support and collaboration of the Primary Health Care Department of the Ministry of Health, Saudi Arabia, and World Health Organization (EMRO) in November 2015. Based on the literature review of previous studies conducted for similar purposes, relevant questionnaires were developed. These consisted of four forms, each of which was directed at a different authority to achieve the above-mentioned objectives. Data of all questionnaires were coded, entered, and analyzed using SPSS version 16.RESULTS:There are 2282 primary health-care centers (PHCCs), 60% of which are in rural areas. More than half of the PHCCs have a laboratory and more than one-third have a Radiology Department. Out of the 6107 physicians, 636 are family physicians (10%). All medical colleges have a family medicine department with a total staff of 170 medical teachers. Thirteen departments run family medicine courses of 4–8 weeks' duration for students. Fourteen colleges have internship programs in family medicine and four colleges have postgraduate centers for family medicine (27%). There are 95 training centers for Saudi Board (Saudi Board of Family Medicine [SBFM]) and 68 centers for Saudi Diploma (Saudi Diploma of Family Medicine [SDFM]). The total number of trainers was 241, while the total trainees were 756 in SBFM and 137 in SDFM.CONCLUSIONS:This survey showed that there is a shortage of qualified family physicians in all health sectors in Saudi Arabia as a result of the lack of a strategic plan for the training of family physicians. A national strategic plan with specific objectives and an explicit budget are necessary to deal with this shortage and improve the quality of health-care services at PHCCs.

Teaching communications skills to medical students using a reflective teaching method and access to online video cases

This article was migrated. The article was not marked as recommended. Introduction In our family medicine course the students work eight days in a general practice clinic, video-record their consultations, and analyze them in small group sessions at the university. The aim of this study is to find a way to evaluate the course after adding online material. Material and Methods On the first and last day of the course all students watch the same test-video of a consultation. After watching the video they fill in a questionnaire, designed to structure the analysis. Outcome is the change in answers from the first questionnaire (A) to the last one (B).For the on-line teaching we use 16 short video-cases of consultations accompanied by on-line questions. The control group has the usual course, Results In seven out of ten items there are significant changes in the answers in the control group. The tendency is the same in the intervention group but not significant. Apart from one item the two groups finished at the same answers. Conclusion Teaching consultation skills to medical students using a reflective teaching method is effective. Adding access to video cases has a minor effect. Discussion Further studies into how to use e-learning material in teaching communication skills is needed.

Sistema Nacional de Saúde Cubano: vivências de uma equipe multiprofissional

DOI : 10.12957/interag.2015.15901 In January 2015, a group of Brazilian professors and students participated in the Primary Health Care and Family Medicine Course, in Havana, organized and hosted by the National School of Public Health (ENSAP), of the Health Ministry of Cuba. There, we had the opportunity to know services, strategies and policies of the National Health System. In this text, we intend to report some experiences, with particular focus on social participation, maternal and child health, environmental health and mental health, areas of interest of the authors. The activities developed, with professionals of ENSAP as well as professionals of the services, enabled an approach to the context of the Cuban National Health System, with an understanding of its operating dynamics beyond the technical and scientific issues.

International primary care snapshots: Nigeria and Poland.

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 …

Identificación y clasificación de competencias profesionales en Medicina Familiar

Objective: identify the professional competencies of the Family Medicine specialist in Mexico. Methods: qualitative, and descriptive study, and occupational analysis; with prior informed consent. It was applied the Developing a Curriculum (Dacum), Team Kawakita Jiro (tkj) and Critical Incident (ci) techniques in a sample of 152 specialists in Family Medicine. Using the technique of analysis of content some concepts and ideas were identified and organized by categories and domains of competence. The results were compared with similar studies in the United States, United Kingdom, Spain, and Canada. Results: from the 1 840 records collected from the three techniques, it was obtained 3 831 concepts; from these and using the Dacum technique, it was identified 57 different categories in relation to knowledge, skills and attitudes; the tkj technique recognized 879 concepts of essential elements to provide family medical care; and the ci technique identified 21 categories of essential elements for solving problems in the practice of Family Medicine. All identified categories were merged by similarity of content according to the three techniques and 42 different categories were concluded, which were considered as competences. Finally, they were grouped into 12 competence domains. Conclusions: the framework of competences of this study will allow bringing into the program of the “Family Medicine Course of Specialization” certified by the National Autonomous University of Mexico (unam), the necessary elements to train specialists in this discipline towards the achievement of their professional skills.

Students’ perceptions about the family medicine course in Qassim, Saudi Arabia

Background: This study explores students’ perceptions and attitudes regarding educational methodology, content and assessment methods in the Family Medicine (FM) Course at Qassim University College of Medicine (QUCOM) with a view to build innovations and improvements on its findings.Research design and methods: Three batches of undergraduate medical students attending FM Course – 2011/12 participated in a cross-sectional questionnaire-based study. Data collected through anonymous self-administered questionnaires were analyzed using Statistical Package for the Social Sciences (SPSS).Results: Participation rate was quite high; of the 79 students constituting the course cohort, 68 (86%) responded. Students’ perceived problem-based learning (PBL) tutorials positively while both male and female students rated classroom lectures negatively. Primary health care training activities and evidence-based medicine received high positive scores. Male students assigned high positive scores to consultation skills and breaking bad news (BBN) modules, and to a lesser extent the medical audit module. By contrast, female students rated them negatively and gave significantly lower scores. These were the only areas indicating significant differences between opinions of male and female students.Conclusion: Although the degree of students’ satisfaction with the different learning activities varied, students felt that having a variety of learning and teaching experiences was more appropriate.

A experiência da Medicina de Família e Comunidade enquanto disciplina no curso de graduação em medicina

Este estudo relata a experiência de implantação da disciplina eletiva de Medicina de Família e Comunidade (MFC) no curso de graduação em medicina, na visão dos discentes da Universidade Federal de Juiz de Fora, Minas Gerais, Brasil. Levando-se em conta a metodologia aplicada, verificou-se que os alunos consideraram os conteúdos práticos mais relevantes em comparação aos teóricos, o que pode ser atribuído ao fato de a prática permitir a crítica, a problematização e a resolução de situações cotidianas, sendo, além disso, um elo entre o jovem estudante de medicina e a realidade da prática médica. Diante da necessidade de aprimorar a abordagem integral à saúde dos indivíduos, considerando seus aspectos biopsicossociais, torna-se necessário que as alterações no currículo médico tenham como eixo norteador os princípios da Atenção Primária à Saúde (APS). Nesse contexto, a Medicina de Família e Comunidade (MFC) é a especialidade chave para a APS, pois estimula a formação de médicos generalistas capacitados a oferecerem cuidado longitudinal e responderem às necessidades em saúde das pessoas.