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Q: What is Family Medicine?
A: Family medicine is the medical specialty which provides continuing, comprehensive health care for the individual and family. It is a specialty in breadth that integrates the biological, clinical and behavioral sciences. The scope of family medicine encompasses all ages, both sexes, each organ system and every disease entity. (1986) (April Board 2010) (Source: American Academy of Family Physicians)
“General practitioners/family doctors are specialist physicians trained in the principles of the discipline. They are personal doctors, primarily responsible for the provision of comprehensive and continuing care to every individual seeking medical care irrespective of age, sex and illness. They care for individuals in the context of their family, their community, and their culture, always respecting the autonomy of their patients. They recognize they will also have a professional responsibility to their community. In negotiating management plans with their patients they integrate physical, psychological, social, cultural and existential factors, utilizing the knowledge and trust engendered by repeated contacts. General practitioners/family physicians exercise their professional role by promoting health, preventing disease and providing cure, care, or palliation. This is done either directly or through the services of others according to health needs and the resources available within the community they serve, assisting patients where necessary in accessing these services. They must take the responsibility for developing and maintaining their skills, personal balance and values as a basis for effective and safe patient care” (Source: European Academy of Teachers in General Practice)
A: One: The family physician is a skilled clinician. Family physicians demonstrate competence in the patient- centered clinical method. Two: Family medicine is a community-based discipline. Family practice is based in the community and is significantly influenced by community. Three: The family physician is a resource to a defined practice population. The family physician views his or her practice as a “population at risk”, and organizes the practice to ensure that patients’ health is maintained whether or not they are visiting the office. Four :The patient-physician relationship is central to the role of the family physician. Family physicians have an understanding and appreciation of the human condition, especially the nature of suffering and patients’ response to sickness. Family physicians respect the privacy of the person. Family physicians provide continuing care to their patients. (Source: College of Family Physicians of Canada)
A: (1)Family Practice is normally the point of first medical contact within the health care system, providing open and unlimited access to its users, dealing with all health problems regardless of the age, sex, or any other characteristic of the person concerned.(2) Makes efficient use of health care resources through co-coordinating care, working with other professionals in the primary care setting, and by managing the interface with other specialties taking an advocacy role for the patient when needed. (3) Develops a person-centered approach, orientated to the individual, his/her family, and their community. (4) Has a unique consultation process, which establishes a relationship over time, through effective communication between doctor and patient. (5) Is responsible for the provision of longitudinal continuity of care as determined by the needs of the patient. (6) Has a specific decision making process determined by the prevalence and incidence of illness in the community. (7) Manages simultaneously both acute and chronic health problems of individual patients. (8) Manages illness which presents in an undifferentiated way at an early stage in its development, which may require urgent intervention. (9) Promotes health and well being both by appropriate and effective intervention. (10) Has a specific responsibility for the health of the community. (11) Deals with health problems in their physical, psychological, social, cultural and existential dimensions. (Source: European Academy of Teachers in General Practice)
A: The renaissance in family medicine / general practice started in the middle of the 20th century, when UK launched its first vocational training programme in 1951. By the 1980s educational programmes in family medicine were also being conducted in other European countries, the USA and Canada, in Australia and New Zealand, as well as in the Asian countries of Singapore, Malaysia, the Philippines, Sri Lanka and Nepal. The postgraduate training programmes in UK, USA and Australia, are all of three years’ duration. In UK, the National Health Service vocational (postgraduate) training programme for general practice is conducted through deaneries in different regions. The training is conducted in hospital posts and under GP trainers recognized by the Joint Committee on Postgraduate Training for General Practice (JCPTGP). At the end of the period of training doctors have to pass the summative assessment. The JCPTGP gives a certificate of prescribed experience to those who have successfully completed the training programme and passed summative assessment, which is the license to practice as a GP in the UK. In USA, residency training programmes are conducted by university departments of family medicine. The Board examination is conducted by the American Board of Family Physicians and those who pass are Board certified as specialists in family medicine for seven years. To retain Board certified status, they have to take the Board examination again. In Australia, the vocational training programme is conducted by the Royal Australian College of General Practitioners (RACGP). The Department of General Practice of Monash University also conducts a postgraduate course towards a Diploma and a Masters in Family Medicine through distance education. Singapore, Malaysia, Phillipines, Nepal and Pakistan have residency programmes conducted by university departments of family medicine in collaboration with the Department of Health. In Bangladesh, postgraduate courses in family medicine are conducted by the University of Science and Technology, Chittagong, the Bangladesh College of General Practitioners and the Bangladesh Academy of Family Physicians. In Sri Lanka, all medical postgraduate training including family medicine are conducted by the Postgraduate Institute of Medicine, University of Colombo. The Board of Study in Family Medicine has representatives from all the universities and the College of General Practitioners of Sri Lanka. In most countries, doctors registered with the country’s medical council for independent practice are eligible to follow the training programme. Some countries specify a number of years after registration prior to eligibility. Under graduate training: Most of the undergraduate programmes in Family Medicine in these countries are now conducted in the third, fourth and final year, while in some schools, the programme extends through all years of study. The teaching learning methods include lectures, seminars and tutorials to cover common clinical problems and the behavioural sciences; training in communication skills: clinical skills teaching and learning sessions, and clerkship rotations to University Family Medicine centers and GP preceptors in the community for periods ranging from 2 - 6 weeks or more. (Source: WHO: Report of a Regional Scientific Working Group Meeting on Core Curriculum - Based on presentation by Prof Nandani de Silva)
A: The undergraduate curriculum in India does not have a specific family medicine component. Indian institutions offered two postgraduate qualifications: the Fellowship of the Indian Medical Association College of General Practitioners (FIMACGP) and Diplomate of the National Board of Examinations (Family Medicine). Only the latter is recognized as a specialist qualification by the Indian Medical Council. Other qualifications were offered in conjunction with foreign institutions: the Diploma in Family Medicine is offered by the PGIM of the University of Colombo Sri Lanka, in conjunction with the IMACGP, and the MD (General Practice) was offered by Tribhuvan University, Nepal in conjunction with CMAI. PGDFM (Post Graduate Diploma of Family Medicine) is offered by CMC Vellore in distance learning mode spread over two years with three contact programs in a year. Another distance learning program (DFM) is offered by Apollo Hospitals in association with RCGP UK.
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