Family Medicine最新文献

{"title":"Just in One Lifetime.","authors":"Amanda Howe","doi":"10.22454/FamMed.2025.857163","DOIUrl":"https://doi.org/10.22454/FamMed.2025.857163","url":null,"abstract":"","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progress and Challenges in Family Medicine and Residency Training Over 25 Years in Nepal.","authors":"Tula Krishna Gupta, Lani Kay Ackerman","doi":"10.22454/FamMed.2025.591411","DOIUrl":"https://doi.org/10.22454/FamMed.2025.591411","url":null,"abstract":"<p><p>Over the past 25 years, Nepal has made admirable progress not only in improving living conditions and health indices but also in training family physicians, called medical doctors in general practice (MDGPs). This article examines the evolution and contributions of family physicians, the development of their own unique residency curriculum, and their current and evolving practice scope. It also evaluates recruitment and retention challenges and suggests strategies for advancing family medicine in Nepal. Family physicians have been pioneers in health care delivery in Nepal and have had a profound impact on improving access to primary and emergent medical care for the rural population. They have contributed to the decrease in morbidity and mortality rates and improved life expectancy. Family medicine residencies and physicians have been and are evolving to meet the ever-changing needs of their country, leading primary and emergency care; but urgent reforms are needed for their recruitment and retention. Despite Nepal's uniqueness and leadership in South Asia in its recognition for and development of full-scope, well-trained family physicians, MDGP leaders need collaboration and support from both their own government and medical community, as well as from international educators, to continue to lead the country in improving health and decreasing health disparities.</p>","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Teaching Family-Oriented Patient Care to Family Medicine Residents in Chile.","authors":"Diego Garcia-Huidobro, Gabriela Soto, Maria Victoria Rodgriguez, Pamela vonBorries, Solange Rivera","doi":"10.22454/FamMed.2025.245190","DOIUrl":"https://doi.org/10.22454/FamMed.2025.245190","url":null,"abstract":"<p><strong>Background and objectives: </strong>Family-oriented patient care, an approach to involve the patient's family in clinical encounters, is essential to family medicine. The Pontificia Universidad Católica de Chile offers a Family-Oriented Patient Care (FOPC) course within its family medicine residency program, aiming to enhance family involvement skills among residents. We present the course and report residents' self-efficacy, satisfaction, and competencies with family-oriented care after the course.</p><p><strong>Methods: </strong>The FOPC course is an 8-week program using a flipped-classroom model with interactive discussions, role-play with simulated patients, and clinical activities. Evaluation methods include resident-reported self-efficacy, course relevance, satisfaction, clinical supervisors' assessments of family-oriented care competencies, and Observed Structured Clinical Examination (OSCE) scores on simulated scenarios.</p><p><strong>Results: </strong>Residents reported high self-efficacy in family-oriented practices, with mean scores above 4.0 on a 5-point scale across various domains, including conducting family-oriented clinical visits and using family assessment tools. Course relevance and satisfaction received high ratings, with average scores of 4.7±0.7 on a 1-5 scale for relevance and 6.2±0.8 on a 1-7 scale for satisfaction. Clinical supervisors' evaluations indicated integration of family-oriented skills in patient care. However, OSCE scores suggested partial application of these skills in simulated clinical encounters.</p><p><strong>Conclusions: </strong>After participating in the FOPC course, residents reported having confidence to apply family-oriented care skills in patient encounters, but OSCE ratings did not confirm clinical translation. Results highlight the need for continued reinforcement to enhance skill application in real clinical contexts, supporting the need for longitudinal training integration throughout residency.</p>","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Evolution and Challenges of Family Medicine in Kyrgyzstan: A Health System Analysis.","authors":"Aiperi Asanbek Kyzy, Gulnura Sulaimanova, Roman Kalmatov, Kanykey Mamyrova, Kubat Abdyrasulov, Paul Fonken, Inis Jane Bardella","doi":"10.22454/FamMed.2025.891335","DOIUrl":"https://doi.org/10.22454/FamMed.2025.891335","url":null,"abstract":"<p><p>Following its independence from the Soviet Union in 1991, Kyrgyzstan became a pioneer in Central Asia by implementing extensive health care reforms that introduced family medicine. Beginning in the late 1990s, these reforms strengthened primary health care by introducing family medicine as a specialty and a key component of the health care system. This approach improved the quality of medical care while reducing health care costs and gradually extended to reforms in medical education and the broader health care system, including efforts to address the rural medical workforce. However, challenges remain in fully embedding family medicine into Kyrgyzstan's medical education and health care system. This paper aims to analyze the progress made since the early reforms, assess recent developments, and explore the ongoing challenges in institutionalizing family medicine within Kyrgyzstan's health care landscape. A full-text Russian translation of this article is available from author Paul Fonken (paul.fonken@gmail.com).</p>","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Personal and Contextual Influences on African Medical Students' Career Choices in Primary Care: A Cross-Sectional Mixed-Methods Study.","authors":"Alec Bernard, Dawit Mengesha, Kathryn Flaharty, Nina Tiertoore, Abdi Tolera, Hellen Wubishet, Tadael Gebeyehu, Hamdi Abdullahi, Amani Abdu, Yesuf Adem, Shannan Berzack, Karl Golnik, Geoff Tabin","doi":"10.22454/FamMed.2025.256581","DOIUrl":"https://doi.org/10.22454/FamMed.2025.256581","url":null,"abstract":"<p><strong>Background and objectives: </strong>The choice of specialty by medical students is pivotal for their careers and the health care system. The shortage of trained medical providers makes this choice particularly salient in Africa. Understanding the motivations and preferences of African medical students can inform interventions to improve the distribution and retention of doctors across specialties and regions. This study aims to explore the factors influencing specialty selection among medical students across Africa using a cross-sectional, mixed-methods approach.</p><p><strong>Methods: </strong>A survey conducted from June to October 2023 included 1,044 students from 152 medical schools. Descriptive statistics summarized sample characteristics, and linear regression models identified predictors of primary care selection. Thematic analysis was performed on qualitative data.</p><p><strong>Results: </strong>Students interested in primary care were, on average, older and reported higher anxiety levels compared to their counterparts. Key factors influencing specialty choice across all students included personal interest, scope of practice, and intellectual stimulation, with prestige being least important for those choosing primary care. Additionally, the importance of mentorship was lower among primary care aspirants. Country-specific analysis revealed that students from Benin, Botswana, Ivory Coast, Senegal, and Sierra Leone were more likely to choose primary care.</p><p><strong>Conclusions: </strong>This study provides an overview of the motivations behind specialty choice among African medical students, highlighting the need for tailored interventions to address regional health care needs. Understanding these preferences can help in designing strategies to enhance the distribution and retention of medical professionals in various specialties, ultimately improving health care outcomes.</p>","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Family Medicine: Step-by-Step in Somaliland.","authors":"Fathia Mohamed Nour, Sarah C Kent, Kara Beth Thompson","doi":"10.22454/FamMed.2025.184299","DOIUrl":"https://doi.org/10.22454/FamMed.2025.184299","url":null,"abstract":"","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building a Home for Family Medicine: Reflections on the Development of a Consultant Clinic at Mangochi District Hospital in Rural Malawi.","authors":"Modai Mnenula, Martha Makwero, Jessie Mbamba, Anna McDonald, Jacob Nettleton, Prosper Lutala","doi":"10.22454/FamMed.2025.699233","DOIUrl":"https://doi.org/10.22454/FamMed.2025.699233","url":null,"abstract":"<p><p>This article reflects on the establishment of a family medicine consultant clinic at Mangochi District Hospital in rural Malawi, highlighting its significance in enhancing primary health care access and education. Founded under the Department of Family Medicine at Kamuzu University of Health Sciences, which was established in 2008, the clinic aims to address the high disease burden faced by the district's 1.3 million residents, where specialist care is often inaccessible. Since its inception in early 2020, the clinic has provided critical care for patients with complex medical needs, emphasizing a holistic, patient-centered approach to their care. The clinic facilitates continuity of care and coordinates referrals to higher-level facilities, while also functioning as a training platform for medical students and residents. Challenges such as patient overflow, inappropriate referrals, and resource limitations are discussed, alongside strategies for ongoing evaluation and improvement. Early anecdotal evidence indicates a positive impact on patient satisfaction and care quality. The article underscores the importance of integrating family medicine specialists into rural health care settings to strengthen clinical education and improve patient outcomes. This initiative exemplifies a successful model for expanding family medicine influence in other rural districts and will potentially contribute to improved health systems throughout Malawi.</p>","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Beacon of Hope in the West Bank: An-Najah National University Family Medicine Clinic.","authors":"Suha Hamshari","doi":"10.22454/FamMed.2025.424306","DOIUrl":"https://doi.org/10.22454/FamMed.2025.424306","url":null,"abstract":"","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Doing Global Health Work: Approaches That Really Make a Difference.","authors":"Shivani Malhotra","doi":"10.22454/FamMed.2025.213347","DOIUrl":"https://doi.org/10.22454/FamMed.2025.213347","url":null,"abstract":"","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"UCLA International Medical Graduate Pathway to Family Medicine Board Certification and Underserved Practice.","authors":"Michelle Bholat, Ann M Hernandez, Blanca Campos, Ricardo Antillon, Patrick T Dowling, Gerardo Moreno","doi":"10.22454/FamMed.2025.344685","DOIUrl":"https://doi.org/10.22454/FamMed.2025.344685","url":null,"abstract":"<p><strong>Background and objectives: </strong>The University of California, Los Angeles (UCLA) International Medical Graduate (IMG) program addresses the need for more bilingual and bicultural Latino family physicians in California where Latinos are the largest racial/ethnic minority group and a large percentage of the population speaks Spanish. The objective of this descriptive study was to assess family medicine residency match, board certification, and initial practice location outcomes of the program graduates.</p><p><strong>Methods: </strong>We conducted a cross-sectional study of program graduates (N=204) from 2007 to 2024. Data were abstracted from program administrative files and the California Medical Board. Primary outcomes were match rate into California family medicine residency programs, completion of a residency, board certification, and initial training practice location. We computed descriptive statistics for participant characteristics and outcomes.</p><p><strong>Results: </strong>A total of 177/204 (87%) participants completed the UCLA IMG program and entered the match. The country with the most graduates was Mexico followed by Cuba. All graduates, 177/177 (100.0%), that applied and entered the National Resident Matching Program matched in a family medicine residency program. A total of 172 (97%) matched in California programs and 5 (2.8%) matched out of state. Family medicine board certification was verified for 152/159 (95.6%) of those eligible. Few completed a fellowship.</p><p><strong>Conclusions: </strong>The UCLA IMG program was effective at preparing program graduates that were fluent in Spanish and bicultural to match in a California family medicine residency program and subsequently practice family medicine in underserved areas. Future studies will examine long-term practice outcomes, predictors of success, and participant perspectives on the program.</p>","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}