Family Medicine最新文献

{"title":"Family Medicine Diploma Program in Jordan: Components for Success and Sustainability.","authors":"Benjamin Colton, Therese Zink","doi":"10.22454/FamMed.2025.442203","DOIUrl":"10.22454/FamMed.2025.442203","url":null,"abstract":"<p><strong>Background and objectives: </strong>Jordan has residency positions available for approximately 20% of graduates from Jordanian medical schools, with approximately 30 in family medicine. Most graduates never complete a residency program and instead work as outpatient general practitioners (GPs). The need for more well-trained GPs is overwhelming. To address this gap, ERASMUS+ funding provided the money and technical expertise of European family medicine faculty to create a diploma program that enhanced prior efforts. In this paper, we share the evaluation data gathered for three levels of Kirkpatrick's four-level model and discuss the additional steps taken to ensure sustainability of the diploma program.</p><p><strong>Methods: </strong>A needs analysis consisting of a series of surveys, site visits, personal interviews, and bilateral meetings was conducted by the project consortium to identify the items most necessary in developing a sustainable project. The four levels of the Kirkpatrick evaluation model were used to evaluate the project.</p><p><strong>Results: </strong>Trainees improved in areas of understanding primary care, ethics and values, communication skills, and patient management. Six months after diploma completion, Level 3 data showed decreases in both antibiotic prescriptions and referral rates. To increase sustainability, our program involved local stakeholders from the beginning of the project, provided training for family medicine mentors, offered incentives for program trainees, and developed a sustainable financial model.</p><p><strong>Conclusions: </strong>Diploma programs fill an important void in the expertise of GPs. Building on prior diploma program efforts, our program added critical elements to create a successful and sustainable program.</p>","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":" ","pages":"364-370"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","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":"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":"371-378"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212031/pdf/","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":"OA","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":"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":"328-332"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212029/pdf/","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":"OA","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":"10.22454/FamMed.2025.184299","url":null,"abstract":"","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":" ","pages":"326-327"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212042/pdf/","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":"OA","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":"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":"379-380"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212026/pdf/","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":"OA","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":"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":"381-384"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212032/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Five Years of Family Medicine Education in Zambia: Challenges, Milestones, and Lessons Learned.","authors":"Matthew S Haldeman, Evaristo Kunka, Bassim Birkland, Mpundu Makasa","doi":"10.22454/FamMed.2025.569547","DOIUrl":"10.22454/FamMed.2025.569547","url":null,"abstract":"<p><p>Over the past 2 decades, the growing need to strengthen primary care in southern Africa has fueled a rising interest in the specialty of family medicine. Given the region's heavy burden of both communicable and noncommunicable diseases, along with restricted health care resources and limited access to care, family physicians may play a key role in improving health care access and quality in these settings. The development of family medicine in Zambia began in 2013 as a working group of committed clinical and public health academics, and progressed to the launch of that country's first family medicine residency in 2019. Despite enormous challenges, the program has flourished since that time, growing rapidly from the inaugural two residents in 2019 to 45 residents and recent graduates by 2025. While this growth has allowed the residency to become a leader in family medicine education in the region, it also has brought a new set of challenges. In this narrative, we describe the health care context of Zambia, the introduction of family medicine as a specialty to a new health care landscape, and the launch of that country's first ever and rapidly growing family medicine residency, as well as unique challenges, strategies employed, and lessons learned along the way. We conclude the article by looking ahead at new challenges and recommendations for the program's continued growth. The experiences and lessons learned may be used by future family medicine residency start-ups throughout sub-Saharan Africa.</p>","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":" ","pages":"333-339"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","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":"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":"355-363"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212037/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Just in One Lifetime.","authors":"Amanda Howe","doi":"10.22454/FamMed.2025.857163","DOIUrl":"10.22454/FamMed.2025.857163","url":null,"abstract":"","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":" ","pages":"387-388"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212034/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Family Medicine Education and Training in Sub-Saharan Africa.","authors":"Robert Mash, Innocent Besigye, Akye Essuman, Jean-Pierre Fina Lubaki, Mpundu Makasa, Martha Makwero, Gulnaz Mohamoud","doi":"10.22454/FamMed.2025.291430","DOIUrl":"10.22454/FamMed.2025.291430","url":null,"abstract":"<p><p>In this article we reflect on the state of family medicine education and training in sub-Saharan Africa; in particular, we focus on these key issues: advocacy, evidence of impact, barriers and enablers, and implementation strategies. Sub-Saharan Africa is the last region of the world to embrace family medicine, and adoption varies widely among countries. Family physicians with postgraduate training are relatively few. In the public sector, primary care is mostly offered by nurses or physician assistants, while in the private sector, it is offered by general practitioners. Family physicians work in both primary care and primary hospitals, in multidisciplinary teams; as clinicians, consultants, capacity builders, clinical trainers, leaders of clinical governance and may also have some managerial functions. Advocacy for the contribution of family physicians and training programs is needed with departments of health, regulatory bodies, higher education institutions, and other health professions. Evidence of impact in the African context is limited due to the small numbers and limited research outputs. Barriers and enablers to education and training are related to the stage of development. Key issues include a lack of academic and teaching expertise, a need to develop learning environments and clinical trainers, sufficient training posts, and appropriate deployment of new graduates. Implementation strategies to overcome these barriers can be categorized into planning, educational, financial, quality management, and policy related strategies. A South-South-North approach to support and partnerships is advocated. More attention should be given to engaging the public on the contribution of family medicine.</p>","PeriodicalId":50456,"journal":{"name":"Family Medicine","volume":" ","pages":"342-348"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}