What is it about?

Family physicians (FPs) play a vital role in primary health care teams. A competent FP has so much to offer his/her community.That's where the catch is, being a competent family physician. As more African countries look to post-graduate training in Family Medicine as a means to improving primary health care, there is a need to ask current trainees what they think of their competence. Indeed we asked them to reflect and think about what they havent mastered yet. If they will make any impact on their communities after the PG training, now is the time to ask them what is deficient in their training.

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Why is it important?

Evidence exist to show that improving primary health care provision improves the overall health of a community and indeed a nation. This applies to developed countries and more so to Africa. What better way to ensure this, than to ensure that those who should provide primary health care are competent. Our traditional ways of ensuring competency may not achieve the required goal if the trainees themselves are not involved. Indeed a trainers work achieves more impact when a trainee says "i know you want me to learn so and so but, can we start from this one thing that i dont know?" .Post-graduate training in Family Medicine and indeed the medical sciences in general, must become more trainee-centered.

Perspectives

I think this publication offered a voice to PG Family Medicine trainees in Africa. We chose the bottom-top approach by eliciting the perspectives of the trainees themselves, not the trainers who might be regarded as not having a "boots-on-the ground" expereince. When we designed the study tools (especially the list of competencies), we thought that trainees in family medicine will complain about their lack of surgical skills or other clinical skills but to our amazement, the results showed that trainees were concecernd about their ability to critically appraise and utilise scientific knowledge. Wow! We sincerely did not see this coming. This is what Africa needs, physcians who regularly sift through scientific knowledge and know what is relevant to the unique problems of our society. Knowing is not enough, we need more clinicans who can connect knowledge and problem solving. Indeed this is a key area we should focus on and I am glad our respondents recognised this. Primary care will make little impact if it is not community-oriented. So our findings did get me thinking, respondents percieved they were more competent in providing person/family related care compared to comunity oriented primary care. Lastly, how can we adress the above without effective mentor-mentee relationships? As i looked at our findings, I could literally feel the void in effective medical mentorship across Africa. This should get us all thinking. That these findings are coming from the trainees themselves means PG Family Medicine Trainers across Africa have a unique opportunity to engage their trainees in the above mentioned areas of competency deficits. This is how family medicine can make more impact and I hope this publication helped draw attention to this issue.

Dr Kenneth Yakubu
University of Jos

Read the Original

This page is a summary of: Perceived competency deficits and challenges of family medicine trainees in sub-Saharan Africa, Education for Primary Care, August 2016, Taylor & Francis,
DOI: 10.1080/14739879.2016.1219236.
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