The future of Family Medicine- our young doctors and residents
An invitation has been sent to our College from the AAFP, one that is specifically directed to our young medical graduates- to join with their North American counterparts in starting a Regional Initiative that will empower our young "residents" to become more proficient in what they are being trained to practise- namely the discipline of Family Medicine as they share what they do with other "residents" across the world.
The term "residents" is strangely foreign to our British trained ears, yet we acknowledge them as the graduands of the UWI- run programme that began in Trinidad at the Mt. Hope- based Faculty of Medical Sciences of the UWI St. Augustine Campus but was rationalized across all the UWI Campuses so that doctors could access the part-time, in service, post- internship programme at Mona, Cave Hill, Nassau and in the smaller islands- that is, provided the various Faculty Deans were amenable and welcoming to the programme. Since the inception of the programme, online courses have also been added.
This programme was not the first of its kind since UWI had earlier offerred a 4-year DM programme in Family Medicine in Jamaica and Barbados, but that had been a full time residential programme that became increasingly difficult for busy young and impecunious doctors to access, especially since it meant giving up practice for those four years.
Trinidad & Tobago insisted initially that their governments would pay only for a 2-year Postgraduate Diploma, a degree that was most unwelcome to the other Campuses who felt that a 3-year Masters in Family Medicine would be more appropriate. However, T&T , from which most of the funding apparently was being derived, forged ahead with the Diploma and has succeeded in delivering five graduating classes to date, many members of whom have elected to continue to the Masters and a few others to the Doctorate in Family Medicine (UWI). Most of these doctors have remained in the Health Centres, some being assigned to the smaller district hospitals in middle management positions.
The programme has been accepted in Cave Hill- Barbados which will also service the needs of potential graduands in the OECS territories (St. Vincent, St. Lucia, St Kitts-Nevis and Dominica) and also on the Nassau Campus in the Bahamas, but after a promising start in Jamaica, there have been many hiccoughs there and finally everything stalled. UWI Mona- Jamaica is strong in the Public Health department and is very committed to the MPH, which is offerred to all health professionals unlike the MSc, Family Medicine which of necessity is confined to doctors only. Recently, T&T has joined the fray and the MPH has been offerred as well from the same Department that runs the postgraduate Family Medicine programme.
Our CCFP Family Medicine "residents" are a motley crew because they will, by definition comprise not only those graduands from the UWI (University of the West Indies) but also Dutch and French doctors - many of whom would have trained in France or in the Netherlands and who will qualify for exchange visits with their European counterparts, whereas many of the English speaking "residents" will not have that privelege now that their "mother country" - the UK is offically part of Europe and no longer linked in a maternal way to the former colonies in the West Indies, whom in a sense are now regarded as non- entities, unless they fall under the category of UKOT (United Kingdom Occupied Territories)
UKOT "residents" , whom also qualify to belong to the CCFP group, would come from Anguilla, British Virgin Islands, Cayman Islands, Montserrat , Turks & Caicos Islands and Bermuda.
Strictly speaking, many are not "residents" at all by the standards used in North America so how will the CCFP respond?
The spotlight has now been turned on the young ones- those who will take the baton passed on by the pioneers, those visionaries that in this past century have rekindled the torch of family medicine, of 'family doctoring". The flame was lit in Mexico at Wonca Cancun 2010 by young doctors like Naomi Harris from Australia and the Wonca Asia-Pacific Rajakumar Movement which was itself inspired by the Wonca Europe VascoDa Gama movement, represented by doctors like Alex Gouveia from Portugal and doctors from the Giotto Movement in Italy.Young doctors attending the Wonca Conference from all the other Regions were so invigorated that they now feel that it is incumbent on them to make sure that none is left out.
Wonca North America therefore has not forgotten the Caribbean and it would be remiss of us not to take up the challenge to make sure that our graduands are a part of the change that is to happen - the change that will bring equity and quality to medical care on the ground ; bridging the gap between merely group care and public health and care of the individual in the context of family and community.
But will our Caribbean graduands respond in the way these doctors in Europe and in Australia, the Pacific and the Far East have and as those in the USA and Canada undoubtedly also will?
Or will they ask as we usually do in the Caribbean- what is in it for me? and why do I have to do anything?
To learn more about the Vasco da Gama and Rajakumar Movements you can log on to these websites:
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