Family Medicine Training and Residency Program

1
Family Medicine Training and Residency Program

• Ion Ababiy
• Kishenev-Norfolk Partnership

2
Legal Foundation and the Principles It Mandates

• Shift to principles of general practice/family
  medicine
• Establishment of the Department of General
  Medicine and Primary Medical Care, which will be
  responsible for residency training and the
  instructional methodology for other forms of
  training for general practitioners/family
  medicine physicians (GP/FMP)
• Retraining of pediatricians, internists, and
  primary health care personnel in general practice
• Training of family physicians in a three-year
  residency program
• Transition to principles of general
  practice/family medicine

3
The History Of Postgraduate Training Of
Physicians

• 1950-1962 Primary specialization in specialized
  departments
• 1962 Department of Physician Training -- Primary
  specialization (6 months)
• 1965-1967 Subordinancy (1 year)
• 1968-1991 Internship (1 year)
• 1991 Residency (3 years)

Mandatory Skills Upgrade Training (4-16
weeks) Every 3-5 years
4
Physician Qualities

• Selflessness
• Professional Knowledge
• Professionalism
• Sense of responsibility

5
Introductory Courses

• Fundamental biomedical disciplines
• Vertical integration
• Horizontal integration
• Reproductive type of instruction

6
Advanced Courses

• Clinical disciplines
• Experiments and hands-on based type of
  instruction
• Practical orientation
• Teaching algorithms
• Limited student responsibility for
• Justifying a diagnosis
• Selecting a treatment
• Planning rehabilitation

7
Methods for Assessing Skills and Knowledge

• Fundamental disciplines
• Practical skills
• Testing students understanding of the theory

• Clinical disciplines
• Practical skills at the patients bedside
• Testing the students understanding of theory
• Oral examination on a topic

8
Change in Ratios of Hours Devoted to Different
Subjects in University Programs
9
Diagram of Family Medicine Specialty Training
Specialized Middle School (Lycée) (12
years) Bachelor Degree
Appointment as Clinical Staff Physician (2 years)
RESIDENCY Specialization in Family Medicine (3
years)
Continuing Skills Up-Grade Training For
Physicians
Medical Department State University Medical
School Testemitsanu
 Post Graduate Work (3 years)
Medical College (3 years) Bachelors Degree
Doctoral Work (2 years)
10
Family Physician Training Schedule
Residency 3 years
Specialization 6 months
General practitioners and Pediatricians
Continuing Education
11
STRUCTURE OF THE PRIMARY SPECIALIZATION CYCLE

• INTERNAL DISEASES
• PEDIATRICS
• FAMILY MEDICINE
• CARDIOLOGY
• OBSTETRICS AND GYNECOLOGY
• SURGERY
• EMERGENCY MEDICINE
• INFECTIOUS DISEASES

• TUBERCULOSIS
• ONCOLOGY
• TRAUMATOLOGY AND ORTHOPEDICS
• OTORHINOLARYNGOLOGY
• OPHTHALMOLOGY
• DERMATOLOGY AND VENEREOLOGY
• PSYCHOLOGY AND DRUG ADDICTION TREATMENT
• NEUROLOGY, INCLUDING PEDIATRIC NEUROLOGY

12
Medical Specialties in Residency

• 1992 Surgery. Obstetrics and gynecology
• 1993 Traumatology and orthopedics
• 1994 Otorhinolaryngology. Ophthalmology
• Pediatrics, Neurology, NeurosurgeryPediatric
  surgery, Internal diseases
• Dermatology and veneral diseases, Traditional
  medicine,Pediatric Traumatology
• 1997 FAMILY MEDICINE
• Microbiology, Analysis of drugs,
  Radiology,
• Abnormal morphology, Oncology, Infectious
  diseases, Psychiatry,
• Emergency Medicine, Neonatology, Pediatric
  hygiene, Epidemiology,
• Tuberculosis and diseases of the lungs,
• Clinical pharmacology,
• Pharmacological management

13
Curriculum for Training General Practice (Family)
Physicians During Their Residency
Family medicine (rural)
Family medicine (urban)
Others
Social medicine .
Year III
Neuro- psych.
Oth.
Year II
General surgery
Medical sp.
Infectious dis.
Obstetrics gynecology
Surgical Sp.
Fam. Med.
Year I
Internal diseases
Pediatrics
0
10
20
30
40
50
14
Structure of the Continuing Medical Education
Curriculum

• Mandatory cycles
• Family medicine
• Emergency medicine
• Internal diseases
• (selected issues)
• Pediatrics
• (selected issues)

• Optional cycles
• Surgery
• Hematology
• Infectious diseases
• Neurology
• Psychiatry
• Tuberculosis
• Obstetrics and gynecology
• ENT-diseases
• Ophthalmology
• Oncology
• Endocrinology
• Epidemiology

15
Ways to Evaluate Knowledge and Practical Skills

• Written evaluation of theoretical knowledge using
  standardized tests
• Colloquia on sections of the training program
• Evaluation of practical skills at the patients
  bedside
• Oral examination on a subject

16
Main Problems

• Establishment of model family medicine centers
  equipped with advanced medical and instructional
  equipment
• Improvement of the programs for training family
  physicians, performing expert evaluation of them,
  and bringing them up to modern standards
• Training and improvement of instructors on family
  medicine
• Instructional material (textbooks, manuals,
  anatomical atlases, models, etc.)
• Continuous development and implementation of
  information systems