ID-5184 Wonca Abstracts supplement A-K 13-10-23 - Flipbook - Page 133
WONCA 2023 Supplement 1: WONCA 2023 abstracts (A–K)
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Building family medicine through education and training
reform: The journey in three countries
Dr Sambath Cheab1,2, Dr Fitriana Murriya Ekawati3, A/Prof Nagwa Hegazy4, Laura Goldman5
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University of Health Sciences, 2Ministry of Health, 3Universitas Gadjah Mada, 4Menoufia University,
Boston University
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As family medicine (FM) is increasingly recognised as critical to effective health systems in the postCOVID world, there is momentum to establish the speciality though education and training reform.
Cambodia is in the early phase of development, whereas Indonesia and Egypt have decades of
experience. In this presentation, sentinel events in the journey establishing FM in each country will be
described. Effective strategies will be highlighted, and barriers discussed.
In Cambodia, the medical education system is tightly controlled by the Ministry of Health (MOH).
Reform has focused on faculty development and developing leaders as champions of FM and
medical education. In 2022, Family and Community Medicine was adopted by the MOH as one of six
core competencies for doctors. Persistent challenges include entrenched biases against creating a
specialty of FM and traditional exclusion of private and community practices in medical education.
Advocacy at the university, local and national levels in the 1990s led to the development of FM from
brief trainings to formal FM specialist programs in Indonesia. Progress was accelerated through
the inclusion of ‘primary care doctor’ in the Indonesian Medical Education Act 20 in 2013, followed
by regulations and the work of the National Taskforce of Family Medicine. Challenges remain in
professional acknowledgement of FM specialists (ie incentives and practice authority).
In Egypt, FM was introduced in the 1970s with advocacy by the MOH that led to specialised FM
training. Later, universities began FM departments and speciality training programs. The MOH initiated
a health system reform in the 1990s including FM as a main pillar. Challenges include political changes
preventing further expansion, community recognition for family physicians and the career pathway.
Following brief presentations, lessons learned and common issues will be identified. Strategies for
continued progress will be discussed. Finally, a roadmap to FM development in LMICs may emerge.
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