WONCA Europe has released a statement on Family Medicine during the 67th session of the WHO Regional Committee for Europe (Statement on session 5 (c): Towards a sustainable health workforce in the WHO European Region: framework for action). You may find the full text of the statement below the video and attached as PDF.
WONCA Europe welcomes the framework for action for a sustainable health workforce in the WHO European Region, and acknowledge the focus on education as one of the strategic objectives that can accelerate progress towards achieving universal health coverage by providing the appropriate workforce. We also welcome the focus on the contextualised education that addresses the needs of the population, the accreditation of the educational institutions, and the monitoring and addressing the international mobility of health labour.
We would like to draw your attention to the educational needs of the professions related to family medicine / general practice.
The World Health Assembly WHA 60.12 Resolution (2009) urged member states: “(5) to train and retain adequate numbers of health workers, with appropriate skill mix, including primary health care nurses, midwives, allied health professionals and family physicians, able to work in a multidisciplinary context, in cooperation with non-professional community health workers in order to respond effectively to people’s health needs.”
Acknowledging that both undergraduate and postgraduate education is not meeting the needs of the future workforce and producing adequate number of primary care health workers, we believe it is crucial to highlight the following gaps in our sector:
- No minimum standards exist for the undergraduate family medicine curriculum, and there is scarce or non-existent early clinical exposure to primary health care at medical schools across the member states.
- There is little recognition of the interdependence of the health professions and promotion of interdisciplinary education and collaboration.
- Specialist training programmes where they exist in the WHO European region, vary considerably in length and content.
- The regulation of the quality of the specialist training, as well as the lifelong learning, is deemed insufficient in many contexts.
- There is not enough investment in teaching the teachers of family medicine.
- Little has been done to support the migration and emigration of family doctors, and the recognition of their professional identity, which also ensures respect to the context of relocation.
In spite of political strategies aimed at strengthening primary health care, we are still witnessing: the entrenched attitudes in medical schools where training is focused on secondary and tertiary care; a lack of standardised quality education and regulation in primary health care; insufficient policies for retaining family doctors, and; an increasing mobility of health workforce. This situation aggravates the mismatch between the educational offering and population needs.
We urge:
- Once and for all, each member state and educational institution to fully recognise the discipline and specialty of family medicine with its own educational content, research, evidence base and clinical activity.
- Member states and educational institutions to promote a shared strategy for the establishment of shared minimum standards for the undergraduate curriculum and ensure increased exposure to primary health care and reflect the patient journey through different health care settings.
- Member states and educational institutions to seek a common core set of standards for the specialist training and continuous professional development for family medicine in all European countries. Provision should also be made for training the teachers of family medicine.
- Member states to develop appropriate strategies for career development and lifelong learning as means for retaining health care professionals.
- Human Resources for Health (HRH) departments and units to work closely with the appropriate stakeholders to support the development of contextualised curricula, and a transparent pathway for the migrating health care professionals.
- The WHO Regional Office for Europe to support member states in building capacity and strengthening primary care and family medicine in all the countries of the region.