Developing an Specific Rural Training Programme for

European Trainees/Registrars in

Family Medicine.

Jaume Banqué Vidiella

Institut Català de la Salut. CAP Xerta. Spain

Euripa – Semfyc - Camfic

jbanquev@meditex.es

Common themes in rural health…

• At the heart of the rural health education agenda is that rural people have different healthcare needs and reduced access to services….

• Rural populations tend to have different profiles to those of urban populations…

• Rural health professionals face additional isolation issues…• Isolation from professional support requires a broader scope of

practice, more training and stronger support networks…

RB Hays. School of Medicine, Keele University, Staffordshire, UK“Rural medical education in Europe: the relevance of the Australian

experience”. Rural and Remote Heatlh 7: 683. (Online), 2007.

Why an specific European Rural Training Programme for Trainees...

• Big variety across Europe about Rural Training in Family Medicine.• Huge interest in Rural Practice between Young Family Doctors.• Accomplishing “The Euripa Strategy : Research – Education –

Quality and Policy development”.• Creating Evidences and Knowledge about Rural Practice in Europe.• Working and Exchanging Experiencies for a Common Rural Health

Agenda in Europe.

Rural Training Programme. It is based on...

• The European Definition of General Practice/Family Medicine. Euract 2002.

• The Spanish Training Program in Family Medicine. Compulsory Rural Rotation. 2005.

• Vasco da Gamma and Euripa Wonca Conferences participation: Posters, Oral Presentations, Workshops,...

• Different European experiences and Rural Working Groups recommendations.

• Stakeholder participation.

Compulsory Rural Rotation in Spain...

• In 2005, a new Family Medicine Training Programme was launched by the National Commission in Spain. Four years in length. A Compulsory Rural Training Period is included for the first time (Three months ).

• National Commission for Family and Community Medicine > Creates the Programme.

• Main Training Centres > Produce and apply the programme and this Rural Trainging Period.

• Rural Working Groups from Family Medicine Associations > Develop and spread opinion, guidelines and tools to help to all parts involved in this process.

• Trainees > Attend and evaluate this learning term.

Vasco da Gamma Survey-Rural Practice Nowadays-

• Presented in the 9th Rural Health Wonca World Conference in Crete. May 2009.

• Aim: “To exhibit the differences between GP Rural Training programs in Europe”.

• “Cross Sectional Stydy” from 13 Countries.• Email questionary.

Main Results “46.67% countries have a Complusory Rural Rotation”. “The evaluation has registered vast differences within compulsory GP

programmes but the same needs in each country”.

Vasco da Gamma Survey “Main issues, common to all countries”

• Training for emergencies.• Chronic management with limited human and material resources.• Cardiovascular and skill disease.• Obstetrics: Mother and child health.• Contraception.• Vaccination Programmes.• Home Care for the elderly and Palliative Care.• Minor Surgery.• Poisonings.

Vasco da Gamma Survey “Main issues, common to all countries”

• Become conscious about yourself.• Difficult communication between GPs and Hospital.• Isolation, less social life, more distances, difficult access..• More heavy, technological and financial problems, working for longer.• Lacks of… Final Conclusions “General Practice Education must include a special practice training

based in rural settings, because remote medicine is another way to feel the kind of real doctor you are”.

Raquel Gomez Bravo et al