Sunday, October 28, 2012

Development of the Kuwaiti Family Practice Training Program

Last week, I wrote about how the Kuwaiti primary care was in the early 1980s. It was felt then by the MOH that a major primary care reform was much-needed. In the beginning of 1984, a decision was taken by the MOH to develop the Kuwaiti primary care sector and the RCGP was asked to help plan and implement the development of 'family practice' in Kuwait.

Of the various models of primary care delivery, the MOH identified its particular preference. It decided that its future family practitioners would provide personal, comprehensive, and continuing care and integrate between primary and secondary care. The choice of the name 'family practitioner' has later created a new type of primary care centers: the family practice model centers—in addition to the existing so-called general practice model centers, which provided care to male and female patients in separate clinics. The newer family practice centers were established to provide care for the patient and his/her entire family throughout life and regardless of the patient's age, gender, or presenting complaint.

Initially, two of the existing centers were selected to be model centers of family practice. The strict separation of sexes was discontinued, clinical policies were introduced, and quotas of families were allocated to each consulting room. These changes facilitated the development of continuity and longitudinality, and hence the provision of better care. The newer model centers were—and still are—better liked by doctors and patients alike.

With the establishment of the new model centers of family practice, a training program of family practice was founded. After an interview, 14 doctors were selected to join the program and were moved to the two model centers, where a 15-month training program took place. Following formal assessments of the enrollees, 10 of them were recognized as family practitioners and were, as well, appointed as trainers in the newly established program.

In the next year, 1985, the first class of trainees entered the training program. Two years later, they were to be formally examined by RCGP examiners and awarded the diploma in family practice, as the qualification was called. In the beginning, Kuwaiti doctors were reluctant to enter primary care, but with time they began to be attracted to the family practice program.

In 1991, the RCGP issued a statement that the Kuwaiti diploma in family practice "is the equivalent postgraduate qualification in Kuwait to that of the MRCGP in the UK". This gave a considerable boost to the program. Soon afterwards, KIMS recognized the diploma as equivalent to MRCP and FRCS. This meant that, for the first time in Kuwait, family practitioners could obtain an equivalent career status to hospital consultants.

Over the years, the family practice training program has been growing steadily. Since around the year 2000, more Kuwaiti medical graduates chose family practice than any other specialty. In 1987, family practitioners constituted only 2% of the total number of general practitioners. By 2002, the made up more than 25% of all general practitioners.


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