Does the establishment of universal health coverage drive the foundation of postgraduate education for primary care physicians?

Indah S. Widyahening, Rodri Tanoto, Fedri Rinawan, Elsa P. Setiawati, Zorayda E. Leopando



DOI: http://dx.doi.org/10.13181/mji.v26i2.1857

Abstract


Background: Studying the formation of postgraduate training in primary care within countries which has attained Universal Health Coverage (UHC) is important to support the development of similar training in low-and middle-income countries aiming to achieve UHC by 2030. This review aims to describe the state of postgraduate training for primary care physicians in UHC-attaining countries.

Methods: A literature review of published literature and official documents from the websites of regional and global health/primary care organizations or societies such as World Health Organization (WHO), World Organization of Family Doctors (WONCA), European Forum for Primary Care, European Union of General Practitioners (GP)/Family Physicians (FP), European Academy of Teachers in GP/Family Medicine (FM), as well as the websites of GP/FP organizations in each of the respective countries. The list of UHC attained countries were identified through WHO and International Labor Organization databases.

Results: A total number of 72 UHC-attained countries were identified. Postgraduate education for primary care physicians exists in 62 countries (86%). Explicit statements that establish primary care postgraduate training were corresponded with the policy on UHC is found in 11 countries (18%). The naming of the program varies, general practice and family medicine were the commonest. In 33 countries (53%), physicians are required to undertake training to practice in primary level. The program duration ranged from 2–6 years with 3 years for the majority.

Conclusion: Although UHC is not the principal driving force for the establishment of postgraduate training for primary care physicians in many countries, most UHC-attaining countries make substantial endeavor to ensure its formation as a part of their health care reform to improve national health.


Keywords


family medicine; general practice; primary care physician; universal health coverage; postgraduate training

Full Text:

PDF

References


  1. World Health Organization. Alma-Ata 1978 Primary Health Care. Geneva: World Health Organization, 1978.
  2. World Health Organization. Primary health care now more than ever. Geneva: World Health Organization, 2008.
  3. GBD 2015 SDG Collaborators. Measuring the health-related Sustainable Development Goals in 188 countries: a baseline analysis from the Global Burden of Disease Study 2015. Lancet. 2016;388(10053):1813–50. https://doi.org/10.1016/S0140-6736(16)31467-2
  4. Garrett L, Chowdhury AMR, Pablos-Méndez A. All for universal health coverage. Lancet. 2009;374(9697):1294–9. https://doi.org/10.1016/S0140-6736(09)61503-8
  5. Stuckler D, Feigl AB, Basu S, McKee M. The political economy of universal health coverage. Global symposium on health systems research; Montreux, Switzerland. Geneva: World Health Organization; 2010. p. 11–3.
  6. Williams RL, Henley E, Prueksaritanond S, Aramrattana A. Family Practice in Thailand: Will It Work? J Am Board Fam Med. 2002;15(1):73–6.
  7. www.ilo.org [Internet]. International Labour Organization. ILOSTAT. Geneva: International Labour Organization; 2016. [update 2017; cited 2017 Feb]. Available from: http://www.ilo.org/ilostat/faces/wcnav_defaultSelection?_adf.ctrl-state=131zmqr4t4_91&_afrLoop=28105723263739&_afrWindowMode=0&_afrWindowId=131zmqr4t4_117#!
  8. World Health Organization. Global Health Observatory Data Repository. 2012. [update 2016; cited February 2017]. Available from: http://apps.who.int/gho/data/view.main.1610?lang=en
  9. McWhinney IR, Freeman T. Textbook of Family Medicine. 3rd ed. Oxford: Oxford University Press; 2009. p. 460.
  10. Engström S, Foldevi M, Borgquist L. Is general practice effective? A systematic literature review. Scand J Prim Health Care. 2001;19(2):131–44. https://doi.org/10.1080/028134301750235394
  11. Kruk ME, Porignon D, Rockers PC, Van LW. The contribution of primary care to health and health systems in low- and middle-income countries: A critical review of major primary care initiatives. Soc Sci Med. 2010;70(6):904–11. https://doi.org/10.1016/j.socscimed.2009.11.025
  12. Starfield B. Primary care: an increasingly important contributor to effectiveness, equity, and efficiency of health services. SESPAS report 2012. Gac Sanit. 2012;26(Suppl 1):20–6. https://doi.org/10.1016/j.gaceta.2011.10.009
  13. Haq C, Ventres W, Hunt V, Mull D, Thompson R, Rivo M, et al. Where there is no family doctor: The development of Family Medicine around the world. Acad Med. 1995;70(5):370–80. https://doi.org/10.1097/00001888-199505000-00012
  14. Lopez E, Blanco M, editors. Starting family medicine in Argentina. Presentation at WONCA World Conference. 2004 October 13–17; Orlando, USA.
  15. Pan American Health Organization. Health in the Americas. Washington DC: World Health Organization, 2012.[updated 2012; cited 2017 Feb]. Available from: http://www.paho.org/salud-en-las-americas-2012/index.php?option=com_content&view=article&id=18&Itemid=129〈=en
  16. Spann SJ. Primary Care and General Practice in Latin America. In: Jones R, Britten N, Culpepper L, Gass D, Grol R, Mant D, et al., editors. Oxford Textbook of Primary Medical Care. Oxford: Oxford University Press;2005. p. 62–4.
  17. Hovhannisyan SG, Tragakes E, Lessof S, Aslanan H, Mkrtchyan A. Health care system in transition: Armenia. Copenhagen: European Observatory on Health Care Systems, 2001. p. 41–7.
  18. Ohanyan M, Danielyan A, Hopaiyan K, Mash B. Making strides towards Family Medicine in Armenia. Br J Gen Pract. 2015;65(635):308–9. https://doi.org/10.3399/bjgp15X685381
  19. Hays RB, Morgan S. Australian and overseas models of general practice training. Med J Aust. 2011;194(11):63.
  20. Trumble SC. The evolution of general practice training in Australia. Med J Aust. 2011;194(11):59–62.
  21. Hofmarcher MM. Health Systems Review: Austria. Copenhagen: World Health Organization, 2013. p. 151–64.
  22. Masseria C, Irwin R, Thomson S, Gemmill M, Mossialos E. Primary care in Europe. Policy brief. The London School of Economics and Political Science. 2009. Sponsored by the European Commission.
  23. Redaèlli M, Wilm S, Simic D, Sprenger M. Austria. Kringos DS, Boerma WGW, Hutchinson A, Saltman RB, editors. Building primary care in a changing Europe. Copenhagen: European Observatory on Health Systems and Policies; 2015. p. 1–9.
  24. Sammut MR, Lindh M, Rindlisbacher B, On behalf of Euract-the European Academy of Teachers in General Practice. Funding of vocational training programmes for general practice/family medicine in Europe. Eur J Gen Pract. 2008;14(2):83–8. https://doi.org/10.1080/13814780802095576
  25. Spiegel W, Pichlhöfer O, Haoula D, Schneider B, Maier M. Specialty selection and relative job satisfaction of family physicians and medical specialists in Austria. Croat Med J. 2008;49:375–83. https://doi.org/10.3325/cmj.2008.3.375
  26. The New Leeuwenhorst Group [Internet]. A commentary on the present state of learning and teaching general practice in Europe. [update 1985; cited 2017 Feb]. Available from : http://euract.woncaeurope.org/sites/euractdev/files/documents/archive/publications/commentary-present-state-learning-and-teaching-general-practice-europe-new-leeuwenhorst-group-1985.pdf
  27. Abyad A. Family Medicine in the Middle East: Reflections on the Experiences of Several Countries. J Am Board Fam Pract. 1996;9(4):289–97.
  28. Abyad A, Al-Baho AK, Unluoglu I, Tarawneh M, Al Hilfy TKY. Development of Family Medicine in the Middle East. Fam Med. 2007;39(10):736–41.
  29. Al-Al-Tahoo L. Health System Profile: Bahrain. Cairo: World Health Organization - Eastern Mediterranian Region, 2007. p. 51–4.
  30. Alnasir FAL. Family Medicine in the Arab world. Is it a luxury? Lecture presented at Health Congress 2011, December 14–6; Kurdistan, Iraq.
  31. Cartier T, Ryssaert L, Bourgueil Y. Belgium. In: Kringos DS, Boerma WGW, Hutchinson A, Saltman RB, editors. Building primary care in a changing Europe - Case studies. Copenhagen: European Observatory on Health Systems and Policies; 2015. p. 9–18.
  32. Gerkens S, Merkur S. Health System Review: Belgium. Health systems in transition. 2010;12(5):1–266.
  33. Jatić Z, Račić M. Family medicine education in Bosnia and Herzegovina. EURACT Messenger. 2015(4):1–2.
  34. Masic I, Skopljak A, Jatic Z. Comparative review of Education Programs of Family Medicine (FM) in Bosnia and Herzegovina and Several Transition Countries. Mater Sociomed. 2014;26(6):411–8. https://doi.org/10.5455/msm.2014.26.411-418
  35. Račić M. Family Medicine Development in Bosnia and Herzegovina. J Fam Med. 2015;2(4):1031.
  36. Švab I, Pavliè DR, Radić S, Vainiomäki P. General practice east of Eden: an overview of general practice in Eastern Europe. Croat Med J. 2004;45:537–42.
  37. Mbuka DO, Tshitenge S, Setlhare V, Tsima B, Adewale G, Parsons L. New family medicine residency training programme: Residents' perspectives from the University of Botswana. Aft J Prim Health Care Fam Med. 2016;8(1):1–8. https://doi.org/10.4102/phcfm.v8i1.1098
  38. Ogundipe RM, Mash R. Development of Family Medicine training in Botswana: Views of key stakeholders in Ngamiland. Afr J Prm Health Care Fam Med. 2015;7(1):1–9. https://doi.org/10.4102/phcfm.v7i1.865
  39. University of Botswana Faculty of Medicine. Master in Medicine programme. Gaborone, Botswana: University of Botswana; [cited 2017; cited 2017 Jan]; Available from: http://www.ub.bw/programdet/pid/187//master-in-medicine/
  40. Haq C, Gusso G, Anderson MIP. Strengthening Primary Health Care with Family and Community Medicine in Brazil. Rev Bras Med Fam e Com. 2006;2(7):196–202. https://doi.org/10.5712/rbmfc2(7)55
  41. Rodnick JE, Blasco P. Brazil: Family medicine in Brazil-establishing the specialty. Fam Med. 2005;37(9):668.
  42. Starkey C, Matthews B. A modular family medicine training program at the master's-degree level and taught at a distance. Acad Med. 2001;76(5):569–9. https://doi.org/10.1097/00001888-200105000-00119
  43. Anonim. Specialty training and career structure for family medicine in Brunei Darussalam [power point presentation]. Available from: http://docslide.net/documents/specialty-training-and-career-structure-for-family-medicine-in-brunei-darussalam.html
  44. Kringos D, Salchev P. Bulgaria. In: Kringos DS, Boerma WGW, Hutchinson A, Saltman RB, editors. Building primary care in a changing Europe - Case studies. Copenhagen: European Observatory on Health Systems and Policies; 2015. p. 19–29.
  45. Krztoń-Królewiecka A, Švab I, Oleszczyk M, Seifert B, Smithson WH, Windak A. The development of academic family medicine in central and eastern Europe since 1990. BMC Family Practice. 2013;14(37):1–10. https://doi.org/10.1186/1471-2296-14-37
  46. Hennen BKE. Academic family medicine in Canada. Can Med Assoc J. 1993;148(9):1559–63.
  47. Pullon S. Training for family medicine in Canada and general practice in New Zealand: how do we compare? J Prm Health Care. 2011;3(1):82–5.
  48. Bossert TJ, Leisewitz T. Innovation and Change in the Chilean Health System. N Engl J Med. 2016;374(1):1–5. https://doi.org/10.1056/NEJMp1514202
  49. Organisation for Economic Co-operation and Development. Health Systems Characteristics Survey 2012 and 2016. Organisation for Economic Co-operation and Development (OECD), 2016.p.4. [update 2017; cited Feb 2017]. Available from: stats.oecd.org/fileview2.aspx?IDFile=f1d6c79f-6f31-4435-8147-172cba38f3ad
  50. Wonca News [Internet]. From the President: The theme is team - Primary Health Care in Chile. [update 2017; cited 2017 Feb]. Available from : http://www.wonca.net/News/FromthePresidentThethemeisteam- PrimaryHealthCareinChile.aspx.
  51. Chen T, Du Y, Sohal A, Underwood M. Essay - Family medicine education and training in China: past, present and future. Br J Gen Pract 2007;57(541):674–6.
  52. Dai H, Fang L, Malouin RA, Huang L, Yokosawa KE, Liu G. Family Medicine Training in China. Fam Med. 2013;45(5):341–4.
  53. Mash R, Almeida M, Wong WC, Kumar R, von Pressentin KB. The roles and training of primary care doctors: China, India, Brazil and South Africa. Human Resources for Health. 2015;13:1–9. https://doi.org/10.1186/s12960-015-0090-7
  54. Wang J, Kushner K, Frey III JJ, Du XP, Qian N. Primary Care Reform in the Peoples' Republic of China: Implications for Training Family Physicians for the World's Largest Country. Fam Med. 2007;39(9):639–43.
  55. Kidd M. From the President: Family Medicine in Costa Rica. WONCA News. 2016;42(4):2–4.
  56. Scyner A. Family and community medicine in Costa Rica: where professionalization meets development. Montreal: McGill University; 1997.
  57. Katiæ M, Jureša V, Oreškoviæ S. Family Medicine in Croatia: Past, Present, and Forthcoming Challenges. Croat Med J. 2004;45(5):543–9.
  58. Keglević MV. Family Medicine/General Practice in Croatia: some facts [power point presentation].
  59. Cardelle AJ. The preeminence of primary care within Cuban predoctoral medical education. International Journal of Health Services. 1994;24(3):421–9. https://doi.org/10.2190/2YG8-0P0C-CCYJ-330N
  60. Demers R, Kemble S, Orris M, Orris P. Family Practice in Cuba; evolution into the 1990s. Family Practice. 1993;10:164–8. https://doi.org/10.1093/fampra/10.2.164
  61. Keck CW, Reed GA. The Curious Case of Cuba. American Journal of Public Health. 2012;102(8):e13–22. https://doi.org/10.2105/AJPH.2012.300822
  62. Samoutis G, Tedeschi P. Cyprus. In: Kringos DS, Boerma WGW, Hutchinson A, Saltman RB, editors. European Observatory on Health Systems and Policies. Copenhagen: World Health Organization; 2015. p. 31–40.
  63. University of Nicosia Medical School. Postgraduate Diploma and Masters in Family Medicine. In: University of Nicosia Medical School, editor. Nicosia, Cyprus: University of Nicosia Medical School; 2016. p. 1–8.
  64. Vychytil P, Marx D. The reform of specialist training for general practice in the Czech Republic. Cent Eur J Public Health. 2009;17(3):146–51.
  65. Windak A, Oleszczyk M, Seifert B. Czech Republic. In: Kringos DS, Boerma WG, Hutchinson A, Saltman RB, editors. Building primary care in a changing Europe. Copenhagen: World Health Organization; 2015. p. 41–8.
  66. Forde I, Nader C, Socha-Dietrich K, Oderkirk J, Colombo F. Primary Care Review of Denmark. Paris: Organisation for Economic Co-operation and Development, 2016. p. 6–16.
  67. Hasvold T. Denmark. In: Kringos DS, Boerma WG, Hutchinson A, Saltman RB, editors. Building primary care in a changing Europe. Copenhagen: World Health Organization; 2015. p. 49–56.
  68. Pedersen KM, Andersen JS, Søndergaard J. General Practice and Primary Health Care in Denmark. J Am Board Fam Med. 2012;25:S34–8. https://doi.org/10.3122/jabfm.2012.02.110216
  69. Maaroos H-I, Lember M. Specialist training of family physicians in non-UEMO countries: An Estonian experience. European Journal of General Practice. 2007;13(4):246–7. https://doi.org/10.1080/13814780701627479
  70. Põlluste K, Lember M. Estonia. In: Kringos DS, Boerma WG, Hutchinson A, Saltman RB, editors. Building primary care in a changing Europe. Copenhagen: World Health Organization; 2015. p. 57–66.
  71. Polluste K, Lember M. Primary health care in Estonia. Family Medicine & Primary Care Review 2016;18(1):74–7. https://doi.org/10.5114/fmpcr/58608
  72. Sumanen M, Aine T, Halila H, Heikkilä T, Hyppölä H, Kujala S, et al. Where have all the GPs gone – where will they go? Study of Finnish GPs. BMC Family Practice. 2012;13(121). https://doi.org/10.1186/1471-2296-13-121
  73. Vuorenkoski L. Finland: Health System Review. Copenhagen: World Health Organization, 2008. p. 85–121.
  74. Winell K, Dedeu T. Finland. In: Kringos DS, Boerma WG, Hutchinson A, Saltman RB, editors. Building primary care in a changing Europe. Copenhagen: World Health Organization; 2015. p. 67–75.
  75. Cartier T, Bourgueil Y. France. In: Kringos DS, Boerma WG, Hutchinson A, Saltman RB, editors. Building primary care in a changing Europe. Copenhagen: World Health Organization; 2015. p. 77–87.
  76. Horder J. Training for general practice at Bobigny, Paris. Journal of the Royal College of General Practitioners. 1975;25:197–9.
  77. Miani C, Hinrichs S, Pitchforth E, Bienkowska-Gibbs T, Disbeschl S, Roland M, et al. Best Practice: Medical training from an international perspective. Santa Monica, California: RAND Corporation, 2015;5(1):2.
  78. Knabe H. The training of the general practitioner in the German Democratic Republic. J Roy Coll Gen Pract. 1969;18:374–6.
  79. Simic D, Wilm S, Redaèlli M. Germany. In: Kringos DS, Boerma WG, Hutchinson A, Saltman RB, editors. Building primary care in a changing Europe. Copenhagen: World Health Organization; 2015. p. 89–98.
  80. Economou C. Greece: Health system review. Copenhagen: World Health Organization, 2010 Contract No: 7.
  81. Mariolis A, Mihas C, Alevizos A, Gizlis V, Mariolis T, Marayiannis K, et al. General Practice as a career choice among undergraduate medical students in Greece. BMC Med Educ. 2007;7(15):1–8. https://doi.org/10.1186/1472-6920-7-15
  82. Rurik I. Postgraduate education, vocational training in the Family Medicine in Hungary. Stary Smokovec. 2012.
  83. Wilm S, Vajer P, Rurik I. Hungary. In: Kringos D, Boerma W, Hutchinson A, Saltman R, editors. Building primary care in a changing Europe. Copenhagen: World Health Organization; 2015.
  84. Bardardottir E. News from the Nordic Colleges of General Practitioners. Scandinavian Journal of Primary Health Care. 2006;24(3):129–30. https://doi.org/10.1080/02813430600845319
  85. Halldorsson M. Health Care Systems in Transition: Iceland. Copenhagen: WHO Regional Office for Europe on behalf of the European Observatory on Health Systems and Policies, 2003.
  86. Hutchinson A. Iceland. In: Kringos D, Boerma W, Hutchinson A, Saltman R, editors. Building primary care in a changing Europe. Copenhagen: World Health Organization; 2015.
  87. Jónsdóttir SH. General Practice in Iceland at the turn of the millennium. Rome: European Union of General Practitioners, 2000.
  88. Solberg IB, Tómasson K, Aasland O, Tyssen R. The impact of economic factors on migration considerations among Icelandic specialist doctors: a cross-sectional study. BMC Health Services Research. 2013;13(524):1–7. https://doi.org/10.1186/1472-6963-13-524
  89. Hutchinson A. Ireland. In: Kringos DS, Boerma WG, Hutchinson A, Saltma RB, editors. Building primary care in a changing Europe. Copenhagen: World Health Organization; 2015.
  90. Irish College of General Practice. A career in General Practice. In: Irish College of General Practice, editor.: Irish College of General Practice; 2006.
  91. McDaid D, Wiley M, Maresso A, Mossialos E. Ireland: Health System Review. Copenhagen: World Health Organization on behalf of the European Observatory on Health Systems and Policies, 2009.
  92. Tandeter H. Family Medicine in Israel: A national overview and examples from Ben-Gurion University in the Negev. Archivos en Medicina Familiar. 2007;9(1):65–70.
  93. Tedeschi P. Italy. In: Kringos DS, Boerma WG, Hutchinson A, Saltman RB, editors. Building primary care in a changing Europe - Case studies. Copenhagen: European Observatory on Health Systems and Policies; 2015. p. 133–43.
  94. Cegolon L, Heymann W. International primary care snapshot: academic primary care in Italy. British Journal of General Practice. 2016. p. 34. https://doi.org/10.3399/bjgp16X683197
  95. Takamura A. The present circumstance of primary care in Japan. Quality in Primary Care. 2015;23(5):262–6.
  96. Takamura A. The new era of postgraduate certified general practice training in Japan. Education for Primary Care. 2016. p. 1–4. https://doi.org/10.1080/14739879.2016.1220235
  97. Al-Baho AK, Serour M. Development of Family Practice Specialty Training Program over a 20-year period (1983–2002) in Kuwait. Bulletin of the Kuwait Institute for Medical Specialization. 2003;2:59–63.
  98. Almussalam S, Serour M, Alwagayan A, Alzayed K, Buhamra A, Alnajjar A, et al. Family Medicine Residency Program Trainers' & Residents' Guide to the curriculum: Kuwait Institute for Medical Specialization Faculty of Primary Healthcare; 2014.
  99. Osman H, Romani M, Hlais S. Family Medicine in Arab Countries. Fam Med. 2011;43(1):37–42.
  100. Fonken P, Brouhard K, Chubakov T, Djuzenova B, Pirnazarova G, Burns D, et al. Family Medicine in Kyrgyzstan: The First Nine Years 1996–2005. Bishkek, Kyrgyzstan: USAID, 2005. p .11–26.
  101. Hardison C, Fonken P, Chew T, Smith B. The Emergence of Family Medicine in Kyrgyzstan. Fam Med. 2007;39(9):627–33.
  102. Jurgutis A, Jukneviciute V. Primary Care in Lithuania. Utrecht, the Netherlands: European Forum for Primary Care; [update 2013; cited 2017 Feb]; Available from: http://www.euprimarycare.org/column/primary-care-lithuania.
  103. Kasiulevičius V, Lember M. Lithuania. In: Kringos DS, Boerma WG, Hutchinson A, Saltman RB, editors. Building primary care in a changing Europe - Case studies. Copenhagen, Denmark: European Observatory on Health Systems and Policies; 2015. p. 155–61.
  104. Kringos D, Aubart M, Leners J, Stein R. Luxembourg. In: Kringos D, Boerma W, Hutchinson A, Saltman R, editors. Building primary care in a changing Europe - Case studies. Copenhagen, Denmark: European Observatory on Health Systems and Policies; 2015. p. 163–70.
  105. Ng CJ, Teng CL, Abdullah A, Wong CH, Hanafi NS, Phoa SSY, et al. The status of Family Medicine training programs in the Asia Pacific. Fam Med. 2016;48(3):194–202.
  106. Academy of Family Physicians of Malaysia. Graduate Certificate in Family Medicine. Kuala Lumpur: Academy of Family Physicians of Malaysia; [update 2016 ; cited 2017 Feb]; Available from: https://www.afpm.org.my/programmegcfm.
  107. University of Malaya. Master of Family Medicine (MFamMed). Kuala Lumpur: University of Malaya; [update 2016; cited 2017 Feb]; Available from: https://www.um.edu.my/academics/master/medicine/master-of-family-medicine.
  108. Camilleri AF, Sammut D. A Curriculum for Specialist Training in Family Medicine for Malta: Malta College of Family Doctors; 2009. p. 7–11.
  109. Galbur O. Concerning the comparative analysis of the classification and lists of the medical specialities in the EU and Republic of Moldova with concrete suggestions of improvement and fittings to the European Standards. Chisinau, Moldova: 2010.
  110. Atun R, Berdaga V, Turcan L, Stefanetz S, Cibotaru E, Ibragimov A. Review of Experience of Family Medicine in Europe and Central Asia: Moldova Case Study. World Bank, 2005 Contract No.: 32354-ECA.
  111. Zarbailov N, Carelli F. Family medicine development in the Republic of Moldova - Trends in European education of Family Physicians. The Synapse. 2017.[updated 2017; cited 2017 Feb]. Available from: http://www.thesynapse.eu/corporate/associates/jamesco/item/321-family-medicine-development-in-the-republic-of-moldova-trends-in-european-education-of-family-physicians.
  112. Kroneman M, Boerma W, van den Berg M, Groenewegen P, de Jong J, van Ginneken E. The Netherlands: health system review. Health Systems in Transition. 2016;18(2):1–239.
  113. Kringos D, Paap JvR, Boerma W. The Netherlands. In: Kringos D, Boerma W, Hutchinson A, Saltman R, editors. Building primary care in a changing Europe - Case studies. Copenhagen, Denmark: European Observatory on Health Systems and Policies; 2015. p. 181–92.
  114. Westin S, Östensen AI. General Practice Recognized as a Speciality in Norway. Scandinavian Journal of Primary Health Care. 1987;5(1):60–1. https://doi.org/10.3109/02813438709024189
  115. Hasvold T, Christensen B. Norway. In: Kringos D, Boerma W, Hutchinson A, Saltman R, editors. Building primary care in a changing Europe - Case studies. Copenhagen, Denmark: European Observatory on Health Systems and Policies; 2015. p. 193–200.
  116. Rørtveit G. Primary Care in Norway. Utrecht, the Netherlands: European Forum for Primary Care; 2017 [update 2017; cited 2017 Feb]; Available from: http://www.euprimarycare.org/column/primary-care-norway.
  117. Al-Shafaee M. Family Medicine Practice in Oman, Present and future. Squ Med J. 2009;9(2):116–8.
  118. Knox L, Ceitlin J, Hahn RG. Slow Progress: Predoctoral education in Family Medicine in four Latin American countries. Fam Med. 2003;35(8):591–5.
  119. Sagan A, Panteli D, Borkowski W, Dmowski M, Domański F, Czyżewski M, et al. Poland: Health system review. Health Systems in Transition. 2011;13(8):1–193.
  120. Kumar R, Barata AN, Floss M. Primary care education: medical student and young doctors' perspective from Brazil, India and Portugal. Education for Primary Care. 2016;27(5):345–8. DOI: 10.1080/14739879.2016.1225519
  121. Fonseca C, Dedeu T, Pisco L, Gouveia A. Portugal. In: Kringos D, Boerma W, Hutchinson A, Saltman R, editors. Building primary care in a changing Europe - Case studies. Copenhagen, Denmark: European Observatory on Health Systems and Policies; 2015. p. 211–22.
  122. Verjee MA, Abdulmalik MA, Fetters MD. Family medicine's rapid establishment and early leadership role in Qatar's health care system. Journal of Healthcare Leadership. 2013;5:47–52. https://doi.org/10.2147/JHL.S43715
  123. Pavlič DR, Miftode R, Balan A, Pall ZF. Romania. In: Kringos D, Boerma W, Hutchinson A, Saltman R, editors. Building primary care in a changing Europe - Case studies. Copenhagen, Denmark: European Observatory on Health Systems and Policies; 2015. p. 223–32.
  124. Thomas SL. Family Medicine Specialty in Singapore. J Family Med Prim Care. 2013;2(2):135–40. https://doi.org/10.4103/2249-4863.117402
  125. Goh LG, Ong CP. Education and training in family medicine: progress and a proposed national vision for 2030. Singapore Med J. 2014;55(3):117–23. https://doi.org/10.11622/smedj.2014031
  126. Windak A, Oleszczyk M, Jurgova E. Slovakia. In: Kringos D, Boerma W, Hutchinson A, Saltman R, editors. Building primary care in a changing Europe - Case studies. Copenhagen, Denmark: European Observatory on Health Systems and Policies; 2015. p. 233–42.
  127. Pavlič DR, Švab I, Pribaković RB. Slovenia. In: Kringos D, Boerma W, Hutchinson A, Saltman R, editors. Building primary care in a changing Europe - Case studies. Copenhagen, Denmark: European Observatory on Health Systems and Policies; 2015. p. 243–52.
  128. Bulc M, Švab I, Pavlič DR, Kolšek M. Specialist training of Slovene family physicians. European Journal of General Practice. 2006;12(3):128–32. https://doi.org/10.1080/13814780600780759
  129. Chun CB, Kim SY, Lee JY, Lee SY. Health System Review: Republic of Korea. Health System in Transition. 2009;11(7):1–184.
  130. Paek YJ, Shin HC, Kim CH, Choi YS, Lee H, Cho AK, et al. Curriculum and Training Difficulties of Family Medicine Residency Programs in Korea. Korean J Fam Med. 2007;28(5):367–74.
  131. Dedeu T, Bolibar B, Gené J, Pareja C, Violan C. Building primary care in a changing Europe - Case studies. In: Kringos D, Boerma W, Hutchinson A, Saltman R, editors. Copenhagen, Denmark. European Observatory on Health Systems and Policies2015. p. 253–64.
  132. Gofin J, Foz G. Training and application of Community-oriented Primary Care (COPC) through Family Medicine in Catalonia, Spain. Fam Med. 2008;40(3):196–202.
  133. de Silva A, Ranasinghe T, Abeykoon P. Universal health coverage and the health Sustainable Development Goal: achievements and challenges for Sri Lanka. WHO South-East Asia J Public Health 2016;5(2):82–8. https://doi.org/10.4103/2224-3151.206257
  134. Ramanayake R. Historical Evolution and Present Status of Family Medicine in Sri Lanka. Journal of Family Medicine and Primary Care. 2013;2(2):131–4. https://doi.org/10.4103/2249-4863.117401
  135. World Health Organization - Regional Office for South East Asia. Regional Consultation on Strengthening the Role of Family/Community Physicians in Primary Health Care. New Delhi: World Health Organization, 2012. p. 11–3.
  136. Anell A, Glenngård AH, Merkur S. Sweden: Health system review. Copenhagen: World Health Organization, 2012 Contract No: 5.
  137. Björkelund C, Maun A. Primary Care in Sweden. Utrecht: European Forum for Primary Care; 2017 [updated 2017; cited 2017 Feb]. Available from: http://www.euprimarycare.org/column/primary-care-sweden.
  138. Hasvold T. Sweden. In: Kringos D, Boerma W, Hutchinson A, Saltman R, editors. Building primary care in changing Europe. Copenhagen: World Health Organization; 2015. p. 265–74.
  139. Buddeberg-Fischer B, Stamm M, Marty F. Family Medicine in Switzerland: Training Experiences in Medical School and Residency. Fam Med. 2007;39(9):651–5.
  140. Cartier T, Senn N, Cornuz J, Bourgueil Y. Switzerland. In: Kringos D, Boerma W, Hutchinson A, Saltman R, editors. Building primary care in changing Europe - Case studies. Copenhagen, Denmark: European Observatory on Health Systems and Policies; 2015. p. 275–84.
  141. Clarke O, Lindh EM, Sammut MR, Price R, Svavardottir AE, O'Shea B, et al. Training, status and migration of General Practitioners/Family Physicians within Europe. The Journal of the Malta College of Family Doctors. 2013;2(2):24–30.
  142. Chen S-C, Yen C-H, Chen C-C, Wu W-Y, Chou M-C, Bell W, et al. Outpatient teaching in family medicine residency training programs in Taiwan. Asia Pacific Family Medicine. 2004;4:1–5.
  143. Lee M. Education and training of family medicine in Taiwan. Journal of Capital Medical University. 2013;34(2):218–23.
  144. Lee M. Integrated care and training in family practice in the 21st century: Taiwan as an example. Family Medicine and Community Health. 2016;4(1):57–9. https://doi.org/10.15212/FMCH.2015.0134
  145. Yen E. Family practice instructional development models in Taiwan, review and prospective. Kaohsiung J Med Sci. 1996;12(11):641–5.
  146. Jaturapatporn D, Dellow A. Does Family Medicine training in Thailand affect patient satisfaction with primary care doctors? BMC Family Practice. 2007;8(14):1–6. https://doi.org/10.1186/1471-2296-8-14
  147. William R, Henley E, Prueksaritanond S, Aramrattana A. Family Practice in Thailand: Will it Work? JABFP. 2002;15(2):73–6.
  148. Wiwanitkit V. Family medicine in Thailand: System, training, and obstacles. Medical Journal of Dr DY Patil University. 2016;9(1):1–6. https://doi.org/10.4103/0975-2870.172412
  149. World Health Organization - Regional Office for South East Asia. Family Medicine - Report of a Regional Scientific Working Group Meeting on Core Curriculum. New Delhi: World Health Organization - Regional Office for South East Asia, 2003. p. 9–16.
  150. Ibrahim H, Nair SC, Shaban S, El-Zubeir M. Reducing the Physician Workforce Crisis: Career Choice and Graduate Medical Education Reform in an Emerging Arab Country. Education for Health. 2016;29(2):82–8. https://doi.org/10.4103/1357-6283.188716
  151. Gibbs T, Khimion L, Lysenko G. Family medicine in Ukraine: changing theory into practice and completing the circle. British Journal of General Practice. 2008:654–6. https://doi.org/10.3399/bjgp08X342066
  152. Kolesnyk P, Švab I. Development of family medicine in Ukraine. European Journal of General Practice. 2013;19:261–5. https://doi.org/10.3109/13814788.2013.807791
  153. Korzh O. Primary Care in Ukraine. Utrecht: European Forum for Primary Care; [Update: 2 February 2017]; Available from: http://www.euprimarycare.org/column/primary-care-ukraine.
  154. Chouinard J. Mandatory training for general practice in the United Kingdom. Can Med Assoc J. 1978;119(8):861.
  155. NHS Choices. The NHS in England. London: National Health Service; [ update 2016; cited 2017 Feb]; Available from: http://www.nhs.uk/NHSEngland/thenhs/about/Pages/overview.aspx.
  156. Wilson A. United Kingdom. In: Kringos DS, Boerma WG, Hutchinson A, Saltman RB, editors. Building primary care in a changing Europe. Copenhagen: World Health Organization; 2015.
  157. María A. Mejía OMQ, María C. D'Avila and Carmen C. Silva. Current situation of family medicine in Venezuela. Aten Primaria. 2007;39(9):495–6. https://doi.org/10.1157/13109501
  158. Romero N, Gruber F, Rincon M, Thompson R. Teaching family and community dimensions of clinical family medicine in Venezuela. Fam Med. 1994;26(2):89–92.
  159. Thompson R, Gruber F, Marcano G. Family medicine training in Venezuela. Fam Med. 1992;24(3):188–90.





Copyright (c) 2017 Indah S. Widyahening, Rodri Tanoto, Fedri Rinawan, Elsa P. Setiawati, Zorayda E. Leopando

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

All articles and issues in Medical Journal of Indonesia have unique DOI number registered in Crossref.
 
Romeo
 
http://mji.ui.ac.id/journal/index.php/mji/pages/view/stat
Unique Visitors