Dr Ahmed Al-Mujil is a Family Medicine Doctor from Saudia Arabia on a one year attachment to the Academic Dept of Primary care at Imperial. In this blog he gives us a unique insight into Family Medicine training in Saudia Arabia.
The Family Medicine Residency Training Program in Saudi Arabia was established in 1994, at which time the first edition of the curriculum was written. Since then, Family Medicine and medical education have undergone significant changes. The curriculum was revised many times, until recent adoption of the Canadian Medical Education Directive for Specialists- CanMeds competencies framework in which the “competent physician” seamlessly integrates the competencies of all seven CanMEDS Roles. (Medical expert, Collaborator, Communicator, Leader, Health Advocate, Scholar and Professional).
The duration of training in Family Medicine is four years starting from the first of October every year. All trainees must go through the rotations in their training manual; each rotation has its own aims and objectives as well as description of the content, competencies and assessment*. The trainee portfolio is a pre-requisite for the summative assessment and should be reviewed with the trainee’s mentor every two weeks. Apart from rotations, formative and summative assessments, trainees must pass the part one exam- usually after 2nd year- and part two or Final Exam after completion of training, which is held over two days and with trainees awarded the Saudi Board of Family Medicine (SBFM) certificate. Family physician is the term used to describe a qualified physician in family medicine- whether by obtaining SBFM or an equivalent degree outside Saudi Arabia- and the term GP is used to describe a non-qualified physician in family medicine- often doctors who did not obtain SBFM or their degree is not equivalent to SBFM.
* Table shows the structure of training in family medicine.
Medical students can apply for the Family Medicine training program - after completion of 6 years medical school study and a mandatory one year internship through the Saudi Council for Health Specialties (SCFHS) in which each applicant is assessed for eligibility against his grade-point-average, CV review and degree of Saudi Medical License Exam (SMLE). After acceptance into the Family Medicine Residency training programme students individually apply to different family medicine training centres. Again each centre will assess the applicants and usually they will interview them and final registration will be issued upon acceptance in a training centre.
Family medicine is a highly competitive specialty and it is not easy to obtain a place. In order to secure a place, medical students usually increase their chances by having elective rotations during their medical school in family medicine, or get involved in academic activities or research as well as securing a recommendation from a family medicine consultant.
Family Practice is not well established in Saudi Arabia, although Saudi Arabia signed the Alma-Ata Declaration on 1978 which was the first international declaration underlining the importance of primary health care. They established the primary care system almost from scratch and now there are more than 1900 Primary Health Centres across the country with the effort and resources afterwards aimed at the secondary and tertiary care. Most of the Family physicians work in primary care departments within the hospitals. As most of the primary care centres are not well organized, well- equipped or lack support, they can be an unhealthy working environment. The good news is that as stakeholders start to realize that primary care is vital care in any health care system, efforts are ongoing to revise and improve primary health care which has resulted in a lot of an excellent Primary Health Centres with good Support.*
Ahmed Al-Mujil, MD, SBFM, ABFMDr.email@example.com