Family Medicine (FM) is a medical specialty devoted to comprehensive health care for people of all ages. It is a division of primary care that provides continuing and comprehensive health care for the individual and family across all ages, sexes, diseases, and parts of the body. It is based on knowledge of the patient in the context of the family and the community, emphasizing disease prevention and health promotion. According to the World Organization of Family Doctors (Wonca), the aim of family medicine is to provide personal, comprehensive and continuing care for the individual in the context of the family and the community.
Family Medicine in India:
Family Medicine (FM) came to be recognized as a medical specialty in India only in the late 1990s. According to the National Health Policy – 2002, there is an acute shortage of specialists in family medicine. As family physicians play very important role in providing affordable and universal health care to people, the Government of India is now prompting family medicine. There are lot of poverty and bad law and order situation in India which further make difficult for family medicine.
Although family medicine is sometimes called general practice, they are not identical in India. A medical graduate who has successfully completed the MBBS (Bachelor of Medicine and Bachelor of Surgery) course and has been registered with Indian Medical Council or any state medical council is considered a general practitioner. A family physician, however, is a primary care physician who has done specialist training in the discipline of family medicine.
The National Board of Examinations conducts family medicine residency programme at teaching hospitals accredited by it. On successful completion of their three-year residency, candidates are awarded Diplomate of National Board (Family Medicine). The curriculum of DNB (FM) comprises: (1) medicine and allied sciences; (2) surgery and allied sciences; (3) maternal and child health; (4) basic sciences and community health. During their three-year residency, candidates receive integrated inpatient and outpatient learning. They also receive field training at community health centers and clinics.
The Medical Council of India permits accredited medical colleges (medical schools) to conduct a similar residency programme in family medicine. On successful completion of three-year residency, candidates are awarded Doctor of Medicine (Family Medicine). However, medical colleges are yet to start this MD (FM) course, even though there is an acute shortage of qualified family physicians in India.
As India’s need for primary and secondary levels of health care is enormous, medical educationalists call for some systemic changes to include family medicine in the undergraduate medical curriculum as well.
Regarding how family physicians will practice their specialty in India, one can only speculate now. Possibly, three models might evolve, namely (1) private practice, (2) practicing at primary care clinics/hospitals, (3) practicing as consultants at secondary/tertiary care hospitals (4) practicing as GP’s/Family Physicians with Nationwide Primary Healthcare Services Pvt. Ltd.