Wonca Working Party On Education And Student Exchanges Checklist
The Wonca Working Party on Education (WWPE) was very happy to be approached by the International Federation of Medical Student Associations (IFMSA) to help in developing student exchanges in primary care. As a first step in this process, our group has been developing a checklist for student experiences in family medicine. This checklist will become part of IFMSA’s handbook that every medical student going on an exchange will take with them.
Our goal is to ensure that students will understand the essential experiences in understanding and learning about family medicine, in the context of the country in which they are learning. This is a challenge, given the international nature of student exchanges and the fact that family medicine/ primary care is very context specific. We also would like to see more medical students experience family medicine/ general practice during their training. The checklist is not a list of procedures and interventions, but much more of a guide to the sorts of things that family doctors all over the world do as they practice.
We used a modified Delphi process to develop a list of essential experiences, using the email list of the Working Party on Education. First, the core executive members of the working party developed a list of experiences, having reviewed an existing checklist from IFMSA’s handbook (one for an experience in obstetrics and gynecology). They were asked to consider what a medical student should experience in a short placement, in another country or in their own. Up to ten items could be forwarded to the working party chair. The resulting 27 items were combined, with wording made consistent and circulated to the email list of the working party. Members were asked to rate each item for its importance, and also offered an opportunity to add additional items. Space for comments were included. In the first round, 18 responses were received. In the second round borderline items, new and revamped suggestions were sent out. In this round, 13 responses were received. In all, responses were received from 15 countries and 5 continents.
Preliminary results were presented at Wonca Europe in Warsaw, September 2011.
The checklist is undergoing discussion and review amongst the working party members and we anticipate it will be finalized very soon.We believe this checklist is a representation of a global consensus of what is important for medical students to experience in family/general practice, no matter where in the world the clinical placement. The preliminary consensus items for the checklist are as follows:
- Describe the health care system and the position and impact of primary care within this system
- Understand and describe which conditions are handled in family practice, and which by other levels of care in this health care system
- Explain Select differences in diagnostic procedures and treatments related to incidence and prevalence in primary care, as compared to secondary and tertiary care
- Discuss the doctor patient relationship unique to family practice
- Explain differences between illness and disease, using the patient centered clinical approach
- Perform and explain a patient centred consultation
- Demonstrate empathy and communication skills
- Provide care to patients over time (same patient, several visits)
- Evaluate and manage patients with chronic diseases over time
- Evaluate, diagnose and propose initial management for patients with common acute presentations in this setting
- Deal with situations of clinical uncertainty
- Discuss ethical aspects in family practice
- Demonstrate respect for patients’ culture and sensitivity to their own beliefs and assumptions
Prof Allyn Walsh MD
Chair, Wonca Working Party on Education