A virtual dialogue on the training of specialists in family medicine


Access to health services, especially for people living in underdeveloped countries, is still a major challenge. This is despite the decision taken by 134 countries to provide Health For All In 2000, at the historic international health conference of Alma Ata, sponsored by the WHO, in 1978. At this conference, it was concluded that Primary Health Care (PHC) is the basis of the health system of every nation that wanted to assure health for all their citizens, with equity and in a cost-effective way.

Unfortunately, 36 years later, it is still necessary to rediscover Primary Health Care. Why?

In 2008, 34 years after Alma Ata, the WHO released a publication, entitled Primary Health Care, Now More than Ever and stated that “People are increasingly impatient with the inability of health services to deliver levels of national coverage that meet stated demands and changing needs [...]. Few would disagree that health systems need to respond better – and faster – to the challenges of a changing world. PHC can do that."

In this document, it seems that WHO has overcome one of the biggest challenges to assure quality in Primary Health Care: the comprehension that Primary Health Care cannot be confused with “Primitive Care”. PHC needs high quality professionals and good work conditions to be effective and result in the care of people, families and communities. offering assistance and care to maintain or recover health to the most part of health problems that people have during the most part of their lives.

We must understand why health and education managers have difficulty in understanding that Primary Health Care is complex, as are the secondary or tertiary level of health care, although these have different kinds of complexities.

Nowadays, Universal Health Coverage has been assumed as a compromise by the 197 countries that are part of the WHO. So we must have good PHC now, more than ever.

A virtual dialogue on the training of specialists in family medicine

Thus in July, it was a good opportunity that a group of family doctors had the opportunity to participate, in a virtual dialogue on the training of specialists in Family Medicine under universal coverage “Diálogo Virtual sobre la formación de especialistas en Medicina Familiar en el marco de la Cobertura Universal de Salud”. This event was promoted by the Panamerican Health Organization (PAHO) and organised by Dr Rosa Maria Borrell, a PAHO Regional Associate for Health Sciences Education. We are grateful to her for doing this.

The major purposes of this ‘Dialogue’ were to:
• Contribute to strengthening the educational processes for the future Family Doctors, to meet the needs of Universal Health Coverage and PHC
• exchange experiences of “best practice” in training Family Doctors by residency programs;
• present the progress and recognition that Family Medicine has been achieving in recent years in the context of health systems’ reforms;
• generate a community of “innovative practices” on polices regarding family medicine training using the WHO Health Human Resources Observatory website.

Besides my participation, as the President of WONCA Iberoamerica- CIMF, seven other Family Doctors from Argentina, Brazil, México, Peru, Spain, United States of America and Uruguay attended this event. Many people sent online questions and we had the opportunity to clarify some questions and to broaden our comprehension of others.

There is a good material available at the website: videos and power point presentations and some documents of interest on the theme.

We would like to suggest the use of this lecture and material in different places – by and with students, residents, managers.

Inez Padula
WONCA Iberoamericana- CIMF President