WONCA Accreditation supporting Family Medicine training

Written by Professor Afif Ben Salah: Chairman of Family and Community Medicine Department, College of Medicine and Medical Sciences, Arabian Gulf University, Bahrain.

The clinical Masters program in family medicine was launched by the Arabian Gulf University in April 2019 at the request of the government of Bahrain. It aims to: i) Develop the capabilities of physicians to deliver Primary Health Care (PHC) services in Bahrain; ii) Achieve the core objectives and standards of the health care systems in the Gulf Cooperation Council (GCC) countries and iii) Increase the ratio of skilled family physicians per patient in the GCC countries to the international recommended level. The program is family oriented and focused on balanced clinical training in the primary health care and secondary care settings. It is characterized by a hybrid educational contents and crowned by a quality improvement project to nurture a culture of critical appraisal and evidence-based clinical practice. 

The challenge is to ensure the Masters program achieves competency standards for postgraduate training for unsupervised practice. Our aim is to achieve WONCA accreditation when our doctors graduate. But how to achieve the necessary standard? WONCA agreed for two experts to visit, review the proposed curriculum and primary care training sites with us and make recommendations on how to meet the Working Party on Education (WWPE) standards.

The curriculum was approved and endorsed with the WONCA logo as we launched the program for 40 trainees. But then came the COVID-19 pandemic with the challenges of safety, switching to online consultations for most chronic patients and limitations of face-to-face meetings. The academic program committee found ways to adapt the implementation process without compromising the learning outcomes. A trainee to trainer ratio of 2 to 1 ensured deep learning with protected trainer time. We reduced the trainee group size for face-to-face meetings, integrated new online education technologies and structured all rotations on a Moodle learning platform in a standardized way. An electronic portfolio (e-portfolio) was developed to document the progress of a trainee’s performance and ensure regular monitoring of learning progress and implementation of corrective actions when needed. At the same time, in line with WONCA recommendations, we developed assessment tools to harmonize the training and feedback from consultants in the workplace. A mentorship program identified trainees who were struggling allowing us to respond to their educational or socio-psychological needs.

We have just successfully finished the first year of training and assessment. A time to reflect on progress against WONCA standards. As the academic committee evaluates the first-year experience further consultation from the WONCA experts is planned in May to prepare the ground for a better performance and full accreditation in March 2022. The year 2 training of the first cohort will allow increased autonomy for the trainees to deal with more complex clinical situations and practice in a comprehensive manner under the supervision of their trainers. 

The support from WONCA has been invaluable in helping us on our challenging journey to ensure we meet the Government requirements for a high standard of fully competent family medicine doctors to deliver primary care services in Bahrain.