1(st) National Conference on Family Medicine and Primary Care: A Journey Toward Stronger Primary Care in India.

Academy of Family Physicians of India organized the first National Conference on Family Medicine and Primary Care (FMPC) on 20-21 April 2013 at India International Centre New Delhi. The conference was a major success towards positioning of requirement for a distinct academic discipline (family medicine) within the medical and nursing education system as a means for strengthening of primary care in India. The event gained its prominence in the times when universal health coverage is being debated. A generalist approach in development of human resource prominently figured in the discussions. The deliberations and talks of the Indian as well as international experts were recorded and released as the report of national consultation on family medicine programme.

Background

India is moving towards universal health coverage (UHC) and national health mission (NHM). Multi-skilled and competent primary care providers and their knowledge figure prominently in the evolving schemes, themes and initiatives of our health care systems. Family medicine has received attention in several policy documents of the Government of India including the National Health Policy 2002. The concept of family medicine has also been supported by the Mehta Committee Report, Prime Minister's National Knowledge Commission, National Rural Health Mission (NRHM) task force on Human Resource Development, Medical Council of India (MCI) Vision 2015 and Planning Commission's Steering Committee on Health in 12th National Plan (2012-17). In order to give a momentum to this national need, the Academy of Family Physicians of India (AFPI) organized Family Medicine and Primary Care (FMPC) on 20-21 April 2013 at India International Centre New Delhi.[12]

Inaugural Session

FMPC 2013 was attended by senior policy makers, government officials and all major stake holders in the health care delivery system. The conference was inaugurated by Shri. Keshav Desiraju, the Union Health Secretary Government of India.

Prof. Michael Kidd, President Elect of World Organization of Family Doctors (WONCA) addressed the august gathering as guest of honor. He emphasized on the social responsibilities of the family physicians. The keynote address was delivered Prof. K. Srinath Reddy president of the Public Health Foundation of India (PHFI), who discussed the role of Family Physicians (FP) in the context of universal health coverage (UHC). MCI was represented by one it its governing board members Dr. Purushottam Lal, who suggested several innovative ideas to popularize family medicine programme in India. Dr. T. Sundaraman, Executive Director of the National Health System Resource Centre (NHSRC) National Rural Health Mission (NRHM), elaborated on the requirement of family medicine experts in the public health delivery system. On the second day of the conference, a keynote address on medical generalism was delivered by Dr. Clare Gerada, Chair of the Royal College of General Practice UK.

National Consultation on Family Medicine Programme

The conference also hosted a national consultation convened by NHSRC, NRHM on the development of family medicine programme by exploring the list of competencies required by a family medicine practitioners at CHC (community health centre) level. The objective of this consultation was to ensure availability of multi-skilled and competent medical doctors capable of providing comprehensive package of services at sub-district/block level. Experts also looked into prospects of developing the discipline of family medicine in Nursing.

Participants and the Scientific Programme

The conference attracted leading Indian as well as international experts in the area of family medicine with a common objective to define this discipline. More than four hundred participants from all over Indian attended the conference. Several of them came from rural, remote and far away locations. The delegates benefitted from deliberations of the learned faculty from all over world. Several interesting session on clinical practice and management were organized. South Asia Primary Care Research Network also conducted a research workshop addressing academic requirements of the primary care physicians.

Youth leadership summit for Primary Health Care (YLS-PHC): Medical students vouch for family medicine

The conference was also an endeavor to encourage the younger generation of medical doctors to opt for a career in community based health care delivery system. Participation of medical student and young doctors was the hallmark of this event. The conference demolished the myth that young doctors in India are not interested in primary health care (PHC). YLS-PHC was a unique initiative of the AFPI. The organizing committee invited concept notes from medical/nursing students, young health professionals on how to strengthen primary health care in India. Successful applicants were invited to New Delhi to present their ideas with the support of travel grants.

The highlights of this session were activities such as talk on leadership by Dr. Ramnik Prarikh, discourse by DoctorHangout.com founder Subramaniam Karuturi and leadership workshop by Vishal Marwah.

Spice Route Pre-conference

FMPC 2013 hosted the second Spice Route pre-conference. The Spice Route is the WONCA South Asia Region working group for new and future doctors who have an interest in Family Medicine, General Practice and Primary Care.[3] It aims to promote excellence in this field and to address the challenges pertaining to global health. Other similar groups in different parts of world are-the Vasco de Gama movement in Europe, the Rajakumar movement in the Asia-Pacific region, Waynakay in the Iberoamericana region and New and future family doctors in the North America region. The group comprises of (a) doctors and undergraduate medical students who are planning to train in family medicine (b) doctors who are undertaking post-graduate training in family medicine (c) doctors who have completed their post-graduate training in family medicine within the last five years (d) young doctors belonging to WONCA South Asia Region: India, Pakistan, Nepal, Sri Lanka, Bangladesh, Afghanistan, Bhutan and the Maldives. This pre-conferences hosted enthusiastic participants from India, Pakistan, Nepal and Sri Lanka.

Rainbow Session — International Family Medicine Experts of Indian Origin

Rainbow session was organized as an exclusive forum for family medicine faculty, residents and practicing physicians of Indian origin residing abroad. Every year a large number of Indian doctors emigrate abroad to join family medicine residency training and take primary care job assignments. According to rough estimates approximately 20% of the GPs working in the National Health Scheme (NHS) UK, are of Indian origin. Family medicine is picking up fast in India. Many non resident Indian (NRI) doctors have already started their own primary care ventures in India. This special session was addressed by family medicine experts of India origin from USA, Singapore, Middle East, UK and Australia.

Support of academic institutions and organization

FMPC received academic support and endorsement from nationally reputed medical institutes such as All India Institute of Medical Sciences AIIMS Jodhpur, Calicut Medical College Kerala and Christian Medical College Vellore. Supporting grants were received from Indian Council for Medical Research and Council for Scientific and Industrial Research. WONCA extended its support as an international partner. Professional organization such as FFPAI (Federation of family physician associations of India) and IMA CGP (Indian Medical Association College of General Practitioners). Nationwide, the family doctors, from Bangalore participated as principal partner.

Outcome

Conferences advance our understanding, knowledge and practices. The first academic conference organized to discuss and develop family medicine, achieved many objectives in India. A wider awareness was created about the concept of generalist medical care among the policy makers, young doctors, medical professionals and general public at large. Immediately after the conference the MCI governing body approved the curriculum of post-graduate family medicine programme, which was pending for several years. The Union Health Secretary Government of India has issued a letter to all state health secretaries emphasizing the importance starting family medicine at all medical colleges in India and suggested to make MD/DNB - family medicine, a desirable qualification for recruitment at community health centers and sub district hospitals.[4] The report of the national consultation has been prepared and released. It is expected that the recommendations of this report will have far reaching impact on the health care delivery system especially in the context on UHC.