Reaching national consensus on the core clinical skill outcomes for family medicine postgraduate training programmes in South Africa

Abstract

BackgroundFamily physicians play a significant role in the district health system and need to be equipped with a broad range of clinical skills in order to meet the needs and expectations of the communities they serve. A previous study in 2007 reached national consensus on the clinical skills that should be taught in postgraduate family medicine training prior to the introduction of the new speciality. Since then, family physicians have been trained, employed and have gained experience of working in the district health services. The national Education and Training Committee of the South African Academy of Family Physicians, therefore, requested a review of the national consensus on clinical skills for family medicine training.MethodsA Delphi technique was used to reach national consensus in a panel of 17 experts: family physicians responsible for training, experienced family physicians in practice and managers responsible for employing family physicians.ResultsConsensus was reached on 242 skills from which the panel decided on 211 core skills, 28 elective skills and 3 skills to be deleted from the previous list. The panel was unable to reach consensus on 11 skills.ConclusionThe findings will guide training programmes on the skills to be addressed and ensure consistency across training programmes nationally. The consensus will also guide formative assessment as documented in the national portfolio of learning and summative assessment in the national exit examination. The consensus will be of interest to other countries in the region where training programmes in family medicine are developing.

A self-assessment study of procedural skills of doctors in peri-urban district hospitals of Gauteng, South Africa

“…The current full-time M Med registrar programme has been running for 10 years now; it is an opportune period to explore and study the procedural skills competencies of these graduates, to determine if, indeed, there is improvement compared to the current revised skills list. 40 Family physicians have a big role to play in PHC and the long-term goal should be to develop a critical mass of skilled family physicians who can fulfil the key roles of a care provider, supervisor and capacity builder to other cadres of health workers in the district health services. 8…”

The role of family physicians in emergency and essential surgical care in the district health system in South Africa

“…10 Most FM postgraduate training programmes require training in 18 of the 28 World Bank EESC DH procedures. 11 A previous study acknowledged the importance of major surgical skills in the scope of FP practice, 12 and at a workshop at the 2019 Rural Health Conference, South African FPs also expressed interest in improving access to safe and timely surgical care at DHs. Several barriers were identified as obstacles to scaling up DH EESC by FPs at the workshop, including staff shortages, insufficient skills mix in the DH, a lack of support from surgical and anaesthetic departments at higher levels of care, a lack of funding for equipment and supplies, and a lack of appropriate post-operative care.…”

A scoping review on family medicine in sub-Saharan Africa: practice, positioning and impact in African health care systems

“…The family physician functions as a generalist who accepts everyone seeking care in contrast to other physicians who limit access to their services on the basis of age, sex and/or type of health problem." Table 2 Specific terminology related to the discipline and human resources in family medicine in sub-Saharan Africa ( [7,8,38], anecdotal)…”