General practitioner

Last updated
Consultation with a mobile health team doctor in Madagascar Free consultation with a Doctor of mobile health team has Madagacar.jpg
Consultation with a mobile health team doctor in Madagascar

In the medical profession, a general practitioner (GP) is a medical doctor who treats acute and chronic illnesses and provides preventive care and health education to patients.

Contents

A general practitioner manages types of illness that present in an undifferentiated way at an early stage of development, which may require urgent intervention. [1] The holistic approach of general practice aims to take into consideration the biological, psychological, and social factors relevant to the care of each patient's illness. Their duties are not confined to specific organs of the body, and they have particular skills in treating people with multiple health issues. They are trained to treat patients of any age and sex to levels of complexity that vary between countries.

The role of a GP can vary greatly between (or even within) countries. In urban areas of developed countries, their roles tend to be narrower and focused on the care of chronic health problems; the treatment of acute non-life-threatening diseases; the early detection and referral to specialised care of patients with serious diseases; and preventive care including health education and immunisation. Meanwhile, in rural areas of developed countries or in developing countries, a GP may be routinely involved in pre-hospital emergency care, the delivery of babies, community hospital care and performing low-complexity surgical procedures. [2] [3] In some healthcare systems GPs work in primary care centers where they play a central role in the healthcare team, while in other models of care GPs can work as single-handed practitioners.

The term general practitioner or GP is common in the United Kingdom, Republic of Ireland, Australia, Canada, Singapore, New Zealand and many other Commonwealth countries. In these countries, the word "physician" is largely reserved for certain other types of medical specialists, notably in internal medicine. While in these countries, the term GP has a clearly defined meaning, in North America the term has become somewhat ambiguous, and is sometimes synonymous with the terms family doctor or primary care physician , as described below.

Historically, the role of a GP was once performed by any doctor with qualifications from a medical school and who works in the community. However, since the 1950s, general practice has become a specialty in its own right, with specific training requirements tailored to each country. [4] [5] [6] The 1978 Alma Ata Declaration set the intellectual foundation of primary care and general practice.

Asia

India and Bangladesh

The basic medical degree in India and Bangladesh is MBBS (Bachelor of Medicine, Bachelor of Surgery. These generally consist of a four-and-a-half-year course followed by a year of compulsory rotatory internship in India. In Bangladesh it is five years course followed by a year of compulsory rotatory internship. The internship requires the candidate to work in all departments for a stipulated period of time, to undergo hands-on training in treating patients.

The registration of doctors is usually managed by state medical councils. A permanent registration as a Registered Medical Practitioner is granted only after satisfactory completion of the compulsory internship.

The Federation of Family Physicians' Associations of India (FFPAI) is an organization which has a connection with more than 8000 general practitioners through having affiliated membership. [7]

Pakistan

In Pakistan, 5 years of MBBS is followed by one year of internship in different specialties. Pakistan Medical and Dental Council (PMDC) then confers permanent registration, after which the candidate may choose to practice as a GP or opt for specialty training.

The first Family Medicine Training programme was approved by the College of Physicians and Surgeons of Pakistan (CPSP) in 1992 and initiated in 1993 by the Family Medicine Division of the Department of Community Health Sciences, Aga Khan University, Pakistan. [8]

Family Medicine residency training programme of Ziauddin University is approved for Fellowship in Family Medicine. [9]

Europe

France

In France, the médecin généraliste (commonly called docteur) is responsible for the long term care in a population. [10] This implies prevention, education, care of the diseases and traumas that do not require a specialist, and orientation towards a specialist when necessary. They also follow the severe diseases day-to-day (between the acute crises that require the intervention of a specialist).

They have a role in the survey of epidemics, a legal role (constatation of traumas that can bring compensation, certificates for the practice of a sport, death certificate, certificate for hospitalisation without consent in case of mental incapacity), and a role in the emergency care (they can be called by the samu, the French EMS). They often go to a patient's home when the patient cannot come to the consulting room (especially in case of children or old people), and have to contribute to a night and week-end duty (although this was contested in a strike in 2002). [ citation needed ]

The studies consist of six years in the university (common to all medical specialties), and three years as a junior practitioner (interne) :

This ends with a doctorate, a research work which usually consist of a statistical study of cases to propose a care strategy for a specific affliction (in an epidemiological, diagnostic, or therapeutic point of view).

Greece

General Practice was established as a medical specialty in Greece in 1986. To qualify as a General Practitioner (γενικός ιατρός, genikos iatros) doctors in Greece are required to complete four years of vocational training after medical school, including three years and two months in a hospital setting. [13] General Practitioners in Greece may either work as private specialists or for the National Healthcare Service, ESY (Εθνικό Σύστημα Υγείας, ΕΣΥ).

Netherlands and Belgium

General practice in the Netherlands and Belgium is considered advanced. The huisarts (literally: "home doctor") administers first line, primary care. In the Netherlands, patients usually cannot consult a hospital specialist without a required referral. Most GPs work in private practice although more medical centers with employed GPs are seen. Many GPs have a specialist interest, e.g. in palliative care.

In Belgium, one year of lectures and two years of residency are required. In the Netherlands, training consists of three years (full-time) of specialization after completion of internships of 3 years. [14] First and third year of training takes place at a GP practice. The second year of training consists of six months training at an emergency room, or internal medicine, paediatrics or gynaecology, or a combination of a general or academic hospital, three months of training at a psychiatric hospital or outpatient clinic and three months at a nursing home (verpleeghuis) or clinical geriatrics ward/policlinic. During all three years, residents get one day of training at university while working in practice the other days. The first year, a lot of emphasis is placed on communications skills with video training. Furthermore, all aspects of working as a GP gets addressed including working with the medical standards from the Dutch GP association NHG (Nederlands Huisartsen Genootschap). [15] All residents must also take the national GP knowledge test (Landelijke Huisartsgeneeskundige Kennistoets (LHK-toets)) twice a year. [16] In this test of 120 multiple choice questions, medical, ethical, scientific and legal matters of GP work are addressed. [16] [17]

Russia

In the Soviet Union specialty "general practitioner" did not exist, similar functions were performed by the Therapist (Russian : терапевт). In the Russian Federation, the General Practitioner's Regulation was put into effect in 1992, after which medical schools started training in the relevant specialty. The right to practice as a general practitioner gives a certificate of appropriate qualifications. General medical practice can be carried out both individually and in a group, including with the participation of narrow specialists. The work of general practitioners is allowed, both in the medical institution and in private. The general practitioner has broad legal rights. He can lead junior medical personnel, provide services under medical insurance contracts, conclude additional contracts to the main contract, and conduct an examination of the quality of medical services. For independent decisions, the general practitioner is responsible in accordance with the law.

The main tasks of a general practitioner are:

Spain

Francisco Valles (Divino Valles) DivinoValles.jpg
Francisco Vallés (Divino Vallés)

In Spain GPs are officially especialistas en medicina familiar y comunitaria but are commonly called "médico de cabecera" or "médico de familia". [18] Was established as a medical specialty in Spain in 1978.

Most Spanish GPs work for the state funded health services provided by the county's 17 regional governments (comunidades autónomas). They are in most cases salary-based healthcare workers.

For the provision of primary care, Spain is currently divided geographically in basic health care areas (áreas básicas de salud), each one containing a primary health care team (Equipo de atención primaria). Each team is multidisciplinary and typically includes GPs, community pediatricians, nurses, physiotherapists and social workers, together with ancillary staff. In urban areas all the services are concentrated in a single large building (Centro de salud) while in rural areas the main center is supported by smaller branches (consultorios), typically single-handled. [19]

Becoming a GP in Spain involves studying medicine for 6 years, passing a competitive national exam called MIR (Medico Interno Residente) and undergoing a 4 years training program. The training program includes core specialties as general medicine and general practice (around 12 months each), pediatrics, gynecology, orthopedics and psychiatry. Shorter and optional placements in ENT, ophthalmology, ED, infectious diseases, rheumathology or others add up to the 4 years curriculum. The assessment is work based and involves completing a logbook that ensures all the expected skills, abilities and aptitudes have been acquired by the end of the training period. [20] [21]

United Kingdom

In the United Kingdom, physicians wishing to become GPs take at least 5 years training after medical school, which is usually an undergraduate course of five to six years (or a graduate course of four to six years) leading to the degrees of Bachelor of Medicine and Bachelor of Surgery.

Until 2005, those wishing to become a General Practitioner of medicine had to do a minimum of the following postgraduate training:

This process changed under the programme Modernising Medical Careers. Medical practitioners graduating from 2005 onwards have to do a minimum of five years postgraduate training:

Medical career grades of the National Health Service
YearCurrent (Modernising Medical Careers)Previous
1 Foundation doctor (FY1 and FY2), 2 years Pre-registration house officer (PRHO), 1 year
2 Senior house officer (SHO),
minimum 2 years; often more
3 Specialty registrar,
general practice (GPST), 3 years
Specialty registrar,
hospital speciality (SpR), minimum 6 years
4 Specialist registrar,
4–6 years
GP registrar, 1 year
5General practitioner,
4 years total time in training
6–8 General practitioner,
5 years total time in training
9 Consultant, minimum 8 years total time in trainingConsultant, minimum 7–9 years total time in training
OptionalTraining is competency based, times shown are a minimum. Training may be extended by obtaining an Academic Clinical Fellowship for research or by dual certification in another speciality.Training may be extended by pursuing medical research (usually 2–3 years), usually with clinical duties as well

The postgraduate qualification Membership of the Royal College of General Practitioners (MRCGP) was previously optional. In 2008, a requirement was introduced for doctors to succeed in the MRCGP assessments in order to be issued with a certificate of completion of their specialty training (CCT) in general practice. After passing the assessments, they are eligible to use the post-nominal letters MRCGP (so long as the doctor continued to pay membership fees to the RCGP, though many do not). During the GP specialty training programme, the medical practitioner must complete a variety of assessments in order to be allowed to practice independently as a GP. There is a knowledge-based exam with multiple choice questions called the Applied Knowledge Test (AKT). The practical examination takes the form of a "simulated surgery" in which the doctor is presented with thirteen clinical cases and assessment is made of data gathering, interpersonal skills and clinical management. This Clinical Skills Assessment (CSA) is held on three or four occasions throughout the year and takes place at the renovated headquarters of the Royal College of General Practitioners (RCGP), at 30 Euston Square, London. Finally throughout the year, the doctor must complete an electronic portfolio which is made up of case-based discussions, critique of videoed consultations and reflective entries into a "learning log".

In addition, many hold qualifications such as the DCH (Diploma in Child Health of the Royal College of Paediatrics and Child Health) or the DRCOG (Diploma of the Royal College of Obstetricians and Gynaecologists),the DPD (Diploma in Practical Dermatology) or the DGH (Diploma in Geriatric Medicine of the Royal College of Physicians). Some General Practitioners also hold the MRCP (Member of the Royal College of Physicians) or other specialist qualifications, but generally only if they had a hospital career, or a career in another speciality, before training in General Practice.

There are many arrangements under which general practitioners can work in the UK. While the main career aim is becoming a principal or partner in a GP surgery, many become salaried or non-principal GPs, work in hospitals in GP-led acute care units, or perform locum work. Whichever of these roles they fill, the vast majority of GPs receive most of their income from the National Health Service (NHS). Principals and partners in GP surgeries are self-employed, but they have contractual arrangements with the NHS which give them considerable predictability of income.

GPs in the United Kingdom may operate in community health centres. Jericho Health Centre 20050326.jpg
GPs in the United Kingdom may operate in community health centres.

Visits to GP surgeries are free in all countries of the United Kingdom, but charges for prescriptions are applied in England. Wales, Scotland and Northern Ireland have abolished all charges. [22]

Recent reforms to the NHS have included changes to the GP contract. General practitioners are no longer required to work unsociable hours, and get paid to some extent according to their performance, (e.g. numbers of patients treated, what treatments were administered, and the health of their catchment area, through the Quality and Outcomes Framework). The IT system used for assessing their income based on these criteria is called QMAS. The amount that a GP can expect to earn does vary according to the location of their work and the health needs of the population that they serve. Within a couple of years of the new contract being introduced, it became apparent that there were a few examples where the arrangements were out step with what had been expected. [23] A full-time self-employed GP, such as a GMS or PMS practice partner, might currently expect to earn a profit share of around £95,900 before tax [24] while a GP employed by a CCG could expect to earn a salary in the range of £54,863 to £82,789. [25] This can equate to an hourly rate of around £40 an hour for a GP partner. [26]

A survey by Ipsos MORI released in 2011 reports that 88% of adults in the UK "trust doctors to tell the truth". [27]

In May 2017, there was said to be a crisis in the UK with practices having difficulties recruiting GPs they need. Prof. Helen Stokes-Lampard of the Royal College of General Practitioners said, “At present, UK general practice does not have sufficient resources to deliver the care and services necessary to meet our patients’ changing needs, meaning that GPs and our teams are working under intense pressures, which are simply unsustainable. Workload in general practice is escalating – it has increased 16% over the last seven years, according to the latest research – yet investment in our service has steadily declined over the last decade and the number of GPs has not risen in step with patient demand ... This must be addressed as a matter of urgency.”. [28]

In 2018 the average GP worked less than three and a half days a week because of the “intensity of working day”. [29]

There is an NHS England initiative to situate GPs in or near hospital emergency departments to divert minor cases away from A&E and reduce pressure on emergency services. 97 hospital trusts have been allocated money, mostly for premises alterations or development. [30]

North America

United States

A medical practitioner is a type of doctor.

The population of this type of medical practitioner is declining, however. Currently, the Medical Departments of the US Air Force, Army and Navy have many of these general practitioners, known as General Medical Officers or GMOs, in active practice. The GMO is an inherent concept to all military medical branches. GMOs are the gatekeepers of medicine in that they hold the purse strings and decide upon the merit of specialist consultation. The US now holds a different definition for the term "general practitioner". The two terms "general practitioner" and "family practice" were synonymous prior to 1970. At that time both terms (if used within the US) referred to someone who completed medical school and the one-year required internship, and then worked as a general family doctor. Completion of a post-graduate specialty training program or residency in family medicine was, at that time, not a requirement. A physician who specializes in "family medicine" must now complete a residency in family medicine, and must be eligible for board certification, which is required by many hospitals and health plans for hospital privileges and remuneration, respectively. It was not until the 1970s that family medicine was recognized as a specialty in the US. [31]

Many licensed family medical practitioners in the United States after this change began to use the term "general practitioner" to refer to those practitioners who previously did not complete a family medicine residency. Family physicians (after completing medical school) must then complete three to four years of additional residency in family medicine. Three hundred hours of medical education within the prior six years is also required to be eligible to sit for the board certification exam;[ citation needed ] these hours are largely acquired during residency training.

The existing general practitioners in the 1970s were given the choice to be grandfathered into the newly created specialty of Family Practice. In 1971 the American Academy of General Practice changed its name to the American Academy of Family Physicians. [32] The prior system of graduating from medical school and completing one year of post-graduate training (rotating internship) was not abolished as 47 of the 50 states allow a physician to obtain a medical license without completion of residency. [33] If one wanted to become a "house-call-making" type of physician, one still needs to only complete one or two years of a residency in either pediatrics, family medicine or internal medicine. This would make a physician a non-board eligible general practitioner able to qualify and obtain a license to practice medicine in 47 of the 50 United States of America. [33] Since the establishment of the Board of Family Medicine, a family medicine physician is no longer the same as a general practitioner. What makes a Family Medicine Physician different than a General Practitioner/Physician is two-fold. First off a Family Medicine Physician has completed the three years of Family Medicine residency and is board eligible or board certified in Family Medicine; while a General Practitioner does not have any board certification and cannot sit for any board exam. Secondly, a Family Medicine Physician is able to practice obstetrics, the care of the pregnant woman from conception to delivery, while a general practitioner is not adequately trained in obstetrics.

Prior to recent history most postgraduate education in the United States was accomplished using the mentor system.[ citation needed ] A physician would finish a rotating internship and move to some town and be taught by the local physicians the skills needed for that particular town. This allowed each community's needs to be met by the teaching of the new general practitioner the skills needed in that community. This also allowed the new physician to start making a living and raising a family, etc. General practitioners would be the surgeons, the obstetricians, and the internists for their given communities. Changes in demographics and the growing complexities of the developing bodies of knowledge made it necessary to produce more highly trained surgeons and other specialists. For many physicians it was a natural desire to want to be considered "specialists".[ citation needed ]

What was not anticipated by many physicians is that an option to be a generalist would lose its prestige and be further degraded by a growing bureaucracy of insurance and hospitals requiring board certification and the financial corruption of the board certification agencies. [34] It has been shown that there is no statistically significant correlation between board certification and patient safety or quality of care [35] [36] [34] which is why 47 states do not require board certification to practice medicine. Board certification agencies have been increasing their fees exponentially since establishment and the board examinations are known to not be clinically relevant and are at least 5 years out of date. [34] Yet, there is still a misbelief that board certification is necessary to practice medicine and therefore it has made a non-board eligible general physician a rare breed of physician due to the lack of available job opportunities for them. [34]

Certificates of Added Qualifications (CAQs) in adolescent medicine, geriatric medicine, sports medicine, sleep medicine, and hospice and palliative medicine are available for those board-certified family physicians with additional residency training requirements. Recently,[ when? ] new fellowships in International Family Medicine have emerged. These fellowships are designed to train family physicians working in resource-poor environments. [37]

There is currently[ when? ] a shortage of primary care physicians (and also other primary care providers) due to several factors, notably the lesser prestige associated with the young specialty, the lower pay, and the increasingly frustrating practice environment. In the US physicians are increasingly forced to do more administrative work, [38] and shoulder higher malpractice premiums.

Canada

The College of General Practice of Canada was founded in 1954 but in 1967 changed its name to College of Family Physicians of Canada (CFPC). [39]

Oceania

Australia

General Practice in Australia and New Zealand has undergone many changes in training requirements over the past decade. The basic medical degree in Australia is the MBBS (Bachelor of Medicine, Bachelor of Surgery), which has traditionally been attained after completion of an undergraduate five or six-year course. Over the last few years, an ever-increasing number of post-graduate four-year medical programs (previous bachelor's degree required) have become more common and now account more than half of all Australian medical graduates. After graduating, a one-year internship is completed in a public and private hospitals prior to obtaining full registration. Many newly registered medical practitioners undergo one year or more of pre-vocational position as Resident Medical Officers (different titles depending on jurisdictions) before specialist training begins. For general practice training, the medical practitioner then applies to enter a three- or four-year program either through the "Australian General Practice Training Program", "Remote Vocational Training Scheme" or "Independent Pathway". [40] The Australian Government has announced an expansion of the number of GP training places through the AGPT program- 1,500 places per year will be available by 2015. [41]

A combination of coursework and apprenticeship type training leading to the awarding of the FRACGP (Fellowship of the Royal Australian College of General Practitioners) or FACRRM (Fellowship of Australian College of Rural and Remote Medicine), if successful. Since 1996 this qualification or its equivalent has been required in order for new GPs to access Medicare rebates as a specialist general practitioner. Doctors who graduated prior to 1992 and who had worked in general practice for a specified period of time were recognized as "Vocationally Registered" or "VR" GPs, and given automatic and continuing eligibility for general practice Medicare rebates. [42] There is a sizable group of doctors who have identical qualifications and experience, but who have been denied access to VR recognition. They are termed "Non-Vocationally Registered" or so-called "non-VR" GPs. [43] The federal government of Australia recognizes the experience and competence of these doctors, by allowing them access to the "specialist" GP Medicare rebates for working in areas of government policy priority, such as areas of workforce shortage, and metropolitan after hours service. [44] Some programs awarded permanent and unrestricted eligibility for VR rebate levels after 5 years of practice under the program. [45] There is a community-based campaign in support of these so-called Non-VR doctors being granted full and permanent recognition of their experience and expertise, as fully identical with the previous generation of pre-1996 "grandfathered" GPs. [46] This campaign is supported by the official policy of the Australian Medical Association (AMA). [43]

Medicare is Australia's universal health insurance system, and without access to it, a practitioner cannot effectively work in private practice in Australia. [ citation needed ]

Procedural General Practice training in combination with General Practice Fellowship was first established by the "Australian College of Rural and Remote Medicine" in 2004. This new fellowship was developed in aid to recognise the specialised skills required to work within a rural and remote context. In addition it was hoped to recognise the impending urgency of training Rural Procedural Practitioners to sustain Obstetric and Surgical services within rural Australia. Each training registrar select a speciality that can be used in a rural area from the Advanced Skills Training list and spends a minimum of 12 months completing this specialty, the most common of which are Surgery, Obstetrics/Gynaecology and Anaesthetics. Further choices of specialty include Aboriginal and Torres Strait Islander Health, Adult Internal Medicine, Emergency Medicine, Mental Health, Paediatrics, Population health and Remote Medicine. Shortly after the establishment of the FACRRM, the Royal Australian College of General Practitioners introduced an additional training year (from the basic 3 years) to offer the "Fellowship in Advanced Rural General Practice". The additional year, or Advanced Rural Skills Training (ARST) [47] can be conducted in various locations from Tertiary Hospitals to Small General Practice.

The competent authority pathway is a work-based place assessment process to support International Medical Graduates (IMGs) wishing to work in General Practice. Approval for the ACRRM to undertake these assessments was granted by the Australian Medical Council in August 2010 and the process is to be streamlined in July 2014. [48]

New Zealand

In New Zealand, most GPs work in clinics and health centres [49] usually as part of a Primary Health Organisation (PHO). These are funded at a population level, based on the characteristics of a practice's enrolled population (referred to as capitation-based funding). Fee-for-service arrangements still exist with other funders such as Accident Compensation Corporation (ACC) and Ministry of Social Development (MSD), as well as receiving co-payments from patients to top-up the capitation-based funding.

The basic medical degree in New Zealand is the MBChB degree (Bachelor of Medicine, Bachelor of Surgery), which has traditionally been attained after completion of an undergraduate five or six-year course. In NZ new graduates must complete the GPEP (General Practice Education Program) Stages I and II in order to be granted the title Fellowship of the Royal New Zealand College of General Practitioners (FRNZCGP), which includes the PRIMEX assessment and further CME and Peer group learning sessions as directed by the RNZCGP. [50] Holders of the award of FRNZCGP may apply for specialist recognition with the New Zealand Medical Council (MCNZ), after which they are considered specialists in General Practice by the council and the community. [51] In 2009 the NZ Government increased the number of places available on the state-funded programme for GP training. [52]

There is a shortage of GPs in rural areas and increasingly outer metropolitan areas of large cities, which has led to the use of overseas trained doctors (international medical graduates (IMGs)). [53] [54]

See also

Related Research Articles

Physician Professional who practices medicine

A physician, medical practitioner, medical doctor, or simply doctor, is a professional who practices medicine, which is concerned with promoting, maintaining, or restoring health through the study, diagnosis, prognosis and treatment of disease, injury, and other physical and mental impairments. Physicians may focus their practice on certain disease categories, types of patients, and methods of treatment—known as specialities—or they may assume responsibility for the provision of continuing and comprehensive medical care to individuals, families, and communities—known as general practice. Medical practice properly requires both a detailed knowledge of the academic disciplines, such as anatomy and physiology, underlying diseases and their treatment—the science of medicine—and also a decent competence in its applied practice—the art or craft of medicine.

Emergency medicine Medical specialty concerned with care for patients who require immediate medical attention

Emergency medicine, also known as accident and emergency medicine, is the medical specialty concerned with the care of illnesses or injuries requiring immediate medical attention. Emergency physicians care for unscheduled and undifferentiated patients of all ages. As first-line providers, their primary responsibility is to initiate resuscitation and stabilization and to start investigations and interventions to diagnose and treat illnesses in the acute phase. Emergency physicians generally practise in hospital emergency departments, pre-hospital settings via emergency medical services, and intensive care units, but may also work in primary care settings such as urgent care clinics. Sub-specializations of emergency medicine include disaster medicine, medical toxicology, ultrasonography, critical care medicine, hyperbaric medicine, sports medicine, palliative care, or aerospace medicine.

Internal medicine or general internal medicine is the medical specialty dealing with the prevention, diagnosis, and treatment of internal diseases. Physicians specializing in internal medicine are called internists, or physicians in Commonwealth nations. Internists are skilled in the management of patients who have undifferentiated or multi-system disease processes. Internists care for hospitalized and ambulatory patients and may play a major role in teaching and research. Internal medicine and family medicine are often confused as equivalent in the Commonwealth nations.

A podiatrist, also known as a podiatric physician or foot and ankle surgeon, is a medical professional devoted to the treatment of disorders of the foot, ankle, and lower extremity. The term originated in North America but has now become the accepted term in the English-speaking world for all practitioners of podiatric medicine.

Anesthesiology Medical specialty that focuses on anesthesia and perioperative medicine

Anesthesiology, anaesthesiology, anaesthesia or anaesthetics is the medical specialty concerned with the total perioperative care of patients before, during and after surgery. It encompasses anesthesia, intensive care medicine, critical emergency medicine, and pain medicine. A physician specialized in this field of medicine is called an anesthesiologist, anaesthesiologist or anaesthetist, depending on the country. Nurses that specialize in anesthesia are called CRNA, Certified Registered Nurse Anesthetist, or Nurse anesthetist.

Doctor of Medicine Postgraduate medical degree

Doctor of Medicine is a medical degree, the meaning of which varies between different jurisdictions. In the United States, and some other countries, the M.D. denotes a professional graduate degree. This generally arose because many in 18th-century medical professions trained in Scotland, which used the M.D. degree nomenclature. In England, however, Bachelor of Medicine, Bachelor of Surgery was used and eventually in the 19th century became the standard in Scotland too. Thus, in the United Kingdom, Ireland and other countries, the M.D. is a research doctorate, higher doctorate, honorary doctorate or applied clinical degree restricted to those who already hold a professional degree in medicine; in those countries, the equivalent professional to the North American and some others use of M.D. is still typically titled Bachelor of Medicine, Bachelor of Surgery (M.B.B.S.).

Podiatry

Podiatry or podiatric medicine' or foot and ankle surgery is a branch of medicine devoted to the study, diagnosis, and medical and surgical treatment of disorders of the foot, ankle, and lower extremity. The term podiatry came into use in the early 20th century in the United States and is now used worldwide, including in countries such as the United Kingdom, Australia, and Canada.

Hospital medicine is a medical specialty that exists in some countries as a branch of internal or family medicine, dealing with the care of acutely ill hospitalized patients. Physicians whose primary professional focus is caring for hospitalized patients only while they are in the hospital are called hospitalists. Originating in the United States, this type of medical practice has extended into Australia and Canada. The vast majority of physicians who refer to themselves as hospitalists focus their practice upon hospitalized patients. Hospitalists are not necessarily required to have separate board certification in hospital medicine.

Residency (medicine) Postgraduate medical training

Residency or postgraduate training is specifically a stage of graduate medical education. It refers to a qualified physician, podiatrist, dentist, pharmacist, or veterinarian who practices medicine, usually in a hospital or clinic, under the direct or indirect supervision of a senior medical clinician registered in that specialty such as an attending physician or consultant. In many jurisdictions, successful completion of such training is a requirement in order to obtain an unrestricted license to practice medicine, and in particular a license to practice a chosen specialty. An individual engaged in such training may be referred to as a resident, registrar or trainee depending on the jurisdiction. Residency training may be followed by fellowship or sub-specialty training.

Family medicine (FM), formerly family practice (FP), is a medical specialty devoted to comprehensive health care for people of all ages. The specialist is named a family physician or family doctor. In Europe, the discipline is often referred to as general practice and a practitioner as a general practice doctor or GP. This name emphasizes the holistic nature of this speciality, as well as its roots in the family. Family practice is a division of primary care that provides continuing and comprehensive health care for the individual and family across all ages, genders, diseases, and parts of the body. Family physicians are often primary care physicians. It is based on knowledge of the patient in the context of the family and the community, emphasizing disease prevention and health promotion. According to the World Organization of Family Doctors (WONCA), the aim of family medicine is to provide personal, comprehensive, and continuing care for the individual in the context of the family and the community. The issues of values underlying this practice are usually known as primary care ethics.

Medical Corps (United States Army)

The Medical Corps (MC) of the U.S. Army is a staff corps of the U.S. Army Medical Department (AMEDD) consisting of commissioned medical officers – physicians with either an M.D. or a D.O. degree, at least one year of post-graduate clinical training, and a state medical license.

A medical specialty is a branch of medical practice that is focused on a defined group of patients, diseases, skills, or philosophy. Examples include children (paediatrics), cancer (oncology), laboratory medicine (pathology), or primary care. After completing medical school, physicians or surgeons usually further their medical education in a specific specialty of medicine by completing a multiple-year residency to become a specialist.

Medical education in Australia

Medical education in Australia includes the educational activities involved in the initial and ongoing training of Medical Practitioners. In Australia, medical education begins in Medical School; upon graduation it is followed by a period of pre-vocational training including Internship and Residency; thereafter, enrolment into a specialist-vocational training program as a Registrar eventually leads to fellowship qualification and recognition as a fully qualified Specialist Medical Practitioner. Medical education in Australia is facilitated by Medical Schools and the Medical Specialty Colleges, and is regulated by the Australian Medical Council (AMC) and Australian Health Practitioners Regulatory Agency (AHPRA) of which includes the Medical Board of Australia where medical practitioners are registered nationally.

Medical education in the United States includes educational activities involved in the education and training of physicians in the United States, from entry-level training through to continuing education of qualified specialists.

A medical intern is a physician in training who has completed medical school and has a medical degree but does not yet have a license to practice medicine unsupervised. Medical education generally ends with a period of practical training similar to internship, but the way the overall program of academic and practical medical training is structured differs depending upon the country, as does the terminology used.

Royal College of General Practitioners

The Royal College of General Practitioners (RCGP) is the professional body for general (medical) practitioners in the United Kingdom. The RCGP represents and supports GPs on key issues including licensing, education, training, research and clinical standards. It is the largest of the medical royal colleges, with over 50,000 members. The RCGP was founded in 1952 in London, England and is a registered charity. Its motto is Cum Scientia Caritas – "Compassion [empowered] with Knowledge."

Royal Australian College of General Practitioners

The Royal Australian College of General Practitioners (RACGP) is the professional body for general practitioners (GPs) in Australia. The RACGP is responsible for maintaining standards for quality clinical practice, education and training, and research in Australian general practice. The RACGP represents over 40,000 members across metropolitan, urban, rural and remote Australia.

Modern medical education in Hong Kong started with the founding of the Hong Kong College of Medicine for Chinese in 1887. Currently, six institutes of higher education are engaged in the training of medical practitioners in Hong Kong.

The American Board of Family Medicine (ABFM) is a non-profit, independent medical association of American physicians who practice in family medicine and its sub-specialties. Founded in February 1969 as the American Board of Family Practice (ABFP), the group was the 20th medical specialty to be recognized by the American Board of Medical Specialties and was formed out of a need to encourage medical school graduates to enter general practice. It adopted its current name in 2005.

A clinical officer (CO) is a gazetted officer who is qualified and licensed to practice medicine. In Kenya a clinical officer operates under the jurisdiction of the Clinical Officers Council which is responsible for their training, registration and licensing and each officer must (1) study clinical medicine and surgery for three or four years (2) graduate from an approved medical training institution (3) pass a national government licensing examination (4) complete an internship year at a teaching hospital (5) register as a clinical officer (6) apply for a practicing licence (7) complete a three-year period of clinical supervision under a senior clinical officer or a senior medical officer (8) apply for a practising certificate (optional) which allows one to provide general medical services directly to the public under their own name (9) go into training for specialization (optional) and (10) become a trainer. Clinical Officer (CO) is a protected title and its use by unregistered persons is prohibited by law and punishable by up to five years in jail with or without a fine. Globally, the title may not have legal restrictions and can refer to a job grade rather than a medical qualification such as junior assistive clinical staff, licensed medical professionals or high-level corporate officers, directors, and managers.

References

  1. "The European Definition of General Practice / Family Medicine - Edition 2011" (PDF). World Organisation of Family Doctors. 2011. Archived from the original (PDF) on 11 June 2014. Retrieved 11 October 2014.
  2. De Maeseneer, Jan; Flinkenflögel, Maaike (2010). "Primary health care in Africa: Do family physicians fit in?". British Journal of General Practice. 60 (573): 286–292. doi:10.3399/bjgp10X483977. PMC   2845490 . PMID   20353673.
  3. http://www.stfm.org/fmhub/fm2008/April/Bill284.pdf
  4. Gandevia, B. (1971). "A history of general practice in australia". Canadian Family Physician. 17 (10): 51–61. PMC   2370185 . PMID   20468689.
  5. "A oral history of general practice - homepage". personal.rhul.ac.uk. Archived from the original on 2013-03-31. Retrieved 2013-03-09.
  6. Simon, Chantal (2009). "From Generalism to Specialty—A Short History of General Practice". Innovait: Education and Inspiration for General Practice. 2: 2–9. doi:10.1093/innovait/inn171. S2CID   72934495.
  7. "About us". FFPAI. Archived from the original on 20 May 2014. Retrieved 20 May 2014.
  8. "Family Medicine". Aga Khan University. Archived from the original on 7 June 2014. Retrieved 4 June 2014.
  9. "List of Accredited Institutions (A-G)". College of Physicians & Surgeons Pakistan. Archived from the original on 2008-03-27. Retrieved 2008-06-17.
  10. "Accueil: Secteurs: Fiches métier: médecin généraliste". www.onisep.fr. National Office for Information on Education and Occupations (ONISEP). Archived from the original on 5 November 2016. Retrieved 4 November 2016.
  11. Marchand-Antonin, Benoît. "The numerus clausus : its side effects - its place in globalization of the medicine Archived 2011-07-20 at the Wayback Machine "
  12. Guedes-Marchand, Cécile. "Le remplaçant, cet intermittent de la médecine générale : sa place dans le système de soins Archived 2011-07-20 at the Wayback Machine "
  13. "Primary Care in Greece". European Forum for Primary Care. Archived from the original on 2014-02-01. Retrieved 2013-11-18.
  14. "GP in Europe: The Netherlands". UEMO. Archived from the original on 31 May 2014. Retrieved 31 May 2014.
  15. "NHG-Standaarden". Nhg.artsennet.nl. 2012-10-18. Archived from the original on 2013-01-16. Retrieved 2012-10-28.
  16. 1 2 "Huisartsopleiding Nederland - LHK-toets". Huisartsopleiding.nl. Archived from the original on 2013-05-21. Retrieved 2012-10-28.
  17. "Opleiding tot huisarts". Knmg.artsennet.nl. Archived from the original on 2012-07-10. Retrieved 2012-10-28.
  18. es:Medicina familiar y comunitaria
  19. "Ministerio de Sanidad, Servicios Sociales e Igualdad - Ciudadanos - Ministerio de Sanidad y Consumo - Ciudadanos - Sistema Nacional de Salud - Centros". www.msc.es. Archived from the original on 2010-01-09.
  20. "Archived copy" (PDF). Archived (PDF) from the original on 2013-05-13. Retrieved 2013-03-07.CS1 maint: archived copy as title (link)
  21. es:Examen MIR
  22. "Scots prescription fees abolished". 2011-04-01. Retrieved 2019-08-15.
  23. Jo Revill (2006-04-23). "Perks of an island GP: seals, scenery and £300,000". London: The Observer. Archived from the original on 2008-01-02. Retrieved 2008-06-17.
  24. "Gp Average Salary". www.mysalary.co.uk. Archived from the original on 2013-03-31.
  25. "Pay for doctors". NHS careers. Archived from the original on 2014-05-12. Retrieved 2014-05-11.
  26. Boseley, Sarah (2006-04-19). "The question: Is your GP worth £250,000?". London: The Guardian. Retrieved 2008-06-17.
  27. "Doctors are most trusted profession – politicians least trusted Trust in Professions 2011". Ipsos Mori. 2011-06-27. Archived from the original on 2011-07-01. Retrieved 2011-07-03.
  28. Association, Press (11 May 2017). "GP recruitment crisis intensifies as vacancies soar to 12.2%". The Guardian. Archived from the original on 12 May 2017.
  29. "GP hours and the much needed tech-care revolution". Health Service Journal. 22 August 2018. Retrieved 1 October 2018.
  30. "Further £21m allocated for services set to move 200 GPs into hospitals". GP Online. 16 June 2017. Archived from the original on 19 June 2017. Retrieved 14 July 2017.
  31. Pisacano, Nicholas J. "History of the Specialty". American Board of Family Medicine. Archived from the original on 2007-08-08. Retrieved 2007-08-08.
  32. "The History of the AAFP". American Academy of Family Physicians. Retrieved 31 May 2014.
  33. 1 2 "State Licensure Requirements".
  34. 1 2 3 4 "Is Board Certification Overrated?".
  35. Sharp, L. K.; Bashook, P. G.; Lipsky, M. S.; Horowitz, S. D.; Miller, S. H. (2002). "Specialty board certification and clinical outcomes: The missing link". Academic Medicine. 77 (6): 534–42. doi: 10.1097/00001888-200206000-00011 . PMID   12063199.
  36. Grosch, Eric N. (2006). "Does specialty board certification influence clinical outcomes?". Journal of Evaluation in Clinical Practice. 12 (5): 473–481. doi:10.1111/j.1365-2753.2006.00556.x. PMID   16987109.
  37. "International Family Medicine Fellowship" Archived 2010-06-27 at the Wayback Machine , Via Christi Retrieved 4/14/2010.
  38. Kavilanz, Parija B. (July 16, 2009). "Why primary care doctors are shrinking in the U.S." CNN Money. Archived from the original on 2009-07-31. Retrieved 12 February 2020.
  39. "About CFPC: College History". College of Family Physicians of Canada. Archived from the original on 15 May 2014. Retrieved 1 June 2014.
  40. "About the AGPT program". General Practice Education and Training Limited. Archived from the original on 7 June 2014. Retrieved 31 May 2014.
  41. "Australian General Practice Training program (AGPT)". Australian Government Department of Health. Archived from the original on 6 June 2014. Retrieved 31 May 2014.
  42. Royal Australian College of General Practitioners
  43. 1 2 "Archived copy". Archived from the original on 2014-09-29. Retrieved 2014-12-14.CS1 maint: archived copy as title (link)
  44. Division, Australian Government Department of Health, Health Workforce. "Other Medical Practitioners (OMPs) programmes". www.health.gov.au. Archived from the original on 2014-12-14. Retrieved 2014-12-14.
  45. Division, Australian Government Department of Health, Mental Health and Workforce. "MedicarePlus for Other Medical Practitioners (MOMPs) Programme". www.health.gov.au. Archived from the original on 2014-12-14.
  46. "Bureaucratic discrimination". www.fairgofordoctors.org. Archived from the original on 2014-12-14.
  47. "Advanced rural skills training (ARST)". Royal Australian College of General Practitioners. Archived from the original on 25 June 2014. Retrieved 3 June 2014.
  48. "Competent Authority Pathway for General Practice". Australian College of Rural and Remote Medicine. 14 May 2014. Archived from the original on 14 July 2014. Retrieved 7 June 2014.
  49. "General Practitioner: About the job". Careers New Zealand. 5 November 2013. Archived from the original on 9 October 2014. Retrieved 3 June 2014.
  50. "GPEP - General Practice Education Training Programme". The Royal New Zealand College of General Practitioners. Archived from the original on 5 June 2014. Retrieved 31 May 2014.
  51. "General practice". Medical Council of New Zealand. Archived from the original on 31 May 2014. Retrieved 31 May 2014.
  52. Johnston, Martin (8 December 2008). "State GP training overtakes user-pay scheme". The New Zealand Herald . Retrieved 3 June 2014.
  53. Skerrett, Angie. "'Concerning trend': Study shows further decline in rural doctor numbers". Newshub. Retrieved 30 March 2020.
  54. Trigger, Sophie (2 July 2019). "GP registrars choose city training as under-doctored regions flounder" . Retrieved 30 March 2020.

Bibliography

Further reading