International Family Medicine

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International Family Medicine physicians are family physicians that specialize in working with under-served populations in resource-poor environments, often in developing nations. These physicians face the challenge of diagnosing patients without advanced laboratory or imaging techniques. Because of limited access to medications and specialists, International Family Medicine physicians must have flexible treatment strategies and a broad scope of practice.

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History

Peter Parker, MD was one of the earliest full time American medical missionaries in 1834. He opened an ophthalmology hospital in China. [1] Many physicians have worked in developing nations over the years. Surgeons and primary care physicians alike have donated their time or their entire lives to needy populations in the world. Modern Organizations such as Doctors Without Borders (Médecins Sans Frontières) organize physicians from around the world to provide disaster medicine and relief work during times of extreme need or natural disasters.

Interest in international medicine among medical students and residents has been increasing. Many medical schools and residencies are offering global health tracks. [2] Family Medicine physicians, because of their broad scope, are particularly well suited for practicing in areas where specialists are not readily available. For those family physicians that desired full time careers in international medicine would generally begin their work immediately after residency. Because of the varied conditions of the developing world versus the training environment there is often a very steep learning curve for Western trained family physicians.

In response to improving the preparedness for American Family Physicians International Family Medicine Fellowships have emerged recently. [3] These fellowships aim to better prepare Family Medicine graduates for the challenges that they will face overseas. The need for physicians well suited for international challenges is greatly needed, especially in areas with large refugee populations. [4]

Scope of Practice

Family physicians that practice in the United States have the broadest scope of all of the specialties. Family physicians frequently treat illnesses related to obstetrics, pediatrics, adult medicine, orthopedics, outpatient and inpatient care. International Family Medicine physicians must also manage tropical medicine, surgery, anesthesia, burn care, HIV, and even dentistry.

In addition to the medical challenges, International Family Medicine physicians must often act as hospital administrators as well. The issues faced often range from obtaining local pharmaceuticals and supplies to repairing broken medical equipment. Engaging the public health issues of communities relating to sanitation and clean water is yet another task that falls on the wide shoulders of the physician. Cultural differences and corrupt governments also add impediments to the delivery of healthcare by International Family Medicine physicians.

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Medicine Diagnosis, treatment, and prevention of illness

Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness. Contemporary medicine applies biomedical sciences, biomedical research, genetics, and medical technology to diagnose, treat, and prevent injury and disease, typically through pharmaceuticals or surgery, but also through therapies as diverse as psychotherapy, external splints and traction, medical devices, biologics, and ionizing radiation, amongst others.

Physician Professional who practices medicine

A physician, medical practitioner, medical doctor, or simply doctor, is a health 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 is the medical speciality concerned with the care of illnesses or injuries requiring immediate medical attention. Emergency physicians continuously learn to care for unscheduled and undifferentiated patients of all ages. As first-line providers, in coordination with Emergency Medical Services, they are primarily responsible for initiating resuscitation and stabilization and performing the initial investigations and interventions necessary to diagnose and treat illnesses or injuries in the acute phase. Emergency physicians generally practise in hospital emergency departments, pre-hospital settings via emergency medical services, and intensive care units. Still, they may also work in primary care settings such as urgent care clinics.

In the medical profession, a general practitioner (GP) is a physician who treats acute and chronic illnesses and provides preventive care and health education to patients of all ages. Their duties are not confined to specific fields of medicine, and they have particular skills in treating people with multiple health issues. They are trained to treat patients to levels of complexity that vary between countries.

A podiatrist is a medical professional devoted to the treatment of disorders of the foot, ankle, and related structures of the leg. The term originated in North America but has now become the accepted term in the English-speaking world for all practitioners of podiatric medicine. The word chiropodist was previously used in the United States, but it is now regarded as antiquated.

Healthcare industry Economic sector focused on health

The healthcare industry is an aggregation and integration of sectors within the economic system that provides goods and services to treat patients with curative, preventive, rehabilitative, and palliative care. It includes the generation and commercialization of goods and services lending themselves to maintaining and re-establishing health. The modern healthcare industry includes three essential branches which are services, products, and finance and may be divided into many sectors and categories and depends on the interdisciplinary teams of trained professionals and paraprofessionals to meet health needs of individuals and populations.

Anesthesiology Medical specialty concerned with anesthesia and perioperative care

Anesthesiology, anaesthesiology, or anaesthesia 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 anesthesiology is called an anesthesiologist, anaesthesiologist, or anaesthetist, depending on the country. In some countries, the terms are synonymous, while in other countries they refer to different positions and anesthetist is only used for non-physicians, such as nurse anesthetists.

A physician assistant or physician associate (PA) is a type of mid-level health care provider. In North America PAs may diagnose illnesses, develop and manage treatment plans, prescribe medications, and may serve as a principal healthcare provider. PAs are required in many states to have a direct agreement with a physician. PAs typically cost the practice employing them less than half as much as a fully qualified physician.

Primary care Day-to-day health care given by a health care provider

Primary care is the day-to-day healthcare given by a health care provider. Typically this provider acts as the first contact and principal point of continuing care for patients within a healthcare system, and coordinates other specialist care that the patient may need. Patients commonly receive primary care from professionals such as a primary care physician, a physician assistant, or a nurse practitioner. In some localities, such a professional may be a registered nurse, a pharmacist, a clinical officer, or an Ayurvedic or other traditional medicine professional. Depending on the nature of the health condition, patients may then be referred for secondary or tertiary care.

International emergency medicine is a subspecialty of emergency medicine that focuses not only on the global practice of emergency medicine but also on efforts to promote the growth of emergency care as a branch of medicine throughout the world. The term international emergency medicine generally refers to the transfer of skills and knowledge—including knowledge of ambulance operations and other aspects of prehospital care—from developed emergency medical systems (EMSs) to those systems which are less developed. However, this definition has been criticized as oxymoronic, given the international nature of medicine and the number of physicians working internationally. From this point of view, international emergency medicine is better described as the training required for and the reality of practicing the specialty outside of one's native country.

Hospital medicine is a medical specialty that exists in some countries as a branch of family medicine or internal 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, dentist or podiatrist (DPM) who practices medicine, dentistry, or podiatry, respectively, 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. In the meantime they practice "on" the license of their supervising physician. 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 Medical specialty

Family medicine is a medical specialty within primary care that provides continuing and comprehensive health care for the individual and family across all ages, genders, diseases, and parts of the body. The specialist, who is usually a primary care physician, is named a family physician. It is often referred to as general practice and a practitioner as a general practitioner. Historically, their role was once performed by any doctor with qualifications from a medical school and who works in the community. However, since the 1950s, family medicine / general practice has become a specialty in its own right, with specific training requirements tailored to each country. The names of the specialty emphasize its holistic nature and/or its roots in the family. It is based on knowledge of the patient in the context of the family and the community, focusing on disease prevention and health promotion. According to the World Organization of Family Doctors (WONCA), the aim of family medicine is "promoting 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.

An eye care professional (ECP) is an individual who provides a service related to the eyes or vision. It is any healthcare worker involved in eye care, from one with a small amount of post-secondary training to practitioners with a doctoral level of education.

In the United Kingdom, Ireland, and parts of the Commonwealth, consultant is the title of a senior hospital-based physician or surgeon who has completed all of their specialist training and been placed on the specialist register in their chosen speciality. Their role is entirely distinct from that of general practitioners, or GPs.

Disaster medicine

Disaster medicine is the area of medical specialization serving the dual areas of providing health care to disaster survivors and providing medically related disaster preparation, disaster planning, disaster response and disaster recovery leadership throughout the disaster life cycle. Disaster medicine specialists provide insight, guidance and expertise on the principles and practice of medicine both in the disaster impact area and healthcare evacuation receiving facilities to emergency management professionals, hospitals, healthcare facilities, communities and governments. The disaster medicine specialist is the liaison between and partner to the medical contingency planner, the emergency management professional, the incident command system, government and policy makers.

MEDICC is a non-profit organization founded in 1997 that works to enhance cooperation among the US, Cuban and global health communities through its programs.

Refugee health in the United States

Refugee health in the United States focuses on the health, treatment, and healthcare barriers of migrants to the United States who have relocated from their country of origin, often because of factors such as political instability, war, or natural disaster. Special considerations are needed to provide appropriate medical treatment for these individuals, who often face extreme adversity, violent and/or traumatic experiences, and travel through perilous regions. Such considerations include screenings for communicable diseases, vaccinations, posttraumatic stress disorder, and depression.

Physicians in Canada Canadian physician

Physicians and surgeons play an important role in the provision of health care in Canada. They are responsible for the promotion, maintenance, and restoration of health through the study, diagnosis, prognosis, and treatment of disease, injury, and other physical and mental impairments. As Canadian medical schools solely offer the Doctor of Medicine (M.D.) or Doctor of Medicine and Master of Surgery degrees, these represent the degrees held by the vast majority of physicians and surgeons in Canada, though some have a Doctor of Osteopathic Medicine (D.O.) from the United States or Bachelor of Medicine, Bachelor of Surgery from Europe.

Teaching hospital Hospital or clinic providing medical education

A teaching hospital is a hospital or medical centre that provides medical education and training to future and current health professionals. Teaching hospitals are almost always affiliated with one or more universities and are often co-located with medical schools.

References

  1. Glover, p. 149
  2. "International Health Track - Baylor College of Medicine, Houston, Texas". Archived from the original on 2010-06-05. Retrieved 2010-05-16.
  3. "International Family Medicine Fellowship", Via Christi Retrieved 4/14/10.
  4. Kristina M Adams, Lorin D Gardiner, Nassim Assefi. Healthcare challenges from the developing world: post-immigration refugee medicine. BMJ 2004;328:1548-1552 (26 June), doi : 10.1136/bmj.328.7455.1548

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