“What Essential Competences young familydoctors have to learn and practice for working in rural areas appropriately? “ Results from 16th and 17th Wonca Europe Conferences Workshops “ A tribute to Claudio Carosino “ Jaume Banqué Vidiella . Euripa – Semfyc – Camfic Institut Català de la Salut. CAP Baix Ebre. Spain firstname.lastname@example.org
Common themes in rural health…●At the heart of the rural health education agenda is that ruralpeople have different healthcare needs and reduced access toservices….●Rural populations tend to have different profiles to those of urbanpopulations…●Rural health professionals face additional isolation issues…●Isolation from professional support requires a broader scope ofpractice, more training and stronger support networks…RB Hays. School of Medicine, Keele University, Staffordshire, UKRural medical education in Europe: the relevance of the Australian experienceRural and Remote Health 7: 683. (Online), 2007
Wonca Europe Conf. 16th Conf. Málaga 10.2010 Workshops 17th Conf. Warsaw 09.2011 Participants: 32 Compulsory RT Experience in Rural (Countries: 23) period for young GP Health ? : 20 partic. in your country ? : 5 (60,6%) countries
Results faced with Core Competences ( European Definition of GP / Family Medicine Euract. Wonca Europe 2005 ) Results grouped into Core Competences – Euract 2005●Abilities, training andknowledge. (42) ●Specific solving problems skills●Working in a rural setting (28) ●Primary care management●Being a GP and a rural doctor ●Person centred care(25) ●Comprehensive approach●Collaborative practice (10) ●Community orientation●Community medicine (10) ●Holistic approach●Family and home care (4)
Abilities, training and knowledge Specific solving problems skills●Skills and training in emergencies●Communicational skills●Paediatrics●Geriatrics●Gynaecology and obstetrics●Palliative care. Pain Control●Up to date in technologies
Working in a rural setting Primary care management / Comprehensive approach/ Holistic approach●Flexibility●Integration with population●Knowing the idiosyncrasy of population where you work●Commitment of at least 3 – 5 years to a rural community●Leadership●Be in touch with other colleagues. Don’t stay isolated.●Being part of your community as private person as well asprofessional (How to live and work in the same and smallcommunity)● Patient guide and rural doctor´s style: going slow without stop.
Being a GP and a rural physicianPrimary care management / Comprehensive /Holistic approach●Dealing with uncertainty●Holistic approach●Facing the challenges: Ability to work under stress andindependently●Physician’s health●Treating all kind of people●Be closed but maintaining your doctor´s role●Greater range of skills: Procedural, diagnostic, public health...●How to prevent and treat occupational diseases●Dealing with CPD and professional development.
Collaborative practicePrimare care management●Networking●Multidisciplinary point of view●How to work with different specialist and institutions : socialservices, local politicians, veterinarians, agricultural engineers....●Collaborating with regional services
Community medicineCommunity orientation●Working with the community●Social, demographic and epidemiologic point of view●Empowering population●Community oriented primary care●Community involvement (coherence between lifestylerecommendations and personal choices)●Knowledge of local culture and community
Family and home carePerson centered care●Collaboration with family to resolve problems●Home care●Long term care for chronic diseases●Traditional care in rural areas.
Rural training concepts●Rural Doctor > Complete family doctor > Core and paradigm of theGP speciality > Model for young family doctors●Rural Practice > Specific kind of practice > Health care for aparticular community > Working with sustainability●Rural Center > Locus for training and learning > Under and PostGraduate Doctors●Rural Rotation > “Not a problem of contents but a problem offuture life conditions”
Rural medicine values for trainees●Getting an opportunity for working and knowing “The GP´s role”inside a defined community●Emphasizing the holistic view in Family Medicine : “The bio-psyco-social model”●Underlining the importance of “Equity” in health services : Equalaccess / Equal utilization / Equal health outcomes