This document summarizes the results of workshops at the 16th and 17th Wonca Europe Conferences on the essential competences young family doctors need to learn and practice for working in rural areas. The results were grouped into abilities/training/knowledge, working in a rural setting, being a GP and rural doctor, collaborative practice, and community medicine. Some of the key competences identified include skills in emergencies, flexibility, understanding the local community/culture, leadership, networking with other services, and community-oriented primary care. The document advocates for rural rotations to emphasize holistic family medicine and equity in health services.

1. “What Essential Competences young family doctors
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
jbanquev@gmail.com

2. Common themes in rural health…
• At the heart of the rural health education agenda is that rural people
have different healthcare needs and reduced access to services….
• Rural populations tend to have different profiles to those of urban
populations…
• Rural health professionals face additional isolation issues…
• Isolation from professional support requires a broader scope of
practice, more training and stronger support networks…
RB Hays. School of Medicine, Keele University, Staffordshire, UK
Rural medical education in Europe: the relevance of the Australian experience
Rural and Remote Health 7: 683. (Online), 2007

3. Wonca Europe Conf.
Workshops
16th Conf. Málaga
17th Conf. Warsaw
10.2010
09.2011
Participants: 32
(Countries: 23)
Compulsory RT period
for young GP in your
country ? : 5 countries
Experience in Rural
Health ? : 20 partic.
(60,6%)

4. Results faced with Core Competences
( European Definition of GP / Family Medicine
Euract. Wonca Europe 2005 )
Results grouped into
• Abilities, training and
knowledge. (42)
• Working in a rural setting (28)
• Being a GP and a rural doctor
(25)
• Collaborative practice (10)
• Community medicine (10)
• Family and home care (4)
Core Competences – Euract 2005
• Specific solving problems skills
• Primary care management
• Person centred care
• Comprehensive approach
• Community orientation
• Holistic approach

5. 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

6. 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 as
professional (How to live and work in the same and small community)
• Patient guide and rural doctor´s style: going slow without stop.

7. Being a GP and a rural physician
Primary care management / Comprehensive / Holistic
approach
• Dealing with uncertainty
• Holistic approach
• Facing the challenges: Ability to work under stress and independently
• 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.

8. Collaborative practice
Primare care management
• Networking
• Multidisciplinary point of view
• How to work with different specialist and institutions : social services,
local politicians, veterinarians, agricultural engineers....
• Collaborating with regional services

9. Community medicine
Community orientation
• Working with the community
• Social, demographic and epidemiologic point of view
• Empowering population
• Community oriented primary care
• Community involvement (coherence between lifestyle
recommendations and personal choices)
• Knowledge of local culture and community

10. Family and home care
Person centered care
• Collaboration with family to resolve problems
• Home care
• Long term care for chronic diseases
• Traditional care in rural areas.

11. Rural training concepts
• Rural Doctor > Complete family doctor > Core and paradigm of the GP
speciality > Model for young family doctors
• Rural Practice > Specific kind of practice > Health care for a particular
community > Working with sustainability
• Rural Center > Locus for training and learning > Under and Post
Graduate Doctors
• Rural Rotation > “Not a problem of contents but a problem of future
life conditions”

12. 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 : Equal
access / Equal utilization / Equal health outcomes