Attitudes of Slovene young family doctors towards their postgraduate

educational training

Rade Iljaž, Vojislav Ivetić

In only ten years

• Our own specialization• Medical departments on

two Medical faculties• 7 university teachers and

more than fifty affiliates to FM Department

• Many international and local research and educational projects

• Dozen international and local conferences and professional meetings each year

Slovenian FM have got

• WONCA conference 2003

• Presidency and secretariat of WONCA till 2004

• Representatives in all important European GM/FM societies and boards

At the same time we faced with :

• Shortage of GPs/FPs• Expected reforms of

health care system• Thriftiness of state’s

insurance service• Political pressures • “Affairs” about PHCs• Clinicians’ jealousy? • Too high public

expectations?

Postgraduate training

0%

20%

40%

60%

80%

100%

specialisti - vocationally trained

na specializaciji - in service training

brez specializacije - without vocational training

– New specialization /started in 2000/ :

• 4 years• 2 years in practices • 20 workshops

Cross-sectional study

• Structured and semi-structured interview

• 103 young family doctors participating

• open-ended question on suggestions on recommended improvements in their postgraduate training - central part in our study

Central question:

• “Please, give us some suggestions on current postgraduate training and some recommendations for its improvement.”

• 44 participants (42.7%) suggested some changes in current postgraduate educational process.

• Generally, young doctors were very critical of hospital training and much more satisfied with workshops and training performed in family medicine settings

The main complaints

– “Hospital training isn’t oriented toward our real needs “

– “We need more community based practice prior to hospital training (1,2,1 model)”

– “Specialists couldn’t find time to talk with us”

– “We are needles there, and their methods are useless to us”.

Desires to be satisfied

• “Missing clinicians’ lectures and chance for fair discussion about “hot” topics.”

• “I am interested in practice in community hospitals”.

• ”One week on clinical ward is too short period”.

• More work in regional hospitals’ wards needed (good for later cooperation, closer to home, cheaper)

Suggestions about non-hospital part of PG education:

“Not enough tutors on the country”

“ Shortage of separate examining rooms”

“Missing more discussion with tutor”

“ Need more autonomous work”

Some interested suggestions

• To follow successful models abroad – more practical work and less theoretical one

• More extensive use of informatics technology on hospital wards as well as in practices

Heartfelt wishes

“Need more tutors on the country”

“To many patients in practices’ lists. To reduce number of practice visits as well of coddled patients.”

“Hospital training should start after a year in a family practice/community setting,so that we could identify our personal developmental and learning needs.”

“Much work with tutors in practice settings with counseling and appraising”.

Optimistic views

• “It should be better, when we get more family doctors in Slovenia. This way,we’ll get much more time for study and training”.

• “We should have a personal tutors who could be completely committed to each of us”.

• “We need to learn an uniform medical doctrine , not the local hospitals’ tenet.”

The best one• When you have a proper

working conditions /acceptable number of practice visits and on duty days, separate urgency etc/ FM is the best field of medicine, which assumes holistic health care for entire human being, not just a part of hers/his body.

• Do we demand too much?

I wish you a nice weekend!