Family Medicine - Family Medicine in India

Family Medicine in India

Family Medicine (FM) came to be recognized as a medical specialty in India only in the late 1990s. According to the National Health Policy - 2002, there is an acute shortage of specialists in family medicine. As family physicians play very important role in providing affordable and universal health care to people, the Government of India is now prompting family medicine. Poverty and lawlessness exacerbate this shortage.

Although family medicine is sometimes called general practice, they are not identical in India. A medical graduate who has successfully completed the Bachelor of Medicine, Bachelor of Surgery (MBBS) course and has been registered with Indian Medical Council or any state medical council is considered a general practitioner. A family physician, however, is a primary care physician who has completed specialist training in the discipline of family medicine.

The Medical Council of India requires three-year residency for family medicine specialty, leading to the award of Doctor of Medicine (MD) in Family Medicine or Diplomate of National Board (DNB) in Family Medicine.

The National Board of Examinations conducts family medicine residency programmes at the teaching hospitals that it accredits. On successful completion of a three-year residency, candidates are awarded Diplomate of National Board (Family Medicine). The curriculum of DNB (FM) comprises: (1) medicine and allied sciences; (2) surgery and allied sciences; (3) maternal and child health; (4) basic sciences and community health. During their three-year residency, candidates receive integrated inpatient and outpatient learning. They also receive field training at community health centres and clinics.

The Medical Council of India permits accredited medical colleges (medical schools) to conduct a similar residency programme in family medicine. On successful completion of three-year residency, candidates are awarded Doctor of Medicine (Family Medicine). However, medical colleges are yet to start this MD (FM) course, even though there is an acute shortage of qualified family physicians in India.

The Indian Medical Association’s College of General Practitioners, offers a one-year Diploma in Family Medicine (DFM), a distance education programme of the Postgraduate Institute of Medicine, University of Colombo, Sri Lanka, for doctors with minimum five years of experience in general practice. Since the Medical Council of India requires three-year residency for family medicine specialty, these diplomas are not recognized qualifications in India.

As India’s need for primary and secondary levels of health care is enormous, medical educators have called for systemic changes to include family medicine in the undergraduate medical curriculum.

Recently, the residency-trained family physicians have formed the "Academy of Family Physicians of India" (AFPI) AFPI is the academic association of family physicians with formal full-time residency training (DNB Family Medicine) in Family Medicine. Currently there are about two hundred family medicine residency training sites accredited by the National Board of Examination India, providing around 700 training posts annually. However, there are various issues like academic acceptance, accreditation, curriculum development, uniform training standards, faculty development, research in primary care, etc. in need of urgent attention for family medicine to flourish as an academic specialty in India. The government of India has declared Family Medicine as focus area of human resource development in health sector in the National Health Policy 2002