Family Medicine in Palestine: A Dangerous Idea 6 years on

Conference:

SAPC ASM 2018 - London

Talk Code:

2A.4

Presenter:

Anita Berlin

Co-authors:

Paul Wallace (8), Samar Musmar (3), Gene Feder (6), Ann Louise Kinmonth (5), David Jewell(2), Lucy Kynge (4) Lubna AlSaudi (3) , Suha Hamsari(3) Bishara Bisharat (3) The Trainees (3) Marlene Laubli Loud (7),

Author institutions:

1. Queen Mary University of London. 2. FIDFMP . 3 An Najah National University, West Bank. 4 Medicine Africa. 5 University of Cambridge (6) University of Bristol (7) LAUCO Evaluation & Training Consultancy (8) Primary Care & Population Science, UCL

Problem

In the Dangerous Ideas Session at the national SAPC conference in 2012 (Glasgow) Professor Paul Wallace (following the Plenary by Dr Samar Musmar, Foundation Head of Family Medicine at An Najah National University, Nablus) presented a problem to UK primary care academics: how can we support our isolated Palestinian colleagues, unable to travel, in their quest to establish sustainable, high quality family medicine training and service development.

Approach

The Foundation for the International Development of Family Medicine in Palestine (IDFMP) was born: an umbrella organisation to using systems approach to combine educational and service development initiatives. Its aims are:• improve morale by providing solidarity, relieving isolation and inviting Palestinian doctors to share their successes• involve Palestinian doctors in the international community of family physicians • share approaches and solutions to common problems • long term, improve health outcomes Evaluation is embedded throughout the programme's process to regularly "take stock » of achievements and obstacles so that efforts can be better focused in the following phase.The presentation is in two parts (1) project narrative: description of the multiple stakeholder approach, the coproduction of the "seven pillars" for family medicine with a timeline of educational interventions supported by FIDFMP, and informal feedback(2) a summary of 2017 mid-term external evaluation: mixed method utilization-focused evaluation (Patton 2008) including 25 interviews, review of 17 key documents; 13 e-survey responses; 3 sites visits and a stakeholder workshop.

Findings

The narrative outlines the multi-level approach: individual level (mentoring academics); programme level (curriculum, workshops; research skills; online tutorials; and training practice development), and organisational level (university, Ministry of Health & Palestinian Medical Council) . The mixed method evaluation uses Frey, , et al . (2006) to analyse partnership working . A SWOT analysis highlights achievements, weaknesses and work to address these- the most pressing being improved knowledge sharing with Ministry of Health, establishing training centres and recognising trainers.

Consequences

We will share practical, socio-political, cultural-linguistic and economic challenges the project faces. We will conclude with reflections from trainees: "Today I am on call .... A woman came complaining of chest pain, I started to take a history.the pain is not organic and I asked her ..about her life?She told me about her problems, I tried to calm her down and find solutions..... she smiled, she told me that she did not meet a doctor like me before, ……..Thanks to Family medicine, that gave me my own unique glasses to see my patients in a holistic approach including organic, psychological, social aspects.….And finally I thank God who gave me the opportunity to specialize in Family medicine, …..and the hope of…this specialty in Palestine."

Submitted by:

Anita Berlin

Funding acknowledgement:

FIDFMP is supported by Medical Aid to Palestinians and the British Council