Community-based training in Family Medicine - a different paradigm

Introduction Community-based education is an important strategy for trainin g students appropriately for delivering primary health care services. A com munity-based training rotation in Family Medicine and Primary Care was intr oduced at the University of Stellenbosch, South Africa, in January 1998. Objective The aim of this study was to explore the perceptions of final yea r medical students about the new rotation and to provide feedback on the va lue of this experience to the Faculty. In this article we explore the influ ence of differing world views held by biomedically oriented training instit utions and the systems view of life adhered to by the discipline of Family Medicine on attempts to reform medical education. Method Quantitative and qualitative curriculum evaluation methods, includin g a questionnaire and focus groups discussions, were used. Students rated t he value of the block as 7.8 out of 10. Results Eighty-eight percent of students felt that there should be an earli er exposure to Family Medicine and Primary Care in their training. The main themes identified from the qualitative results supported the literature fi ndings and included the difference in type of practice between tertiary and primary levels of care and the value of learning a new approach to patient care. Despite the fact that the results emphasized the importance of inclu ding community-based training in Family Medicine and Primary Care at an ear ly stage in the medical curriculum, resistance to implementation was encoun tered. This led to reflection on possible reasons on why the recommendation s of the study were not immediately adopted into the curriculum.