UEMO 2003 Declaration on Specific Training in General Practice/Family Medicin in Europe

General practitioners/family physicians are in principle the first point of contact for a unselected group of patients. Health education, preventive activities, early detection, problem oriented care, terminal care and palliation are the tasks GP should be able to address and perform, as well as coordination the specialistsí treatment and knowledge on all existing services within the local health care system.

General practitioners are the ones to counsel and guide patients with chronic diseases such as diabetes, cancer, asthma, respiratory and cardiac disorders, as well as the basic care of psychosomatic disorders. At last but not at least they must be able to treat and follow up poly-morbid and terminal patients.

General practitioners should be familiar with all common diseases in the community and with all preventable conditions. They must be familiar with the therapeutic principles of pharmaceutical products, their side effects and interactions, since they prescribe most of the medicaments in ambulatory care. They must also consider the treatment possibilities in other medical fields in order to be able to advocate their patients.

To achieve all that, GP/FF should have special communication skills, since he/she has to inform patients on their diseases and treatment options in a way, adapted to the individual patient.

1. With this document the UEMO wishes to establish goals and proposals with special relevance for the specific training of general practitioners.

2. Specific training is a prerequisite for the good practice and must take its starting point as soon as possible in general practice. It must be conducted on both a theoretical and a practical level and ought to be of direct use in the practitioner's daily work. General practitioner organisations should strive to place general practitioners in charge of all aspects of specific general practice training, no matter if it is undertaken in general practice setting or at clinical posts.

3. All doctors should be exposed to training in general practice both in their undergraduate training and as part of the postgraduate training before entering specific training.

4. Specific general practice training must be orientated towards general practice throughout the entire training period. The content of training is the responsibility of the national professional and academic organisations in GP/FM, as well as the organization and standards of training. The frameworks within which the training takes place must necessarily include cooperation with the health and the financing authorities.

5. The goal is for the duration of training for general practice to be of the same duration as other specialist training, including a practical and theoretical part, and for the content to be relevant and appropriate, aimed at acquiring the required competences. Flexibility should be available to take account of individualsí educational experience and needs.
Minimum of half of training time should be spent in the general practice environment.

6. UEMO supports the migration process in Europe- guaranteed the quality of care for both, migrating patients and migrating GPs.

7. The purpose of training for general practitioners is to produce a doctor who has obtained a level of clinical competence sufficient for independent practice.

8. The quality of the scientific and educational posts in general practice must be delivered through explicit contracts specifying the educational content and mechanisms for evaluation, establishing precise goals and appropriate criteria, promoting the methodology and implementation of research and quality assurance in general practice.

9. Common core content of GP/FM throughout Europe was defined to prepare general practitioners for independent practice in all European countries.

10. No part of training should have a minimum commitment of less than 50% of full time training. The total duration of training will be extended pro rata to compensate for any periods of part time training.

11. An attempt to develop methods for assessment and follow up process and results of specific training must be supported. Methods of evaluation must be integrated into the educational programmes. General practice organisations must decide on and take responsibility for the evaluative procedures.

12. Sufficient and substantial resources must be provided for training to produce skilful and competent independent general practitioners. It is the responsibility of the individual general practitioner to make optimal use of resources. It is the responsibility of the professional organizations to secure and develop an effective framework for the specific training- the network of trainers, training practices (in GP/FM), hospitals and training programs. It is the responsibility of the health care systems to guarantee the financing of specific training and training posts, both economically and professionally.

13. Specifically allocated resources (time, money, programs and trainers) are a prerequisite for the quality assurance of structured training in GP/FM. Each member state needs to plan to meet its own workforce needs and access to general practice.

14. It is high time to finally recognise the new position of general practice/family medicine in Europe, admitting that the GP/FM as a speciality equal to all others.