Building capacity in family medicine in Canada and beyond

Francine Lemire

Dear colleagues,

The CFPC’s Global Health Committee is entering its 10th year of work. The focus of the committee in its first decade was to raise awareness about global health issues and engage members by publishing articles in this journal and by facilitating relevant workshops at Family Medicine Forum. The committee also connected with the 17 academic departments of family medicine across the country, all of which are active in global health, and identified a faculty member in each department to work with the College.

In parallel, the College has participated in presentations and discussions about various aspects of Canadian family medicine at the request of governments and academic institutions from several countries. This reflects the high regard we are held in by health system leaders for our journey to date in family medicine. The following are some specific areas of focus and exploration for collaboration in these countries:

developing family medicine at the undergraduate and postgraduate level;
supporting generalists practising within their countries’ health systems (usually not trained family physicians) in achieving and maintaining competence for practice;
developing training standards;
setting up and increasing the robustness of professional associations of general practitioners and family physicians so that they can become true “professional homes” for these practitioners; and
collaborating with professional organizations of general practitioners in order to help them to meaningfully influence their health care systems.

In 2009, Dr Sadok Besrour, a Life Member of our College, made a seed donation to the Research and Education Foundation (REF), and nudged the leadership of the CFPC toward thinking about the College’s potential role in supporting capacity-building in family medicine beyond Canada’s borders. On November 11 and 12, 2012, representatives from 15 Canadian departments of family medicine and 12 countries gathered just outside Toronto, Ont, to further advise the College on potential areas of engagement. This first gathering was made possible by support from Dr Besrour through the REF, as well as through a grant from the International Development Research Centre. Dr Besrour’s donation also enables the CFPC and the REF to support an award in global health every year.

As I reflect on our journey to date, 3 things impress me:

the ongoing need for understanding and affirmation of family medicine and family practice as a respected and recognized discipline in many countries;
how far we have come in Canada as a discipline—our ability to define the competencies of our graduates, from coast to coast (having a common “product”) is viewed by visitors as an important enabler and an essential component for building a solid foundation for the discipline of family medicine; and
the importance, in this work, of learning from one another.

We are now at a crossroads in the sense that we have probably gone as far as we can with the current dedicated resources. Several questions arise: Should the College be more active in the area of global health? Why would or should the CFPC be involved in international activities? Can the REF really raise funds to help support the College in such an endeavour? What should the role of academic departments of family medicine be in such a project? How does an involvement in international relations and global health benefit CFPC members?

We are at the beginning of our reflection on this. There is a sense that engagement in international activities around global health has the potential to help us achieve our strategic goals—social accountability and increasing the attractiveness of family medicine to medical students, for example. Collaboration and partnerships with universities and university departments of family medicine are not only desirable, but essential. Creating and strengthening relationships with universities, governments, and other organizations around family medicine has the potential not only to facilitate the development of our discipline on an international scale, but also enables us to learn from those experiences, affecting our work in here in Canada.

We have reached a stage of maturity as a discipline and as an organization. We need to be careful but deliberate. The time is right to consider how to best share what we have learned, and to inspire one another. I look forward to being part of the furthering of our work in this area.