Canadian pioneer in continuing medical education

Dr John N. Premi, the family physician who started the practice-based small group learning program, died peacefully on February 19, 2021.

Dr Premi attended medical school at the University of Toronto in Ontario, interned at the Hamilton General Hospital, and then became an active family physician in Hamilton, Ont. He served as Director of the Charlton Family Practice Unit in the Department of Family Medicine at McMaster University in Hamilton and was the Chair and Assistant Dean for Continuing Education in the McMaster Faculty of Health Sciences during the 1980s.

Dr Premi was a Fellow and Life Member of the College of Family Physicians of Canada and Professor Emeritus at McMaster University.

In the late 1980s, Dr Premi had an exciting vision of an innovative approach to the continuing education and professional development of family physicians—one that involved the formation of small groups of peers learning together in their own communities. The groups would meet regularly to discuss real patient cases, supported by evidence-based materials developed by and for family doctors. Group discussion, led by a peer facilitator, allowed for sharing of practice experiences and focused on how best-practice information for selected conditions could be implemented in day-to-day practice to improve patient care. Ongoing meetings provided the opportunity to review the success of the planned practice changes and find strategies to overcome barriers.

Despite early setbacks and innumerable challenges, Dr Premi’s enthusiasm and energy for this novel approach did not wane. The first pilot of the practice-based small group learning program began in 1992 in Ontario. Within several years, the program became available across the country and was the first accredited Mainpro-C program of the College of Family Physicians of Canada. Over the nearly 3 decades since its beginning, practice-based small group learning has grown to become a national-level program covering all provinces and territories. The program received the CFPC CPD Program Award in 2012 and now has more than 6000 members across Canada. The practice-based small group learning program was also adopted in Scotland in 2006 and has more than 2000 members there.

His life’s motto was faciendo discimus (we learn by doing), and he embodied this in his professional work. Dr John Premi has left a very special legacy for continuing professional development.

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