FOUNDATION COURSES Family practice requires from its practitioners knowledge, skills and more especially an attitude that

is patient centered, family focused and community oriented* Competencies needed to achieve this have been prescribed by the PAFP and are therefore considered to be essential in all accredited Family Medicine training programs. These have been grouped into 12 foundation courses.

A. FAMILY MEDICINE PRINCIPLES AND FAMILY PRACTICE 1) Analyse both biomedical as well as psychosocial needs of the family as it goes through the various transitions of its family life cycle 2) Analyse family systems and its psychodynamics utilizing appropriate tools of family medicine 3) Identify the various factors that influences family systems utilizing such knowledge in assisting the family as it deals with different stages of illness 4) Prepare and maintain a family health record 5) Conduct family meetings for various reasons from disclosure to education to provision of primary counseling 6) Promote the wellness of the family B. PRIMARY AND SECONDARY CARE [ USE OF THE BIOPSYCHOSOCIAL APPROACH] 1) Deal effectively with the undifferentiated patient and recognize the various modes of presentation of an illness 2) Manage common medical problems of children, adults and the elderly in various settings : out patient clinic, in patient, emergencies, home 3) Recognize the various factors socio-cultural, economic, political or environmental - that impact on the illness of patients 4) Provide continuing, comprehensive and personalized care to patients with chronic conditions 5) Coordinate the care of patients with other specialists or agencies to achieve optimum health of the patient C. PREVENTIVE CARE AND WELLNESS [ CHILDREN, ADULTS, EDERLY, FAMILY, COMMUNITY] 1) Recognize and anticipate the specific needs of each population group - children, women, men, elderly - to prevent occurrence of disease or its complications 2) Cognizant of any existing risk factors , prepare suitable periodic health exam package for a patient inclusive of lifestyle check, screening tests, immunization and chemoprevention 3) Promote healthy lifestyle and health promoting behaviors to patients, families and population groups D. COMMUNICATION AND RELATIONAL SKILLS 1) Demonstrate adequacy of communication skills in the following medical situations: a. Getting the clinical history b. exploration of health beliefs c. disclosure of diagnosis d. clinical decision making e. patient education f. lifestyle counseling or behavior change g. bereavement 2) Communicate effectively to patients and their families in various stages of illness from onset to its termination

3) Adopt the correct non-verbal communication stance in different situations : emergencies, bereavement, cultural and gender differences, etc 4) Develop the following core values : social responsibility, compassion, genuineness, and integrity 5) Maintain harmonious relationships with patients and their families as well as with colleagues in the profession 6) Present clinical cases or researches to colleagues in small group discussions as well as in medical conferences 7) Train community health workers to achieve competencies that will enable them to function more capably in their respective communities E. COMMUNITY ORIENTED PRIMARY CARE 1) Recognize a community as a population at risk 2) Critically analyze the health situation of a community 3) Analyze how health systems work and the workings of its components: a. Delivery of health services b. Management of health information c. Health financing d. Formulation of health policies 4) Apply the recognized steps of COPC to a population group a. Identification of the population group as community b. Description of the community c. Identification and prioritization of a health problem/ health concern of the community d. Assessment of the prioritized health problem e. Facilitate intervention to manage the problem f. Monitor the impact of the intervention 5) Utilize participatory strategies in the conduct of health promotion activities for the community 6) Promote the education of the general public on health matters 7) Advocate for mounting efficiency of the health system resulting in improvements of health indicators F. EVIDENCE BASED MEDICINE 1) Appropriately translate a clinical dilemma into a researchable/ focused medical question 2) Search the medical literature for the suitable medical information that will answer the clinical dilemma 3) Critically appraise the evidence of medical research on therapy, diagnosis, harm, and prognosis 4) Determine criteria for use of any test to screen for or diagnose a clinical problem 5) Appropriately apply obtained medical evidence to patient care 6) Promote the use of updated and cost effective medical evidence G. QUALITY ASSURANCE 1) Achieve and maintain the standards on family practice set by PAFP 2) Conduct a clinical audit of a family practice H. RESEARCH 1) Constantly update ones medical knowledge 2) Contribute to the growth of medical knowledge and the advancement of health care by conducting relevant researches I. INFORMATION TECHNOLOGY 1) Utilize modern technological advancements that will enhance patient care

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2) Appropriately search the internet to increase knowledge and facilitate learning MEDICAL ETHICS AND PROFESSIONALISM 1) Demonstrate ethical behavior in the management of patients and their families 2) Recognize ones rights as a physician 3) Document accurately medical information on legal documents such as medical charts, patient records and certificates 4) Be consistently mindful of ones own professional conduct 5) Act appropriately when aware of unethical conduct by a colleague 6) Coordinate with an ethics committee in the conduct of medical research 7) Be guided by the PMA Code of ethics in the practice of ones profession LEGISLATION ON HEALTH AND THE FAMILY 1) Identify important legislation that impact on health and the family 2) Become familiar with the various policies of DOH especially those that relate to primary / family care PRACTICE MANAGEMENT AND HEALTH ADMINISTRATION 1) Identify the protocols and requirements in the establishment of a family practice 2) Manage time for personal activities as well as organizational ones 3) Work with a health team in the promotion of health of the family practice patients 4) Work towards the achievement of goals whether they are those of a project or of an organization

These are terminal competencies and Residency training programs are given the freedom to plan their instructional designs specifying the content or what will be covered in a particular learning activity and how this will be evaluated. The prescribed instructional design should show the following: COMPETENCY TO BE ACHIEVED Terminal ones Prescribed by the PAFP but Residency training programs are given the choice to prepare progressive ones for every year level of training CONTENT What will be covered to achieve the competency. LEARNING ACTIVITY How the competency will be taught. This maybe through lectures, case discussions in different venues, reports etc EVALUATION Knowledge and skills must be evaluated to check if competencies have been achieved. The manner this will be done is given to training programs. Written exams at the end of every year and at least one OSCE to check skills are prescribed.

Residency training programs are not prohibited from adding to the foundation courses. However, the latter are essential and must be present in the curriculum of the training program.