• To develop Family Medicine as a discipline and service that is recognized, understood and used by government, community members, by health service providers and by the academic community.
• To graduate sufficient numbers of fully trained Family Medicine doctors for all sixteen district hospitals of the Eastern Region.
• To encourage a higher standard of private practice in the region

Objectives

• better balance in the department in numbers of junior and senior doctors
• Raising the standard of care provided in the Emergency and Family Medicine Outpatient services of BPKIHS
• Development of district hospital services in collaboration with many stake holders
• Developing referral systems and professional relationships throughout the region
• Establish a Family Medicine teaching base with resident faculty near a district hospital.
• Regional CME program for both publicly employed and private doctors in collaboration with Dept of Health educational activities
• Regional Family Practitioner / Generalist Newsletter
• A more highly qualified private practitioner work force
• Involvement of private practitioners in training of doctors
• Collaboration of private practitioners with public health services for reporting and implementing national health strategies
• Development of anaesthetic, surgical, obstetric services, and blood availability in district hospitals

Plan of Action

• Intake and graduation of residents. To staff 75 districts with 2 MDGP or MD Fam Med doctors is the reason for an expansionist vision.
• Establish the District Base of the Family Medicine Department (office, teaching facilities and residences) at e.g. Dhankuta in 2063.
• Faculty to be resident long term, at the Base and other district hospitals progressively from 2063 onwards (depending on recruitment).

Elective students from Israel and Holland are expected throughout the year
Faculty visits anticipated: Dr Jill Benson – September 2005; Dr Ana - November 2005; Emergency Consultant – January 2006; Dr Malcolm Moore – Feb to Mar 2006. All are Australian general practitioners

Development in the Post Graduate Training Programme

• Expansion of the programme depends on many factors including promotion of the career to junior doctors, maximum utilisation of peripheral hospitals and, recruitment of MDGP qualified doctors as SR, faculty and supervisors. A ratio of one faculty member for 2 new residents is appropriate considering the role of faculty other other disciplines in the programme and the recruitment of Clinical Supervisors outside of BPKIHS. Places for 8 new residents will be requested this year.
• Utilisation of Koshi Zonal Hospital as a training site for the surgical and obstetric terms in the first year will be implemented from August 2006
• Clinical Supervisors Doctors outside of BPKIHS who are teaching our Residents will be invited to apply for the title of Clinical Supervisor.
• Training sites in the hills. The district hospitals of Phidim, Terathum, Taplejung, Bojpur, Dikhtel, Gaigat, Okhaldunga, SoluKhumbu could become training sites if security improves. An important criteria is that a MD GP/ Fam Med doctor should be there as Clinical Supervisor. Phidim meets this criterion.
• M. Phil in Emergency Medicine. A curriculum will be developed and a proposal put to the Academic Committee for a one year post MD programme in Emergency Medicine leading to the degree of M.Phil Emergency Medicine. The curriculum is to be developed in consultation with other international Emergency training programmes.
• National General Practice/ Family Medicine Committee. We will work towards a common curriculum and common final exam

Promotion of Family Medicine.

• hope to influence government and INGOs to provide incentives for trainees and for MDGP/ MD Fam Med doctors who actually serve in rural communities for significant periods of time, with added incentives to those who are performing LSCS.
• Regular meetings with colleagues in the TUTH and NAMs programmes
• Regular deputations to meet Director General of Health and Ministry of Health officials, to improve promotion, work conditions and to provide sponsored seats.
• Regular contact with donors such as DFID, who may be the source of incentives for doctors willing to work in remote areas.
• Preparation of a brochure for the promotion of the career and the training options.

Faculty:-The current four faculty will be supplemented by Senior Residents (possibly 3). The department continues to search for more permanent and visiting faculty.
Undergraduate Teaching

• The department considers it important to be involved in the Phase 1 of the Undergraduate Curriculum. The following areas of involvement by family doctors are suggested
  • General concepts of health, disease, illness behaviour
  • Concepts of being a doctor whether generalist or specialist.
  • Clinical skills
  • Problem Based Learning
  • Teaching of Ethics
  Team teaching with other disciplines would enhance the learning experience for the students