Title: Insights on Developing General Practice Education in China
Abstract: To the Editor: We read with great interest Wu and Lam’s1 update about family medicine education in China. The Peking University Health Science Center (PUHSC), Department of General Practice (GP) was established 2011. Founded by Professor K.K. Cheng from the University of Birmingham, United Kingdom, the department is currently headed by Professor Chunhua Chi. PUHSC and University of Birmingham work closely and have conducted primary-care-related training programs in both the United Kingdom and China to more than 1,000 GP trainers and 4,000 general practitioners from 30 provinces in China. Based on this PUHSC experience, we would like to make three points relative to developing GP education in China. First, the top priority is developing a large cohort of GP teacher physicians. In the current Chinese context, most GP teaching physicians are hospital-based specialists. They need further training to adapt to their new role in GP education. Some important elements include the following: What does GP actually involve? How does it differ from secondary care? What are key skills for GP consultations, and what is the best way to teach GP trainees in the hospital setting? In parallel, China needs to develop the skills of teaching physicians working at the community level. Second, community health centers need to provide adequate and high-quality general practitioner-led primary care services to mitigate the problem of primary care patients overloading hospitals.2 General practitioners are required to develop competencies in managing common acute, self-limiting conditions; chronic diseases in patients of all ages; common mental health conditions; end-of-life care; and preventive health care related to primary care. They also need to coordinate and deliver care for the elderly, many of whom suffer from multiple comorbidities. Academic GP in China needs to greatly expand and implement continuous professional development courses relative to delivery of primary care services. Third, the curriculum for GP residency training needs to reflect the real work of community health care and be more competency oriented rather than knowledge based. A key element needs to focus on developing trainees’ lifelong learning skills for clinical practice. These knowledge-acquisition skills are critical to ensure that future general practitioners will practice safely and effectively during their careers. By investing in education and people, we are hopeful that China’s primary health care reform will result in long-standing and self-sustaining changes at the current crossroads. Michael D. Fetters, MD, MPH, MAProfessor, Department of Family Medicine, and codirector, Michigan Mixed Methods Research and Scholarship Program, University of Michigan, Ann Arbor, Michigan; [email protected]; ORCID: http://orcid.org/0000-0001-8521-5681. Chunhua Chi, MDDirector, Department of General Practice, Peking University Health Sciences Center; director, Health Management Center, Peking University First Hospital; professor and chief physician, Respiratory and Critical Care Medicine, and chair, Family Medicine Department, Wu Jieping Medical Foundation; standing committee member, General Practice Branch of Chinese Medical Association; and executive president, Chinese Alliance for Respiratory Diseases in Primary Care, Beijing, China. Lin Hu, MScSino UK general practice project manager, Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom.