North America/Non-Hispanic Caribbean
Family medicine is quite established in North America. Canada and the USA are quite similar in the way that they train their family physicians and the length of training as well. Both of these countries require high school to be completed, along with an undergraduate degree. This degree varies in length from 3-4 years, as some medical schools will accept a student out of a 3rd-year in their undergraduate degree. After getting in, there is a 4-year medical school training followed by a 2-year residency in Canada and a 3-year residency in the States. Canada has the shortest residency program for family physician training. Canada’s first residency was created in 1966 and the USA’s was created in 1968. Both of these countries have relatively high ratios of family doctors and physicians to the population. Family doctors are used as gatekeepers in both settings and both healthcare systems are a mix of private and public, with the States predominantly having a private system.
Many of the countries in the Non-Hispanic Caribbean region do not have residency programs for family medicine and only offer diplomas. Family medicine is a fairly new concept and is not fully developed in these countries. The only countries in this region with training programs are Trinidad and Tobago which has a 2-year diploma which was started in 2000, St. Lucia with a 2-year diploma that started in 2008, Jamaica with a 3-year masters program that has been restarted in 2010, a 3-year masters in Guyana that started in 2015, Barbados with a 3-year masters program that started in 1981, the Bahamas with a 2-year diploma which started in 2002, and finally Haiti with a 3-year residency program that was established in 2011. These values are all according to the University of West Indies and its affiliate campuses. According to WONCA, the Caribbean region as a whole has a college of family physicians that was formed in 1987 (The Caribbean College of Family Physicians). On average most of these countries require a high school education along with a couple years of an undergraduate degree. Most medical schools are between 4-7 years in length depending on if some courses weren’t taken in undergraduate studies or if the applicant skipped an undergraduate degree and needed to take any preparation programs at the medical school. Most of the medical schools in this region prepare their students to write the USMLE’s where they get matched for residency in the USA. The majority of family physicians in this region are gatekeepers due to the public sector of healthcare present in these countries, however Haiti is predominantly a private healthcare system and as a result, the family physicians rarely act as gatekeepers here.