training

The year family medicine established: 2007 (Mash, 2018)

Type of Training: It is both a Masters and Diploma program (von Pressentin, 2019)

Length of Training: (Mash, 2018).

• 6 years medical school to obtain MBChB degree

• 2 years internship – includes 4 month rotation in family medicine

• 1 year of community service to the country

• Then you can specialize in family medicine - 4 years

Number of institutions that offer family medicine: (Mash, 2018), 9 Medical Schools, and all 9 have post graduate training in family medicine.

Number of family medicine residents graduating each year: (Mash, 2018), 5-6 graduates per year, per institution. In total, there are 50 graduates per year.

practice

Number of family doctors in a country (2018): 1064 (Mash, 2018)

Physician to population ratio (2016): 80 physicians per 100,000 people, (“Physicians per 1,000 People”).

DALY: 44,148 per 100,000 individuals (Due to all Causes).

Life Expectancy:

• Females 2017: 67.0 years

• Males 2017: 59.9 years

Mortality rate 2017:

• 2017 Males: 379 per 1,000 male adults.

• 2017 Females: 258 per 1,000 female adults.

Infant Immunization-HepB3: % of 1-year-old children received: 74%

College of Family Physicians (Y or N):

• Yes: The College of Family Physicians of South Africa.

training

Family physician training in South Africa aims to produce specialists who are able to not only practice competently in district hospitals, but who are also able to work with teams of healthcare professionals to improve healthcare outcomes of the communities they serve. In the public sector family physician specialists are paid at the same level as other specialists. In the private sector, family physicians are not yet recognized as being able to charge specialist rates.

practice

Primary care is a nurse driver entity (Mash, 2018). In South Africa, the public sector looks after 80% of the population. The private sector looks after roughly 20% of the population, where people will see a general practitioner (von Pressentin, 2019). In the public sector, in primary care, you will see a nurse 80% of the time, 20% of the time you will see medical officers, community service officers, and occasionally family physicians. (Mash, 2018),  A family physician is a senior clinician in the team. They tend to see more complicated patient problems that are referred to them by the nurses and junior doctors. There are six roles (Mash, 2018).

1. Clinician, trained to work independently

2. Consultant

3. Capacity builder

4. Clinical governance

5. Champion of community-oriented primary care

6. Clinical trainer

In the public sector, doctors do act as gatekeepers (Mash, 2018). Not everybody has to go through the family physician to be referred but the family physician overlooks quality and nature of the referrals made by nurse practitioners and junior doctors (von Pressentin, 2019). In the private sector, medical insurance gives access to any physician without having to go through primary care providers (Mash, 2018).