Trinidad and Tobago
Population, (2017): 1.369 M
Income per Capita, (2018): 15350.90 US
Percentage of GDP on healthcare, (2015): 6.02%
training
Year Family Medicine was Established: 2000 (Adams, 2018)
Length of Medical School: 5 years (The University of the West Indies, n.d.)
Length of Training Program: 2 years (personal interview, 2018)
Type of Training: Diploma (personal interview, 2018)
Number of Institutions That Offer Family Medicine Training: 1 institution (personal interview, 2018)
Number of Trainees: 29 spots each year (personal interview, 2018)
practice
Number of Family Physicians: 46 family physician per 100,000 (personal interview, 2018)
Number of Physicians: 18.2 physicians per 100,000, (Trading Economics, 2011).
DALY: 19,721 per 100,000 individuals (Due to all Causes).
Life Expectancy:
Females 2017: 74.4 years
Males 2017: 67.4 years
Mortality rate 2017:
2017 Males: 213 per 1,000 male adults.
2017 Females: 120 per 1,000 female adults.
Infant Immunization-HepB3: % of 1-year-old children received: 99%
College of Family Physicians (Y or N):
Yes: The Carribean College of Family Physicians of Trinidad and Tobago
Healthcare System
The healthcare system in Trinidad and Tobago is a mix of public and private health systems. Some physicians separate their days or weeks and work in both. In public systems, they are usually in a team and in the private system, there is a mix of solo and group practices. Family medicine is well recognized here due to its public funding and also to the fact that preference is given to physicians who are qualified in family medicine over ones that are not. Family medicine is also recognized by the medical board as a specialist. There is also a college that rules over them called the CCFP, the Caribbean College of Family Physicians, with a Trinidad chapter which was created on world family doctor day in 2018. There are roughly 200 family physicians in the public sector and around 400 in the private sector (personal interview, 2018).
Everyone theoretically has access to free health care. Some barriers are location, transport and waiting times. Some patients go to the private system to save time. All vaccination protocols except varicella are covered by the government and vaccinations are a legal requirement for entry into school. The private sector doesn’t have access to all medications because of supplier issues, but the public system is better in this regard as it has different channels to get vaccines from. Most essential medications are available to the population. Family physicians have a good stock of equipment such as stethoscopes, BP kits, glucose testing machines, ECG machines, and ophthalmoscopes (personal interview, 2018).
PRACTICE
Some other primary health care providers include pediatricians, internal medicine, and OBGYNs. Oddly, there are no nurse practitioners nor physician assistants in this country. The role of a family physician is to be the first point of contact for patients. They deal with general medicine, minor procedures, and some go into teaching and research as well. The family doctors are used as gatekeepers in the public system all the time, however, they are only rarely used as gatekeepers in the private sector. Most private specialists see patients without a referral, however, they may ask for a referral sometimes (personal interview, 2018). They use the polyclinic model which is a community-based model of health (personal interview, 2018).
References
Informant #2, email message to Althaf Azward, November 21, 2018
Adams, P., email message to Althaf Azward, October 30, 2018
“Medicine | The Faculty of Medical Sciences.” n.d. Accessed November 25, 2018. https://sta.uwi.edu/fms/medicine-depts.
“Trinidad And Tobago Physicians Per 1 000 People.” n.d. Accessed December 1, 2018. https://tradingeconomics.com/trinidad-and-tobago/physicians-per-1-000-people-wb-data.html.