European family medicine/general practice (FM/GP) has travelled a long and successful journey of profiling the discipline and has produced valuable position papers on education and research. However, the turmoil inherent to the medical field—with its sub-specialization and educational and research self-centredness—has touched also European FM/GP. Looking behind the curtains of the podium disputes, we can identify three major risk factors for future stagnancy in the development of European FM/GP.
Lack of common goals. This threat can be identified on the international level as differences between countries in terms of size, health care system, position of FM/GP and the development of FM/GP. It is also seen inside individual countries where everybody in FM/GP is busy with his/her own institution, organization or project.
Diversification of the objectives. On the international level, one can observe this in the multitude of formal and informal networks and special interest groups—all striving for justified particular FM/GP objectives—with little or no cohesion seen. The same happens within national contexts. On the one hand, societies and colleges fight for an appropriate position of FM/GP within the national health services, emphasizing financial aspects and mandatory specialty training in FM/GP; on the other hand, university FM/GP faculties are busy working with students, protecting their own position within a tough university environment, caring for own staff development.
Asymmetric power distribution. Wonca Europe is a big organization with acceptable budget but little important projects of its own, relying mainly on the networks and special interest groups, which sometimes pursuit their own goals, which are not necessarily always in line with Wonca Europe mission. Identical problems can be found within individual countries. In developed countries, hidden, or overt struggles can be seen between practitioners, professional organizations, regulatory bodies, universities, etcetera, and in less developed countries development of academic usually falls back in confrontation with the struggle for financial recognition for FM/GP work.
Alternatively, the level of the ‘development’ of the discipline in Europe is mainly measured through the successes of few countries. This puts less developed countries—and those not able to promote or adequately measure their development—on the rim of the spinning development of FM/GP in the world. In addition, it exposes the whole discipline to the threat of individual universities tempting to squeeze out departments of FM/GP and replace them by more ‘scientifically productive’ medical specialities, leading to even more sub-specialized curricula and less comprehensive and holistic education. We have to take into account that without a clear and strong position of the FM/GP profession regarding the content and objectives of FM/GP teaching in medical schools, heads of the department are exposed to pressure of deans who usually benchmark his/her own medical school with one which he/she picks up. It might happen that in that particular university FM/GP will not be in an optimal position.
The position of FM/GP is under heavy debates and financial pressure. To turn threats into opportunities, EURACT proposes a project to establish and facilitate collaboration within the academic sphere of FM/GP and between universities and clinical preceptors (tutors, trainers, coaches, supervisors, mentors) for FM/GP in Europe. Such a project would provide a sound platform to support sustainability of GP/FM's great achievements in the future. The objectives are:
Networking and collaboration in basic medical education (BME)
Platform for the exchange of the curricula, programmes, projects in undergraduate and postgraduate education
Promotion of common family medicine content and context in Medical Schools’ curricula
Core family medicine curricula for BME
Network for students and teachers exchange
Teaching agenda for undergraduate education
Quality improvement of undergraduate and postgraduate teaching
Innovative approaches in undergraduate and postgraduate teaching
Research in postgraduate education
Teaching the teachers courses
Support to less developed departments/medical schools
Collaboration with other Wonca networks, SIGs and different regional networks