I would like to reflect on the pioneering achievement of my Alma mater during my tenure as Principal of that Institution. MD program in Family Medicine was initiated by my college, marking as the first college to start such a program in India. Consequently, my college stood as the sole institution in the country to provide this course for the subsequent three years. “Why it was so important? There was no formal department of family medicine in any medical college at that time. There were no eligible faculty either.
We started working on it in 2010 when CMC Vellore conducted a workshop on Family Medicine in India under the guidance of the Medical Council of India and the Health & Family Welfare Department, Govt. of India. The Principal Secretary of Health, Govt. of Kerala, attended the workshop and I was asked to join him. After the workshop, I was entrusted to look into the possibility of starting Family Medicine training in Kerala. Back then, we lacked a thorough understanding of this course, aside from the existence of a training program at Vellore that granted a diploma. It was not approved by MCI.
Later part of that year I had the opportunity to meet an expert in Family Medicine from Canada, Dr. Peter Kuling. We had a day-long discussion on implementing family practice in India. On getting some insight, I thought I would apply for an MD in Family Medicine. We had to face many obstacles. First of all, there was no curriculum approved by the Medical Council of India. Setting up a department was not easy, especially in a Govt. run institution.
With the constant support and encouragement from the Principal Secretary, I got Govt. orders to create a department of Family Medicine by pooling faculty from departments like General Medicine and Paediatrics. Then a curriculum for the course was prepared and submitted to the University for approval. The next stage and most difficult one was to convince the Medical Council of India. I didn’t face many hurdles there as expected and in 2012 Govt. Medical College, Kozhikode was sanctioned 2 seats for MD Family Medicine. So, my college became the first and only college in India to start this course.
In India, the medical practice has become specialty-oriented, unlike other developed countries. Here each MBBS graduate is seeking a specialization and hence primary care or family practice is ignored. We need a healthy combination of generalists and specialists for comprehensive health delivery. We know that nobody can discourage an MBBS graduate from seeking a career in a specialty. Then how can we build up family practice at the primary level? The only way possible is to promote specialty degrees in Family Medicine and post them in primary care facilities. With this idea, we promoted MD in Family Medicine. Following our steps, many colleges started this course subsequently.
I recall a few incidents. During the initial years, all the institutions seeking information on Family Medicine were directed to me by the officials of the Medical Council of India. One doctor from Canada approached the Medical Council for training in the Indian system of Family Practice. He was sent to me and he spent one year in my college and prepared a report of his observations and experiences. In his report, he mentioned that our curriculum and training were at par with the system in Canada.
I was felicitated at the National Conference of Family Physicians in India and was awarded an appreciation for my contribution to family practice in India.
I felt excited when I attended the examination of the first batch of students. They were all elated to know that they were the first student to receive an MD degree in Family Medicine in India. Later Govt. of Kerala decided to redesignate all primary health centers as Family Health Centres and decided to appoint postgraduates in Family Medicine to these centers. I know that it will take some time to have sufficient family physicians in these centers. This marks a beginning and a welcome shift away from the traditional specialist-centered practice in India.I am proud that I have played a little role in initiating this change and hope that in years to come we will have strong primary care practice based on the family health system.
