The challenges of cross-cultural research and teaching in family medicine: How can professional networks help?

Modern medical training emphasizes the value of understanding the patient’s ideas, concerns and expectations, and the use of their personal perspective to assist communication, diagnosis, and uptake of all appropriate health and treatment options. This requires doctors to be ‘culturally sensitive’, which “… involves an awareness and acceptance of cultural differences, self-awareness, knowledge of a patient’s culture, and adaptation of skills”. Yet most of us work in one country, and often one community, for much of our professional careers. Those who enter into academic pursuits will similarly be constrained by our own backgrounds and experiences, even though universities and medical schools often attract a multicultural membership. We therefore rely on our professional training and networks to extend our scope and understanding of how cultural issues impact upon our research and its relevance to our discipline and curricula. This article uses a reflexive narrative approach to examine the role and value of international networks through the lens of one individual and one organisation. It explores the extent to which such networks assist cross cultural sensitivity, using examples from its networks, and how these can (and have) impacted on greater cross-culturalism in our teaching and research outputs

Principles of patient and public involvement in primary care research, applied to mental health research. A keynote paper from the EGPRN Autumn Conference 2017 in Dublin

Clinical research relies on patients being willing to participate in research projects, and making this possible for patients with mental health problems can be a particular challenge. In the modern era, many countries have seen a movement to give a stronger voice to patients both in choices around their care and in how research is conducted. How to achieve effective patient and public involvement (PPI) and to make the patients real partners in this effort is itself a subject of research evaluation. This opinion piece—based on a keynote lecture given at the European General Practice Research Network 2017 autumn meeting in Dublin—describes both the reasons for expanding PPI, how it can usefully be achieved, and how this may relate to the particular context of mental health. There can be moral, methodological or policy reasons for PPI. The three commonest models of good practice in PPI are the ‘one off,’ the ‘fully embedded’ and the ‘outreach’ models. In research into common mental health problems in family practice, ‘outreach’ approaches that minimize commitment over time may work best. ‘Expert patients’ from mental health charities can sometimes play this role. PPI may be challenging and involve extra effort, but the gains for all may be considerable. Wonca Europe networks including EGPRN can extend this message and findings

Learning or leaving? An international qualitative study of factors affecting the resilience of female family doctors

Background: Many countries have insufficient numbers of family doctors, and more females than males leave the workforce at a younger age or have difficulty sustaining careers. Understanding the differing attitudes, pressures, and perceptions between genders toward their medical occupation is important to minimise workforce attrition. Aim: To explore factors influencing the resilience of female family doctors during lifecycle transitions. Design & setting: International qualitative study with female family doctors from all world regions. Method: Twenty semi-structured online Skype interviews, followed by three focus groups to develop recommendations. Data were transcribed and analysed using applied framework analysis. Results: Interview participants described a complex interface between competing demands, expectations of their gender, and internalised expectations of themselves. Systemic barriers, such as lack of flexible working, excessive workload, and the cumulative impacts of unrealistic expectations impaired the ability to fully contribute in the workplace. At the individual level, resilience related to: the ability to make choices; previous experiences that had encouraged self-confidence; effective engagement to obtain support; and the ability to handle negative experiences. External support, such as strong personal networks, and an adaptive work setting and organisation or system maximised interviewees’ professional contributions. Conclusion: On an international scale, female family doctors experience similar pressures from competing demands during lifecycle transitions; some of which relate to expectations of the female's ’role’ in society, particularly around the additional personal pressures of caring commitments. Such situations could be predicted, planned for, and mitigated with explicit support mechanisms and availability of workplace choices. Healthcare organisations and systems around the world should recognise this need and implement recommendations to help reduce workforce losses. These findings are likely to be of interest to all health professional staff of any gender

New perspectives - approaches to medical education at four new UK Medical Schools

To create more UK doctors, the government has funded an increase in medical student numbers of 57% (from 3749 to 5894)1 between 1998 and 2005. This has been done by increasing student places at existing medical schools; creating shortened programmes open to science graduates; “twinning” arrangements, which host an existing curriculum at a new site; and four entirely new schools (table 1). Through reflection on our experiences and the literature evidence, we examine to what extent these new schools have a common vision and approach to undergraduate medical education, and we discuss the rationale for and likely outcomes of these new ventures

The coronavirus outbreak: the central role of primary care in emergency preparedness and response

On the last day of 2019, a cluster of cases of a pneumonia with unknown cause were reported by the Chinese authorities to the World Health Organization (WHO), believed to be connected to a seafood market in Wuhan, China. This market was closed the following day. On 7 January 2020, a novel coronavirus was isolated, and known pathogens were ruled out.1 Coronaviruses usually cause respiratory illness ranging from the common cold to severe acute respiratory syndrome (SARS). Clinical symptoms and signs of the Wuhan coronavirus include fever, with some sufferers experiencing difficulty breathing and bilateral pulmonary infiltrates seen on chest X-ray. WHO are referring to it as ‘2019-nCov’. At the time of writing, there have been over 4,500 confirmed cases and 106 deaths, including among healthcare workers. Over 98% of these cases are within mainland China, but cases have also been confirmed in tens of other countries