1. “What Essential Competences young family
doctors have to learn and practice for working in
rural areas appropriately? “
Results from 16th and 17th
Wonca Europe Conferences Workshops
“ A tribute to Claudio Carosino “
Jaume Banqué Vidiella . Euripa – Semfyc – Camfic
Institut Català de la Salut. CAP Baix Ebre. Spain
jbanquev@gmail.com

2. Common themes in rural health…
●At the heart of the rural health education agenda is that rural
people have different healthcare needs and reduced access to
services….
●Rural populations tend to have different profiles to those of urban
populations…
●Rural health professionals face additional isolation issues…
●Isolation from professional support requires a broader scope of
practice, more training and stronger support networks…
RB Hays. School of Medicine, Keele University, Staffordshire, UK
Rural medical education in Europe: the relevance of the Australian experience
Rural and Remote Health 7: 683. (Online), 2007

3. Wonca Europe Conf. 16th Conf. Málaga 10.2010
Workshops 17th Conf. Warsaw 09.2011
Participants: 32 Compulsory RT Experience in Rural
(Countries: 23) period for young GP Health ? : 20 partic.
in your country ? : 5 (60,6%)
countries

5. Results faced with Core Competences
( European Definition of GP / Family Medicine
Euract. Wonca Europe 2005 )
Results grouped into Core Competences – Euract
2005
●Abilities, training and
knowledge. (42) ●Specific solving problems skills
●Working in a rural setting (28) ●Primary care management
●Being a GP and a rural doctor ●Person centred care
(25) ●Comprehensive approach
●Collaborative practice (10) ●Community orientation
●Community medicine (10) ●Holistic approach
●Family and home care (4)

6. Abilities, training and knowledge
Specific solving problems skills
●Skills and training in emergencies
●Communicational skills
●Paediatrics
●Geriatrics
●Gynaecology and obstetrics
●Palliative care. Pain Control
●Up to date in technologies

7. Working in a rural setting
Primary care management / Comprehensive
approach/ Holistic approach
●Flexibility
●Integration with population
●Knowing the idiosyncrasy of population where you work
●Commitment of at least 3 – 5 years to a rural community
●Leadership
●Be in touch with other colleagues. Don’t stay isolated.
●Being part of your community as private person as well as
professional (How to live and work in the same and small
community)
● Patient guide and rural doctor´s style: going slow without stop.

8. Being a GP and a rural physician
Primary care management / Comprehensive /
Holistic approach
●Dealing with uncertainty
●Holistic approach
●Facing the challenges: Ability to work under stress and
independently
●Physician’s health
●Treating all kind of people
●Be closed but maintaining your doctor´s role
●Greater range of skills: Procedural, diagnostic, public health...
●How to prevent and treat occupational diseases
●Dealing with CPD and professional development.

9. Collaborative practice
Primare care management
●Networking
●Multidisciplinary point of view
●How to work with different specialist and institutions : social
services, local politicians, veterinarians, agricultural engineers....
●Collaborating with regional services

10. Community medicine
Community orientation
●Working with the community
●Social, demographic and epidemiologic point of view
●Empowering population
●Community oriented primary care
●Community involvement (coherence between lifestyle
recommendations and personal choices)
●Knowledge of local culture and community

11. Family and home care
Person centered care
●Collaboration with family to resolve problems
●Home care
●Long term care for chronic diseases
●Traditional care in rural areas.

12. Rural training concepts
●Rural Doctor > Complete family doctor > Core and paradigm of the
GP speciality > Model for young family doctors
●Rural Practice > Specific kind of practice > Health care for a
particular community > Working with sustainability
●Rural Center > Locus for training and learning > Under and Post
Graduate Doctors
●Rural Rotation > “Not a problem of contents but a problem of
future life conditions”

13. Rural medicine values for trainees
●Getting an opportunity for working and knowing “The GP´s role”
inside a defined community
●Emphasizing the holistic view in Family Medicine : “The bio-psyco-
social model”
●Underlining the importance of “Equity” in health services : Equal
access / Equal utilization / Equal health outcomes