Family physicians across the country can trace their daily practices and bedside manner back to The University of Western Ontario.
Western, along with St. Joseph’s Health Care, celebrated 40 years of family medicine at a ceremony on Dec. 10.
London, said to be the “birthplace of family medicine,” became the home to the first full-service family medicine teaching centre in Canada, St. Joseph’s Family Medical and Dental Centre, and Western was the first medical school in the country to offer post-graduate training in family medicine.
“It represented the first teaching unit of its kind and it has served as a model on which all the other teaching sites across the country have been based,” says Dr. Tom Freeman, chair of Western’s family medicine department, adding post-graduate training in family medicine has since become standard at all medical schools in Canada.
The first person to sit as chair of the department, Dr. Ian McWhinney, attended the anniversary event, along with several other founding physicians of the original family medical centre. McWhinney joined Western in 1968 and his pioneering work is credited for establishing family medicine as specialized discipline, a model which was replicated across the country.
Dr. Calvin Gutkin, executive director and CEO of the College of Family Physicians of Canada, Jan Kasperski, CEO of the Ontario College of Family Physicians (OCFP), and Dr. Stephen Wetmore, president of the OCFP, also attended.
Prior to the establishment of a department of family medicine and training site at St. Joseph’s Hospital, Freeman says medical students would engage in 12 months of in-hospital training before being awarded a general license.
But family doctors don’t typically practice in hospitals – they work in the community. Freeman says this left a gap between what medical students were learning and what they would encounter in their practices.
“The kinds of issues and solutions to the issues patients have in the community are quite different than what happens in hospital-base practices,” he says.
“The diseases, the problems and the solutions that occur in a teaching hospital have no bearing or very little relevance to what happens out in the community.”
It was with this understanding that family medicine evolved across the country. Students at Western now receive a minimum of two years training in family medicine upon graduation from medical school, including half of the time spent in a teaching site or community-based practice and half in a teaching hospital.
“Now every medical school has a department of family medicine,” says Freeman.
“Because family medicine is the basis on which our health care system in Canada is based, the importance of having developed such teaching sites and capacities to train people for that has been a really important contribution to health care in Canada.”
More than 1,000 medical students have graduated from Western’s family medicine program since its inaugural class.
Freeman says the increasing demand for family physicians has created new pressures for the program. To address this need, Western plans to raise its class size from 54 to 75 residents by 2012.
The university is also looking to curb the decline over the past decade of fewer medical graduates entering family medicine. Similarly, the profession must also look at ways to bridge the needs of female family physicians looking to start a family while maintaining a medical practice.
Continuing its tradition of breaking new ground, Western has the only family medicine department to offer a master’s degree and beginning in September, it will have the first PhD program in family medicine in North America.
“The first chair of the department had quite a robust vision for where family medicine needed to go and it’s been possible to follow through on a lot of those initiatives,” says Freeman.