DOI: 10.4103/jfmpc.jfmpc_685_26 ISSN: 2249-4863

Navigating Indian Family Medicine: Unveiling training structures, student confidence, and perceptions

Hemavathi Dasappa, Mohan Kubendra, Vishnu B Satheesh, Raman Kumar, Lijo Joseph
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BSTRACT

Introduction:

The present study aims to critically analyze the existing Family Medicine (FM) training framework in India and to propose practical, context-specific, and feasible solutions to strengthen training quality and to enhance the capacity of primary and secondary healthcare systems across the country.

Methodology:

A cross-sectional, questionnaire-based study in which students in the final year of the FM postgraduate program (Diplomate of National Board) in India or doctors who have finished FM postgraduate training in the last 10 years in India were contacted through various associations, including Academy of Family Physicians of India and Spice Route Movement. Consenting doctors filled a Google form. Filled Google forms were assessed and evaluated.

Results:

The adherence to recommendations, confidence on competency, and perception of training were compared between two groups: participants with a dedicated FM department versus those without. A statistically profound gap was observed in curriculum recommendation adherence between the two groups ( P < 0.001). Institutions with an established FM department scored nearly twice the mean baseline of non-department sites (62.09 vs. 35.11). No statistical difference was observed between the groups regarding self-rated clinical competencies before training ( P = 0.837), after training ( P = 0.804), or in overall competency improvement ( P = 0.650). Trainees without a dedicated department ranked significantly higher in perceiving that their “teaching was not in line with family practice” ( P < 0.001) and had significantly worse overall negative perception scores (11.98 vs. 9.34, P < 0.00). Those backed by an authentic FM department reported profoundly higher qualitative training satisfaction ( P < 0.001).

Conclusion:

Adherence to the National Board of Examinations (NBE) curriculum recommendations was suboptimal across institutions. The presence of an FM department does not necessarily change how much clinical medicine residents claim to learn by year three; rather, it changes the entire protective structural framework under which they learn it. Without an FM department, residents achieve the same confidence level but do so while navigating a fragmented, poorly aligned system that exposes them to significant identity confusion and structural strain.

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