Professional Development of the Family Physician

Vocational Training & Continuing Professional Development of the Family Physician

The vocational training and continuing professional development of the Family Physician is marked by four milestones, namely, the. attainment of the award of the Graduate Diploma in Family Medicine (GDFM), the Master of Medicine in Family Medicine (MMed(FM)), the Collegiate Membership of the College (MCFP(S)) and the Fellowship of the College (FCFP(S)). Figure 1 summarises graphically the three phases of the development of a family physician: Undergraduate education, Vocational training, and Continuing Professional development.

The first two postgraduate awards are conferred by the National University of Singapore (NUS). The second two postgraduate awards of MCFP(S) and FCFP(S) are conferred by the College of Family Physicians Singapore (CFPS).

One can choose to attain one or more of these milestones in the course of his professional career. GDFM will be the milestone that all family doctors need to pass eventually. Over time, it is hoped that many will set their sights on the other three milestones.

Vocational training milestones

The vocational training programmes are the Graduate Diploma in Family Medicine (GDFM) and the Master of Medicine in Family Medicine (MMed (FM)).

The GDFM is a basic requirement to be a family physician and to be registered in the Family Practice Register (FPR) which provisionally will be implemented in 2011.

The next level beyond the GDFM is the MMed(FM). The aim of the MMed(FM) is to train an echelon of family physicians who will be on par with the hospital specialists and be able to take on the role of leaders, trainers, and administrators in family medicine development.

One can progress from the GDFM to the MMed(FM) through the Programme B route. Alternatively, one can do the MMed(FM) in one step bypassing the GDFM through the Programme A which has 2 years of hospital rotation programme and a 1 year of primary care posting. Both the Programme A & Programme B sit for the same MMed(FM) examination. The differences between Programme A & B are shown in Figure 3.

Professional development milestones

Figure 2 shows the relationship between the vocational and continuing professional development programmes.

The MCFP(S) is the professional benchmark for recognition as Senior Family Physicians. It may be attained via one of two routes: (1) Family physicians with GDFM must undergo the two-year MCFP(S) by assessment programme; and (2) those with MMed(FM) need 1 year of clinical experience post-Masters are elected by interview.

The fourth training milestone, the FCFP(S) is awarded to family physicians with MCFPS who have successfully completed a two-year prescribed Family Medicine Fellowship Programme (FMFP).

Figure 1: Professional Development of a Family Physician

Figure 2: Overview of Family Medicine Vocational Training Programmes in Singapore

Figure 3: Comparison of the GDFM & M.Med FM Programmes

GDFM	MMed (FM) - College Route
ENTRY REQUIREMENTS Conditional or full registration with SMC	ENTRY REQUIREMENTS Conditional or full registration with SMC
CLINICAL WORK No special requirement	CLINICAL WORK Required to sign an undertaking that he/she is able to continue working at least 6 sessions a week of which 2 sessions must be in an approved FM setting
DISTANCE LEARNING 2-year FMMC 8 quarterly modules of distance learning & workshops	DISTANCE LEARNING Not more than 5 years from the satisfactory completion of all 8 modules of the FMMC
TUTORIALS 8 small group tutorials	TUTORIALS 20 small group tutorials 10 clinical sessions, ward rounds 10 FM joint sessions
COURSES 5 skills courses P & P CCC PEL 1 x Elective GDFM Revision Course	COURSES & ACTIVITY Attend 2-week advance family medicine course 5 day clinical refresher course. Clinic audit
EXAMINATION MCQ 100 MCQs 10 KFP (Key Feature Problems) 10 OSCE (Objective Structured Clinical Examination)	EXAMINATION (for 2015) Part 1 (Written) - 325 min ABMS Paper MCQ - 250 questions Part 2 (Clinical) - Total 218 min Station 1: Logbook-based viva assessment (40 cases) Station 2: Slides-based short answer questions Station 3: 11 Clinical Skills Assessment Stations
ADMINISTRATION Distance learning - CFPS Examination - by NUS Examination training	ADMINISTRATION Distance learning - CFPS Clinical Skills Short Course Tutorials - CFPS Examination - by NUS Examination training

Overview of Family Medicine Professional Development Programmes in Singapore

MCFP(S)	FCFP(S)
Requirements	Requirements
GDFM for MCFPS by assessment : MMed (FM) for MCFPS by election	MCFPS
Primary care practice FM teaching appointments & evidence of professional development	Primary care practice FM teaching appointments & evidence of professional development
Programme Details	Programme Details
2-year MCFPS by assessment programme Video consultation assignments Audit project College leadership project	2-year FM fellowship programme Clinical coursework FM seminars e.g. teaching & audit Research activity – course & project
Exit Interview	Exit Interview
Completed MCFPS by assessment trainee logbook	Completed FCFPS advanced trainee logbook