A cross-sectional survey on medical education needs of general practitioners and family medicine: Delhi, Himachal Pradesh and Tamil Nadu, India

Background: In India, most physicians pursue a specialist's degree resulting in a dearth of general practitioners (GPs). To provide primary care across populations and support universal healthcare coverage (UHC), there is a need to develop a core educational foundation for generalists and family medicine in undergraduate and post-graduate training. Methodology: A cross-sectional survey was conducted as a part of a medical educational needs assessment (ENA) with a focus on family medicine. Respondents included practicing physicians, residents and medical students in Himachal Pradesh, Delhi and Tamil Nadu. Descriptive and bi-variate data analysis (Pearson's Chi square, independent t-tests and analysis of variance [ANOVA]) was performed to summarise data and determine significant differences between demographic groups of respondents. Results: Three hundred and sixty-one surveys were completed. From which, 80.7% (284) of respondents felt that family medicine would be beneficial/very beneficial to the Indian health system. Respondents were split over whether family medicine programmes should be integrated within the existing bachelor of medicine and bachelor of surgery (MBBS) programmes (149/42.5%) or created as a separate post-graduate level specialty (131/37.3%). Overall, 84.2% (292) and 85.4% (294) agreed/strongly agreed that family medicine would benefit specialists and decrease the health disparities. Challenges include lack of information about family medicine and patients' use of specialists for primary healthcare needs. Conclusions: There was a positive response to expanding education for generalists and development of family medicine as a specialty in India. Mechanisms to support policies and programmes need to be further explored to ensure successful implementation across the country. Interest in skills-based courses can be an opportunity to provide GP and family medicine training while broader system-level changes are considered.