Department of Family Medicine

The practice of Family Medicine is viewed as central to an effective and efficient delivery of health care in developed countries, and it is slowly gaining strength in developing countries as well.

Family Medicine at Aga Khan University (AKU) was a part of the Community Health Sciences (CHS) Department since its inception. However, in response to the continuing expansion of on and off campus services; increasing responsibility of undergraduate, postgraduate and continuing medical education; and an ever rising number of faculty and other family practitioners employed by the division within CHS,  Family Medicine, a division, was raised to the status of an independent department. The proposal for the Department of Family Medicine was approved and became effective on January 1, 2003, with Dr Riaz Qureishi as the Chair.

In Pakistan, AKU is the pioneer institution in establishing the first three-year structured training programme in Family Medicine with the result that well trained Family Medicine consultants are now available for providing caring, cost-effective and high quality curative, preventive and rehabilitative services along with promotion of health in a primary care setting.

The core values of the Family Medicine Department of AKU are:

• Practice Family Medicine with focus on the needs of our patients;
• Educate AKU medical students and trainee Family Physicians with focus on developing caring and competent physicians, providing effective and efficient care;
• Conduct community and hospital-based research programmes to improve patient care and to benefit society;
• Continuously improve all processes needed for patient care, education and research;
• Foster compassionate teamwork with personal responsibility, honesty, integrity and trust.

AKU has the distinction of being the first medical college/university in Pakistan to have included Family Medicine as a specialty at undergraduate and postgraduate level. Establishment of an independent department has further enhanced the standing of the University and it will help the policy makers in Pakistan realise the pivotal role of Family Medicine in the health care delivery system. An independent Family Medicine Department will be more attractive to students and faculty.

Undergraduate study
There would be expansion of undergraduate educational responsibilities, including active involvement in Problem and Evidence Based Learning with responsibility of teaching in all the three clinical years: 10 weeks in third year, four weeks in fourth year and 12 weeks in final year. 

Residency Education
A well-established residency programme is in place. In November 1993, a three-year residency program was started with the induction of four residents per year. This programme has been extended to a four-year residency since November 2001 with the induction of five residents.

Scholarship and Research
Following are some examples of the scholarly activities of the department:

• Development and implementation of the first undergraduate Family Medicine curriculum in Pakistan;
• Development and implementation of the first Family Medicine residency programme in Pakistan;
• Obtaining approval of Family Medicine as a specialty by the College of Physicians and Surgeons of Pakistan (CPSP) and assisting CPSP in conducting Membership and Fellowship examinations in Family Medicine;
• Establishment of academic/service linkages nationally and internationally.
• Accreditation of AKU Family Medicine residency programme by the Royal College of General Practitioners, UK, in 1997 for the MRCGP examination.

Following are some examples of research undertaken:

• Dissertations for FCPS by the residents;
• Thesis for master's programmes by two faculty members;
• Journal publications by faculty;
• Two University Grants on Mental Health Research;
• One faculty member enrolled in a PhD programme at AKU;
• Inter-departmental research projects are valued immensely by the Family Medicine Department.

Clinical Care
Promotion of an integrated health care system with linkages and collaborations across all clinical disciplines is the focus of the department. Family Medicine is currently providing clinical care across all socio-economic groups from Edhi Centre to the Executive Clinic of Aga Khan University Hospital (AKUH). A recent survey conducted by AKU marketing department indicates highest patient satisfaction level at the Community Health Centre (being managed by the Family Medicine Division), amongst all clinical departments of AKUH. This achievement has been recorded in many previous surveys as well.

The Department is providing the following family medicine services:

• AKU Campus
  
• Consulting Clinics including procedure clinics;
• Community Health Centre Clinics;
• Executive Clinics;
• Student Health;
• Employee Health and pre-employment check-ups (AKUH and other Organisations including USA consulate);
• Disability evaluation for insurance companies and others;
• Family Medicine Cardiology follow-up clinics.
  
• Off Campus
  
• Teaching and service field clinics (three sites) in lower socio-economic areas;
• Integrated units (Family Medicine, Pharmacy and Phlebotomy Services) – one site. At least four more sites to start in Karachi in 2003;
• Family Health – AKU/AKHSP (five sites);
• Corporate Sector Clinics (four sites).

The Department of Family Medicine enhances the national, regional and international status and reputation of AKU in the field of Family Medicine and will be a replicable model for other national and regional medical institutions. The expanding off campus Family Medicine sites will provide key avenues for service, teaching and research across different socio-economic sectors of the population. Through expansion in corporate and community-based services, significant financial contributions will be made to the Institution through increased specialist referrals, laboratory tests, radiology, pharmacy usage and direct fee for service payments.

The anticipated development of a research unit within the Department of Family Medicine will enhance the output and quality of clinical research by its faculty and residents with promotion of inter-departmental projects.

The new department with its expanding activities will be better placed to create and promote professional opportunities for AKU medical college and family medicine residency graduates.

Family Medicine Services, Aga Khan University Hospital, Karachi