While we were all coming to terms with COVID 19, TC Harold made it worse, a double blow that will undoubtedly add more misery to our economy, health ….

Although most narrowly escaped the full impact of the cyclone, it nevertheless caused widespread flooding, damage to the infrastructure, farms and crop devastation, roofs blown off, loss of electricity etc etc

Worst damage was reported from the islands that came in the path of the cyclone namely Kadavu, Vatulele and the Lau group. Images of the total devastation in these areas reminds of the damage caused by Cyclone Winston

Thousands took refuge in evacuation centres saving themselves from potential dangers and harm. Thankfully all were reported to be safely taken care of and many have since returned to their homes as the situation and weather improved.

Power was off in most urban and rural areas but most urban centres received the power by midday allowing many GP’s to reopen their practices     

The corona pandemic is far from over and we should continue to play our role

Much has been said about PPE and other aspects and I’m sure, once the questionnaires are analysed we’ll get a clearer picture   

On a brighter note though, the MOHMS as well as all other arms of the government including our active honorable PM, have done well. With swift and decisive operations, the battle against the invisible enemy is paying dividends    

Research in GP

This brings me to highlight the subject of Research in GP. It appears some of our younger colleagues are not familiar with research

Those who have done prescribed courses in GP or FM are familiar with this subject which is strongly promoted and forms part of the curriculum.  Most of us were never taught this subject in medical school ie research methodologies in general practice or medicine

It’s important to engage practicing GP’s in generating relevant research questions, facilitating research in their practices and implementing findings. This results in GP’s who are more analytical about monitoring their own practices, with the potential to improve their practice (ultimately benefits the patients)       

Mentors and Mentees   

Some of the mentees are probably not getting the proper guidance from their mentors and this needs strengthening.   

What are the prescribed or recommended textbooks an aspiring GP must possess and read ? The Education Committee of the College (needs to be revived perhaps) has to work closely with the Censor in Chief. Will work more on this aspect soon; guide, streamline as well as standardize the criteria on the pathway for membership and fellowship

Scope of General Practice or Family Medicine (FM)  

The depth and breadth or scope of a GP is unlimited. GP is synonymous with FM, a term more commonly used in USA and Canada

The discipline of GP/FM as a speciality is relatively new that evolved in the 1950’s starting in UK, later Canada and USA. It was more commonly referred to as Family Physicians in Canada and USA, referred to as College of Physicians

1954  saw the birth of Canadian College now ka College of Family Physicians of Canada

In 1986 they adopted 4 principles of FM namely:

  1. The Family Physician is a skilled clinician
  2. Family Medicine is a community based discipline
  3. Family Physician is a resource to a Defined Practice Population  
  4. Patient Physician relationship is central to the role of the FP

RCGP

The British College of GP’s was formed in 1952 with the sole purpose of improving education and standards in GP

It was not until 1972 when the British College was granted the Royal Charter and thus adopted prefix “Royal” instead of British College of GP’s which still exists today (RCGP)

Legalisation of RCGP

By an act of parliament in 1976, the College was granted recognition and legislation approved making vocational training a requirement for any doctor seeking to become a GP

Royal Australian College of General Practitioners  (RACGP) The Australian College of GP’s under the umbrella of the British College was started in 1958 and they appointed 3 major committees namely

  • Undergraduate Education
  • Postgraduate Education
  • Research in GP

and later in 1959 they added 2 more committees

  • Preventive Medicine
  • Publications

The first national convention was organized in 1960 in Melbourne. Prior to that most of the Australian States had local chapters  

In 1969 Royal Charter granted to Australian College thus the prefix “Royal”

Australian Family Physician Journal is launched in 1971  

RACGP received the first funding of 1.1 million dollars from the government to start Family Medicine Program in Universities. Chairs of GP in various leading medical schools and universities started soon after

RNZCGP was started in 1974. Prior to that NZ had a very close relationship with the Australian College for many years and jointly held conferences, meetings etc     

FCGP  

Fiji College was inaugurated on 20/02/1993 at the Sheraton Fiji Resort in the presence of the late President of Fiji Rau Sir Kamisese Mara, who was our Chief Guest of Honor and first patron of the College   

Just over 60 members became the foundation members of the College

Dr Ponsamy Gounder was the first President and myself as the Secretary. The inaugural AGM was held at the same venue earlier in the day    

Our constitution was largely based or borrowed from NZ, Australian and UK Colleges (we had their blessings) and we representing RACGP was Prof Neil Carson of Monash University. Prof John Murtagh as well as Leon Pitterman were also in attendance  

Rabuka’s govt at the time of our inauguration did not recognize us but he (Sitiveni Rabuka) did finally accept our offer of negotiations and attended one of our annual conferences as the Chief Guest held at the Warwick Fiji Resort

WONCA

The world organization of family doctors is a global professional organization representing family physicians and general practitioners from all regions of the world that was founded in 1972. Fiji became a member in 1994

Medical and Dental Practice Decree 2010

After 17 yrs of struggle, attempts, persuasion and commitment FCGP was granted formal recognition by Bainimarama’s interim government. Dr Neil Sharma, former President of the College ,was the Minister for Health

The dreams of the founding fathers of the College was finally fulfilled. We have, however, more to achieve and endeavor.

The recent experience with COVID 19 and PPE’s has exposed inherent weaknesses. We are yet to be accepted as one of the primary health care group or providers. We had undertaken proactive approach to this pandemic as well as measles earlier on but our efforts were largely ignored

Our very active member in Suva Dr Keshwan Nadan continued to represent the College at ministerial level, attending meetings and workshops. His reports and that of MOHMS was always circulated to all the members and we wish to thank Keshwan for his untiring efforts on our behalf

We are well aware that this pandemic is a unique public health issue and despite the lukewarm reception, we’ll continue to make our position clear and continue to work with all the stakeholders

The questionnaire survey results will hopefully expose the strengths and weaknesses, outcome etc and it will be interesting to see the results of this research. Dr Neil Sharma is undertaking to complete the research analysis who will let us know soon

You are also probably aware of a special task force set up by our Secretary Dr Kanna Gounder, now in Auckland on sabbatical, on COVID 19. The task force group presently active on viber will discuss pertinent issues related to the pandemic, role of College members, PPE’s, diagnostic tests etc. We were hoping to have a “Zoom” meeting soon

Rather unfortunately and sadly, Kanna’s mother died yesterday (Sunday 12th April) after a long illness in Lautoka. Our heartfelt condolences to Kanna and his family members

Summary and conclusion

We are all in the most difficult and testing times of our lives in the midst of the pandemic. It’s an unprecedented situation and the greatest crisis ever

We are likely to see unprecedented and undifferentiated illnesses in the near future, topped by mental health problems

We just have to bid our time and let’s all hope and pray this will come to an end sooner or later. The doctors, nurses and all other paramedical staff in the hospitals are to be highly praised for their exemplary work, under tiring conditions and limited resources in looking after the COVID 19 patients and others

I have presented a brief historical background on the development of GP/FM and the various colleges as well as our very own College. I intend to write a more detailed history on the birth of our College soon, from the very early days in 1984. Some will recall Western Private Medical Practitioners Association ……

FMDC has requested us to provide “Scope of GP” which will be subject for another document, not only for the council but for all the members as well

In the meantime, adjust yourselves (and  your practices) with a prime focus to care for your patients

Some of our colleagues have been taken to task by FMDC and there are several pending cases being investigated. They are usually cases that arises from a lapse of “Duty of Care” and not upholding the highest ethical and professional standards in GP

FROM FCGP PRESIDENT 

Dr Ram Raju 

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