The Rights of Physicians and Future Physicians Who Are Lactating, Breastfeeding, or Chestfeeding: An American Medical Women's Association Position Article

Breastfeeding is a fundamental and biologically normal function with well-established benefits for both lactating parents and infants. Despite these benefits, physicians, particularly those in training, often face significant obstacles when attempting to meet their breastfeeding and pumping goals. In response to these challenges, the American Medical Women's Association (AMWA) and a diverse group of health care professionals have come together to advocate for comprehensive lactation support policies in medical learning environments and workplaces. This position article highlights the ethical necessity of comprehensive lactation support in medical educational and workplace settings, emphasizing the importance of not only providing physical accommodations but also fostering a cultural shift, educational initiatives, and policy reforms to empower lactating parents. It offers an examination of the difficulties encountered by lactating parents within medical environments and proposes guidelines for the formulation and enhancement of supportive policies. The position article envisions a future where medical professionals can thrive in both their careers and parenthood through collaborative efforts and a commitment to the key elements of Effective Lactation Support Programs in medical workplaces based on the following: (1) well-equipped lactation facilities, (2) customized work schedules, (3) mentorship and support networks, (4) lactation support in clinical settings, and (5) research and advocacy.

The curious case of extinction of family physicians from the Indian Health System - An open letter to the members of the National Medical Commission: Draft competency-based medical education curriculum regulations 2023 - Complete exclusion of family physicians/family medicine education from the MBBS course curriculum!

In 2012, India Today, a news agency, reported that 'Family Physicians are dying silent death' in India. The number of practicing family physicians is declining rapidly in the most populous country in the world with pressing public health needs. The previous generation of general practitioners/family physicians/family doctors has entered the age group of the seventies and eighties in both urban and rural areas. Unfortunately, no new family physician is opening the practice in these areas. The recent COVID pandemic has clearly demonstrated the ongoing need, demand, and popularity of family physicians among the general public as first-contact dependable and trustworthy doctors. While it may be an enigma why MBBS doctors are no longer opting to become family physicians, to the experts of this domain, it is not a surprise. To outside observers, this phenomenon may appear to be an outcome of changing times, the expansion of medical sciences, new emerging career choices for medical students, or competition within the healthcare market. However, a closer study reveals that the decline of family physician services in India is not a default situation but an outcome of decades of institutional neglect and perhaps a deliberate exclusion. According to the recently released National Medical Commission (NMC) draft curriculum 2023, the undergraduate medical education program is designed with the national goal of creating an "Indian Medical Graduate" possessing the requisite knowledge, skills, attitudes, values, and responsiveness so that she or he may function appropriately and effectively as a PHYSICIAN OF FIRST CONTACT of the community while being globally relevant. However, we are disappointed to note that the Family Medicine subject (discipline of family physicians) component has been entirely excluded from the draft of the MBBS curriculum. The words such as 'Family medicine', 'Family Physician', 'General practitioners', and 'Family Practice' have not even been mentioned in the entire 83 pages of the draft MBBS curriculum document. This is not an inadvertent occurrence or a default situation. The erstwhile MCI, the Medical Council of India, played a significant role in diminishing the role of family physicians in the Indian health system. It is to be seen if the NMC is able to reverse this trend by easing the regulatory restrictions on family physicians/family medicine training by including it in the MBBS course.

Medical education in Greece: Necessary reforms need to be re-considered

For the past years, and even more now with the major challenge of the COVID-19 pandemic, we are faced with the inadequacies that undermine the healthcare system in Greece. As healthcare system performance and medical education are directly and reciprocally linked, a substantial part of healthcare services' dysfunctions could be partially attributed to the training of the young doctors. Thus, in order to improve the performance of the healthcare system in the best interest of patients and communities, the education of healthcare personnel should be a priority. By reviewing the existing literature in combination with our experience we attempt to delineate the weak points of the undergraduate and postgraduate medical education in Greece. Additionally, based on medical curricula from other countries, we suggest reforms in order to achieve a uniform, clinically oriented, emphasis on training in public health issues in undergraduate medical education. Reforms are also suggested for postgraduate training with regard not only to specialization curricula, but also to the accredited institutions which provide specialty training. Finally, the necessity for Continuing Medical Education (CME) is underlined; medical education must have a continuum that begins with undergraduate training but does not end there; it is life-long learning.

Family medicine takes center stage in India: National Medical Commission Act 2019

The National Medical Commission-NMC-Act has been passed in the Indian parliament. NMC replaces the MCI-Medical Council of India act and promises to facilitate in delivering quality primary health care. Family medicine has been mentioned thrice in this act and both undergraduate and postgraduate boards of the NMC have been mandated to promote family medicine discipline.

Academic institutionalization of community health services: way ahead in medical education reforms

Policy on medical education has a major bearing on the outcome of health care delivery system. Countries plan and execute development of human resource in health, based on the realistic assessments of health system needs. A closer observation of medical education and its impact on the delivery system in India reveals disturbing trends. Primary care forms backbone of any system for health care delivery. One of the major challenges in India has been chronic deficiency of trained human resource eager to work in primary care setting. Attracting talent and employing skilled workforce seems a distant dream. Talking specifically of the medical education, there are large regional variations, urban - rural divide and issues with financing of the infrastructure. The existing design of medical education is not compatible with the health care delivery system of India. Impact is visible at both qualitative as well as quantitative levels. Medical education and the delivery system are working independent of each other, leading outcomes which are inequitable and unjust. Decades of negligence of medical education regulatory mechanism has allowed cropping of multiple monopolies governed by complex set of conflict of interest. Primary care physicians, supposed to be the community based team leaders stand disfranchised academically and professionally. To undo the distorted trajectory, a paradigm shift is required. In this paper, we propose expansion of ownership in medical education with academic institutionalization of community health services.