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Overview on Family Medicine Training in Turkey

Most of the primary care work has to be done by general medical officers, includingadministrative and forensic work. But the Turkish Ministry of Health is targeting new training

policies for the general Medical officers. In 2004 transitional training will be available to

general Medical officers to be awarded with the certificate as family doctor (which is indistinction to the diploma of specailist of family medicine, which needs a three year

postgraduate vocational training).

Highlights of Medical Education in TurkeyPopulation of Turkey: 67,803,927; urban population: 64.9%; lifeexpectancy: 68.8 years; infant mortality rate: 29Undergraduate Medical Education Turkey had 50 Faculties of Medicine located in different areas in 2004.c

Newer schools are expected to be established in the near future and 46are accepting students for undergraduate training.d• Most teaching positions are full-time. Full professors and associateprofessors for more than 5 years are allowed to work part-time. Almostthree-quarterswork full-time.d• There is a 6-year curriculum. Students enter medical school afterpassing a national entrance examination after finishing high school ~11years!.• Curriculum: study lasts 6 years:e 2 years of basic sciences, 3 years of clinical sciences, 1 year devoted to family practice ~internship!.

• Entrance is limited to the best graduates ~first 9.19%! and a tuition feeis requested. Students attending a private university might have a lowerexamination score ~first 27.98%! but pay higher tuition fee.f • Number of students entering and attending last year of Faculty of Medicine: about 4,760 and 4,634, respectively.• Total number of registered medical students is 32,807.d• Students typically enter at age 17 and graduate at age 23 as medicaldoctors, who are allowed to work as such Graduate Medical Education• A low ratio of new graduates enter a specialty program. Almost 23% of 14,273 applicants were matched to a residency in autumn 2007.gExamination is given twice a year.e

• Graduate specialty training is free and residents receive a salary fromthe hospital.• All specialty programs have a national admission test.• The specialties can only be obtained as residency programs provided byuniversities and Ministry of Health training and research hospitalsh ~43specialties!. MSc and PhD degrees can be earned at the Institute of HealthSciences at universities.• The specialty of family medicine was created in 1984.h• Specialty programs have a heavy workload and the duration of residency is 3–6 years.

• There are 95,110 active physicians. The national average is 721 peoplefor one doctor. Number of medical doctors ~Faculty of Medicine



graduates!i the number of specialists exceeds them: ie, 51,530 vs. 43,660~54% vs. 46%!.c• The number of doctors is higher in Central and Western Turkey.c• Despite an increase in the doctor workforce at the primary health carelevel, only 43% of primary health care center posts are occupied by

medical practitioners.c• There are several public and private health care provider organizations.

Source: Güneş ED, Yaman H. Transition to Family Practice in Turkey. Journal of Continuing Education in theHealth Professions 2008; 28(2): 106-112.

Postgraduate education (Residency training) in Family Medicine

In the early 1980s the first department of family medicine was established. In 1984 familymedicine was recognised as a medical specialty and the first curriculum was announced. In1985 the first family medicine residents were accepted for training for family medicine

specialisation at state hospitals. At the beginning of the 1990s, education for family medicineflourished again. Nine teaching hospitals in three larger cities (Istanbul, Ankara, and Izmir)were in charge of training. In 1993, the Higher Council of Education accepted familymedicine as an academic discipline and it was resolved that family medicine departmentswould be founded in all universities and family medicine specialists would be allowed toachieve academic careers there.

To gain access to a family medicine residency, the applicant must have graduated from a six-year undergraduate Medical education programme. According to the current curriculum infamily medicine, the residency lasts three years. It consists of five main fields and the courseschedule is shown in Table 2. On completion of the three-year course and passing the

examination, the graduates are awarded a Specialist of Family Medicine title from theMinistry of Health. The current curriculum aims to produce graduates who are proficient inthe management of common health problems and can provide timely emergency surgical andobstetric interventions. Graduates from these family medicine residencies are nowadays,working for the Ministry of Healths National Health System (Health Centers, Centers for Mother and Child Care, Emergency Services etc.) Some of them choose an academic career inone of the over fourty active departments of family medicine at the universities or work in

private health institutions, such as health centres, hospitals, emergency centres.

Table 2. Course Schedule of my family medicine residency training in Turkey

Field Time (months)

Child Health and Disease 9İnternal Medicine 9Gynaecology and Obstetrics 8General surgery (with intense emergency participation) 6Psychiatry 4

Source: Yaman H. Training in Family Medicine: The Current State in Turkey. Education for Primary Care 2002 ;13(3):394 – 397.

A newer vocational/residency training scheme has been proposed by the Turkish Board of FamilyMedicine (Türkiye Aile Hekimliği Yeterlilik Kurulu) (Table 3). According to a regulation, whichis has been enforced in January 2010, a new Postgarduate Training Committee in Family



Medicine is preparing a new training scheme, which is in concordance with the proposed threeyear training time, proposed by the Ministry of Health new regulation.

Table 3: Proposed Training Program for Family Medicine

Field Time (months)Family Practice 12

Internal Medicine 6 (1 month in cardiology

outpatient)

Pediatrics 6

Gynecology and Obstetrics 5

General Surgery 2

Psychiatry 3

Elective-1 1

Elective-2 1

References

1. Güneş ED, Yaman H. Transition to Family Practice in Turkey. Journal of ContinuingEducation in the Health Professions 2008; 28(2): 106-112

2. Yaman H. Training in Family Medicine: The Current State in Turkey. Education for PrimaryCare 2002 ;13 (3):394 – 397

3. Turkish Board of Family Medicine. Working report and Core Curriculum of Family MedicineSpecialization Education. (in Turkish). June. 2007.

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