Way back in 1983, General Assembly of United Nations gave a call to celebrate a day in a year to highlight the role of family in strengthening the society. Thus, 15 May is observed every year as International Day of Families.
We, the teachers of Preventive and Social Medicine (now called ‘Community Medicine’ in India) laid stress on Family Health in our practical training much earlier. In many Medical Colleges in India, field practice demonstration area (FPDA) was developed to teach medical undergraduates on how to conduct family care? In the current curriculum also, such exercise begins for a student when s/he enters in Medical College and lasts till s/he reaches final year. The objective of such a curricular content is to let the future Doctor observe the dynamics of Health. Even if one visit is sincerely done to an allotted family per month over four years, it is enough to conceptualize demographic change, reproductive issues, disease at its
pre-pathogenesis stage, influence of social determinants on occurrence of disease and application of different level of preventing diseases.
When I started my career in the discipline of Preventive and Social Medicine at RHTC, Naila, fifty years back, we developed folders for each family with cards inside it for individuals i.e. infant, toddler, adolescent, pregnant woman, adults and old age (1975 was a pre-computer era in India!). We could do it only for the headquarter village and three subcenters of our Rural Health Training Centers albeit we had 54 villages in our field practice area.
A chain of All India Institute of Medical Sciences popularly known as AIIMS (tertiary level teaching and medical care institute) which have sprung up in last couple of decades highlighted the family in the center of Health by creating distinct departments under the banner of “Family Medicine”.
Contextually two major changes have occurred in last quarter century in India.
Firstly, globalization and the new economic wave within last three decades has impacted the fabric of family. Beside the increasing nuclearization of families, enhanced migration is adding to its disintegration. Worldwide recognition of LGBTQ and identification by certain governments of homosexual marriages has also diluted the institution of family!
- Superspecialists’ now ruling the domain have made students lose their interests in grasping the niceties of public health. A substantial number of students join the medical courses with a firm determination to rise and rise only as superspecialists. Privatization hijacking the medical education sector is catalyzing the process of outgrowth of postgraduate seats!
Its high time to contemplate on the course of family medicine! 🤫
