Primary health care in Portugal has provided since the 70's health centres where doctors work side by side and as a team with nurses and other health technicians. Doctors working in a health centre hold responsability for a file with about 1500 to 1800 people. They are organized by families, so they can be integrated in a bio-psycho-social vision. In a file, we have different health programs and provide services, such as adult, child and maternal health, family planning, diabetes, hypertension, minor surgery, nutrition, home visits and on-call service. The last years, there has been some changes underway in the system of primary care. We have two main organizing systems - 'USFs' (family health units) and 'ACES' (health centres groups, recently established).  

Role of the GP in the Primary Health System

Portuguese GPs/Family Doctors have got to be able to aquire competences, so they can:

1. Be the first contact with Health Care System, dealing with all kind of health problems, no mater age, gender or any other individual caracteristics

2. Provide care along the years, according pacient's needs

3. Cordinate health care, promoting a better use of health resourses and interacting with other specialities

4. To be able to make a 'think-decide' process determined by prevalence and incidence of the comunity pathologies

5. Develop an aproach centered in the individual that interacts with is family and his comunity as well as to be aware of all possible dimensions of the disease process - somatic, psycological, social and cultural

6. Establish an appropriate comunication, based on a pacient-doctor relationship - so many times terapeutical and time prolonged.

7. To simultaneously handle acute and chronic diseases in a pacient

8. Approach a pathology in the different phases of presentation

9. Promote health and well being

 

Postgraduate training scheme

During graduation, we have contact with Family Medicine at 1st, 5th and 6th years. Just after we graduate, we attend a multiple choise seriation exam that will give us the opportunity to choose our specialty training a year later. During this year, we make a foundation training by rotating though different specialties, including Family Medicine.

General Practicioner specialty training ('MGF' - General and Family Medicine) is at present 48 months long, in wich a senior specialist is going to take a continuous role in GP training of each resident, by being his/her tutor.

It consists on various rotacions, including some at health centre (obligatory) and other at the local hospital (obligatory - Pediatrics, Gynaecology/Obstetrics, Psychiatry and Emergency - and three optional).

Depending on the region of Portugal, there is a final exam at the end of each year or rotation.

The training program also predicts short rotations to aquire competence in specific procedures as well as curricular formation defined by each region.

At the end of GP training, there is a final exam that consists in three parts: curricular discussion, practical exam (patient's interview, organizacion and discussion of the information taken) and theoretical exam.

 

Why Portugal?

Nowadays, our country's health organization is going through a reform. We want to keep good practices and improve aspects we think that could be better. You are welcome to see and take an active part on it through Hippokrates Program!

 

National Exchange Coordinator for Portugal

Dr Catarina Matias (catarinaismatias@gmail.com)