Ateneo de Zamboanga University School of Medicine, Zamboanga City, Philippines.
Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
Int J Public Health. 2023 Jan 26;68:1605359. doi: 10.3389/ijph.2023.1605359. eCollection 2023.
Primary care and public health comprise the bedrock of health systems, but their divergence has produced two groups of practitioners either focused on individual health or population health. We explored how primary care and public health were integrated in medical students' training in Zamboanga Peninsula, Philippines. Our qualitative study reviewed community health plans in two municipalities and thematically analyzed the perspectives of medical students, faculty, alumni, and community stakeholders through focus group discussions and in-depth interviews. Integration began by operationalizing a curriculum requiring medical students to serve rural communities during most of their training-a departure from the conventional, hospital-based medical education in the Philippines. The medical students' community immersion provided opportunities for integrating primary care and public health activities that influenced their personal orientations and the health situation in communities. Integration continued after training as alumni found themselves serving as primary care and public health practitioners in the region. Social accountability and community-engaged medical education provided the foundation for medical students to integrate primary care and public health in practice to respond to local needs.
初级保健和公共卫生是卫生系统的基石,但它们的分化导致了两类从业者,要么专注于个人健康,要么专注于人群健康。我们探讨了菲律宾棉兰老岛的医学生培训中如何整合初级保健和公共卫生。我们的定性研究回顾了两个直辖市的社区卫生计划,并通过焦点小组讨论和深入访谈,从主题上分析了医学生、教师、校友和社区利益相关者的观点。整合始于实施一项课程,要求医学生在培训期间的大部分时间为农村社区服务——这与菲律宾传统的以医院为基础的医学教育不同。医学生的社区融入为整合初级保健和公共卫生活动提供了机会,这些活动影响了他们的个人取向和社区的健康状况。培训结束后,作为校友,他们发现自己在该地区担任初级保健和公共卫生从业者,整合仍在继续。社会问责制和社区参与式医学教育为医学生在实践中整合初级保健和公共卫生以应对当地需求提供了基础。