Perceptions of resources available for postgraduate family medicine training at a South African university

Abstract

Background: Clinical training is one of the roles of family physicians (FPs) in decentralised postgraduate training. Effective training requires skilled trainers and sufficient resources. Little is known about the resources available for decentralised clinical training in district health systems in low- to middle-income countries, especially in sub-Saharan Africa.

Aim: To explore FPs’ and registrars’ perceptions of the available resources in a decentralised postgraduate family medicine (FM) training programme.

Setting: Five decentralised training sites affiliated with the University of the Witwatersrand across two provinces in South Africa.

Methods: This qualitative study forms part of a broader project evaluating a FM registrar training programme using the logic model. Semistructured interviews were conducted with a purposive sample of 11 FPs and 11 registrars. The interviews were transcribed verbatim and analysed thematically.

Results: Three themes were identified: ‘Impact of resource constraints’, ‘Family physicians’ skills and knowledge could be further improved’ and ‘Family physicians need additional support to optimise their training role’. The additional resources needed include more FPs, equipment, infrastructure and funding. Knowledge and skills of FPs were reported variable and needed further improvement. Additional support was required from peers, the district management and the university.

Conclusion: Well-resourced decentralised training environments with sufficient skilled trainers and adequate resources are needed to positively influence FP training and supervision, especially in middle-income countries like South Africa.

Contribution: Clinical trainers need adequate resources and support from peers, district management and the university for effective decentralised clinical training.