by Dr. Christie Newton

I was eager to read the most recent CFP Triple C instalment, The Last C – Centred in Family Medicine, because ever since the introduction of Triple C I have questioned why ‘centred in family medicine’ needed to be one of the Cs. I mean isn’t it obvious, we are talking about the postgraduate curriculum for Family Practice, shouldn’t it be a given that it is centred in family medicine?

As I read the article I realised that I had fallen victim to one of the oldest challenges faced by teachers. I had become an ‘unconsciously competent’ family physician, at that place in the Learning Cycle where we think things are obvious – “it’s just the way it’s done” – but our learners aren’t there yet. Fortunately for me, not only did the article induce this revelation, but it also nicely articulated some of the ways we as teachers can role model explicitly how we are ‘centred in family medicine’.

The key features necessary to support a curriculum “centred in family medicine” include:

1. Teachers who are family physicians: these teachers may consult specialists for assistance with teaching and care, but the primary preceptors are family physicians.

2. The teaching context is the comprehensive family practice setting: considering the various models of family practice currently in BC this setting could be a an individual family physician who provides full scope family practice or a group of special interest family physicians who together provide full scope family practice or any variations thereof.

3. The processes of teaching, learning and most importantly care are all oriented to family practice: the medical content our learners need to know may be similar to that of our specialist colleagues, but the teaching and application thereof is unique to family practice.

I recently had a conversation with one of my residents that started out, “Why don’t preceptors follow clinical guidelines?”

In the typical teaching fashion, I responded with a question.

“Why do you think the preceptors don’t use clinical guidelines?”

Pleasantly, the resident did not immediately reply with because they don’t know them, but paused and said,

“Well I think it depends on the patient”.

This provided me the opportunity to explicitly focus on the complexity of the family practice context, the unique nature of the family physician-patient relationship (that is both comprehensive and continuous) and how these influence care processes like the application of guidelines.

So, to achieve the third C — centred in Family Medicine — we, the family practice preceptors, must first recognise that we see the world through this unique lens, and then we must help our students to don these ‘rose coloured glasses’ of Family Practice.

Christie Newton MD CCFP FCFP is a practicing family physician and an Assistant Professor at UBC. She is the Director of Continuing Professional Development and Community Partnerships in the UBC Department of Family Practice as well as Director of Interprofessional Professional Development, UBC College of Health Disciplines.

Illustration by Lindsay Gowland.