School of Medicine

In correspondence of the 40^th Anniversary of Alma-Ata Declaration, after the WHO Global Conference in Primary Care held in October 2018 in Astana, representatives of governments declared:’ We are convinced that strengthening primary health care (PHC) is the most inclusive, effective and efficient approach to enhance people’s physical and mental health, as well as social well-being, and that PHC is a cornerstone of a sustainable health system for universal health coverage (UHC) and health-related Sustainable Development.

Program aims

The aims of the Nazarbayev University School of Medicine’s Family Medicine Residency are to:

1. Train residents to become excellent family physicians who care for the Kazakhstani community, especially the underserved populations;
2. Provide training in behavioural medicine and family dynamics to foster the physician’s awareness of the importance of the family unit in treating the patient;
3. Provide physicians training experiences in outpatient care effectively and appropriately according to Evidence-based Medicine and updated international standards;
4. Provide residents with basic skills necessary to implement preventive care and to consistently educate patients about health and wellness, supporting health advocacy and patient education in Kazakhstan;
5. Support appropriate training in mental health, women health, palliative medicine, communicable and communicable diseases fostering community health with broader competencies

Program Learning Outcomes

By the end of the Family medicine Residency Program, the residents should achieve the graduation target in the following areas:

Domains:	Description
Patient Care	Cares for acutely ill or injured patients in urgent and emergent situations and in all settings; Cares for patients with chronic conditions; Partners with the patient, family, and community to improve health through disease prevention and health promotion; Partners with the patient to address issues of ongoing signs, symptoms, or health concerns that remain over time without clear diagnosis despite evaluation and treatment, in a patient-centered, cost-effective manner; Performs specialty-appropriate procedures to meet the health care needs of individual patients, families, and communities, and is knowledgeable about procedures performed by other specialists to guide their patients’ care.
Medical Knowledge	Demonstrates medical knowledge of sufficient breadth and depth to practice family medicine; Applies critical thinking skills in patient care.
System-based Practice	Provides cost-conscious medical care; Emphasizes patient safety; Advocates for individual and community health ; Coordinates team-based care.
Practice-based Learning and Improvement	Locates, appraises, and assimilates evidence from scientific studies related to the patients’ health problems; Demonstrates self-directed learning; Improves systems in which the physician provides care.
Professionalism	Completes a process of professionalization; Demonstrates professional conduct and accountability; Demonstrates humanism and cultural proficiency; Maintains emotional, physical, and mental health; and pursues continual personal and professional growth.
Communication	Develops meaningful, therapeutic relationships with patients and families; Communicates effectively with patients, families, and the public; Develops relationships and effectively communicates with physicians, other health professionals, and health care teams; Utilizes technology to optimize communication.

 

Clinical Sites

All clinical activities of the Program will be carried out in the following UMC and affiliated hospitals:

• University Health Center, Nazarbayev University (UHC);
• National Research Center for Mother and Child Health (NRCMCH);
• National Children’s Rehabilitation Center (NCRC);
• Medical Centre for Mental Health Problems (MCMHP);
• City Hospital #2, Nur-Sultan;
• City Polyclinic N9;

Curriculum Description

Postgraduate Level (PL) –Year 1

The “Intern” year (1st year Residents) focuses on the clinical experience with patients affected with acute and chronic illnesses in several inpatient and outpatient departments and primary care centers, with appropriate supervision from UMC Attending Physicians and/or NUSOM Faculty.

The residents will pass through a series of 4-week rotations at inpatient and outpatient departments,

Postgraduate Level (PL) - Year 2

The second year will be devoted to acquire additional clinical skills, develop more independence, and gain more experience in leadership and supervision.

Supervisory roles will be provided on inpatient and outpatient services, in both general and subspecialty medical and surgical teams. New skill sets will be developed also in the Medical Centre for Mental Health Problems (MCMHP), located in Astana’s hospitals outside the UMC. The remaining part of the year will consist of further subspecialties rotations, including outpatient clinics and longitudinal clinic experiences, as a foundation for family medicine practice.

Moreover, the Residents will be encouraged to cultivate and broaden their potential research interests, through mentored and individual quality improvement and NUSOM research projects.

Postgraduate Level (PL) - Year 3

The third year will emphasize supervisory experiences in the inpatient general and subspecialty general medical and surgical teams, as well as in primary care centers. In this regard, part of the year will consist of elective rotations (which allow each Resident to shape own clinical training and to concentrate on areas of interest and career-specific experiences) or will be focused on longitudinal experiences that may continue in primary care settings.

In the former case, substantial research and elective time will be provided to the Residents, in order to explore their specific skills, to prepare for their future careers and eventually to enter in specific Academic Programs. In the latter case, also community service opportunities will be available and encouraged, like rotations in either a rural practice or an urban community.

Table - Family Medicine Residency Curriculum in blocks

PL-1		PL-2		PL-3
Course	Weeks	Course	Weeks	Course	Weeks
Family Medicine	4	Medical subspecialties/ Cardio, Respiratory, Neuro, Endocrinology, Dermatology (12 weeks)	4	Family Medicine	4
Family Medicine	4		4		4
Family Medicine	4		4		4
Inpatient Medicine	4	Obstetrics & Gynecology	4	Community medicine/Rural practice, home visits, occupational medicine (12 weeks)	4
Pediatrics Inpatient	4	Pediatrics Inpatient	4		4
Pediatrics Outpatient	4	Psychiatry	4		4
General Surgery	4	Community Medicine	4	Electives/ various specialties depending on the elective choice (12 weeks)	4
Obstetrics & Gynecology	4	Surgical subspecialties/ Orthopedics, ENT, Urology, Ophthalmology (12 weeks)	4		4
Intensive Care Unit	4		4		4
Vacation	4		4	Women and Children/ Children’s rehabilitation center, Obstetrics and Gynecology, Outpatient Pediatrics (12 weeks)	4
Emergency Medicine	4	Family Medicine	4		4
Community Medicine	4	Vacation	4		4
Inpatient Medicine	4	Family Medicine	4	Vacation	4
PGY-2 and PGY-3 rotations are combined as “upper level” (highlighted in grey) There are five upper levels, 12-week longitudinal rotations; each divided into half-day/weeks, meaning that the time spent doing these rotations is equally divided between Family Medicine Course and other specialties. Didactic teaching on Family Medicine is taking place throughout the whole year.