1. 'The traveller within' - why international perspectives matter for every GP
Amanda Howe OBE MEd MD FRCGP
President, World Organization of Family Doctors
Professor of Primary Care, Norwich Medical School,
University of East Anglia, U.K.

2. International perspectives
Diversity of patients and their backgrounds
Diversity of colleagues
Our own diverse backgrounds
Global health challenges
Environmental impacts
Global warming
Global markets
Family medicine - worldwide

3. A few statistics
UK population – 65.2m, 14% non-white ethnic background (2011)
NHS staff profile – more mixed!
Profile of recent refugees and forced migrants in Europe – “The latest net migration statistics show that in the year ending September 2016, net migration to the UK was 273,000”. EU > nonEU.
Cases of communicable diseases in UK from overseas contacts – “A small proportion of the non-UK born bear the greatest burden of infectious disease reported in the UK. In 2010, 73% of TB cases reported in the UK, almost 60% of newly diagnosed cases of HIV, and 80% of hepatitis B infected UK blood donors were born abroad”
Food imports - more than 50% food eaten in UK
238 million passenger journeys by air in/out of UK in 2014!
Numbers of doctors leaving UK to work abroad – increased by 30% last year … ……

5. Where is this journey going? – the consultation (plus)
Rights of access in the health care system (and other)
Insights and skills of the team and individual workers
Translation
Willingness to engage in a professional relationship
Consultation skills plus … cultural questions and insights
Clinical risk factors – social determinants, ethnicity, global travel…
Antecedents - choice versus escape, experiences of change…
Psychosocial factors – resilience… and damage
…. The journey we make together

6. Structured training for international perspectives
… all of the above
Consultation skills & relevant assessment
Global health curriculum
Electives
Purposive exposure to patients from different backgrounds (*GP)
Community based placements with minority groups (*COPC)
Postgraduate placements with different communities (*urban / rural)
Out of programme options

7. Additional options for international experience
Travel – holidays, volunteering, study trips, exchanges …
Conferences – focused CPD, sharing expertise, new networks .. .
Work abroad – including twinning projects
Hosting elective students and study visitors
Mentorship (including local students)
Supporting others (donations, partners and colleagues going abroad…)
Added awareness and altruism (*RCGP / WONCA / ….)
Supportive advocacy
Other?

8. Strategic perspectives
The penalty of distance – supporting rural and remote
Carbon footprints – resource consciousness, remote meeting..
Migrant and conflict health – support for local family doctors
Emergency preparedness – including community resilience
Sustainable lifestyles and practices
Social accountability of medical schools
Empowerment - community engagement
Advocacy for equity – including for providers …

9. 'The traveller within‘…
General practice and the patient voice
The journey into the world of the other
Professional duties and ethics
Human rights
The diaspora
Conveying this voice to others
Making learning respectful and positive
‘Systematic inclusivity’

10. WONCA’s Mission fostering high standards of care in family medicine
- improve the quality of life of the peoples of the world by
fostering high standards of care in family medicine
promoting personal, comprehensive and continuing care
promoting equity in the context of health care and other societal needs and initiatives
encouraging and supporting the development of academic organizations of general practitioners/family physicians;
providing a forum for exchange of knowledge and information
representing family physicians to other world organizations and forums concerned with health and medical care
WONCA’s Mission

11. WONCA processes National member organisations
Working Parties and special interest groups
Links with World Health Organization
Registered as a non-governmental organization
Regional presidents link with relevant W.H.O. offices
Advocacy, standard setting and advice / consultancy
Collecting and disseminating data
Sharing information, experiences and expertise
Participating in teaching, training and research

12. 'The traveller within' - why international perspectives matter for every GP
Amanda Howe OBE MEd MD FRCGP
President, World Organization of Family Doctors
Professor of Primary Care, Norwich Medical School,
University of East Anglia, U.K.