1. What’s Going on in Turkey? Current Developments in Family Practice Nezih Dagdeviren, Zekeriya Akturk, Suleyman Gorpelioglu

2. This is the story of a country trying to redefine its way to high quality health care, found and lost fifty years ago.This is the story of a country trying to redefine its way to high quality health care, found and lost fifty years ago.

3. Some Figures Population: 65 millionPopulation: 65 million Total number of physicians: 70 thousandTotal number of physicians: 70 thousand Primary care:Primary care: –Untrained practitioners: 15 thousand –Family physicians: 1700

4. Background 1947 First residency on General Practice1947 First residency on General Practice 1949 Cancellation of the program (residents distributed into different specialties)1949 Cancellation of the program (residents distributed into different specialties) 1985 Family practice residency positions1985 Family practice residency positions 1993 Academic departments at the universities1993 Academic departments at the universities 2003 Primary care health reform2003 Primary care health reform

5. Aim Presentation of the achievements and plans of the Turkish Association of Family Physicians (TAHUD) regarding the changes in primary care so farPresentation of the achievements and plans of the Turkish Association of Family Physicians (TAHUD) regarding the changes in primary care so far

6. Achievements Two workshopsTwo workshops –Update of the corporate policies on primary care –Transitional training of untrained practitioners Coordination and cooperation with the ministry of health in accordance with the TAHUD policy papers.Coordination and cooperation with the ministry of health in accordance with the TAHUD policy papers.

7. Achievements Family practice advisory board meetingsFamily practice advisory board meetings –Four meetings –Many subgroup meetings. A two-phase transitional education was decided for the untrained practitionersA two-phase transitional education was decided for the untrained practitioners

8. Achievements Curriculum and teaching materials for the transitional phase preparedCurriculum and teaching materials for the transitional phase prepared Core educators course was doneCore educators course was done Training the trainers courses were startedTraining the trainers courses were started Planning of the second phase education startedPlanning of the second phase education started

9. Achievements Family practice residency positions increased about ten fold: around 600 residency positions were released at April 2004Family practice residency positions increased about ten fold: around 600 residency positions were released at April 2004 Active support from WONCA-EUROPEActive support from WONCA-EUROPE

10. Plans First level of the vocational training will be completed by the end of 2004First level of the vocational training will be completed by the end of 2004 Family practice resident positions will be increasedFamily practice resident positions will be increased New residency education centers will be establishedNew residency education centers will be established

11. Plans Part time residency educationPart time residency education Second phase training will start by 2005Second phase training will start by 2005 Regulations obliging residency education in order to practice medicineRegulations obliging residency education in order to practice medicine

12. Plans The new health system will start in pilot citiesThe new health system will start in pilot cities A new contract for primary care will be implementedA new contract for primary care will be implemented

13. Conclusion Some lessons can be taken from the current changes in Turkey,Some lessons can be taken from the current changes in Turkey, Our expectation: Turkey will have a great acceleration in family practice in the near future, provided that, the developments have continuity in the academic, political as well as practice levels.Our expectation: Turkey will have a great acceleration in family practice in the near future, provided that, the developments have continuity in the academic, political as well as practice levels.