Create Learning Experiences in Different Units

Nelson Gaspar, Cecilia Shinn, Inês Maio, Marta Marquês, Matilde Padrão Dias

Keywords: family medicine training experiences access handbook


The Family Medicine Residency Coordination of the Lisbon Region (FMRCLR) organizes the training of almost 800 residents in 180 health care units. Residents are placed in health care units with proven capacity to provide adequate training conditions and achieve curricular objectives, but some training is hospital-based. We have been increasing yearly training spots for family doctors, but reduced hospital-based training capacity limits our overall capacity, and some hospital-based training is not always relevant for training family doctors.


In Portugal we have over 1.1 million people without an allocated family doctor. These patients can seek health care in units called UCSP which do not have adequate training conditions for the 4 year training of family doctors. In some UCSP, spontaneous training centers have arisen which allowed partial internships and created multiple opportunities to increase training quality as well as addressing the social inequity of patients not having access to primary health care. To elaborate guiding principles certifying that these centers comply with national quality guidelines in Family Medicine training programs, the FMRCLR organized consultative meetings with relevant stakeholders (president of the regional health administration, regional executive and clinical directors, residency directors, tutor and residents).


Guidelines were created and discussed in several settings and resulted in the publication of the Manual in May 2023. Residency directors have initiated formal creation of Training Centers and expanded existing centers Initial feedback from stakeholders involved has been positive.


Difficulties in planning residency training outside allocated health care units and achieving curricular objectives identified an opportunity to increase the quality of family medicine residency training. We created formal guidelines for the creation of Training Centres. Some Centers were implemented during the documentation process. We plan to evaluate the implementation of Training Centres in 3-month intervals during the first year.

Points for discussion:

Curriculum development and improvements

Creating new training opportunities

Guideline development for training centers


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