Family Medicine in Syria: Entry Points and Priorities for Support and Way Forward

In Syria, the Family Medicine program started in 1992. The specialty of family medicine was established in the mid-1990s in partnership with the Ministry of Health and the World Health Organization (WHO). Residents receive integrated training in six medical areas: pediatrics, obstetrics and gynecology, internal medicine, psychiatry and neurology, surgery, and community medicine. The FM doctor trained for three years, spending 29 months in hospitals and 7 months in Primary Health Care Centers. Starting in 1996, FM doctors must complete a four-year training in Ministry of Health hospitals and centers to obtain a specialization certificate in Family Medicine. The program admitted 40-50 doctors annually and produced 400 family doctors by 2008, with 60% practicing abroad. The Master’s Degree in Family Medicine was added to the University of Damascus in 1998, offering a 3-year training program in educational university hospitals. In 2001, the Higher Education Council mandated that master’s programs at Syrian universities last 4 years. However, since the opening of the Master’s Degree in Family Medicine until 2023, there have been only around 50 graduates. The Scientific Council of Family Medicine was formed in 2004, and both certificates are now awarded by the Syrian Board. A four-year Ph.D. The Family Medicine program opened in 2017 with only two Ph.D. students(1). Family medicine clinics have been established in medical centers across the country. This project has been successfully implemented in areas such as Damascus, Hama, Latakia, Daraa and As-Suwayda. The Family Medicine program at Damascus University consists of nine accredited health training centers. These centers train students and residents in specialized Family Medicine. A committee is responsible for overseeing curriculum standardization, training, and center equipment. Two family medicine training centers were accredited in Aleppo in 2007 for Family Physicians at the eastern and northern regions. These centers offer comprehensive care, diagnose and manage around 80% of common diseases, and provide individual and family-centered healthcare as the first point of contact with the family doctor. Families are registered in the file system and individuals have medical records. Referrals for specialists are made by the family doctor and recorded. Most graduates worked in less than 5% of primary care centers, but the number of residents decreased in the eastern governorates. In 2007, there were 178 residents. By 2009, this number decreased to 99 residents. Due to the crisis in Syria and limited access to certain areas, the family medicine project has been negatively affected. Graduates are currently working in medical centers or have traveled to Gulf countries(1).