Abstract

PIP: Among the recommendations made to the IPPF Central Medical Committee by its Medical Education Subcommittee following a meeting held in London in November 1970 were: 1) family planning is an intrinsic part of medical care and therefore should be part of medical training; 2) as a subject, family planning involves many disciplines and should be a continuous process in medical training; 3) family planning should be taught to all those involved in the health care of the community, including doctors, dispensers, auxiliary nurses, 'traditional midwives,' and community leaders; and 4) the current pattern of medical training along specialized lines can, on occasion, jeopardize the doctor's ability to take a balanced overview of the community problem. As family planning and human reproduction are multidisciplinary, the teaching program should be the responsibility of several departments in any medical school and a specially appointed committee might be created to insure cooperative instruction. Subject matter could be classified under 3 major headings (biological, social, and clinical) and could be introduced at each level of medical training. A suggested curriculum schedule is charted in the report. It is suggested that during obstetric and gynecological rotating internships, the student be assigned to a family planning clinic and receive training in methods of contraception, including IUD insertion and vasectomy. The latter may also be taught during surgical internships. In countries with chiefly agricultural economies, interns should visit rural areas at this stage to apply their knowledge to community medicine. Postgraduate training would inculcate inservice training and specialization. Training for doctors already in practice should be identical to that recommended for undergraduate students although the courses should be brief and condensed. After training, these physicians should be able to offer comprehensive advice on all methods of contraception as well as the treatment of infertility. The subcommittee unanimously endorsed the training of all nurses and midwives in human reproduction and family planning including the various topics recommended for undergraduate medical students. Some members of the committee favored the idea of nurses and midwives taking over the distribution of oral contraceptives and the insertion of IUDs but ultimately the particular duties and responsibilities of such personnel will be determined first, by the needs of the specific country, and second, by the attitude of the resident medical profession. 'Traditional midwives' or health attendants take charge in nearly 70% of the births in developing countries and consequently, the acceptance or rejection of family planning services in rural communities in these countries is largely dependent upon the advice of these people. The importance of giving them some family planning training and the opportunity which such orientation courses afford in further improving maternal and child health services in the community need to be stressed. Lay personnel, such as social workers and volunteers, require family planning education if they are to be viable members of the health team, but contraceptive training should prove unnecessary.