1. Teaching Family Medicine at the Ends of the Earth
Just before you fall off.
Barry J. Bacon MD

2. Teaching Family Medicine
Abstract: Teaching Family Medicine in remote places is one of the most significant contributions that we can make to improving healthcare systems and healthcare quality. It is important to bring up to date knowledge and skills modeled by competent, caring family physicians as our gift to humanity. In addition to creating well trained physicians skilled in core areas of family medicine, we must be willing to customize training to fill local gaps in primary care.

3. Disclaimers
I have no associations with large corporations who are making tons of money by sending doctors to teach family medicine in remote areas of the world.

4. Teaching Family Medicine Objectives
To understand:
The unique challenges of teaching family medicine in remote or conflict areas of the world.
The unique modifications necessary for teaching family medicine in remote or conflict areas.
The unique rewards of teaching family medicine in remote or conflict areas.
How to carve out time and finances committed to teaching family medicine as one of the most significant contributions that we can make abroad

5. Consider these pictures
Please reflect on the following images. What do these pictures tell you about the nature of health in other locations?

22. Family Medicine
What is the most significant contribution that you see yourself making to healthcare abroad?
What specific plan to you have in place to make this a reality?
How will you make time for affecting change and improving health abroad?
How do you keep your practice intact at home while working abroad?
What other barriers do you see to teaching or providing healthcare abroad?
Is it realistic to keep a practice in the U.S. and teach or work abroad?
How do you balance the rest of life with work abroad

23. Teaching Family Medicine
Experience in one remote site abroad:

34. Unique Contributions of Family Medicine
Much of the world is rural (Africa, Asia)
Healthcare systems often depend on understaffed district hospitals to perform much of the care
Well trained family doctors in such locations are equipped to provide 95%+ of the care needed in these locations.
Family medicine in many countries is very broad and includes not only excellent clinical care with additional expertise in emergency and surgical care, but a knowledge of mental health, community health, public health, wellness, prevention

35. Brokenness
Violence, chaos, tribal conflicts, political conditions can act as barriers to implementing functional healthcare systems.
This often determines where a family medicine training program can realistically be set up.
Examples:
Infrastructure, primary care, tools, politics, governmental support, security all determine where and whether family medicine can be taught.
Some of the most troubled areas of the world are also the most in need of family medicine
The teaching of family medicine in challenging areas can be among the most rewarding and transformative experiences of a lifetime

36. Commitment
Care of the poor, transformation of healthcare systems, teaching abroad- it’s only time and money, right?
How do you make it happen?
What are the barriers to implementing teaching abroad in your life?
What reactions do expect from your patients? Employers? Colleagues? Bill collectors?

38. Conclusions
Write your own: