Development of the family practice specialty training program over a 20-year period [1983-2002] in Kuwait

The study examined the evolution of the Family Practice Post graduate Training Program [FPSTP] in Kuwait during the period 1983 to 2002 and identified the main changes and achievements as well as limitations in order to identify ways to improve the program for the future. In a review of the main records of the FPSTP and manpower statistics in Qadsia, Kuwait Institute for Medical Specialization [KIMS] and Ministry of Health [MOH] covering the last 20 years, three years were selected for observational comparisons. These were 1987, the year of graduation of the first batch of Family Medicine Graduates [FMG], 1995 when the program was reactivated after the Iraqi invasion, and 2002. Data reviewed included numbers of graduates, year of graduation, sex and nationality. The study showed that the number of FMG has increased tremendously over the 20 year period, from 13 in 1987 to 152 in 2002, with the percentages of Kuwaitis increasing from 7.7% to 77%. The percentage of females also changed from 38.5% to 62%. This increase was also accompanied by the loss of FMG to attachments or posts other than clinical general primary care work. Steps have been taken to make the program local, with decreasing Royal College of General Practitioners [RCGP] participation in the courses and examinations. Training centers, however, have not increased since 1995, despite the rise in the numbers of trainers and examiners. The study revealed that FPSTP has exp and ed, with an increase in the number of FMG, in spite of the substantial shift away from family practice as a career for some graduates. There have also been improvements and additions to the curriculum in conformity with international postgraduate [PG] programs

Development of family practice specialty training program over a 20-year period [1983-2002] in Kuwait

Objectives The study examined the evolution of the Family Practice Post graduate Training Program [FPSTP] in Kuwait during the period 1983 to 2002 and identified the main changes and achievements as well as limitations in order to identify ways to improve the program for the future. Methods In a review of the main records of the FPSTP and manpower statistics in Qadsia, Kuwait Institute for Medical Specialization [KIMS] and Ministry of Health [MOH] covering the last 20 years, three years were selected for observational comparisons. These were 1987, the year of graduation of the first batch of Family Medicine Graduates [FMG], 1995 when the program was reactivated after the Iraqi invasion, and 2002. Data reviewed included numbers of graduates, year of graduation, sex and nationality. Results The study showed that the number of FMG has increased tremendously over the 20 year period, from 13 in 1987 to 152 in 2002, with the percentages of Kuwaitis increasing from 7.7% to 77%. The percentage of females also changed from 38.5% to 62%. This increase was also accompanied by the loss of FMG to attachments or posts other than clinical general primary care work. Steps have been taken to make the program local, with decreasing Royal College of General Practitioners [RCGP] participation in the courses and examinations. Training centers, however, have not increased since 1995, despite the rise in the numbers of trainers and examiners. Conclusion The study revealed that FPSTP has expanded, with an increase in the number of FMG, in spite of the substantial shift away from family practice as a career for some graduates. There have also been improvements and additions to the curriculum in conformity with international postgraduate [PG] programs

Perceptions of patients, doctors and clerks of their roles in causing problems in medical records

To study the perceptions of clerks, doctors and patients regarding their roles in the causation of current problems in medical records in Primary Health Capital area. The problems were summarized as follows: the nonretrieval, improper storage and loss by clerks, the non recording by doctors, and the no-arranging and nonrequesting for file retrieval by patients. The aim was to study the possible strategies for each group of personnel dealing with the medical records in Kuwait. Method: 16 clinics in the capital health area were studied out of 20. Four clinics were excluded as the percentages of Kuwaiti citizens were less than 50% of the population. The study consisted of three parts. Self-filled questionnaires were administered at the three possible levels of interaction: the clerks, the doctors and the patients. The sample of doctors consisted of all those working in primary care clinics of the capital area [101 participated], the sample of clerks consisted of all clerks working in general practice section in the morning shift from the 16 clinics [47 participated], and then a convenience sample of patients in the waiting rooms of each clinic taken in the morning shift [521 patients participated]. Main outcome: The perceptions of clerks, doctors and patients of their roles in the current problems in medical records. [a] The majorities of patients [82.7%], clerks [93.5%] and doctors [92%] had good perception of the importance of having a medical record for every patient. [b] The overall rate of file retrieval by clerks was 69% [range 48-100%]. [c] The overall rate of doctor's recording in the file was 60.5% [range 42-100%]. 56% of clerks blamed the lack of files on the clinic itself and 53% blamed overcrowding as a cause of not retrieving the medical record. A significant correlation [two-sided] at 0.001 level was observed between the non-retrieval of files and the absence of files from the clinic, absence of a law for punishment, lazy clerks and the ways of keeping and storing medical records. 66% of doctors insisted on retrieving patient's file on each visit, 74% of doctors could work without a file. 87% of patients already had their medical records but only 46% of patients always asked for their files when they came to the clinic. 79% of patients said that they always brought their civil identity cards for clinic visits and 71% agreed to make a file when they didn't have one. Conclusions: Although clerks, doctors and patients had good perceptions of the importance of having a medical record, yet there was a real problem of the medical records retrieval and storing system. All the three parties played a role in the filing system defect and should cooperate to correct it

Epidemiology of self-dependence among Kuwaiti elderly population of Abdullah Al-Salem area

Amniotic fluid embolism, although fortunately rare, is one of the most catastrophic situations in obstetrics. It cannot be predicted nor prevented. The clinical events in this syndrome include respiratory failure, cardiopulmonary collapse, and disturbances of the clotting mechanism. Maintenance of oxygenation, circulatory support and correction of the coagulopathy can be life saving. Although maternal and fetal prognosis is grave, death need not be the inevitable outcome if diagnosis is made early and is followed by prompt and aggressive management. Future efforts must be directed toward s more clearly delineating the presentation, pathogenesis, diagnosis and outcome of amniotic fluid embolism