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    Training for COPC in the Netherlands and around the world.

    Greep JM

    In: Connor E, Mullan F, ed. Community oriented primary care: new directions for health services delivery. Washington, D.C., National Academy Press, 1983. 250-7.

    Education of doctors for community oriented primary care (COPC) in the Netherlands is described. A basic doctor has 6 years of training and is prepared for further specialty training in general practice (currently only 1 year), clinical specialty (4-6 years), and social medicine (4 years). After high school, a weighted lottery is performed. Out of 6000 interested graduates, 1950 are placed in medical faculties. Only straight A students have a double chance. In 1970, the Dutch government started a new medical faculty that was community oriented and emphasized primary health care. For this, the educational system of this facility had to be different. A problem-oriented system was adopted. In 1974, an integrated innovative curriculum was started. The basic philosophy emphasizes a preference for orienting medical education to primary care. By the 5th and 6th year, students must acquire: 1) practical experience in solving primary care problems; and 2) the ability to recognize unusual problems and develop appropriate referral. During the 1st 4 years the problem-solving process is encountered; the problems must be increasingly complex; and the teaching program progresses from the general to the specific. The teaching program should begin with health problems and proceed to consider normal and abnormal functioning. The original arrangement for hospital internships is not yet feasible. It seems that hospital organization is too rigid to combine with a less department-linked program. Evaluation is mandatory. A theoretical final M.D. exam was designed. The World Health Organization (WHO) held a meeting at which key figures from 18 selected schools were brought together. From this meeting, it was agreed that a network would be developed linking schools. The network members met again and formulated objectives.
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