# Exploring options for family medicine subspecialisation in South Africa: A proposed way forward following a national workshop

## TL;DR

A national workshop in South Africa explored potential subspecialization pathways in family medicine to improve healthcare delivery and physician satisfaction.

## Contribution

The paper proposes a structured approach to FM subspecialization through a Delphi study and stakeholder engagement.

## Key findings

- FM subspecialization could improve access to expertise and address complex healthcare needs in primary settings.
- A Delphi study is recommended to build consensus on subspecialization pathways.
- The workshop highlighted the need for collaboration among stakeholders to shape future training programs.

## Abstract

Family medicine (FM) is a clinical discipline that provides comprehensive, continuous, contextualised, first contact and person-centred health care. The practice of FM is not limited by the patient’s age, gender or diagnosis, thus encompassing the broad scope of general medical practice. Given the current epidemiological landscape in South Africa, however, there is an increasing demand in primary healthcare spaces (district hospitals, community health centres, and clinics) for in-depth knowledge and advanced skills to respond to the burgeoning complex needs of the population. The potential benefits of FM subspecialty training in relevant areas are therefore significant, including broadening access to expertise and skills for patients and improving career pathing and job satisfaction for Family Physicians (FPs).

Subspecialisation in FM can enhance the quality of clinical care by strengthening the district health system to deliver effectively on the nation’s health priorities. Recognising this potential, the College of FPs (South Africa) set up a task team to explore subspecialisation in FM through a workshop at the 25th Annual South African Academy of FPs in August 2023. This report details the background, proceedings and significant findings of the workshop. It suggests a way forward, including a Delphi study to explore subspecialisation possibilities further and build consensus within the discipline and with other key stakeholders.

This article reports on a national workshop convened by the College of FPs of South Africa to explore future subspecialisation pathways in FM. It represents an initial, exploratory phase of a broader research and policy development process rather than a hypothesis-driven empirical study. The purpose of sharing these findings is to document key deliberations, generate dialogue within the Colleges of Medicine, and inform the design of subsequent consensus-building steps, including a Delphi study.