Dr. Kenneth Yakubu from Nigeria shares his experiences in the Toronto International Program to Strengthen Family Medicine and Primary Care
My attraction to family medicine started during my time as a medical intern in Nigeria. I came to appreciate the family doctor as a “Super-doc”. One able to solve multiple health problems, and one with vast knowledge. I would often day-dream about how valuable I could be to my future patients; so I enrolled in the residency training as soon as I got the chance to do so.
I had high expectations and a lot of pleasant learning experiences during my time as a trainee. I also had my challenges and foremost was reconciling the principles of family medicine with the reality of the practice I had come to know. I was told that my training made me different from the general practitioner who had no postgraduate family medicine residency training; it made me more patient-centred and evidence-based in my approach to undifferentiated care. I thought so too and can identify with these; but, I was not entirely convinced and I kept asking myself if I was really different. As a trainee, I also struggled with long patient queues and with a focus on quantity of health services, rather than adding value to the patient-encounter.
I wanted more, more than just ensuring I had seen all the patients on the waiting line, more than the “practice silos” of vertical care. I wanted mentorship. I wanted someone to show me that family medicine values were real, not a figment of my imagination. I sought my definitions of a career in primary care/family medicine and even though I eventually finished the residency training and got a job as a family medicine specialist/lecturer, I knew I was still searching for an alternate experience.
In 2015, I heard about the Toronto International Program to Strengthen Family Medicine (TIPs-FM) through AfriWon Renaissance (the WONCA Africa Young Doctor Movement). While AfriWon offered me a platform for interaction with a valuable virtual community of young family doctors in Africa, I thought TIPs-FM was just what I needed to expand my experience of what family practice ought to be and see how it was practiced in Canada and elsewhere.
When I eventually got to Toronto in 2016, my first impression was that the entire world lived in this city. I was much more surprised at the hospitality I received. As an African, I did not think I would experience so much warmth and respect in a western country.
As the programme started, I got to see a different value system, a different approach to public health. I thought it was people-centered and for the first time in my career, I could see a functional public health care system with family medicine at its core. I enjoyed the collegiality shared as I saw family health teams working together to serve their communities. This is one experience that I enjoyed most, seeing people who enjoyed working with each other, who knew about task sharing/shifting and were competency-driven.
I saw first-hand, a commitment to equity and social accountability. I thought the didactic sessions offered me the scholarly environment and focused on mentorship that I yearned for; but much more, I loved it that participants were respected and encouraged to have a self-directed approach to learning.
While I knew the health/education system in my country had more than its fair share of challenges, the TIPs faculty gave me so much hope. They were honest about their humble beginnings and though they had achieved a lot of success, they did not hide their concerns for the poor health indices among the First-Nations people in Canada and the high cost of pharmaceuticals throughout Canada. This honesty inspired me to go on creating my own experience back at home. That is what TIPs-FM offered, enabling me as an agent of change.
I got to attend TIPs-FM for the second time in 2017; this time as faculty. My observations from 2016 did not change. Rather, I became even more consumed with the desire for change. In my work setting, I have seen more of the top-bottom approach to change management but being a part of the TIPs-FM community has convinced me of the value of the “middle-out” and the “bottom-up” approach to change leadership.
Now back home, I have fallen more in love with the idea of primary care and generalism. I am convinced that family medicine has its own value system, theoretical domain and approach to practice. I love the team approach to care and actively seek interaction with other health professionals (medical and non-medical).
I am committed to mentorship and hope to promote value in the learning experience of my trainees. I am learning to be respectful and treat everyone with the same kindness I experienced during my two TIPs-FM events, looking for more collaboration among people with similar interests in my country. I am grateful for the opportunity to experience something different and hope this translates to real change in the way family medicine is practised in my country.