The College of Family Physicians of Canada

The Narrative Working Group was tasked with the collection and synthesis of qualitative accounts of successes in the implementation of family medicine in the context of numerous international partners such as Brazil, Chile, China, Ethiopia, Haiti, Indonesia, Kenya, Laos, Mali, Nepal, Palestine, Tanzania,Tunisia and Uganda.
We have been working together to better understand the rich diversity of initiatives around the world that are building innovative family medicine programs. To do this we asked southern partners of Canadian universities to provide a brief perspective on what is happening in their country. The objective was an effective understanding by all of us as to how we can work together to have a major impact on the health of all of our citizens.

                                                                                     View of Laos, one of our participating countries.


The challenges to the development of family practice are very real and run the gamut from simple awareness of the concept, through developing appropriate curricula and attracting excited students, to creating a system that can employ trained graduates instead of seeing them emigrate to other countries where they can practise their hard-won skills. However, the narrative project seeks to explore the many successful ways in which the individual schools, the partnerships, and the networks have worked to thrive in spite of (perhaps because of?) the remarkably difficult work involved. The Besrour initiative seeks to understand and build upon the rich array of experiences such that Canadian and overseas partners become “more than the sum of their parts.” The narrative project is a living website that will grow as schools increasingly share their successes and we continue to refine the themes that arise from those accomplishments. The current thematic analysis is a platform on which to build the collective capacity to use ideas and passion, rather than slogging strife, to build the global future of family medicine.
It is likely that the process of reviewing both the narratives and the themes will provide clarity and accuracy in the reports but, more importantly, will provide an exercise in “reflective practice” as each of the existing and new partnerships learn from one another’s stories and experiences.
In the initial phase of identifying the themes, three faculty members reviewed the descriptions sent to the template designed to organize a narrative picture of developments in each country. The separate lists were then explored and a consensus reached on the themes, their definitions, and the schools exemplifying the themes. This is intended to form the foundation upon which further narratives and new themes can be built so that the Besrour initiative can become more than the sum of the individual relationships—it can become a “learning organization” to collectively advance family medicine throughout the world and across Canada.

In the spirit of networking and collaboration through this process, we were delighted to discover parallel initiatives, such as the work of Dr John Parks, who has done extensive work in creating a database detailing the landscape of family medicine around the world. Our synergistic efforts provide a micro and macro lens to the scope and breadth of family medicine while being enriched with local voice and perspective. If you would like to know more about the John Parks project, please contact him at [email protected]. For any questions or feedback on the Besrour narratives project, please contact us.
This document presents an introduction to our work and we endeavour to enrich it with your contributions and suggestions. Through this work, we recognize that there are incredible and inspired champions of family medicine all over the world. Please contact us to add your voice and share the narrative of how you are promoting the development and implementation of family medicine in your country. We invite and encourage contributions to this collection of narratives.
We wish to recognize the contributions of Innocent Besigye, Katrina Butterworth,Christine Gibson, Videsh Kapoor, Andy Shillingford, and Robert Woollard.