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(32) 16 33 74 64
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(32) 16 33 74 80
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In Turkey, most health services are provided by three largely autonomous systems
– the Ministry of Health, the social insurance system and the 47 medical schools.
Sixty five percent of the population is covered by health insurance. Forty-three
percent of health service resources are from the general budget of the Turkish
government, 25% are collected from insurance fees and the remaining 32% are
obtained from paying patients. Funding of healthcare is largely governmental.
The total government health expenditure is 2.6% of the gross national product
– US$108 per capita.
Since the socialization of health services in 1961, the government has been
committed to a programme of nationalisation of public health services, with
the main objectives of providing primary care in rural areas and providing both
preventive and curative services.
Medical care is provided by the Ministry of Health through teaching hospitals,
state hospitals, health centres, health posts, mother and child health and family
planning centres, as well as through other hospitals, such as private, military
and university hospitals, and other units, such as tuberculosis dispensaries,
malaria and cancer control centres and private polyclinics. Workers and their
family's healthcare needs are covered by social insurance hospitals and dispensaries.
The basic healthcare units are health posts at village level, manned by midwives and serving a population of 2500 to 3000. There are about 11 905 health posts
in Turkey.
Health centres serve a population of 5000 to 10 000 and are staffed by a medical team, which consists of a physician (most of whom have no residency training
in family medicine and often little clinical training), nurses, midwives, health technicians and medical secretaries. There are 5366 health centres in Turkey.
Inpatient health services are provided in 1180 hospitals, of which 49.8% are
the property of the Turkish Ministry of Health. In addition to the governmental
hospitals, there are approximately 244 private, foundation, municipality, minority,
and foreign hospitals. According to Ministry of Health records, 77 344 doctors
are employed in governmental and private institutions. Fifty-one percent are
employed by the Turkish Ministry of Health, 18% by medical schools, 10% in social insurance institutions and 15% in private institutions. Of these physicians
34 189 are specialists and 43 155 general medical officers (graduates with no
residency training) and residents in postgraduate training. According to the
Association of Turkish Family Physicians, there are about 1200 specialists and
400 residents in family medicine in Turkey.
Most of the primary care work has to be done by general medical officers, including
administrative and forensic work. But the Turkish Ministry of Health is targeting
new training policies for the general Medical officers. In 2004 transitional
training will be available to general Medical officers to be awarded with the
certificate as family doctor (which is in distinction to the diploma of specailist
of family medicine, which needs a three year postgraduate vocational training).
Postgraduate education (Residency training) in Family Medicine
In the early 1980s the first department of family medicine was established.
In 1984 family medicine was recognised as a medical specialty and the first
curriculum was announced. In 1985 the first family medicine residents were accepted
for training for family medicine specialisation at state hospitals. At the beginning
of the 1990s, education for family medicine flourished again. Nine teaching
hospitals in four larger cities (Istanbul, Ankara, Izmir and Adana) were in
charge of training. In 1993, the Higher Council of Education accepted family
medicine as an academic discipline and it was resolved that family medicine
departments would be founded in all universities and family medicine specialists
would be allowed to achieve academic careers there.
To gain access to a family medicine residency, the applicant must have graduated
from a six-year undergraduate Medical education programme. According to the
current curriculum in family medicine, the residency lasts three years. It consists
of five main fields and the course schedule is shown in Table 1. On completion
of the three-year course and passing the examination, the graduates are awarded
a Specialist of Family Medicine title from the Ministry of Health. The current
curriculum aims to produce graduates who are proficient in the management of
common health problems and can provide timely emergency surgical and obstetric
interventions. Graduates from these family medicine residencies are nowadays,
working for the Ministry of Healths National Health System (Health Centers,
Centers for Mother and Child Care, Emergency Services etc.) Some of them choose
an academic career in one of the 33 active departments of family medicine at
the universities or work in private health institutions, such as health centres, hospitals, emergency centres.
Table 1: Course schedule of family medicine residency training in Turkey
Child Health and Diseases (9 months)
Internal Medicine (9 months)
Gynaecology and Obstetrics (8 months)
General Surgery (with intense emergency participation) (6 months)
Psychiatry (4 months)
Family Practice (12 months) (Optional, mostly performed in academic departments)
References
- Ersoy F and Sarp N . Restructuring primary healthcare services and the
changing profile of family physicians in Turkey. Family Practice 1998; 15:
576–8.
- Gorpelioglu S, Korkut F and Aytekin F. Family practice in Turkey. Family
Practice. 1995; 12: 339–40.
- Yaman H. Training in Family Medicine: The Current State in Turkey. Education
for Primary Care 2002 ;13 (3):394 - 397
Country Coordinator:
Hakan YAMAN, MD, MS
Associate Professor of Family Medicine
University of Akdeniz
Medical Faculty, Department of Family Medicine
Antalya, TÜRKİYE
Tel: 0090 242 227 43 43
Fax: 0090 242 227 44 90
GSM: 0090 536 320 99 33
e-mail: hakanyaman@akdeniz.edu.tr
Turkey – HOST PRACTICE
University of Akdeniz
Medical Faculty, Department of Family Medicine
Outpatient Clinic
Antalya, TÜRKÝYE
Tel: 0090 242 227 43 43
Fax: 0090 242 227 44 90
GSM: 0090 536 320 99 33
e-mail: hakanyaman@akdeniz.edu.tr
Geography:
Our clinic is placed in urban area at the Mediterranean Sea and within the University
Campus of Akdeniz University. Antalya has a population of approximately 800.000
inhabitants. We have just 15 kilometers to an international airport.
Doctors:
We are 2 FP's (1 female and 1 male) working in the clinic - and five young
doctors during their training in family medicine. For shorter periods we also
have a medical student in the clinic.
Apart from the daily work with the patients the doctors are engaged in education
in family medicine in many respects - allowing you to be invited to these educational
sessions.
Staff:
In Turkey staff in family practice clinics is very limited. We have three full-time
secretaries.
Clinic:
We run a well-equipped modern clinic. Our clinic is placed in a separate
building lying in a little garden. Our clinic serves as an open-access clinic.
Special:
We especially offer reproducive health training in our clinic.
Preferred visiting periods:
We accept every season residents from different countries. We prefer your contact
as early as possible allowing us to plan a good exchange visit for you.
Accommodation:
It might be possible to stay in summer months at student dormitories at
our university. Affordable pensions are situated close to our health clinic.
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