Royal Decree 3303/1978 of 29 December, which regulated Family and Community Medicine as a specialty of the medical profession provided for in Article 6. that post-graduates in the training period would be in a number of health services in the Ministries of Education and Science and Health and Social Security and Local Corporations are needed from among those located in the the university district in which the residence or hospital is located, to which the post-graduate is attached

Training areas will comprise hospital services, special units and supervised practices in urban and rural areas.

After nearly two years since the beginning of primary care training in urban and rural extra-hospital teaching units, the experience gained advises their regulation, addressing the organizational and specific functional elements of the same.

In its virtue, heard by the General Council of Medical Colleges, I have had to dispose:

Article 1. According to the program of the specialty of Family and Community Medicine, the objectives of the training will be:

-Knowledge of frontline healthcare medicine in its normal and urgent facets in contact with a defined population group, through teamwork,

-Knowledge of the methods of study of the level of health and of the economic, socio-cultural and environmental factors that influence it.

-Acquire the knowledge and ability to apply the various methods of health promotion, prevention and rehabilitation of the disease.

-Make it possible for resident physicians to know all the health resources available in the community and make optimal use of them.

Art. 2. 1. The primary health care training of the Family and Community Medicine specialty will be conducted in Centers with teacher accreditation located within the primary care structure, in urban and rural areas that practice a Comprehensive and continuous health care, about a population defined geographically and socially and based on multidisciplinary teams working in full time dedication.

2. The implementation of teaching units of Family and Community Medicine as structures with its own entity is necessary in view of the non-generalization of the basic health units and basic primary care equipment with teaching capacity. which meet the above mentioned characteristics.

Established these units and equipment, the functions attributed in this Ministerial Order to the teaching units will be integrated into the training activities of these basic primary care and units The Ministry of Health and Consumer Affairs are also responsible for the health and safety of health workers.

Art 3. 1. For each hospital with programs of the specialty there will be a teaching unit that will act in coordination with him.

2. The teaching units will be established in institutions outside of the Social Security, Local Corporations or other Entities, which will meet the precise conditions, both in the facilities and in relation to the equipment of personnel and material whose functional management makes it possible to develop comprehensive health care.

3. The teaching units, carried out in accordance with the accreditation and approval procedure referred to in Article 4.1 of Royal Decree 3303/1978 of 29 December 1978, shall comply with the following minimum conditions:

-Functional.

-Enable comprehensive assistance through teamwork and full time dedication of the unit's staff.

-Develop a previously established scheme of teaching activities according to the objectives set by the official programme of the specialty. The teaching proposal should also include the possibility of continuing training programs for professionals in primary care and clinical and epidemiological studies in this area.

-Resources.

-Humans with full integration into the Unit.

-Coordinator of the Teaching Unit.

-Two Extrahospitalarian Tuitors.

-A Technician in Public Health or Community Medicine.

-Four Resident Doctors.

-An ATS by Tutor Extracspitalarium.

-An Administrative Auxiliary.

-A Celter.

-Humans on a collaborative basis.

-Social Assistance.

-Mental Health Technicians.

-Physical.

-Two Consultoires by Tutor Extracts.

-A File-Secretariat.

-A Library-Reunion Room.

-Own or shared areas: Waiting Room and Emergency Zone.

-Materials.

The Units will have the necessary teaching aids for the development of their activities, including the use of the relevant diagnostic aids.

Art. 4. 1. The training of post graduates in the Teaching Units will be directed towards the realization of a comprehensive health care, developing the various aspects contained in the program of the specialty, trying to give an eminently practical to the teachings.

2 During their extra-hospital training, the residents of Family and Community Medicine will continue to be administratively dependent on the Hospital Institution to which they are attached.

3. In order to meet the objectives of the Teaching Units, the population cared for must follow the approximate ratio of 1,000 people for each Resident Doctor.

4. Last year Resident Doctors will conduct a minimum of three monthly extra-hospital guards in the area of the Unit's influence. To this end, the programme manager shall establish relevant collaborations with the Emergency Services in the area.

Art. 5. 1. The General Practitioners attached to the Teaching Units will be the Extractive Tutors of the program.

2. The selection of the Tutors will be carried out by the Provincial Directorates of the National Institute of Health by means of a specific call following the rules established for the coverage of places of General Medicine of Social Security.

3. Doctors with an extra-hospital place may be designated as Tutors, specialists in Family and Community Medicine who will be present, or, failing that, other Doctors who can certify a professional qualification appropriate in the different areas of the specialty.

4. The Extra-Hospital Tutors will have a schedule of forty hours a week, without prejudice to the dedications that may correspond to the participation in the guard shifts in those places where there is no Emergency Service.

5. Will be the functions of the Extractive Tutors:

-Be responsible for running the craft program.

-Participate in the teaching and clinical and epidemiological studies of the Unit.

-Monitor the care activity of the Resident Doctors.

-Participate in community medicine programs to be established.

Art. 6. 1. To facilitate the realization of comprehensive health care and the development of aspects of preventive medicine, health promotion and public health in general contained in the program of the specialty, as well as the planning and supervision The teaching assessment of the Teaching Units will be assigned to the same Public Health and Community Medicine Technicians.

2. The selection of the Technicians in Public Health and Community Medicine will be carried out by the Provincial Directorates of the National Institute of Health.

3. The attachment to the Teaching Unit will be performed:

-By Service Committee if the selected is a Technical Administration or Social Security Management Entities.

-By hiring or gratification for hours of decency to impart, in the remaining cases.

-The time dedication of the Public Health and Community Medicine Technicians attached to the Units under the contract or in the commission of services will be determined by the Provincial Directorates of the National Institute of Health, according to the needs foreseen for the implementation of the programme.

4. They will be the roles of the Technicians in Public Health and Community Medicine:

-Plan and, if necessary, impart the practical theoretical program of Public Health and Community Medicine of the specialty in collaboration with the Tutors.

-Plan and supervise the evaluation of the teaching and care tasks of the Unit.

-Participate in other training programs and research activities that develop in the Unit.

-To promote and channel the mechanisms of participation of the population cared for in the work of the Unit.

Art. 7. The Medical Doctors Order of Social Security who attend the same core of population that the Unit will be able to integrate in the same as teachers when the possibilities and needs of the Unit so advise. In this case, they will receive the intended complement of decency for the Extractive Tutors.

Art. 8. 1. The management and management of the Family and Community Medicine program of each province will be carried out by a Coordinator, who will be appointed by the Provincial Director of the National Institute of Health, among the professionals with teachers in the specialty program and at the proposal of the Hospital tutors, Extracospitalaries, Public Health and Community Medicine technicians and Resident Doctors of the same.

2. In those provinces in which there are several Teaching Units and the needs for management and management of the programme so advise, the Coordinator shall be dedicated exclusively to this function under the Service of the Service Commission. category and rights and facilitating their replacement by another optional. The Coordinators shall receive the assets corresponding to their professional category of origin, including the addon of decency fixed for the same and without prejudice to other supplementary remuneration which may result from the performance of their functions (displacements)

3. For the correct development of his duties the Coordinator will be integrated in the Commissions of Decency of the Hospitals with program of the specialty.

4. They will be the Coordinator's functions:

-Coordinate and supervise the development of the teaching program established for the specialty of Family and Community Medicine in its hospital and beyond-hospital aspects and in its territorial scope of action.

-Order and manage all aspects related to the extra-hospital performance of the craft

-Monitor the evaluation of all the teaching and teaching elements of the program.

-To carry out and present the annual report of evaluation of the program to the Provincial Delegate Commission, to the Teaching Commissions, to the National Speciality Commission and the Ministry of Health.

5. In order to fulfill these tasks, the Coordinator will be advised by the Hospital tutor of each Center, the Extracheptalarios of each Unit and the Public Health and Community Medicine Technicians of the program.

5. The Coordinator is responsible for the development of the program before the Provincial Delegate Commission and the National Specialty Commission,

Art. 9. The annual budget for the Teaching Units will be included as a spending center in the Provincial Directorate of the National Institute of Health or Local Corporations to which they belong, enabling the necessary economic means for the staffing, material and maintenance of the Teaching Units, including the cost of the extra-hospital guards of the Resident Doctors.

Art. 10. 1. All Units will be subject to an annual assessment and teacher evaluation based on the following points:

-Degree of compliance and quality of the clinical teaching program and Public Health and Community Medicine.

-Degree of compliance and quality of scheduled work and practical activities.

-Development and current status of teaching accreditation requirements.

2. The evaluation report shall be based on the detailed bilateral assessments of each of the parts of the programme carried out by the teachers and the teachers, providing the documentation generated in this respect.

3. This report shall be sent to the Provincial Directorates of the National Institute of Health during the first quarter of each year by the Programme Coordinator, as indicated in Article 3., point 4. The non-referral of the report within the time limit shall mean the suspension of the teaching accreditation of the Units.

Art. 11. The Teaching Units must be actively involved in the implementation of the programs for the continued training of Primary Health Care personnel in their area of influence.

Also, the Teaching Units will be able to collaborate in the training of medical and nursing graduates.

TRANSIENT PROVISIONS

One. For the purposes of Article 3 (2), the continuity of the currently operating units and meeting the accreditation requirements set out within a maximum period of six months shall be considered in particular the publication of this Ministerial Order.

Two. -It will be considered to be a preferred merit for the appointment as Tutor Extracahospitalario, having acted as such on a continuous basis in the current established Teaching Units, according to regulations of the Directorate General of the National Institute of Health of 25 April 1981, extended in successive circulars, subject to the relevant accreditation certificate issued by the current Coordinators and accompanied by the assessment of the resident doctors who have been trained in them.

FINAL DISPOSITION

By the Directorate General of Health Planning of the Ministry of Health and Consumer Affairs, detailed rules for the application of the content of this position will be adopted.

Madrid, December 19, 1983. -XX_ENCODE_CASE_CAPS_LOCK_ON lluch Martin.