[How family physicians estimate their knowledge and skills in musculoskeletal problems?]

Musculoskeletal conditions are common reasons for consultation in primary care and constitute 14-28% of primary care visits and visits to emergency services. General practitioners [GP] diagnose and treat the majority of patients with musculoskeletal problems. Surveys conducted confirmed the discrepancy between the number of GP musculoskeLetal consultations and the amount of time spent on orthopedic and musculoskeletal teaching in undergraduate and postgraduate education in different countries. It would be considered negligent for a GP to be incompetent in assessing the function of the heart or lungs, yet it is quite common for students to leave medical school without being able to make a general assessment of the musculoskeletal system. This review analyses the forms and duration of medical teaching on musculoskeletal disorders in several parts of the world and in Israel. Some studies have investigated the current situation in the undergraduate education of musculoskeletal teaching. The recent survey by the Bone and Joint Decade of undergraduate teaching in different specialties in 32 countries considered that the average length of medical teaching time of orthopedics, rheumatology and physical medical rehabilitation is insufficient and usually emphasize surgically managed musculoskeletal problems that are not relevant for the future practice of most doctors. The surveys that investigate postgraduate training have tested the confidence of GPs in performing regional musculoskeletal examinations and management of specific conditions. They found the different levels of confidence between GPs in UK, Canada, USA (including Hawaii) and developing, countries, with the tests showing deficient knowledge and skills in assessment and treatment of musculoskeletal conditions.

It should be the personal obligation of GPs to update themselves regularly and monitor their performance to ensure the appropriate care of musculoskeletal problems. This will be possibLe through increasing the curriculum time of studying musculoskeletal diseases to at least 6 weeks and developing a CME musculoskeletal program. Different CME Musculoskeletal programs are being established in Family Medicine departments in Israel. It is important to investigate all musculoskeletal programs and to develop the universal musculoskeletal program for postgraduate education.