Family practice training in Estonia

The collapse of the Communist regime has required many newly independent countries to reform their health care systems. This article presents the unique experience of Estonia's development of family practice training and the introduction of this specialty to the existing health care system. Family practice training programs began in 1991 and include several pathways to certification in family practice. For physicians currently working as district doctors, pediatricians, gynecologists, or emergency doctors, there is the possibility of part-time retraining while continuing their work as primary care physicians. For new graduates of the medical school, there is an internship and residency in family practice or the option of part-time or in-service vocational training while maintaining a clinical practice. An important aim of the programs is to develop the identity of family physicians. The success and the failures of the Estonian experience in launching this project may be useful to other countries facing health care reform.