HISTORY OF THE FAMILY MEDICINE DEPARTMENT OF THE UNIVERSITY OF SIERRA LEONE TEACHING HOSPITALS COMPLEX (CONNAUGHT FREETOWN)

The University of Sierra Leone Teaching Hospitals Complex (USLTHC) began the establishment of its Family Medicine Department in October 2017 to provide training for undergraduate and postgraduate students in family medicine practice. This initiative included collaboration with Blue Shield Medical Centre, a private hospital accredited for postgraduate training in family medicine. Efforts at Blue Shield included reopening the operating theatre, which had been closed following the Ebola outbreak, to facilitate surgical training for family medicine residents. By October 2018, a junior resident passed the Part 1 examination, and four medical officers completed the primary exam—one in April 2018 and three in October 2018.

In August 2018, the process of officially establishing the Family Medicine Department at USLTHC began. Previous attempts to relocate the department to Jui Chinese Hospital were unsuccessful, leading to its integration within Connaught Teaching Hospital. Several structural modifications were made at Connaught Hospital to prepare for the department’s accreditation, including creating a waiting area, ambulance parking space, triage area, and additional consulting rooms.

In November 2018, the West African College of Physicians accredited the department to train four senior registrars and eight junior residents. Operations commenced on November 12, 2018, and between November 2018 and November 2019, significant progress was achieved. Collaborations included support from the Royal College of General Practitioners (RCGP) through partnerships and the initiation of ultrasound training. The department also participated in the World Organization of National Colleges and Academics of Family Physicians (WONCA) Africa Chapter conference in Uganda in June 2019 and began the process of departmental registration with WONCA. Throughout this period, the department benefited from ongoing support from various stakeholders.

Initially staffed with one consultant, three senior registrars, two junior residents, and two medical officers, the department faced challenges, including a high patient load and limited staff. Over time, two medical officers departed for academic pursuits abroad, and the junior resident began external postings. Senior registrars worked on their proposals for the Part 2 fellowship exam, with one completing the exam in October and another preparing for the April session.

Efforts to enhance service delivery included defining staff-patient interaction protocols and ongoing staff training. Community health officers (CHOs) were reassigned to improve service quality. Proposals for a consultant lounge were initiated to foster collaboration and motivate junior colleagues to pursue consultancy roles.

In November 2021, a proposal was submitted for optimizing the outpatient department’s operations. Renovation of the outpatient department began in October 2022 and is expected to conclude in March 2023. Continued reform and restructuring of health facilities, particularly Connaught Hospital as the primary referral centre, remain critical for improved service delivery and overall functionality.