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Lesotho FM Residency

Family Medicine Specialty Training Program

Ministry of Health in conjunction with Boston University, USA & The University of the Free State RSA

Development of the FMSTP

The Family Medicine Specialty Training Program was created to strengthen district health
services in Lesotho. Lesotho faces many health challenges, including the highest prevalence of
TB and the second highest HIV globally. At the same time the country suffers from an extreme
shortage of physicians, as there are less than 40 Basotho doctors practicing in Lesotho, with a
large majority of these physicians located in Maseru.

The purpose of the Lesotho Family Medicine Specialty Training Program (FMSTP) is therefore
to increase the number of well-trained physicians in the country who have the knowledge, skills
and commitment to meet the health needs of the people of Lesotho, with special attention to the
clinical and management skills which are required in government district hospitals.

The program runs over a period of four years. We accept young Basotho doctors after they have
completed internship and who intend to stay in Lesotho long term, and are ready to work towards
a decentralized Health Care System. Registrars/ Family Medicine students are assigned to
various district hospitals. Among the group of 2015-2018 these are Mokhotlong, Butha-Buthe,
Leribe and Mafeteng. They return once a month for a week-long Contact Session, organized by
the FMSTP faculty based at Motebang Hospital in Hlotse, which is the main teaching and
learning site of the program. The three Faculty members also visit the districts for supervision
visits on a quarterly schedule.

The first two of the four years focus intensely on primarily district based clinical training,
introduction to concepts of Family Medicine and patient centered care, and basics of district
health management. The third and fourth years have a greater focus on Community Orientated
Primary Care (COPC) with a supervised project. In addition they do clinical rotations and attend
quarterly contact sessions in Leribe. During their training registrars conduct a relevant
Operational Health Systems Research Project.

The FMSP is the first and only physician specialty training program in Lesotho and the only
medical higher education program in the country which has received a full 5 year accreditation
by the Council on Higher Education (CHE) of Lesotho (in December 2015). This came
following a rigorous 3-year accreditation probation period during which the program further
developed and transformed its curriculum and policies to ensure compliance with the Lesotho
higher education quality assurance processes.

Today the FMSTP focuses on 4 pillars; Clinical Family Medicine, Community Orientated
Primary Care, District Health Management, and Operational Health Systems Research. The
program can accept 4-6 new registrars per year.

The specialty training program operates in an academic partnership with the Lesotho Ministry of
Health, Boston University School of Medicine (BUSM), the University of the Free State in
Bloemfontein, Maluti Seventh Day Adventist Hospital in Mapoteng, the Consortium of New
Medical Schools in Southern Africa (CONSAMS), the World Organization of Family Doctors
(WONCA), the Primafamed Conference for Africa with Ghent University in Belgium, and the
Wales Royal College of General Practitioners. Our academic network is rapidly expanding in a
digitally supported environment.

Boston University also conducts (together with FMSTP) training workshops for faculty
development for Lesotho physicians to help them update and improve teaching skills.
In the absence of a fully established Lesotho School of Medicine, in which FMSTP would
ideally become a Department, Boston University School of Medicine certifies the graduates who
have successfully completed the 4-year training.

Lesotho FM Specialty Training Program