JMIR Publications

ABSTRACT

Background:

Family medicine is the cornerstone of primary healthcare, yet evidence remains limited regarding the alignment between required professional competencies and those available among graduates in Syria.

Objective:

This study aimed to identify the essential competencies required for family medicine practice in the Syrian context and to evaluate the perceived gaps between their necessity and actual availability among graduates.

Methods:

A descriptive, cross-sectional study was conducted using a 95-item competency-based questionnaire developed through a Delphi method. The instrument identified and assessed competencies across three domains: knowledge (29 items), skills (41 items), and attitudes (25 items). A total of 78 family medicine graduates and heads of training departments rated the "degree of need" and "degree of availability" for each competency using a 5-point Likert scale. Content validity was established via expert consensus, and internal consistency was verified using Cronbach's alpha. Data were analysed using descriptive statistics.

Results:

The study successfully identified 95 core competencies required for family medicine practice in Syria. Participants (n = 78) reported high to very high perceived need across all domains (category means ranging from 3.88 to 4.37 out of 5). In the knowledge domain, assessment and diagnosis competencies received the highest mean need score (M = 4.36, SD = 0.57). In the skills domain, management-related competencies were prioritised (M = 4.37, SD = 0.65). Reported availability was consistently lower than perceived need across all categories (range 3.16-3.68), and no category reached the availability levels seen for need. Measurable competency gaps were identified across all categories, with the largest discrepancy observed in the attitude domain (mean need 4.14 vs mean availability 3.39; 9 of 25 items showing a shortfall), followed by the scientific categories of the knowledge and skills domains (6 items each).

Conclusions:

This study identified essential family medicine competencies and revealed significant misalignment between competencies required for practice and those currently possessed by graduates in Syria. The observed gaps, particularly in professional attitudes and scientific knowledge, highlight an urgent need for systematic review and contextual adaptation of training curricula to strengthen medical education in fragile health systems.