Masato Niimura, MD, and colleagues have responded productively to our research regarding the importance of pediatric training in family medicine, especially in rural contexts, such as rural island medicine.1 We agree with them that managing health conditions in all age groups is critical for family physicians. Family medicine education should also include social determinants of health, such as aging societies and the COVID-19 pandemic, and this is particularly important in rural communities. Thus, rural family medicine educators should collaborate with community stakeholders, including citizens, particularly with respect to their concerns about COVID-19.
Considering community needs in family medicine training is critical for effective education. Involvement in community activities expands resident knowledge regarding both medical and psychosocial issues through dialog and shared experiences2 and allows them to connect identified medical issues with the life experiences of community members. As Niimura et al suggested, rural family medicine trainees and physicians must deal with children in the context of community problems, such as vaccination and health promotion. Adjusting their work to the community and learning from the citizens can improve their skills for assessing community needs and establishing consistent collaborations.
The COVID-19 pandemic has dramatically impacted rural family medicine training. In some cases, rural family medicine education and community-based medical education (CBME) have been withdrawn out of COVID-19 fear resulting in the loss of training motivation within educational organizations. In our own institution, the ongoing importance of rural CBME for the sustainability of rural medical care had to be reenforced.3 As the fear of COVID-19 continues, each medical educational institution should discuss their aims and motivate stakeholders to provide effective education blended with on-site and online educational methods.
Niimura et al’s suggestion is critical for pediatric training in family medicine education during the COVID-19 pandemic. Waves of contagion can be inhibited by proper infection control and the provision of the COVID-19 vaccination.4 Care and education of children regarding infection control and vaccination can be vital for the prevention of future pandemics.5 Therefore, CBME for family medicine remains crucial and must be continued.