Curriculum gaps in Family Medicine education across the Americas: an institutional assessment of educational preparedness for 21st century practice

Abstract

Background: Family medicine training programs must evolve to meet emerging healthcare challenges, including climate change, digital health integration, and emergency preparedness. Understanding institutional perspectives on curriculum gaps is essential for strategic educational planning and resource allocation across diverse healthcare systems.

Objective: To assess family medicine training curriculum coverage across the Americas from the institutional perspective of professional associations and identify priority areas for educational modernization.

Methods: Cross-sectional institutional assessment across 19 countries in the Americas. All WONCA-affiliated family medicine professional associations completed standardized 22-item surveys assessing curriculum coverage across 25 core competency areas. Analysis focused on identifying institutional curriculum gaps using threshold methodology (competencies with <70% adequate coverage classified as priority gaps).

Results: Professional associations achieved 100% participation across all target countries. Traditional clinical competencies showed universal institutional coverage (100% for non-communicable diseases, communicable diseases, emergency medicine, women's health, children's health, and adult health). Critical curriculum gaps emerged in contemporary competencies, with significant disparities, particularly in areas such as climate change and environmental health, telehealth integration, and healthcare management training.

Conclusions: While family medicine institutions demonstrate strong curriculum coverage in traditional clinical areas, critical gaps exist in emerging competencies essential for 21^st-century healthcare, with marked regional disparities. Climate change and environmental health represent the most significant institutional curriculum gap, particularly affecting Latin American programs. Strategic curriculum modernization and targeted support are urgently needed to prepare family physicians for the contemporary healthcare challenges they face.