Principles of Family Medicine and Primary Care
The Iraqi Board examination tests whether you can apply the defining attributes of family medicine to undifferentiated problems in primary care, rather than reproduce hospital specialty knowledge. The domain covers first contact, continuity, comprehensiveness, coordination, community orientation and patient-centred care, including the family and biopsychosocial context.
Core rules
- Family medicine is first-contact care: most problems are undifferentiated and managed without referral.
- Continuity means using the longitudinal record and repeated visits to refine diagnosis and build trust.
- Comprehensiveness includes prevention, acute care, chronic disease and palliative care across ages.
- Coordination requires knowing when to refer, what information to send and how to follow up.
- The family system affects symptoms, adherence and decisions; confidentiality still applies to each member.
Worked example
A 45-year-old man presents with recurrent headache. The trainee orders a brain scan immediately. The family physician first asks about red flags, medication overuse and sleep, examines fundi and neurology, and uses the record to note recent marital stress and hypertension. No red flags are present, so the plan is analgesia review, blood pressure monitoring and a scheduled review. The reasoning is not “do nothing”; it is purposeful, time-limited primary care with safety-netting.
Traps
Calling every problem “stress” without excluding red flags; referring without a focused question; ignoring family context; and breaching confidentiality when a relative asks for information.