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Studies & Degrees in Primary Care

Primary care is the first level of a health system: the family doctor or general practitioner (GP), the community nurse and the health centre team that people see first and keep seeing over the years. NHS Health Careers in the United Kingdom describes GPs as doctors who treat all common medical conditions and refer patients to hospitals and other services for urgent and specialist treatment. Much of the work is caring for people with chronic illness and long-term conditions.

The World Health Organization (WHO) uses the wider term primary health care (PHC): a whole-of-society approach to health that focuses on people's needs as early as possible, from health promotion and disease prevention to treatment, rehabilitation and palliative care. Primary care services are one of the central pieces of that approach.

What students learn

Primary care is not usually a first degree. Doctors and nurses qualify first and then specialise. Training is broad rather than deep in one organ or technique: common illnesses in children, adults and older patients, prevention and screening, the long-term follow-up of chronic disease, mental health, home visits, communication with patients and families, and work with the community. Most of it takes place in health centres under supervision, with hospital rotations.

Qualifications and levels

  • Family doctors in Spain. The medical specialty is called Medicina Familiar y Comunitaria. Its official programme (Orden PJC/798/2024, which replaced the 2005 programme) sets a duration of four years in the residency system and requires a prior degree in Medicine.
  • Nurses in Spain. Enfermería Familiar y Comunitaria is an official nursing specialty. The programme (Orden SAS/1729/2010) lasts 2 years and requires a nursing degree.
  • United Kingdom. The usual route is a five-year undergraduate degree in medicine, the two-year foundation programme and specialty training as a GP, which takes a minimum of three years, according to NHS Health Careers. To practise as a GP, a doctor must be on the General Medical Council's GP Register.
  • United States. The specialty is family medicine. The American Academy of Family Physicians (AAFP) describes the path as four years of medical school, a residency that is typically three years long and board certification through the American Board of Family Medicine (ABFM).
  • Master's degrees and continuing education. Universities also run master's degrees, research programmes and short courses in primary care for practising professionals. The Institute of Primary Health Care (BIHAM) of the University of Bern, for example, states that it trains the next generation of family doctors, researchers and teachers in primary care.

Where to study

SpainExchange lists 13 active schools for primary care. Spain has 5 and the United Kingdom 2. Ireland, the United States, Ukraine, the Netherlands, Switzerland and Russia have 1 each.

In Spain, the list includes three universities: the Universidad Autónoma de Madrid, the Universidad Miguel Hernández de Elche and the Universidad de Las Palmas de Gran Canaria. The other two entries are training centres rather than universities: Churruca Formación in San Sebastián, which prepares candidates for public-sector competitive exams, and Aranda Formación in Madrid, a vocational training school. Abroad, the list includes the University of Northampton and the University of London in the UK, Utrecht University, the University of Bern and the University of Dublin, Trinity College.

Specialty training is organised by each country's health system, not only by universities, and it is done in the language of the patients. Doctors and nurses who qualified abroad need their degree recognised before they can enter specialty training in Spain. In the UK, the Royal College of General Practitioners (RCGP) describes separate pathways to the GP Register for doctors with a qualification in general practice or family medicine from outside the country. Ask each school which programme it offers in primary care and what recognition the qualification has.

Careers

Family doctors and community nurses work in public health centres, group practices, rural clinics, home care and out-of-hours services. Some combine clinical work with teaching, research or management. In the UK, NHS Health Careers notes that GPs can also develop special interests in areas such as sports medicine, adolescent health, diabetes or palliative medicine.

The WHO argues for more investment in this level of care: it estimates that scaling up primary health care in low and middle-income countries could save 60 million lives and increase average life expectancy by 3.7 years by 2030. No official employment figures for primary care professionals were found for this page.

Frequently asked questions

How long does it take to become a family doctor in Spain?

After the degree in Medicine, the specialty of Medicina Familiar y Comunitaria takes four years of residency.

Are primary care and primary health care the same thing?

Not exactly. Primary care is the first level of health services, such as the family doctor and the health centre. Primary health care, in the WHO's definition, is a wider approach that also includes public health functions, policies in other sectors and the participation of communities.

Can nurses specialise in primary care?

Yes. In Spain the specialty of Enfermería Familiar y Comunitaria lasts 2 years and is open to holders of a nursing degree.

Can a family doctor trained abroad work as a GP in the United Kingdom?

Only once accepted onto the General Medical Council's GP Register. The RCGP publishes the pathways for doctors with qualifications in general practice or family medicine from outside the UK.