Family medicine in the Russian far East.

BACKGROUND AND OBJECTIVES Over the last decade, Russia and other former Soviet states have attempted to move from a fragmented health care system dominated by specialty and hospital care to one emphasizing primary care and prevention through the introduction of family medicine. This report describes the development of family medicine in Russia's Far East region. METHODS The Far East was one of the first places in Russia to develop family medicine education. Early interaction with the United States and adoption of an American training model allowed rapid development of the training program. The Russian Ministry of Health issued a health order in 1992 to transition the organization of primary care in Russia to a family medicine model. RESULTS There are now 15 family medicine training programs in Russia, with several now established in the Far East. Introducing family medicine effectively into an "entrenched" medical system that does not reward prevention has proven difficult for reasons including lack of funding and training that does not fully prepare physicians for practice in their geographic area. CONCLUSIONS Family medicine training has been developed in the Russian Far East with some success, but a number of challenges still remain.