Survey of General Practitioners` points of view about the common and uncommon symptoms of diseases in Iran

Introduction. One of the most important reasons of failure of traditional medical education in preparing efficient and competent physicians for the real world of practice is using disease-oriented medical education. However patients never tell their diseases to physicians, but mostly they complain their symptoms and the physicians should diagnose the problem and attempt to its treatment. Unfortunately in our programs in Continuing Medical Education (C.M.E.) there is a little chance for teaching clinical process. For adjusting C.M.E. programs with stages of clinical process we should first determine the most important & common symptoms (physicians' needs) and then focus the C.M.E. programs on teaching clinical process of these symptoms. Methods. By using the classic semiology books, a questionnaire which contained demographic information and 153 questions ranked by Likert scale was designed. First we did a pilot study. According to statistics of Medical Council we selected 5000 general practitioners (G.P.s) by multi-stage random sampling method from 26217 G.P.s in Iran. 1707 questionnaires were completed and returned to researchers. Results. In data analysis the frequency and percent of G.P.s who were encountered with symptoms, were described and then by K square test the difference between 2 groups were identified. Also according to sex of physicians and duration of practice, the most common symptoms of each system of the body were tested and there was a significant difference statistically. The most common symptoms in each of the disciplines were as follow: General system: fever (84%), Skin problems: itching (90%), Head and Neck: headache (96.5%), Eye Diseases: red eye (75.8%), Ear problems: ear infection (81.8%), Nose & Throat problems: discharge of nose (90%) & epistaxis (90.1%), Mouth problems: hoarseness (94%),Neck problems: stiffness (67.7%), Breast problems: pain or discomfort in breast (46.5%), Respiratory system: coughing (97.5%), Heart disorders: palpitation (91.8%),G.I . disorders: nausea & vomiting (93.9%), Urinary system: hematuria (95.5%),Female genitalia: dysmenorrhea (86.1%), psychology: depression (88.9%), Male genitalia: penis sore (45.6), Neurology: tremor (72.4%), Vascular system: muscle spasm (80.3%), Musculoskeletal system: back pain (98.3%),Endocrine system: high blood sugar(82.5%), Hematology: anemia (92.1%). Conclusion. We had a final result from the most common symptoms in Tehran and other provinces. It is proposed to design C.M.E. programs in direction of evidence-based medicine and G.P.s' needs in practice and also on the basis of determining the sex of G.P.s and duration of practice, and the state of their practice, so that the physicians will be more competent and efficient to solve the needs of the community.