Looking back to look forward: Learning from past innovations in family medicine training.

Under the leadership of the late Professor Sam Fehrsen, the Medunsa MPraxMed, which commenced in 1979, was an innovative programme offering doctors in South Africa the unique opportunity to be trained in family medicine within the context of their workplaces. This article describes its pedagogical approach that profoundly influenced a generation of family physicians. Eight shifts in learning arose out of the programme's development and iterative renewal. These included a focus on context and real-world application, greater autonomy for students with learning being focused on their needs, modelling the doctor-patient relationship in the educator-student relationship, facilitation of learning more than teaching, offering resources rather than courses, lecturers and students being co-learners and supporting reflective action. Most of the shifts in the Medunsa MPraxMed are now recognised as good educational practice underpinned by evidence, and are still necessary today.Contribution: Current postgraduate family medicine training programmes in South Africa and beyond are offered the opportunity to reflect on what they might learn from the past approaches of the Medunsa programme.