Objectives: This paper outlines the development of family medicine in South Africa with special reference to the process leading to the recognition of this discipline as a medical specialty. It also examines the constraints under which the discipline has had to function, considers where the discipline should be, seeks to identify the barriers to its further development and suggests ways in which to overcome these. Methods: A short review was carried out of the available South African literature to record the advancement of the discipline and the international literature was searched for articles supporting this direction. Results: The situation in South Africa is complicated by the existence of many doctor groupings claiming to represent the generalist and the perception that family medicine only addresses the needs of middle-class citizens. A flawed consultative process leading up to the present stage has contributed to this perception. Conclusions: The available literature supports the establishment of family medicine as a speciality. Developments in South Africa, such as raising the status of Family Medicine and creating a compulsory rotation through family medicine as an extended internship and the creation of registrar posts in family medicine will advance the discipline in a positive manner, whilst possibly attempting to resolve the medical migration issues that are presently destroying Sub-Saharan Africa's health services.
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