📖 ABSTRACT/OVERVIEW
Background: The biopsychosocial model has been the philosophical foundation of family medicine globally since its articulation by Engel in 1977. However, its epistemological compatibility with Nigerian sociocultural realities and its practical articulation in local clinical discourse has not been critically examined. This study conducts a critical discourse analysis of the biopsychosocial model's philosophical underpinnings in contemporary Nigerian family medicine. Methodology: A critical discourse analysis examined 120 published family medicine case reports, clinical guidelines, and residency training curricula produced in Nigeria between 2015 and 2024. Additionally, 20 in-depth interviews with senior family medicine consultants across five geopolitical zones explored philosophical orientations. Foucauldian discourse analysis provided the theoretical framework. Results: Biomedical discourses remained dominant in clinical documentation despite rhetorical endorsement of the biopsychosocial model in curricula. Spiritual and communal dimensions of health were frequently invoked by practitioners but absent from formal training frameworks. A tension emerged between individualistic Western patient-autonomy values and collectivist African health decision-making norms. Conclusion: Nigerian family medicine practice inhabits a philosophical hybridity that existing frameworks do not adequately theorise. This study contributes an original critical discourse contribution challenging the uncritical adoption of Western philosophical frameworks and proposing an Afrocentric biopsychosocial model responsive to Nigerian epistemic realities. Keywords: biopsychosocial model, discourse analysis, Nigerian family medicine, philosophy, Afrocentric
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