Training on death and dying: handle with care
BMJ 2011; 342 doi: https://doi.org/10.1136/bmj.d3110 (Published 23 May 2011) Cite this as: BMJ 2011;342:d3110
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As a Core Medical Trainee I already have an ambition to enter into a
career within Palliative Care. In part, this has stemmed from working for
inspirational Consultants and being taught by inspirational lecturers.
However, the thing that made me more dedicated than ever was my last
placement working in a Specialist Palliative Care hospice in South Wales.
The opportunity provided the chance to work day in day out with patients
suffering from terminal disease, both malignant and non malignant as well
as hear and see end of life terminology being used with ease and without
the air of awkwardness. It also made me evaluate what I had been taught at
medical school and what my peers often regarding as "Palliative Care".
Very often their responses are "the last few days of life" and "just
before a patient dies". It does not often involve mention of symptom
control and non curable illnesses. Surely we have to tackle these
misperceptions and incorporate palliative care into all areas of practice,
as well as into our every day practice before we can think of improving
communication at the end of life.
Whilst there is now a perception that medical education is full of
"soft stuff" such as communication skills, breaking bad news etc. this
remains a false environment without the real life conundrums and questions
that patients and relatives pluck out of thin air. The only way to truly
get a flavour and to develop skills in palliative medicine and handling
end of life care is to experience it first hand. I believe now is the time
to expand the number of palliative care training posts, both at Foundation
and at higher training levels in order to nurture our skills as a
profession. Looking ahead, with patients living longer with co-morbidities
we are likely to see an explosion of demand for palliative care in the
near future, whatever our chosen speciality.
Competing interests: No competing interests
Re:Rotations in Palliative care open trainees' eyes
I must take issue with Dr Samuel's declaration of his fellow
colleagues ignorance of the role of Palliative Care in modern medicine.
Some trainees may have misconceptions about palliative care but the
majority of us understand very well the wider role they have to play.
This is due largely to pro-active and helpful Specialist Palliative Care
teams in the hospital settings, who have worked hard to educate and
illuminate their colleagues about the potential for their involvement in
patient management.
To say that most junior Doctors feel that Palliative care is only for
"the last few days of life" is an out of date and unjust cliche and has
been delivered without any evidence.
Competing interests: No competing interests