Making the most of a palliative care experienceBMJ 2020; 368 doi: https://doi.org/10.1136/bmj.l6893 (Published 11 February 2020) Cite this as: BMJ 2020;368:l6893
- Laura Jayne Beeley, paediatric trainee1,
- Sarah Winfield, foundation year three doctor2,
- Deborah Adams, specialty trainee registrar3
- 1University Hospitals Plymouth NHS Trust, Devon
- 2Aintree University Hospital, Liverpool
- 3Palliative Medicine, Peninsula Deanery, Plymouth
At some point in their training, most medical students will encounter palliative care during their placements. In the UK nearly half of all deaths happen in hospital and therefore end of life care is a core skill for junior doctors.1 This article outlines the importance and relevance of palliative care and offers advice on how to use a palliative care placement to optimise the future management of patients who are nearing the end of life.
What is palliative care and who receives it?
Palliative care is more than caring for patients at the end of life. It is an approach to terminal illness that focuses on holistic, individualised care and symptom control, rather than cure or prolonging life.2 Palliative care teams support patients with incurable chronic diseases or life limiting illnesses. Adult palliative care teams can attend to patients from age 16 upwards. Although many of the patients will have cancer, the teams also support those with incurable, progressive conditions, such as heart failure, chronic respiratory disease (chronic obstructive pulmonary disease, fibrosis), progressive neurological disease (motor neurone disease, dementia), and end stage renal and liver failure.
You might be exposed to palliative care during many of your medical school placements, particularly general practice and medical specialties such as respiratory or geriatric medicine. Although doctors and nurses often provide palliative care without being specialists in the discipline, you might spend time with dedicated palliative care specialists in a variety of settings.
You could be placed in a hospice, an establishment dedicated to supporting patients receiving palliative care and their families and friends.3 Services offered by hospices are variable; some have only outpatient …