Palliative Medicine has been recognised as a specialty since 1987; it is the medical component of the holistic care offered to patients and carers, when a patient has incurable and advancing disease with a limited prognosis. Control of physical symptoms, particularly pain and caring for the psychological, social and spiritual aspects of life are paramount. The focus of care is quality of life.
The knowledge base and skills of the specialty first developed in hospice care mainly for cancer patients, but have now extended and are applicable to medical practice in all areas. In Anglia a career in palliative medicine offers the opportunity to work within hospices, palliative care units, the community, district general hospitals and regional specialist centres.
More information about some of the unique opportunities available for palliative medicine trainees in the East of England can be found by looking at the links on the right and the drop down boxes below.
The Training Programme
From August 2022, Palliative Medicine is now a group 1 specialty, providing dual training with Internal Medicine leading to a CCT in both specialties. The four year training programme for Palliative Medicine and Internal Medicine is provided in a variety of settings, including independent hospices, NHS hospices, district general hospitals, teaching hospitals and community based services. Trainees rotate annually to benefit from the experience offered by the different training posts. At least 9 months will be spent working in Internal Medicine and participating in the acute unselected medical take on calls. Palliative Medicine, on call is non – resident throughout the locations. The region is divided into three sub-rotations - East, West and South. (The sub-rotation document is added to the page below). Applying candidates will know which post and sub-rotation they will start-in, and the remainder of their rotation is likely to include placements in that sub-rotation only. However, in some circumstances trainees may need to be placed in a unit in a different sub-rotation. Once appointed to a sub-rotation, a trainee may apply for a transfer to another sub-rotation, but this cannot be guaranteed.
The wide geographical area of the East of England offers a variety of urban, suburban and rural settings. The trainees run a monthly training day rotating through the different locations. This provides the opportunity to explore clinical scenarios in depth, address aspects of the curriculum not regularly encountered in practice and to network with their colleagues. They are actively encouraged to participate in multi-centre audit and research. Opportunities to participate in teaching in formal and informal settings are numerous.
- Completion of a core medical training programme or equivalent.
- Documented evidence of achievement of level 1 competencies in general internal medicine (acute) and generic curricula.
- MRCP(UK) Part 1 or equivalent at time of application or the first part (if applicable) of other qualifying examinations.
- MRCP(UK) Full Diploma or equivalent or MRCGP (with CCT) or FRCA or FRCS or MRCS (full) or equivalent by time of appointment.
- An enquiring approach to both people and diseases
- Good communication skills
- Ability to work with and utilise all the skills of a multidisciplinary team
- A sense of adventure – pioneering novel approaches to complex problems
- A good sense of humour
Work Based Assessments — the requirements are changing annually, but will comprise a number of the following:
- DOPS (directly observed procedural skills)
- sub section: Syringe driver set-up and Paracentesis are compulsory over the 4 years
- MSF (multi-source feedback) formerly known as 360 degree assessment
- sub section: Currently an annual requirement
- are likely to include in the future:
- sub section: Case Based discussion
- Patient survey
- Assessment of audit
- Assessment of teaching
These are set against the curriculum drawn up by the RCP. The required number must be completed each year and will be checked at your annual review. It is the responsibility of the trainee to ensure the required number and type of assessments are carried out.
It is recommended that trainees meet with their Educational Supervisor prior to, or shortly after, commencing in post to discuss their 'job plan' and requirements for the year. They should also meet half-way through and then at the end of the post, to review progress made and to consider future needs. A number of competencies and skills must be signed off against the curriculum during the training period.
See the JRCPTB website for Assessment forms and updates.
RITA (Record of In-Training Assessment) and ARCP (Annual Review of Competency Progression)
Currently trainees are invited to attend annually to meet and discuss the progress of their training. The purpose of the meeting is to ensure that trainees are making satisfactory progress and that they are able to move on to the next year of training. Usually present at this meeting are:
- Associate Dean
- Chair of the Speciaty Training Committee
- Programme Director
You may be asked to make a presentation about your achievements over the previous year and plans for the forthcoming year. You will be required to provide evidence of your achievements, for example:
- Study days attended, with programme
- Teaching sessions given, with evidence of feedback
- Weekends on-call worked (eg copy of rota)
- Completed assessments
- Copies of audits / research undertaken