Welcome to Palliative Medicine

Palliative Medicine

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

The four year training programme for Palliative 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. On call is non – resident throughout the locations and there is no acute medicine cover. Broadly speaking the rotations may be based in the north of the region, the west, or the south east.

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.

 

Essential Qualifications for Entry
Personal Qualities
  • 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
Trainee Information

Welcome to the rotation.  Here are a few things you need to be aware of when you start out as a registrar.

JRCPTB — within the first three months of your post you must enrol with the Joint Royal College of Physicians Training Board. If you wish for LAT posts to be counted towards your time in training this must be agreed with them in advance. A fee is payable upon enrolment. In return you will receive a copy of the curriculum plus information about e-portfolio (currently still in development) The JRCPTB is responsible for publishing forms and guidance on assessments (see Assessments).

Pay - For information in respect of pay and terms and conditions of service you should contact your employing trust's medical staffing department..

Assessments

Work Based Assessments — the requirements are changing annually, but will comprise a number of the following:

  • Mini-CEX
  • 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
Contacts, Links and Training Days

Further Advice

Position

Location

Dr Kath Oakley  Training Programme Director

St Helena Hospice, Colchester

Dr Sarah Bell Training Committee Chair / Regional Speciality Advisor Garden House Hospice Care, Letchworth
Dr Fraz Mir  Head of School of Medicine Health Education England, working across the East of England
Dr Arjun Kingdon Trainee Representative

Broomfield Hospital, Chelmsford

Jo Makepeace

School of Medicine Administrator Norfolk and Norwich University Hospital

Please click on the names above to send an email (your email should load). 

Detailed guidance on the Palliative Care assessment blueprint and curriculum is available from the JRCPTB website.

Useful links

For a full list of upcoming training events and study courses aimed at all medical specialties within the region - Please visit the following links:

Palliative Medicine Specialty Trainee Committee (STC)

The STC is comprised of Educational Supervisors representing the Trusts across the East of England Deanery. Should you have any points of discussion that you wish to be raised on a Deanery level, you may wish to contact your local STC member:

Name Role/Location
Dr Kath Oakley TPD, St. Helena Hospice
Dr Fraz Mir Head of School of Medicine, HEE
Dr Arjun Kingdon Trainee Representative
Dr Sarah Bell Regional Specialty Adviser, Garden House
Dr Anna Spathis Academic Lead, CUH
Dr Alison Blaken St. Elizabeth Hospice
Dr Caroline Barry Norfolk and Norwich University Hospital
Dr Kate Gretton Southend University Hospital
Dr Catherine O'Doherty Basildon and Thurrock University Hospitals
Dr Lorraine Petersen Arthur Rank Hospice
Dr Penny Macnamara Bedford Hospital
Dr Qamar Abbas St. Claire Hospice
Dr Richard Partridge Sue Ryder Hospice
Dr Sarah Mollart St Nicholas Hospice Care
Dr Sarah Gough Norfolk Community Health & Care
Dr Ben Clark Addenbrooke's
Dr Zoe Helman Farleigh Hospice

 

Introduction to Palliative Medicine by Dr Zoe Helman (Former Trainee Representative)

Palliative Medicine is a fantastic specialty that allows you to truly care for patients and their families. It involves multidisciplinary teamwork and lateral thinking. The specialty is patient focused rather than doctor focused, making it particularly rewarding.

  • Involves holistic care; not only treating complex physical symptoms but considering emotional, spiritual, psychological and social needs. We tend to involve the family throughout the patient journey.
  • The training programme is four years if one is working full time.
  • In this time trainees are expected to experience Palliative medicine in multiple settings (inpatient hospice, community and acute hospital trust). 
  • At least one year must be spent in a specialist inpatient unit with at least ten beds, six month cumulative experience in community specialist care and six months in an acute hospital trust are all required to complete training.
  • Trainees will also be involved in supervising and educating junior colleagues, medical students and other healthcare professionals.
  • There are opportunities to be involved in medical student teaching at Cambridge University.

Curriculum /Eportfolio

  • All trainees must enroll with the JRCPTB to have access to the e-portfolio. 
  • http://www.jrcptb.org.uk/specialties/palliative-medicine
  • We only have the Palliative Medicine curriculum. We currently do not dual accredit in GIM. There is a ‘Physicians academic checklist’ in the curriculum section which allows us to record non clinical parts of the curriculum (e.g. teaching).
  • A new decision aid was released in September 2015.
  • The DOPs have changed in the last few years but are clearly listed in the decision aid.
  • Paracentesis is the only DOPS that requires two assessors on two different occasions to complete summative forms. 
  • Requirements for assessments clearly listed on the ARCP decision aid. Assessments consist of curriculum requirements, reflections and WPBAs.
  • Unique to Palliative medicine is the ‘Palliative Medicine reflection form’ – two are required per year. These will include comments from consultant supervisors These are referred to as Records of reflective practice (RRP) on the ARCP decision aid. (Other reflections during the year can be completed on generic reflection forms).  
  • Multiple consultant report – Two are required annually in addition to educational supervisors report

ARCP

  • Requirements for assessments clearly listed on the ARCP decision aid. Asessments consist of curriculum requirements, reflections and WPBAs.
  • Unique to Palliative medicine is the ‘Palliative Medicine reflection form’ – two are required per year. These will include comments from consultant supervisors These are referred to as Records of reflective practice (RRP) on the ARCP decision aid. (Other reflections during the year can be completed on generic reflection forms).  

Reading list

  • Oxford Handbook of Palliative Medicine
  • Palliative Care formulary. Currently 5th Edition.
  • BMJ Supportive and Palliative Care
  • Palliative Medicine journal (via APM membership).
  • Association of Palliative Medicine – Tall trainees are encouraged to join the APM. They publish the Palliative Medicine journal and two yearly Congress.

Diary

  • Training days are monthly and rote between different sites. 
  • Registrars take turns to organise the training day at their own place of work. This includes arranging speakers, venue and sometimes lunch! Trainee rep helps to co-ordinate this and keeps records of attendees and topics.
  • Topics are chosen by the trainee organising the study day depending on the speakers they have access to in their particular area.
  • We try to choose topics that we may not encounter in every day clinical practice or are more non-clinical. Therefore we aim to cover as much of the curriculum as possible.
  • It is the responsibility of the trainee to organise speakers and book an appropriate room for the study day in their place of work (with help from admin support staff for booking).
  • In general January and June training days are in Addenbrooke’s/Arthur Rank Hospice and tend to be about research.  We endeavor to conduct research in small groups led by trainees and supported by consultants.
  • The trainee rep keeps a list of topics covered and attendance and forwards to the training programme director.
Tuesday, 11 June, 2019
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