This is a four year training programme for palliative medicine, provided in a variety of settings including:
- - In-patient Specialist Palliative Care units / hospices (NHS and independent)
- - Day Hospice
- - District General Hospitals
- - Regional Cancer Centre and teaching hospitals
- - Community-based services.
There are opportunities to experience out-patient work, both new and follow up, and for exposure to oncology, chronic pain services, interventional pain management and related medical specialties required by the curriculum.
Trainees rotate every 12 months to benefit from the experience offered by the different training posts. Currently the changeover takes place in August.
The wide geographical spread of the East of England offers a variety of urban, suburban and rural settings.
The on-call commitment is non-resident throughout the rotation and there is no acute-medicine cover. The frequency of on-call varies from post to post but will be no more than one in five weekends. Some posts require that you cross-cover another hospice nearby when on-call. There may be posts with no on-call commitment.
There are currently separate posts at the following locations; between them these posts offer a varied experience of Palliative Medicine.
Evaluation of the Norfolk & Norwich Hospital Palliative Medicine Education Post - Dr Ben Kennedy SpR
I have been asked to write a brief summary of the training post at the Norfolk and Norwich University Hospital for this website in order to highlight the many opportunities that the job offers registrars training in palliative medicine. As part of the year in Norwich trainees are offered the prospect of enrolling in the University of East Anglia’s postgraduate course in Clinical Education culminating in a Postgraduate Certificate in Clinical Education and fellowship of the Higher Education Academy. This part time course at the University campus (a ten minute walk from the hospital across the University’s playing fields) is fully funded by Health Education England, working across the East of England and comprises three modules taught in a multidisciplinary environment across the entire 12 month posting.
On its own the part-time postgraduate certificate course from the UEA might be reason enough to consider applying for the post in Norwich but it is also worth considering the merits of the remainder of the registrar’s week. The Norfolk and Norwich is a large acute modern hospital with a busy workload for the palliative team. This offers many opportunities both for learning and for teaching that may not be presented at other trusts. The senior palliative staff have worked hard to maintain good professional relationships with the other specialities; consequently referrals can come from all areas of the hospital. The palliative team maintain a regular presence on the oncology and haematology wards and are frequently involved in many aspects of patient care and advance care planning. The team consists of two consultants, a registrar, an experienced staff grade and a part time FY2 doctor, complimented by a vibrant team of specialist nurses. The working relationship between the doctors and nurses within the team form one of its great strengths. On calls for the registrar are as part of a rota held at the local inpatient unit, the Priscilla Bacon Centre, and are non-resident, busy but well supported by the 2nd on call tier when necessary.
The postgraduate certificate from the UEA is taught by an experienced faculty from across the disciplines allied to medicine as well as occasionally by doctors from both the community and hospital settings. The emphasis throughout the course is on learning as an adult and the onus is very much on the student to read and research the required areas rather than be spoon fed and lectured at didactically. The modules are assessed in a variety of ways and learning about the appropriate assessment methods forms part of the course itself. This “learning about learning” and indeed “teaching about teaching” is a recurring theme throughout each of the modules and the resulting reflective nature of the whole process forms a central skill evolving out of the course.
The first module concentrates on continuing professional and personal development. Students develop an understanding of the principles of learning and teaching, specifically within an adult environment, through the use of a reflective diary and a variety of continuing professional development tools. This module highlights the way the course is both structured and run, and in particular introduces students to their respective supervisors who are available for individual support throughout the entire course. It is assessed through the production of a reflective account of the students learning, allowing for a fair amount of flexibility in the manner of the submitted work and hence a great degree of freedom to reflect and learn in a manner most suitable to the individual student.
The second module incorporates a work-based project, again giving the individual student plenty of scope to choose the nature of their particular project. The choices made are representative of the various multidisciplinary backgrounds of the students involved. Students are supported by learning about the various teaching methods and styles, culminating in a videoed session of each student teaching their classmates. Assessment for this module is split between the teaching session’s feedback and an account of the work-based project itself.
The final module for the postgraduate certificate builds on some of the progress made in the second module and asks students to develop a further work-based project, again of the individual student’s design. This project is deliberately open ended with no set time frame involved in its assessment which encourages students to develop real and meaningful pieces of work that might conceivably continue even after the module is deemed complete. Assessment is through a submitted portfolio of evidence that reflects much of the learning throughout the three modules, tying together many of its principles and reinforcing much of the student’s learning.
Overall the placement at the Norfolk and Norwich Hospital represents outstanding value for a training registrar. The hospital team actively support the registrar’s commitment at the university and protected time is offered to allow for self-directed study. The mix of clinical work and study allow for a significant degree of progress to be made as a palliative doctor, not least through the reflective and personal journey resulting from the time at the University. All registrars passing through specialist training are to be the educators of the future, both on a formal basis for their trainees and patients and an informal one as mentors and supervisors throughout their clinical working life. This course provides a sound basis upon which to explore the concepts within medical education that are relevant to our own personal careers. It introduces much of the continual learning and reflective practice necessary for success, all the while exposing the training registrar to a varied and challenging clinical workload that makes this placement a highlight within the palliative medicine rotations offered in Health Education England, working across the East of England