A Career in Palliative Medicine in the West Midlands

A Career in Palliative Medicine in the West Midlands

What is Palliative Medicine? Palliative medicine is the active holistic care of patients with advanced life limiting illness. The job involves symptom control as well as psychological, social and spiritual care The goal of palliative care is achievement of the best possible quality of life for patients and their families. Often this involves working closely alongside other health care professionals particularly other specialty consultants, clinical nurse specialists and GPs. Palliative Medicine is delivered across a variety of settings including home, hospice, hospital and outpatient clinics.

A Career in Palliative Medicine Palliative medicine is perhaps unique within medicine in that we often deliver care across a variety of settings, maintaining continuity for patients. We are also lucky enough to have time to spend with patients and their families exploring their needs and priorities to ensure we deliver individualised care. We spend time discussing the benefits and burdens of investigations and tests with patients, and where these are not thought appropriate, we need to rely on clinical judgment and knowledge. Strong team working and a supportive work environment are valued by all. Work both in advisory role to hospital colleagues and as the direct decision making clinician within hospices

A New & Expanding Specialty Palliative medicine is a young specialty which is rapidly expanding and is prioritised by government. There is therefore the opportunity to develop and expand services. Consultant posts are often varied in their structure and allow work across several sites, and involvement in teaching and training of many health care professionals. It offers early involvement with strategy and involvement at a board level within both hospice and hospital settings and really makes a difference in setting direction of teams at an early and then consistent profile across consultant career

What does Palliative Medicine have to offer? Palliative medicine involves working as part of a multidisciplinary team delivering holistic care to patients. Essential qualities for a doctor in this field include a background in general medical care, good communication skills, and a flexible approach to problem solving. It is vital to be able to work closely with not only doctors but also other healthcare professionslas such as clinical nurse specialists and AHPs

A Wide Scope of Patient Support & Care Palliative Medicine encompasses much more than care of the dying cancer patient. We are expanding our referral criteria to other life limiting illnesses including COPD, heart failure, and degenerative neurological conditions, and our intervention is coming earlier in the patient journey. There is plentiful patient contact in Palliative Medicine, even as a consultant. We work closely with most hospital specialties and with GPs and often provide continuity for patients across a variety of settings. We are a growing specialty with the opportunity to influence and develop local services. With most on calls from home, the specialty offers a good quality of life to trainees and consultants, as well as the opportunity to train flexibly.

A Challenging Career The Speciality can be emotionally challenging and demanding. A solid background in general medicine and good clinical skills are a must as at times medical tests and procedures may not be appropriate. There is a smaller research base than in other specialties, though many are trying to change this.

West Midlands Training Programme Palliative Medicine is a well established specialty in the West Midlands, with approximately 20 trainees. We benefit from working with experienced and enthusiastic consultants and nurses, with chance to see a culturally diverse mix of patients in many settings. We are a supportive group of registrars and meet once a month for a training day covering diverse topics within the field. The West Midlands houses a diverse population, and experience can be gained in many areas through the four year rotation.

Routes into Training Programme Placements Training can be entered from several routes, the most common being Medicine, General Practice and Anaesthetics. The training programme consists of four years following from core training. It broadly follows the format below although variation is sometimes required. Placements are decided in conjunction with the Programme Director to fulfil each trainee s learning needs.

The Training Programme Curriculum The first year gives a good grounding and helps trainees develop the core skills in palliative medicine. The ST4 and 5 years often consist of two six month placements which give a variety of learning environments. By the time a trainee reaches their ST6 year, they will have gained skills and experience which enables them to deliver palliative care in a variety of clinical settings. The ST6 year therefore focuses on ensuring the trainee develops the senior management and leadership skills which are essential for the consultant role. Throughout training, an educational supervisor gives feedback and ensures that the trainee fulfils their educational needs. Similar to many other medical specialties, there is a Specialty Certificate Exam.

The On Call Experience All jobs have a palliative medicine on call requirement encompassing weeknights and weekends. Most of these on calls can be done from home, though proximity is sometimes an issue. On calls are mainly for hospice inpatient units with the opportunity to give advice to generalist and specialist colleagues via telephone. During on calls, we are often the point of contact for GPs, hospital consultants and CNS team members, answering queries, advising on management and arranging emergency admissions. All units provide senior consultant cover for on calls.

Additional Opportunities Higher Degrees Although this is not compulsory, several trainees complete higher degrees during their time on the palliative medicine rotation. There are several universities which provide Palliative Medicine Masters degree courses including Cardiff and Bristol. Other trainees have elected to study relevant subjects including health care ethics, law, management and medical education degrees. OOPE Trainees have previously used out of programme experience to perform research or to deliver palliative medicine within a resource poor setting. There are consultants with links in the West Midlands to many areas of the world.

Personal Qualities Click link to view personal specification

Where to go for more information NHS health careers JRCPTB specialty page and curriculum ST3 Recruitment RCP (London), Specialty spotlight Association for Palliative Medicine Health Education England, West Midlands All palliative medicine physicians are happy to talk with you and may well offer taster days/shadowing etc. to gain a experience of the varied roles.