About the Course
Palliative care is an interdisciplinary medical care giving approach aimed at optimizing quality of life and mitigating suffering among people with serious complex illnesses. The principles of palliative care should be applied as early as possible to any chronic and ultimately fatal illness and should work in tandem with the curative treatment.
End of life care is an important component of palliative care. Although in most instances, palliative care is provided towards the end of life, it is not limited by the condition of the patient as, its main focus is to improve the quality of life in a patient with a chronic illness. The common conditions where palliative care is usually applicable include cancer, HIV/AIDS, congestive cardiac failure, COPD, multiple sclerosis and other neurodegenerative conditions.
In Sri Shankara Cancer Hospital and Research Centre, the Fellowship course in Palliative care, lasting 12 months will mainly focus on cancer patients with Symptoms assessment, End of Life care, Pain, Distress and Anxiety, Nausea and vomiting, Hydration and Nutrition. It will also expose the candidate to the approach of working in a multidisciplinary team and will create an awareness of all the medical and non-medical ways of disease management, communication skills, decision making skills, procedure skills related to palliative medicine, ethical practice, leadership, teaching and research.
At the completion of the Specialist Training Program in Palliative Medicine, as defined by this curriculum, it is expected that the postgraduate trainee will have acquired knowledge base, attitude and clinical skills required for competent palliative medicine practice.
It is expected that a trainee who has completed 12 months of specialist training and has passed the theory and practical examinations will be able to:
1. Explain pathophysiological basis of pain and other physical symptoms, use appropriate clinical assessment methods, rationally choose required investigations and provide relief of pain and symptoms by pharmacological and non-pharmacological methods.
2. Explain role of psychological, emotional, social, spiritual and existential issues in illness, suffering and symptom manifestations, able to assess these issues clinically using appropriate assessment methods and manage these issues by self, help of multi-disciplinary team and by referring to relevant specialists.
3. Explain the experience of illness and suffering in the socio-cultural context of the patient and families. Able to understand the meaning of illness, its impact and consequences to patient and family.
4. Able to make expert clinical decisions on symptom control, supportive care, options available for disease management, encourage shared decision making with full consideration of patient/families preferences, value systems and beliefs and facilitate good clinical decision making.
5. Able to provide good supportive care in patients with advanced life limiting illness and able to manage concurrent illness, complications, co morbid illness and emergencies
6. Able to understand natural history of illness, illness trajectory and course, transition points and has complete knowledge of available disease management options relevant to a patient in Palliative Medicine setting.
7. Able to provide specialist palliative care in all clinical setting i.e. outpatients, ward, home, hospice and as consultation liaison
8. Able to recognize the terminal phase, recognize the dying process and end of life needs, participate in effective end of life decision making with colleagues/peers, communicate effectively with the family, plan and provide good end of life care.
9. Able to communicate with the family in a sensitive and emphatic manner, able to communicate bad news, able to deal with difficult and advanced communication situations. Able to communicate effectively with the peers, supervisors and other members of the team.
10. Able to develop, maintain good rapport/therapeutic bonding with patients and families a relationship that is based on understanding, trust, empathy and confidentiality.
11. Able to work as a member of the team in a multidisciplinary team, respect opinion of others, provide leadership and work in a coordinated manner to achieve common goal
12. Able to mentor and supervise junior doctors, maintain active interest in academics and exhibit high level of teaching
13. Able to undertake research in palliative care, conduct observation studies, RCT and clinical audits.
14. Able to manage human resource, financial, quality assurance, data management, and administrative aspects of his/her own practice or palliative care service. Able to allocate resources effectively.
15. Able to manage his/her own time and resources effectively in order to balance patient care, professional development, managerial and administrative duties, learning needs, and personal life.
12 months. Affiliated with Rajiv Gandhi University of Health Sciences (RGUHS).
The Fellow will work with a multidisciplinary team consisting of Physicians, Nurses, Physiotherapists, Psychotherapists, Dieticians, Social workers and spiritual consultants to provide palliative care. The trainee will be delivery the care in 3 types of settings hospital wards, out patient and domicilliary care.
Support from the Institution
1. Stipend as per standard norms
2. Twin-sharing on campus accommodation (nominal charges)
3. Access to full-fledged library – print and digital
4. Continuous peer monitoring and support
5. Periodical assessment and mentorship
6. Rigorous academic schedule with participation in latest scientific developments
7. Nationally & Internationally recognized faculty and facilities
Dr. Vinod N K
Dr. Prashanth Putran
Dr. B.S. Sunitha