Position paper on undergraduate Palliative Medicine education for doctors in South Africa

Abstract

Background: Basic palliative care teaching should be included in training curricula for health care providers (HCPs) at all levels of the health service to ensure that the goal set by the South African (SA) National Policy Framework and Strategy for Palliative Care, to have an adequate number of appropriately trained HCPs in South Africa, is achieved. Furthermore, palliative learning objectives for nurses and doctors should be standardised. Many SA medical schools have integrated elements of Palliative Medicine (PM) teaching into undergraduate medical training programmes for doctors; however, the degree of integration varies widely, and consensus and standardisation of the content, structure and delivery of such PM training programmes are not yet a reality.Aim: This joint position paper aims to describe the current state of undergraduate medical PM teaching in South Africa and define the PM competencies required for an SA generalist doctor.Setting: Palliative Medicine programme leads and teachers from eight medical schools in South Africa.Methods: A survey exploring the structure, organisation and content of the respective medical undergraduate PM programmes was distributed to PM programme leads and teachers.Results: Responses were received from seven medical schools. Through a process of iterative review, competencies were defined and further grouped according to suitability for the pre-clinical and clinical components of the curriculum.Conclusion: Through mapping out these competencies in a spiralled medical curriculum, the authors hope to provide guidance to medical curriculum designers to effectively integrate PM teaching and learning into current curricula in line with the goals of the SA National Policy Framework and Strategy on Palliative Care (NPFSPC).

The influence of context on the implementation of integrated palliative care in an academic teaching hospital in South Africa

“…Many senior clinical leaders have received little to no PC training in South Africa. 45 , 46 These individuals are the clinical decision-makers and leaders in the wards. Junior PC-trained colleagues have recognized that it is difficult to initiate a PC approach when the decision-makers do not support this approach.…”

What do medical students and their clinical preceptors understand by primary health care in South Africa? A qualitative study

“…However, in Africa there is still shortage of doctors and nurses with adequate skills and training in palliative care [ 61 ], impacting on student training. Burger et al, in their recently published position paper on undergraduate palliative medicine education for doctors in South Africa, have remarked on the lack of consensus and standardisation of the content, structure and delivery of palliative training programmes in South Africa [ 62 ].…”

Paediatric palliative care for the generalist

“…Palliative care and especially paediatric palliative care remain a neglected area of medicine with few healthcare providers having any formal training in South Africa. 1 According to a collaborative study by the United Nations International Children’s Emergency Fund (UNICEF) and the International Children’s Palliative Care Network, less than 5% of children with palliative care needs in South Africa, receive it. 2 While palliative care can be provided in any setting, 3 it is most likely that children will be down referred to facilities nearer home when curative interventions are no longer appropriate.…”