INTEGRATING PALLIATIVE MEDICINE INTO MBBS UNDERGRADUATE CURRICULUM
From 2019 onwards, the MCI has revised the MCI curriculum and has introduced several new topics relating to palliative medicine. It has introduced an entirely new section called AETCOMS (Attitude, Ethics and Communication) which has aspects related to principles and practice of palliative care. The topics relate to managing pain and symptoms, principles of palliative care, ethics and decision making, end of life care and communication skills.
Dr. Sushma Bhatnagar and Dr. Naveen Salins identified the topics related to palliative care by screening through all years of MBBS curriculum. The set of topics identified through screening was presented to Dr. Vinod K Paul, Chair of the Board of Governors of Medical Council of India. It has been approved by the chair of MCI that these topics are palliative medicine related topics and preferably taught by the palliative medicine professionals when available.
We must congratulate Prof V. K. Paul and his team for this achievement. This was long awaited. We hope we will produce doctors who will have knowledge of holistic care of patients full of compassion, empathy and humanity.
The link to the AETCOMS curriculum can be found here: https://www.mciindia.org/CMS/information-desk/for-colleges/ug-curriculum
Palliative Care program started in all six AIIMS of the country and many more leading medical Institutions
The All India Institute of Medical Sciences (AIIMS) is in collaboration with the Asia Pacific Hospice Palliative Care Network (APHN) to provide a Palliative Care Training Program aimed at Cancer Treatment Centres (CTCs) in India. This has the support of the Ministry of Health and Family Welfare, Government of India (MOHFW) as part of the implementation of the National Program for Palliative Care (NPPC) of the Government of India, which mandates that all institutions dealing with cancer and non-communicable diseases have palliative care services.
The program has four important outcome criteria, to begin with, at the end of one year the Institute should start:
- Regular Out-Patient Services for Pain and Symptom Management.
- Should have an uninterrupted supply of Oral Morphine for intractable cancer pain management.
- Should start consultative services in the whole of the respective institute for all those patients suffering from a chronic debilitating condition and need help.
- Must integrate Palliative care education in medical and nursing curriculum.
The training is taking place over 12 months. There is a total of 19 training days comprising of:
- a 5-day centralized Foundation Course,
- a 5-day clinical attachment at AIIMS, Delhi
- ongoing mentoring by email & teleconferencing
- 2 x 3 days of follow-on clinical training at the respective CTCs
- a 3-day centralized follow-on training (Refresher Course)
The master trainers and mentors are expert palliative care physicians and nurses in India who are part of a team supported by international faculty from Asia Pacific countries such as Australia, Singapore and the United Kingdom. The curriculum will cover pain and symptom management, communication skills to enable participants to give psychosocial support to patients and their families, ethical issues at the end of life, how to start and manage palliative care services in different settings of care, monitoring standards and auditing treatment outcomes.
On completion of training, the teams will enable the CTC to achieve Recognized Medical Institute (RMI) status for the procurement, storage and dispensing of strong opioids needed for pain and symptom control, according to the amended Narcotics Drugs and Psychotropic Substance (NDPS) Act.
To strengthen this program further AIIMS, New Delhi started combined teaching program through telemedicine services in all six AIIMS of the country. Every Friday at 8-9AM AIIMS, New Delhi is conducting seminars on topics related to Palliative Medicine and there is live telecast of the lectures to all six AIIMS of the country. Any Institutions where telemedicine facilities are available can join this continuum Medical Education program by sending a request to Director’s AIIMS with a copy to Dr Sushma Bhatnagar. Recently Manipal Institute of Medical Sciences has joined hands to strengthen this program.
We are grateful to AIIMS, administration, Mr Lee Poh Wah, CEO of Lien Foundation, Dr Cynthia Goh, and our Brilliant faculty Dr Jeremy Johnson, Dr Santosh Chaturvedi, Dr Naveen Salins, Dr Anjum Joad, Dr Priya Kulkarni, Dr Charu Singh, Dr Seema Roa, Dr SPS Rana, Dr Roopesh Jain, Dr Savita Butola, Dr Mayank Gupta, Dr Aditi Chaturvedi, Sister Stella, Sister Govindi, Sister Nelimma Shinde and many more.
AAHPM Annual Assembly at Orlando, Florida
Dr. Mohd. Yunus Khilji from Bikaner, an active member of IAPC, Dr. Sunil Kumar M. M. from Pallium India and Dr. Spandana Rayala from Hyderabad represented India at AAHPM Annual Assembly at Orlando, Florida, USA from 13th to 16th march 2016. They were selected as international scholars by AAHPM to represent their country and speak about status of palliative medicine in their respective regions.
There were many scientific sessions particularly focusing on quality of delivered care and other important topics in palliative care. There was a session on last day which was focusing on last year’s research to come up with some recommendations on certain topics.
Dr Sunil Kumar spoke about community based Palliative care model of Kerala and global collaboration of Pallium India, Dr Spandana about hospital based palliative care and global research partnerships and Dr Khilji about partnership with unique CTC program in India and efforts to develop MD program at SP Medical College Bikaner.
Bright Spot in Jammu & Kashmir
The first Palliative Care Center for cancer, terminally ill patients inaugurated at District Hospital, Gandhi Nagar, on 12th March.
First center for Palliative care programme and treatment of cancer patients was inaugurated by Principal Secretary,Health and Medical Education, Atul Dullo at district hospital, Gandhi nagar in Jammu.
Dr. Rohit Lahori, Head of Center and Pain treatment said that this is the first center that would provide palliative care to patients with cancer. The center would be treating patients suffering from cancer and terminally ill on daily basis. The centre has an attached 10 bedded ward with state of art facilities and trained staff from the Govt. Hospital, Gandhi nagar, Jammu would be deployed here. It has been set up under the national palliative care programme, AIIMS, New Delhi, in collaboration with the Union Health Ministry APHN, Singapore. He added further that the power pf healing does not lie in just prescribing drugs and medical treatment and that caring is what is essentially required.
Apart from cancer it deals with diseases like HIV/AIDS, dementia, stroke, end stage and renal diseases as well.
Courtsey: The Kashmir Monitor. For more details visit: http://www.thekashmirmonitor.net/jk-gets-its-first-palliative-care-center-for-cancer-patients/amp/
A booklet on Procedural Guide for Limitation of Life Sustaining Treatment and End of Life Care was be released by Dr. B. N. Gangadhar, Director of NIMHANS and Member Board of Governer, Medical Council of India on 24th March Sunday 9:30 AM, University Senate Hall, Manipal Academy of Higher Education.
PRESPECTIVE: My interest in Palliative Care. Why? Find the purpose and the means follow.
Before Life Ends, Understand and Evaluate the Choice of Medical Treatment offered Methodised Action Plan for Limitation of Life-Sustaining Treatment and End of Life
Mr. K. V. Ganpathy, Volunteer Counseller, TMH, Mumbai
As a unit of family care giver, seeing your sibling go through physical and psychological distress is indeed too overwhelming.
I can say this, as I had the misfortune of playing the role of care giver to my sister who died of cervical cancer way back in 1999. The illness spanned for four months, from diagnosis on June 26th to her death on November 1st.
But the suffering of these four months left its mark for life time. Also, as a clinical psychologist, I realized how dimension of one’s personality has its take on illness. The person referred here was my sister, highly social in nature with food and feeding as prime passion. To see the disease restricting her fundamental desire, only added to the distress of the patient and the care givers. I had absolutely no idea that there could still be ways to help a patient and address these distresses.
That is when I decided my calling to help those afflicted by cancer, in my own little way. When I say this, I fully understand the scale of help one individual can offer to a person afflicted by enormity of the disease.
However, true to the belief that ‘if one finds a purpose, means follows’ and that is exactly what happened to me.
In the November of 2011, after due considerations, I chose to head one of the NGO’s called JASCAP (Jeet Association for Support to Cancer), primarily into cancer education and financial assistance to patients. The NGO has its office in Tata Memorial Hospital, Parel, Mumbai. As an academician, I always believed in the power of information and hence I was able to identify with the organization’s goal of educating cancer community.
The NGO has to its credit app 200 titles of various kinds of cancers, some of them in different in Indian languages ranging from Hindi to Assamese.
By sheer coincidence, I was introduced to the department of Palliative Medicine of the hospital where I saw the families and patients going through similar suffering that I could easily identify with. From then there was only moving forward to helping the department advocate the palliative care services through various interventions, one of them being an active counsellor.
Since then, for about 8 years I have been counselling patients and family caregivers, of Tata Hospital, both paediatric and adult. I have further made myself aware about different dimensions of help to palliative patients through my participation in the IAPCON all these seven years.
Moving ahead, I helped the department run two Home Care services, one out of hours, and one regular plus out of hours, providing financial support to patients and free ambulance service and providing educational support to children of the patients, both deceased and surviving.
That apart I have also been actively participating in the volunteers / doctors six weeks training programme by delivering sessions on some of the psychological and counseling issues. Actively followed up with resource persons for getting their chapters to form a composite syllabus for the volunteers training programme. Conducted a sixteen hours pilot programme at CIPLA Pune from January 5th to 8th, 2019.
My goal is to rope in more community support for sustaining the pall care services throughout Mumbai at least. In the entire process, I have received significant encouragement from the doctors of the department and my counsellor colleagues.
Today as a member of Central Council, my objectives are:
- Find opportunities for running more training programmes for volunteers.
- Creating a network that can help family rehabilitation.
Students Association of Palliative Care
4th National Conference 16, 17, &18 August 2019, Thrissur, Kerala
Pre-Conference on 2019 August 14th & 15th, 2019.
Theme: “Rehabilitating the Physically Challenged”
Students Association of Palliative Care, an initiative of Alpha Charitable Trust, the parent organization of Alpha Palliative care, has been mobilizing students, teachers and youth for Palliative Care, from October 2006. The Initiative has achieved its initial objective of enhancing awareness and commencing small projects in the educational institutions through Palliative Clubs. The geographical reach is now increased to cover many states in India and Gulf Countries.
Objectives of Students Association of Palliative Care
SAPC has a mission to make youth aware of the compassionate needs of the community;
Offers opportunities to students to serve the community without discrimination irrespective of cast, creed, race, religion and political affiliation;
Inculcate the qualities of leadership in Palliative Care and Social Service in India;
Change the outlook of the community towards the people suffering from pain and distress especially those at the bottom of the socioeconomic pyramid;
To transform the youth as a corrective and unifying force based on mutual love, respect, understanding and selflessness.
We are pleased to announce the 4th Conference of Students Association of Palliative Care (SAPC), the one and only Students Association dedicated to Palliative Care! The conference will be held in Thrissur in Kerala on August 16th, 17th, and 18th, 2019. The pre-conference workshop will be on August 14th and 15th, 2019.
The national and international delegates must participate in the pre-conference workshop which will give them an opportunity to participate in the “homecare visit” of different Alpha link centers.
SAPC Conference will have various competitions to enhance the awareness and increase the student’s participation. The conference proceedings has started with launching of SAPC Conference Logo at Punarjani Karunya Sangamam conducted for the physically challenged patients on December 31st.
Competitions with the theme will be held during the 4-month period starting from May 2019 and run up to the SAPC Conference in August 2019.
For further details of participation, kindly contact:
Please click the link to learn about the history and evolution of SAPC: SAPC EVOLUTION & HISTORY Youtube video link.