Dr. Abhinav Singh, IAPC Central Council member and an experienced palliative care physician, has contributed to the ‘Lexicon’, 24th Edition, ‘The cloak that matters’, in the section ‘Diverging Roads’ which is dedicated to the Deptt. of Palliative Care,CMC, Vellore.

CAREER IN PALLIATIVE CARE: THE FUTURE IS ALREADY HERE – TIME TO RECKON

Dr. Abhinav Singh, Patna.

Introduction: A trained palliative physician is a precious and rare professional in India. Care of terminally ill or those suffering from incurable disease is like a ship in an uncharted sea, seeking some guidance by the light thrown by the palliative care providers. Despite rapid socioeconomic progress there are limitations and challenges in providing palliative care. One of the major challenges is shortage of trained palliative care professional. Due to this shortage, training programme in palliative care needs more attention. This shortage of demand and supply can be assessed from the fact that about 1% of population is able to avail palliative service. Less than 1% of medical colleges are providing specialised training for same and in most palliative care as specialised department is non-existent.

Current scenario for training: Palliative care is naïve to Indian medicine. Unlike other disciplines of medical sciences viz internal medicine, surgery, radiology, obstetrics and gynaecology, psychiatry etc post graduate training is not provided by all medical colleges in India. Medical council of India (MCI) recognised Palliative Medicine as specialised branch in 2010(2). First post graduate training programme was started in second year of second decade of this century at Tata Memorial hospital, Mumbai. The first batch exit exam was conducted in 2015. After one year of exit of first batch of Tata Memorial Hospital first batch admission in post graduate programme was commenced in AIIMS, New Delhi. At present these two institute are providing post graduate degree.

There are many institutions and organisations nurturing palliative care providers. Institutional Fellowship in palliative medicine is provided by Christian Medical College, Vellore. Training is onsite one-year residency programme. One of the benefits of training at institutions like Christian Medical College, Vellore, Tata Memorial Hospital,Mumbai and AIIMS Delhi is exposure to diverse group of patients. These institutes care of patients from all over India, adding to versatility of patient disease and complications.

DIVERGING ROADS

As a part of comprehensive primary health care across country government is willing to collaborate with private sector through health and wellness centre. Partnerships with special emphasis for palliative services is under consideration. Overall national health policy is providing new platform for the palliative care provider to grow, flourish and serve needy.

Prospects for Palliative Care provider: In country like India where less than 1% of population is able to assesses Palliative care has vast potential to grow as career. Many well-established specialities have more competition and less opportunity. Contrary to which palliative care has less competition and more opportunity to work. Being Naïve in the medical world, gives ample opportunity for growth. In end remember “rare gem is always precious” and palliative care provider is one of those gems in world of medical sciences.

References:

1. Rajagopal MR and Joranson DE. India: opioid availability – an update. J Pain Symptom Manage 2007; 33:5: 615-622

2. Salins N.: Specialist palliative medicine training in India. Indian J Palliat Care 2015:21:257

3. Prospectus of Christian medical college Vellore – http://www.cmch-vellore.edu/SITES/Education/prospectus.pdf

4.Official website of pallium india – https://palliumindia.org/courses/

5. Official website of The Bangalore Hospice Trust (BHT) – Karunashraya https://www.karunashraya.org/

6. Salins N. The Indian College of Palliative Medicine: A concept in evolution. Indian J Palliat Care 2017;23:353-4

7. National health policy 2017 , https://mohfw.gov.in/documents/policy


For more articles by doctors M R Rajagopal, Robert Twycross and Reena George, kindly log on to the following link: http://www.lexiconin.com/latest-edition/

About the author: Dr Abhinav Singh is palliative physician from Patna, Bihar. He completed one-year fellowship in palliative medicine from Christian Medical College, Vellore. He is member central council, Indian Association of Palliative Medicine.