Palliative medicine provides holistic medical care to people with advanced, progressive life-shortening illnesses (both cancer and non-malignant disease). It focuses on improving the quality of life of the person though physical symptom control, psychosocial support and spiritual care. An excellent knowledge of patho-physiology & pharmacology along with high level communication and decision making skills are required to be able to support symptom control and future care plans tailored to a person’s wishes and needs. The multi-perspectival approach of palliative medicine means that a desire to work as part of a multi-professional team and ability to liaise closely other specialties is essential. The ability to support and care for people (and those important to them) who are living with the effects of life-shortening illnesses means that palliative medicine can be an incredibly rewarding speciality to work in.
Palliative medicine training in Wales is delivered across three regions: North Wales, South West Wales and South East Wales. Trainees are based predominantly in one of these three training regions through the course of the training program. Training starts in a specialist palliative medicine inpatient unit or hospice before moving to the hospital hub for general medicine training. The trainee will then move to a Hospital palliative medicine attachment in the same hub. Further placements in palliative medicine in each region will involve community sites and regional oncology units including Velindre University Hospital NHS Trust, Singleton Hospital, Swansea Bay UHB and Glan Clwyd, North Wales. General medicine is woven throughout the training programme in the form of a consistent ongoing monthly clinic commitment, educational training days and on call at the hub hospital. Palliative medicine skills are maintained throughout the general medicine component of training through palliative medicine clinic commitment (with the hospital palliative medicine team) and palliative medicine study days.
Some specific elements of the Welsh training programme include understanding the role of interventional pain management through close links with local interventional pain teams and the management of young adults transitioning from paediatric to adult services. Close links with the Marie Curie Research centre enables interested trainees to pursue diverse research opportunities, in addition to clinical leadership opportunities with HEIW itself. There are opportunities to develop teaching and management experience throughout the programme including through established connections with universities throughout Wales delivering undergraduate and postgraduate education and through opportunities that arise working in the both the third sector and in NHS organisations.
Palliative Medicine is a group 1 specialty and on completion of training doctors will be dual accredited in medicine and palliative medicine. Trainees in palliative medicine in Wales have a single lead employer within the NHS although they may move between different hospital and voluntary/3rd sector sites.
With a beautiful coastline, spectacular mountains and vibrant cities, Wales has something for most people. The structure of training in Wales gives trainees experience working in palliative multidisciplinary teams across acute hospitals, cancer centres, inpatient units, and the community setting along the M4 corridor and North Wales. If you choose carefully you can live in one location throughout your entire training. There are unique training opportunities for example working as part of the cancer associated thrombosis clinic, the supportive heart failure team and attending motor neurone disease and other specialist clinics. All rotations include an active non-resident on-call experience, where you see and manage hospice inpatients, and take advice calls from ambulance crews, and primary and tertiary care colleagues. The clinical experience is supported by the consultant team, who take an active interest in registrar training. As you progress through your training leadership and management opportunities develop in preparation for life as a consultant.
Every placement has opportunities for teaching, including medical student attachments, junior doctors, colleagues in other specialties and departmental level multidisciplinary sessions. We have a 6 weekly registrar teaching programme, which also provides the chance for networking and socialising.