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Palliative care education in Swiss undergraduate medical curricula: a case of too little, too early

Service de Soins Palliatifs, University of Lausanne, Lausanne; Service de Médecine Palliative, University of Geneva, Geneva jose.pereira{at}chuv.ch

S Pautex

Service de Médecine Palliative, University of Geneva, Geneva

B Cantin

Service de Soins Palliatifs, University of Lausanne, Lausanne

H Gudat

Hospice, Basel; University of Basel, Basel

K Zaugg

Department of Radiation Oncology, University Hospital of Zurich, Zurich

S Eychmuller

Palliative Care Service, Kanton Hospital, St. Gallen and Palliative Care initiative, University of Bern, Bern

G Zulian

Service de Médecine Palliative, University of Geneva, Geneva

Palliative medicine education is an important strategy in ensuring that the needs of terminally ill patients are met. A review was conducted in 2007 of the undergraduate curricula of all five of Switzerland's medical schools to identify their palliative care-related content and characteristics. The average number of mandatory hours of palliative care education is 10.2 h (median 8 h; range 0–27 h), significantly short of the 40 h recommended by the European Palliative Care Association's Education Expert Group. The median time allocated to designated palliative care blocks is 3 h (range 0–8 h). Most of the education occurs before the clinical years, and there are no mandatory clinical rotations. Three schools offer optional clinical rotations but these are poorly attended (<10% of students). Although a number of domains are covered, ethics-related content predominates; 21 of a total of 51 obligatory hours (41%). Communication related to palliative care is largely limited to ‘breaking bad news'. In two of the schools, the teaching is done primarily by palliative care physicians and nurses (70% or more of the teaching). In the others, it is done mostly by educators in other clinical specialties and ethics (approximately 90% of the teaching). These findings show significant deficiencies.

Key Words: curriculum • end-of-life • palliative • undergraduate

Palliative Medicine, Vol. 22, No. 6, 730-735 (2008)
DOI: 10.1177/0269216308094560


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