February 25, 2016 has become a significant milestone for the implementation and development of paediatric palliative care (PPC) in Portugal as the first class of the first undergraduate optional curricular unit on PPC for medical students of one of Lisbon’s Medical Schools took place!
The challenge of organising this unit was given to Dr Ana Lacerda by Prof Maria Teresa Neto, Chair of Paediatrics at Nova Medical School, as part of the 5th year curricular review and renewal. (In Portugal, medical education and training takes 6 years.) Dr Lacerda is a paediatric oncologist with an MSc in Palliative Care from King’s College London / Cicely Saunders Institute . Since 2012 Dr Lacerda has been a champion for PPC in Portugal.
The Educational Council of the School promptly accepted the contents and organisation of the unit, which comprises classes on the basic principles of PPC, service organisation and provision, care planning and coordination, ethics, peri and neonatal care, symptom control, communication with the child and family, grief and bereavement.
Although currently there are no paediatric hospices or specialised PPC teams in Portugal, plans are in place for the students to interact and care for severely ill neonates, including a death-in-the-NICU and bereavement programme, at the Hospital Sao Francisco Xavier. They will also spend time caring for children with neurological disorders and other complex healthcare needs at Lisbon Children’s Hospital, Hospital Dona Estefânia.
The students will visit and learn from not-for-profit organisations which help support children with palliative care needs in the community. These being ACREDITAR, the national association for children with cancer, which created a home volunteering programme in Lisbon and Oporto, “Arco-íris – Rainbow” and Fundação do Gil, a charity that designed and supports most of the existing paediatric home care teams in Lisbon and Oporto and the UMAD “unidades móveis de apoio domiciliário” – home support mobile units.
The students will also become familiar with the palliative care needs and care planning for children with cancer at the Paediatrics Department of the Portuguese Institute of Oncology, Lisbon Centre.
Little Stars film
The first class included a viewing of the movie “Little Stars – accomplishing the extraordinary in the face of serious illness”, which helped set the mood for the unit and sparked mixed feelings of sadness and joy (for becoming part of the much needed change).
When preparing the proposal for the Medical School, Dr Lacerda set a minimum of 6 and a maximum of 10 students for the unit to take place. It was a wonderful surprise to learn that this was the first optional unit to close for enrolment and that many more students were interested in taking it! The 10 delightful young women who were lucky to get the places have different reasons for attending the unit – some want to become paediatricians, others want to be general practitioners, internists or public health doctors, but all share the same desire: to learn about this area of care that until now had been forgotten in Portuguese healthcare professions undergraduate curricula.