In India, formal academic pursuits in Palliative Care have achieved a major goal in 2012 by the launch of the MD programme in Palliative Medicine at Tata Memorial Centre, Mumbai. After getting approval from the Medical Council of India, the programme was started in July 2012 with two students enrolling into the programme. Nisha Krishnadas, editor of the India edition of ehospice, interviewed the two young doctors.
Q: What motivated you to choose MD in Palliative Medicine?
Dr. Arunanghu Goshal and Anuja Damani:
Most of the patients with no option for curative treatments are always neglected in our country. India, being a highly populated country, has a lot of scope to develop effective palliative care services. Being an MD in palliative medicine provides us great opportunities for developing and spreading awareness of such programs.
Q: Did you have any exposure to Palliative Care before joining for the MD programme?
Actually no. But after joining the course, we felt more motivated towards the subject. Now, we are indeed happy about choosing the subject.
Q: What is your future plan? Would you continue to practice in palliative care?
Of course. We plan to work with palliative medicine. There is ample scope for research and development in this branch in this part of the world especially because we are a step behind the rest of the world in terms of resources.
Q: Since you have decided to continue in the field of palliative care, what you think that makes you different from other doctors practising in various other specialities?
Instead of focusing on particular diseases, we try to consider the total care of patients and their families by focusing not just on the physical symptoms but on the psycho-socio-spiritual issues as well…As you know, these are often being taken care of otherwise.
Here we treat patients with incurable diseases in a different way to offer a better quality of life for them. One of the patients we have seen recently is a lady, 60 years old, from middle socio-economic strata with CA ovary. She presented with a past history of sub-acute intestinal obstruction. Over a span of 3 years she had to undergo 6 cycles of chemotherapy.
She and her family members just wanted to know her future prognosis on her first visit to us.
As in many other cases, cancer was a taboo in her family; ripping her off the love and proximity of her beloved grandchildren. So, after proper set-up and counselling, she was told about her prognosis and physical symptoms were well taken care of. Family was also counselled. A month and a half later, the lady came herself with her daughter and grandchild to the hospital. She seemed to have accepted the progressive and incurable nature of her disease and was relieved from physical discomforts. So, with minimum physical disabilities and a better quality of life she looked satisfied.
Q: Do you like to share the importance of palliative care training with the young doctors in India?
Happily of course. There is a great need to inculcate the principles of palliative medicine among the undergraduates so that more and more young doctors become aware of this essential branch and can enrol for similar academic programmes. We feel that it is necessary to include palliative concepts in MBBS curriculum as we lag a lot in such services. We have to improve in it as well. It should be added as a separate section along with internal medicine as it forms an inseparable part in the “total care” of the patient.