Medical students should receive more end of life care training

Categories: Education.

As reported in The Independent yesterday (13 July), the study found that thousands of new doctors qualify to practise medicine without the skills or training to give frail elderly patients the respect and treatment they deserve.

Some medical undergraduates receive as little as 55 hours of specialist training in this field over their five-year courses.

The study, published in full in Age and Ageing, included a poll of British medical schools and found that there is a “consummate mismatch between the proportion of the medical workloads made up by diagnosis and management of frail older people and the amount of undergraduate teaching devoted to it.”

The report’s author, Dr Adam Gordon, a consultant and lecturer in medicine of older people at the Nottingham University Hospital, said: “Many of the difficulties we have faced in the past 10 years around the management of frail elderly patients are caused by inadequate communication, poor recognition of problems and by difficulties around communication around end of life, resuscitation and dementia.” The main reason, he said, was “a consequence of the fact that doctors are not receiving the right sort of training at the right sort of intensity.”

Marie Cooper, Nurse – Practice Development Lead at Help the Hospices, responded to the report by saying: “The NHS urgently needs to invest in more training for doctors and other healthcare professionals work in hospitals to enable them to provide better quality care for frail older people – including those approaching the end of life – and their families. There will be much greater demand for this type of training in hospitals in future given the expected surge in the number of older people in the UK over the coming decades.

“Increasing awareness about the needs of older people among doctors needs to start early on, so we welcome the call in this report for more teaching on ageing and geriatric medicine to be included in medical training.

“Hospices have long-standing expertise in supporting older, dying people and their families and are increasingly supporting frail older people living longer with complex health conditions. Hospices have worked successfully in partnerships with hospitals to improve practice among nurses in caring for older, dying people and a similar model could be developed for doctors to improve quality of care for frail older people.”

Commenting on the new report, Norman Lamb, Care and Support Minister, said: “There is nothing more important care for the elderly in hospital and end of life care. This is precisely why I challenged the system by establishing the independent review of the Liverpool Care Pathway and oversaw the new priorities for care guidelines. It is true this area has been neglected in the past … with stories of lack of compassion being a key issues as well as families not being kept informed and not involved in decision making. Now, though, we have a real opportunity to establish a standard of care for the frail elderly, across the board.”

The full paper can be read on the Age and Ageing journal website.

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