Researchers have found a significant proportion of U.K. medical students expect palliative care to be less satisfying than other specialties. During their careers, all doctors will be involved in the care of the dying, and this is likely to increase with current demographic trends. The study was published online in BMJ Supportive & Palliative Care.
Future doctors need to be well-prepared for this," they add. "Little is known about medical students' expectations about providing palliative care. To investigate, they had 1,132 first-year students (61% women) and 780 final-year students (62% women) at 15 U.K. medical schools complete a voluntary online questionnaire; response rates were low, at 30.4% and 21.3%, respectively. The questions came under three headings: doctor's responsibility, psychological impacts, and negative personal impact.
Overall, 19% of first-year and 16% of final-year students expected palliative care to be less satisfying than other areas of care. Men and first-year "standard entry course" students were significantly more likely to find palliative care less satisfying. "At the start and end of training, a significant minority of medical students expect palliative care to be less satisfying than other areas of care," the researchers write.
They note that these students were more likely to be men who recognized the importance of palliative care but were concerned about its negative personal impact. Dr. Laura Shoemaker, director of Palliative Medicine at the Cleveland Clinic in Cleveland, Ohio, told Reuters Health by email, "The authors highlight the increasingly unmet need for more palliative care specialists, and that attitudes formed during medical education will likely influence the future palliative care workforce."
Dr. Shoemaker, who not involved in the study, said, "Caring for dying patients is an essential skill for any physician and an area deserving of increased attention." Dr. Holly G. Prigerson, co-director of the Center for Research on End-of-Life Care and the Irving Sherwood Wright Professor of Geriatrics at Weill Cornell Medicine in New York City, echoed Dr. Shoemaker's assessment.
The authors are attempting to elicit medical students' expectations and attitudes about 'palliative care,' but the focus of the survey is limited to end-of-life care," by noting that end-of-life care is an essential component of specialist palliative care. A duty but a privilege for physicians to care for patients at all stages of their lives.
They have a current serious shortage of palliative care clinicians, with demand outstripping supply, so there's a need to address what persuades or dissuades medical students from wanting to deliver palliative care," Dr. Prigerson. Dr. Shoemaker said the study's limitations include equating palliative care with end-of-life care, a bias toward negative attitudes and a modest response rate.