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41 Forty years of palliative and end of life care teaching: a retrospective and an update
  1. Thomas Weetman,
  2. James Brimicombe,
  3. Jane Gibbins,
  4. Paul Paes,
  5. Steven Walker and
  6. Stephen Barclay
  1. University of Cambridge, Royal Cornwall Hospitals NHS Trust, Newcastle University, St Giles Medical London and Berlin


Background Palliative and end of life care (PEOLC) is now a core competency for all UK graduating medical students. In 1983, a UK-wide survey investigated how PEOLC was being taught in medical schools. A similar survey has been conducted every decade since, in 1994, 2000, 2013, and now 2021. This paper presents 2021 survey data, providing an overview of current national practice and historical comparison over the last forty years.

Method An anonymised web-based 46-item questionnaire was sent to the PEOLC Teaching Lead(s) at 35 UK medical schools. Results were compared between all previous surveys.

Results Responses received from 32 schools. Time allocated to PEOLC teaching continues to increase, with mean hours (1983, 1994, 2000, 2013 and 2021) being 6-h, 13-h, 20-h, 36-h, and 39-h respectively. There is greater focus on clinical experience than before (in 1983 hospice visits were usually optional and rarely offered), with medical students spending more time in relevant clinical environments. However, in 38% of schools students are allocated less than one week (average 2 days) in total to attend clinical areas relating to PEOLC. The number of PEOLC teaching topics addressed in each survey has increased (respectively 8, 15, 19, 21, and 29 topics) and are reported to be covered in greater detail. Assessment of PEOLC teaching has evolved from informal student feedback to the use of formal examination (respectively 0%, 22%, 58%, 83%, and 91%).

Conclusion PEOLC has grown to become a mandated subject with its own widening curriculum. The quantity and quality of medical school PEOLC teaching has increased over the last forty years, with students spending more time meeting patients with palliative care needs. There is however great variability in what is provided, and recent literature on the preparedness of new doctors suggests that there is still considerable room for improvement.

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