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BMJ India launches three months certification course in palliative care

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Supported by the Narotam Sekhsaria Foundation, the course will help address the dearth of palliative care-trained staff in India

BMJ India recently launched a three months certification course in palliative care in association with the Narotam Sekhsaria Foundation (NSF). The course aims to enable learners to understand and apply the principles of palliative care in chronic and life-limiting illnesses, help them to identify the palliative care needs of the patients, assess and manage pain and other physical symptoms amongst many more important areas. Delivered online, the course content has been developed by national and international experts.

At a course fee of Rs 15000 plus 18 per cent GST, this e-learning course is available for doctors and nurses. The provision for scholarship is also there for candidates who are interns, post graduate medical students as well as NGO workers.

The World Health Organisation defines palliative care as ”an approach that improves the quality of life of patients and their families facing problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psycho-social and spiritual.”

Explaining the need for the course, Prashant Mishra, MD, BMJ India said, “There is an unmet need for palliative care in India. While 5.4 million people need palliative care each year, only two per cent have access to it.” He estimated that there were just 1000 facilities providing palliative care in the country.

In India, and other developing countries, the accessibility to palliative care services is quite low, and people receive palliative treatment quite late in the course of their disease-related suffering.

Dr Simi Kaul, Senior Clinical Editor, BMJ gave details about the course content and how each module has a blend of international and national level subject matter experts.

Explaining NSF’s philosophy, Dr Monique Kamath, CEO, NSF, said that the Foundation believes not just in financial support but also in building capacity of communities and strengthening existing systems.

The NSF supports civil society initiatives in seven sectors, including health, where the Foundation engages with public and private charitable hospitals to elevate the health status of the marginalised and vulnerable sections of society. Within health, cancer care is a focus area of intervention. Drawing the link between the crucial need for palliative care in cancer care, she said, “This is where programmes such as BMJ’s palliative care come in and the reason for NSF’s support for the course.”

“We at NSF believe in building unrestricted capacity amongst healthcare professionals, stepping beyond conventional methods. This course on palliative care addresses the need of the hour and provides seamless accessibility to quality medical education,” said Dr Kamath.

The director of the palliative care course, Dr Naveen Salins, Professor and Head of the Department of Palliative Medicine and Supportive Care, Coordinator, Manipal Comprehensive Cancer Care Centre, Kasturba Medical College, Karnataka spoke about the need for palliative care education in India, and the advantages of the 12 module course. Two more modules will be added soon.

India ranks 67th in the quality of death in a study conducted by The Economist. Dr Salins analysed that this low ranking was due to low demand and low supply based on a lack of awareness among both patients and healthcare providers. He cited several empirical studies that showed that nurses, doctors and pharmacy staff in India had low knowledge and awareness levels of palliative care.

Oncologists too had low awareness of the impact and needs of palliative care to help cancer patients.

About BMJ’s latest offering he said, “We are pleased to be associated with BMJ in starting a certification programme in palliative care that is at par with any international certificate courses. Skills and knowledge in palliative care among health care professionals will go a long way in mitigation of pain and suffering among people with chronic and life limiting illnesses.”

Patient’s perspective of palliative care

Giving a patient’s perspective of palliative care, Dr Mary Ann Muckaden, Professor, Dept of Palliative Care Medicine, Tata Memorial Centre, Mumbai said, “A course like this will help doctors, nurses, healthcare practitioners to understand the palliative care approach. To understand that palliative care is about respecting a patient’s self autonomy and understanding the limits of medical care in a hospital setting.”

She underlined the message that advising patients to opt for palliative care is ethical as it is in the best interests of the patient. She emphasised that the support of GPs is crucial because once an end of life patient is brought home, they will have to support the family with dressings, advice on how to care for patients at homes and hospices.

“If this approach is supported by the medical and clinical fraternity, then palliative care and end of life care will also help keep the cost affordable for patients and their families. We need the support of the doctors, especially GPs, who need to advise patients and their caregivers how and when to opt for palliative care rather than continue with hospital care. Today, caregivers hesitate to take their patients home from hospitals because it will be seen as a lack of care or willingness to spend. GPs and doctors need to counsel the patient and caregiver of the benefits of palliative care and that making such patients feel as normal, wanted and loved as possible and remain an integral part of the family,” said Dr Muckaden. Summing up, she said, public awareness of palliative care has to increase so that demand increases and providers then see the value of providing palliative care facilities.

Other courses from BMJ India

The palliative care course is the third course launched by BMJ India. The first one, a six month certification course in diabetes, was launched in 2016 in association with the Royal College of Physicians and Fortis C-DOC and comprises 48 modules.

Dr Kaul revealed that the diabetes course is being updated based on feedback and a revised version will be launched in 2020, with eight more modules and video content to improve the user experience. BMJ India is also in talks to launch the six month certification course in diabetes across selected countries in Asia.

Ten groups of doctors have completed the course to date. Dr Kaul said that more than 600 professionals from India, Nepal, Sri Lanka and Bangladesh have benefited from this course.

The second course, a three months certification course in chronic kidney disease (CKD) with 12 modules, was launched in 2018. It is accredited by the Indian Society of Nephrology in India and has so far benefited 200 clinicians in India.

Each course is led by global experts like Dr Kieran Walsh, Clinical Director, BMJ Learning and BMJ Best Practice, London, as well as India-based clinical experts lending credibility to the content.

Prashant Mishra, Managing Director, BMJ India and South Asia said “We firmly believe that these courses are essential in helping doctors and healthcare professionals acquire skills to provide quality palliative care to their patients. We are hopeful that healthcare professionals will enroll in this course and undertake this opportunity to further build their skills.”

Mishra also revealed that BMJ India is preparing to launch at least three more new courses in 2020 in areas like rheumatology, respiratory medicine and emerging infectious diseases based on the feedback from the clinical fraternity on which areas had greater unmet need for such courses.

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