Introduction
Palliative medicine is a specialty of the Royal College of Physicians that involves providing comprehensive care for patients with life-limiting illnesses and their families. You will encounter a wide range of illnesses and complexities during a period when patients and their loved ones are most vulnerable. To excel in this field, trainees must develop essential skills in symptom assessment and management, psychological support, and practical assistance for individuals with various complex conditions. Training in palliative medicine encompasses multiple settings, including: inpatient hospices, liaising with hospital teams from the emergency department to general wards, patients’ own homes, and more. While challenging, working in palliative medicine offers the unique opportunity to enhance the quality of life for patients and their families. Effective palliative care also demands close collaboration with a multidisciplinary team. Individuals who excel in communication, teamwork, quick decision-making, and applying pharmacological knowledge to complex problems are encouraged to pursue this specialty.
As of August 2022, palliative medicine is classified as a Group 1 specialty, and the training program leads to a dual-accredited CCT in palliative medicine and General Internal Medicine (GIM). The Thames Valley deanery’s palliative medicine training program spans four years, including two six-month blocks of GIM to fulfill the 12-month GIM training requirement for the CCT.
Entry into this four-year program occurs at the ST4 level through the National Recruitment process, following appropriate internal medicine training and post-graduate membership examinations.
The program offers placements in Oxfordshire, Berkshire, and Buckinghamshire, providing training opportunities in various settings, including both NHS and independent providers.
For further information, please contact:
Training Programme Director (TPD) Dr Matthew Carey: matthew.carey@ouh.nhs.uk
Specialty Trainee Representative This is a rotating post. Please contact the TPD for contact details.
Palliative Medicine Training in the Thames Valley
The training program spans four years, integrating both palliative medicine and GIM across various settings. Trainees will be assigned both a palliative medicine Educational Supervisor and a GIM Educational Supervisor at the program’s outset. Whenever possible, Educational Supervisors will remain consistent throughout the four years to provide continuous support and mentorship.
Four Year Program
Year 1: Hospice Care
The first year focuses on inpatient hospice care for six months in a specialist hospice inpatient unit, followed by six months of community palliative care (at either Katharine House Hospice, Banbury; Florence Nightingale Hospice, Aylesbury; or Duchess of Kent Hospice in Reading). As well as gaining experience in key elements of palliative medicine there are four weeks spent in GIM throughout the year to stay connected with general medicine. You will be encouraged to develop teaching, research, governance, and audit skills during this time too.
Year 2 Hospital Care
The second year includes six months of General Internal Medicine (GIM) at the John Radcliffe Hospital in Oxford, followed by six months with the Oxford Hospital Palliative Care Team learning how to provide liaison palliative medicine to a wide variety of different specialties.
Year 3 Development
At the end of year two, trainees have experienced key aspects of palliative medicine and GIM. The third year is spent in a hospice (Katharine House Hospice, Banbury; Florence Nightingale Hospice, Aylesbury; or Duchess of Kent Hospice in Reading). This year aims to further expand experience in inpatient and community care, allowing opportunities to refine teaching, research, governance, and audit skills. On-calls during this year are in palliative medicine, with four weeks in GIM at the hospital associated with the hospice.
Year 4 Consolidation
The final year of the program starts with six months of GIM at the John Radcliffe Hospital in Oxford, completing competencies in preparation for CCT and practice. The last six months are spent with the Oxford palliative medicine team, addressing any outstanding training requirements. This may involve a combination of inpatient work at Sobell House Hospice, community work, or collaboration with the hospital palliative care team. On-calls are based on your clinical base, covering GIM and palliative medicine.
| Year 1 Hospice | Inpatient Hospice Care (6 months) | Community Palliative Care (6 months) |
| Palliative Medicine Oncalls | ||
| Year 2 Hospital | General Internal Medicine (6 months) | Hospital Palliative Medicine (6 months) |
| General Internal Medicine Oncalls | ||
| Year 3 Hospice | Hospice and Community Palliative Care | |
| Palliative Medicine Oncalls | ||
| Year 4 Hospital and Hospice | General Internal medicine (6 months) | Palliative Medicine (6 months) |
| General Medicine Oncalls | Palliative Medicine Oncalls | |
Post Locations
Most trainees find that they do not need to relocate their accommodation during their training since units are within reasonable commuting distances from a central location. Trainees can be placed at any of the training locations in the region, including Sobell House Hospice Oxford, Katharine House Hospice Banbury, Florence Nightingale Hospice Aylesbury, and Duchess of Kent House Reading. GIM training is undertaken with the acute general medicine team at the John Radcliffe in Oxford. Stay Connected days in GIM can be undertaken at the Horton Hospital, Banbury, Stoke Mandeville Hospital, Aylesbury, and the Royal Berkshire Hospital, Reading.
The frequency of on-call commitments varies between posts, but in palliative medicine, it requires non-resident availability within a fixed traveling time.
Trainees are allocated half a day per month for palliative medicine teaching and one day monthly for GIM teaching days. The palliative medicine teaching runs on a two-year cycle, covering the key elements of symptom management, education, audit, governance, and research. Trainees organize this with support from the TPD as needed. The training program has strong links with other specialties in Oxford and the wider area, enabling comprehensive curriculum coverage. There is an annual simulation day for trainees in palliative medicine, which receives positive feedback. Being a small training program, many opportunities arise for trainees to collaborate on developing guidelines, research projects, posters, and presentations.
There are multiple opportunities to contribute to teaching across the region in all placements, including undergraduate medical students, junior doctors, and local and regional teaching. There is a biannual IMT palliative medicine study day in which specialty trainees are expected to participate at least once a year.
Essential Courses
During training, trainees must complete several essential courses, including:
- Advanced Communication Skills training
- Management Course
- Teaching course
Most trainees will also benefit from attending the SCE revision course.
Self Development and support
Palliative medicine is a rewarding but emotionally demanding specialty. The Thames Valley region provides various resources to support trainees if required, in addition to mentoring from their Educational Supervisor and support from colleagues.