In the third year of training, most medical students typically take hours of coursework in the area of reproductive medicine, embryology, prenatal care, labor and delivery and neonatal care. Four-to-six weeks rotations are required in obstetrics and pediatrics. Yet there are no required classes and clinical rotations on topics of grief, care giving, palliative care and spirituality relating to the end-of-life. Today’s medical schools offer a curriculum that is antiquated and better suited to the 1940’s and 1950’s when most doctors delivered babies and routinely took care of infants. Yet, only about 50 percent of the American population will have children, and 100 percent will die. It is time to change how our doctors and nurses are trained in this important area of death and dying. While it is valuable to take some death and dying courses during their training, physicians also need to have learning opportunities such as rotations within hospices, nursing homes and assisted living facilities to practice their skills.
The newly emerging specialty area of palliative care should also be included as mandatory in the training of our upcoming medical personnel. Atlanta palliative care specialist Dr.Melissa Schepp states, “I think if I had my magic wand, I would make it so that every caregiver knew a little bit about the basics of palliative care.Basically, that comfort is paramount regardless of whether you are going for a cure or not. We need to pay more attention not just to pain management but to good pain management.”
Back in 1997, Harvard Pilgrim Health Care,Inc. organized a two-day National Consensus Conference on Medical Education for Care Near the End-of-Life. In a report prepared by Kelsey Meneham, Rx: More Training Urged for Physicians Treating Dying Patients, for the Robert Wood Johnson Foundation, (http://pwebl.rwjf.org/reports/grr/029360s.htm), the eighty –five medical professionals attending the conference recommended that:
Teaching end-of life care to physicians should focus on four major goals: developing appropriate communication skills; acquiring essential technical knowledge for treating symptoms and relieving pain; learning to address the psychosocial,cultural, and spiritual needs of patients and their families; and developing the ability to reflect on personal attitudes about this work.
The late Dr. M. Scott Peck, in his work Denial of the Soul: Spiritual and Medical Perspectives on Euthanasia and Mortality (New York: Harmony Books, 1997) suggested acourse of training for medical professionals that includes:
As health care practitioners you can request that your hospital offer training programs and continuing education courses that are required as mandatory for all hospital physicians and nurses.Suggest that they can follow the guidelines as outlined by Dr. Peck and the Harvard backed recommendations. As alumni of medical and nursing schools you can write to your school administrators to get them to re-examine the need for mandatory end-of-life care training to the students. Through incorporation of mandatory coursework in palliative, emotional and spiritual care and rotations with the terminally ill, our U.S.medical and nursing schools can be updated to a better level of service.
In a survey done for research for my book, Soul Service: A Hospice Guide to the Emotional and Spiritual Care for the Dying ( Balboa Press, 2013) we contacted 122 medical schools and 34 of the top 50 U.S. News and World Reports nursing schools to determine what the U.S. training is currently in palliative,emotional and spiritual care to the dying. Only 8 medical schools and none of the nursing schools offered this coursework as mandatory, 16 had elective courses in these areas.
Medical schools that are currently offering mandatory coursework in palliative,emotional and spiritual care to the dying include:
1. Stanford UniversitySchool of Medicine
2. Johns Hopkins UniversitySchool of Medicine
3. Mayo Clinic College of Medicine
4. University of South Carolina School of Medicine
5. Texas A&M Health Science Center College of Medicine
6. Eastern Virginia Medical School
7. Keck School of Medicine of University of Southern California
8. David Geffen School of Medicine at UCLA
About Soul Service SoulService is a book that speaks to the medical professional, lay person,dying person and family member about treating the dying from a holistic perspective. It provides a detailed navigation to spiritual and complementary care as well as assists with the process of how to choose a hospice. Soul Service serves as a useful resource guide to the myriad of organizations that are currently available to assist with the dying process.