Medical School Elective MED-880;
Medical students at UB have the opportunity to take a month-long elective
in palliative medicine during their fourth year. During the rotation the
student will spend time in a variety of settings, including hospital
consultation services and hospice home care. Students also take part in
the Extended Standardized
Patient Scenario (ESPS) a unique educational experience using
standardized (simulated) patients to recreate complex decision making
near the end of life.
Upon completion of the rotation, the resident/student will:
- be able to propose and defend comfort care for patients when cure is no longer a rational goal.
- understand palliative care as good medical practice consistent with traditional medical values and goals in appropriate patients.
- honor medical decisions that are guided by the philosophy and values of the patient.
- be able to describe the multiple determinants of suffering: physical, psychological, social and spiritual.
- understand the importance of determining and conveying prognostic information in end of life care.
- understand the importance of the physician maintaining a continuous relationship with dying patients.
- understand the physicianís role in an interdisciplinary team, particularly in a hospice setting.
- be able to evaluate and treat symptoms common in terminally ill patients including:
- understand the neuroanatomy and physiology of different pain mechanisms.
- be familiar with the pharmacology of common analgesics, particularly opioids.
- understand the pathogenesis of non-pain symptoms in terminally ill patients.
- be familiar with the anorexia-cachexia syndrome and its implications for treatment.
- be familiar with and conversant in the published literature regarding medically provided hydration and nutrition in terminally ill patients.
- know the essential features of insurance coverage for palliative care, particularly the Medicare Hospice Benefit.
- be comfortable collaborating with the interdisciplinary team.
- be able to communicate effectively and compassionately with patient and caregivers with particular attention to:
- breaking bad news
- conveying uncertainty
- formulating decision plans consistent with patientsí values
- eliciting patientsí goals of treatment, fears, and recognizing non-verbal cues.
- allaying fears and misconceptions about opioid treatment
- be able to appropriately evaluate patients using standard history and physical examination skills regarding pain and other distressing symptoms.
- be capable of evaluating such symptoms with the least invasive and intrusive testing modalities necessary for appropriate treatment.
Bibliography and Resources
For more information, contact
Dr. Jack Freer, 871-1571,
This page was last updated 02/09/13.