Abstract
BackgroundIn 2009, palliative medicine became an integrated and compulsory part of undergraduate training in Germany by legislation. After a transitional period, all medical faculties were required to provide adequate teaching with an according examination and certification procedure. In parallel, we conducted bi-annual surveys on all medical faculties in Germany to examine for potential discrepancies between the implementation process and their intended consequences on teaching time and content.MethodsFour consecutive bi-annual surveys (2006, 2008, 2010, 2012) of all 36 medical faculties in Germany were performed, using purposively for this study developed questionnaires. Likert scales and closed questions were analyzed descriptively.ResultsMedical Faculty response rate increased from 50 % in 2006 to 88.9 % in 2012. Teaching coordinators in palliative medicine primarily had an anesthesiology or internal medicine background. There was a noted increase over time of the involvement of specialized palliative care units (PCUs) as providing the setting for education. The number of faculties that were able to offer a complete 16 weeks of training in palliative medicine during the “final year” rose steadily. In addition, increased patient-centered teaching formats have been implemented over time. The faculties which offered innovative teaching formats with actors as patients (standardized patient interaction) increased, as did the total number of mandatory examinations. The number of faculties that provided compulsory teaching in a condensed manner within a single academic year increased sharply from 3 of 31 responding faculties in 2010 to 19 of 32 responding faculties in 2012.ConclusionsUntil now, teaching conditions and structures in palliative medicine in Germany have proven to be extraordinarily heterogeneous. Although professorships (“Chairs”) in palliative medicine proved to be particularly beneficial and supportive in curricular and structural development, only a minority of faculties provide leading academic positions in palliative medicine.
Highlights
In 2009, palliative medicine became an integrated and compulsory part of undergraduate training in Germany by legislation
The European Association for Palliative Care (EAPC) stresses that training in palliative care in medical schools has a major impact on the future of palliative medicine (PM)
The aim of this study is to examine for potential discrepancies between the implementation process establishing palliative medicine as core training, and the effect upon teaching time and clinician development
Summary
In 2009, palliative medicine became an integrated and compulsory part of undergraduate training in Germany by legislation. In Germany, during the last two decades, funding programs of the German Cancer Aid (and, to a lesser extent, of private trusts) have catalyzed palliative medicine as a core academic subject within medicine [6]. This funding has forced the development of clinical structures at university hospitals and endowed professorships (currently 8 of 10 endowed chairs [7]) to implement teaching and research capabilities in this new field of medicine
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