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Introdução: A formação dos profissionais é um pilar essencial na construção de um sistema nacional e integrado de Cuidados Paliativos (CP). Na perspetiva médica, para intervir positivamente no processo formativo é prudente começar por conhecer a realidade atual do ensino dos CP. O objetivo deste estudo é identificar conteúdos paliativos nos currículos pré-graduados dos cursos de medicina e nos programas de formação de 16 especialidades médicas, no ano letivo 2017/2018, em Portugal. Metodologia: Estudo quantitativo descritivo que consiste na pesquisa de conteúdo paliativo nos currículos pré-graduados de medicina e currículos de 16 especialidades médicas. Como modelos comparativos foram utilizadas as recomendações da Associação Europeia de Cuidados Paliativos para o ensino médico pré-graduado de CP e as competências centrais dos CP, respetivamente. Resultados: No ensino pré-graduado, os resultados sugerem que não existem grandes diferenças entre faculdades. Verificou-se que alguns sub-conteúdos paliativos estão praticamente ausentes na maioria dos planos curriculares, nomeadamente: abordagem da maioria de outros sintomas que não a dor; desenvolvimento e organização dos CP; luto antecipatório, luto complicado e seus fatores de risco; assuntos práticos, financeiros e legais; espiritualidade; eutanásia vs CP; negociação de ordens-de-não reanimação; burnout. Relativamente aos currículos das especialidades avaliadas, destacam-se os seguintes resultados: apenas Oncologia apresenta um estágio obrigatório em CP; a maioria dos programas das especialidades, 10 em 16, não possibilita qualquer estágio em CP; 7 das 16 especialidades não apresentam, no seu plano curricular, qualquer objetivo que se traduza em competência paliativa; Oncologia, Medicina Geral e Familiar e Medicina Interna são as especialidades que incluem mais competências paliativas nos seus currículos. Conclusões: Os resultados indiciam que a formação médica em CP é globalmente incompleta, no momento pré-graduado, e escassa ou mesmo nula, no contexto de várias especialidades. Tal cenário merecerá verificação e reflexão dos responsáveis pela formação médica em Portugal.
Introduction: The education of human resources is an essential pillar in the edification of a national and integrated system of Palliative Care (PC). From a medical point of view, to intervene positively in the training process, it is prudent to start by knowing the current reality of PC teaching. The objective of this study is to identify palliative contents in the pre-graduated medical syllabus and in the training programs of 16 medical specialties, in 2017/2018 academic year, in Portugal. Methodology: Descriptive quantitative study that consist in search for palliative content in pre-graduated medical syllabus and in 16 training programs of specific medical specialties. The European Palliative Care Association's recommendations for CP undergraduate medical education and PC core competencies, respectively, were used as comparative models. Results: In pre-graduate education, the results suggest that there are no major differences between colleges. Some palliative sub-contents were found to be practically absent in most of the curricula, namely: approach to other symptoms, besides pain; PC development and organization; anticipatory mourning, complicated mourning and its risk factors; practical, financial and legal matters; spirituality; euthanasia vs PC; orders-of-non-resuscitation negotiation; burnout. Regarding the specialties curricula, the following results stand out: only Oncology presents a PC mandatory internship; most specialty programs, 10 out of 16, do not allow for any PC internship; 7 of the 16 specialties do not present, in their curricular plan, any objective that could be translate into a palliative competence; Oncology, Familiar Medicine and Internal Medicine are the specialties that include more palliative skills. Conclusions: The results indicate that medical PC education is globally incomplete at the pre-graduate level and scarce or even null in the context of several specialties. This scenario will deserve verification and reflection of those responsible for medical training in Portugal.
Introduction: The education of human resources is an essential pillar in the edification of a national and integrated system of Palliative Care (PC). From a medical point of view, to intervene positively in the training process, it is prudent to start by knowing the current reality of PC teaching. The objective of this study is to identify palliative contents in the pre-graduated medical syllabus and in the training programs of 16 medical specialties, in 2017/2018 academic year, in Portugal. Methodology: Descriptive quantitative study that consist in search for palliative content in pre-graduated medical syllabus and in 16 training programs of specific medical specialties. The European Palliative Care Association's recommendations for CP undergraduate medical education and PC core competencies, respectively, were used as comparative models. Results: In pre-graduate education, the results suggest that there are no major differences between colleges. Some palliative sub-contents were found to be practically absent in most of the curricula, namely: approach to other symptoms, besides pain; PC development and organization; anticipatory mourning, complicated mourning and its risk factors; practical, financial and legal matters; spirituality; euthanasia vs PC; orders-of-non-resuscitation negotiation; burnout. Regarding the specialties curricula, the following results stand out: only Oncology presents a PC mandatory internship; most specialty programs, 10 out of 16, do not allow for any PC internship; 7 of the 16 specialties do not present, in their curricular plan, any objective that could be translate into a palliative competence; Oncology, Familiar Medicine and Internal Medicine are the specialties that include more palliative skills. Conclusions: The results indicate that medical PC education is globally incomplete at the pre-graduate level and scarce or even null in the context of several specialties. This scenario will deserve verification and reflection of those responsible for medical training in Portugal.
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Cuidados paliativos Médicos Formação Educação Palliative care Physicians Training Education