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Reflections on being a Palliative Medicine Trainee

Author: Dr Jennifer Palfrey
08 August 2017

Dr Jennifer Palfrey’s work in hospices spurred her to join a fellowship programme in Clinical Leadership to learn more about the wider picture of end of life care. Here she explains her experience of the training so far.

As an ST4 palliative medicine trainee I love my job. I feel that palliative medicine offers me the challenges of diagnosis and complex medical problems accompanied by the important focus on true patient-centred holistic care. Good palliative care creates a balance of a medical model of care with the psychosocial model of care.

Death is an inevitable part of life but I feel that as a society we have somehow forgotten this. People experience death in numerous ways with very different levels of support. I feel privileged to have worked in hospices where I feel people have experienced excellent end of life care.  But how representative is this? Have I got lost in the “hospice bubble”? Have I over-medicalised death? Registrar training is intense and sometimes having time to explore and ponder the “bigger questions” is helpful.

I want to learn about the bigger picture; an elderly population that is expected to double by 2020, I want to learn about big organisations; the NHS is the fifth biggest employer in the world, I want to learn about big ideas; new models of care that straddle the health and social care divide.

I had heard of the Darzi Fellowship, a clinical leadership programme, through a number of different people – all reports had been positive and in some circumstances career-changing.  Surely this was something I should have a go at. The Fellowship uses a Health Education England grant to fund a PGCert in Clinical Leadership and project placement for a year. It has been running in London for eight years and has now extended for the first time to Kent, Surrey and Sussex. It is open to all clinicians at the start of their careers to enable them to build their leadership skills.

I have been a Darzi Fellow for three months now. I have been immersed in a very different style of work, have met some amazing people and have been challenged to think differently. I have completed workshops at the London South Bank University and am engrossed in my project at Princess Alice Hospice, Esher.

My cohort includes other doctors, pharmacists, nurses, paramedics and psychologists to name just a few. Most Fellows work within the NHS on a variety of different projects whereas my Fellowship is predominantly based in Princess Alice Hospice. This gives me a unique challenge and huge scope to explore not only the third sector but also the relationship that hospices have with the wider health and social care system. All of which will be invaluable in my continued work in palliative medicine.

My project is looking at the opportunities for digital innovation within the hospice, in particular looking at our community patient service and evaluating whether through the use of digital technology we can improve and extend our service. I am learning change management techniques and I look forward to putting them into practice in the coming months.

I will write more about my experiences as I progress through the Fellowship, but even at this early stage I would wholeheartedly encourage others to think about this, or a similar programme for their own professional development and to strengthen the future of hospice leadership and management.  

For more information visit Darzi Fellowships in Clinical Leadership

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