CONFERENZA PERMANENTE DEI PRESIDENTI DEL CONSIGLIO DI CORSO

CONFERENZA PERMANENTE DEI PRESIDENTI DEL CONSIGLIO DI CORSO DI LAUREA MAGISTRALE IN MEDICINA E CHIRURGIA (Roma 25 giugno 2012) LE CURE PALLIATIVE IN EUROPA prof. Gian Luigi Cetto Cattedra di Oncologia Medica - Università di Veron a

LE CURE PALLIATIVE IN EUROPA Ø Sviluppo dei servizi Ø Formazione e certificazione Ø Ricerca

2006 Mapping levels of palliative care development: a global view (Help the Hospices and the National Hospice and Palliative Care Organization) 2007 EAPC Atlas of Palliative Care in Europe (Palliative Care Facts in Europe for 2005) 2008 EAPC Review of Palliative Care in Europe (Analysis of the development of PC in Europe between 1995 and 2005) 2008 Palliative Care in the European Union (European Parliament: Policy Department Economic and Scientific Policy) 2009 Council of Europe: Resolution 1649 “Palliative care: a model for innovative health and social policies” 2011 Mapping levels of palliative care development: a global update 2011 (Worldwide Palliative Care Alliance)

Palliative Care in the European Union (European Parliament 2008)

Palliative Care in the European Union (European Parliament 2008)

LE CURE PALLIATIVE IN EUROPA Ø Sviluppo dei servizi Ø Formazione e certificazione Ø Ricerca

UK & Ireland Specialization since 1987 in UK, and 1995 in Ireland l Training period of 4 years l – Accepted 2 years in family medicine, oncology, hematology, pediatric or infectious diseases – Minimum of 2 mandatory years in PC specialized services – Final examination at the end of the training period – Research experience is encouraged and supported and can count for up to a year of HMT l Certification: Royal Colleges of Physicians Training Board & Irish Committee on Higher Medical Training

France l l l Subspecialty since 2008: DIPLÔME D’ÉTUDES SPÉCIALISÉES COMPLÉMENTAIRES DE MÉDECINE DE LA DOULEUR ET MÉDECINE PALLIATIVE Institution: Ministère de l'éducation nationale, de l'enseignement supérieur et de la recherche Access: from previous Anesthesia, Hematology, General Medicine, Internal Medicine, Neurosurgery, Neurology, Oncology, Pediatrics, Pulmonology, Psychiatry, Physical Medicine and Rehabilitation, Rheumatology – The DESC Coordinator may accept a candidate who holds one of the other than those mentioned above. Content: 2 years training time (4 semesters) with training session Final examination: not required – Final Memory – Coordinator's agreement Filbet M. Personal communication, Jan 2012

Germany l Sub-specialty since 2006 l Only need a previous specialization in any clinical subject (not, for instance, in pathology)… Institution: State Chambers of Physicians as corporations under public law, are in charge of the administration of all matters related to specialty training in Germany. A Board of Pall Med is established. Content: 1 year training time: 12 months with a training officer or 120 hours, including case seminar supervision and 40 hours training course in Palliative Medicine Final Oral examination (3 external Professors) but depends the region l l l Elsner, F. Personal communication, Jan 2012

Sub-specialization in Europe POLAND (1999) – Palliative Medicine as a medical specialty was introduced in 1999. It has a second level status which means that it is available only for those physician who are already specialist in other clinical disciplines. It takes two years to complete specialty training ROMANIA (2000) – There is recognition of PC as a medical subspecialty since 2000 by an order of Ministry of Health. Training consist in a 12 weeks course (8 weeks theory and 4 weeks practice. Official certification…Pall Med (2007) Clark D. Pall Med as Specialized Discipline. In: Oxford Textbook…, 4 th Ed. (2010)

Sub-specialization in Europe SLOVAKIA (2005) – Palliative medicine is acknowledged as sub specialization from January 2005 CZECH REPUBLIC (2005) – The new law about medical education encompasses the new medical specialty “Palliative Medicine and Pain Management” GEORGIA (2007) Official certification…Pall Med (2007) Clark D. Pall Med as Specialized Discipline. In: Oxford Textbook…, 4 th Ed. (2010)

Accreditation in progress SPAIN – The Spanish Society of PC and the National Commission on Medical Specialization are working on an “Specific Capacitation Area in Palliative Medicine” with access from several previous specializations NORDIC COUNTRIES: DENMARK, FINLAND, SWEEDEN, NORWAY, ISLAND – Nordic Specialist Course in Palliative Medicine – Two year theoretical training – Are Working with the Ministry of Health in each country looking for accreditation (more advanced in Norway and Sweden)

CERTIFICATION OF PALLIATIVE MEDICINE IN EUROPE Specialty (recognized) Sub-specialty (recognized) not yet recognized in discussion/in progress

IN THE WORLD l CERTIFICATION FOR PALLIATIVE MEDICINE IN: UK, CANADA, USA, l FRANCE, GERMANY, IRELAND, POLAND, SLOVAKIA, ROMANIA, CZECH REPUBLIC, AUSTRALIA, NEW ZEALAND, HONG-KONG, SINGAPUR, TAIWANG, MALASYA, ARGENTINA, GEORGIA l l The status of Pall Med remains under-documented in the published literature 18 countries worldwide have established Pall Med as a subspecialty (or specialty) There is considerable variation in procedures of the specialty status The global categorization of Pall Care development is closely correlated with the state of Pall Med as a field of specialization at the country level

LE CURE PALLIATIVE IN EUROPA Ø Sviluppo dei servizi Ø Formazione e certificazione Ø Ricerca

EAPC Review 2008

DEVELOPMENT Palliative Care Programs / Services Academic Programs Education/Training and Research

A WHEEL OF THE MACHINE Phy Cer sician tific atio n Postgraduate training ATE U D A R G E PR UM CURRICUL