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More manpower needed in palliative care sector

In 2020, more than 10,000 Singaporeans are expected to be in need of end-of-life care. To meet this need, the Health Ministry estimates it will have to double manpower capacity in the palliative care sector from the current 150 to 300 by 2020.

SINGAPORE: In 2020, more than 10,000 Singaporeans are expected to be in need of end-of-life care. To meet this need, the Health Ministry estimates it will have to double manpower capacity -- such as doctors, nurses and medical social workers -- in the palliative care sector from the current 150 to 300 by 2020.

In addition, other healthcare professionals should also be well-equipped with the skills to deliver palliative care. One suggestion is to make basic palliative care training a must in non-palliative care disciplines.

Currently, palliative care is taught to medical students as part of their undergraduate curriculum. Beyond that, some post-graduate residency programmes such as internal medicine and family medicine incorporate palliative care modules into their training.

However, observers said this module should also be extended to other sub-specialities.

Dr Alethea Yee, director of education for the Lien Centre for Palliative Care, said: "There are other disciplines like oncology, cardiology, surgery, renal medicine, neurology, etc. that could really benefit to have that palliative care component incorporated into their training.

"These residency trainings are different across clusters. Some clusters may have the component, and some do not. So it's pretty patchy and ad-hoc.

"Ideally, if there is a national core curriculum that mandates these components into the training of all doctors, then I think we'll reach a scenario where all doctors are adequately trained in this area."

Dr Yee said it is important that, in addition to family doctors, specialist doctors are equipped with palliative care training.

Others, however, feel that medical professionals should have the choice to upgrade themselves.

Dr Wong Tien Hua, 1st vice president of the Singapore Medical Association, said: "It's very difficult to make anything compulsory. I think what's important is that we seek the interest of doctors, because some doctors will have more interest in seeing elderly patients, in treating chronic diseases, and other doctors, more acute conditions.

"The best way forward really is to try and find out who are these interested doctors."

Dr Wong said having better exposure of the avenues available for palliative care training will have an impact.

The Singapore Medical Association said it actively publicises such opportunities, such as the recently announced Graduate Diploma in Palliative Medicine. The course is fully booked with 23 students.

At present, there is no official central coordinating body for palliative care education, but a variety of healthcare and educational institutions offer courses as well as in-house training, lectures and workshops on palliative care.

Going forward, Dr Yee said it is hoped that more of such programmes are made available locally to allied health professionals, such as occupational therapists and physiotherapists.

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