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The Indian College of Palliative Medicine: A Concept in Evolution
Address for correspondence: Dr. Naveen Salins, Department of Palliative Medicine Tata Memorial Centre, Mumbai, Maharashtra, India. E-mail: naveensalins@gmail.com
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The Indian College of Palliative Medicine (ICPM) represents a system and structure that aims to develop, execute, and sustain a competence-based specialist palliative medicine education in India and facilitate integration of the existing nonspecialist palliative care education in India. It will strive to create a specialist palliative medicine training pathway for India, which will promote physician readiness in symptom management, supportive care, awareness of a range of medical and nonmedical options available for the disease management of the palliative care patients, psychosocial support to patients and families, working in a multi-/inter-disciplinary team, working in different clinical settings, communication skills, decision-making skills, procedural skills relevant to palliative medicine, ethics-based good clinical practice, leadership, teaching, and research.
The objectives of the ICPM is to:
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Develop a process and pathway for Level 3 specialist palliative medicine education in India, which will facilitate physicians to become specialist palliative medicine practitioners
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Facilitate integration of Level 2 generalist palliative medicine education across India
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Facilitate integration of Level 1 palliative care sensitization/awareness programs across India
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Distinguish levels of palliative care education as Level 3 (specialist palliative medicine education), Level 2 (generalist palliative medicine education), and Level 1 (palliative care sensitization/awareness education program).
The Annual General Body Meeting (AGBM) of the Indian Association of Palliative Care (IAPC), held at Coimbatore on February 11, 2017, authorized formation of a committee, which will oversee the creation of the ICPM (section 8 h-minutes of the IAPC AGBM dated February 11, 2017). These recommendations of the AGBM were ratified at the central council meeting of the IAPC, which was held on September 2, 2017, at Jharkhand. A ten-point roadmap is proposed for the creation of the Indian College Palliative Medicine.
CREATION OF THE INDIAN COLLEGE OF PALLIATIVE MEDICINE CONSTITUTION, BYELAWS, AND THE ADMINISTRATIVE STRUCTURE
It involves laying down the rules and regulations for the formation and functioning of the ICPM, its governing body, and the board of overseers. It also involves creating a structure for the administrative and financial, induction of new members, and awarding the fellowship of the college. Although ICPM will seek guidance and mentorship from the IAPC, the ICPM will function as an independent body with its own administrative structure.
CREATION OF THE HANDBOOK OF THE INDIAN COLLEGE OF PALLIATIVE MEDICINE
The handbook of the ICPM will comprise of eligibility criteria for the ICPM membership and fellowship, training positions, training sites, membership process, application process for the Fellow of the Indian College of Palliative Medicine (FICPM), process of training and training pathway, roles and responsibilities of the trainees, roles and responsiblities of the supervisors, mandatory and optional training requirements, log book, exit examination process, and award of the fellowship.
CREATING A WEB PLATFORM FOR THE INDIAN COLLEGE OF PALLIATIVE MEDICINE
It involves designing an online platform, which will support the contents, online application process, resources, and links necessary for the functioning of a virtual ICPM.
CREATION OF THE LEVEL 1 (SPECIALIST PALLIATIVE MEDICINE EDUCATION) TRAINING PROCESS AND PATHWAY LEADING TO THE FELLOW OF THE INDIAN COLLEGE OF PALLIATIVE MEDICINE
It involves creation of a structured pathway that outlines the becoming of the FICPM for MBBS graduates, MD/MS from various clinical specialties, and MD Palliative Medicine. All the FICPM applications will be screened by the board of the overseers, who will assess the prior qualifications and training and will recommend further learning and training requirements necessary for the award of the FICPM. The training requirements will include completion of the learning modules, clinical training, research publications, log book, and passing the exit examinations.
CREATION OF COMPETENCY-BASED TRAINING CURRICULUM AND LEARNING MODULES FOR FELLOW OF THE INDIAN COLLEGE OF PALLIATIVE MEDICINE
It involves the creation of a comprehensive subject-specific learning domains in symptom management, palliative pharmacology, oncology and nononcology palliative medicine, communication and decision-making skills, ethics-based practice, end-of-life care, and supportive care medicine in palliative care. Training will also comprise of palliative care teaching skills and research methodology.
CREATION OF THE FELLOW OF THE INDIAN COLLEGE OF PALLIATIVE MEDICINE TRAINING DOCUMENTS
It includes the creation of the ICPM membership application, application for the path leading to the FICPM, trainee report formats, supervisor report formats, application form for the assessment of the qualifications and training, report of the board of overseers, log book, and exit examination application.
IDENTIFICATION OF THE ACCREDITED CLINICAL SUPERVISORS AND ACCREDITED CLINICAL SITES
It includes identifying clinical supervisors who are willing to provide clinical and academic mentorship to the trainees pursuing the FICPM pathway and identifying and accrediting clinical sites equipped to provide essential clinical training to the trainees pursuing FICPM.
FORMATION OF THE BOARD OF OVERSEERS
Board of overseers will assess the previous qualifications and training of the candidates enrolled in the FICPM pathway and will recommend further clinical training and learning. They will advise the candidates about the process of meeting the requirements prescribed in the FICPM pathway. The board will also oversee the training progress, exit examinations and will recommend award of the fellowship after satisfactory completion of the FICPM training requirements.
INTEGRATION AND ACCREDITATION OF ALL LEVEL 2 TRAINING PROGRAMS (GENERALIST PALLIATIVE CARE EDUCATION)
It involves identification and integration of nonspecialist palliative care training programs such as residential 6 weeks training and nonresidential 1-year distance education programs, as Level 2 generalist palliative care education.
INTEGRATION AND ACCREDITATION OF ALL LEVEL 1 TRAINING PROGRAMS (PALLIATIVE CARE AWARENESS/SENSITIZATION)
It involves identification of all the training programs offered for few days to <6 weeks of clinical attachment as Level 1 palliative care training program or palliative care sensitization/awareness program.
ICPM is a process and structure envisaged for providing specialist palliative medicine education in India as a viable alternative to augment the attenuated specialist palliative medicine workforce in India. We are hoping that over the next 2 years, the ICPM will be able to complete most of the steps of the proposed ten-step roadmap. A philanthropic foundation is willing to offer its support by providing a seed money to initiate the process. We hope that this will be a successful, self-sustaining, and scientific enterprise that will create opportunities for an exemplary specialist palliative medicine education in India.
