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1.6 Palliative and End of Life Care

1.6 Palliative and End of Life Care			Core Rotation	Elective Rotation	Academic Program	Special Interest Elective
The family physician is a skilled clinician
The resident will be able to:
1.6.1	K/S	Manage common palliative symptoms:
1.6.1.1	K/S	Pain	FM, AEM, IM, GM, PC	UC, FMH, ICU	X
1.6.1.2	K/S	Nausea & vomiting	FM, AEM, IM, GM, PC	UC, FMH, ICU	X
1.6.1.3	K/S	Dyspnea	FM, AEM, IM, GM, PC	UC, FMH, ICU	X
1.6.1.4	K/S	Skin care	FM, AEM, IM, GM, PC	UC, FMH, ICU	X
1.6.1.5	K/S	Constipation	FM, AEM, IM, GM, PC	UC, FMH, ICU	X
1.6.1.6	K/S	Delirium	FM, AEM, IM, GM, PC	UC, FMH, ICU	X
1.6.1.7	K/S	Terminal agitation	FM, AEM, IM, GM, PC	UC, FMH, ICU	X
1.6.1.8	K/S	Depression and anxiety	FM, AEM, IM, GM, PC	UC, FMH, ICU	X
1.6.1.9	K/S	Feeding and nutritional issues	FM, AEM, IM, GM, PC	UC, FMH, ICU	X
1.6.2	K	Describe psychological and spiritual needs of terminally-ill patients and their families	FM, AEM, IM, GM, PC	UC, FMH, ICU	X
1.6.3	K/S	Assist terminally-ill patients in decision-making around end-of-life issues (e.g. resuscitation)	FM, AEM, IM, GM, PC	UC, FMH, ICU
1.6.4	K	Describe an approach to common legal issues in palliative care (e.g. competency, advance directives, pronouncement and certification of death)	FM, AEM, IM, GM, PC	UC, FMH, ICU	X

Family medicine is a community-based discipline
The resident will be able to:
1.6.5	K/A	Describe and appreciate the role of family physicians and palliative care consultants in palliative care	FM, AEM, IM, GM, PC	UC, FMH, ICU

The family physician is a resource to a defined practice population
The resident will be able to:
1.6.6	K/S	Identify local resources that can assist in the provision of care to terminally-ill patients in various care settings: home, hospital, etc.	FM, AEM, IM, GM, PC	UC, FMH, ICU

The patient-physician relationship is central to the role of the family physician
The resident will be able to:
1.6.7	K/A	Describe the common physical, psychological, social and spiritual issues of dying patients and their families	FM, AEM, IM, GM, PC	UC, FMH, ICU	X
1.6.8	S	Communicate effectively with terminally-ill patients and their families	FM, AEM, IM, GM, PC	UC, FMH, ICU
1.6.9	S	Communicating bad news to terminally-ill patients and their families	FM, AEM, IM, GM, PC	UC, FMH, ICU

References
End-of-life care. Recommended Curriculum Guidelines for Family Medicine Residents.
APPENDIX C Specific Standards of Accreditation for a One Year Program of Added Competence in Palliative Medicine. Standards for Accreditation of Residency Training Programs: Family Medicine; Emergency Medicine; Enhanced Skills; Palliative Medicine (The Red Book)
Standards for Accreditation of Residency Training Programs. The College of Family Physicians of Canada. 2006.
Suggested Learning Objectives for Palliative Care in Family Medicine Residency Programs.