Careers in Palliative Medicine
Palliative Medicine is a rewarding career, allowing you to support patients and families at vulnerable times. There are opportunities for complex problem-solving, challenging communication and fascinating ethical dilemmas. Excellent palliative care requires multi-professional teams and interactions with a wide variety of hospital and community colleagues. Palliative Medicine specialist training takes place in hospitals, hospices and in the wider community.
Over 40% of the Palliative Medicine workforce is composed of SAS doctors, which includes Specialty Doctors, Specialist Doctors, and those on now closed contracts, such as Staff Grade doctors and Associate Specialists. This is a diverse group with higher proportions of females, less than full time doctors, international medical graduates and doctors from black and minority ethnic backgrounds within the SAS workforce in comparison to the Consultant workforce.
Entry into the Specialty Doctor grade requires a minimum of four years postgraduate experience. Some enter the grade from General Practice or from another specialty. Some join after completing Internal Medical Training, often with the intention of gaining further experience before applying for specialty training, but many individuals choose to become a career SAS doctor. These roles, which are often Hospice-based, offer the opportunity to balance service provision with flexibility and continuity, and are increasingly well supported to encourage both retention and career progression.
The Specialist Doctor role was introduced in 2021 to recognise the experience of senior SAS doctors and to provide a clear opportunity for career progression. Specialists are autonomous workers and expert clinical decision makers, holding responsibility for patient care within their area of practice.
Locally Employed Doctor posts are usually fixed term non-training posts and include Clinical Fellow, Hospice Doctor and Trust Doctor. These posts can offer doctors early in their career or in a move from another specialty the opportunity to gain experience in Palliative Medicine prior to making a decision about future SAS or training progression.
If training full-time in a numbered post, it takes four years to gain a Certificate of Completion (CCT) in Palliative Medicine. Since 2022, Palliative Medicine has been dual accredited with General Internal Medicine. This means that, of the four years of specialist training, one must be spent in acute medicine.
The RCP census shows that Palliative Medicine is the 11th largest medical speciality, with around 700 consultants across the U.K. Further to this, trainee numbers in palliative medicine are on the rise. Approximately 48% of consultants work less than full-time, with a comparable proportion of trainees choosing to train flexibly.
Around a third of consultant roles are joint NHS and third-sector positions. This reflects the options available to work across settings and organisations. Speciality trainees rate their training highly in the GMC trainees’ annual survey.
