Dr Prasanth C V
Thiruvananthapuram, India

Clinical Fellowship in Palliative Medicine at Department of Palliative Medicine, National Cancer Centre, Singapore

October – December, 2005

The International Association of Hospice and Palliative Care and National Cancer Centre in Singapore sponsored me for a three months clinical fellowship in palliative medicine at the National Cancer Centre. After working for a few years as a palliative care physician in a Regional Cancer Centre in India, I felt the need to upadate myself about the state of the art of palliative medicine. The clinical fellowship started in October and ended in December 2005. It was a student oriented, and needs based, training program that did not impose a fixed curriculum on anyone. It also gave me an opportunity to interact with a world renowned faculty in palliative care.
 
Dr Cynthia Goh, the head of Palliative Medicine Department, identified my needs and expectations from fellowship training and made every effort possible for me to realize them. I participated in ward rounds, consultation service, family meetings and multidisciplinary team meetings. I learned a lot of new methods in symptom control.
 
This fellowship also gave me an opportunity to interact with various community hospice programs in Singapore. I strongly believe that total care in palliative medicine can only be effectively achieved if home care is a part of the program.  During the clinical fellowship, I was able to spend two weeks with at the Hospice Care Association (HCA), the main provider of palliative care in the home in Singapore. During my rotation with HCA, I learned many practical things that can be done in a home care setting. HCA has five homecare teams that cater to different parts of Singapore and the service was available around the clock. I learned quite a number of things about building and maintaining a huge service and team.
 
I also had the opportunity to spend a few days with Dr Noreen Chan and her team at Dover Park Hospice which gave me a good exposure to an inpatient hospice setting.
 
The World Hospice Day celebration, conducted by the Singapore Hospice Council, was a memorable event and an occasion to interact with hospice care providers throughout Singapore.
 
During this fellowship program, I also had the opportunity to join a stoma care team and learn a lot of new things about this subject. I was also able to observe invasive procedures conducted by the chronic pain service. I remember with gratitude the interactions that I had with oncologists and other teams in the Singapore General Hospital, where the National Cancer Centre provided the inpatient service.
 
I was also fortunate to spend a few days with Dr Rosalie Shaw at KK Women and Children Hospital, Singapore. I learned from her a number of things about communication, handling psycho-social issues in palliative care and symptom control strategies.
 
Apart from academic matters in palliative medicine, the fellowship broadened my vision of palliative care. The program provided to me the opportunity to share my own experience with my colleagues in various palliative care services in Singapore. 
 
I would like to thank Liliana De Lima & the International Association of Hospice and Palliative Care; Dr Cynthia Goh & her team at the Dept. of Palliative Medicine, National Cancer Centre, Singapore; Dr M R Rajagopal, Chairman, Pallium India Trust; Dr Rosalie Shaw, Executive Director, Asia Pacific Hospice Network and Dr B Rajan, Director, Regional Cancer Centre, Trivandrum, India for providing the support that made this fellowship possible.