How comprehensive is clinical medical resident education really?

Another Match Day has come to pass with a new academic training year on the horizon. By the end of years of training, will these future clinical practitioners, particularly those in the primary care specialties, be able to:

  • Provide family-centered assistance in the end-of-life and afterlife decision-making process for the deceased?
  • Educate families about the patient care quality assurance benefits of the medical autopsy?
  • Obtain consent from the next-of-kin for a medical autopsy and be cognizant of religious restrictions and objections?
  • Utilize the expertise of the hospital pathologist to gain understanding of clinicopathologic correlation and the lethal potential of disease?
  • Identify deaths that need reporting to the Medical Examiner or Coroner?
  • Identify the fundamental goals of the Medical Examiner and Coroner and how they intersect with clinical medicine?
  • Properly certify a death in a timely manner and recognize that there are consequences for not doing so?
  • Identify the importance and many uses of the death certificate?
  • Realize the many important roles of the clinical practitioner including the role as a mandated reporter and as a public health steward?

Most importantly, have training programs made routine efforts to connect the trainee with the many available resources and put systems in place that check progress and identify deficiencies in all of the above (1,2,3 )?

Education and guidance regarding the practitioner’s role in end-of-life (palliative) care exists for some in medical school and residency with efforts towards the development of standardized curricula (4, 5 ). Continuing efforts are needed to improve the underdeveloped curricula regarding an additional important component of patient care-afterlife care.

 

References:

  1. Armstrong E J. Essentials of Death Reporting and Death Certification-Practical Applications for the Clinical Practitioner. Available at: https://www.amazon.com/Essentials-Death-Reporting-Certification-Applications/dp/0998533408
  2. https://www.cdc.gov/nchs/nvss/writing_cod_statements.htm
  3. http://www.massmed.org/Continuing-Education-and-Events/Online-CME/Courses/Cause-of-Death-Training-for-Medical-Certifiers/Cause-of-Death-Training-for–Medical-Certifiers/
  4. https://www.acponline.org/clinical-information/clinical-resources-products/end-of-life-care/papers-by-the-end-of-life-care-consensus-panel
  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4077186/pdf/nihms584235.pdf

 

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