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Surgical Resident Education for Pain Management in Cancer Patient - A Result of an Institutional Experience in Japan

Hisaharu Oya, Motohiro Matoba, Satoshi Murakami, Takashi Maeda, Masahiko Koike, Mitsuro Kanda, Chie Tanaka, Daisuke Kobayashi, Suguru Yamada, Tsutomu Fujii, Goro Nakayama, Hiroyuki Sugimoto, Shuji Nomoto, Michitaka Fujiwara and Yasuhiro Kodera

Although an increasing number of Japanese hospitals have established palliative care departments, the provision of palliative care in the current health care system is insufficient. In 2012, 2.6% of all Japanese hospitals had a palliative medicine unit. Additionally, in 2008, only 2.3% of hospitals had a palliative medicine unit with specialists in palliative medicine, and only 4.2% of hospitals, which had teams of palliative medicine specialists and palliative medicine units, were deemed cancer care hospitals. Specifically, in many hospitals, specialists in non-palliative care treat numerous symptoms in oncology patients. Palliative care is an essential part of integrated oncology treatment. According to a survey of certified oncologists regarding palliative care, knowledge pertaining to palliative medicine and its requisite skills are necessary for oncologists. Several societies have carried out educational programs pertaining to palliative care for lay people. Furthermore, a Japanese organization, The Japanese Society of Palliative Medicine, has launched a program on symptom management called the Palliative Care Emphasis and a project called the Assessment for Continuous Medical Education for trainers, as well as regular seminars using an integrated curriculum for medical students and primary staff in oncology. However, for physicians in training, the requirement and development of a primary palliative medicine skill set has not yet been well established. Therefore, given the increasing attention to these concerns, since 2009, all surgical residents in the palliative care department of National Cancer Center in Tokyo have been involved in a mandatory one-month training session that we conducted. For this article, we performed a review regarding physician education in palliative care in Japan over the recent years and we considered palliative care training including management of pain for surgical residents