Optimizing Palliative Medicine

Training in the Gulf Region

Mohammad Zafir Al-Shahri, MD

Consultant, Palliative Medicine, KFSHRC
Associate Professor, College of Medicine, Alfaisal University
Director, Palliative Medicine Fellowship Program, KFSHRC
What is Palliative Care?

An approach that improves the QOL of

patients & families facing the problems
associated with life-threatening illness,
through the prevention and relief of
suffering by means of early identification
and impeccable assessment and
treatment of pain and other physical,
psychosocial and spiritual problems
 Physician

Others Nurse

Patient
Dietitian & Social worker

Family
Physical Spiritual
therapist advisor
Occupational
therapist
 Physician
Others Nurse

Patient
Social
Dietitian & worker
Family
Physical Spiritual
therapist Occupatio advisor
nal
therapist

PM is the physician component of

the interdisciplinary practice of PC
 History
• 1960s Modern PC movement in Europe
• 1970s PC movement in North America
• 1987 PM specialty recognized in UK
• 1988 Recognized in Australia &
New Zealand
 History ..
• 1996 ABHPM not recognized by ABMS
• 2006 PM subspecialty recognized in USA
• 2009 29 programs accredited in USA
 KSA Experience

• 2000 KFSHRC fellowship program

• 2008 Accredited by SCHS as a training program
• 2012 Accredited by SCHS as a subspecialty
 KSA Experience ..
• 2000 – 2013 One program in KSA (KFSHRC-R)
• 2014 - KFSHRC-R
- KFMC, Riyadh
- 3 more applications
Graduates (2000-2013)

Male
33% Female

67%

Total = 12 Physicians
 Graduates (2000-2013) ..
• 9 KSA
• 2 Kuwait
• 1 Bahrain
 KFSH

KFSHRC

RKH

NGHA

NGHA

KAMC
 Country Population FTE at present FTE needed % of met needs

KSA 30,814,000 20 308 6.5%

UAE 9,446,000 1 95 1.1%

Oman 4,071,000 0 40 0%

Kuwait 3,656,000 1 37 2.7%

Qatar 2,268,000 1 23 4.4%

Bahrain 1,319,000 1 13 7.7%

Total 51,574,000 24 516 4.7%

Benchmark: 1 (0.8-2) FTE PM specialists/100,000 population

516 FTE PM Physicians for Gulf Region

Recommendations for
Bridging the gap
 Recommendations
• Recognition of PM by respective authorities as
a RARE and PRIORITY subspecialty
• Scholarships
• Incentives
• Waiver of certain requirements (e.g. having to receive
overseas training)
• Supporting the current programs with
resources and increasing their number
 Recommendations ..
• Inclusion of palliative care in the
undergraduate & postgraduate curricula
• Mandatory PC rotations for residents &
fellows
• Promoting and supporting short PC courses
• PC availability should be made a prerequisite
for establishing oncology services
Thank
You