RESUMEN
Nepal has witnessed demographic and epidemiological transition resulting in the shift from infectious diseases to non-communicable diseases as the major disease burden. Around 60% of mortalities and morbidities are attributable to non-communicable diseases of which the majority end with the need for palliative care services. The current palliative care services in Nepal are in the infancy stage compared with other services. Undignified dying is a challenging public health problem and as such requires a public health approach to address it with the involvement of all stakeholders. Recognizing the need for the end spectrum of non-communicable diseases patients, the Ministry of Health, Nepal recently introduced the policy to address the unmet need through the community-based palliative care program, a laudable initiation. Keywords: community health care; Nepal; palliative care; public health.
Asunto(s)
Enfermedades no Transmisibles , Cuidados Paliativos , Humanos , Cuidados Paliativos/métodos , Salud Pública , Enfermedades no Transmisibles/epidemiología , Enfermedades no Transmisibles/terapia , NepalRESUMEN
Competency-based medical education has evolved as an alternative approach in the residency training program. It shows potential to align educational programs with health system priorities through defining the competencies of graduating doctors. Designing and implementing Competency Based Post Graduate (CBPG) training in a resource-limited setting, where most of the trainings are still run in a conventional approach, is a big challenge. Patan Academy of Health Sciences, School of Medicine has taken the competency-based approach in the postgraduate residency training. Defining core competencies and connecting those to teaching methodology and assessment system are important initial steps in implementing the competency-based approach. The institution has implemented Entrustable Professional Activity (EPA), which is a unit of professional practice and helps to measure the trainees' achievements in the form of milestones. This paper describes the process of piloting and implementing the CBPG program at this school. The school launched the CBPG training in 2018 and so far, three batches of residents have been enrolled in nine different subjects/disciplines. The first batch of trainee, having the PAHS Core competencies and the pre-defined discipline-specific EPAs certified, will be completing their training soon. The program is time and resource consuming. Continuous faculty development, commitment, supportive leadership and faculty readiness to adapt to newer approaches are the key to the program's successful implementation. Keywords: Competency based medical education; Nepal; patan academy of health sciences; post graduate training; residency program.