Dr Rahul Devender Arora, Consultant Physician in Palliative Medicine, currently practicing as a Consultant in India.
While I was one of the first few postgraduates to obtain a specialization in the discipline, my growing distance from the mainstream narrative driving the growth and development of the specialty has been necessitated by a growing realization of poor training standards and grudging acceptance of the fact that much more than foundational knowledge in Internal Medicine is integral to competent clinical practice. To this end, I have persevered to obtain postgraduate qualifications, which provide me with some proficiency in the subject.
Having not been able to pass the Specialty Certificate Examination twice, this blog is perhaps also a timely manifestation of the fact that UK-based practice of Specialist Palliative Medicine has been integral to my understanding and engagement with the discipline. In fact, the name of this website might have been subconsciously influenced by my academic engagement with the Pall Med Pro team which offers dedicated resources for exam preparation (note to self that their services might be required yet).
I believe that the real motivation for publishing this blog has been the damning realization that this discipline is not being given its due along with the grudging reality that postgraduate practice is being reduced to a narrow construct which tends to limit the vast expanse of specialist palliation to pain only, conveniently forgetting the reality of daily practice which demands astute clinical management skills, incisive planning and strict competence in internal medicine.
In retrospect, this effort represents a crystallization of my ideological belief in positioning Palliative medicine as a sub-specialty of Internal Medicine and advocates for the responsible practice of Interventional pain management by pain specialists only.
Though not intentionally, but by virtue of its very existence, this endeavour might be positioned in opposition to the dominant ideology which tends to overlook the science and sidestep the complexities around decision making in advanced illness for an insulting oversimplification, which does not do justice to the lived reality of this physician’s experiences, my patients and their families.
However, despite this foreseeable ideological friction the intention remains to engage, to empower and to educate.
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